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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 Z-23594 Date APRIL 12, 1995 THIS, CERTIFIES that the building 'ALTERATIONS Location of Property 2820 46 SHIPYARD LANE EAST MARION NY House No. Street - Hamlet County Tax Map No. 1000 Section 38.2 Block 1 Lot 46 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1994 pursuant to which Building Permit No. 22298—Z dated SEPTEMBER 6, 1994 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 CONSTRUCT ALTERATIONS TO ROOF OF EXISTING CLUB HOUSE AS APPLIED FOR. (ATTIC IS NON—HABITABLE). The certificate is issued to CLEAVES POINT CLUB & MARINA INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N345626 MARCH 17, 1995 PLUMBERS CERTIFICATION DATED N/A /Vidirig Inspector Rev. 1/81 �W4\/ FORM NO.3 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) Date .. .... ................................................ 19....,�. N2 22298 Z Permission is hereby granted t _ / �,... .. ................................................. ...................... ........ �... i to .... .......... ... .. � ...... .. ,�r'�5...... .V..l�....... .��.� .................................................................................................. .................................................................................................................................................................. ................................................................�04 ................................................................................ CC ' at premises located at....Pry.p.'. ..... ' ...... . ...... ............................................ . .... .................................................................................. County Tax Map No. 1000 Section ....��.U... Block......... ..�......... Lot No. ........7.. ........... pursuant to application dated ....... 1.. ....................................... 19F)4........ and approved by the Building Inspector. Fee$.. a/��� n ....... ..... ...................... uiiding Inspector Rev. 6/30/80 Q.0-�3nY Y Fi Form No. TOWN OF SOUTHOLD @N BUILDING DEPARTMENT APR 6 ��_. TOWN HALL 765-1802 B DO.DFPT `OVJI d OF SOUTF9OL63 APPLICATION- FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and .submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. ApproW-,il of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17. lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer. responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and .y "pre-existing" land uses: �. 1 . Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling 825.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00•, Commercial $15.00 Date . . . . . . . . . . . . . C,.��T. . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing 1�Building ,^. . . . . . . . . . . . . . . _ Location of Property. . .OW. . . . . . . . . . . . . . . . � .�° np .� 4=. . . . . . . . . . . . . .A5.1 fhNIZIor�S . . . . House No. Street Hamlet �ly,� ii'' Dnwer or Owners of Property-CL 'Y�.(?PJpp��T.Ct�(?.).�O0L44 I N• ca. . . . . . . . . . . . . . . . . . . bounty Tax Map No 1000, Section. . .U! �. . . .Block. . . . v �. . .Lot. . . . . . +. . . . . . . . . . . . Subdivision... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . . . . . . . . . . . . . . . . . .Lo Permit No, a �77, ,Date Of Permit. . . �. �lJ. "^^'"c ,lU�, GlAGLwT . d'1��Ug�' 19P� . . . .Applican .1 . . . . -Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . ]?1. _i ,%A . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . 4/9,-,3 D q . . . .a ./�Iz . &ta-Mi.PfiRf(JA4 lye, C3J 9� hrla APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAr4E 1 1000121 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date WRC.H 1.7,1995 Application No.on file 06983695/95 14 345626 MA THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of CLEAVES PT. VILLAGE ASSO, ;SHIPYARD LANE, EAST MARION, N.Y. in the following location; ❑ Basement 1XI 1st Fl. ® 2nd Fl. OUT Section Block Lot was examined on MARCH 13,1995 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 19 25 13 15 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 5 - SERVICE DISCONNECT NO.OF S E R V 1 C E METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP 1,02W 1,9 3W 3,B'3W 3,B'IW PER Z OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL i OTHER APPARATUS: MOTORS:2-3' H.P. PAUL R. BURRS L IC.#3897-E P.O.BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR a BUILDING DEPARTMENT..THIS C0—rV OF C-FR 8FICATC MUST NOT'LAF ALTERED IN ANY MANNER. ���S�FFOL�coG . y� Town Hall,53095 Main Road y Z Fax(516)765-1823 P. O. Box 1179 �O • Telephone(516)765-1802 Southold, New York 11971 4i �! col � �a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 21, 1995 Cleaves Point Club & Marina, Inc. C/O Susan Hallock P.O. Box 29 Greenport, NY 11944 To Whom This May Concern: We are unable- to complete your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check is not on file. $50.00 No Health Department Approval on file. No final inspection has been made. . No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22298-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M-1soz BUILDING DEPT. INSPECTION- [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: DATE �' � INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION . [ ] FRAMING [ ] FINAL REMARKS: C �— Ile 0 10011) DATE D INSPECTO r, LDi: �I �C)M011;NTs rl N FOUNDATION ( 1st ) c FOUNDATION ( 2nd ) rxj 2 . r z 0 ROUGH FRAME & Cj -PLUMBING ' —� kr cc 3 . H rri ' INSULATION PER N . Y. r3 (� H STATE ENERGY CODE . 4 . H FINAL ADDITIONAL COMMENTS : - -o rri : x . b• d H BOARD ' OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . , . li TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . f;r BUILDING DEPARTMENT c21Ecr; . . _ _ �- C 1994 f TOWN HALL SEPTIC .FOR:i i SOUTHOLD, N.Y. 11971 }-01—I_0C)6' TO BL DEPT TEL.: 765-1802 NQTI FY SOUTFiOLD CALL� ; !✓ ! _ r : _ . . . .I. - F r Examined . . . . . . 19r1AIL T0 : Approved . . . . . . 1ermit No. . . �r 91f . . . . . . _ . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . (B din Spector) APPLICA ION FOR BUILDING PERMIT Q 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 building for necess ry inspe tions. (Signature of appli ant, or name, if a corporation) (Mailing address of applica t) State whether applicant is owner, lessee, a en architect, engineer; general contractor, electrician, plumber or builder. . . . �, i: . . 1116 W)( AJ. .I Wo o.. ... . . . . . . . . . . . . . . ... . . . . . . Name of owner of premises . . , .'Q I t .I. �'. . . . :. . . . . . . . . . . . . . . . . . . (as on the.tax roll or latest deed) If-appI' is a corpor on, s'b ture of duly authorized officer. Q1iL4� ` • fP. l PMJT (Name a tie of corporate office Builder's License No. I•�/; Plumber's License No. Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . ... . . ... . . . ... . . . . . . . . . . . . . . ��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . = �� . . AIZA0ri. . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . :.® rj o . . . . Block . . . . . . . . . . . .. . . . Lot . . . . . . 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 - -�1�}�1� �(i1Vil'N.G.��IpD�i�l b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . .� h.'. :J . . 75 0 : : . .. ... . . . . . . -3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition Alteration"Repair . . . Removal T �,Q`�^F• . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) ` 4. Estimated Cost . . . . . . . . . j�i. . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . ... . . . . . . . . . . . .. Number of dwelling units on each floor . . . . . : . If garage, number of cars • • • • • • • 6. If business,4commercia or mixed occupancy, specify nature•and extent of•each•type of'use �I�U�iNQ�SE f�,� {Jap Qu�� 7. Dimensions of existing structures,if any: Front . . . Rear Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear . . . . • . . • . . Depth . . . . . . . Height . . . . . . . . . . : Number of Stories . • • . • • � • • • • • • • • • • 8. Dimensions of entire new construction: Front . . . . . . . . Rear . Depth .Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front Rear. . . . . . . . . . . .Depth . . . . . . . . . . . 10. Date of Purchase O(%t0f3 ,, • '�l`�•g , , , , , , , , , , , Name of Former Owner 0.0L0 a.My. 0406.'f 1V#jbN#1 j Nye, 11. Zone or use district in which premises are situated . . . . . . . . . . . 12. Does proposed construction violate any,zoning law, ordinance or regulation: • • . . . 13. Will lot be regraded g �l��'�11�®Ul�,>tl�Tq► . . . . . . . . . ®• • Will excess fill be rem ved from premises: Yes j 14. Name of Owner of premises e: l�S X.U013!M.A�ti�',�ddress .a=:1;�5? ,i'�1�ft;i �, o P . . . . .Phone No.477-�6�7 Name of Architect .Address ` • • • �� . Phone No. Name of Contractor �. t . .Cr;,?Ju;f�a� .Address .� l,S, rn�. . .Phone No. ,..7 :�� , 15. ' Is this property within 300 feet of a tidal wetland? * .� • • • Yes.. , . . . No. . , . . . . . . *If yes, Southold Town Trustees Permit may. .be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, 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. STATE OF'NER ` `J . . . 5cf-YA. . -44c(., © . . . . . . . . . . . . beingduly y sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . ,. . , (Contract , agent, corporate officer, etc.) ,)f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this-application are true to the best of his knowledge and belief;and that the ,vork will be performed in the manner set forth in the application filed therewith. Sworn to before me its . . . . . . . . . . day - of. . 19 4otary Public, . . . . . County CLAIRE L GLEiN Notary Public,State of Newyork � � No.4879505 . • • • • • - Qualified in Suffolk County (Signature of applicant) Commission Expires December 8,I u 1 . - a _ i► - - -- ----- -"- ---fir- ---. _--- -- -- � ----� -�-- --------- ---- - ----- -----�— -- -. - -- - --- ----- _- �- � I 1 r \ / r.. 4 i -LI , LA -- --7 - - P JI ? k~r{, Il M1if a „ dt 1 A y t t ,n s qqg F 1' 4 1 ~ 41 •_QCCI~P~INGY OR'. USE US U~I~11fU,lt " IN7TIQUi C~RTIRICGITE -l, OF UCCUPRRGY ,a AP N cC7~3NO~F.~, I - - 'I DA.oF PPd~i.~{- ,:1 FECRV y1~P1 V 2 9- 9 D6FPM ' 765 1802 !3AM 5C7 YtNM;'t T r ' - YQLL€IWiNG'INSE*EC7f)'ON$: 4 9 F[RED CRETE, UIR6D Fotl POURED CONCRETE - 2. ROIJOH FFdAMt'"fO & PLUMRit~6 Y 8- INSULATIo'N + - - - 4. FINAL -;CONSTRU(.T,LtJN 14~5PST - RE CONfFLETE FDR C 0 ALL CONSTRUCTION $14A4~. ~11EET THE Nj^ - - THE REQUIREMENTS OF STATE CONSTRUCTION' &EN~POV - R. ' COC S: 'NORESPQNSIBLE 9 E ."'T fR. '.;DESlONQR CONSTRUCTION'ERROR$,s I W ~ r e,r 1- r C r^ 1 -Trp 4' tl rpr n - 3 4M I t 1 MID S e sn J . _.m , n a t. i ~ r y. ' Cbiv[Etp3i \ "MIA OF _ ~ 09GWE fLPWt f - i 1 ' ~ ~ ' F 1 ~ ~ i; t ~ . H ~ ~ ~ ->v~ - ~ ~ r O~, ~~UF NEWT _ O rT, BM r ~ K t I R Sam I Kam, 1 F~ a n ~ ' 1 {v ,i I1) i 'J~ r 1 t ke Ya,' 5 k IY f: 3 z. ) n Y c a' S- ~ A V w F~ Y z . F2xt~-'Rr4GC~~,'~c 2a7a.- Ifs" b. m' H _ Beta ?%r 0 C R1 4i _ ~7 1 l X~ nk'.G 7x¢r s h. t lG IZ - { a, k-2~cly. 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