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Home My WebLink About16757-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17693 Date JANUARY 23, 1989 THIS CERTIFIES that the building. Location of Property 6955 BAY AVE House No. County Tax Map No. 1000 Section 104 Subdivision NASSAU FARMS Filed Map No. 1179 ONE FAMILY D¥[ELLING CUTCHOGUE, NEW YORK Street Hamlet Block 4 Lot 33.2 Lot No. 140 conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY llt 1988 pursuant to which Building Permit No. 16757-Z dated FEBRUARY 25, 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 ONE FAMILY DWELLING WITH GARAGE & ATTAC~ED DECKS The certificate is issued to EDGAR & DONYA VAN BUREN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 85-SO-09-JANUARY 19~ 1989 UNDERWRITERS CERTIFICATE NO. N042898 - OCTOBER 31, 1988 PLUMBERS CERTIFICATION DATED NOV. 19~ 1988-PECONIC PLUMBING & HEATING Building Inspector Rev. 1/81 FOB~ NO, O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK AUTHORIZED) N916757 z Date ...~.~.~.. ............................................. , Permission is hereby granted to: ~...~:..~..~...&~; ......... ..~..~-¢ Z~,.....~..,.,...~'~...~--~, ~-~ at premises located at ..~.~.,~..~.......~.~..~.'~ .................................................................. ~ J ............ .............................................................. County Tax Map No. 1000 Section ..... ./.~.~....~... ...... Block ......... ~ ....... Lot No.....~....,'~..:....~n:.. .... pursuant to application dated ...................... ~'1 J JJ/~ ............... , 19.~.'~..., and approved by the Building Inspector. Fee Rev. 6130/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTROLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE=EXISTING BUILDING ...... VACANT LAND ........ Location .OUSE NO. " '':::E~.T~'.'~ ........ '_/~i~i~ ......... ~ealth Dept. Approval .......... ~nder~riter* tpprova ..... Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ?. .............. APPLICAHT. ~ ................. ~ .... rev. 10/14/88 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. owner (please' pri~t) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~ ~pl~b~r' s signature) Sworn to before me this ~ day of ~__ , 19~. Notary Public, (~))_ ~/~,, County IE~ARSARA SI'EPNOWSKI N~ar~ Public, State of Now York , No. 48~752 Oualifi~in Su~kCoun~ ~ ~mi~ien ~ire~l ~ CO~£MTg FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME & .?LUMBING INSULATION PER N. STATE ENERGY CODE FI'NA/ AUDITION~L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [P]~'NSULATION [ ] FRAMING FINAL DATE, ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [/~JROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [~]~RAMING [ ] FINAL DATE ~/16/~', , ,NSPECTOR~/~ ~ '~ /~?f7 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT, INSPECTION [/FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION _INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ '~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ,'~ FINAL REMARKS: ~/~ c~, ~ DATE /'/ { ~o,~ THE NEW yORK BOARD OF FIRE UNDERWRITERS lie ' BUREAU OF ELECTRICITY I~ ~ . . _B~ JOHN STREET, NEW YORK. ~ ,Y~ ~O38 '~ 04~0~ B THIS CE~IFIES T~T I~ ~ examin~ ~ end /~nd to ~ m ~m~lanee with the requl~ments o/ th. ~rd. V I C ~ R?. Jl ~ BOX SO{JND AVENUf,; FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM . ]Z ......... TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .~../.5~.~5~. ....... 19 .~geermit No./~.' .~..~..7../ NOTIFY CALL MAIL Disapproved a/c ..................................... (Bm' d~i'~g Inspector) APPLICATION FOR BUILDING PERMIT Date February 11 1988 INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ed'don. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issned a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ (Signature of applicant, or name, if a corporation) .% .qo..z.u.m.b.u..s..~.,(e... ,..s. Ln$.~. o.v.n.,..~.z..U. 7..ST... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises . .. 12;.d~.r...A....8~. ])p.n.y..a.y.~.n. ]:3.u?.e.n. ......................................... (as on the tax roil 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. ~qr~g. f,.ce~.k..~Q.m.e?..I.n.c.. lumber s License No..t?O ¢ 9~J,q. P.~tCbi[~g. ~. )lear lng-Ge orge Be try Electrician's License No. , ¢. ,,ti 0..0 ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..~.~Y..h..v.e.n.u.e.,..Qq~. 9.h.o.gu..e.,..N.Y. .................. ...1~ ~.,5..5. ........................ ~..~y..~.~.~.~.~.q .................. c..~.t.o.h.o.g.~.e.,...NT.: ............. House Number Street Hamlet County Tax Map No. 1000 Section ..... J .0.4. ......... Block .... 4. ............. Lot....~....5.5.,.~. ....... Subdivision....lqg85g.~. ?g~2.nl~ ................... Filed Map No .... 3..q .7.9. ...... Lot. 2~..°.~. J.49 .... (Name) 2. State existing use and occupancy of premises and intended nse and occupancy of proposed constrnction: a. Existing use and occupancy ........ .~.At,P~ .~..0~. ............................................. b. Intended use and occupancy .... .0.N.~..P.A..M?.L.¥. }.t.0~ ............................................. Nature of work (check which applicable): New Building .. ¢.e.v~ .... Addition .......... Alteration .......... Repair Removal.' Demolition Other Work (Descrip~tion) .!47 7o0' F Estimated Cost .. ., .......... , ................... ee ...................................... ' · (to be paid on filing this application) ' 7 ' dwelling units. If dwelling, number of ............ Number of dwelling units on each floor .... .up. If garage, number of cars ....~ .. If business, commercial or mixed occopancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, ifa'ny: Front ............... Rear .............. Depth ............... Height ............... Number of Stories .................... : ................................... Dimensions of same structure w~th aKeratmns or add~tmns: Front ................. Rear .................. Depth ...................... H~ight ...................... Number of Stories ...................... Dimensions of entire new construction: Front .... .4 ~.~ Rear . .5.0.'. Depth .46 !... Height ~ 4 ~ Number o'f Stories 1 ~ Size of lot: Front ... J ~.~. ~. J Rear ~ 25.' .... Depth o i ....... ;R .......... ~..~7~.. Date of Purchase . .JgiT... ] ~5.~...i .............. Name of Former Owner Ge orge . ~ut;hill 1~ . . Zone or use district in which premise~ are situated A Does proposed .... construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ..... ~,.~ o. ...... I ............... Will excess fill be removed from premises: xYes No Name of Owner of premises ~d~ar ?a,n. Buren .. Address~,Q!C~lC~,~s ....... ................ ~ ......... w.,; .~¥e.. PhoneNo. ¢.6.5.-033.c~... Name of Architect .............. ; ............. Address ................... Phone No ................ Robert ]3oi er ~,' 1 .i? d .. Name of Contractor ............. g ............ Addre~?o~o.~. ~.~..I~. ,.. Phone No. 765. x] ..... ,. ls th±s property located w±th~n 300 feet of a t:i. dal wetland? *Yes ..... No .. ?-.0. '1£ yes, SouthoJ. d Town Trusteeg Perm±t maybe required. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, andAndieate all set-back dimensions from~ operty lines. Give street and block number or description according to deed, and show street names and indicate whether :erior or corner lot. .qcl.,uofis AP , TO REMOV~ c ~ ~ FROP? ADOV[ PREMISE~ D~ REGRAOI~ DRIVEWAY c~STRUCTION ~ CEs~OL CONSTRUCTI~ ~ ~ -- j 'ATE OF NEWYOR[(,,. · ,. ~.,¢..~./,. t. ..... i ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )ye named. j (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )lication; that all statements contained lin this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set !orth in the application filed therewith. om to before me this tary Public ...... ............ County I~DWARD C. QUII~IN NOTARY PUaLIC, $*me of N.w Yor~l .... No, 4677686; suftolk ¢ounly ! . . , ., , SUFFOLK CO. HEALTH O~.PT. AII'pIItOVAL H.S NO. , m~ntain ac :quate sanlta~ ~a~t ~IT~%JWk~.~Y, SUFFOLK CO. HEALTH DEPT. APPI~O-VAI~. ,. e¢ ~CALE 50'/ AI~EA 2.4 020 5 ~' STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF SUFFOLK CO DEPT OF HEALTH (si , ,. APPLICANT SUFFOLK COUNTY D~PT. ~ HEALTH SERVICE5 - FOR ,~P~R~OVA.L OF CONSTRUCT ION ONLY DATE :. H S.~EF NO ~' - , APPROVED: , ' . ,," SUFFOLK CO'. TAX DIST SECT. BI,.:OC:~ PCL DEED: L, P* TgP'6OIL L.OAr-f SEAL F-NF_.IRtT~Y CODE CALC:OL.A.TION.5 ¢;~,,.,o,o-=,_~,-,-~,~...,¥=,,-o ® ! BLDG. OEPT. TOWN OF SOUTHOLO BLDG DEpT, TOWN OF SOUTHOLD _] Phone 477-0400 Main Road GREENPOR'[ N,Y. 11944 .5 L