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Home My WebLink About12638-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, Z12.4.33 Date. April 25 ............................................... 198~. THIS CERTIFIES that the building --nee .d.w. ?.ll.i..rig Location of Property . .19.5. ..... Mathews Lane Cu,t. chogue House No. Street Ham/et County Tax Map No. I000 Section ..... 0.8..4 .... Block . ..0.1 ........... Lot .. 015 Subdivision Northwoods 2 ............................... Filed Map No...5.4.6.9., .Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 21 198..3. pursuant to which Building Permit No. 12638 Z · dated .... S.~. p.t.~.m.b..o.r. ,2.6. .......... 19.8..3, was issned, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... a. pri. v.a..t.e qn. 9.-f.a.m..i.ly' dwelli.n9 The certificate is issued to ~ICHAEL E. FINNICAN, JR. & LESLIE T. FINNICAN {owner, less~'o1--zsrra'rltJ of thc aforesaid building. Suffolk County Department of Health Approval .1..3.-.8.qr .1.6 .1. ,. . .3 [ .2. 6. /. .8 .4 . , .~. 9.b.e....5:..V.%.l.l.a., UNDERWRITERS CERTIFICATE NO ........ ~ . ~ .4.0.1 Q ~ ................................. Building Inspector Rev, 1/81 I~O~M NO. 2 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) 12638 Z Permission is hereby granted to: .....~..~.~...~.~.~ ............................................. ...~~.~....~..:~..,..:..1.!.~.~. ,o ...... .~.~......~ ............................................................................................................................. at premises I~ated at ...... ~.::~.~.....~.~~......'~ ....... ~~ ..~.. County Tax Map No. 1000 Section ..... .~.~..~...~.. ...... Block ....... .~. ............. Lot No ...... ~...~.:~. ............ pursuant to application dated ....... ..~.~.'~....~D.....~......k~.......c~.../ ...... , 19..'.~.~, and approved by the Building Inspector. Build'rog Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, 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 Inmec- 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. §. 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 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 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 3. Copy of certificate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building ........ Old or Pre-existing Building ............ Vacant Land . '-T ........ Location of Propert ........................................................ House No. - Street Ham/et County Tax Ma,p/~o.~_1000 Section ............... Block ..... / ......... Lot.../~..~..~.. ...... ................................. ' Map No ................ Health Dept. Approval . ./..~, .~ ..... ':' ......... Labor Dept. royal ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary/. Certificate ..................... Final Certificate .... ~ ............ Fee Submitted $ ..... O. .................. Construction~_..t on/~)~(J~-~ab°ve described.~ Ap p I ,c a n t .~.~~,~'~_~ .building a~ I~.r~l i~hl ee~ab I e.- ~ ~.~. co~s an~ .regulations.... - [ ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO38 THIB CERTIFIES THAT only the electrical equipment as desc~bed bel~ and int~duced by t~ applicant na~d on the able applicatio~ number in the premises of in thefollowinglocation; ~ Basement ~ 1st FI. ]~ 2nd FI. Section Block Lot was examined on ~ 5 ~ ~9~ and /ound to be in compliance with the req~zirements of this Board. FIXIU~E FIXTURES RANGES. ~ ;OOKING DECK~ OVENS DISH WASHERS EXHAUST FANS FEEDERS SPECIAL REC'PT TIMECLOCKS INIT HEATERS MULTI-OUTLET DIMMERS DRYERS FURNACE MOTORS FUTURE APPLIANCE DELL SYSTEMS ~T. K W OIL H,P, GA~ H,P. ~T, NO, A.W.G, ~T ~P, ~T. AMPS TRANS. ~T, H P HO. OF FEET A~T WATTS SERVICE DISCONNECT NO. OF S E R V I C E METER A.W,G A,W G. PER ~ OF CC. CON~, OF HI-LE~ OF NEUTRAL OTHER APPARATUS: ~xA3 R~oves ~rk N.Y. 11901 ~C. 377 eSN$.at MANAGE~.~. 11 This certificate taus1 not be oltered in ony menner~ return to the office of the Boord if ~ncorrect. Jnspecto~ m~y be identified by their crede~h~ls. COPY FOR ~B~UILDI~G DEPARTMENT. THIS COPYOF CERTIFICATE NIUS-~T ~I~E ALTERE~D IN ANYMANNER. · ~ FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [] ROUGH PLBG. [ ] FOUNDATION 2ND []INSULATION ~FRAMING []FINAL REMARKS! DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined .... .C~¢.'.~fl.-..o~. {<, 19 .~.~.~ ......... , 19 '.~. Permit No. l .~,..(o. ':3.~...E:. Approved ..... .~flr.~-. a-(o ~' Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tltis 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. Fee 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 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 wit.h all app. licab!e !aws, ordinances, building code~ho~g code ~d regulation?, and to admit authorized inspectors on premises and m building for neces..~~/~..~/J~4,q'~..,~-.~ _ ~ ;' (S'ignature of applicant, or,amc, if a o p t'o ) (Mailing a~res; o~'abbJi;;l~;) ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ...................................................................................... Name of owner of premises .~'~O_.~. ¢.E...C...~..~. [ .¢4.~. i .O~..~..7.~.... ~.~. ~....~..~.!i. ~.~.../.-~....~. ~..64..M.[~..O..~J ...... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (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 proposed work will be done .................................................. · ........... .......... .................... House Number Street Hamlet County Tax Map No. 1000 Section .(~4 ............ Block .... [ ............. Lot..[.~.-7 .............. Subdivision.· ~O.T[:[.'9~O.O.~.~ ..................... Filed Map No...~..~ ........ Lot .. ~ ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... q...O~.* .~.~.T'. .... /..M. 9.~.. ~ ........................................ b. Intended use and occupancy ...... ~0¢.$~ .... ./...~.07. F~ .......................................... 3. Nature of work (check which a plicable): New Building . .X ...... Addition .......... Alteration .......... Repair Removal Demolition Other Work ~ .~ '~)1,0.O12) (Description) 4. Estimated Cost .... : ....................... Fee .................................... (to be paid on filing this application) 5. If dwelling, number of dwelling[units ...... \ ........ Number of dwelling units on each floor... 'r-7'. ........... ' 2- 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 Stones ........................................................ Dimensions of same structure w!ith alterations or additions: Front . ~ ...... Rear ............... Depth ...... . ............. ;.. Height .... :~. ....... Number of Stories ...................... Depth .~..~ .......... 8. Dimensions of entire new construction: Front ....~.O..~. ., ..... Rear .. ~.O.I ........ ' I Height ............... Number of Stories ....... ~ .[~ ......................... : ................ Size of lot: Front .~. 1~55. ~..; ........... Rear ...I.~.~- ............... Depth . ~ .~.C>. ~. .............. .D. ate o f Purchase .(.J.¢..¢-.i 3~. q,~,(~ .~ .t.q,~ ........ ~. Namq o f Fgrm e~ Owner .~.c~o, fi ~. ~. ~ lo.qr..q-.~ ........ Zone Or use district in which premises are situated..~,..~.f?.(O.~.O.~..o-.[ ..... k5 ............................. I)obs proposed construc[iqn violate any zoning law, ordinance or regulation: . ~.~.Q ........... ~ ............... .W. ill lot ~b~regrade~ ...)].?. i ..... ¢' Cz ...... '4." Will ex~cess fill be removed from premises. ~ Yes No Name of Architect ' Address Phone No Name of Contractor . .~).ctl O.~ {~. ............... Address ................... Phone No ................ 10. 11. 12. 13. 14. 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. O,.Sr~0.~c~.~ ~\. STATE OF NEW/YORK . . . ?//~.~. ~/.~.~.. ~ .,~..~q . .e~....~.., ........... being duly sworn, deposes and says that he is the applicant ' (Name of individual signing co~fract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y 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 OWNER: .1' SUFF' cO' HEAL.TH I~,,E,PT* APPRovAL I H. $. NO. ~.67 37 20 E. I55.~ // ~ ~s su~w~ ~s x wo~n~ o~ ,"t' ' ~, ~ ] ~ ( R ES i[2~bJ( L) ~SSED SEAL SHALL NOT ~ CO~ID~D .~ ~D~CK VAN TUY~ P. C. cO. DEPT. OF H~ EALT~.,, ,,, ,,~E,~,Vt~I~;~ ,,, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE D~NCE WILL CONFORM TO THE (~) I o~ HAP OF LOT Z, [ A,T ~E~CK VAN ~YL, ~. C, Fo~ .~ovAb OF D~NCE WILL C~FORM TO THE