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Home My WebLink About12528-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of OccuPancy No. Z12883 Date Oct. 11 19 84 THIS CERTIFIES that the building ....A.d.d. ~..t.i.o.n...~9..E..x.i.s.'q.J:.n..cj..O,n..e, ?,a.m, ,i,l,y. ,D..w?.l.l. ing Location of Property .... 3. .3.7.5. ............. D.?.o~...H.o.l.e...D.r.. ........ M..a.~.~. ~..u.c.k. ....... House No. Street Hamlet County Tax Map No. 1000 Section . .1.1.5. ....... Block ...l ff. .......... Lot .... 0. 1, .7 .......... Subdivision..D.e.e.p..H.o.l.e...C.r.e.e..k..E.s.~.: ...... Filed Map No. 0.0.4.2.5..6..Lot No. 5 7 conforms substantially to the Application for Building Permit heretofore filed in this office dated June 29 1252.8Z ...................... 19 83 pursuant to which Building Permit No. dated ..... .J.u.l.'d...2.8. ............. 19..8.3, 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 ......... ..... Aa.a..&e.~.o.n., .~?..~..x.~.s.~. ~ .n~..9 .n.e..r.~..m.Z.~y.. p.~?.z. ~..~.ng. .......................... The certificate is issued toSTEPHEN & BARBARA ABBOTT ..................... ?o;?.,,'o;. ¥;d,'-o'~'tC;,d,'O ...................... of the aforesaid building. Suffolk County Department of Health Approval ...N./.A. ...... . .............................. UNDERWRITERS CERTIFICATE NO ......... N6.61844 & N617598 Rev. 1/81 Building Inspector FOUM* NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. 12528 BUILDING PERMIT (THIS P£PJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLm'~ON OF THE WORK ^UTHOR,ZED) Z Date ......... .~.....~...~.. ................. . ! 9..~..~ Permission is hereby granted to: (~ . ,, .... .................... . at premises located at ..;.~..~.~..~.......~......~.c~,%,....~'~..~.~.~ ......... .~....~...~...~.~..C~ ........ County Tax Map No. 1000 Section .~......J.;I.~.. ...... Block ...... )...~ ......... Lot No ...... [..~. .............. pursuant to application dated ......... ..~l,~,~......~..~ ..................... , 19.,'~...~, and approved by the Building Inspector, Building Inspector Fee $,~,%.: ............... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~:'~)uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitte~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 disposai-(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 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 3, Copy of certificate of occupancy $1,00 use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location ofProperty .~.2]?..~. .~.~.~../) .~./-~ ~' /~/~7-7-/7Z,'(~/~ ,~,;~,: House No. Street Ham/et r' ............... Owner or Owners of Property ....................... -~/ .......... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/.~'..~??..~. Date of Permit Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Cert f cate ....................... Fee Submitted $. ~.~ ..................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 AppJicant .................................................... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~b~ot~; ~75 ~ole ~i~, ~tti~ N.Y. ~I~$ '~S~CTION COMMSNTS ~'~ ~'i FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 1001375 THE NEW YORK BOARD OF MIRE UNDERWRITERS BUREAU OF ELECTRI:CI~ ~ ~ 85 JOHN STREET, NEW YORK, NEW~ORK 10038 THI~ CERTIPIES THAT only the ele~trlcal equipment as ~scribed below and tnt~duced by t~ applica~ ~d on the a~e application number in the premises of Sre~h~n ~, 3375 D~p ~o~e ~, ~ ~t~, ~.Y. in the follo~ving location; ~ Bosement ~ 1st FI. was examined on Sepl:e~nber 19, 1.983 RXTURE ~i FIXTURES DRYERS EURNACE MOTORS ! FUTURE [] 2nd FI. : Section Block and found to be in compliance with the kequirements of this Board. Lot FEEDERS OVENS EXHAUST FANS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E ~ V I ~ ~' C OTHER APPARATUS: 2/0 ~ 2/0 This De~ni$ D. Claire, Jr. P. O. ~ox 284 L~arel~ N..Y., 11948 ust not be altered in , manner; return to th< office of the Board re.ct. GENERAL MANAGER iSentifled by their credentials. ¥,MANNER. / '/VOTE: ~ = MO/*IUMENT SUBDIV/$10N ~,'tAP FILED/N TN~ OFFICE OF THE C~E~If OF SUFFO~ COUNTY ON SURVEY FOR: BEN IVlENDO.ZZA EOT 57 "DEEP-HOI AT MATTITUCK ESTATES,", LOT LOT 5~ 59 LOp TH£REs4 DR/VE SURVEY FOR STEPHEN 8~ BARi AT MATI'I TUCK TOWN OF 50UTHOLD SUFFOLK COUNTY, N.Y. SCAI. E : I"* 40' SEPT. 26, 1984 )TT Irt&ED JAN. 28,1~65 IrlLE NO. ~JARANTL~ED TO: N:Yt LIC. NO; fi?RS RIVERNEAD~ N.Y. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined ..... ~.t. h~'.~.., 19~.'.~. Approved ..... ~4~.3.~., 19~'.~. Permit No. ).*.~ .~..~..~ Disapproved a/c ..................................... Application No.. ! .~:..~"..."~..~. ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins 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 tins application may not be commenced before issuance of Building Permit. d. Upon approval of tins 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 constructibn of buildings, additions or alterations, or for removal or demolifion, as heroin 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 building for necessary immectiom. .~ __ / (Sig~tture of applicant, or name, if a corporation), &.,r.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................ ? ............... .,~.: ....... q .~-.~ ......................... (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 .... '~ fig~/~')~r' 1. Loc~'ti.(~. of land on which proposed work will be done .................................................. / ..... .... ..... ................. House Number Street Hamlet Connty Tax Map No. 1000 Section ...... ~./..~. ....... Block ...... /..~. ......... Lot .... ./?. ...... .~..... Subdivision . .~?.~.4. J~..4.~. ?.~.~.~:.~...~F.~..~.~5. .........Filed Map No...~.O..~.~..o~..~.... Lot..~.~'.7.....~. .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~.~.5. t?.~..~.~( .,~.t: .................................................... b. Intended use and occupancy ...?.~.~f .~.~.~. ?.~/..L .................................................... 3. Nature of work (check which applicable): New Building .......... Addition. ~'"" Alteration Repair .............. Removai .............. Demolition .............. Other Work ............... ~. : (Description) ~ ~, .~. ' Fee 4 E timated Cost (to be paid on f'fling this application) ' / 5. If dwelling, number of dwelling dnits ............. Number of dwelling units on each floor .... J. ........... If garage, number of cars ..... i · ./ ................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of exis in structure~ if an ' Front '.~.~ . . Rear ~-q D~,,~h 024- ~ g ., Y ........................... ~. ................ Height ..../~. ......... Number of Stories /'. ........................................... Dimensions of same structure wi{h alterations or additions Front ... ~-~ .......... Rear Depth.. fl./ ................ ~. Height .... ./._s~ ............... Number of Stori;s .... 8. Dimensions of entire new construction: Front .... 3. ~ ........ Rear ... 3..>~. ........ Depth . ./.~ ........... Height ., ./.~. .......... Number of Stories .... ./ ................................................... 9. SJzeoflot: Front .... //8 Depth . ./..~f. ................ 10. Date of Purchase .~/.p.~. ......... Rear ...... /.~.o. ............ .......... . .................. Name of Former ~wner .~.~...~f..~..*~.~. r~'~..~g'..~. 11. Zone or use district in which premises are situated ........................ .~ ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation' gqO 13. Will lot be regraded ....~, .... , .... , ............ ~. Will excess fill be removed from premises: _ Y.~es .N.o 14. Name of Owner of premises' ,~-~'~t~. '. ,.~0¢..2~gq~}... ~J~ (~. Address' .~.97.~....~.. ~..tfi. ~h~'..... Phone No. ~.~.~.' .' .s .17.4 .... Name of Architect .......... I..... ..... ....... Address Phone No. Name of Contractor ~ .......... Address ................... Phone No ................ 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 fiumber or description according to deed, and show street names and indicate whether interior or corner lot, STATE OF NEW, OInK, . . ~ COUNT. O . .. ,S.S .... .... · ~ .................... beggarly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file this application;that ail statements contorted ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~nek set forth in ~e application filed therewith. Sworn to be feared, his County ~O, Stata of I%w ¥ofl~ Z' ~/ (Signature of applicant) }10. ,52-g125850, Su~fol~ C~ ~erm Expires ~arch 30, _ ! ~J