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HomeMy WebLinkAbout9656-zNO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z9275 Date October 30 19.78 THIS CERTIFIES that the building located at .7.0.0...R?-.-~/~.~?.o0.d' .D..r.. ......... Street Map No .... 5240 .... Block No ........... Lot No ...... .12 .......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ... April ..... ~. ...... , 19..7.8 pursuant to which Building Permit No .... 9..6.5.6.Z dated ... April ..... .4. ......., 19.7.8., 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 ......... ~.rivate. On.e .Family. Dwelling. .............................. The certificate is issued to ........ Robert. Lil~cl~hult ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....... * UNDERWRITERS CERTIFICATE No .......... N/40578.1 ........................... HOUSE NUMBER ..... .Tp.0. .....Street ....... .R.o.s..e~..o.o.d...D.r.i.v.e. .................. Mattit.u. ck~ New York Building In§pector · High Nitrates - Water not to be used for preparation of baby formula or consumption by infants under 6 mos. of age. County TaxMap # ** Second floor non-habitable, will require a Building Permit to finish second floor. TOWN OF SOUTHOLD ~ DEPARTMINT 'TOWN CLERK'S OFFI4~ SOUTHOLD, N. Y. BUILDING PERMIT (THTS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9656 Z Permissian is hereby granted to: ~rsuont to oppl~otion doted ............................. .~. ................... 1 ....., ond Qpptove~ by the Building Inspector. Building Inspector FOltN[ NO. S TOWH OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application rnust be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the fallowing; 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 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, 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 oil property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner os 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 certlficofe of occupancy $1.00 Date ....... /..~.::...~.,.,~.:. Z. ~.. ............ New B~ilding .......~dition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~,/..~.....,'~...o..~..~,T.,W,o,.~.&...~,,C~, .............. ,,/~,~..~:,..,,~,,(.,~.,~,'.?;,,,,'~,....,/~,., ,~,,, .............................. Owner Or Owners Of Property .....~-./?;: ..~./'~ Subdivision ..'~:~.V~..~',~,..~..~,....,.~.~/,,~, ................ Lot No.....~..,.,;~, Block No ............. House No ............. Permit No..,.~L~,': ,~..~.~,,..o Date Of Permit ....~-/-.~ -/~..,.Applioant 7 -~7----- Health Dept, Approwl ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate .......................................... Fee Submitted $ ..,~.~,~(.~ ..................... Construction on above described building and permit meets ~11 applicable ~odes and regulations. Sworn to before me this , ..... day of ............................ ......... I~OTARY PUBLIC, Slate of New York (stamp or seal) DEPARTMENT OF' HE. ALTH SERVICES The attached approval was issued sub?eot to the notation ccntaf_ned .©ur approval s~vq). Would you please t~Te the foi!ow~:g cendivion approval oH the f~nal C of 0 as this ~11 ensure tha~ any future %~11 be made aw~re of the niLrate "Private well with hmgh nitrates- see asa±th Department. note on .~a~. _ su.,~,,*~y~ ", · ~hank you~ Robert A. Vi~la o. E, THE NEW YORK BOARD OF FIRE UNDERWRITERS No. o. f,,. N405781 THIS CER'rlFIES THAT 22 3P. 18 22 DRYERS FURNACE MOTORS RJTUIm AJ'~AHC;E FND#S I ~ 2nd Fl. Section Block and found to be in compliance with the requirements of this ~oard. ~A= 2 'COOKING DECKS [ O-- 'DISH WASI4JRS 12 EXHAUST FANS DIMMERS 1 1/0 Oakhurst Electric Const. Corp. P.O. Box 83 Sound Beach, L.I. 11789 Llo.822-E This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Inspectors may be identified COPY ?O~R~ B~UUILDING~D~ARTMENT. THIS COPY OF CERTIFIC~AT~E MUST NO~? B_I ALTIR~~ AHY MAIINER. TOWN I-IF E~OUTHOLD T~]WN OLERK'S OFFIOE SOUTHOLD, N. Y. 119~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. No. - roved L/ ... Z ............................... /~Pp .................. ..~.~.--....../..., lY ........ rerm,T J'~O ..................................... Disapproved a/c7'~~.. (Building Inspector) APPLICATION FOR BUILDING PERMIT / ......... ........................ , INSTRUCTIONS a. This application must be completely filled in by typewriter or, 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 qdjoining premises or public streets o~ areas, and giving a detailed de~cripti0n of layout ofproperty must be drawn ah'the diagram which is part of this application. c. The work covered by this applicatJon~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 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, end 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. / '/-7--- Nameof owner of premises ............... ¢~........¢. ........ ~:~ ............................................................................................................. if applicant ~~., signatureofdulyouthorizedofficer. (Name and title of corporate officer) Builder's License No ............~.~....~.....~....(.~.:..~ ................... Plumber's License No .......... ...~....~.~.....~.. ............... Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which~r~pb~e---d'~'O~ will~/' IP ~,be done. Map No?t~Sz,~..,..~.,~.~./., ....... Lot No ...... J.~ ......... Street and Number ...... ..~T...J.'..~JJ.....'..~:~.(~.~z.'"L~...,.D... '.~........L)..~ ......................................................................... Municipality 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 ............................ ~ ......................................................................... 3. Nature of work (check which applicable): New Building, .....~. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, .................... Other Work .................................................... (Description) 4. Estimated Cost ..... ..~...'.~.,..C~...0...~.'...O......C:~... ...................... 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 ........~..~!. ............................................................................................................... 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 ............................ Dept~ ................................ Height ............. .N~mber of Stories ...... :~ .............. 8. Dimensions of entire new construction: Front .....~...~ ......................, Rear .,.i...~ ............. Depth ..,...~T......f~.. .......... Iqeight .~.~....~....~ ......... Number of Stories ...... ~....~-.~-..Q-~....-J.I/...~..,.....L~..,~.~..,,~'-~.c.~..~i.~.,' ............................. 9. Size of lot: Front [ .~. ( Rear ( -~.~.,.: ................... Depth 10. Date of Purchase .,~ ............... I...~..-Z...-Z. ........................ Name of Former Owner ........................................................ 11. Zone or use district in w,hich premises ore situated .)~ .............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ .~...,.O.. ................................... 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes (~o 14. Name of Owner of premises .~g,'~'......~...!..~..~..~...¥'..I.~.., ...... Address .~.~,.,~,J~....~... Phone No ....................... Nome of Architect ,J~..JVXl~.~.~..'ml~,~(.......~.~...~..'~- ............. Address .~,J.~,..L~.(~'~...%;-l~hone No. Nome of Contractor A.J~l,.9...~..~.~...cl.~,.(.....~'_~ ..... Address ..~....~..~.~.,..~.....~.....~. P*-hone No...~..~..~...2_,/..?.~ PLOT DIAGRAM I_ocote 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, S]'A'TE OF NEW YORK, [ c ¢ COUN'r¥ OF ~.'~..~. ~__'~-_"~D '~V¥ ~.~_~.~.,,.~ be ng duly sworn, deposes and soys that he is the applican~ (Name of individual signing contract) ' above n~med. He is the ~O~~. 7, ......................... (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 st~tement~ Fogtained 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 ~re me this .......... i i'o{ opp cant) t~/O/¢ section ?. Cy cf the N;~w York Stero Educahor~ ~ ~,, Copies of ti,is rurvc7 r, Top Ilot bea;tr[] t(~ Im~u o,~ ~ subsequent owners, COX:NECK 0 APPROVED SURVEY FOR ROBERT L.I TCHHUL_T AT MA TTI TUCK TOWN OF SOUTI*-iOL. D SUFFOLK COUNTY, N.Y. SCALE: 1"--30' MARCH 27, 1978 COUNTY iTAXMAP REFEI~ENGE ' M/O'R~EWOOD ~$TATE$ FILED JAN. 24, 1969 FILE NO. $240 ~JARANT~ED TO ' 141 so¢~ o~ embos&e~ sea~ *hail ~ot be considered to be o or cc t,f,cot~ns 'are not transferabJe to addihona[ inditution~ ~ COX NECK LANE C) ,O.56'¢o°° COU]'fTY D~zAR.L,~,:,.,~. 0.? H:~uS_'!{ SERV] FOR APPROVAL Off ~ .... ;,.":. ',70N ONLY \ The water supply & sewage disposal ][$ DZE?. NO. ~ \ ~ems for th~s residence wrtl contorm to t~ ~_ ~_~ ~ Standards of the Suffol~ Coun~ Depa~ ~ent of Health ~0~ .... SU/~VEY FOR ROBERT LI TCHHULT M/OltO$~wooo FILE N¢. ~High Nitrates -Water not to I preparation of baby formula or consumpt~ by infants under 6 mos° Of Unauthorized alteration or Sdditlon to this survey is a violation of section 7209 of the New York State Education Law. Copras of this survey map hot bearing the land surveyor's inked · seal or emb6ssed seal shaft not be consldored to be a valid copy· : ~r cerl~flc~tlons ind~cmed hereon sha~ ~un only to th~ p:~rsc n ~or whom the surve~ is prepared, an~ on his behalf to the ttlb company, governmental( agency and lending instilution listed her~n, and to the assignees of th~ lending insfitutiom Guarantees or certif;cat~ns are nol lrqns~erable to additional institutions ~ ~/o/¢ v,A~ COX NECif LANE ROBERT J. a MARG~RET~k~'~[~T' ~ ~oW~ O~ sour~co ,, ~*~ ~' *~ ~ LEVAT I o '~ 7~-/~ 765-2660 ~AM to 4PM FOE REQUIR- ED 1~SPECTIOHS: I, BEFORE ~ACKFJLLIHG FOUNDA- {21 I // II