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Home My WebLink About16812-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17675 Date JANUARY 13, 1989 THIS CERTIFIES that the building Location of Property i245 OLD FARM ROAD House No. County Tax Map No. 1000 Section 026 Subdivision BAYVIEW FARM ONE FAMILY DWELLING Street Block 4 Filed Map No. 7045 ORIENT, NEW YORK · Hamlet Lot 2 Lot No, 11 ~ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 1988 . pursuant to which Building Permit No. 16812-Z dated MARCH 11, 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 ATTACHED GARAGE AS APPLIED FOR The certificate is issued to GERALD & MARGHERITA DENNEh~ff (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-14-JAN. 9, 1989 UNDERWRITERS CERTIFICATE NO. SEPT. 16~ 1988 -. N033767 PLUMBERS CERTIFICATION DATED AUG. 22~ 1988 - PECONtC PLUMB.~4EATING ' Building Inspector Rev. 1/81 FORM NO. 0 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_16812 Z Permission is hereby granted to: _ r ..~.~....~~....%.... ....................... .....~.....G.,g~..~...~....O.., ..................... .:a~..~,..~.,~.........t:.z~.~, ......... ,"-'--% ,o County Tax Mop No. 1000 Section ...... ..C~....-~....~.. .... Block ........ ~....~ ..... Lot No, ....~.....~tm~... .......... pursuont to application dated ......~.~...~....~.. ....................... , ,9~.~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Owner or Owners of ~ou~ty Tax ~ap No. ]000 Section ..~B~ock subdivision .... .JdY?/~/¢..~.~... ~iled Map / NEW CONSTRUCTION .d-...OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property...??.SX.-~. HOUSE NO. STREET ~AMLET ~ro~ert~ ............ ...~.. ~o~ ..~ ..... Planning Board Approval Request for Temporary Certificate ....... Ftaal Fca Submitted: $ ...... Certificate ................ APPLICANT .................... 9~c,3~q10 rev. 10/14/B8 TOWN OF $OUTtlOLB OFFIcI£ OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL £OUTIIOLD, N.Y. 11971 TEL. 765480,2 To Whom 'Ihls Ma~ Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_-// An application for Certificate of Occupancy is /lot on file. /__~ No Underwriters Certificate on file. /~//The c},eck i:; (~*~!~L~i~al/not on file. ) ~,~ /~// No Ilealth Dept. Approval on file. /:/ No final inspection has been made. P]ease contact ()ur o.ffice on this matter. Thank you for your cooperation. Building Dept. / *~*///Uo_ Plumber Soldc~3 Certificate on file. ( all permits involving plumbing being issued after AprJ. 1 1,1984 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. I ~/2 -O Owner ~X~ _~/m~ (pleas& print~ Plumber ~.~* _,~/£~~/~ ~//~ (pleas~ prihC) / / I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (p~um~r' s si~ture) Sworn to before me this County o{a J Pu ic - ?'i£LD .~,,S ..... u ~ {{D~r~ COMNgN~TS FOUNDATION FOUNDATION ROUGH FRAME &~ INSULATION PER N. STATE ENERGY CODE/ ADDITION, COMMENTS: FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. 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. Approva~ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancv on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 ......... X× New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............../,~ Old Farm ~.oa~. ...... , ............................................ Orient House No, Street Hamlet OwnerorOwflersofProperty .. Peter Blank, Jr. and Mary Louise Blank 026 04 002 County Tax Map No. 1000 Section ............... 8lock ............... Lot ................ Subdivision ' Map of Bayview Farm, ...Filed Map No. 7045 . .Lot No. 11 Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... XX Fee Submitted $ 5.00 Applicant .-~././~?/.../. .......................... /~-~llam ~~Jr .Attorney/Agent Rev. 10-10-?a for Peter Blank, Jr. and Mary Louise Blank THE NEW YORK BOARD OF FIRE UNDERWRITERS THIS CE~IFIES ~AT ~EKAt,O ~NN~HY, OLD FARN ~O~O, OR17E~, N.Y~ was examined on ~ 2nd Fl. Section Block and found to be in compliance with the requlreme~ts of this Board. Lot RXTUBI FIXTURIS RANGIS OVENS EXHAUST FANS OUT~BTS SWITCH4S DRYIRS IqJRNAC]E MOTORS RJTU~ A~JANC! ~ TIMI C~QCKS OIMMIRS ! DISCONI4CT S I SMOKE DETECTOR:-2 TRACK LIGHTING:-8 R V I C I { THRE]~ 'C' ELECTRIC RT. {3, BOX 45H SOUND AVF, MUE LlJC~;NSE NO. 332~ g ~k m~fk~ m~t ~t ~ a~ in any manner; ~urn ~ ~ ~l of ~ ~d if i~r~, {m~. ~ 765-1802 BUILDING DEPT. INSPECTION [ j FOUNDATION 'ZND [ ] INSULATION FRAMING [ ] FINAL 765.1802 BUILDING DEPT. INSPECTION FOUNDATION t$T [ ] ROUGH PLBG. / [Y~/FOUNDATION ZND [ ] INSULATION* FRAMING FINAL REMARKS: , /~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING i~FINAL REMARKS: DATE ' INSPECTOR~~ 765-1802 BUILDING DEPT., INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST [ ]/~OUGH PLBG. / FOUNDATION 2ND [/] INSULATION [ ] FINAL DATE // INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ~/RROUGN PLBG. J/~NDATION 2ND ~ ~ INSULATION FRAMING / ~ ~ FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. J FOUNDATION 2ND [ ]INSULATION ]FRAMING I:ORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT SE?TIC TOWN HALL NOTTFY SOUTHOLD, N.Y. 11971 CALL TEL.: 765-180P MAIL Disapproveda/c ............................. ..,..,./ / (Building Inspector) APPLICATION FOR BUILDING PERMIT TO: BLDG. DEPT. TOWN OF $OU'OqOLD 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 application may not be commenced before issuance of Bui/ding 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 inspection.s. ~ (Signature of applicant, or name, if a corp6~tion) ...... ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................................ Name of owner of premises ...~.~?.C .'~e..~. · .~....,~...~--e?~. ~'/,~ .~.~-., . .~..~...~..~. .............. (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... . .54,. ................ ......... House Number Street Hmnlet County Tax Map No. 1000 Section O ~-~:~ Block ~ Lot. Subdivision .~..~../.~rx/ /~/-,¥4 Filed Map No. ~'5e:'3'" Lot .././. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................... ~ ............... b. Intended use and occupancy ....... ~.~..-7f.."77-~.. ~. d.~..~...<....-~,:.~.~...~-,,(~,~'/.~....~). 0,/..e..,/./.~.~.~.t. ....... 3. Nature of work (check which applicable): New Building t'/"' Addition ...~. Alteration Repair .............. Removai ..... ~ ........ Demolition ........... I · Other Work ............... ' (D scrJp, tion) 4 Estim ted Co F · a st ....................... ee .......... ~ ........................... " (to be ~aid on filJn~ this application) 5. If dwellin¢, number of dwelling units .... ~ .......... Number of dwelling unit~ on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... 7. Dimensions of ex~st~ng structures, if any: Front ............... Rear ....... ~ ....... Depth .......... Height ............... Number of Stories ............................ ~ ............................ Dimensions of same structure with alterations or additions: Front ' Rear ................ Depth ...................... Height ...................... Number or'Stories .............. z .... ' 8. Dimensions of entire new construction: Front ., ~.. ,. ..... ~ear . .~. ,~, ....... Depth . ~..~ ....... Height , .~.q ..... Number of Stories .... ~ .......... ? ........... ~, .............. ~ ......... 9. SJzeorlot: Front ...~.q ......... Rear .(~t~ ~Depth ~f~~ , 11. Zone or use district in which premises are situated ~ ~~ ~ ~ 12. Does proposed construction v~late any zoning law, ordinance or regulation: .. ~ ..................... ..... .;. ,,...,,...,. · ,.,. fit p mis,,: 14. Nme of Owner of premises . ~.~~~dress ~ ~(~.~8¢ Phone No ~ N~e of ~chitect ........ ~. ~ Address~ ~~q.~h~-~ x~' 'w,' ~ .... ~5. Zs this properey located within 300 feet of a tida~erland? ~Z~s ..... No ~** · Zf yes, SouEhold To~ Trustees Permit maybe required. PLOW DIAG~M Locate cle~ly ~d distinctly fll bufldb~gs, whether existing or proposed, and. ifidicate fll set-back dimensions from property Shes. Give street and block number or description according to deed, ~d shdw street nines and indicate whether inte~or or corner lot. STATE OF NEW YORK, COUNTY OF. · S.S ............ .~-~.~ .~...~..~.'~..~¢.,,~. ............... being duly sworn, a~poses and says that he is the applicant (Name of individual signing contract) above named. He is the ~4~ ' (Contractor, agent, corporate officer, etc.) ' , d is duly authorized to perform or have performed t~e said work and to m~e md file this application; that all statements contained ~ this application are true to the best o~his knowledge and belief; and that the work w~l be perfo~ed in the m~ner set forth ~ the application filed therewith. Swonl to before me this ........... /~7 ......... day of ........... , 19~ Nota~ Public, . .......... County <OAv. I SUFFOLK CO. HEALTH DEPT. APPROVAL H, S. NO, . - ~ ' ?14'.J?L i<X; 'Ax SING[ E PALJLY DWELLING ONLY E~r': ,-w<""~ --- EXPIRES T~VC YEARS FROM DATE OF APPROVAL ............................................. ;-~j STATEMENT OF INTENT ' h'-i" *.. ~ t - ' THE WATER SUPPLY AND SEWAGE DISPOSAL ... :. ~::. ......f SYSTEMS FOR THIS RESIDENCE WILL ~¢~ CONFORM TO THE S~ANDA~DS OF THE ~?~ .,-- , , SUFFOLK CO, DEPT. OF HEALTH. SERVICES. ,/ ~. APPLICANT {4'~~ '-., SUFFOLK COUNTY DEPT.' OF HEALTH * DATE: . - 'e~/~., ~>~:. APPROVED: '~%~ SUFFOLK CO; TAX ~P D~I~ATI~: DIST. SECT. BL~K ADDRE~: DEED: .g N/A TEST HOLE ~AMP . RODERICK VA~YL. P.C. 0 LICENSED LAND SURVEYORS GREENPORT NEW YORK ~I.I~FOLK CO. HEALTH D~.PT. A~VAL ...... .~ THE WATER S~Y A~ ~WAGE ~, S~RVICES -- FOR APPROVAL StN~.E FAMILY DW~ ~ .... have Deuri ~ec[ed by this ~a~ a~/or /Z/? ' ' <" ' Of Phone 477-0400 " M~ill Road GREENPORT, N.Y, I 194.4 OWG EL E_VAT t Ofq PLAN NO '-/ ~L~-F JSCALE ! r Nq~TC t~-'t-y; , t '1 $~C ON i.b L 1 ./ Phone 477-0400 ~ Mai~ Road GREENPORT, N.Y. 11944