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Home My WebLink About11954-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12537 Date June ~1 198.6.. THIS CERTIFIES that the building One family dwelling Location of Property 660 Alois Lane Mattituck House No. Street Hamlet County Tax Map No. 1000 Section .. ! .2.3 ....... Block . ...6 ........... Lot ,P../.0..h. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .... ~ ¢ p.~.... 1 7 ......... 19~. 2.. pursuant to which Building Permit No. ! .~ .9.5. 6. .Z .............. dated . .O.c.t.....6 .................... 19B.2. . , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ~.9r a..o.n.e c..a.m.~.y..dy.e.Z..~.~.n.g. Robert G & Renee M. Lauriguet The certificate is issued to ..................... of the aforesaid building. Suffolk County Department of Health Approval .. ] ¢ ~.(g 9 9 ..... 4. [.2.6./..g .~ .................... UNDERWRITERS CERTIFICATE NO ..... ~;N606701 6/16/83 Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF $OUT~OI~) BUILDING DEPARTMEN* TOWN ,HALL SOUTHOLD, N~ Y. BUILDING- FE~!T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ULL COMPLETION OF THE WORK AUTHORIZED) i ~ N? 11954 Z Date ' ~i ........ ~. ............. 19.~..ga? Permission is horeb¥ 0ronted to: at prem~seS located at ... .~ .... ~.....*~ pursbont to application dated ~~.~ ,,1 and ~pproved by the B~ildlng Ihspector. ' ~: : Buildsng In~ector Rev. FORM NO. 6 TOWN OF $OUTHOLD 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 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 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 unusual natural or topographic featu res. 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. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use --?z~e-E×~-sf,±ng C. 0. $15 · 00 3. Copy of certificate of occupancy $1.00 ~'acanf, land C.O. $ 5.00 .... ...... New Building .... '.~.'...... Old or Pre-existing ~uilding ............ V,acant Land ............ ' ation of Pro-er, · LOC id y · ~.-. ,~ .......................... ~1 ........ House No. Street Ham/et Owner or Owners of Property .~.~.0~...~......~. ~)~ZD.~..'~.... ~'_~.' ..... ~1.~' ~.~ ~ .... County Tax Map No. 1000 Section .... l~.~.. ...... Block ...... ,~. ...... i'~;.ii ,~//~.~,... Subdivision ................................. Fi{ed Map No ........... Lot No .............. Permit No., ~' ~6- ~) ~l'! .~..~.~'.~-~-. Date ofj ,Permit /.8/~./~.o~, .Applicant .~.~.~ .~.:.. ~,,.a.L~.(.~ I~.,.~ .~J..~ . .~./.o~...~ ~...~ ........ Labor Dept. Approval ........................ Health Dept. Approval ..-.. _ ' '~'//~./.~. ~. ........... Planning Board Approval ...................... Underwriters Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ........ . .~.~. Construction on above described building and permit meets a, II apJ)licable coders and regulations. ¢' FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ................... , . . . Subdivision ................. Filed Map No ................. Lot No .................. · .~.-.~. ...... c:~-,~,~...,:...~.:.~:~:. .... ~.*~-.~,..:.~.. ............. · Buflding Inspector /80 ioooisi THE NEW YORK BOARD OF FIRE UNDERWRITERS I~UREAU OF ELECTRICITY THiS CERTIFIES THAT only th~lectrical equipment as described bel~ end introduced by t~ applicant ~a~ o~ tl~ ~v~pi~cotion ~mber i~ the prendses of ~ ~i~uet, 'lois ~e off c~p ~in~la P~, ~titu~ N~ . ~oS exa~i~ed o~ ~10 l~ ~ l~ m~d found to be ~ compJlance wi~h the requirements of ~his Board. FIXTURE OUTtETS ~7 SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST I~ANS ' DRYERS FURNACE MOTORS APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R OTHER APPARATUS: 2~G.F.C.I. 2-~h~ke D~te~%ors I C E NO OF CC COND, A W O NO OFHI-LEG A W, G INa'OFNEUI'RALS A W, G PER J)' OF CC. COND. OF HI LEG OF NEUTRAL 1 3/0 / i 310 Box 243 Lic, 459. This certificate must not be aJtered ir~ any manner; re, urn to the office of the Board if incorrect. Inspecto?s may be i~ li their credentials. COPy FOB pUILD[pG DEPARTMENT. THIS COPy OF CER~TIF~C~T~ .,,I,,~,~O~ ~J,~T,.~,,E~L~,TE~I~Eo I~ AN~.~ MANNER. ~'IELD INSP~CT~-¢)k~ ~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY GODE FINAL ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT. INSPECTIrON- [] FOUNDATION 1ST ~ ROUGH pLBG. ]] FOUNDATION 2ND[ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE_ INSPEcToR~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND £ ] INSULATION [ ] FRAMING FINAL I ? · C (' FORMNO. 1 ~'~'C.~ '~ ~ ~.~-~ TOWN OF SOUTHOLD ~-~ ~-~.-J~<~ . BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ,,, roveda c . . . . . . . ........ ....... .......... · ~PLICATION FOR BUILDI~ PERMIT / a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Nee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 Bulldhig 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, build'm.g code, ho~l~ing code, ,and regulations, and to admit authorized inspectors on premises and in building for necessary~.~. State whether applicant is own,r, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................. ~eme o~ owner of premises .q~ ,~,T, , ,~, , ~.~ ~. . . ~',~ ........................ (Name and title of corporate officer) Builder's License No.~. ........................ Plumber's License No. ~.. II .~.~.f~..~.~..~}~1~.. Electrician's License Sc~..~ ~...~. E..~ ~/~.: . ~f. .i ..~[~ 'r ¢ '4 .~c~ Other Trade'S License No ...................... 1. Location of land on which proposed work will be done..'J~. .................. .. . House Number Street Hamlet County Tax Map No. I000 Section ..... t .~..~. ........ Block./o ............... Lot. ~)/~..~. ........... Subdivision ........ . ............................. Filed Map No ............... Lot ...... · ......... (Name) 2. State existing u~ and occupancy of premises and intended use and occupan, cy ofproposed construction: a. Existing use and occupancy .... · ' 3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration Repair ....... 'e~ .... RemOval__ .............. Demolition ............. - Other Work ............... 4. Lstnnated~ Cost'~.~. 0'-07)' ,~2, ;7Z~ -~ ~ (Description) , . ...................... ................................ i (to be paid on filing this application) 5. If dwelhng, number of dwellinglunits ............ Number of dwelling units on each floor .... If garage, number of cars .... : .b%~ .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Dim i f if R pth · ensonso existing structures, any: Front ........... .... ear .... ...... .. .. De ............... tleight ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ............. ' Rear .................. Depth. .................. !.. Height ......... 4 ' ~ .......... Number of Stories ...................... 8. Dimensions of entire new construct/on: Front .r~ 7 . Rear '7 *7 t n~,,*h .~A-> Iteight ............... Numberof Stories i'' :i i,i ..... i i .i'i:iiiiii": '-.;- ............ 9. Size oflot: Front .... ~:~.3]i' ........... Rear..~.~.'~ ........... Deptt;' ''/.~(7'~ ............ 10. Date of Purchase . .~"'.~/~....{.q~. d~..' ............ Name of Former O~vne;' h' )~2 ~"~'~.;.~i .~ 1 1. Zone or use district in which pr~mises are situated ............................. ' ........] ................ 12. r)oes pxoposed construction violate any zoning law, ordinance or regulation: ........................... 13. Will lot be regraded .... i .................. Will excess fill be removed from premises: Yes 14. NameofOwnerofpremises ...2 ................. Address ................... PhoneNo ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor : . Address ................... Phone No.. PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lifies. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ........ ~ being duly sworn, deposes,(Name and says that he is the applicant above name~. He is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly autho~zed to perform or have perfomed the said work and t0 m~e and file this application; that all statements cont~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ~o~g~. ~,~ Vbr* ~ ' (Sign~ure of applie~t) IJ~E IS ~NLAWFiJL WlTi,I~;'[ CERTIFICATE OF OC~lJ?ANC¥ FEE~Z~O~. : NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING ItdSPECTIONS: '1. FOUNmATION ~ TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ~. [NSULATI'~N 4, FINAL - CONSTRUCTION MUST lIE COMPLETE FOR C. O. ALL CONSTRIJCTION SHALL MEET THE REQUIREMENTS OF THE N Y ~I'ATE CONSTRUCTION & ENERGY CO~IES, NOT RESPONSIBLE FOR ~ OP. CONSTRUCTION Ell. lC)RS, If c~Opper fubing is used for water distributing system; piping shall be of types K or L only DES DRF'T c K 'D ~ ~ W. OLSON ENGINEERS DRAWING NO, I 'i t- JOHN ENGINEERS DRAWING NO, I' IL JOHN W. DES CK'D DRAWING NO, OLSON ~.~. ENGINEERS 233.0~ (VACAN-6 ~68,25 SCALE- A~EA,4t,8265,F, ~ ,-; "~C$'~-.' ....... APR SUFFOLK CO. HEALTH DEPT. APPROVAL H.s. NOJm~0'9~ ~T aF 6 PM ql STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISFOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE ~UFFOLK CO DEPT, OF HEALTH SERVICES. (si APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH I SERVICES -- FOR APPROVAL OF[ CONSTRUCTION ONLY DATE: H. S. REF. NO.. ~--~-~"O ;~(~ ' :~ - APPROVED: SUFFOLK CO, TAX MAP DESIGNATION: DIST· SECT, . BL~K flCL, ~ l~ 6 . Plo 4, OWNER~ ADDRESS: - ~ 0~' ,= ~X 1,0 I TE~ HOLE ~AMP SEAL I FIT~ 14' l'~WtJ" '~"": -~ _~_._:.' liUlI~ ~ ~ D3EP~%I~fJ{N! .I'~A,B A~EKIDED J.AtA, ZT~ l~8~, ~ m~ ~taposal ~a ,a~er aur,pl~ GUA~ANTE~f~'~E FI~TJA~EEI~ ~W~VEYED ~0~ h~AP =OF R~O. PEr~TY I.AUFZGUET MA:rTl EUI~FOLK CO HEALTH ~i~PT'. APPI~OV&L · H.S, NO, ;~'~E~ ~ . , , ,. ,,,, ~~ ~ STridENT OF INTENT TH~ WAT~ $U~LY AND ~EW~E DIS~L .... .' '. ' GONFORM. TO TH. ST~ND~. OF THE ........ ~ SU~POLK ~O.~EF '..O~/HgALTH SE~WCES. 8,E'RVICE$ -- FOR APPROVAL ~ _~ ¢~X C°NSTRUCTI~NONLY ~ ~ 7 ' ~ ,~,~~ -~ ms~. SECT. ~LOCK ~ ~'//?~ ,, ~,~[ ,, "'. ~'',' ~ ',~ , iFA~ ~ ~o ~,, ~,,~., ~ o, ,., ~,.~,~. ,