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HomeMy WebLinkAbout12529-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, .ZJ.q.957 ......... Date ......... 0c~.o. ber..5. ............. 19 8.5 THIS CERTIFIES that the building .New, .D~rel2.±ng ................................. Location of Property ,...57,-~./lherega. Dr£xre ....... ~/e$t' ..... Hag.'~.ituc/~ ............ I-louse/ye. Ham/et County Tax Map No. 1000 Section .... ~t~ .~ ..... Block ...... ~I 5 .......Lot ..... 5 · ' Subdivision .]Deep .IfofLo. C~?aek. Eg~agea..Filed Map No....g.P~6.Lot No ..... ~.q ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~Ia~ .q~ ........... 19~.~. pursuant to which Building Permit No. ~£529g .............. dated .... ~Tu;1.3n .~© ................ 19~ ,5,, 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 ......... ~or a..n.e.w. 9.n.e. ~..a.m.i. ly..I~..elling The certificate is issued to . Z~T-ZGlq'D. HO3~EE- .ENO..: ..................................... towner, levee or tenant) ~ of the aforesaid building. Suffolk County Department of Health Approval ~ 3-8 o-~ 6 UNDERWRITERS CERTIFICATE NO.. ~ .iq 6. ~ 8 ~ 30 ' Rev. 1/81 Building Inspector ~ORM NO. :~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~ ............. ..~.......~.X......L~. ............................................... .................. ,. County Tax Map No. 1000 Section ........ ~..,J...~..'~. ...... Block / ~' Lot No. '-%'-' pursuant to opplication doted ........................................................ , 1{) ........ , and opprovod by the Building Inspector. Fee $ J.~....~..:~...~... .... Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building 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: I. 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 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 5'/ 2. Certificate of occupancy on pre-existing dwelling/r land use $ / $5,00 3, Copy of certificate of occupancy $1.00 Date ..Sept.ember 27~ 1983 .. New Building............,XX Old or Pre-existing Building(X)._..~,. .-, = /Vacant Land ............. Location of Property 57~ Theresa Drive Ma.t_tituckLN. Y. House No, Street Ham/et Owner or Owners of Property Inland Homes~ Inc. County Tax Map No. 1000 Section .. 1.1,5 ......... Block , .],-5 ........... Lot .... .5 ........... Permit No. 12529Z Date-of Permit ?./.3.O/.8.?.Applicant INLAND .~.OMES; INC. Hea~th Dept. Approval .. ~)/9/83 ...... Labor Dept. Approval Underwriters Approval 6181~O .... Planning Board Approval .~ . ~ a~y Certifi Fin ICe tificat~ Request for Temper cate ..................... a r ........ - ......... * Fee Submitted $5.. t .O.O ......................... Construction on above described building and p~r~mit'meets ail app~ab~e$ and regulations. Applicant ~:S~' "INC'. ....... FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: DATE COMMENTS ADDITIONAL' COMMENTS: FIEL~SPECTION FOUNDATION (ls FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY C,ODE FINAL BUILDING DE,PT..~ · [ ] FOUNDATION 1ST [,] ROUGH! PABG. [ ] FOUNDATION ZND [ ] INSULAtiON [ ] FRAMING [ ] FINAL REMARKS. DATE INSPECTOR, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~/~1:~5 BUREAU OF ELECTRIC. IT~ , 8,5 JOHN STREET, NEW YORK, NE~gV ~ORK 1003~ ..t~ se~,t~r~?, zas:~ -~p,,llc..o. No.o..~.e a'~'a~z/e3 N 618130 THIS CERTIFIES THAT ' only the electrical equipment as described below and introduced by the applicant ~a~ed on the above application nurnber in the premises of John De Fabrizio~ Theresa l~ive~ ~ttit~ck,: N~Y. in the followlng location; [] Basement ~ 1st FI. [] 2nd FI. Section Block Lot was examined on and found to be in compllahce with the ~equirements of this Board. ~XTUEE BX~URE$ RANGEE OUTtE?S aUOR~$C~ EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1-b~e d~tector C A. WG OF HI-LEG NO, OF N TRAL$ OF NEUTRAL .L 249 Oakland Avenue "' GENERAL MANAGER . .. ~ Per-- 11 ~_Thls certificate ~ust not be altered in any manner; return to the office of the Board f nc4?rect. InspectOrs may be identified h~ ,h.~. Z COPY FO~,~UILDI~G DEPARTMENT. ~HIS:COPY OF CERtIFiCaTE M~ST]NO~ BE ALTERED N AN~ MAN~,. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined 'i Approved ..~..~.., 19~.~... Permit No./.0.5..&.q. ~.. Disapproved a/c .... -TT:, ,._~_~- . . ................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No...}...~:'..~..2~..~ .... Datel~. ?¥..1.8. ........... , 19.83.. INSTRUCTIONS a. This application must be completely filled in by typewriter o? 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 promises 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 befo~ 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 promises 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 inspectom on premises and in building for necessary inspections. ....... L .c. ,. ................. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises . .I.N..L.P~. D...I-I..c~..~. ,..~.N..~: ............................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......... ?. ,e,n.t. ..... (Name and title of corporate officer) Builder's License No .......................... 517-P Plumber's License No ......................... Electrician's License No.. , .~.3,8.1..6 .............. Other Trade's License No ...................... ~._/~- 1. Location of land on which proposed work will be done .... .L.o.t...~.4.1.~...T.h.~.r.~..~.a..D.r.:[v.~, .Mattit.uck, .N...Y.. House Number Street Hamlet County Tax Map No. 1000 Section .... 1.1~ .5 ........... Block . .1.5. .............. Lot .... .5. ............. Subdivision... M.a.P...o.~..D..~p..H.o.l.~..c.r..~.~.k...~.$.t.a.t. ~i[led Map No ..... 4.~..5.6 ......Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... 1 family dwelling b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building . .X..X ...... Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... i (to be paid on filing this application) 5. If dwelling, number of dwelling Units ! Number of dwelling units on each floor. If garage number of cars 1. ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dnnenslons of existing structureS, ~fany: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wi,th alterations or additions: Front ................. Rear .................. Depth .................... :.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front 62 Rear ...6..2 .... Depth .g.7. Height Num er of Stories ..... 9. Size of lot: Front 110 : Rear 110 Depth 18g. ......... 10. Date of Purchase ........... i .................. Name of Former Owner ........................... 11. Zone or use district in which pre,mises are situated ................................................... 12. Does proposed construction violhte any zoning law, ordinance or regulation: .............................. 13. Will lot be regraded ......... , ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .INLAND. HIZINl~S,.l. NCAddress l~l~,~Jit~hi~tav. Phone No. 2~tB.-.9696 ...... Name of Architect .......... i ................. Address ................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all Ibufldings, 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. STATE OF NEW YORK, iS.S COUNTY OF..$..1~.1~0..~. ....... ........... .R.o.b..~.r.t..1~.:·. · · ·..:. · ·... · · ·...........Htlt~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the... Con~:r~.ctor (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dull 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 m the manner set forth m the application filed therewith. Sworn to before me this , ............ .... ...... ..... Nota~ Public, ~ ~ ~ ~ount JUDITH T. TERRY Notary Public, State of New[York ............................. ~ ~7'~ '.: .... , No. 52-0344963 Suffolk C~untYr;>t ~ (Signature~[..gl~plicant) Oommiasion Expires March $0 ~NEW 4&3' 25 00o; ~.~ rg 50' RESIDENCE AREA OF PLOT ~O, OE, 0 Se. FT. ~ Ist ,FLOOR ~ B~NT S~J: FT. P~. ~I, RAi~E Se. F~. THERE IS NO SU~CEWATER WITH. ~00 FEET 27 SURFACE MAP OF DEEpHOLE CREEf~ ES'TA'rE~ ' JAN, 28 ~19,65 MAP'N0~4256 TYPIC~ PP.E~ SEP~!C TAN~ , , ,'," ' NO~ ;SCALE "' '~ GUARANTEED TO INLAND HOMES::INC. MAP OF LAND LOCATED AT MATTITUCK TOWN OF SOUTHOLD COUNTY OF ,~JFFOLK SURVEYED FOR INLAND HOMES INC. NEW t 9.64' N 8,7° ZONE0 RERIOEHCE AREA OF PLOT _mO, O20 SQ. FT. PR01? Ist FLOOR ~G ~ ~ ~SEMENT ~q.~ ~ GARAGE gQ. ~ DATUM ~ ~ ~ ~ THERE IS NO ~URFAGE WATER WITH)N ~ FEET ~ THE ~T ~' - UTILITY POLE SUFFOLK AVE. ZO" E 20" W 42 25 SUFFOLK COUNTY DEPT OF HEALTH GERVICER FOR PPROVAL OF CONSTRUCTION ONLY AFFROVED , ! 182.00' LOT 4 I :~ tS2.00' 40 27 FACE GRADE TEST HOL LOCATION OF WATER LINES WELLS~ MAP OF DEEP HOLE CREEK ESTATES JAN. 26)1965 MAP N0.4256 $~0' DIA. · J TYPICAL PRECAST SEPTIC TANK NO SCALE GUARANTEED TO INLAND HOMES INC. /vL,6,P OF LAND LOCATED AT MATTITUCK TOWN OF SOUTHOLD COUNTY C~ SUFFOLK INLAND HOMES INC. I ~ o^'r=, 4- 14-83 .~^~, i'.30' I LIRocKY POINT, N.Y. 11778 MAP ~, J 5 800 II lltg." v ] APPROVED AS 140TED , NOT1FY BUILD ~65-1~0~ 9 AM ~. FOUNDATION ' ~O R~QUI~SD FOR gOU~ED ~. ROg~ - FRA~tNG & pLUMBIN~ 4. F~NAL - C~NS~'LI~N ~UST , 1- I I I