Loading...
HomeMy WebLinkAbout9612-zFOF,,M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy No ............. Date ............................ , 19 .... Z9055 June 9 78 THIS CERTIFIES that the building located at ............................ Street Map No ............. Block No ........... Lot No. /450 Knollwood Lane conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... , 19 .... pursuant to which Building Permit No ......... ., 9612Z dated .. J..~.u.a..r~....3.°. ...... ,1978 ...., was issued, and conforms to all of me require- ments of~%~p~icabl%lprovisions o~he law. The occupancy for which this certificate is issued is ........................................................................ The certifieat~ i~l~[~t~t~o ~..F..A~4. !L.Y..D. ,w~..L..I.N~.... !W~.TH..A.T..T.A.C.~. ?..A~...G.E. ! ..... Daniel Sullivan (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... May 25, 1978 ---7-S0-190 UNDERWRITERS CERTIFICATE NO ............................................. N 588797 HOUSE NUMBER ............. Street .......................................... ~450 Knollwood Lane Ma~c~ci'cuck, New York BUiLDINg TOWN CLERIC'S OFFICE SOUTH'OLD, N. Y. BUILDING ,PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 9613 Z Permission is hereby granted to: .~.I~. C~'..L:.( ........... ': .......................................... ~ ~t,f /:L ..~U ZL, I ..... 1~. ...... ~: ......................................................... at premises located at ......... /.'zi...~.Zc ..... (~.~(.~).~:./:...~(..0.(.~..~.. ~ ./. ). ~ ./ tf~. ................................... Building Inspector. Fee FOI~ NO. 6 TOWN OF $OUTHOLD Building Depaltment Town Clerks Office Southold, N. ¥o 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, in triplicate to the Building 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 installations, (3 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 o'f 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 3. Copy of certificate of occupancy $1.00 $5.00 Date New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ ro . O. n,_, ..... Location Of Property .......... ..~ ............................................................................................................. Owner Or Owners Of Property ............ '...~...~ ...... ~..?...~...l~.~..~.....l~..~ .................................................. J Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No...~..~.~.. ......Date Of Permit ..!l./.!.l...~...~..,Applicant ......... ...~.....~...~...'~....{~'.....~.....J. ............................ Health Dept. Approval ......... ."]~....O....!..?....O.. ........... Labor Dept. Approval ................................................ Underwriters Approval ......J~....,..~....~...~....~.,.~.~.. ............. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ......... .~'.......~.... .............. Construction on above described building end pe~_.~z~~cable codes and regulations. Applicant ..~~~ ..... . .. . Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS pet BUREAU OF ELECTRICITY ~--- JOHN STREET, NEW YORK, NEW YORK 10038 8S THIS CERTIFIES THAT only the e/ectr/ea~ equ/pm~t as descr/bed be/ow and/i~troduced by the ~pp//eaat named o~ the abo~e app//ea t/o~ number ~t tlmpremises o~ D. Sulltvan. Knollwood Lane~, ~f Or&nd Avo.~ F~tttltuok. L.~. June 1, 1978 a.xt/ou~dtobel, co.rpl~a~ce with the require.~e.ts o/ this Board. RXTUI~ LECEPTACLESl SWITCHES I FIXTUEEE RANOE~ ICOO~INO DE~KS [ OVENS [DISH WASHERS EXHAUST FANS I 100 CB x 1 3 1 OTHER ~A~TUS: Moto~/s:l-F 1-Smoke Detector Walte~ Zlnger P.O. Box 991 Mattituek, L.I. 11952 This certificate must not be altered in any manner; re~urn to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ~ MANNER. WILLIAM J. CLARK ATTORi~EY AT LAW June ~2, Mr. George H. Fisher Building Inspector Town Clerk's Office Southold~ N.Y. ~197~ Dear Mr. Fisher: Re: C/O Z 9055 Daniel Sullivan In accordance with our telephone conversations I am returning the above captioned Certificate of Occu- pancy. Kindly issue a corrected certificate indicat- ing ~ addition of the attached garage. WJC:er enclos. Very truly yours, William J]~O~rk TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN ~LERK'S OFFICE~/~do~~ t~ proved ........ ...... ........... ..................................................................... .. .= ........ , /'~' ,,-· /_ ................... ../...~.,.~...../......../...../~..~~'¢~, (Building Inspector)' APPLICATION FOR BUILDING PERMIT ~ Date ....;~.:.~ ........ /....../. .................... , 19.Z.;i ...... [:~ INSTRUCTIONS a. This application must be completely filled in by typewriter oc in ink and submitted in triplicate 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 o~ areas, and giving a 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 perm t shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used Jn whole or in pa rt 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 ar 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) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~..; ; If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No ....... ~.?~.~x.~,......l~.t.~.~,,~.I ...... El~ctricion's License No. .~v,x~.~:,~.~,.~.~....t~,.t.~,f~..t.~,~.'~ Other Trade's License No ............................................... 1. Location of land on which progosed work will be done· .M(~ No.: ............................. Lot No ..... 1¢~o~.~.~oo~ I.../4, . ~/~'1--~C;~ ........................ btreet ana mumDer Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy /~'/~'/'~ ! b. 'ntendeduseondoccupancy ........................ "'~'~---'-,,,~,,,,/~,,./....t~....?,.. J~-~l~..)~.t--~. -~'"' . . . 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................... - (Description) 4. Estimated Cost ...........~.....?..~..~ .......................... Fee ............................................................... (to be paid on filing this application) I 5. If dwelling, number of dwelling units .....j ...................... Number of dwelling units on each floor ............................ If 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 .........~.~..J~,c..~lJlLl'6'r ................................ Depth .................... Height Number of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear .......................... Depth ................................ Height ............................ I~lj~J:~, of Stories ............. 8. Dimensions~,~,lof entire new construction: Front .................. 3--~ ................. Rear ............................ Depth ........................ Height .................... humbler o,~,f Stories ........................................... [':4:';~ ............................... 9. Size of lot: Front .............. t...O.....~. ......... Rear ..~.. ... Depth .......I '~ ....... 'f.. 10. Date of Purchase ........................................................ Nome of Forz'ner 9Whet ....................................................... 11. Zone or use district in which premises are s tuated ...~.. 12. Does proposed construction~.~,,,~violate any zoning law, ordinance or regulation: ................................. ~ .............. 13. lot be regraded ......... ..r~.~..~ ....... Will ~,xcess fill be removed from Pre~m~ises: ( ) Yes ( ) No 14 ........ ,~- u ........ ~ ............................ : ................... w' ~aaress ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....: ......................... ~L.~....(~.. :.. .. ......... Address ..~S~..,,'rz.~...~.~...~..£~,. Phone No~,~JT...'.,~..~.~.~i. PLOT DIAGI~M 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 indicaie whether interior or corner lot. STATE OF NEW YORK, ~¢ COUNTY OF ................................ ~ ~'"~ ......... '~"J'~,~...-.~.;-.~O~4~..~:-~J~,e..~,., ..................being duly sworn, deposes and says that he is the applicam uNa~ at inaivi~u~l~gning contracf) above named. (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 tha~ the Work Will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~g~l~ ~u= ~ ~ture of applicant) ~ e o~ New o~ former fro ~¢ier' KNoL. L TITLE NO. 77-5~18164 APPLICANT. _ ADDRESS TEL oo~ formerly 40( 17o REVISIONS MAY2$, 1975 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG 'SURVEY FOR: DANIEL SULLIVAN 6t MAFCGAt~ETSUIIIVAN AT MA TTITUCt¢ GUARANTEED TO: USLIFE TIF~E INSUR, ANCE COMRAI/Y OF 'TOWN OF ~SOUTHOI D ~/Ew ro/~ SUFFOLK O. ~ ~*~'~C SCALE: / "= ~0 now ¢. r,o¢ Or foreerl¥ IZO ~reO THE LOCATION OF WELLS A~/D CESSPOOLS SHOWN HEREON ARE FROM FIELD ODSERVATIONS AND OR FROM OATA OSTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTemS FOR THIS RESIDENCE APPLICANT: __ I -- ADDRESS TEL ...... SUFFOLK COUNTY DEPAR?MENT OF IIEALTH SERVICES DATE APPROVED 0© FOR APPROVAL OF CONSTRUCTION ONLY formefly now Ff. G\ DEC 29 AM ¢NoL. bW°°p NOTE ~ W = I~ONUI~ENT THERE ~E NO DWE~IN~S WITHIN I00 ~ OF THIS PROPERTY O~ER ~ ~OSE SHOWN HEREON WA~R SERVIC~-PRIVA~ WELL lO 87 REyI$IONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALE)EH W, YOUNG HOWARE) W. YOUNG SURVEY FOR: 2,4/VIEL SULLIVAN E~ M~G~ET SULLIV~N %T GUARANTEED TO: M~ TTITUCK USt/FE r/~ /~SUR~CE ~MPAN~ OF ~OWN OF : *SOUTHOLD l~w roux ~1~ ~ ~ ~ IIOTIFY BUILDING DEPARTMENT AT - '76 5 ~ g"O~9,~M ~o 4PM EOR REOU~r~- ~ ED INSPECTIONS: '~'- ' ~1~ 1, BEFORE "ACYFILLING FOUI~4DA- , ~ ' ' 4. FtHAL WHEN J~ ¢OMPLE'I',E..D R!r',;f-~t.:,- . ' ~. £T,'.'i~'~S~ -_~_, _??~_~ ......