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Home My WebLink About13982-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 1..5Q07 Date October 17 8..6 THIS CERTIFIES that the building ...0..n.e..f.a..m.i.l.y...d.w.e.l. 1. ~.n.g... ..................... Location of Property 610 SHEPARD DRI.VE SOUTHOLD House No. Street Ham/et County Tax Map No. 1000 Section ...0.7.8 ....... Block 0 2 .Lot. 47 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... .M.ay. 10 198.'5. pursuant to which Building Permit No. dated .... I~.a.y..2.8. ................. 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 ......... .... .o.n.e..f..a,~..~.z.~..d.~.e.~..~ .~.n.~ .. .................................................... The certificate is issued toJOHN B. WATSON SR. ..................... i~,;,'e;,~id, cy~x ..................... of the aforesaid building. Suffolk County Department of Health Approval 14-SO-38 June 3, 1986 UNDERWRITERS CERTIFICATE NO. N756456 June 27, 1986 PLUMBERS CERTIFICATE Sept. 26, 1986 Rev. 1/81 i~0~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13982 Z .................... ............................... County Tax Mop No. 1000 Section ..~.....~...~.. ..... Sl~k ..~.~. ......... ~t No..~0~ ...... pursuant ,o application doted ~.~.~......l..~ ............. , 19.~,d opprov~ by the Building Inspector. Fee $....~.~ ........... ~ 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: 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 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: I. Certificate of occupancy $5.00 2. Certificate of o~:cupancy 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 New C on s t p u c t i o n.....~/. Old or Pre-existing Building $15.00 Date~l ' ....... ............ Vacant Land ............. House iVo.~ .......... ~ ................................. Street f' ' ' ' "~' ........... Ham/et Ow,er or Owners of Property ;.. .................... - County Tax Map No. 1000 Section . ,0, ]?~, ...... Block . .~. ,~2~. ........ Lot..,~...~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit N ......... Date of Permit .......... Applicant .... : ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ · Z Underwriters Approval.... ................. Planning Board Approval ................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building~rmit/meets ~l~,)applLcab.~e codes and regulations. Applicant . ~.~.~ ;._ .... ~ ................... R~, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY dT'tllle ~7, l~°~,i~ 85 JOHN STREET, NEW YORK., NEW~].4~/~YORK 10~38 THIS CERTIFIES THAT John B. W'~t~n, Shep~d D~ve, ~ut~ld, N.Y. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS Z7 39 24 27 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIJ~ERS SYSTEMS NO. OF FEET SERVICEi DISCONNECT S E R V I C )THER APPARATUS: 1-G.F. CI. 1-Smoke L~tector NO. OF CC. COND, [- A. W, G. 1 1/0 E 1/0 John B. Watson 610 Shepard Drive Southold, N.Y. 1.1971 must ~lot dtered in any manner~ return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BU T. THIS COPY OF CERTIFICATE ~ST ~OT BE ALTERED IN ANY M~NNER, TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION -. · ,r 26; .__ Building P mit .o. 1398 - Owner %..~H~J %, bdA'r~ou (please print) (please ~print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 26th day of September 19 86 Notary Public, Suffol BERI,IADr. TTE L, TAPLIN NOTARY PUBLIC, State d New York Res~dhrg m Suffolk County I~ommi$smn E~pJms ~r~h 20, County Notary Public /- FIELD INSPECTION 1. FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd} iNSULATION PER No STATE ENERGY qpDE FINAL ADDIT,IONAL COMMENTS 7GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR 7GS-'"802 BUILDING DEI)T. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS: ~~ M~Y 2 I1~ *FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BL~G, OEP'!' Received ........... ,19... a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 s~ts 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 ~eas, and giving a det~led description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tkis 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 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 ~ Certificate of Occupancy been granted by the Building inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 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. applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to authorized inspectors on premises and in building for necessa~:winsl~.c~ns. ~ ~ ~ ~/2'--' o '; /// ~c (Mailing address of applicant) State whether applicant is owner, lessee, agent; architect, engineer, general contractor, electrician, plumber or builder. ................................................... Name of owner of premises ..... .Q ! .J~. · · · .~. · ~. ~/~i-~'o~o ~' p~ (as on the tax roll or latest deed) is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License NO ............... ~7. ' ~ Plumber's License No..~. ~-,'~..~"..(~f~'~- - · E ectrician s Lice e N ................... Other Trade's License No ...................... ~ /~ Location of land on which proposed wor~ will b~ done. ~ ~ ........................ ~ ............ z .... House Number Str~5~ Hflmlet oun , 000 ....... 7. ...... ........ ...... ............ Subdivisinn ..................................... Filed Map No ............... Lot .... ~7 ........ (Name) State existing uso and o~cupancy of pr~mis~s and intended use and occupancy of proposed ~onstru~tion: a. Existing use and occupancy .. ~ ...................... b. Intended use and o~upaney ............................. ~ ..................................... of work (check which apphcable): New Building .......... A. ddit/.on ......... Alteration .......... Repair . ~.p~ 0 { '~,[~ Removal .............. Demolition i Other Work ............... 4. Estimated ¢o ' "~"'" i ........................ Fee-~. ~.. ~. ~.% ................... Z ~" (to be paid bn filing this application) 5. It dwelling, number of dwelling 9nlts ............. Number of dwelling units 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 structurei, if any: Front .... .g-(./&.: .... Rear .............. Depth ............... Height Num,ber of Stories ........................................................ · .............. ' .~.'/~ Rear DimenSions of same structure wlth alterations or additions: Front ............................... i · ... Number of Stories .................... Depth ...................... Height .......... ~ ........ , t ~ t ~ ¢ ' ' ...'7 ...... ~.,. Rear ...~io...~:.~.... Depth .~7. ......... 8. Dimensions of entire new construction: Front ~ ~ If4~,' ~q N ' fSt ri .. ' . , .... Height . ~'. umber o o es ' ./ ............................. .......... i ....................... pth 9. Sizeoflot:Front..,/.~?L~. ............. Rear ~. /,/~,~o.~. ...... De ./.~ ................ 10. [)ate of Purchase ..... ~../...i .................. Name of Former Owner ....................... . . . ... 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construct/on violate any zoning law, ordinance or regulation: .,qZ'. q ............................ 13. Will lot be regraded ...... ~.~.'..~.~. ............... Will excess fill be removed, f_rom premises: Yes 14. Name of Owner of premises ,'~,)~,E,?,'?~.: ~..~.-~...~. Address .(~..~. ! .-t~..¢~..x~...~.~.~: P~6,~e No.. ~)-t ~.%Q Z, 3 ..... . Name of Architect ~. ~-////////'~.....~... ~Address : .~..iq..~..~. :~t, fq'~Ph~&'F.'. ............ Name of Contractor .. C~. .............. Address Cq~-./.q..rt.. [ .-W..~...x~'A .Phone No. ~c:~. t.-t-.~a'~..% .... pLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. (Name of individual si,fining contract) above named. being duly sworn, deposes and says that he is the applicant He is the .................................. (Contractor , agent , corporate officer , etc . ) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements con. tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the maniaer set forth in the application filed therewith. Sworn to before me this ............. f.d...~.. ..... day ~f ..... Notary Public, ..~..~..~).~..~..0~.. ...... Coun~,~'/". ,,~ '~/~/~7'--' : ! ~e 4707878, Suffolk C0un[v, ,~/ (Signature of applicant) ' ' t, rm [×prm~ Mar~h 30, 19,J~' '0 RODERICK V.~b 'TUYL, P.C, LICENSED LAND SURVE'~0R~ GREENPORT NEW YORK SUF~-~O~-¢O. HEALTH DEPT. APPROVAL STATEMENT OF INTENT THE WATER SUPPLy ANG SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICE.~ APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERV)C~S --,FOR APPROVAL OF CONSTRUCTION ONLY DATE H S. REF. NO SUFFOLK CO. TAX MAP DESIGNATION, DIST SECT BLOCK PCL OWNERS ADDRESS SEAL . ~ ' ' SUE ~OL~ CO ' "[ ALTH DE~T m A~ROV A~ SY~EMS- FOR THIS RESIDENCE -WILL ~ '~ o , ,, ~ CONFO~ TO T~ STAN~RGS .OF THE '"' ............ '~ ,,~H. ~ .~' . ~~~~~~~ SUFFOLK'CO. DEPT. OF APPLICANT 'AP~OVED: ~= ~ ~ ~ ~,.~*~-e,~~ ~ T~ ~r'/~ r,/_~. ;' ~-,-'~ ' , . - . - z~.~ .... . . , . ,~r 6~ . . '"' ' ' ' ' ' i ~o be satlsfac~o~ : ' ~ ~-, : ' " . ,