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HomeMy WebLinkAbout11770-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certifi te Of Occul ncy No..:~3.1.~1 ..... Date December 8 .................................... ,19 82 THIS CERTIFIES that the building ................................................ Location of Property ~ 23.,5 Oaklawn Avenue Sou~;ho~.d House No. Street Hamlet County Tax Map No. ]000 Section ...Qr~O ...... Block 03 .Lot 002 Subdivision ....... .~ ....................... Filed Map No. x .Lot No. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated .... ~.~r}O. 2.8. ........ ,19 .~.2. pursuant to which Buildin~ Permit No. 1 1 ? ? 0 Z dated .... .~.u.~.7...2 .......: ......... 19 .8.2. , 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 ......... a p. rivate one-famll~ dwelling. The certificate is issued to WILLIRM A. & MARY C. STEGMAN (o~.ner, I~ of the aforesaid building. Suffolk County Department of Health Approval . .1.2..-.~.0.:5..5 !..1. ! ./}?/.8..~.~..R.o..b.~.....~:..V~l.~a ,. . . UNDERWRITERS CERTIFICATE NO. Pend lng Rw. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N©. 11770 Z Permission is hereby gronted to: ....:g...~.s..~.~ ......... .~.~.~.~.~ ........ ~... .... ~. ....... ~.~..~.O..~,,.....~:.Lq...a..~..~ .~ ,,s~, ~_ ,o ....~!.k~. ........ .A......~.L.c..9..'T..g ......... O..~.g ........ ~a.!.'..t!...t...'.(. ....... ~...~..L!.n!.~..~-. County Tox Mop No. 1000 Section ............. .'~...,,0,... Block ....... ~,. ......... Lot No. ~ ................. pursuant ,o opplication dated ......................... ...~....~....~...~,. ........ ..~....~., 19~.~.,~ and oppmved by the Building Inspector; Fee $......~...,~-. ............ Building Insl:~ctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 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 of premises, or other perti.nent 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 November 22~ ],982 New Building .... X..X~.'. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .1.~3...5..O.a.~.. ]..a?.n...Ay?.q~.?~..S.o.?.t.~.o.]...cl.¢. Ne~/ York House No. Street Ham/et Owner or Owners of Propert¥ Willi~t~, & F~ary Stegm~n, County Tax Map No. 1000 Section 70 Block 3 Lot 2 Subdivision ................................. Filed Map No. 5.3..3...7 ...... Lot No..3. ........... PermitNo. 11770Z Date of Permit 7,,/,2./,8.~..Applicant TNLA~D Health Dept. Approval 21/19/82 .Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 5.O0 Construction on above described building a~mit meets all applical~codes and regulations. Robert E. Hiltz~ InT~n~ Homes~ Inc. FOUNDATION ( 1 st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) COMMENTS INSULATION PER N. STATE ENERGY ~ODE FINAL NAL CO~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ./~. ?., ...... 19... f3~-,-~ >- 19 --~(~mit No.. (~ '7 ~ ~ ~ Approved Disapproveda/c ........ . ..k,,~,~.......~... ............................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date . gu. Vg..2.8. ~...1.9.8.2.., 19... INSTRUCTIONS a. This application must be completely filled in by typewriter, or iq 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 locatloff 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 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, and to admit authorized inspectors on premises and in buildings for necessary inspections. ..... I.~..t~a~.....u.c~...~. ,..~c.: .................... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contraator, electrician, plumber or builder. ................... 9e..n.e~a..x..C.o.n. ~..r .a.c.~. 9 .r ........................................................ Name of owner of premises . ~.i:l-li~ .&*..~..M.a.~.y...C.o..S.$.eg~..a.n.. i ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Robert E, Hiltz~ President (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ..... .5,1.7.-. P. .............. 2148-E Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done....e./?..o...~, p .~..1.a.w.n..A. y?.n.u.? ...................... .../. ~.~.... ~ .~..~...~.......ca?.. ............. ~. ??.~.o..~i,' .~. ?.~. ~o..~.~. ?. ~. ?.~.~. .................. House Number Street Hamlet County Tax Map No. 1 Block .... 3. ............. Lot ................... Subdiws~on¥?~.' ' ~'- - .~.~'~*err-."'q .-::-P.~ .~'~r~. ~--':..~.~.: ~. · ,--5'~'~' · Filed Map No ............... Lot ............... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: Vacant a. Existing use and occupancy ..................................................................... b. Intended use and occupancy I £amil~ . .~.911~D.9:.; ........... 3. Nature of work (check which applicable): New Building XX Addition Alteration ' Repair .............. Removal .............. Demolition .............. _.Qther Work ............... (Description) 4. Estimated Cost .......... ,/..o..., .% ..................... Fee .... .~'..'~. ..... ' ........................ ] (to be paid on tiling this application) 5. If dwelling, number of dwelling units ....... l. ....... 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 .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ... ~..5..2 ....... Rear ...... .5.2. ...... Depth ....3.:3. ......... Height ..... 1.8. ........ Number of Stories ........................................................ 9. Sizeoflot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ................ ii ........... Will excess f'fll be.removed from premises: Yes No 14. Name of Owner of premises .~.i..l.l.:i...m?...t.o..~..a.n.. Address Ll~h~C~l~/.n,..NSl.t~_... Phone No.8.8..7.'.3.6.9..2 ...... Name of Architect .................. Address . '.~ ........ '...: ..... Phone No ................ Name of Contractor .I.?..H...01~.. !...J~.C.: .... Address . .B.o.x...1.1.7., ......... Phone No. 2.9.8..-.9.6.9..6 ...... Matt ituck, N.Yo 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 accordin~to deed, and show street names and indicate whether interior or corner lot. t-~ {4¢-u / STATE OF NEW YORK. COUNTY OF..S..UI~.F. 9.L~.. ....... S.S Robert E. Hiltz ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the Contractor (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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public, . ..... ;_~ .... .~/<-~... ~ CountyY -"') (~ // ~.~z-.-.-.-.-.-.-.-~- ./) - ~ ~om~'/~suc sm, ~ s~, v~ Robert E, Hiltz (Signature o"~fapplicant) N0. 5'2-81258S0. SIdfolk r~m EXDirSS I~reh ~. SUFFOLK C0. HEALTH DEPT. A~OVA~' '" 'AL/'" H..S NO. .............. '// ...................... SUFFOLK CO. DE~. OF HEALTH ~RVICES, ' ~ , SUFFOLK COUNTY DEPT. OF HEALTH ~ ~ SERVICES -- FOR APPROVAL C~STRUCTION ONLY ~,o~ ~AW. ~ ~ R~iCK VAN TUYL, P.C. j LICENSED LAND SURV~ORS FO~ "it should be noted this property is located in an agricultural oreo, the possibility exists that the water supply mey contain trace amounts of pesticides and/or nitrates. Special analys~s Contact this Oeportment prior '~^, SUFFOLK CO. HEALTH DEPT. APPEGVAL · .,/~~,~// ' H.$. NO ............. STATEMENT OF INTENT THE WATER SUPPL~Y AND ~--~"WAGE DIE~:~SAL SYSTEMS FOR THIS RESIDENCE WILL ~ ~3ox 117 -- ,, SUFFOLK CO ~J~'~' ~Pi'lf25 ~:)F HEALTH SERVICES -- FOR APPROVAL' OF ~ DATE: ,,, ~ ,~ q ~- ~~ ,, ,,, ,. ,,, (~L,,,, .,, ~e~.~), , , MEAN ~A L~L~_ T¢~. H&E' ' ~ ...... GUA2~T[ED ~ ~E/!TLE:G~A2&NTlEC ~. m ~ ~.~,, ' ',, .: .' ' . "'"' ..... ;. { D ~O~ICK V~N TgYL P.C. LICENSED LAND SURV~O~S GREEN~RT NEW YORK W OR. IS UNLAWFUL CERTIFICATE~' OCCUPANCY A...OW" As ' FEE: ~'~ ~''~-~ BY: NOTiFY'BUILDING DEPARTMENT Af 765-]802 9 AM TO 4 PM FOP. TH[ FOLLOWING INSPECTIONS: il. FOUNDATION - TWO REQUirED' FOR. POURED CONCRETE , 2. RouGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST' BE COMPI~ETE FOP. C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROP-S. I I c--1 I- F t~o