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Home My WebLink About14138-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .Z.1.4.~ .2.7 ...... Date ........... J..u.n.e..~ 7 .............. 19 ~.6. THIS CERTIFIES that the building ..... p.n.a. ~ .f .a.m.~. l. y. fi.v!, e. ~ ~_.i.a g, ................... Location of Property .... 1.7. 0..0 ............ .~.l.d. ~. ~.c.h.. L..a.n.e. ............. L..a 97. e..~ ........ House No, Street Hamlet County Tax Map Ho. ]000 Section ....1.2.5. ..... Block ......... .q ..... Lot .... ,~...1.~ ........ Subdivision.. L. ~.u?.e. 1...E.s. ~. a..~ .e.s.. E..a.s.k ....... Filed Map No... 7.8.7.q .Lot No ....... .7 ...... conforms substantially to the Application for Building Permit heretofore flied in this office dated · d.u. 1. 7..L0. ............ 19 fi}Spursuant to which Building Permit No ..... 1.6. ~..3.8.Z. .......... dated ........... 4 u..J_ y..1, ~ .........19.8.5, 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 ......... · ??.~.¥ ~.t.e.. o..n.~.-.f.a.m.~.~.y...d.~.e.~. ~..i.n.a .. ............................................. The certificate is issued to .............. I~ ~.VXN. ~.T.&[~ $ 7 ............................... of the aforesaid building. Suffolk County Department of Health Approval ................. ~35.-:~'9r.1.(~ $ .............. UNDERWRITERS CERTIFICATE NO .......................... 317. 5 3 9.1. ~ ............... Rev. 1/81 Boilding Inspector FO~M' NO. Il TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLL~I'ION OF THE WORK AUTHORIZED) NB 14138 Z Permission is hereby grant~,d4~ ~ ~ .._......~ ....... ..4...!..~.~. ....... rt ............... ,o County Tax Map No. 1000 Section ..... /. ................. Block ............ .J ........ Lot No ................ ..~. ..... pursuant to application dated ....... .~.~...I..D. ...................... , 19..'~..b,...'~', and approved by the Building Ir~spector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD I/All .Mi III III Building Department 111111 '~ · O~ III III Town Hall J~ ~ ~-' Iii III Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ,~ to th~d~s~- tor with the following; for new buildings or new use: 1. Final su~ey of property with accurate location of all buildings, property lines, ~reets, and unumal natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-g form or equal). 3. Approval of electrical installation from Board of Fire Unde~riters. 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. 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 featu res. 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 $ :15.00 3. Copy of certificate of occupancy $1.00 c.o. 5.Updated C.O. $15.00 Date ............. New Building ..... .~...... 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 ... ~..~. ....... lot..,~.<.~...~. ...... Subdivision....~..~-. ~../~... /.:(.'('.~..~. )..~r./.?~.. <..('Filed Map No.~.,~'. ?.o. .... Lot No .... ~ ....... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...~'~ .~.....V~.. ~:.~. ~ ....... Construction on above described building and permit..m~ets all applicable ~odes and regulations. , ~- A~plicant .... . ,.--.-/ ........... y ........ Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 10004&8 Jl~ BUREAU OF ELECTRICITY J~ 8S JOHN STREET, NEW YORK, NEW YORK 10038 June 11~ 1986 THIS CERTIFIES THAT only the el~trlcal equ~m~nt ~ descri~d.~elo~ and introd~ b~ ~qppl~a~t na~ed,~ the ~bo~e applicatlo~ n~mber i~ tl~ore~ises of in the followlnS Iocatlon~ ~ nasement ~ 1st FI. ~ ~nd FI. Seetlon BIoc~ Lot was examlned on ~ 0Ss ~9~0 and found to be in complia~ce with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHER OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS NO. OF FEET OT~T~lhp. ,1~314~ jacuzzi E R V I RCC~C A, W O NO. OF Hi-LEO NO, O1~E OND. OF CC, COND. C AWG, OF HI-LEG NO, OF EUTRALS OFANEUTRAL 2/0 A~exauaer ~. ilubbar8 ~~//~x~~ ,~o~ 212 ~T~cer~ca~e~ust~b~ah~redi~a~a~ner~re~ur~he~ce~f~heB~ard~nc~rr~c, .,._ '/ ~ ~U , ' ' ' ' . Inspectors may be identified bv their cre entials. ~MENT, THIS COPY OF CERTIEI~ATE MU~T N~T B~ ALTERED IN ANY ~ANNEfl ~,!! ~ FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY C,ODE ADDITIONAL COMM~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] FRAMING [ ] INS/ULATION ~]~NAL REMARKS: 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [~ INSULATION FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ ROUGH PLBG. REMARKS: INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 !Examined ~.~..~ 19 .~.( !D~sapprove a c ..................................... .......................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This 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 shah 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 ~t 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 necessary insp~ (Signature"/~' ' '~" ~' ~"~'cfi' applicant, or' 'c:~7' ' ' ' ' 7' ' ': "~name,,ff a corporation) ' ' (Mailing address of applicant) k-~, Y. I 1~2~ { State whether ~applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... I~ .e-.V J.lq.. ~.~ .t~i~,.%.x'j ............................................. (as off 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 ...... ~...-./tZ..· ............ .... N Electrtc~an s L~cense o ................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .... 1.~5 ......... Block .... .~.~ .......... Lot...~ ,~ .~ .......... Subdivision, ~ ~.~%.L, .~ ~.T.~ [~. ~5~..~.I Filed Map No. 7~~ ~ Lot .~. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constmcti°n: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy . ~...~, .eT. .... .~. d / ~ ~,4~, ~'.~'~ .... ............... :,.,. ~!;~5.~,.,.~ ..................... 3. Natureofwork(checkwhichapplicable):NewBuilding ...~ .... 'Ad Repair ' '~0't'~ Rem?al .............. Demolition.~.. 4. Estimated Cost .,?~,~... ~(.~.f ............... Fee. 5. If dwelling number ofdwellinglunits .............. Number of d, If garage number of cars · "i' ~ ............................ 6. If business, commercial or mixed occupancy, specify nature and extent c 7. l)lmensmns of exlmng structures, if any Front ............... Rear iition .......... Alteration .......... Other Work ........ ~ ...... (Description) (to be paid on filing this application) ling units on each floor ................ f each type of uso ..................... ............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... ,.. Height ......... ~. ............ Iq amber of Stories ...................... · 8. Dimensions of entire new const~ction: Front ..... d. ~/. ...... Rear ... ~..~ ....... Depth . . .~..~ ...... 9. Size o~lot: Front ..... ]. 00.~ ........... Rear ...... /.<2).{3.( ......... Depth, ..... ~.~.~ .... ~ ..... 10. Date of Purchase ...... ./. ~. ~.~., .............. Name of Former Owner.~..~.../~../~...ce... ............F/'~z.r 11. Zone 9r use district in which premises are situated ........................... 12. Does proposed constructmn we!ate any zomng law, ordinance or regulat] an: ....... ././~. ................... 13. Will Iot be regraded ........ i ................... Will excess fill t e removed from premises: Yes 14. Name of Owner of premises ./.q~.~.ff. C4..f?-.~./~-.-q.~..Address .~f.~.~./.~. ./.~.*.q~.?2~.~.PhoneNo. 7...~..V~..°.~.( . Name of Architect ...o~.~.~. ~....~-..,F..~..~,*.~.~... Address .??~: .~q, .~*{~..Q... Phone No ................ Name of Contractor ./.~..~.?q ~. 7~.qr ./?.?f ....... Address ./ff?~..>.~? /ft~ ¢ ,~e~.~Phone No. 2..J<.-~...'.~..~.°/... PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether .existing or propos~ property lines. Give street and bloc~ number or description according to dee~ interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... ........i S.S being duly (Name of individual sigging contract) above named. He is the ..................................................... (Contractor, agent, corporate o: of said owner or owners, and is duly authorized to perform or have perfo~ application; that all statements conitained in this application are true to the work will be performed in the man,er set forth in the application filed there~ Sworu to before me this _.. , ..... dayCf... .......... , i, and, indicate all set-back dimensions from and show street names and indicate whether yom, deposes and says that he is the applicant fleer, etc.) med the said work and to make and file this best of his knowledge and belief; and that the Ath. su.v Y FOR ~ ~ l \"~ KEVIN STAKEY ,~L~ ~0'0~ O[~RT~E~T OF HEAL~ SERVICES LOT NO.7 "LAUREL ESTATES EAST, SECT. i" AT LAUREL DATE FEB.23.1985 ' SCALE: 1"=50' FOR A~PR0~AL 0~ CONSTRUCTION 0F ~N ~ SOUTHOLD 0nly SU¢~OLK COUNTY, ~W ~RK No. Single Famity Residence · .,,, ~GUARANTgE$ INDICTED HERgON HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ~E ~R~ FOR WHOM THE SU~EY IS PREPARED ~LIC~T, ~,ff P~PERTY LINES OR FOR THE ERECT(ON ~ FENCES &~ ~[ ? ~/~ ) r ~c. 7 ~ ~ ~ ~/ ~ RIVER~AD, NEW YORK NOTE:I:MONUMENT G=STAKE ALDEN W. YOUNG, PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y.S. UCENSE N0.12845 SUFFOLK COUNTY ON APR. 4, 1985 AS F~LE N0,7870 HOWARD W. YOUNG~ LANO SURVEYOR The se~,a~e disposal and ~ater supply ~ ~ lo~t~on have inspected by tkis departatent ~ found Chief of ~ene~l Englne~rtn~ $~SDIVI~ION ~P FILED IN TH~ OFFIC[ OF THE SURVEY FOR KEVIN STAKEY LOT NO.7 "LAUREL ESTATES EAST, SECT. I" AT LAUREL TOWN ~ 80UTHOLD SUFFOLK COUNTY, NEW YORK dUNE ~, 1986 APR. 14,1986 MAR. 18,1986 APR.30d985 DATE: FEB.25,1985 SCALE: I"; §0' NO. 85~182 RUM&UTHORSZED ALTERATION OR ADDITION 10 THIS SURVEY I$ A VIOLATION OF SECTIOR 7209 OF THE HEW YORK STATE EDUDATIOH LAW #DOPIE$ OF THIS SUffVEY HOT ~ARIN~ THE LARD SURVEYOR'S IRKED SEAL OR EMEO$SED SEAL SHALL HOT lie COH$1DEREDTO BEA VALID TRUE DOPY NDUARA#TEES INDIC&TED HEREON SHALL RUH ~LY '10 THE P~:RSOId FOR WHOM THE SURVEY IS PREP&NED AHO (~ HIS IiEHALF TO THE TITLE COMP4HY, GOVERN' MERTAL AOEHCY ARD LE#DIHG IHSTITUTIOH LISTED HEREO~, AND TO THE ASSI~IHEES OF THE LENDIHD IRSTITUTIO~I. GUARARTEE$ ARE i'~T TR~I~SFERABLE TO ADOtTIORAL INSTITUTIONS OR SUBSEQUENT OWNERS #DISTANCES S~OWN HEREOR FROM PROPERTY LIHES TOEXlSTIN; STRUCTURES ARE FOli A SPECIFID PURPOSE ANO ARE NOT TO lie USED TO ESTAIiLISII P~OPERTY LINES OR FOR THE EREDTION OF FENCES GUARANTEED TO= USLIFE TITLE INSURANCE COMPANY OF NORTH FORK BAN COMPANY YOUNG a YOUNG ALDEN W. YOUNG~ PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR N.Y.S. LICENSE N0.45893 400 OSTRANDER AVENUE RIVERHEAD~ NEW YORK