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Home My WebLink About14264-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g. ] ~.1.?.6. ......... Date ..... ff.a.n. :..2) .................... 19.8.6. THIS CERTIFIES that the bufldingO, n.e.. f.a.m..i.ly..d..w.e.l.l.J:..n/~ .......................... 55 BAY HAVEN LANE. SOUTHOLD Location of Property ............................................................ House No. Street Hamlet County Tax Map No. 1000 Section..0.8.8 ......... Block . 04 . .Lot... 27 Subdivision .M..ap..qr...B.a.y...H.a.v.e.n. ........... Filed Map No...2.9.1.0...Lot No .... 38 conforms substantially to the Application for Building Permit heretofore fried in this office dated .i.u.g ,. ).2. ............. 198. ~. pursuant to which Building Permit No. 1.4.~5 z~ ~ ............... dated .. ,-~e p ~....l I ................ 19/~5., was issued, and conforms to all of the requirements of the applicable pwvisions of the law. The occupancy for which this certificate is issued'is ......... P~-e. f~,m J, 1 y..4~/~l~,J,~g~ ........................................................ The certificate is issued to .... J..QS ~ ~°~-I. 6. AI/I~ $. Y. Abg PY.% C. ............................. of the aforesaid building. Suffolk County Department of Health Approval 85 - S O- 139 N730560 UNDERWRITERS CERTIFICATE NO .................................................. Plumbers Certificate 12/27/85 Building Inspector Rev. 1/81 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) NB 14264 Z / Permission is hereby granted to;~ ..~..~~..0.,.~.......JJ..~.'~ '"I' ......... i .................. ; ...... '" ,o at pr~ml~* ~ot~d ~ .................................... ..... ................................................................................. ~OUn~ T~x Mop ~o. I000 Section ..... ~.~ ........... Bilk ...... ~ ......... lot ~o ...... ~.~ ............ Building Insp~tor. Building Insl~ctor Rev. 6/30/~80 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~_~:1.350~[ BUREAU OF ELECTRICITY j[ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT inthe/ollowinglocation; ~ Basemettt ~lstFt. ~ 2nd FL Section B~ck Lot was examined on ,~f ~D3~ ~,~r (~ ~ J ~ ~ ~ and found to be in compliance tvlth the requlrements of thls Board, FIXTURE FIXTURES OUTLETS 'SWITCHES LFLUORESCENT DRYERS FURNACE MOTORS RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATERS MULT~-OUTLRT DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNEC~ OTHER APPARATUS: ~,~ ~ost G.~%Co-~,.-I~ S~oke Detect, o~'~' I S E R V I C NO OF NEUTRALS 4/0 O,.,~A, MA.^O,. Per_ rnu~ no~ be oh~rod in on}' moaners return ~o ~he offi¢~ o~ *he Boord i} in¢orr~cL [nspodors m~¥ be id~n*ifi~d by ~h~ir credenfi~}s. COPY FOR UILDING DEPARTMENT. THIS COPY OF CER'rlFIqATE MUSTNOT:BE ALTERED IN ANY MANNER. TOWN OF SOUTE[OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 BLDG. DEPT. CERTIFICATION Date~ Building Permit No.J~d2 Owne r~ 0 (pleas~e 'print) Plumber ~ ~.~_ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plu~e~' s signaturS~ Sworn to before me this Notary Public ~_~/~ .Count Y FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Halt ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitte~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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all propertv lines, streets, buildings and unusua~ natura~ 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: Certificate of occupancy $5.00 / 31 Certificate of occupancy on pre-existing dwelling land use --Pre-Ex±st±rig C. 0. $15 · 00 3, Copv of certificate of occupancy $1.00 Vacant land C.O. $ 5.00 Date ................... New Building ,. ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property House No. Street Ham/et Owner or Owners of Property J..o. 5.?. ,~.~. h ~.~,...~. ~..~.~.~-¢..i. ¢~. ...................... County Tax Map No. 1000 Section ...~.~. ......... Block ...~. .......... Lot. ~.~.~.'; ... ;... Subdivision ~.~.1~. ~.~. j~i~..~..~'.~,.~..~.~ ........ Filed Map No. ~..~..l.~.` .Lot No. ~3~ ......... Permit No./..~.~..~..z'~.Z~. Date of Permit ~'~'/.-~'..///~'~.Applicant o ~C, ~-~.~f~..P~$ i I~.~ .. Ap p royal ~, .--.~,; ~.~'~, Health Dept .................................. Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate · ~ ................. Fee Submitted $...~'~4).~-). · ..~. ?.~.0 ............ Construction on above described building and permit meets all applicable cp. des and regulations. Apphcan ............. Rev. '~o-'~O-Ta C.O, l ( Yr FOUNDATION ( 1st NDATION (2nd ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ?DE FINAL COMMENTS ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, FINAL INSPECTION WAS MADE 11/27/85 and it is ready for C.O. We are unable to complete your Certificate of Occupancy because ,of the following reasons. /_~// An application for Certificate of Occupancy is not on file. /_~/ No Underwriters Certificate on file. /~ The check is(outdated~not on file.) /~/No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ _~ ~ ~ ~ ~ Z Building Dept. ***/~/~No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BLDG. DEPT, TEL.: 765-1802 ,, , TOWN OF SOUTHOL0 Examined .~e~..~...l!.., 19~ .S."~ AppliCation No .................. Approved .':.., Pc,mit · Disapproved a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .~..~.~. .... /.~..! ..... 19~..~-' 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 gi¥ing a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work coYered 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 tail 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 roll 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or .eguiations, for the construction of buildiogs, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~mit authorized inspectors on premises and in building for necessar~ inspections. ·..l,..q.~...,...~...a:..r~.=..~... ~,..o..~...~, ~...~.~.q..,. (Signature of applicant, or name, if a corporation) .~. ~ .m . ~ o,. .¢. ~ . e.o. ~:. .u,.~ .q . 4 o,~. ~ :. ~o. .~. . .~. ~ (Mailing address of applicant) rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C, ~,~-~- o~-c ~.~.~ ................... ................. ~.~ ........ .c,, ..... .O, .... c>. P-, ..................... l ame of owner of premises . .,,~.o..5[ l~,c~.~,.~ ~q,H~.%...k~. N [, ~..O.~.t.C- ................................ (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. .... .. ........ (Name and title of corporate officer) Builder's License No Vlu~ber's License No.. 7 ~ .S..-..P. ............. Electrician's License No. ~..~'.7,-. ~ ............ Other Trade's License No ~ 1. Location of land on which proposed work will be done. ~./.~'..~. ~.~..-.t~?.~..~a. ~'.~. ·~. A .~K..~F..8-. F/.~.l.~. ..... House Num bec Street Hamlet County Tax Map No. I000 Section .. ~. ............ Block . ..~. .............. Lot .~..c.~.~.~.~. ~ Subdivision ~FI .~. ¢..a. ~...~?..~5..~, .~,~. ~r. t'g .......... Filed Map No. ~,~.q../.O. ........ Lot .~.~) ........... (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?..., . ./--..~.~-7 f ./'r .~(....~.>. ~ .~..~..L!.~?. ~ .&,...; .,:,.-. ~ :.;~. :'.~..:~ .... 3 Nature of work (check which applicable): New Building .... Addition .......... Alteration .......... : Repair .............. Removal .............. Demolition .............. Other Work ............... O-i :~ ~ ~]~ i (Description) 4 i Estimated Cost ~, O.'O 0 Fee ~ ~,~. , . : ~ [ (to be paid on filing this application) 5.~I~iW~lling-~mimb/~-bfa'~lIln~gffnits...~ ......... Number of dwellin unitsone chfl r Ifgamge, number of cars L~l'.~0~O~. ....... i ..... g a co ~3 ............ .. 6. If business, commercial or mixedioceupancy, specify nature and extent of each type of use ..................... 7;' Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ................ Number of Stories ......................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. Height ........... ~ ........... Number 9f Stories ........... ¢ ......... Dimensions of entire n~w construction: Front ~ -~- , Rear ~,e ~'~ . . Depth .~..~. .... 8. Height .. i~..t~.~. :... Nu~!er of Stories ii; 9. Size of!ot: Front ..... /~q./.. L .......... Rear . ./.~.~ ............... Depth /.o~ 7. ................ 10. Date of Purchase ...~.~ ~. ~...; ................. Name of Former Owner ..'~. .......................... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~.O ......................... 13. Will lot be regraded ../~t.O;.. i: ..... . ............ Will ex~sfjll,,l~e,r~.ml?~e~ from premises: Yes No 14. ~2ee ~[ AO~[ p.relnisesOp.~.s.e.~-. ~.~t, ~q?.t. ~ . Address .~Ja~.~v'~"~.*/-~.~/...... Phone No.'P/*.' ~21-. ~q. [.. · .),t~g¢': -- ~'~-.' .~.-Tt~rl'~-t~. ........ Address . . .-Tx. ............. Phone No. :-r. ............. Nam e of Contractor)~*. ~4.e~ .~.0r. ~n4~rr..~q ~. ~ ~ ~.~.,.. Address ~.d ~..al(6t..43q..~/O,P,~,~e~T. Phone No. ~.,~ ..r .~. ~q.. ( .... 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 ~umber or description according to deed, and show street names and indicate whether interior or corner lot. ' STATE OF NEW YORK, !S.S COUNTY OF ................. , .... .~..~. · .~. ~..~'..~.¢~.-. k I..g ~a. ~ ~ .............. being duly sworn, deposes and says that he is the applicant '(Name .... " of individual s~gnilng contract) above named. ~ (Contractor, agent, corporate officer, otc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ 19 ..~.~ : ~ ~ mr. a0, lt..Z.~ 7 (S~gnature of apphcant) A _D O' 0 THE WA SYSTEN CONFOi SUFFOI SUFFO~ SERV CONSTi DATE: H. S. RB SUF~ DISTI OWNER~ DEED: ~; SUFFOLK CO. HEALTH DEPT. APPROVAL :' . .. L H S. NO. ¢/ . .. - -~O~x ;~.~ [~ ¢ THE WATER SUPPLY AND SEWAGE DISBSAL ..... ~ ~'[~/ ~ SY~EMS FOR THIS RESIDENCE WtLL ' ' ' . . ..~.~,~ ' 60~FORM TO THE STANDARBS OF THE , , ~*¢~,% SUFFOL~EP~HE~LTH SERVICES. OF 50D ~ HO~D, NM .. , '~~ ~< : [,----~ ..... SUFFOLK COUNTY 6EPT, OF HEALTH ~ ~ ' ~' '! sERVICES -- FOR APPROVAL OF i --~. ..... ' ~ /E. ¢ ¢~ LiCE~ED LAND SURvEyO~ , , ~EEN~RT ~W Y~K II SUFFOLK CO. HEALTH DEPT. AI~IIf~OVAI., -~ H.S. NO. '~' '- SUe EYE~ ~Wb~i ~'a--/ ~ SYSTE~ FOR THIS N~IDENCE WILL ~ ~ CONFORM TO THE STANDAR~ ~ THE ~ ~*~~ ~ ~**:~ SUFF~K CO. DEFT. ~ HEA~TH ~RViC~. ~' 6 ~ ~dU, HO~D,N,~ .................. -/ ; ' :~FFOLK COUNTY DEPT, ~ HEALTH , ~ ,, ~a ~ERVICES -- FOR APPROVAL OF ...... -- ~ D ?-'~ ~.. ~- . . ~ ,. .. ~ · -: I .~, f~ ,~ ~ ,,, ~ ~,,~ DATE: , . ; -2 ~---~- - ~- }~ ~ ~ ~ X SUFFOLK CO. TAX MAP DESIGNATION: ~' ~ ' !-t'~ , ~ DIST. SECT. BL~K PCL. :~ ' ~ " ' ~ ~ ~ ~'~ "~ 8 '" ......... : ~ facil!+ ~ fer- this lo,:;'{o~have been t~speo[e~ ~y thls ~e~[~e~[ ~ ~o~d ~ ~- U Chief of General ~gtneerine ..... to t~ ~s~n~ ~.._.. '~ ~ " ~.4.'d~_ .. ., " ~.~NL 6'S50TN~I<:~ISE S_~<~ LOT' ~_,...EFE ,~ ~:~ "~F- '-2t' BAY ~A~EN ~,.F?L~: D ~F~ "~'b_ StiFf' .CC. ~ E,-E~'~I f ')t~?~ ~EFE~ l~ MEAN 5~A C F~/~:: L-.,R~ERI~ VAN-~YL. P.C. L~ED LAND ~E~T ~W Y~K AppROVED AS NOTED ,~OTl~ E~¢b~:N!' ~ ':~:',~:'~'T~;;~T /'f FOR POUF, ~ ROUGH ~; ,,h,iv;J =~ ~ PLUMt:~G INSU~TION . ~LL CONSTRUCTION 8HALL ~HE ~E~UIE~E~TSOF THEN~Y TA~E QONSTRGCTION~ ENErgY , ' '~, NOT ~ONSIBEE 'E