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Home My WebLink About12673-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12645 Date ...... July 27 19 84 new dwelling THIS CERTIFIES that the building ................................................ 130 Lloyd's Lane Mattituck Location of Property ............................................................... House No. Street Hamlet 099 03 4.6 County Tax Idap No. 1000 Section ............ Block ............... Lot ................. .H.o.n, eysuckle Hi. lls d M p N .7.0.19. L 6 Subdivision ........................... File a o ..... et No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October ,5 19 83p hBuildi 12673Z ...................... nrsuant to whic ng Permit No ...................... dated ............................Oct°ber 9 19 R3 , was issued, and conforms to ail ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... new .d.w. elling.. WINDSWAY BLDG. CORP. The certificate is issued to ........................................................... (owner, :~ c,r ~ of the aforesaid ,building. Suffolk County Department of Health Approval 13-SO- 17 5 N641915 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOB, M NO. 2 TOW'N 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) 12673 Z Date .................................. Permission is hereby granted to: ..L~..~.&.~~.~....~..: ..... ..1.?..:~.....,~..~ ...... .~..~. .............. ! ......... m at premises located at ................................................ County Tax Map No. 1000 Section ..... ..~)....~...~. ....... Block ...... ..~..'~. ........ Lot NIo ..... !:!..'..(.~. .......... pursuant to application dated .....~....~.....~... .................. , 19.?..~ and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall P~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-J~=fluC~a~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. 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 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. 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 lan~uC.O. $ 5.00 Date ...... .~. .....Z~.~. /.~..~. ...... New Building ... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property. .................... : .............. House No. / ' Street Hamlet Owner or Owners of Property ........ -. ....................... County Tax Map No. 1000 Section ... (~ .~.~ Block b ~ Lot...~."~.~ Subdivision..~'~.¢P/~ ..... Filed Map No ........... Lot No .............. Permit No.. ~/~,. ~ ?~..~ Date of Permit...2'~ ~v~.~...~.Applicant' .' .~.~..~/...~. ~-..~.~ ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and ~11 applicable codes and regulations. 1000?T1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT o~y the electrical equipment as d~e~be4 ~low and iqt~duc~ bXA~ a~p[~a~ namedpn the ab~%~p~un?~in the premises of in the followlng location; [~ Basement [] 1st FI. was exami~ed on April 19~ 1984 [] 2nd Fl. : Section Block and found to be in compliance with the rdquirements of this Board. FIXTURE FIXTURES RANGES OVENS FANS 45 53 25 Lot DRYERS MOTORS iAPPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS ' ' NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: 1-4.5k~. Not Water }~eater 2-G.F.C.I., 3~ke Detec~rs. 4~0' ~ck I~ting 1~ ~tez. NO. OF HI-LEG OF HI-LEG NO. OF NEUTRALS 1 OF NEUTRAL Rul'~d Electric Co. P. O. Rox 143 Mattituck, N. Yo 11952 Ltc. 245 '[his certificate must not be altered in any manner; return to the office of the Board if i,gcorrect. Inspectors~ may be identified by their DERAR'[MENy. TH s copy OF C~ERyIFI, f MANNER. { FIELD INSPECTION IOMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...~......~. ~....~ ........ , 19..~.~. Approved ..~.~.......~. ....... , 19.~.~.. Permit No..1....~....~..12...~......~. ........ Disapproved a/c ............................................................................................ Application No ................................. ~Ballding Inspecto;) ........................ APPLICATION FOR BUILDING PERMIT Date /0 / ................................ ¢;i .......... ..... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 or 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 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. ...... (Signature of c~plJcant, or name, if ~ corl~'~';a'ii~i ........ · ....... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... ..................................................................... · Name of owner of~ premises ............... .~.....z~j...~_.g.,..~'~.U.v~.....k~...t?~l.~.. ............................................................................ authorizec~l:f Jcer. (Na~ and titTe of co~orate officer) Builder's Lic~se No ..................................................... ~ Electrician's License No ........ ~ O her Trade s L~cense No ............................................... ' // u-- ' //' h ~ 1. Location of land on which .roposed work wiU be do~ Map No ~.~ ~1~ A//J Lot No ~ Municipali~ 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 .................. Demolition ............. i..~..., Qther Work ..................................................... (Description) 4. Estimated Cost ....... !...~..?.~..~i%.~...-. .............................. Fee .,.{ -? ',~..:.?....D. ........................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ,e...~.....~.. ........... Number of dwelling units on each floor ............................ If garage, number of cars ...... ¢~...,.~Z~.... ..................................................................................................................... 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 ................................ ~ '~J, ............ 8. Dimensions of entire new con'struction: Front ......... ,~.~. ...... ~ ............. Rear ........ ~..~. .............. Depth ............ Height ...~..~.....: ..... Number[ of Stories .... ~... ...................... : ...................................................................................... ......... ./...~?.,.....&/..~. ........... ~,.. Depth ................................ 9. Size of lot: Front .......... 10. Date of Purchase .~..~..~.~.~...q..~...~.-~.. .................. Name of Former Owner ..~.~..~t.t.J,t.,.~. ................................. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... .~....~. ........................................... 13. W I lot be regraded~.¢.¢.~.¢.~'.~T.. Will excess fill_be_rem~_o.v, ed,ff, o. rn~premises: ( ) Yes (l~No 14. Name of Owner of premises ~..~.~.~,.,~,.-.~,,,.~.~!i~.~?..~.~..~.. ....... Address j..o.~..~..~J..~h~..~.: ...... Phone No~. ~.~.~../.?..~-... Name of Architect ..............' ............................................... Address ................................. Phone No ....................... ./~'~]0.~-- ........... ~ Address Phone No. Name of Contractor ...... ..~ · , '~r*' .......................................................... pLOT DJAGR~,M Locate clearly and distinctly al,I 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 STATE OF NEW~, ,~ /~;~cS (Name of individual signing contract) above named. He is the ................................................................................................... (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is dfl y author zed to perform or hove performed the said work and to make and file this!applicqtion; that oll statemen]ts contained in this application are true to the best of his know edge and belief; and tha~ the ~ork will be performed in the manner set fo~h in the application filed therewith'. Swom to befor~ me this ~ ~ ~ ~ z TITLE NO. 81-52-3?82? ............... KRAST REALTY CORR ~ ..... , .... LOTNO ~~[ ~WN OF SOUTHOLD SCALE: I : 50' ~ ~/~/~~ ~_~ c_~ ~ SUFFOLK COUNTY, NE~ YORK ~ ~ i -]~]. NOT BE COHSIOERI0 TO BE A VALIO TRUE COPY SUBDIVlSIQN MAP ~&~O IN ~ OFF/C~ OP ~H~ CL~K OF A~DEN W. YOUNG~ PROFESSIONAL ENGINE ER . ~UFFOL~ COUNTY ON OC~. I~, 19~1A~ FI&E NO. XOI9 AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 . HOWARD W. YOUNG~ LANO SURVEYOR ~L~T~W~L(WJ,SEPTICTANKIST)eC~S(~)~NH~E~ . N.~ S. LICENSE N0.4589~ 7Hie No. 8~08- /~reO creotiOr~ , _~ ~9~ ~ HEA~TU DEPARTUEN~( SURLY FOR BUILD/NE COR~ --~[.t[~.~ LOT NO. ~ , "HONEYSUCKLE HILLS ~ s~,w,:",, a~r~.~ ~,~,~ ~' ~,ppW AT MA.TTITUCK ~ DEC. 16,1983 inspec*ed b7 ~h~', dc?artroom, It arid found tO be m~tisfaeto~ ..... ~ ]~' a ~ ~.C SUFFOLK COUNTY, NEW YORK NO. 83- 1124 Chief o~' ~eneraZ Engtnee~tn& aEw ~oeK S~TE E~C~T~ Caw ~/CAGO r/r&E/NSU~ANCE Services *coP~gS ~ m~s SURVEY Not ~AR~ t~g CLaD sourHo&D SAV/N~ BANK SURVE~R'~ INKED S~At OR EMBOSSED SEAL SHALL --' NOT OECOH$1DE~DTO ~AVALID TRUE COPY HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUC T ~E ~R~N ~R WHOM THE SU~EY IS PREPARED/-~%4 b .... ~ NEAREST W~ ~*I~__MI. - ~ SOURCE ~ WATER ~I~TE__PUBLIC__ MENTAL A~ENCY ~NO LENDIN~ I~STITUTION L~S~D ~'~ N ~F CO. TAX MAP ~T/ooo SECTION o~ ~CK o3 LOT 4,~ H~E~ AN~ TO ~E ASSigNEES OF THE LENDING / [ /~O' INSTI~UTI~ GUARANTEES~ ARE ~T T~SFERABLE / F~ F ~ 1 ~,~ H~E~ A~ ~ ~ELLI~S WITHIN I00 FEET OF THIS PROPERTY TO ADDITIONAL INSTITUTI~S OR SUBSEQUENT ~ [ [~ OF H~LTH S~ICES. PURPOSE AND ARE NOT TO BE USED TO ESTABLISH [ ~ ~ A~LIC~T. PROPER~Y ~INES OR FOR THE ERECTION ~ PENCES ~.~ ~/ ~. ' '8~ R AVENUE ,, ' YOUNG 6 YOUNG SUBD/VISION MAP ~LED IN ~E OFF/CE OF THE CLERK Of ALDEN W. YOUNG~ PROFESSIONAL ENGINE ER SUFFOLK COUNTY ON OCr. /~,/ga/AS F/4E ~0. POI9 ~ AND '~ANO SURVEYOR N.Y.S. UCENSE NO. 12845 ~ ,~ HOWaRO W. YOU~, LA~O SURVEYOR ~ ~ L~T~ ~ W~L(W), SE~IC TANK(ST)e ~ES~OLS(~) ~H~N HERE~ , ~ ~ N.~ S: LICENSE N0.4589~ ~E ~ FIEL~ ~TIONS ~D OR DATA OBTNN~D F~OM OTHERS TELEDYNE POST N01779