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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y.. CERTIFICATE OF OCCUPANCY No 217642 Date DECEMBER 28, 1988 THIS CERTIFIES that the building ADDITION Location of Property 240 WEST LANE EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 15 Lot 09 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 8, 1988 pursuant to which Building Permit No. 173332 dated AUG. 18, 1988 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JAMES J. & REBECCA WINTON ' (owner, } of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N049417 DEC. 12 1988 PLUMBERS CERTIFICATION DATED N/A °~L_ Building Inspector Rev. 1/81 xosai xo. a 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) N o 017 3 3 3 Z Dote 8 19.~.~r Permissi~eby granted t r 3..~~ fo .~~~..K.-Qy~w!i:G4G~~i .~21......x~r.....sj',~~~j~ ~ ....d.7snC.. ct premises located ut .....r -.7..d.........~1/...~•.••~F!~G County Tax Map No. 1000 Section Block Lot No.........J. pursuant to application doted 19..fS~j and approved by the Building Inspector. ~ Dd Fee $.<l...~/... B ding nspecto Rev. 6/30/80 t ~ ~ ~,L.._. ~._e . D L~ C~_ ~~.~.~~~!w.i~ -i I FORM N0.6 Z ~ ~ TOWN OF SOUTHOLD Building Department Fsll:)G. Il~i'T.~ Town Hall TtrvvvN o~-svur~ia~t? Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY K Instructions A. This application must be filled in typewriter OR ink, and submitted ~ so~re~ to the Building Inspec- torwith 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, acertificate 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 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10.00 4.vacant Land C.O. $ 20.00 ~r 5. Undated C.O. $ 50.00 Date ..~OU:.I~.,.l~~?~.......... NewConstruction,,,,,,OldorPre-existin Buildin ~ Vacant Land Lj / 9 g Location of Property • - ~,~~...~??~c.1.: h-~t-~.~-......I,=:GG~~ . ~~.L.r1~2~ House No. Srreer / ' 1 ~,j,,~~ Hamlet Owner or Owners of Property County Tax Map No. 1000 Section Block ~ Lot . Subdivision ..Filed Map No. ..Lot No. . Permit No. ~ . Date of Permit ..Applicant b~ni ~ea; :~Il4 , ~(~{/,/Q~~!-~~ Health Dept. Approval .....Labor Dept. Approval Underwriters Approval ........................Planning Board Approval Request for Temporary Certificate .....................Final Certificate Fee Submitted$...~r.5: Construction on above described building and p mit meets all applicable codes and regulations. APplicant..~.P4L,C~44!.~.~./~%~le~ .4!•.~.......... •r Rev. 10-1048 n r Coo ~zi~c - . ~ 3 YAS:M .I lrli)trl~i THE NEW YORK BDARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, N~. YOgK 10038 l:Y.f';pIM1A:R t~. 148k ,~?2R.H!i1;3`i N l:tcsdl'i Uot* Application No. on file THIS CERTIFIES THAT only the electrical equipment w described 6eloTO and introducedby the applicant named on the obooe /pplicettan number in the pnmiess of YCNYgyN. ?4tl G, LRNS~„ R. FtAI(St')N, N.V. in thefolfo¢ing lncak~,;r~~~B~mf4~~ ~ let Fl. ? Ynd Fl. .Sectian Block Lot tcae examined on and found to 6e in compliance with the requirernentA of this Board. flXTWE RXTI/R!S RANOL3 COOKING DECKS OVENS DISN WASMBtS EXNAUST FANS " OUTLETS ACLK SWITCHES INCANDESCEM fIUOIIESCEfVT v AMT. K. W. AMT. K. W. AMT. K.W. NAT. K. W. AMT. X. I. 1 ) ? F. DRYERS RIRNACE MOTORS lUTURE AMMIANCE NEDERS SPlGAL REC'ET TMY CIOCKS pLL UNIT NEAiERi At1Ai40UTIET DIMMlRS AMT. K. W. Oll M. P. GAS N. I. AMT. NO. A. W. G. NAT. AAV. AMT. AMPS. TRANS. NAT. N. P. NO. p T NAT. WA1T5 SRRVICE DISCONNECT tsO.Of S E R V 1 C E AMT. AMP. ITPE METER I A ]`I/ l A 3M' S / TV 3 A AW NO. Or CC. COND. A. W.O. NO.OF NbIFG A. W. G. NO. OF ARUTRAlS A. W. G. EyUI?. RER / OP CC. CC1N0. Or NF OF NEUIML OTHER AN'ARATUS: y()X ; 7 5 St>b"I'NQLL~, NY, 114"it OMAtMANA00 f5 LiS"h:lV S; p; Nf;, 5`YHB: Psr '~y This nrtificaN mwt not be altered in any manner; return to the office of the Board if incorrM. Inspectors moy be idaMifisd by tMir «edentioh. COPY !OR ~tNLDNIfi. P TMEHT. THIS COPY OF CERTIFICATE MUST NO'Y RE ALTERED IH AHY l -1ELD i,:s:~~c:,u;: puAT~, ~ ~orrclcHr~ W w P7 V11 ~ ~w ° FOU1dDATION (1st) _ _ G FOUNDATIOid (2nd) _ ~ z . Jy o~ ROUGH FRAME PLUMBING Rl r y 3 . c~ Z I1ISULATIOA! PER N. Y. y STATE ENERGY CODE a . O - ~ ~ .--I y ~ F I ;V A.L~ L... .Z Z ADDITIONAL COMMENTS: ~ z:0 11It n ' x M ~yy~^ z~ 1 x m A«y}~ - 1 b R] ro H r l ~3~~ '~-isoz BUILDING DEPT. 1 NSPECTtON [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]/INSULATION [ ]FRAMING [v7 FINAL REMARKS: I { G rr-r- i f ~i G DATE ~ ~ ~ u ~ INSPECTOR ~•~r ~ _ ~ ~ . _ ~ Z333 X65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: ~Z`... d~7~ DATE ~ U ~ INSPECTOR ~ /733 rss-1802 BUILDING DEPT. INSPECTION [FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / [ ]FINAL REMARKS: "7 DATE INSPECTOR `~~.J i' R `6>~3c~ ~xs;,~a r4 ~,e,~,r ta-:.=aa~e. airy ~n +~~[~,>~~~"~~~~'ft ~.+~'.?k~''~~F',~1 "`x~"i3w_~ c f _P-,~ 2' n ~e~ ~ . ~e ~ y r {.y~,y YbAT ~ ~ ~ . - Y y. ~ "4 r s ~ ~ ~ 1 2 f _ _ ~I N. 58° 58~ 30" 125.U / r i ~ /l ~ ' V ~ a' i /J~ ' I yz a t v ~ oC. 4,_}~ t I iCONCR ~T~0 uARAGt ~ Z~ i ' ~ UI f7 ~ i F i 7 ~ s ~-7 ~--t<--- _JI~ i ~ ~ ~ ~ I 1 ~ °i ~I i 2~CONCR veAL1: ~ ~ I STORY ~ I ~ ~ _ \ FR HOUSE ~ . ~ Q~ I Q ~4i 1 c~ U)' .20 ~ uJ I x. v ~ n_ ~ 46' o , r,,, ~ r ~ ~ /o' -j ~i I ° z! ~ cn i'15.i~ i X71 O Z' . , ~ , 7 Q ~ a { ~ ! 5.5~°58 3C~„~, ~ ~ ~ I I --i ~ ~ ~ ~ I,-.- i SCAT-~. 3Q~- ~I~ i ",A1= :~,;~~~.r,:., -:u ~-u 7~iii_ NC~~~1E TITLE , i' V: yr - ~"v ~ ;~t~. ^H~CAaQ T!~L~: iN~titr~Ct~~t~! ` r - - - - -~C : ~ ~ A„i~V rJ .14 i~ SGt} t !-?0-~.!~ ~AV'!JG$ BANK i 'f .'VII ~ ~ ~.lr ` i_ aT ~'NR ~u`'! SON ~ i cA5_f~ P1P,Fr~`-: ~ ~ ~-o_v~~; ~ _~~.~T ~:i__v, r~~Y° ~IC~Ns~~ ~,Nn s~oRs . __v - Gf2~~Nf?aRTN.Y. 'a ~ < ...a~,~.:: ' ~1 ~ wy.. ' rib r: Vr9...i H.~ ''gtV t ~t BOARD OF HEALTH ...y:• 3 SETS OF PLANS FORM NO. 1 SURVEY . TOWN OF SOUTHOLD CHECK ~¢~33 BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY . SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 ~ " ' ~ ~ " " " " " MAIL T0: Examined . ~8p 19 ~p Approved ~~R........, 19~P. Pennit No.. 7'3 3~~ Disapproved a/c ~~`.~,L~ \w!>,f,~~! IVI fii ~ ~ - 81988 (B ing Inspector) TOWN OF •SOUTHOLD 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 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 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 buildmg for necessary inspections. o N~ .,t3cTi?Tiwc%r ..,r3cz~tr~~~r ~l.G . (Signature of applicant, or name, if a corporation) /3&0 ©.~r~ccclon,~ ..I?!c.~YG:.r 4~?. ~l!P71. (Mailing address of applicant) State whether applicant is owner, ]essee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ..~~~4/1~!Z Name of owner of premises ,~!~'IES... a.% ...G.J/.~!! P.~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. z" .~~.9. • • . Plumber's License No. . Electrician's License No. .~~.~:3 ~LEeT!~,e , . , . , , Other Trade's License No. ~i9S! gyrd~. ~~~TiuET'>~-- 1. Location of land on which proposed work will be done . . 2'~~ ~h1~ST.. ,CAN.. ~A. S.~ (.v1K,1dL/,o~P:............. House Number Street Hamlet p County Tax Map No. 1000 Section ,~,1......... Block f~......... Lot Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended uuse and occupancy of proposed construction: a. Existing use and occupancy D~6.. ~o.OdGfll~.sl~~~ LC1~cF~ . . . , !t fr lr b. Intended use and occupancy I - . ' - 3. Nature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition Other Work . ~ ~ {Description) 4. Estimated Cost 9~~ . ~ Fee . - ! ` (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars .....J 6. If business, commercial or mixed ~~occupancy, specify nature and extent of each type of use . ' 7. Dimensions of existing structuresi, if any: Front ...............Rear Depth . Height ...............NumlierofStories........................................................ Dimensions of same structure with.~lt~rations or additions: Front Rear . Depth He,'i~ht Number of Stories . ' 8. Dimensions of entir. e,~v const ction: Front -?O.:...... Rear . ........Depth ..!o . ,~"@ ~ tS ~ Height t":~.... ~lier oP'Stories . 9. Size of lot: Front P.4 Rear .......1.40 Depth . 10. Date of Purchase .................Name of Former Owner . 11. Zone or use district in which re ' ' ~5~ aE.dT! ' p rmsesaresrtuated..........1~..... HG 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded .........i</.4 Will excess fill be removed from premises: Yes ~ No 14. Name of Owner of premises `k?!4/.Tgrw , , , , , , , , ,Address . W ~:ST.¢~~;~ , , Phone No. 977 229, , Name of Architect ; , ...Address ..~ep~.•T. !L!~02(°:`~.. Phone No . 'Name of Contractor .~.'rt2„T~7~U!;I S+!~!-!?s?es.:+'~c, .Address ~~:,yQ~~!~ Phone No. 7~.s,-!sy,~C, , , , 15.,Is this property located Within 300 feet of a tidal wetlandY *Xes No *If yes, Southold Town Trustees Permit ma be reqguired. PLO DIAGKAM Locate clearly and distinctly ail puildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. I SSE Sv,~d,x~'~r it ~I STATE OF NEW YORK, COtiNTY OF ...S.UF.F~•4K... ~'S (Name of individual signi~ ~ ~ • • ~ ~ ~ ~ ~ ~ • ~ ' ' ' • • being duly sworn, deposes and says that he is the applicant pg contract) above named. He is the Co, i2~0o2~r r ©~'i`/G E ~ . L (Contractor, agent, corporate officer, etc.) 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 alI statements contained 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 fled therewith. Sworn to before me this ...............~.1..~~ ...~d/ay of ./,/~V JU 51 19 P.8 Notary Public, 1. /1; . !~.Q-,Lfd.4-, S,uFFoGK County ~i ~ ~ ~ ~j ~ ~ HELEN K ~ YCE • ]I~YI•u>.~ .J.4~.. /.~X(X~:Ci . NOBBtYPUBLIC,Smte'ofCN~ewMyYaGkq U (Signature of applicant) Ter~m~Eea~lMirok3~0k 11..:FJ 1. OCCU~A9~CY OR USE IS .U~LAINFUL a°,_~.r A.~,~I~FIOUT CERTIFICATE - - - - - ~ ~ ~ ~ CCCU~'Aa~CY ~ `1' ~ ~ ~ /s Jnan"a ~ ~ -7 ' a ~ INDERNIIRERS CEIdIIFIGTE j ~ ~ y~e, ~ IIEQIIIRED tTr^u., o.ur...+ii 7~aeiN~m77m"Ji v<MT" ~ ~ ~„'+ru,- el.s ~ 4 " ~ ,I API~920 ED AS NOTED ' ~ lb '~C- f ,.tal6'w! C'r ic.~fc.f 'L- d - Ga.,b~'j'.-0rCy ,.1- ,i" .7 .arvc'ix, ~;_~3 'y I ( 0 ~ ~ DATE B.P 11 I , ~ ail r' .~Ja' ~ BY _ - ~7~/<q,C~ ~ - Y ~ FEE AA ~ , ' ~ r~P ~ .'C ~~.'~c.+Y 6d/s: ~d'o+l'Y N ~ o ~ NOTIFY 11L LNG DEPAR TAT' ~,1 766.18D2 u AM TO 4 P FOR THE il. ~ ~ ~ ~ ~ FOLLOWING INSPECTIONS: ' . ~ ~ ~ f ~ ~ ~ . ~ ~ 1 f ~ ~ 7. FOUNDATION - TWOREOUIRED ~ ' - - ''I ~ ~ FOR POUREp CQNCRETE ~ ' .-_-r- 2. ROUGH = FRAMING d PLUMBING i ' ~ ~ ~..rLcr.~ss t ~ ' ~ 9. INSULATION ~ ' 4. FINAL - CO.NSTRUCTION MUST BE COMPLETE FOR C.O. ~ ~ j ALL CONSTRUCTION SHALL MEET ; - ~icstr.N.S ',~;,,y~,i,,, ,a;,,~, THE'REQUIREMENi$' OF THE N.Y. ' - ~ ~ ~ ~ STATE CONSTRUCTION ~ ENERGY ~ CODES. NOT RESPONSIBLE FOIL ' ~ ~ ~ ~ DESIGN OR CONSTRUCTION ERRORS ~ a 46' 1 4VIk~ BV. OMWN 5Y ~ ~ ~ ~ t; ~wtLF.*~„5 i 4 sxu, ' ~'IM+bRrr~opxM~a~ ! , ' ~ ~ _ 1 Le :,mss s..,..., ~ _..,.r u. l~ ~ 1 „r r.L. .r 4;11 1 ~ n-..,,_. u o~ ~:r~ ~I ~ S• c„-, - ~ r ,r - ' f ,.I r.. ~ . ~ D ' ~ ~ ~ _ ' „ , i ~ I 35 i a J \ 3 l V V 9, .J r~ a. n i ..'I~ ~ ~ ~ f~ a%V IMfI ~ ~ _ i, 1 „ ^yiSFM }~lE M„ Syf~~~j, ~gg ~+rrsTixJ R4ea ?on!q~ I, 3~. ' 4 „ i ~ k n lWMLE: ~ 4~ t' ~ APYROVEb eY biuVM . ~ s pgAWINO H51MlEP' ' ~ +rreladnsraar taM~iOe„ ~ , r ~ - ' ~ ' . ' I ~ ' ~ ~ ~ ~ i i ' ~'A'k+T oMriY'~dd>r.W'f - tR'~ ~FCAXGG ~s FcFr' yY try' a4i h"ur>< ~ Rnr' . .~i~ft "'il"... - ~ AA lioa7 x .ty gWww ~ ~ ~ ' VIEV r~ ~;4o+cGe~+t~ nes n,.m~. ~elrl~~ ' ~ ~ ~ Mb;frti;HtP, ' ~ ~ ~ ~ ~ ~ ~ ~ ~~k~ Im Asa='ru iN1A - ~~cexbuyO~, , ~,(w~~CJ ~ ~ Yx+ p',~ ~7~0 ~x~~Z~EIr~M f4,"a.¢.. 2AQV.~ f'Y QTR. lYl~rPrR.+ - y~ ' R M+a1 ~(Y{,~ 'If . ~ ~ NIA u~fWRtYVl9 ~yY ~ . -~.h~aq~t~,lgstnartr~gr,~';.' _ - ~ _ _ ~ , _ . r i -„q 'rr v - i... ~ n 1. i .n i - ' ~ ' - i y i ~.,r - F.ifrq~A.r9 ~ ,poo.TO..~ ' j' ~ . . ~ - ~ ' ~ ~ ~ ~ .SO t. ?N FGE. v.,T..e... ~ .c!ea~2'TW' ~EL,EV,gr~f ~ ~ ~ ~ ' T - ,tALw iau,T3..t, _ MnhsM a i ~ ~ eCME: ~ 4~1.= APPROVED eY WN )T ,GATE: aeAw~ o nu eEe ~ AIS xremnEroniede.iae ~ i ~ i ~