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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT 0fflce of the Bulldmng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17670 Date JANUARY 11r 1989 THIS CERTIFIES that the buildin~ Location of Property. 1320 HILLCREST DR. House No. County Tax Map No. 100O Section 13 Subdzvtslon HILLCREST ESTATES ONE FAMILY DWELLING. Street ORIEI~T Block 02 Filed Map No. 7218 Hamlet Lot 8.25 Lot No. 25 conforms substantzally to the Application for Buildmag Permit heretofore filed in thms offmce dated APRIL 8~ 1988 pursuant to which Bumlding Permit No. 16883Z dated APRIL 27, 1988 was mssued, and conforms to all of the requirements of the applicable provlsmons of the law. The occupancy for which thms certificate ms issued ms ONE FAMILY DWELLING. The certlf~cate ms mssued to GARY & DORIS BLAIR (owner, XXXXXXXXXXXXXX~[K) of the aforesaid bumldmng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-35 JAN. 11~ 1989 UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N046209 NOV. 17~ 1988 K & K PLUMBING DEC. 22~ 1988 J7 Bu~ld~ng Inspector 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) N_* 1688~ Z Permission ~s hereby granted to' ..~Z~...~.~.,<.....././.~.oT..[. .......... ........ '-~:"--~ ...... ~ ........ 2; ....... ~'"'~ ....... :' .............. ; .......................................... at premises located at ...../....~......'~.. .......... ~~~.. ............................................... County Tox Mop No 1000 Sect,on ...... /...~. Block ........ ~....,~,~ Lot No ........ Budding Inspector. Fee ............. ~--. Rev 6/30/80 TO~N OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YOgK 765 - 1802 1197l BLDG DEP'F ~.TOWN_ OF SOIJTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ...-~-.'OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Lo~at~o,, o~ P~o,,e~t~..%~,~; ......,. ~.~ ~K. HOUS~ NO. STREET HAHLET O~n~r or O~s o~ Prop~r~y ..... ~ . ..-~ ,/~:,:. ,; :::/~ ,,: Health Dept. Approval .................. Underwriters Approval .............. Planuing Board Approval Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: rev. 10/14/88 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~_00070~ BUREAU OF ELECTRICITY [-- B5 ~HN STREET~ NEW YOR~ NEW YO~ 1~3B SAKY ~I,A~R~ 1~0 HIhl,CK~T UK[VE: ~Rl~;N'r/ ~Y~ in tb fd~wing I~ation; ~ ~e~nt ~ Ist FI. ~ 2~ FL ,~ti~ Bilk ~ examl~ ~ ~O~E~ ~ ~ ~ ~ ~ ~ ~ and found to be ln com~ionce wlth the ~ui~ments of thb ~rd. FIXTUmJ FIXTUII~S OVB4S 50 59 41 50 SIRVI4~ O~SCONNF~' S E R V I C 4 !0 SAhVATORt~; (!. PRAT(.) g I (-:.G.I NS t,AN~ b~C~:N8~; No, 104~ g lhii c~k~ m~t ~ ~ e~ed i~ any man~t~ ~r~ ~ ~ e~ice of ~ ~ ~ i~. In~r~ be COPY OF CERTIFICATE MU~T MOT BE ALTERED IN AHY BLDG. DEFT. TOWN OF SOUTHOLD TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION Date TEL 765-1802 Building Permit No. Owner Q~ ~ "-'~J~ ~kC3~(~ (please print) (please print) ~%fp_C%~_~ u ~-f I certify %hat the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn~o before me this Notary Pu~/ y ~ Notary Public ~ 62 2162100 Qualified In Suffolk County ?~fm E~i~ Jmn. 31, OUNDATION (lst' OUNDATION (2nd DUGH FRAME~'''/ PLUMBiN~'/ ~SULATION PER N. Y~/. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST I ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION [] FRAMING r~FINAL ~ REMARKS: ~ ~ DATE 765-Z,802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ ] ~IGH PLBG. FOUNDATION 2ND [~] INSULATION FRAMING FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [~'/FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE ,NSPECTOR ~ ~~ FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, NY 11971 TEL,: 765-1803 Disapproved a/c APPLICATION FOR BUILDING PERMIT 7od Recezved ........... ,19. INSTRUCTIONS a Tlus apphcanon must be completely filled m by typewriter or m ink and submitted to the Bmldmg Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing locanon of lot and of bmldmgs on prem]ses, relahonshzp to adjoining premises or pubhc streets or areas, and giving a detmled descnptmn of layout of property must be drawn on the dmgmrn which zs part of tlars applk- cation. c The work covered by ttus apphcatlon may not be commenced before issuance of Building Permit d. Upon approval of this apphcatlon, the Building Inspector will ~ssued a Bmldmg Permit to the apphcant Such permit shall be kept on the premises avarlable for inspection throughout the work. e. No buo.dmg shall be occupied or used In whole or zn part for any purpose whatever untO. a Certificate of Occupancy shall have been granted by the Bml&ng Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Braiding Permit pursuant to the Bmldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construct]on of bmldmgs, additions or alterahons, or for removal or demohtion, as hereto described The apphcant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing code, and regulations, and to admit authorized inspectors on premises and m bufldmg for necessary inspections (Signature of apphcant, or name, if a corporation) (Mao.mg address of apphcant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electnman, plumber or builder Name of owner of premises (as on the tax roll or latest deed) If apphcant Is a corporation, signature of duly authorized officer (Name and t~tle of corporate officer) I / '" t '-['k,. I-.p t Builder's License No. Plumber's License No Electrician's License No Other Trade's Lmense No PERMIT INCLUDES APPROVAL TO REMOVE EXCESS FILL FRO~! ABOVE PRF~NllSES REGR/4DING LO~ - - D~'V~A~ C~S~U~CN CEL~R C~TR~JON ~ ............ I Locahon of land on wlnch proposed work will be done ................. House Number Street Hamlet County Tax Map No 1000 Section Ot~ Block ~ .... Lot Subd~v,s~on~Cc C~[~ ~Q~r .... Fo.edMapNo ~1~ Lot .~ (Name) 2 State extstmg use and occupancy of premises and intended use and occupancy of proposed construction a Ex~st~ng use and occupancy V~~ ~. ......... b Intended use and occupancy ....................... 3. Nature of work (check which applicable) New Bufldin .g '-d . Addition ..... Alteratmn ..... Repair . Removal .... Demohtion ......... Other Work (Descnptmn) 4. Estunated Cost IO.q {L)..C~'.~. .......... Fee · (to be prod on fihng th~s apphcation) 5. If dwelling, number of dwelling umts , I .. . Number of dwelling umts on each floor .......... If garage, num her o f cars ..... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............ 7. Dh'nenmons of existing structures, if any Front Rear ......... Depth ........... Height ......... Number of Stones .... Dmaenmons of same structure with alterations or addltmns Front ........... Rear ............ Depth ........ Height ....... .. [~.~ Nu~be~fff Stones..l~e.p.t~....~ ~ ...... Dlmenmons of entire new constructmn Front ~.~ . Rear . t.~ .l ......... Height ..... Number of Stones ..... ~.~ .................... "'-Z~:P, ............. 9. S~zeoflot Front. ~1~ ......... Rear .[.~.~ ..... .,~-~.._ ._Depth '25~ ;~" . ©w'ne~ 10 Date of Purchase ................. .~am~ of Former 1 1 Zone or use dmtnct in which premmes are mtuated ~-~/. ~t:~ (,r&. ~ ................. 12. Does proposed construction violate an,~ z..omng law, ordinance or regulation' . .~.~.~ ................. 13 Will lot be regraded ....... }~(,[O ...... Will excess fill be removed from premmes ~ N 14. Name of Owner of premlses ~{~1~ ...... Address~rr/~:b.~L~7¢.{~..PhoneNo~..~-~..~./~. Name of ArchRect ............... Address ...... ~ ..... 2hone No ............ C (-/~.~ ~'- ddress Name of ontractor .'-'~.t~. ...... A ~7~1,..~5 ~.~]~ho~o~.t/ 15. Is this property located withzn 300 feet of a tidal wetland? *Yes ..... NO~ ..... *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distmctly ail bmldmgs, whether existing or proposed, and red,cate MI set-back dm~enmons fro~ property hnes. Give street and block number or description according to deed, and show street names and ~ndlcate wheth, interior or corner lot. STATE OF NEW YORK, S S COUNTY OF ......... (Name of ~nd~wduaI mgmng contract) above named being duly sworn, deposes and says that he is the apphc. He m the .......................................................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and m duly authorized to perform or have performed the sa~d work and to make and file apphcat~on; that all statements contained m thru apphcat~on are true to the best of his knowledge and behef, and that work wtll be performed in the manner set forth m the apphcation filed therewith. Sworn to before me this ........ ...... Notary Public ........... County ," N01lk~t pU~I.I~ ~tate el Ne~ ( Signature of apphc NO. 4707878, Su~o~k Ce~nif~ (VACANT) LOT 22 r~. N 47° 22' IO"E 293 66' el 47 0 AREA = 42,484 SQ. FT. LOT 20 !~ ACANT) S~OLK C~TY D~TI~ ~ I.F_.ALTH SERVICES SURVEY OF PROPERTY AT OR I ENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N.Y. I000 OI $ 02 SCALE 1"=40' MAR 1,1988 825 CERTIFIED TO' FIRST AMERICAN TITLE iNSURANCE COMPANY OF NEW YORK TITLE HO. 605 $ 5700 SAG HARBOR SAVINGS BANi( GARY E. BLAIR DORIS BLAIR ~.. "' FOR A~IOVAL OF CO~TRUCTION ONLY ~UND VIEW DRIVE o~ ~.~ S LIC NO ~9668 ~ I ELEVATIONS ARE REFERENCED ~ED AU~15,1983 FILE · 7218 ~ ~ TO AN ASSUMD DATUM bi i-- bi NYS PO. SOUTHOLD, N Y. 11971 ('VACANT) LOT LOT ~ S. 47°22'1 W, AREA 22 SOUND VIEW DRIVE LIC NO 49668 ENGINEERS , PC DK (VACANT) LOT 2_4 42,484 SQ. FT. 272.81' SURVEY OF PROPERTY AT OR I ENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N.Y. IOOO ' OI 3 - 02 SCALE I": 40' MAR 1,1988 SU~FC~K COUNTY DEPARTMENT O~ HEALTH SERVICES FOR AI~ovAL OF COHSTRUCT[ON ONLY The Iooa~ms of w~r' md ~ ~ hereon ore from ~:~,rv~lo~ and ~ h'om ~ obldaml fr~ olf~rr., ELEVATIONS ARE REFERENCED TO AN ASSUMD DATUM LOT NU~8 REFER TO SIJEO1VIS~SN MAP OF FILL CREST ESTATES , SECTION I , :*I~.ED AUG 15,1983 FILE # 72i8 825 .! (/) _~ W~ ~ '~.~ ~ ~ ~ SURVEY ~ PROPERTY ~'~' S. 47°22'10"W, 272.~1' 4,' IVACANTI LOT 24 AREA = 42,484 VIEW DRIVE SQ. FT. PO. BOX' 90~ MAIN ROAD SOUTHOLD~ N.Y, 11971 SUFFOL~I~coUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OP CONSTRUCTION ONLY DATE, HS REF. NO. ~': %(, - g<~ '~ APPROVED The locations al waits e~d cesspools shown hereon ere from field observations end or tram dele obfa~tud fram others. OR I ENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 OI 3 02 8 25 SCALE I"= 40' MAR. 1,1988 JUNE la, 'la~ NOV. 4, 1988 (F~NAL) CERTIFIED TO' FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK TITLE NO. 605 S 5700 SAG HARBOR SAVINGS BANK GARY E. BLAIR DORIS BLAIR The wnle~ SUpply & sewag~ Ghpoad sys- lents for this residence wi coflfo~m to Ihe standards of the .Suffcdk County DePart- meat of Heallh Services. Properod Iff acco~d~mce Mth Jim minimum slaEdards Io~ I~le mwvoya as ealabbhed by lbo LJ.AJ..S. md aprovod and ~lod I~ a~ch ~ by The New York Stale L~ad Title Association ELEVATIONS ARE REFERENCED TO AN ASSUMD DATUM. LOT NUMBERS REFER TO ~lSi~3N MAP OF HILL CREST ESTATES , SECTION I · c!;.ED AUG.15,)983 FILE · 7~1~ 88 - 190 -'1 FEEl 76~-1802 9 AM TO 4 FO~ THE I, F~NDATiON , ~R~UI~e~ ' m~ ~Dc0Nc~ 2. ROUGH PLUMBE~ ~~ON ~. ~su~o ON LEAD CONTEA'I' BEFORE "= CO~PU~E ALL CON~uc~:,' ~ CER~FI~ OF ~UPAN~ T.= .~ SO~ER USED IN ~R " ~A~:-c~~ ~D~S. ~ ,~=~y ~ ~Y ~STEM ~NOT DESIGN OR ~. oCCUPANCY OR USE ISUNLAWFUL ~ WITH'OUT CERTIFICATE OF OCCUPANCY, If ~pper tubing for water distributinl lystem; piping sh-II bi ' of types K or L onl[' / 'W 2t% /