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Home My WebLink About13694-Z FOB~ NO. ~ TO~N O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-° 13694 Z Permission is hereby granted to: County Tax Mop No. i000 Section ,...~...~.... ......... Block ..~..~ ......... Lot No.....~..../...~... .......... pursuant to application dated .~~........~...~.. ............... , l~.....-~., and opprove~ by the Building Inspector. ~/ Building Inspector Rev, d/30/B0 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16181 Date Jan. 26 .... ,19.8.6 TH IS CERTIFIES that the building .... ~ .a.p. ~ $ .n..&.. ~ .a .p..v.. ~ .a .t.e.p...s .................... Location of Property ..... 1. ! $ 5..L. 9 .n gy.~. e..w..L.a.n..e ..................... S. 9 .u.t.~ 9.3_ .d ....... House No. Street Hamlet County Tax Map No. 1000 Section ...8.8 ........ Block . .0.~ ........... Lot ...0.1.2 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Penni( heretofore filed in this office dated · dan. 3.1 ............. , 198.5. pursuant to which Building Permit No. J .3.6.9.4. .Z .............. dated ~..ap....3. .1 .................... 19~.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..£amJ&~r. dJ&e.l.:]. J-B.g .................................................... The certificate is issued to MARTIN AND MAR7 WATERS (owner, X~rXO~r~K of the aforesaid building. Suffolk County Department of Health Approval .... .8.5. ~ .s 9:.q ............................ UNDERWRITERS CERTIFICATE NO. N 7 q 0821 FLUMBERS CERTIFICATE Sept. 18, 1985 Bmld~ng Inspector Rev. 1/81 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 pZOperty 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 4.Vacant Land C.O. $5.00 Date../.;/..~..~/. ~: ~ ........... New Building . .~/~ ........ Old or Pre-existing Building ............ Vacant Land ............. f ¢. ?.: Location of Property ././.: ....................................... House No, Street Ham/et Owner or Owners of Property /.~../f./?.T././.l~...~../.~..A./?.~.'... ?J.//.~ .7'.¥/f.~.'. ...................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./~ b ?z~ ,~ Date of Permitly. ?//?.,z~. .Applicant /¥~/~ '~I'A[ //~'/~ ~/~/~_C'. ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ~.~..2.~./~.¢'¢-~..~...~.~.~?.~, .~,. ........................ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000091 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 .ateOctober ~, 19SS ~p,"cat,.nN..o./i,e ~310~7/SS N 7108: 1 THIS CERTIFIES THAT only the electrical equlprnent es described below and introduced by tim applicant named on the above application number in the premlses of in the followlng location; [] Basement [] lst Fl. [] £nd Fl. ~'~-~-e OutsJ~e 8eetlon Block Lot was examined on ~}~)'~/f~,~ff-.~ 23.~ 19~t5 and found to be in compliance with the r~quiretnents of this Board. FIXTURE OUTLETS 29 RECEPTACLES SWITCHES ~ 2~ FURNACE FIXTURES RANGES OVENS EXHAUST FANS INCANDESCENT FLUORESCENT 29 SYSTEMS NO. OF FEET OTHER APPARATUS: 1-G.F.Z E R I C PER ,~ OF CC, COND. 3. 3/0 V NO OF NEUTRAl OF NEUTRAL 3/0 TOWN OF SOUI'HOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit (please print) Plumber~ ~ (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 / 19f Notary Public,~~ County - (plumber's signature) Notary Public 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL Examin ed~/~Z.'T. ........... 19(7. ?. ~.~ Approve~'~...~.. ..... ~, 1~..~. Permit No./~.~.~. ?-'" Disappr~d,a/c ...~ ............... -...~,..~/ ~,,~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INsTRucTIONS BLDG. DEFt. TOWN OF SOUTHOLD Received ........... ,19... Da ..,ff..( ......... 1 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 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 th} issuance of a Building Permit pursuant to the Building Zone OrdinarieS'of the Town of Southold, Suffolk County, New Yorl~, 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 cgde, and regulations, and to admit authorized inspectors on premises and in building for n~ec~es~ary inspections. (Signature ot~'appticant, or name, if a corporation) SOUTHOLD P.O., GEN. DELIVERY 11 (Mailing address of~ applicant) 1155 LONGVIEW LANE State whether applicant is owner, lessee, agent, a~cl{itec~; engineer, gen~ral'¢on, tLactor, electrician, plumber or builder. \ OWNER MARTIN AND MARY ANN WATERS Name of owner of premises .................................. ' ........................................ (as on 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...~.:../~'/.Z:.L./..~?..~ .......... ~ Plumber's License No.. ~' [/ff~qC 7'_t~ r~f Electrician's License No. /~.q .'[/(.O..a~'..../.C.~.~. .... Other Trade's License No. C..~...~.gj.~./.~../t..t~. ...... 1. Location of land on which proposed work will be done ...................... :. ............................ 115 LO CW LANE SO,JT OL ~5~88-¢~ 5 Lot 41 County Tax Map No. 1000 Sectio~% .... Block .................. ................... Subdivision ..................................... Filed Map No ............... Lot ../~ ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy, of proposed construction: a. Existing use and occupancy VAC~ b. Intended use and occupancy ONE F~ILY ~ELLING ' '8. 10. ll. 12. 13. 14. property lines. Give street and block~number or interior or corner lot. '~a'ture 0f work (~he~k ~v'h~i~,~ a~plicable): New Building .......... Addition .......... Alteration ....... -... Rep 'r {i~[ t i ]~6~nl°val D molition Othr W k --'- " '. li~ : (Description) Estimated Cost ' .' Fee ': '" (to be paid on filing this application) If dwelling, number of dwellingl units ....1 .......... Number of dwelling units oh each floor If garage numberofcars" c_._.... If business, commercial or mix0d occupancy, specify nature and extent of each type of use .. ~ ........... Dimensions of existing strnctur~s, if any: Front .... ~ ~ " .... . ~. .... Rear .... v,,.: ;t.: .... Depth .............. Height ............... Number of Stories ......................................................... Dimensions of same structure rith alterations or additions: Front ................. Rear .................. Depth .................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front 66 ' -0" R 66 ' -0" pth 39 ' -0" ............... ear ............... De ............... 'ght 29' Q" ~ · 1 Hel ..... '~ ....... Number of Stones ..................................................... _ Size of lot: Front .... :I,~6.' .-.0.'[ .......... Rear ... ~.1...3.7. ~ ............ Depth ...],g5...Q ['. ........... Date of Purchase .......... ................... Name of Former Owner ............................. Zone Or use district in which premises are situated .... RES.T..DENCE..A. D'rSTRT~ ......................... Does proposed construct~_Itavio~late any zoning law, ordinance or regulation: .............................. Will 10t be regraded ........................... Will excess fill be removed from premises: Yes ~rl~o Name of Owner of pr~r.' rO'ZKO~8I<I ........ Address '4~5~-2'3' 't'f'l' '8~ .... Phone No. ~'l'~-.~g'~ Name .of Architect .......................... Address .h~:,lJSl-III~G,..NY .... Phone No .............. Nam 'ofC t tot Add Phone No e on rac ......................... ress ................................... 763'- t5'7~ PLOT DIAGRAM Locate clearly and distinctly al~ buildings, whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ................. 'S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signling contract) above named. He is the ! :' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file 'this application; that all statements contfiined 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 the application filed therewith. Sworn to before me this Notary public, .... ~ County ' ' ! HELFN K. OE¥OE ": PUBLIC, State '~'flow Yor& (Signature of applicant) RES. -~ / o SEAS. VL. LAND IMP. TOTAL TOWN OF SOUTHOLD PROPERTY~REC:ORD C:ARI~ ~ WLLAGE I DISTI SUB LOT ' ~ ~ W ~PE ~ ~~ FARM CO~. CB. MICS. Mkt. Value Tillable Woodland Meadowland House Plot Total DATE REMARKS FRONTAGE ON WATEI; FRONTAGE ON ROAD DEPTH BULKHEAD , BIdg. ;tension :tension tension rch ~ck Eez6wa¥ ~ra§e Foundation : ~ ~ Bath Basement Ext. Walls Fire Place / Floors Interior, Finish Heat Pool Attic Patio Rooms 1st Floor Driveway Rooms 2nd Floor .~Z~ 00~ ~ DEPARTME~2 The se~ase disp.sal a~d water su]~lF fael%i%iee for this l~eatiom ~ve bleen Inspected bT this de~tmen~ ~ fe~ ~hief of Oen~ral, Engineeri~ ~ervices JAN 17 1986 S.C, DEPT. OF HE~,LTH Sf.R¥~CES RODERICK VAN TUYL, ~.C7 ....... ~" LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT, APPROVAL H.S. NO. 85- 50- i STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS rESIDENCE WILL CONFORM TO THE STANDARD~ OF THE SUFFOLK CO. DEPT. OF HEALTh SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H.S. REF. NO.. ~'~O-I APPROVED: SUFFOLK CO, TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L. TEST hOLE STAMP S~AL