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Home My WebLink About8683-zFOB~ NO. 4, TOWN OF SOUTHOLD BUILI~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No ............. Date .............. ~ .... , 19 .... THIS CERTIFIES that the buildin .... ~ ~'~ Map No. ~<~ Block No. ~g ioca~ea al ..~ ..... ~.~t ...................... Lot No .................................. conforms sub~ti~ly to the App~cation for B~I~ Permit heretofore ffl~ d~ted . ..~./L..['. ......... , l g.~. p~su~t to which B~din~ Pe~it No ......... ~~ ~ /~ . dated ....... ~ T ............ , 19 .... , was issue, ~d co.ores ~ ~ of ~e req~ ments of ~applicable pro~sio~ of ~w. T~ occu~cy lo,which ~ ce~ffica~ is ~sue" /~~ ~ ~~ ~e certificate ~ issued t~ ~? ~..~ ...... ~ .............. ~. ~.- .... ~ ............. (~, lessee or ~n~t) of the ~oresmd b~ld~~ S~olk Co~ty Dep~tment of He~ Approv~ .... ~ ........... ~ .................. ~E~E~S CEa~F~CA~ ~o ...... ~ ........ m ....... .. ...... TOWN OF SOUTHOLD BUILDING DIEI'ARTMEWT TOWN CLERK'S OFFIC~ SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PEPu~IT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8683 Z Permission is hereby granted to: River~.ide homes inc A/C ~ B & Matti Bl~a~l~ .......... ~.~.~.~)xt.~.~ ................................................ ~attituek pursuant to application dated ........................... ~..1~....e.......2.~. ......... , 19.~..6...., and approved by the Building Inspector. Building Inspector FOI~M NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southeld, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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: 1. 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 disposol--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple 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), Non-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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ...... ~ ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~/.~.~?.p.~.A.y..e.~:~.8..~.~'.~.e.~.~.~.~.~..1~.~.~9~9..~.d.~9~.~ ............................................ Owner Or Owners Of Property ....~Tames..an~..tcta.~.~.~..~.Lm~o~z$ ................................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No....[.~7.~.0. Permit No ......~.~.~3.' ....... Date Of Permit ~2~/.7..~ ......Applicant ..~f.~.~'.~.~.~fi..~0.~..e.~...~fi.q... ...................... Health Dept. Approval ...... 6...z.~.0z~ ...................... Labor Dept. Approval ................................................ Underwriters Approval ...... .~..-..2..9..8..3..2..2. ........................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............ ~ ............................ Fee Submitted $ ...5..:.0..0. .......................... Construction on above de scribed building and p~~s a~ble codesand re gulatlons. Applicant ..... ~f,r. · .~.....'~....~T.~....-Z~... ................................... Sworn ~]o~before me thi/s~/~ ' - ~/~7~ ..... ........ ....... ........... ~' ,~ Qualified ,~ Su ~olk County ( ~ / ~ ~ No, 52-4601884 ~ ~ ~ ' ~ ~ommi~sion ~p]res March 30, 19~ RIV RSIDE It0MES~ INC. C 'STOM ~IUILDERS SPECIFICATIONS Jefferson Ranch 947 gquare Feet Electric Heat WEST MAIN STREET RIVERHEAD~ ~: ~ YORK GRADING: MASONRY: CARPENTRY: Rough grade to spot house Size of house: As per plan with attached garage Footings: 16" x 8" concrete Foundation: Poured concrete 84" x 8" with 4 cellar sash Stoops: Front as per plan - concrete Rear - one step and 3' x 3' concrete pad in rear of garage Basement floor: 3" concrete Waterproofing: troweled asphaltum below grade 4 lally columns and bases as per plan Garage: 16" x 8" concrete footing - 32" x 8" concrete foundation walls 4" concrete floor in garage 2' x 8' concrete apron in front of garage Girders: 6 x 8 built up as per plan Floor joists: 2 x 8 - 16" o.c. a6d 12~o.cflwith~wood bridging Ceiling joists & rafters: 2 x 6 - 16" ooc. Studding: 2 x 4 - 16" o.co Sub-floor: 5/8" T. & G. plywood Roof Sheathing= 3/8" plywood Soffits: %" exterior plywood Cornice and fascia: white pine ~2 Siding: front ~ Barn shakes and Tudor siding Sides and rear - Texture 1-11 Insulation: Exterior walls & floors - 3½" Ceilings - ~ Windows as per plan Floors: Living Room~ Bedrooms, Dining Room~ Hall and Closel ~ - Wall to wall carpet as per Riverside Homes~ Inc. s, ~ples Kitche~ and Bathroom - Tile over plywood' Roof Shingles: 235~ asphalt Trim: Clamshell trim on base~ windows and doors - interior Doors: Interior - 1 3/8" Flush luau Exterio~~- Front: 9 light - 1 3/4" cross buck Rear: I 3/8" 3 horizontal light in garage 1 8'0" x 7'0" overhead garage door 3/8" sheetrock on walls and ceilings Kitchen cabinets - as per plan and mica counter tops Bathroom - 3' ~anit¥ Interior stair,~ay t~ cellar as per plan with wood treads a~ stringers (i~n garage) One shelf and closet pole in each closet Bay window as per plan Cathedral ceilings as per plan PECIFICATIO~.S £EFFERSONRANcH ~A E G ~/2 ]LECTRICAL: PLUMBING: HEATING: WATER: CESSPOOLS: DECORATING: TILE: MISCELLANEOUS: Contract(~ shall provide all necessary labor and materials. All work to comply with local ordinances, All lights and switches to be placed according to code, Wiring for electric range, Service Panel 220 Volt 200 AMP~ Romex wiring, Electric light fixtures to the value of $35,00 including installation of same, Any cost in excess of this amount to be paid by owner, 30" ductless hood. Contractor shall provide all labor and materials and shall be properly installed in compliance with all local ordinances. Hot and cold water lines shall be made to bathtub~ shower body~ lavatory~ and kitchen sink, Plumbing fixtures shall be Briggs Beautyware~ owner's choice of color. Bathtub 5' recessed with shower body overhead~ toilet combination~ 18" round lavatory set in vanity~ Kitchen sink - 24" x 21" white, 2 exterior sillcocks, 40 Gallon hot water beater - electric, Electric baseboard heat with separate room thermostats, Electric pump~ storage tank 42 gallon capacity and 2" well. Total allowance for pump and well $700,00, Any amount over and above this to be paid by owner, Board of Health approved sewerage, Total allowance for sewerage $750,00, Any amount over and above this to be paid for by owner, Tape joints and 3 coats of spackle on walls and ceilings~ 2 coats of paint on exterior doors~ windows and trim, 2 coats of paint on interior walls~ ceilings~ doors~ trim and windows, Kitchen - vinyl asbestos tile over plywood Bathroom ~ ceramic tile 5' high in tub area only~ vinyl asbestos tile on floor IN THE EVENT THAT FILL IS TO BE BROUGHT TO THE JOBSITE OR REMOVED FROM THE JOBSITEOWNER WIlL PAY-EX]PENSE, Date THE NEW YORK BOARD OF 'FIRE UNDERWRITERS ~-- al( . ' ' BUREAU OF ELE~"RIO 8~ JOHN STREET, NEW YORK. NEW YORK lO03S .' THIS CERTIFIES THAT J~es & Mattie Simmons, s/side Sound Ave., 80' e/o Lipco Road, Mattituc~ L.I. Towle & Sons Inc., Mastic Beach, L.I. 11951 Lic.550E This cetfi{icote must ~ot ~e olier~ in on~ monner; relurn ~ the o~ice FOm~ ~0. ~ /V/ TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT '~/X~ SOUTHOLD, N. Y ~/ /~o, ,1'2( Disapproved a/c ......................................... ~:.~...~ .................. ~.. .......................... z: .................................................... ........................... ........... AFPLICATION FOR BUILDING PERMIT Dote ... INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building 5: 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 o~ ~ areas, and giving o detailed description of layout ofproperty must be drawn 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 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 annlicable Laws Ordinances or* Regulations, for the construction of buil&ngs, additions or alterations, or for removal or demol tion, as here n descr bed? 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. ---t .. ........................................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................... ........................................................................................................................ Name of owner of premises ......... Jame$..~nd..~tt£..~immo~$ .................................................................................. if applicg.~t is a corporate, signature of duly authorized officer. · _ ~ (Nome gnd titLe.of cam0rate~ officer} _ Richard Wan~olosKl~ V~¢e wreslaen~ Builder's License No ..................................................... Plumber's License No ......... .41~.-.~. ........................... Electrician's License No ..... $5~.E ........................... Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. MaP No.: .D..f~.~o...[r,~.D~J2.1;.~..... Lot No ........................ Street and Number ..~/~..~o~n~..Au~.,,..,&~ox,,~0.tg/,O,,.~IRC.O~.Rd ................. ~..~t~i~ .......... Municipality State existing use and occupancy of premises and in?ended use and occupancy of proposed construction: vacant land o. Exisiting use and occupancy ................................................................................................................................ b, intended use and occupancy one family dwelling 3. Nature of work (check which applicable): New Building .....X. ............ Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) 4. Estimated Cost ....................~.....?~.....~.~.......'.~... .......... Fee .....~....~......'~ ................................................................. (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 .................... .O~.e ................................................................................................................. 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 some structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 52'4" ~ .~'~" 8. Dimensions of entire new construction: Front .................................... r~ear ......................... Depth .;~.~.~..,8..~.*. ........... Height ............. 1.~.!. Number of Stories ......... 1 ........................................................................................................... 9. Size of lot: Front .......... B.Q,.A.7..t ................................ Rear .......... ,1,04-,&]..! ............... Depth ...¢.]..1.,E~0.! ............ unknown kl~-~ of Former Owner .~:~:;~.~:.~.:~.~,....~...~/.~..~"....../..:....~.....~) 10. Date of Purchase ............................................................... 11. Zone or use district Jn which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................. ~o .................................. 13. Will lot be regraded ..........~.es ........... Will excess fill be removed from premises: (x) Yes ( ) No · James and Mattie $imnlo~s ~ ~ ---. 14. Name of Owner or premises .................................................... naaress ...;~..... zo. ne...~~r. Phone No....nor~e ......... Name of Architect Richard Wandoloski East art .... 727-3395 .............................................................. Address .......... ~.. ................... ~none~ ~No ....................... Name of Contractor ..R...~..~..,e.,~. s.~.d...e..,..~..°...m..e...s..!...I,.~c...t ....... AddressR~..~..e...~..h..,e..a...d. ............ Phone No.7..2.?...-..3...3..9...5. .... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SURVEY STATE OF NEW "~[~,1~,.-,.~ COUNTY OF ................................ ................. RI..C..,H..A...R..D...,WA.,~P...O.~..O.~ .... ~ be ng duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................. ~$~e...L~.e~i~ez~t;/,~i.~e-- .......................................................................................................... (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 manner set forth in the application filed therewith. Sworn to before me this of Notary JFYTJ .......... Richard Wandoloski LIPCO' VACANT ROAD SOUND ~;" ) - L (Z3"~/'A~zN'77°20'20"E'ft' ~a~c80'47 _ SUFFOLK UOUNTY HEALTH DEPARTMENT / --· a~lttie~~ ~or ~s loeation have been as~ected ~ tht'~ de~rtment and fo~d ~%o..6_' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL Of CONSTRUCTION dNLY DATE~ HS REF, NO APPROVEO GUARANTEED ONLY TO' ~J~l~E$ 4 I"~ATT~ S~rntno~$ N,.Y.S. LIC. NO. 0A, 8992 HAROLD E TRANCHON, JR. NAME ADDRESS: SCALE: 1":~40 FILED MAP NO.: BOOK ~NO.: 2 HARiOLD LAND SUCCEiSSOR DATE: 6-10-76 DATE: PAGE: 47 E TRANCHON, JR. P C. SURVEYOR TO WILLIAM G. MEIER NORTH COUNTRY ROAO-WADING RIVER, N.Y. 92 9 - 4695 473--3626 ALT CALL ,PENN. LIC. NO 21115-E SITUATE AT, MATTITUCK TOWN OF 50UTHOLD- SUFFOLK COUNTY, N.Y. TELEPHONE: JOB NO.: 76-232 FILE NO.: 2I~FF SURVEYED FOR: JAMES ond MATTI SIMMONS '"LIP C'O ROAD SOUND ~" ) AVE. N,77 20 20E. HOUSE PRIVY 80.47' N,16 06 30 W. 14.64' S U FFOLK COUNTY DE'PARTMENT OF HEALTH SERVICES APPRO~EOLU-q.~&L~r /-'~ 7 gL,/a.- NAME. RIVERSIOR HOMES, INC. ADDRES$: ~S1' MAIN STREET PHONe PARK 7-339S TELEPHONE: GUARANTEED ONLY TO: JOB NO:= 76-232 FILE NO.: SURVEYED FOR: JAMES god MATTI SIMMONS SITUATE AT: MATTI:~TUCK TOWN o'F soUTHoLD~- SUFFOLK COUNTY, N.Y. SCALE= 1"-~40' BATE= 6- 10-76 FILED MA~? NO,: DATE~ BOOK NO.= 2 PAGE: 47 HAROLD E TRANCHON, JR. RC. LAND SURVEYOR J' SUCCE~SSOR TO; wILLIAM G. MEIER -,----~- ~ ~-~.~_._z.. t_ I NORTH G~U'NTRY "OAD--"AO,N~ R V~,,..~. / ~2 ~4695 ,,~, n ~ ~A,,~. ,~ 'N.YS. LIC. NO. O4899Z I ' (516) n~nvLu r, ~'~l~nv~} u~, ~PENN. LIC. NQ 21115-E J ~ ~73 ~3626 ALT CALL AVE 80.47 m ~: F- o SUFFOLK COUNTY DEPARTMENT Of HEALTH SERViC EC~ DATE ....... HS REI:. NO APPROVED o.--5 NAME ADDRESS: TELEPNONE~ o'! $!?~EQUENT '~UAfiAN"[E£E, CN:_Y Tf} IflARO:..D :' *' ~ ' ' 0,%' N Y5 LIC. NO. 048992' , R~ · 4 , JR__ P~N__~_~:LIC, NQ 21115~E JOB NO,: 76-232 FILE NO: 31,n'-F SURVEYED FOR= JAMES ond MATTI SIMMONS SITUATE AT: MATTITUC K TOWN OF SOUTHOLD - SUFFOLK COUNTY, SCALE~ l":40 DATE: 6-10-76 FILED MAP NOi: DATE: BOOK NO.~ 2 PAGE: 47 HAROLD F TRANCHON, JR PC. LAND SURVEYOR SUCCESSOR TO WILLIAM G ME~ER Ndl~'~ H COUNTRY ROAD - ~rACIN G D VIFR, 929 -- 4695 (516) 473--36Z6 ALT CALL 14"-4' 'T