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HomeMy WebLinkAbout10468-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. .7.109.9$ . . . Date . . . . . . NAY . 39. . . . :'. . . . . . . . . . . . .. 1982. THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property440. . . . . . . . . . . . . .Eaptward Court. Mattituck Nouse No. Street . . . .Hem%t County Tax Map No. 1000 Section . 155 . . . . . . .Block . .9.7. . . . . . . . . . .Lot . . . 0.0.7 . . . . . . . . . . Subdivision .Eaa.tward. .ManpR . . . . . . . . . . . . .Filed Map No. 8606 . . .Lot No. 5. . . . . . . . . . . . . conforms substantially to they Application for Building Permit heretofore filed in this office dated . . . .Oc t.ober. .30 . . . . . . 1979. pursuant to which Building Permit No. 10448. Z. . . . . . . . . . . . . dated . . November-9. . . . . . . . . . . . . . 1979. ,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 . . an. . . . . altarati.4n .arid. .coay.Qrai.4n . pf. .g(7rii.PQ . into, bedroom., . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . .Mir-Xla81. .Q . . &. .ROa8P4ar1P. T th, (owner.loscee omenta.} of the aforesaid building. Suffolk County Department of Health Approval . . .nlr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . .N. 55.7606. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .L-. .-:L4-✓.::,� . . Vis... . . . .,lj.'1�,�-,1. . . . . Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST, BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N4 10468 Z Date .....N . .r'.:..........F.......... , Permission is hereby granted to: /C 0 F✓ i .. :... Jar//�+t/.............. ...... .... .............. ................................................. ..� ............................ /yr�i7`T/ G/C N to ...... ........ U / °` ..JeI04�.. ...... %D J<<�KOG —! ............................................r............................................................................................I........................ at premises located at E?.....r� �. ' � .. . . ...................................................................................................................................................... 'f+ ?`' ...........`.............° - # ` pursuant to application dated ... ............ 191.0., and approved by the Building Inspector. Fee $..142:!' 0...... Building Inspector FORM NO.6 1 D } TOWN OF SOUTHOLD 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: 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 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 preparia certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . . New Building . . . . . . . . . . . . . Old or Pre-existing Building(X) . _X_ 'Vacant Land . . . . . . . . . Location of Property /P7W — 7L 1J , �/ House No. /�Street Hamlet Owner or Owners of Property , !��GN✓Fj .���; `;�Cox,kgri'? Ss+ ij�Z County Tax Map No. 1000 Section .��J'' AA�;,7 , , , Block . ... . . . . . . . . . . . . Lot . . Subdivision . �afAx--f 0.,( Filed Map No.%:5:k . . . .Lot No. . . . . . . . . . . Permit No. l�(6P .. Date of Permit lh, f. f,/. , ,Applicant .,O '/44t.el. >,JitfJ j Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . .. . . . . . . . . . . . . . . . . . . Underwriters Approval . ?� 1.0. -.L , , , , , , , , , , , ,Planning Board Approval Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate .!I. . . . . ... . . . . . . Fee Submitted $ . . . ..Si`u0 . . . . . . . . . . . . . . . . . . . Construction on above described building and ermit-meets all applica codes and regulations. ev /- � J Applicant�. ,p �. . . . . . . . . . . . . . R . 10.10.78 l.• -c). �C) Q`l 0 ' Ac 41 S- slz���z ✓ iY3�7 THE NEW YORK BOARD OF FIR ". UNDERWRITERS BUREAU OF ELECTRICIITW,t 85 JOHN STREET, NEW YORK, NEW Y�DRK 10038 ,,,April. 20, 1982 0 263 '79 Application No.on file N 557606 5.+++����6(�VV y'; THIS CERTIFIES THAT 6/ only the elyr al eq ip ent a d acri6 d bel wand introd d 6y t p rcant rd `gid on the o ol+e plication number in the premises of `Mc ,ae t1p8ta�arl :$ r , t�lattc, N.Y. in thefollowinp,location; Basem nt ® 1st Ft. 1:1 2nd Fl. Section Block Lot was examined on April 'j t 198 and found to be in compliance with the requirements of this Board. FIXTUREFIXTURES RANGES COOjUNG DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLE$ SWITCHES INCANDESCENT FLUORESCENT MNRCCOFY AMT K W AMi K W AMT KW AMT ( W AMi H P l 5 4 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PTj TIME BLOCKS I BELL JUNITHEATERS I MULTI-OUTLET DIMMERS SYS AMT K W OIL H P GAS H P AMT NO AWG AMT AMP AMi AMPS TRANS., "T H P NO OFTEMS FEET AMT WAITS 1 SERVICE DISCONNECT NO OF S E R N I C E PMT AMP, TYPE METER 1,e 1W I A'3W 3%3W 3,e 4W NO OF CC COND. AWG NO OF HI LEG A W G NO OF NEUTRAL5 A W G EQUIP. PER% OF CC,COND OF HI-LEG OF NEUTRAL OTHER APPARATUS: Elm itotxn Heateraa:1-l.0kw i Michael Smith, Eq � „utwaard Ct. , A"tattitUCk, N.Y. 11952 GENERAL MANAGER Per 11 This Certificate must not be altered In any manner, return to the office of the Board if lincrfirrect. Inspectors may be identified by their credentials e CORR BUI 41 G DEPkRx RNt . T 5 Y`"=F. I JkJN ANY MANNER. FIELD INSPECTION DATE COMMENTS - - A— b rx FOUNDATION (1st) c FOUNDATION (2nd) w m 2. o R ROUGH FRAME & + PLUMBING r �I Nj �1 3. m C+ INSULATION PER N.Y. C STATE ENERGY n CODE 4. h � FINAL ADDITIONAL COMMENTS: �1 n w � I o �0 x w h d m C+ BURNS AND ROE, INC., New Jersey•New York-Connecticut Ca[Iforma W.O. No. Date I0"30- T9 Book No.. Page No. Drawing No. Calc No iSheet of • By M.U, SMyrlk CheckedAPploved .RD GT.-14 Title I- aT �•.sTwPr� `!� rtC.{Z 14ASZ REQ, f=.0.srw✓at2p MAw�oR MAp'� 56QC�, FC, ?I'! u 1B toEED ' A v 210+1 ern/ 1/ AN�ZIC ! LaLl�1^CTn P^ 1 F'7R Tl `- ,76� 'nit.. , n. ._ J• � F01 _CZ .G :A2. �Qo �SEDa A PL - t .. �+ 4 � T (� r f Lnwc�Lotti f< i r- !'X" ' n i L^� OY SV ^d T1 iSrRLE FCA WtR$p FIRE !h/SU/ F16) A(- lfJ. l is j ,., COQ 5 2+C0JNST- iON ILAR �. `�. S `GPiLP� t � I�N d� - EXIST%r CZ r n poej EhbTER :y1J0�1" L.6AD .y � � t'L� Z'OX6 PI� i �utSPJ-iVAl�ry, 1'P�'�.�T'1Tlot� zil ° 3`�z°` �t�SULliTtOt.L B vEtnL lil-� i� qAC- ®uTLE'� (X) L46J \14TNA 600 t?.t it-cSiS`fkM—f• . #k!!�Ts 6Adz a�tri T ° ?7- VAC, GLE4"t-k141 SSE` ? "RA it OAVE ���, r a( ,) �'x�S ' �kft ��kP I �A�•ACt G 1�oa�.J PQoP05Eo A LMA- off, .b�, rS�- 4c,i Sror-y LC 151. . 4 {t ar7r- ✓1413 4/07 IV 7!/�C1.e i�cNq�/s Form 6R 0002.2 7 _ 4 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined/.LSO • • lq• . . • . . .. 19-7c�� Application No. � . . . . . . . . Approved j`�q . !. . . . . . .. 19�. 1. Permit No.r�� C� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Build' g Inspector) APPLICATION FOR BUILDING PERMIT Date ,30 . . . . . . . .. 19 17c? INSTRUCTIONS a. This application must be completely filled in by typewriter or 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 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. /r'< Com/'• . . . . ��f�''•L�,�. . . . . . . . . . . . . . . . . . (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. [,�/JiJ.✓I Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . 14t CGuetl .6 . • .g! • • i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officers) 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOT (�CaS'�c2Jz9vrr C 7t ;lg4.1Zi i zPG� House Number `i6� Street Hamlet County Tax Map No. 1000 Section�. . 5 . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . Subdivision . �CIZJ/O/�10 c�/CL • . . • . . . . . . Filed Map No. . .5 �� 0�� . . . . Lot . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy a!:��k'g4. . /.r:!Voysq, 2 c,,q G urrt �5; , , , , , p y . . . . . . . . . . . . . . . . . . .�`e .t. . . . . . . . . . . . 11� b. Intended use and occupancy .�l `VO . . . .` . . .'¢.��?W �S. yvr . . . . . . 9 3. Nature of work (check which applicable): New Building . . . ... . . . . . Addition . . . :7� . . . . Alteration : . . . . . Repair . . . . ..= . . . . . Remoival . . . . . . . . Demolition . . . . .7� . . . . . . . Other Work . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . J Fee . . . . . �:©. . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . .-'. . . . . . . . . Ifgarage,number of cars . . . . ... .- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixes} occupancy,specify/n[apture and extent of each type of use . . . .--. . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . .746./ . . . . . . Rear . . .!{ .. . . . . . . Depth . . . . . . . . . . . . . . . Height' Z��Aj/4�??^de. Number of Stories . . . .4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . , , , of s with alterations or additions: Front . . . Ile... . . . . . . . . . Rear . . . .re��'�. . . . . . . . . . Dimensions. .. f same structure wi Height . . . ;2., . . . . . . . . . . . . . . . . Number of Stories . . . . 4. . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . .eP . . . . . . . Rear . . . . . . 0. . . . . . . Depth . . . . . . . . . . . . . Height . . . . b . . . . Number of Stories . . . . .O. . . . . . . . 9. Size of lot: Front . . . . . ./96?"'. . . . . . . . . . . Rear . . .3P / . . . . . . . . . . . . D�egth . . Z . .�. . . . . . . . . . . . . . 10. Date of Purchase .�' . Name of Former Owner . !T?oe.7.-e!` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Tone or use district in which premises are situated . . .��4s< ?+9 �L( . . . . . . . .�./ 12. Does proposed construc,ti,gQn violate any zoning law, ordinance or regulation: . .h. .r?. . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . .n!d. .�,(//��/�a��� . . . . . . . . . . Will excess fill be removed from premises: �Ye� No 14. Name of Owner of premises . rht /t . . . . . . . . . . . . Address . . . , ,Phone No. 49-F.-:ROW. . . . Name of Architect . . . . . .'.'. . . . . . . . . . . . . . . . . Address . . . . . . :-7. . . . . . . . . Phone No. . . :=. . . . . . . . . Name of Contractor . C w1?vr . . . . . . . . . . . . . . . . Address . . . . . ... . . . . . . . . . . Phone No. . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly alll 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. /00 1.v7- # S I 4 X15 7—WAR D CT O r' /W,4-TT/7Ur-/( 6'I I n' 47 1- Levc L- �o _ a � SToRY w Fir. Hzt �, c C� PROFOS�D Woo Z LAR �ZA2AC�6 lz�, ALMRAT)Ov4 DECK LoWEq LEVEL. /2q,iB¢ STATE OF NEW YORK, S.S s No+tl�#04-Y, *V.Y. COUNTY OF . . .$0..F &AX . . . . ./.fLe:N�ow[. .G. . . Sf e?O% . . .' . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .Q.W.N.[itr e��dN72-4..47o-A.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or havep erformed 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 .3J. .y . . . . . . . . . . . . . .day of. . . .QC.T4 .F.!( . . . . .. 19 �19 Notary Publi//c, 0 JACQ EA. D7TICH . . . . . . County Sv Ne YP Ffy LK t `i' S of New Yeik � . . . . . . . . . . . . . . . . No. 52-4601469. Suffolk Coonh Terni Exptcel 31jo/df� (Signature of applicant)