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Home My WebLink About14605-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy N .Z1.~505 December 16 19.86. o ............ Date ................................ , . THIS CERTIFIES that the build~g One family dwelling. . Location of Property C~n.t. ral & Cresen~ Ave's Fishers I.s..1.a.n.d. House No. Street Ham/er County Tax Map No. 1000 Section ., .0..19 Block O..1 ...... Lot 01 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ,F.e.]~,..5. ......... ,19 .8.6. pursuant to which Building Permit No...1.4..6.0.5.Z. . . dated ....M.a.r.c.~ ...3 ................. 19..8.6, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One fam.i.ly dwelling. The certificate is issued to RICHARD I. EDWARDS (owner, of the aforesaid building. Suffolk County Department of Health Approval 8 5-$ o- 1 9 2 UNDERWRITERS CERTIFICATE NO ........ N7. 6 0 9 7 8 . . PLUMBERS CERTIF I CATE 12 / 15 / 86 Building Inspector ~''~ Rev. 1/81 FOEM NO. ~ TO~N O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N.o 14605 Z Permission is hereb/granted to: ............ ,o ~ "--- ~\ ....... ; ............................ pursuant ,o opplicatio, dated ...-~.~~...~. .............. . 19..~...~... and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the bui{ding. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date ...................~.~ .~./j .J.~../..z~',~. , p/NewC°nst~'uction. .... . Old or Pre-existing Building ............ Vacant Land ........... .. Location of Property '-- House No. Street Ham/et Owner or Owners of Property . - - County Tax Map No. 1000 Section ...... /. ~ ...... Block ...... .c?./. ..... Lot ...... ~./. ...... Subdivision ................................ Filed Map No ........... Lot No .............. ....... ~ '. ....... Apphcant ...................... Health Dept. Approval /.~./.~. ~' ~ .~. .......... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate. .................... .. Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Appllcant.. ~.. ~~../;. ~.~~ ........... ooo1 o THE NEW YORK BOARD OF FIRE UNDERWRITERS '" July 29, 19t~3 400158/8~ RJ.~rd I. ]~v~s, M~elin & ~nt~ Fl~ers Isl~ ~s exomined on ~ ~ ~ l~ a~d foun~ to ~e J~ cootpl at, ce u' th the reqt~ire.~e~ts ~f tills Iloard, DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS EYST~MS NO. OF FEET SERVICE DISCONNECt' OTHER APPARATUS: 1-4. 5kw ~)~;~ W~ter ~-I{eater S Ir R V I C E 1 2/0 1 210 Edwa~ts E/ect~lc ~ox 511 ~%~he~ Island, N.Y. o~3go 'LAc,, 1297E GENERAL MANAGER This ced{fkote must not be offered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentlafs. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER, TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX '728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner i~"~'~ %~- (please print) (please pr~nt~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ,,~ ~'~ ,~ (/,~~ _L~- day of IQ~. ~,~ , ' ~_~ % ~,~ Notary Public Notary Public, ~~-'~ CoUntY~ - -. FIELD INSFECTI~ 1. FOUNDATION (lst) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~9DE FINAL ADDITIONAL COMMENTS pcoposed an?it/Os AREA = O. 99 -~.zlcres SEDROOM ~1 </ ~L~'~' ~ I I KITCHEN / DINING AREA lO'-O"x 12'-0'~~ 17'-3~x 12'-0' BEDROOM ~'.2. ~ LIVING R~O, OM ~14'-O'x 12'-0 ~up 15'-6"x 12 -0# 2636-2BR CAPE COD Optional Bath Crawl Space Option Crawl Space Option 088 049 026 BEDROOM 2 ~ V . M 16'-0"x 12'-0" ~ 17'-6 x 12'-0" 2640-2BR CAPE COD Floor plans and room sizes are approximate. Appliances shown are optional. Plans, Specifications and Prices am subject to change without notice. UPPER LEVEL WITH FRON]" DORMER 35,-3'x t 2'-0· Front dormers/shed roof optional. NOTE; Upper levels dra~vn to 36' home. Add 4'-0" to space length for 40' home. Approved ~ .~ .... 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... Date .................. , 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ~' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for nece. taary~ ~3~spections.. '"~' ~ . .~F~.~/~. ~ t~t4 PI / ~ [ - (-Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent,jJ/l~/~:,, i~ii~ii,, ii~irit. ~ntractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ...... ~.. ~.~..7.~. ..~. ........ Electrician's License No....J..~..~..-~....~. ........ Other Trade's License No ...................... Location of land on which proposed work will be done .................. ~.. ~. ~ ............ House Number Street Hamlet County Tax Map No. I000 Section . .j..O. ,.. ~[ .¥.} ...... Block .. ~..~..D. 0 ..... i... Lot..t)..C). I .O..D..~ ...... Subdivision ................................ : .... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and obcupancy of proposed construction: a. Existing use and occupancy .... .2').O.. ~ ..~ ....................... . .................................. b Intended use and occupancy .f~. ~ ~ ~r ?'7 ~ .~. - : 3. Nature of work (check which applicable): New Building .. . Addition . Removal Demolition Repair ...................................... Alteration Other Work ....... ' ...... (Description) 4. Estimated Cost ........ ~ Fee i ..... (to be ~aid on filing this application) ,'5. If dwelling, number of dwelling units ............... Nfimber of dwelling uni~ s on each floor ....... ~ ........ ' If garage, number of cars ......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extant of each type of use ..................... 7. Dimensions of existing stru6tur~s, if any: Front .... : .......... Rear ....... i ....... Depth ............... Height ............... Number of Stories ............................ i ............................ Dimensions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ...................... Height ...................... Number of Stories .................... ;. 8. Dimensions of entire new construction: Front ............... Rear ........ i ....... Depth ............... Height ............... Number of Stories ...................... - ......i ............................ 9. Sizeoflot: Front ...................... Rear ...................... iDepth ............. 10. Date of Purchase ............................. Name of Former Owner .i ............................ 11. Zone or use district in which premises are situated ............... ' .......... i ............................ 12. Does proposed construction violate, any zoning law, ordinance or regulation: .... i ............................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ............... i ....Phone No ................ Name of Architect ........................... Address ............... [ ....Phone No ....... , ........ Name of Contractor .......................... Address ............... i ....Phone No ....... i ........ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and showy street names and indicate whether interior or corner lot. STATE OF NEW YORK COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) -~.-.... above named. He is the (Contractor, agent, corporate officer, etc.)i of ~aid owner or owners, and is duly authorized to perform or have performed the ~)york and to makee' and file this application; that all statements contained in this applic, ation are. true to the best of h lfi'lSwledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. / Sworn to before me this ............ · ~. .......... day of ..... :..'2~'. ......... ,19 Z // /] ~0,¥~ 0~ ~o~)J~)ct} l ~ ~t~ ~ .//-/. ~ (S,gn~at.ure ,of; applicant) P.O. BOX 323 * BERWICK, PENNSYLVANIA 18603 · (717) 762-5914 Beechwood Series DELUXE HOME'S BUILDER yOUR S~!OREL~I¢IE IVIO')[ LAR HOMES, Irc. 1359 BOSTOh PU,~i ,.~ , ~,[,[,I. ON, CT 06443 MAD]SO]'] (:?,H r',)N EAST LYME 203124~-27t~3 2~ ?~/~:'J~l G~I/? 203t~39-3451 Elevations are artist renderings and may vary to actual construction. [~ FE~T ELEV_~T!ON TH S DRAWING D SPLAYS AND/ORD[S~ N~W YORK STATE DIVISION OF HOUSING AND CON~{UNITY RENEWAL STAMP OF APPROVAL FOR A MODEL OR COMPONENT N Y 0 0"60 ~-? Nov I a ~3 lx~W YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL DeLuxe Homes Of Pa.., Inc. 9TH & OAK STS. P.O,'BOX 323 BERWICK, PENNSYLVANIA 18603 PROJECT DRAWN F.~ ~ DATE CHECKED:J APPROVED MODEl. SHEET II t PRONT ~L~VA. TION "COL.C~I/AL" ~ PF-.QNT EL~NATIOkl 5~.b. LE: 14",1~ 2<~ L~'/~L FLC~- LINE ~LU~HU~ PANEL% · 'L~ I[vI~L ZJ~ILIN4 LINE LEVEL FL(3~}~ LIN~ ° %~&LE :1~,'=1'-O" - ~1 L~FT ~l~Y5 ~LEVATIOM ~[ ES/~F. EL~-V&TIO~q b NEW YOI~K STATE DIVISION OF HOUSING AND COMMUNITY I~ENEWAL STAtviP OF APPROVAL FOR A ~ODEL OR COMPONENT NEW YORK STATE--I~VISiON OF HOUSING AND COMMUNITY RENEWAL facility. N Y 0 0 60~'~ffD] NOV ! 8 1983 ~'6OLONIbL.' ~ "TLJlCoE" ELEVATIO},45 Of Pa.,Inc. 9TH & OAA STS. P.O. BOX 323 THiS DRA~THG DISPLAYS AND/OR aLS- BERWICK, PENNSYLVANIA 18603 us~ on OZSCLOS[ SUCH DESZ~S ~XC~PTll~~ ,,~p~ ~ ~ DENTIA~ ~D ~ECRET FROH OTHER5 A~D = . , SCALE ~ N~ CHECKED MODEL SHEET NO, REQUEST. I UPD4~ TO ~ &P~%r ~l~ 7/~/~ LDRAWN F~ G.~.85 APPROVED - ~D~ ~ ~ ~ ~ REV. . DESCRIPTION, BY CHKD DATE ~ NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL STAIViP OF APPROVAL FOR A MOD£L OR COMPONENT NEW YORK STATE DIVISION HOUSING AND COMMUNITY RI~NEWAL faciliW, N Y 0 0 6 ~,~°'7 NOV ! 8 1983J "JZLJSTrC" ~L.e~'-iO~ ~rom '.~c'~.,b~h'y 'or de,l~U~n. 'rom tho oppro,ed ~l~enments DeLuxe Homes Of Pa., Inc. 9TH & OAK STS. P.O. BOX TUZS O~U~ ~[S~LA~S ~o/0~ DES- BERWlCK, PENNSYLVANIA 18603 USE OR DISCLOSE SUCH DESIGNS EXCEPT m4g ~e ~ FOR DELUXE. THIS MATERIAL IS PURPOSES O~LY, MUST BE KEP~ CONFI- DENTIAL AN~ SECRET FROM O?HERS AN~ ~OALE oHEOKED ~ODEL SHEET NO, REQUEST. J ~E ~ ~E~ SP~,' J~ ~/~ DRAWN APPROVED ~ REV. DESCRIPTION BY CHKD. DATE I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PLUMBER CERTIFICATION ON LEAD CONTENI' BEFORE CERTIFICATE OF OCCUPANCY SOL, DER USEDIN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. --ii ~h .t~'ICTURE ~$OW W~NDOWS II THIS DRAWING DISPLAYS A~D/OR DES~ CRIBESORIGINA~PROT~ET[D DESIGNS, IDEA5 ANR.METH§D5 ~F RECIPIENT )IREdTLY FOR HIMS[LE OR ~ LOAflEDAND RURPQSESONL¥; OE~T~AL AHD S~CRET BE RETURNED TO NEW YORK STATE DMSION OF HOUSING AND COMMUNITY RENEWAL fflci]ity. NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL STAI~iP OF APPROVAL FOR A I~ODEL OR COMPONEttT NYO060 A~a NOV181983 COMMISSIONER r DOOR SCHEDULE, SIZE TYPE MAT'L JAMB _WOOD -WOOD ]~EMARKS , HD. BC~ ,FID~ BD, DRYW~N.L H~ OD WOOD H.D.SD. ~/OOD DOW SCHEDULE SIZE :z~ FINISH SCHEDULE. REMARKS NOTES FLC:X~R PI^ ~.5 Of Pa., Inc. 9TH & OAK STS. P.O. BOX 323 BERWICK, PENNSYLVANIA 18603 PROIECT: APPROVB BY: MOOEL NO. SHEET C'HKD.' N~W YOi~K STATE DIVISION HOUSING AND COMMUNITY [~IEWAL STA~viP OF 'ARPROVAL ,' FOR A 'fVlOD£L OR COMPONENT; THATHE~£b NOT B]~CTL¥ O~ D~RECTLY FOR H~MSELF OR OTHERWISE ',' USE OR DISCLOSE SUCH OESIGH~ EXCEPT FOR DELL~E,,THIS f4ATERIAL DMSION OF COMMUNI'VY RENEWAL DeLuxe ,HOmes. Of Pa,, Inc, " 9TH & OAK ST$. p:O.BOX'323, ,, ," ,IBERWICK, PENNSYLVANIA 18603 //'¢% ,ELEV&TlCrq "p" ' NTb-~10< ELLEV&TIOI,,15; IS~Tt4S ¢,; ~ Cf'Cl. R~TINq m ,I t~L T~S ORAWING OlSPLAYS AND/OR DES- CEIBES ORIGINAL PROTECTED DESIGNS, IDEAS AND METHODS OF, DELUXE HOMES. RECIPIENT OF THIS DRAWING AGREES THAT HE WILL NOT DIRECTLY OR IN- DIRECTLY FOR ~IMSELF OR OTHERWISE, USE OR DISCLDSE SUCH DESIGNS EXCEPT FOR,DELUXE.' THIS NATERIAL IS DeLuxe Homes ~Of Pa. Inc ' O. SOX, ' gTH & OAK STS. P; 323 , ,' B£RWICK, PENNSYLVANIA 18603 ' MODEL ' , ,' 4 A?~ROVED 55CTIONC~ ' 10 ' FLIP-uP I~DOF SEC"F~¢,N5 AFC;' ~CU~ A5 ,~oW~ ,, ' ANt:' IFC=TALL '(OOFINq,' (,s) ~10~ COUNON NAILS . ,~/~ INSULATION wlm5 x ~ GAL q~.v. ~TEEL ~'Fi~AF, FA~TENE~ w/CtA LV. (~). Iod 0~K4MON TOE IG~ NAIL *' F~ukUINq , ,AT :--5~' 6Tu~O: I - : ETEEL C (CmLJNq t~ TeXTU?.~. CON%T~ UCTION ALUMINUM N~W YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL ~M sL~e (WiNTEr) ~ NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL STAMP OF APPROVAL FOR AI~;OOEL OR COMPONENT 0 NOV I 8 ~-t~ ~iBE~qLn%~ ~TT ,I~Q~A~ON I% ON w~ ,m~ (W~NT~). , -'f (1~ W~% GLUE OZYW~CL, ~TT E~ , ,, I~. ~F SH~T~q: , ~5~W~T ~INQ~E~ ~ES~ (~UGL~ ~VB~) , C~55 C %~CF ' (2) (4) ~t~CT EACH SNLNqLE (LO~T~ ~K M~C~5~ ~ SECTION~ :, 9TH & oAK STS, P.0. BOX '323 BERWICK PENNSYLVANIA 18603 SCALE HECRED MUST BE RETURNED'?0 DELUXE UPO~ REQUEST , ',,. REQUtREF ': 4 '~Hii'ORAWING DISPLAYS AND/OR DES- CRJRES OR[GINAL,PROT~TEO RECIPIENT OFTHIS OP, RNIND , i~JS? RE RETURNED NEW YORK STATE DIVISION OF HOIJSING AND COIvlMUNITY RENEWAL STA[viP OF APPROVAL FOR A MODEL OR COMPONENT N Y 0 0 6:'0'-:A'~--7 ~ov ~ 8 BY :CHKD.: ~' :'ed al the fac'~orly 'm~tnl~.~Ctuter'a EL, ECT;e:ICAL PL/x?4, s ' DRAWN,,LT~. [. ,DeLuxe Homes Of Pal Inc. 9TH & OAK STS. P.O. BOX 323 BERw cK, PENNSYLVAN A '18603 JECT , , , , V 1~5LL I~TN w/W,-~A~EA V CJ%TOL~ EF, J~ "L~' KITC~EFa [DII, JF4G Ii I [ LIVIHG ~(DOI,,4 I II II /% PICTLJ~ ~ E~OW¢ B~¥ WIt~PO\¥5 THIS DRAWING DISPLAYS AND/OR DES- CRIBES ORIGINAL PROTECTED DESIGNS, IDEAS AND METHDDS DF DELUXE HOMES, RECIPIENT OF THIS DRAWING AGREES N2W yORK STATE DIVISION OF HOUSING AND CO/vlMUNITY RENEWAL STA~iP OF APPROVAL F(J~ A MODEL OR COMPONENT DESCRIPTION I , I I I '1 I J I NEW YORK STATE DIVISION OF HOUSING AND COMMUNITY RENEWAL This pl-m a,,proval ia appqcahle only to 'hose eom}nments of the factory manu- $',dle4 at the fa¢'ory mcnu~acturer's f~dlitr. }6' DeLuxe Homes Of Pa., Inc. 9TH & OAK STS. P.O. BOX 323 BERWICK, PENNSYLVANIA 18603 PROJECT SCALE: 74"= I'-0" MODEL SHEET NO. ,~o,~q. DRAWN PJ~ %'~ APPROVED NEW DIVISION OF HousING AND COMMUNIT'/~;NEWAL , ,' ,STAMP ~OF APPROVAL, FGR A MODE[ OR ~0MP~flE~T, time, thca ~ no[ rm~lMe h OeLux, e','HOmes Of, Pa linc ' 9TH & OAK ST$. PQ BOX 323 ' BERWlOK, PEnNSYLVANiA ~S603 , ,, ~.'P~OV~O, 66 proposed util#/es A REA = O. 99 ~Aores F..,!?I~.ES T~q~O YEARS FROM SUFFOLK COUNTY DEPARTMENT OF HEALTH S~RVIC~S FOR APPROV?~L ~F CON~R CTIO~,~ OF DAT~ APPROVED_ V. ~ SI T£ FL A N PROPO$~'D ~ESIDENCE R/CHARD FI SHEt~ S ED WAND S ISLAND NEW YORK SCALE~ I'= 40ft. .CHANDLER, PALMEF~ ~ KING NORWICH, CONN, AUG, ~0~ AREA -- 0. 99 ~Acras SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES Appmval of Constructed Works H D, Ref, No. SITE PLAN PROPO$~'D RESIDENCE RI CHA RD ED WARD S FISHERS ISLAND HEW YORK SCALE~ I"= 40fl. ~HANOL~, PAL~ER ~ KIN~ AUG, 30~ 1985