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HomeMy WebLinkAbout8753-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Date THIS CERTIFIES that the building located at . .a.r.a..n.d..A.y9 /., .Cg.r~..l..[.n' .~d. Street Map No. ,~.t~ ;..~.t.~., Block No ........ Lot No,..Te..a..7.7....~,a.t..t.~.t.u.~..~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ .~.u]ky.. 2.6, 19.7.6. pursuant to which Building Permit No..8.7.~.~.Z.. dated . ............... irul¥ 26 , lg 76..., was issued, and conforms to all of the req~ire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued ................................... The certificate is issued to , .g.m. i .~.y., R: .~!a..t.h.e.r. ..... 0 .~)e..r .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE ................... No pending ....................... HOUSE NUMBER . .960 .... Street Conk:kin Rd /~ G~,~au~ Ave . ..l~.t.i.~.e~; --Building Inspector { FORM NO. 2 TO~N OF SOU?9OLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTH'OLD, N. Y. BUILDING PERMIT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIE FULL COMPLETION OF THE WORK AUTHORIZED) N? 8753 Z Permission is hereby granted to: to ...~.~;L~...~...o.~.~...~...~...~.~7....~..e.~.~i~ .................................................................................. at premises Jo~ated at ..~L4Q.~L..~.J~...~....~.~. ......... .~..~.~.~-~-~-~-~..~.-~.~J-~..~.-~. .......................................... ............................................ .~..A.*~..../.....c,.o.~..x..~...~ ............ .s...a.~..t.~..k......~.,...z..,. ................ ~pursu-ant to appJication dated.................,..........~1'.1~.. ......... ~,.~ ........ 19.~.~.., and approved by the Building Inspector. 5 .......... FORM NO. $ TOWN OF SOUTHOLD , Building Department Tow, Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Iflsfructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. 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--($-9 form or equal)· 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and similar buildings and installations, 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. B. For existing buildings (prior to April 1957), Nan-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 in- formation required to prepare a certificate C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date i...Q..q .~..o...b..e..z, ... _]-..A:.t.. _1...9..7..0.. ...... New Bqdding XXXX Addition Old or Pre-existing Building i Vacant Land Location Of Property GraD. cl ,Avenue, Hattituck . Owner Or Owners Of Property Emil~. Mather Su ..... ~ OF MATTITUCK HEIGHTS ' ~ .'7..6....-&....?B~ock!No ............. House No 960 oa,v,s,on ................................................................ LO~ No ............ · 7/26/76 · Inland Homes, Inc. Permit No. 875B Z Date Of Permit .................... Appl,cant Health Dept. Approval $..~S.o..~.l.32'....1.O./_l.3/..'Z6....Labor Dept. Approval j..~/..3C ...................................... Underwriters Approval ....... J ...................................... Planning Board Appr[oval .y.~..s. ................................. Request For Temporary Certificate ..... .n...o. .............................. Finczl Certificgte .... .y...e..s. .............................. Fee Submitted $ ...5.....0...0. ......................... Construction on above described building and,Derm~t me.et~..ell applicgb'J.~i codes~dnd regulations. KENNETH W. THURBER - INLAND HOMES, INC. Sworn to before me this ......... .... .... Notary Public ....... ~--~..~..~~ounty'//~'/ (stamp *'" ' ' ' '" ' ,~,,zW ~[O,¢,~ UOA~D Oi: FIRE - al{ ~JlJI~EAU OF ELECTRICITY ~5 JOHN O'¢~{E~ r, NE~V YORK, NE~*I YORI( 10038 ';,'"'"' .... N 309627 FHIS CERIIFIES THAT Emily Mather, Grand Ave., Bayer Rd. & Freeman Rd., Mattituck, L.I. ,,,.,~/,,,,o,,.,~o~,,,,0,,, ~ .,,~,,,~., ~,s,r~. ~.~ r,. outside .....~..,i,,~,toa October 22, 1976 HXTU~E 5~ITCHE~ .... FIXTURE5 - - - RANGE5 OUTLETS FLUOreSCeNT COOKING DECKS OVENS DISH WASHERS EXHAUST FANS lO 13 DRYERS EURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS ~ MULTLOUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT R V I C E OTltER APPARATUS. S E Motor/s: l-3/4hp E~.ec.room heaters: l-2.0kW., 1 G.F.I. '~ i Smoke Detector 1-4.5kw Hot water heater Richard Relyea Delmar Drive, Laurel, L.I. Box 372 1-1.75kw, 1-1.25kw, 1-1.0kw, 1-.5kw TF,s zertJ,cate must not be ultered in any manner, return to the office of the Boord if ~nconect Inspectors may be ~d LI c. 2148E ~N~ D Per .... cledenh(JJs. TOWN OF SOUTHOLD _ BUILDING DEPARTMENT ~ o/j; ~ TOWN CLERK'S OFFI~ ." ~HOLD, N. Y. ~~ . ~ ...................., ...................... , ..........~e~l~ ~o ................................ / .... ~~1 '(Bui APPLICATION FOR BUILDING ~E~IT Date INSTRUCTIONS o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of pla.ns, 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 ofproperty must be drown on the diagram which is part of this application. 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 issue o 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 /V~DE to the Building Deportment 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Nome of owner of premises ............ ...]~..~,../.~.....R..,....~..a:.~...~..e...~. ................................................................................................... If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ............ .5.../.g..'LP.. ......................... Electrician's License No ....... ..~..7....3.-~,~.. ......................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ..M...~..~..~./..~.u...c..~.....~..e.../.~l.~Eot No ..... .'7...6.....&.....7..Z... Grand Ave, M&ttituck. N.Y. Street and Number .......................................................... · ......................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .............. .V..a...c..a...n:.~ .................................................................................................... 1 -Famil b. Intended use and occupancy .............................. ~ ............................................................................................... 3. Nature of work (check which applicable): New Building...~ ...... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... . //' 0 (Description) 4. Estimated Cost ...... '~..~..5..l.~.: ................................... Fee ....'~..l...............'-t-'''''~. ................................................................ (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 ....... .C.~.~...~. ..................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 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 .............. .3.....O~.. .................................. Rear ............. .1...5...O.. ..................... Depth 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .................. .n...o. ................................. 13. Will lot be regraded . ......~..e...s. ............. Will excess fill be removed from premises: ( ) Yes (x) No 14. Name of Owner of premises ..... ...]~..~.....R..t....~...~...~..b..e..z .......... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Narne of Contractor Inland Homes ~ Inc Address ...B..o..x.....X..1...7. .............. Phone No. 298-9696 PLOT DIAGRAM Mattituck, N.Y. 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. \o6,00~ STATE OF NEW YORK, COUNTY OF ................................ ................................................................................................. bein~ly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. Co~$[~O~ He is the ................................................................................................................................................................................. (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 all 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 fo~h in the application filed therewith. Sworn to before me this ........................ dayof ............................................ ,19., ....... Notaw Public, . ................................................... Coun~ .... ~~~.~.~ ..................................... (Signature of applicant) THE LOCATION Of WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR F~OM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DI[PARTMENT 0(~ HEALTH SERVICES APPLICANT ADDRESS -- TEL ........ EL=9 2 The ~ewage d~ spo~al and water suppl7 ~acilitles fur this location have been t[~peot~ b~-this dep~rtmen~ ~~ Lot 80 TESTHOLff Go LOAt~ SAND §7 ...... Lot 81 Lot 82 NOTE · = MONUMENT SUBDIFISION MAP FILED IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON dULY 24, 1955 AS FILE NO WA TER SUPPLY - PR/VA TE WELL S NEAREST WATER MAIN - 2 M/LES~ Kreh now or former, ly, I .£ws,o.s ] YOUNG & YOUNG 5~Pw Z,;97~ 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W. YOUNG ~.,~ *o.~ ,* * v,o~.*,o~ o~ ~*.o. EMI LY R. MATHER ~ LOTS 76 ~ 77 "AMENDED MAP OF MATTITUCK HEIGHTS" TO ~ * VAL,0 ,.U~ C~Y AT MATTITUCK GUARANTEED TO: .~.~o.. *.o ~o ~.~ *ss,..~E~ ~ ~.~ SUFFOLK CO.. N.Y. '"SrlTUTIONS OR eUB~EQUENT OWNER~. : 40' JULY 14, 1976 oD TESTHOLE ~ ~ ........ NOTE ~L=lo 4 .~ ~ i O~ ~ · -- MONUMENT ~ ~ L. ot 8~ SUBDIVISION m~P F/LED IN THE OFF/CE OF THE CLERK OF SUFFO~ COUNTY ON ~ ~ ~ dULY 24, 19~5 AS FILE NO 1184. _~r ~0~ .~ 5 ~r Kreh , no~ or formed ~ , .~ws~o.s YOUNG & Y , ~ 400 OSTRANDER AVENUE, RIV~RH[AD, ~RK LAND SURVEYOR, N THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAtNED FROM OTHERS THE wATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR TH~S RESIDENCE WILL c~Fo,, TO THE S'~.~HE"~.Z~.,~U,Tn~,T.~,T'O~____.....................- ,~-TH APPLICANT -- -- -- -~'~- Wes-'fp~h~-IL'-~. ADDRESS -- -- ~-- --"~7 ~ ~ -~',,,,"7~I;--KF ~ 7209 OF THE NEW YORK ~;TATE EDUCATION SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~) LAW LOTS 76& 77 "AMENDED MAPOFMATTITUCK HEIGHT~' COPIES OF THIS SURVEY MAP NOT BEARING THE LAND 'SURVEYOR'S INKED SEAL OR ~'MBOSSEO SEAL SHALL NOT BE CONBIDERED FOR APPROVAL OF CONSTRUCTION ONLY rD BE A VALID TRUE CORY AT MATTITUCK GUARANTEED TO: JUL 2 2 1976 SURVEYED --ANT. ,ND,CATED HEREON SHALL RUN DATE HS REP. NO.... ONLY ,o THE F'~RSON FOR WHOa THE TOWN OFSOUTHOLD ~ SURVEY IS PREPARED~ AND ON HIS BEHALF TO THE TITLE COMPANY~ GOVERNMENTAL APP~OVm SUFFOLK CO., N. Y ~27 "CALJ~"': '' ,,o, t ,,, I"o. INBTITUTIONS OR SUBBEQUENT OWNERS, I = JULY 14~ I 76-567 AGENCY AND LENDING IN3TITUTION LISTED HEREON~ AND TO THE ASSIGNE'E3 OF THE LENDIN~I INSTITUTION GUARANTEES AR~ NOT TRANSFERABLE TO AODITIONAL it APPrROk/ED AS ,~oOTED NOTIFY BUILDING DEPARTMENT 765-2660 9AM TO 4PM FOR REQUIR- ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. BEFORE COVER. lNG PJ~[LINE :~. FINAL WHEN JOB COMPLETED -I j I.