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Home My WebLink About13956-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. g.l.i ~ 95 ......... Date November 17, 19.8.6. THIS CERTIFIES that the buriding One family dwelling with garage Location of Property 15585 Main Road East Marion N,Y. I~ds~ ~o: .............................................. S~reet Hamlet County Tax Map No. 1000 Section 23 .Block ..... .1 ......... Lot 8.2 Subdivision ............................... Fried Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .I~.ay..1.~, ............ , 19 .8.5. pursuant to which Building Permit No..~.3..9.5.6. Z. ............. dated .. III. ~ y..2. Q ~ .................. 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 ......... One family dwelling with attached garage The certificate is issued to WATERVIEW PROPERTIES (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 85 - S 0- 57 N730475 UNDERWRITERS CERTIFICATE NO .................................................. Plumbers Certificate dated March 4~ 1986 '~l~ector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13956 Z Permission is herebygronted to: ........ ~..,~ .z~.~,¢_~..~. ....- ................. ......................... ...... .~.~z'~¢~2...~..z~.:.~..../.z..¢..7.. ~o ..... ~.O.~..¢..~z~...c,~ ........ ~......~-,~-z.~.~......~-,z,~.-..z'..Z'.z,,z~ at premises located at .......... 'z ................ pursuont to opplicotton doted ...... ...~...~...~.. ........ ./....~.. ................. , 19~...~...,~' ond opproved by the Building Inspector. eS ..~.. ........... ........ ~ ~///~1 Building Inspector 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 m ~ 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 property 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date. ..~. NewOOnstrUct, ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. ~ ..... ,~.. ,~. ,~ ,h..~ ......... ~..~. Hou~ No. ' ...... CounW Tax Map ~o. 1000 Section ............... ~lock ............... lot ................ Subdivision ................................. Filed Ma~ ~o ........... kot ~o .............. Permit~o. t.~........~ Datoof~ormit ...~?~ .... Applicant ...................... Hoalth Do0t. ~pproval ........................ kabor Dept. ~mual ........................ ~ndo~Ht~r~ ~pproval ........................ Plann[nfl Board Approval ....................... ~quost for Tomporarg C~ifieato ........... Fna Gert f cate .. '~.. .... Applicant ...... , ..................... ~ Rev. lO-lO-7a co% 15 Io.5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date ~,~ Building Permit No. /3~5~ Owner ~-~l~u0 ~~5 (please print9 Plumber ~c~m/ P/~t~J/~d~¢/~/~/'V'(, (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (~/l~mber s signature) Sworn to before me this ~L~ day of ~ , · ary Public Notary Public~ County N~ToA~?U~LI~, Slope o~ New York .. · / -.~'~6.)66u5, Suffo k County , '.*omm,ss~on Expires March 30. ! THE NEW YORK BOARD OF FIRE UNDERWRITERS BURE~,u OF ELECTRICI'FY 85 JOHN STREET: NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described belair and introduced by the applicant named on the above application rtumber in the premises of Waterview TTo~'~ies, Route 25, Cau~,?~y, East ~rion, N,¥, in the following location; ~]{ Basement [] 1st FI. ~ 2nd FI. Section Block Lot was examined on J~-lltla l~fu'~ ~j ~ ,~ (~ and found to be in compliance wi~h the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS OUTLETS SWITCHES EXHAUST FLUORESCENT 38 53. 45 38 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCI(S UNIT HEATE[q MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT~ S E R NO' Olde RC~,~,CON D. OF CC COND V I C NO. OF HI-LEG A W. G OF HI-LEG E NO. OFNEUTRAL$ A W, G, OF NEUTRAL Paul 8o~thold, NoT. llDTI Lie. 11 PeL certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by MANNER~ : ELD ~¢N SPE~ TI ON COMMENT~ ,OK ~ I,'OUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PE~I N. STATE ENERGY G,ODE ,~. C~O FINAL IDtTIONAL COMMENTS:, 765.t802 BUILDING DEPT. INSPECTION FOUNDATION xST [ ] ROUGH PLBG. FOUNDATION :'ND [ ] INSULATION FRAMING [ ] FINAL 7~5-XSOZ BUILDING DEPT. INSPECTION []FOUNDATION XST [] ROUGH PLBG. [] FOUNDATION 2ND []INSULATION []FRAMING []FINAL REMARKS: (~ '~, 76S-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION tST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION []FRAMING []FINAL REMARKS: ~._~_~/~Z~ ~/~ /,~-/~,~/,~ , DATE INSPECTOR, .,~ ~_~ 7GS-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ]FRAMING []FINAL REMARKS, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1B02 TOW'~-~ F SOUTHOL~ Approved 19 .~..~Permit No./..,~. ...... Disapproved a/c ...... .~ ............... ...~-, .. ..... k. Received ........... ,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 applica[ion 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 necessary~.ff .7~..inspecti°ns' f.~..~.7.' 'Q./-~..~?../ ........ ............ ........... (Signature of applicant, or name, if a ~) · t/.. .... //.ri.v,, ..... (Mai~ing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .e. ...... .................................................... Name of owner of premises...~/. ~..7~. ~..~ (?. ~ .... ('a'-¢~ ~P~"'~-~/~'~(~'~ ~"t' d~ed')~ u,, ,, ~ ,u.~ ,u,, ~, ,,[, ~ ................. ' ........ If applicant is a oeel~ngt~n, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..1~..~.~?....:-...g~.-...(f~..Z7. · · Plumber's License No ......................... Electrician's License No...~W/... ~.q~.f. .... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number ~' "~'J'~' ~ )/'' ' ~---~ff' '~"'' ' "'~' '/~'~'/"'~' "~' ............... Street Hamlet County Tax Map No. 1000 Section ..... O. tT~.~ ....... Block .... I ............ Lot ~..°~..JT/Z~...~. ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... . ~.A.~..~. [-{i~. ............ .'.'~'i'. ...... -i ...... ........ i~ ............ b. Intended use and occupancy . '.'.. [.. ~../~/./[~... J//d ~.[///0.~. ........................................ Locate clearly and distinctly all property lines. Give street and block nun interior or corner lot. 3. Nature ofw0rk (check which applicable): New Building .......... Addition .......... Alteration .......... Repmr ... ;... ~. 'r.' · · Removal .., ............ ; Demolition .............. Other Work ............... ~ [ ::j~,,~ _--_.~. _~! (Description) 4. ~stimated Cost...'.'../.£C4.._ __crY. q ~ ................... o~ Fee .... ~.%..~.o. ....................... ' ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. Number of dwelling units on eac eot ................ If garage, number of cars ......... ~ .............................................................. 6. If business, qommercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if a~y: Front ..... -.~ ........ Rear ~, ..~:. ......... Depth :.'r~7.. ........... Height ~ ...... Number o! Stories .... ~ ................................................. Dimensions of same structure with alterations or additions: Front . ~-~. ........... Rear . r~r~:.~. ............ Depth ...................... H0xght .. ~ ............. Number of Stories ..... ...--: ................ 8. D~mansmns of entire new constructmn Front ..... ,~..3. ...... Rear .. 7.$ .......... Depth ...~. .... Height .. ~..~. ......... Number of Stones . .~,Z .............................................. 9. size of lot: Front .. ~Zl$ ........ ....... Rear.. ! ~[[ .............. O~ptn · 3~Y, ............... 10. Date of Pureh~e . ~.~... I.a: .~ ............. N~e of Fo~er Owner ..... ~.~ l~l ............... I 1 Zone or use district in w~ich premises are situated .... ~ ~ ~ ~ 12. Does proposed consffuctmn violate any zoning law, Ordinance or regulation: .... ~ .................... 13. Will lot be regradcd .... ~ ~..,. '. ..... ~ ......... Will excess fill b~ re~oved from premises: Yes 14. N~o of Owner of premises ~(~ .~g.... Address .. ~o/~.... Phone No ................ . Nme of Architect ........... Address ................... Phone No ................ N~e of Contractor ~.~ [~)~r~ .......... Address ./~q f~l~0.~. ~. Phone No..~: ~... PLOT DIAG~M ~d~gs, whether' ~xisting or p~opos~d. ~d, indi~at~ ~I s~-baok d~ensions from b~r or d~se~pfion ~eording to deed~ ~d show str~t n~es and ~diea~e whether STATE OF NEW YORK, S.S ! ...... ,....... being duly sworn, deposes and says that he is the applicant (Name of individual s~gmttg contract) .. above named. ~ (Contraqtor,. agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to 'pe~form or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne[ set forth in th~ application filed therewith. Sworn to before me this ~ ....... d.~. .............. day o vff~.¢ .... .. . . ... County ..... . . NOTA~RY PUBLIC, State e~ ~ew Y0r~ (Signature of applicant) No, 4707878, Suffolk Count~ EXCAVATION · '"' '~" ' ,&E, c! W;-' x,:" -t F~ - AC';~ :':' c',~'~ ~ERICK VAN TUYL, P.C. LICENSED LAND SU~VEYONS GREEN~RT NEW YO~K SUFFOLK CO. HEALTH DEPT· APPROVAL H.S. NO. 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. (s~ APPLICANT SUFFOLK COUNTY SERVICES - FOR CONSTRUCTION ONlY DATE' H. S. REF. NO.: DEPT. Of HEALTh APPrOvAL OF SUFFOLK CO, TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL OWNERS ADDRESS: DEED: L. P. ~(~FZ~) TEST HOLE STAMP 'FOP'SOl L SEAL SUFFOLK COUNTY HEALTH DEPARTMENT ~INGLE FAMILY DWELLING ONLY H.D. FIEF. NO. _, ~.5'"~'~3 -,5''7· ., , DATE_ , JU, L .... THE ~'WAOE DISPOSAL AND WATER SUPPLY FAOIUTIE8 FOR HAVE BEEN INSPECTED BY THiS DEPAI~I'MENT AND LOCATION To ........ Ohlef of Wastewater Management Section H.S. NO. 85 - ','<-G~- 5'7, ..,, STATEMENT OF INTENT THE WATER SUPPLY AND SE:WAGE DI~AL SYST EMS FOR THIS RESIDENCE~ WILL CONFORM TO THE STANDARDS OF' TIlE SUFFOLK CO. DEPT, OF HEALTH SERVICES, ,ICANT SUFFOLK coUNTY E~,ER-V IG*F-S-- FOR CONSTRUCT,,OH ONLY DEPT. OF ~E ALT t"l APP ROV H. S. REF. NO.: ): 5"7 APPROVED: , , .sEcT. ~LOCK ' . T~P~ 5QIL. SEAL GR.EENPOR~ NEW ~ORK , , . .: .... :.J..: ....... ' ...... ................ ..... ~'-'-'-~-:': ...... .,,~ ~ .. , ., ~ .A?~-//~ ~'~ ~~ .... , ~' : ' ~ ' ' /' ' ' '" NOTIFY BdILDING BE~RT~ AT , , ' ,' . 9 AM TO 4 ~M ~O~ ~H~ ' . , _~ ; L FOUNDATION - TWO , , . ' BE COMPtETS FOR C O ' '- '~ A~L ¢ONSTRUCTION SHALL ;:' THE REQUfR~EN%~ ¢~ ~He N. ' : ::', '= ' ' STA~E CORSTRUdTICN & ENE~¢~ ,.. , : ' ' , ' ~I~N OB ~QH~TRU~TION. ERRORS. Phone 497-0400 Main Road