HomeMy WebLinkAbout14617-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z-15262 February 10, 1987
No .................. Date ....................................
THISCERTIF1ESthattbebullding One Family Dwelling with attached garage
40 The Crossway & 2765 The Long Way East Marion
Location of Property .......................................................
House No. Street ' ' ' ~t~r~/e~
030 02 ! ! !
County Tax Map No. 1000 Section ............ Block ............... Lot .................
Subdivision..~/.q .?b.b.!e..B.e.a.c.h..F·a.r.m.s. ....... Filed Map No. 6.2.6.6. .... Lot No. 44
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· .F.e.b.r.u.a.r.y..2.1:..1.9.8.6 ..... .. pursuant to which Building Permit No. 1/4617Z
dated March 6, 1986
............................. , 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 FAMILY DWELLING WITH ATTACHED GARAGE
LYNN MENACKER & JUDY MARSHALL
The certificate is issued to ..................... ?oWn'~,)~g~rYt~X ....................
of the aforesaid building.
Suffolk County Department of Health Approval 85- 80- 2 I 9
UNDERWRITERS CERTIFICATE NO. N 78 1404
January 21 1987
PLUMBERS CERTIFICATION DATED: '
Rev. 1/81
1~0~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
14617 Z
Permission is hereb/granted to:
...~..~.....~....~.~.....~...:
...~....o....,t..~....o...'-/. ...............................................
~....~..~..~..~,..'/.,.." ~ ~-' ,
at premises I~.ted ot ...~ ...... ~.. .~3.~.~ ............
...... ....... ........................................................
Coun~ l~x M~p Mo. 1000 Section ...... ~..~.~ ...... Bl~k ...... ~.~ ...... ko~ ~o ....... [J.~. ............
~ursuont to opplic~tion doted ..~~....~J .............. , 19.~.~., ond opprov~ by the
8uHd~n9 Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec-
tor with the following; for new buildings or new use:
1, 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 building.
5, Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non4conforming 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.
Fees:
1. Certificate of occupancy $25.00 -- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3, Copy of certificate of occupancy $ 5.'00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.Oo $ 50.00 Date .... l../.Z~/.~? ..............
New Cons truc t i on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .,~Q, .~. ,C.~q~.~.~.~/'.' ~, ?.?6. ,~, ,e..~:q~. ~;. ~/.~.~,..~.....H.~.~.%9 .~,. ?.¥ .......
Owner or Owners of Property ,__ ~.. . ~ .............
County Tax Map No. 1000 Section ..... 0.~.0 ....... Block .... .0.2, ........ Lot.., .Z.~.3, .........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No..Z.~.Z.?.~.. Date of Permit .~../'.~'.~.~..Applicant .~;c.d.~,:~gT.'.~. ]~.~ .~QD:~.f~];'B.c.bj,~3. Co,
Health Dept. Approval . .. 8~.-.50.-~1.9 .......... Labor Dept. Approval ........................
Underwriters Approval . . . ]~.~.lL~0h ............. Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $.. ~...~ .O .....................
Construction on above described building an~"~rF~t n~ts ~11 applicable codes and regulations.
Applicant ./~7. ~ . . .~ . . ~~ ............
Rev, 10-10-78 '
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECT(
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
C E RTI F I CAT I
Building Permit No. /~/~/7~
Owner ~~I-- ~ri~nt~)~ ~L~'
(please
(please print){
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
~p~um~ber ' s ~g-~atur e )
Sworn to before me this
day of ~ ,
Notary Public, ,~
County
Notary Public
HELEN K. DE VOE
NOTARY PUBLIC, State of New York
No. 4707878, Suffolk
Term Expires Mgrch 30,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
10~10] 7 4 BUREAU OF ELECTRICITY
]~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
oo,o Novo~lo~r 26,19~6 .~.p,i,,.,io. No.o./uo411489/86 N781404
THIS CERTIFIES THAT
Harshall/Hanaker, n/w Cot, Longway, at Crossway, Strand ~ Crossway, East
Hartono
.~,~.,.i,,~do. Nove~ber 21,1996
FIXTURE
OUTLETS
47
IECEPTACLE~47 SWITCHES~
FIXTURES RANGES OVENS
NCANDE$CENT FLUORESCENT V~PO~
47
DRYERS FURNACE ~/IOTORS ~PPLIANCE FEEORRS TIME CLOCKS UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO, OF FEET
DIMMERS
EERVIC~ DISCONNECT S E R V I C
OTHER APPARATUS:
Motors- 2-F H.P.
G.F.C.I.-1, Smoke Detectors~2
Track Lighting- 28'-~" 16-lites
NO, OF CC, COND, A, W G,
Mr CC, COND,
OF HbLEG
OF NEUTRAL
1
Eeco Elec. Corp. CCliff Cornell)
32S Willow Point Rd.
Southold, N.Y.~ 11971
This certificate must not:be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST:NOT BE ALYERED N ANY MANNER.
ADDITIONA ENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FRAMING
REMARKS:
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
[]FINAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
~J_FOUNDATION ZND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS:
DATE ~/~*'*~/~/~ INSPECTOR ~/~'
7GS-:1,802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
DATE INSPECTOR
765-t802
BUILDING DEPT.
[ ] FOUNDATION 1ST
INSPECTION
[ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
FINAL
BUILDING DEPT.
INSPECTION
[~(~ FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
FINAL
Gardiner's Bay Construction Co.
81 Gardiner's Bay Drive Shelter Island, N.Y. 11965
June 4, 1986
Mr. Victor Lessard
Town of Southold
Building Department
Town Hall
Southold, NY 11971
Dear Victor:
Here is the work in progress for Menaker/
Marshall. Permit #14617Z.
REC. ~ s
Yours truly,
President
Gardiner's Bay Construction Co.
765-1802
BUILDING* DEPT.
INSPECTION
FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION :)ND [ ] INSULATION
FRAMING [~/~FINAL
DATE~7~
INSPECTOR
BUILDING DEPT.
IHSPECTION
[ ], I, OUNDATIm~ I, ST [ ] J IJLB~.
[ ] lrOUNDATIOfl ~NO [ ] INSULATION
INSPECTION
[ ] II~Jt, lllll~ lllJ [ ] INIUI~
2xamined..~.a2~..~ .... ,19~. .~.
'FORM NO. 1
ToWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,9OUTHOLD, N.Y. 11971
TEL.: 765-180;~
~pproved...~. ~ .~ .... , 19~.(q. Permit No.[~.('f).'~ .~...
,')isapproved a/c ....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BLDG. DEPT,
TOWN OF SOUTHOLD
Recelved ........... ,19...
Date .... 2./.2® .......... 19..8.6
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
ets 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
;r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
'ation,
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
hall 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
hall have been granted by the Blfilding Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
[egulations, for the construction of buildings, additions or alterafions, or for removal or demolition, as herein described.
;'he applicant agrees to comply with all applicable laws, ordinances, buildip~ code,,j~,~ing code, and regulations, and to
~dmit authorized inspectors on premises and in building for necessary insp~qlo~7///// j)
(sig'nat~re of applicant, or name, if a corporation)
· g.L. Gar.d~me~B~y..D~ ~ · ,,*;.De'$ t~'r · IsS'~ld · i~.'Y.
(Mailing address of applicant) '
I ~ 965
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......... ~.~..~x.../6uiXder ....................................................................
Name of owner of premises ~y. Ilrl. M~xqacka.r/. Jo.dy. Ma.:0aha.l.3: ........................................
(as on the tax roll or latest deed)
If applicant ix~ corpojlatign, signature of duly authorized officer.
/ (~/ame and title of corporate officer)
Buihler's License No ..........................
Plumber's License No.. ~9.0.8. P ................
Electrician's License No. E~co,. S.outh~ld. iq'2.~.
Other Trade's License No ......................
1. Location of land on which proposed work will be done... J.Q°.°..-9~.Q~.2..-.U. ! ..... ~.a~?..~.,.ar.~?.n' ............
........ C. ? .r.n.e.~. Fp.t. .... .T, he, [~r. as.~3. ~ay./..T. he../~oiag. ~I~y ...................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...~.0.0..0 ........... Block .. ? ... ~il~l~ .-r. ~... Lot....I.M .............
Subdivision...M~:p.. o..g..?.~ .b.b~,.e..B. ?.~.c.h. ............ Filed Map No.. 6~6~ ........ Lot ..... :lt~*....~. ~.
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy ...~$n/sle. Fa. mity. · 'Fraln'4 · · 'DweST£fig .............................
3. Nature of work (check which applicable): New Building .......... Addition Alteration ..........
Repair ........... Removal .............. Demolition .' ......... .... Other Work ...............
~ (Description)
4. Estimated Cost ........... ] ........................ Fee ........ i .............................
°" (to be, paid on filing this application)
/ ,
number of dwelling units Number of dwelling uriits on each floor
5. If dwelling, ·...~ · · ~.~.. .................
If garage, number of cars ........ ~.4t.~. ~. ....................... : ............................
6. If business, commercial or mixed occupancy, specify nature and extent of each, t~pe of use ......... .~ .........
7. Dimensions of ex, lsting structures, if any: Front... ~...& ...... Rear ... ~. ....... Depth ..... .~. ......
Height .... ./~.. ....... Number of Stories ........ ~ ...........................................
Dimensions of same structure with alterations or additions: Front .......... ~ ...... Rear .................
Depth ...................... Height ...................... Number of Stories .....................
8. Dimensions of entire new construction: Front ............... Rear ...... i ........ Depth__ ..............
tteight .......... Number of Stories ....................... i i i ! · ~)~il~ · ~../.. ~7 7.~... i i i i .. i: iI
9. Sizeoflot: Front.. ~.'ql/.' ............... Rear .~r~..~ ............
0. Date of Purchase ............................. ~N~mq ol;Foj;mer O~yner.,, ..........................
1. Zone or use district in which premises are situated .... 17,..~,rff4~ .~.. ~.~$~,~-./vf~_~g,.f,~ .............
2. Does proposed construction violate any zoning law, ordinance or regulation: ...'~ ................... ~
3. Will lot be regraded ..... ~...,...., ...... ,...?.. Will excess fill be removed from premises: Yes
4. Name of Owner of premise~-~ffg¥-O.e~./,/~.l~/,q~gt.ff. Address .............. ~i ..... Phone No ..............
Name of Architect ..... .~: ............ ~ ....... Address .............. ' .....Phone No ................
Nmne of Contractor~.~ ~l~te~...~..... Address~. ~L4/~d,~7 ~.'."~ Phone No. '~. ~t/~.~..].~. -S ...
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. lnd~cate all set-back dimensions from
~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether
nterior or corner lot.
;TATE OF NEW YORK, S.S
2OUNTY OF .................
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
tbove named.
te is the ............................................................ [ .............................
(Contractor, agent, corporate officer, etd.)
~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
.pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
york will be performed in the manner set forth in the application filed therewith.
;worn to before me this
............ ~( ......... day of..;.. ~...~.x- ......... ,19
Z
/!
/ ?
RODERICK VAN TUYL, P.C.
LICENSED LAND SUR~'~YORS
GREENPORT NEW YORK
SUFFOLK CO. HEALTH DEPT. APPROVAL
H S. NO.
p.O. BOX 6~
[516] 74~0182
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES.
(si
APPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOr APPROVAL Of
CONSTRUCTION ONLY
DaTE
H. S. REF. NOI.
APPROVED.
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT BLOCK PCL,
OWNERS ADDRESS:
DEED: L. ~',~'~::t p.
TEST HOLE STAMP
Z
//
GREENPOR'I' NEW YORK
SUFFOLK CO. HEALTH DEPT. APPROVAL
h.S. NO.
\' P.O. BOX 604
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT, OF HEALTH SERVICES.
(SI APPLICANT
SUFFOLK
SERVICES -- FOR
CONSTRUCTION ONLY
DATE:
H. S. REF. NO.:
APPROVED:
COUNTY DEPT. OF 'HEALTH
APPROVAL Of
,SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT BLOCK PCL.
OWNERS ADDRESS:
DEED: L.
P.
TEST HOLE STAMP
S£Ak
&OF
1 ~ su,.,.c,-, co. ,-,Z^-T. IXPT. ~OV^L
H.5. NO.
~LTE8 IS~O. N. ~.
~ ~ ,' ~ ~ * ~, M~ o~ ~~ ...... ,,, ,,.
...... ~ .~ o = ~ p~ ~t ~~ ~ ~
SINGLE FAMILY ~WELLI~ ONLY ~" i . '
..=.,E~..o.. - - - _-- .' i' ~' , /t ' ' ~"~=~'
- ~ ti ' ~~/~ ': ..... -
ou ~ ~'~'. ~ ~ /I .... "
i ~~ .................... ~ /, ' ' ~'' ' ~-~'
~ . ~~T ~W Y~
i~ OCCUPANcY'OR
.,use IS uNLAwFuE, ,
WiTHOUT.CERTiFICATE,
OF OCCUPANCY.
· ff oo~es',tub~ng ~ u~d
pCU~fe~R 'C£RnFIC'AnON ' ~ ,
ON ~E~Dr CO~q'ENT B-EFORE ~
CERTIFICATE OF ,OCCUPANCY'__
% % ".,
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k I-rC H E }"~
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Main R oa,d
GR,EENPORT, N,Y, 11'-,44 ,