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HomeMy WebLinkAbout9334-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y UPDATED CERTIFICATE OF OCCUPANCY No Z-27457 Date DECEMBER 12, 200;0 THIS CERTIFIES that the building Location of Property. 801 MAPLE LANE House No County Tax Map No Subdlwslon DWELLING Street 1000 Section 64 Block 1 Lot Filed Map No Lot N~ SOUTHOLD Hamlet 30.2 conforms substantially to the Application for Building Permit heretofore filed ~n th~s off~ce dated Building Permit No 9334-Z JUNE 24, i977 dated JUNE 24, 1977 pursuant to which was ~ssued. and conforms to all of the requirements of the applicable / of the law The occupancy for which th~s certlf~cate ~s provisions / ~ssued is ONE FAMILY DWELLING WITH A1-FACHED GARAGE * The certificate ~s ~ssued to of the aforesaid building JOHN B. WHITESIDE (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N-365497 PLUMBERS CERTIFICATION DATED NOV. 14, 1977 BY R. VILLA NOVEMBER 22, 1977 N/A *NOTE: THIS UPDATES CO Z-8052 DATED DEC. 8, 1977. B~._~ng Inslector Rev 1/81 FOILM NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy Building ~spectof No ............ Date .......... Dgq ....8. ...... , 19. THIS CERTIFIES that the building located at . R ;0. ,.~. ~%p~.e.t.~..n.~..(..Ay.e). Street Map No.. xx ........ Block No....~.... Lot No. xxx..So~lth?JA..~.,X~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Jlr,ne.. 21~, 19 ~.7. pursuant to which Bufld~g Permit No. Q.._,~ZL.~.. dated ....... .J.U~a.e. ~.. , 19.??., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.r.i.v.a.t..e . .9.n.c..f .am~.l.y...al.we. Il .Lg. g ................................. The certificate is issued to . .B~. rE[e.s s..&..D. 9~'.o.t.h.y....Wh.~t.? ?.id. ~ ..... ~:Ln.e.r..s ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .l~.ov.. ~..~..~. ~ ?.7. ...by..R.;..V.t. 1 .l.a.. UNDERWRITERS CERTIFICATE No..N. 3.6 ..... ,1977. .............. HOUSE NUMBER . &0~ ...... Street .... .~apl.e..L~..(.,~¥~) ....... 59~.thgJ~l .... FOF.~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERbtlT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 9334 Z Permission is hereby granted to: pumuant to application dated ..~.,~: ................. ~,....~j. ....... ~., 19...~t, and approved by the ~, .~ Buildin, g ~ Inspector. ..... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Ao 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: Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board o{ Fire Underwriters. Sworn statement from plumber certifying that the solder ~sed in system contains less than 2/10 of i% 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 "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. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, 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 Buildinm - $100!00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50.00 Commercial 5. Temporary Certificate of Occupancy - Residential $15.00, $15.00 November I , 2000 Bate .............. I ........................... New Construction ........... Old Or Pre-existing Building .......... , ....... 801 Maple Lane. Southo. id Location of Property ....................................................................... House No. Street I Hamlet Onwer or Owners of Property ...... .W~.iteside,,John B. . .................... County Tax Map No 1000, Section...P.6.4:pp ..... Block...0.1:9.0 ............................... Lot 030.002 Subdivision .................................... Filed Map .......... I..Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............. Health Dept. Approval .......................... Underwriters ApprovAl ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.. ~--,Fee ~t~ Submitted: ~ $. ~.0...0.0 ...................... ~~ ~. C~~:~2.. ........... lrOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificate Of Occupancy No. Z80i15 ..... Date ........... l~ov ...1~ ...... , 19.7.7. THIS CERTIFIES that the building located atl~,.0 ,lg. E/S. Maple..La ....... Street Map No. x~ ........ Block No... x~ .... Lot No, . .xx .... Soubhold ..... N.,X ....... conforms substantially to the Application for Building Permit heretofore fried in this office dated ......... June. · ~ , 19.77. pursuant to which Building Permit No. 9331~Z.. dated ....... Jun~ .21~ . .., 197.7. ., was issued, and confonn~ to ~1] of the requir~- merits of the applicable provisions of the law. The occupancy for {vhich this certificate is issued is .. P.~i¥~.te one. ~a~.~ly..d, we~ ll~.t ' The certificate is issued to .Bur. gess &. Do~,eth.y .l~'hite$ide ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... N. ov...1.1t...~ ~77...b!r. IL,..Vil3.a. UNDERWRITERS CERTIFICATE No. per~d~ng ..................................... HOUSE NUMBER ........ Street ........................................... Building Inspector I THE NEW YORK BOARD OF FIRE UNDERWRITERS, · BUREAU OF ELECTRICITY '~ [--- cms 8~ JOHN STREET, NEW YORK. NEW YORK 10038 v,.,e Novembe: 22, :1.977 -~p~'".="o',~'o. onJ'"930494 N 365497 THIS CERTIFIES THAT only the~electr!cal_ equipme_nt as desc_rlbed belou~ and introduced by the applicant named on the above application number i~ the premlses of Bu:gess Whiteside, Maple Lane (p:ivate rd.), s/o Main Rd., · Southold~ L.I. in ~,~/o.owt,,~ zo~.t,o.~ L~ aa.,e.~cnt [] ~.t ~'~. [] '~.d ri.outside sccao, mo~k .... 36' 53' ' 4~ 36 ..... 1 7.0 ~,6 .... l 1.2' J I .... MU[ I OUTLET DRYERS I FURNACE MOTORS I FUTURE APPLIANCE FEEDERS SPECIALREC'PT. TIMECLOCKS J BELL IUNITHEATERS ,v,;,,,. DIMMERS SERVICE DISCONNECT NO. OF ...... OTHER APPARATUS. S E R- V I C -- E AW.G OF CC COND 2/0 NO OF HI LEG OF Hi [J~G , , OF NEUTRAL 2-G.F;Ig" 1-Smoke Detecto: 1-4.Skw. Hot Ware: Heate: 1-17.0 kw. Elect:£c Fu:nace 1-Post Lite m Town Ha:bo: Lane ~/ ~ m ~ThJs ceHlficafe mu~ nof ~e alfered in any manner~ rafurn Jo t~a o~ica o~ t~ ~ar~ J~ incurred lnspecfors ma~ be Jdentlhe~ b~. their credentials.._ Wm H Price Jr G16-477-0130 CONSENT TO INSPECTION Susan Cleveland, Executrix of the,Estate of John B. Whit~s~% undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 801 Maple Lane, Southold, NY · which is show-n and designated on the Suffolk County tax map as District 1000, Section 064.09 Block 01.00 , Lot 030.002 That the undersigned (has) (have) filed, 'or caused to be filed, an applies- tion in the Southold Town Building Inspector's Office for the following: updated certificate of occupancy That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances·'~rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for latlons of the laws, ordinances, rules or ~g-ulations o[ the Town of Southold. Dated: November , 2000 ~ , ' ('sligna~ure) ' Susan Cleveland, Executrix of the (print name) Estate of John B. Whiteside (~i~na(ure) (pytnt name) ~ Ax" TOWN OF SOUTHOLD '/~ /~77 TOWH CLERK'S OFFICE ....... .......................... ............. APPLIGATION FOR BUILDING PE~IT I NSTRU~IONS o. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 areas, and gwing a detailed description of layout ofproperty must be drown on the diagram which is part of th~s apphcoti, c. The work covered by this opphcation may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupor 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 i Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein describ The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (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 build ........................................... ........................................................................................................................ Name of owner of premises ....... ~..~...~.~.~.R../.. .D~:~/~..~) .......... ~.~¢ ..................... If applicant/is a corporate, signa~re of duly authoriz~ed officer. (Name and title of corporate officer) Builder's License No .......... -.~.........~-...~. ........................... Plumber's License No .............~...'~....~..~... ...................... Electr.cian's License No ........ ,~'~(~.~.....-~. .................. Other Trade's License No ............................................... ~. ;~ Lot .J~o...~... Location of land on which proposed work will be done. Map No.: ................ i ............... Street and Number ............ ,-.~..-.~'./~-,.. ....... ~...~. ..................................... '. ............. ~.~... ............... I Municipality State existing use and occupancy of premises and integded use ond occupahcy of proposed construction: a Exisiting use and occupancy ............................ .~...~ ............... ......................................................... b Intended use and occupancy ............................ / 3. Nature of work (check which opphcoble) New Buddmg ...... ~ ..... Addttion ................. Alteration .............. Repair ................Removal .................. Demohhor .............. Other Work ................................................. ~,~"~ 7 ~ (Description) 4 Estimated Cost ................ ./....67.~.~)-.~ .................... Fee .... %...~......--~-.- ................................................................ (to be paid on fihng this opphcahon) 5 If dwelling, number of dwelling units ............ /.. ....... Number of dwelhng umts on each floor ..- ~ ................. If garage, number of cars ........... ~ ............................................................................................................. 6 If business, commerc~o] or m~xed occupancy, specify nature and extent of each type of use ......................... 7 D~mens~ons of ex~stmg structures, :f any Front ....................... Rear ................................ Depth ................... Height ....................... Number of Stories ........................................................................................................... Dimensions of same structure with alterohons or additions Front ................................... Rear ......................... Depth ............................... Height ................... .~. N>)mber of Stories ............................. 8 D,mens,ons of .eNtire new construchon: Front ..... Z.~.'.,C.....~-Z ............. Rear ....¢'.'./.;....~... ....... Depth .~.;2~.... ...... He,gh, ...~.~..-... Number of Storms ......... z~'..~..'~. ............................................................................... 9 S,ze of lot Front ........ ,~..~...~.. ................................. Rear ......~...?...Z ....................... Depth ...... ~...~....¢~... ..... 10. Dote of Purchase ...................................................... Name of Former Owner 1 1. Zone or use dmtnct m which premises are situated ........................................................................................... 12 Does proposed construction v~olate any zonmg law, ordnance or regulahon ............ /~..~.-~. .............................. 13 Wdl lot be regraded ......... #,. /l ,. "~' '~" ......... Wdl excess fill be removed from premises: ( ) Yes ~-..) No ]4 Narrm of Owner of premises/~.../.~....~~ddress ................................ Phone No .................... Name of Archttect ................ .~ ....................Address ................................ Phone No .................... Nome of Contractor Z~,~.~....~.... "~.~ ........ Address .~')'Z/.~:i~)...~.,..~. Phone No. Locate clearly and distmctly alt buddmgs, whether exmtmg or proposed, and indicate all set-back dimensions ftc property hnes Gwe street and block number or description accordmg to deed, and show street names and indica whether mtenor or corner lot STATE OF NEW YORK, ~" S COUNTY ~ ,. ....... .~ ....... .~....f~' ......... ' ~ ''~.4~...,~.../r~'~.. ......................... be,rig duly sworn, deposes and says that he ,s the apph, (Name of indiwdual s~gning contracf) above named ~_.~ .~ .~j~. He ,s the ............................................... ~~~ .... ~~ ........................................................... (ContracYor, agent, corp~a~ officer, otc ) of so~d owner or owners, and ~s duly authorized to perform or--have per~ormed the sa~d work and to make end thru apphcahon; that oH statements conto~ned m thru apphcohon are true to the best of h~s knowledge mhd belief; thax the work will be performed m the manner set fo~h m the opphcotion filed ~erew~th ~ Swor~to before me th~s ~ ~'-- ~ ~J[~C(C~- ~ ~ ...... :.:::...".:.: ..... ......... .............. ~0T~Y PUB~ Stat~ of New Y~r~ ~o, 5Z-4643~1, S~ffol~ Cou~ ~rm ~p~res March 30, ~9~ R~VER~AO,ItY. MaP 0#' PR OP£1;!TY ,/ ~5ou T.N/OL L2 / ? ©/U~- , ~' Ar'£¢7: ?/, OO6 f 6'¢. SUI~rOLK COUNty HF~L~H ~he sewage dis~o~,,} a~d water Supply facilities ',. -- - ~_,.ion have been inspected b/ ,.,.. ;~ ~Pa,'~ent and found to be sa~islactoz.~~ ~' Chief of General ~glmeerim~ :I~C"I'ION 7~0~ O~ 1F~ N~W ¥o~' JOfll$ O'F THIS ,9,JIIVE¥ MAP NOT ~ Gflti TO l'-'r,~ ~i~ON ~0~ W~OM IH~ /I M. aP OF 1:)~0PEt~TY ~OU T~' oLD ~V/-/I 7-E J t D E ~'o~ cou.~Y ~Ea~,T~ D~ The sewage dis~oz~-~] a~d ~a%8~ supply facilities f~ · .... .)u_~,ion hay8 b~en inspected b; ~--~ d~p~c~mon% a~d found Chief of General ~glaeerl~S I.~ /VOteD 4T o~ '/ // , / DONALD A. DENIS A.I.A,~ ARCHITECT / / .Il ~ I1 I) t \ , ' ~ t~. ~'-r'"-t"~- ~ © ,:¢:, ~ ..................~ L... ~. f'¢~ 'l k - !