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HomeMy WebLinkAbout9154-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, H,. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9154 Z Date ............................ ~1~ .......... 3.'~ ....... , 19....27 Permission is hereby granted to: ~r~I:~:....~ e, ~,...,,T~ez~J~ ~ ....................................... ................ .~n,4...~..~ .......... ~f~.tJ..~.u~ .......... rob~tld new one fam. ily dwel~ at premises located at ....~../.~...~?...t...~..~....`~..x.e........(.....~.:..t.~9.e.~..~.~..q.~?...~.~.....~..~.~.~.~..~..~) ................... ............................................ }fe,~.C~,.C.~e~ ................................................. - ............................................ pursuant to application dated .................. ~.,~,Z*.....~ .................... , 19...~.~.., and approved by the Building Inspector. Fee $.., .;: ................ * ' - Budding 'Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1, Final survey of property with accurate location of ail buildings, property lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept. of water supply and sewerage disposal-(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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusua~ 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 informa- tion required to prepare a certificate. Co Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date., New Building ............. Old or Pre-existing Building(X); .......... = ~Vacant Land ...... Location of Property, ......... . ............. House No. Street Ham/et Owner or Owners of Property ..... ~.c~. ~... ~':~. .............. ,. ....... County Tax Map No. 1000 Section ..: :-).~'.;~-~ .... Block .... ,~..( ....... L0t....,........... Subdivision ................................. Filed Map No ...... ..... Lot No .............. Permit No ~;:'/~":~/T~. Pate of Permit ./'., ~Applicant Health Dept Approva:~/~. ~ .~../~Z/' .~.~.'.~.~..~':. Labor Dept App rova, ~/~. Unde~riter~Approv~.~'~¢'2. .... ;~:~ PlanningB;ardApprov~l"~/~. '...........~.., ................ Request for Temporary Certificate ..................... Final Certificate ................ * Fee Submitted $ ............................. Construction on above described building and permit'm~ets/elll appl~cable~codes, and regulations. ~? ©, -~ 1110~ --. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ,j~S a5 JOHN STREET, NEW YORK, NEW YORK 10038 V.te February15, t¢7e App,ic.tio..~o.o. Sil~ 9370e3 N 375297 THIS CERTIFIES THAT only the electrlcal eqhlpment ~ descrJb~ below a~d int~duced by the appllcant named on the able application number in the premises of Mr~ Tahir Deniz, Sound Ave., 200' e/o Factory Ave.,Mat~ituck, L.I. Ist FL ~ 2nd FL , Section Bilk ~t in the>llowing h,catlon: ~ Base.tent ~ ou*sl de ~a~ ,...~i,*d o, Feb r u a ry I 3, I 9 7 8 andfound lo be it~ compile.ce with the requirements of this Board. RXTURE' FIXTURES- RAISES OVENS SYSTEMS NO. OF FEET E OTHEE APPARATUS: E R v PER ~ OF CC CC)NO 4 ~ OF HI LEO Motors: I-I/2hp I G.F.C. I . I Smoke detector C Waiter Kronimus 111 Elsenhower Drive East Quogue, L.I. 11942 Lic. 1965E Per D This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by AW.G OF NEUTRAL 4 Exomined ~7,,'[' 6'.,'~ ~' 19..'~,i~. prov ................... '..! ...... ...... , TOWN OF SOUTHOLD BUILDING DEI~ARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Yo Application Porm t ........ ..................................... · -: ....................................... ~/~ Id~ ~ I~ / ~(Building Inspector) ~ ~'~~ t~ -- " ' v' a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicete to the Buildin~ Inspector, with 3 sete of plans, accurate plot pl=n to ~=le. Fee =ccording t0 schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to odjoining premises or public streets o~ areas, ~nd ~iving a detailed description of layout ofproper~ must be dr~wn on the di~grom which is pa~ of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon qpprov~l 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 Ce~ificate of ~cup~ncy sh~ll 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 Bu Id ng 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 ir~ buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ~...U~r/..~ .~.". j-5..." ' .............................................................................................................................................................. Name of owner of premises ......... .~...,,~l../.~.~,z~. ........ (,~..,X.J.J.~....,...~.Z.--~.z'~.../...~ ............................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ Plumber's License No. ~ Electrician's License No. ~ 1. Location of land on which proposed work will be done. Map No.: .., ......... .;......z...,.~/\ ............. Lot No.../d.~./~.~ Street and Number ..,~.d2.'~..,~.~/......~..l~..(.~/'/.~..d?.7/~..~.~.~.~.-,'~.~.:.~-.. .................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....................................................... ; ........................................................................ b. Intended use and occupancy ....... ~¢Z.~.~Z'~../.~..~. ......................................................................................................... 3. Nature of work (check which applicable):~_ew B~[Iding~' ................ Addition .................. Alteration Repair .................. Removal .................. Demolitior, .................... Other Work .................................................... ~'~ "~ .5~ 0 (Description) 4. Estimated Cost ,~..../.,~....~..~.~....'7...:: ............... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ./ .................. Number of dwelling units on each floor ............................ [f garage, number oF cars ............................................................................................................................................. 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 ................................ · -, / Depth ..~,k,~, ............. 8. Dimensions of entire new construction: Front ...,,~.~ .......................... Rear....~-z2 ................. Height ..~..~:~..../. ...... Number of Stories ........ /'. .......................................................................................................... / 9. Size of lot: Front ......./--'~'~'l"/~'":' .......................... Rear ................ Depth ...../(..~..~'2.~..~',~....X.. 10. Date of Purchase ....... / ..... ~9....~.~.....~..,~'.....7...7.. ....... Name of Former Owner .....~,....~..~.4C~'.......,~.~..~..,~.. ...... 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ,x~.~.. ........................................... 13. Will lot be regraded ...../~.42. .............. Will excess fill be removed from premises: ( ) Yes ~-'~ ~o__~ 14. Name of Owner of premises .~.~/Z/~.....~..~tZk'..~.~eT//~.../.~.. Address ~.~.~,~.~....*..~..~:.~... Phone No. Nome of Architect .............................................................. Address ................................ Phon~ No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... 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 NEW ¥6RJ~'/~/~ ,, ~ c S COUNTY OF .>,~~.....~"~' .................... .~../4'.y~..//,.~....~'~4~..Z~......,'~./~..~.,,,~ ............... being duly sworn, deposes and says that he is the applicam (Name of individual signing contracr~ abow, named. 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 th. ar the work will be performed in the manner set fo~h in the application filed therewith. Sworn to ~e me this ~ a _ ..................... ............................. JUDITH T. TERRY ~ ~gnarure or ap~ant~ Nota~ PLiblic, ~'a~9 of Ne~ York No. 52-034~gb3 Cu~ o k Co~mission Expire~ ~,~3rCJl 30, 7EST HO£E top soil UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY ISA VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.- COPIES OF TN S SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. -- GUARANTEED INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE ~OMPANY~ DOVERNMENTAL AGENCy AND LENDING INSTITUTION MDTED HEREON~ AND TO THEASSiDNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INST)TUTIONS OR SUDSEOU~NT OWNERS. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS. THE WATER SUPPLY AND SEWAGE DIDPOSAL SYSTEMS FOR THIS REDIDENCE WILL CONFORM TO THE STANDARDS OF TRE FFOLKwCOUNTY DEPARTMENT OF HEALTH SERVICES ~ ~ _ APPLICANT~_ __ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY NOTES: I-~ MONUMENT D: ST~KE NEAREST WATEB MAIN $ MI&ES WA~'ER SERF/CE-PRIVATE SURVEY FOR: AYTEfl DEfllZ AT MATTITUCK Tow. OF SOUTHO£D ALDEN W. YOUNG, ENGINEER AND LAND SURVEYOR SUFFOLK COUNTY, N.Y. ,OWARD W. TOUN*, LANDSURVEYO~ YOUNG 8~, YOuNG, LAND sURvEyORS ~400 OSTRANDER AVENUE RIVERHEAD, NEW YORK DATE:/ISCALE ,, · N0. 4UG. 20,1975f , =40 TEST HOLE DoW or'formerlY Fred Hell UNAUTHORIZED ALTERATION or ADDITION TO THiS SURVEY ISA VIOLATION OF SECT ON 7209 OF THE NEW YORK STATE EDUCATION LAW - COPIES OF THIS SURVEY I~AP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY· -- GUARANTEES INDICATED HEREON SHALLRUNONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL ASF. J~C¥ AND LENDTNG iNSTITUTION LISTED HEREON~ AND TOTHEASSIONEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR PROM DATA OBTAINED FROM OTHERS. lHE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF TRE SUFFOLK COUNTY DEPARTMENT OF HEALTH APPLICANT: .... , ~he a. ewag~e .dt,l. pcsal and ~ater supply et: ;eae~at ~Aa~e~ NOTES~ I-~ MONUNIE NT E~: ~TAKE NEA.REST WATER MA/IV $ MILES WATER SERVICE-PRIVATE WELLS SURVEY FOR: TAHIR DENIZ AT MATTITUCK · O~NO~ SOUTHOLD GUARANTEED TO: suFFOLK COUNTY, NY ,.,.B.L,C.,O. ~ YOUNG ~YOUNG, LANDSURVE¥oRS !400 OSTRANDER AVENUE R]VERHEAD, NEW YORK DATE. SCALE ,, ~ NO, k/AR. 24/g82 f '~40 82-