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Home My WebLink About10103-zFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy THIS CERTIFIES that the building located at .~/$..WO~.~PS.~a. 1;[.~ MINOR SUB: Map No .... 155 ...... Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~a..n.u.a.r.y. 5 ......... , 19.79. pursuant to which Building Permit No.. ~ O,.1.Q3Z dated., .January..1.8 ........ , 19. I9, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ..r.~y~.~.e.. Q.n.e..F..a.m.i.l.y. Dwelling ................................ The certificate is issued to ..... Rich.ar. cl. Olmst.e.d/Euth. Haas ...................... ( owner, of the aforesaid building. Suffolk County Department of Health Approval April 27, 1979 - 9-S0-2 .......... 'A:' 'W'ii / ....... UNDERWRITERS CERTIFICATE No. N4~0449 ..... ~pril 18, ~979 HOUSE NUMBER 2150 Street Westphalia Road M8ttit. uok, New York Building Inspector County Tax MaD Number 1000-114-7-1J Pt. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10103 Z Date ....... ./.. ........ , 19 Permission is hereby granted to: ~' /~'/~//(Y d ~/V5 /'/t/C- ........... ~.~.c~..~..~.:~., .......... ~.~ 'z~ ~ ....~r~ ... ~.~ ~z,~ to ..... c~.....~ ...... ~ ~ ... ...................................... ~ ........... .~..~..~ ............. : ........ ::~ .......................................................... at premises located at ~.....~Z~ff~:Z~.....~.~.~.~ ............................................. ........................................................................................................ ~z~z~c&.:.~.~,.. pursuant to Building~.r_~lnspector., ~~. Fee $...~...~.........'~...... ,.. ' Budding Inspector FOF.,M NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No Y. NOTICE OF DISAPPROVAL ~9..7..7 for permit to construct ~.,~, .Z~,,,~,~,,~,, .~.,~,~./~t/tt!~,e premises located at ,.,/~,, ,~,,,,/,~?,....: ................. ~.~,,:..,e:xx,,rz../z-r....'.~.~,,......~...~.,,,_-.,.../,,.~-.. ~ z, Mop J..~;:2.~..~.../~./..~.. ........... Block ............ 7.. ............................. Lot ..~...:../.../. .......... : ............. is returned herewith and disapproved on the follow;ng grounds .~., .~,.'~//3~.......,~..Gf..~Cg~.~(.~.~..~. .......... ~'-~ ~....~..r:.........c.~..~..x....y.....~,,~,~.. ~.c,~ ~~...~..~.. ~.,'z'.,~.;. ................ - -- , -- - ' ~ ~.c~'~ x~.- ~:~.~zr.r.~. ...... u~.../......7..~ ............ ~_,z~.......~..r. .......................... y ................ Building Inspector TOWN OF SOUTHOLD , Building Del~tment Town Clerke Office $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 inspector 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 topagraphic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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 installations, 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 property showing all property lines, streets, buildings and unusual natural or topographic features· 2. Sworn statement of owner or previous owner as to use, occupancy a.nd condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: I. 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 .....L .-'./:Z..;:... Addition ................ Old or Pre-existing Building / -- Vacant Land Location Of Property ~-/'.~Z~ /!.~.~)7 2~/y~/-J/.//~ /~'/~ ./.~? 7~/~ /~'~/~' ~/~J" Owner Or Owners Of Property ....~.~.~...¢?:.;.~..~..Z::C/.~ ............ ~-~J...~..,/..~.~/,~.~Z .......................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No. ~.~.~/...~..;~....~. Dote Of P/ermit .~/..~.~7.J....7.~..Applicant ,.~,/[~-~ / 4~ 4_~/ ~/J D/L/~J' /~(. · '""7"r ..................... ?.. ............................... Health Dept. Approval ...... 'Jc...;:~,..,.~..,;L.~.;/; ............. Labor Dept. Approval / i :' -/ ................................................ Underwriters Approval ............................................. Plann'ng Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ............ ~47..'.~.~?...~i?. ........ Construction on above described building and permit meets all applicable codes and regulations. App, cont.. ..... ...... ........ 7. ................................ Sworn to before me this ................ day of ............................................ (stamp or seal) METRO PLUMBING Aquebogue, kong Island, New York 11931 (516) 722-4032 EAST BOB WADDINGTON April 27, 1979 TO~WHOM IT MAY CONCERN: I, ROBERT WADDINGTON, do guarantee ~he unwrapped cold water pipes in the basement area under normal heating conditions at the house being constructed on behalf of Building Permit Nc. 10103. 27th~ay of April, 1979°:~' Sworn to before me this ?/ / Notary Public I~OTAltY ~BL~C, ~ Olmsted, Wesphalia Road, Mattituck, New York, under THE NEW YORK BOARD OF FIRE UNDERWRITERS SUREAU OF ELECTRICITY ['~r EE JOHN STREET, NEW YORK, NEW YORK 10033 THiS CE~IFIES THAT o~y t~ e~t~ ~u~nt ~ ~cd~ ~ ~ int~ by t~ ~pl~nt ~ on t~ ~ ~ numar ~ t~ p~m~es of in the follo~vlng location; [] B ment [] 1st Fl. [] 2nd Fl. Section Block Lot wasexarninedon ~)~1 ]~ 1979 andfoundtobeincompliancewlththerequirem~ntsofthisfloard. FIXTURE RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWIT~S 15 MUL~ DIMMERS SYSTEMS FIO. OF FIET SERVICE IMSCONN~.'T OTHER APPARAT(dS: : c, tors: '~-(;. ~'. C. I. ~-~moke Detecto]' S E R V I ¢ E NO, OF CC. COND, A,W*O* NO, OF HI-LEG A,W.O. A*W*G. Joseph D. ~zzonJ 227 Waverl~ Ave. Medford,N.Y. 3-1763 L~Ce~82 This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Inspectors may be identified by COPY FOR BUILDINg ~INT. THIS COPY OF C~T!FICA, Ti~M~J~T TOWN DF E]DUTHOLD OFFICE F1F ~UILDING INDPECTOR TOWN CLERK'S OFFICE EiOUTHDLD, N, Y, 11~71 TEL. ~65-266D FOR,,~ NO. ! TOWH OF SOUTHOLD BUILDING D£PART,~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No .............................. Approved ,.. · ................. Disopprove~ ,/c :'"~"~"/~'"' "z:~'"O":~":""~"~'~"/~"C~""~"~'''''''-'t?///l . ,"~-~"'"'~"~"~"~:~ (Building Inspector) APPLICATION FOR BUIL~IN~ P[RMIT ............ ........................ , .... 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, occurate plot p~an to scale. Fee occording 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 ogrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ........ ........ ........ (Sig'~'~tu'~ ~f"~'[~'~i'ic~i' or name, if a corporation) (Address of opplicant) State whether applicant is owner, lessee, ogent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................ ,~ ....................................... If applicant is a corporate, signature of duly authorized officer. (Nome ond title of corporote o~icer) Builder's License No ............ ..~.~. .................................... Location of land on which proposed work will be done. M~p No.: ................................................................ ........ 2' ..................... Munic~pa ity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ................................ 7' ...... ' 3. Nature of work (check which applicable): New Building ..... ~... Addition.. ................. Alteration .................. P, epair ...... Remora ............ Demolition ................ ;... Other Work .................................................. -..- ............ ~,~ ~ (Description) Estimated Cost .............. .-.~..-.~.l...0. ..O, .?. ·: .. .O' .. '0' ................. Fee ........ ~...~...-.....~.,.' ............................................................ 4. (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 ................................ ' ............................................... 6. It business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height Number of Stories ............................................ Dimensions of same structure with alterations or addffions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... .~...~ .................. Rear ............................ Depth ....'~-...~. ............. Height .................... Number of Stories ...................................................................................................................... .... ................ 9~ Size of lot: Front '~'~O ................... Rear .......................................... Depth 10. Date of Purchase ..............~..~. .................................... Name of Former Owner .................................................. 11. Zone or use district in which premises are situated ......... ~..: ..................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ....... ~..0. .............. Will excess fill be removed from premises: ( ) Yes 14. Name of Owner of premises ..~.:,..O...~..../~...~.~ .................Address .....~..~...~..~ ......... Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor 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. STATE OF NEW YORK, ( ¢ c COUNT~ OF ................................ f '"'~ , , N~..,.~,.~..~..~I~.......~..~..,I~/.~..~...~... ................ being duly sworn, deposes and says that he is the applicon! ~' °ntra~t)(Name of individual signing c above named. He is the ~..~'..~."~'~'~"": ............................................. : .............................................................. .................................... (~ontracto~ agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and fil~ 1bis application; that all statements contained in this application are true to the best of his knowledge and belief; an~ thaf the wark~ill be performed in the manner set fo~h in the application filed lherewith. .................. .... .. ..... ,...,, ............... .............. SUFFOLKcoUNTY %, ^ ..... ~EOR AP?ROVAL OF CO~TRUC?~O~ ONLY DATE_.,/Lq/~'7~, HS REF. NOV, 2,7, 1978 Unoufhorize(~ a[teraffa~ or addition fo f/~is survey is a vio/at~or section 72C? oF lha New York State Education Law SURVEY FOR aE'FLMi~ , RICHARD E. OLMSTED 8RUTH V. H,4AS aT M,~rr~ ruc~ ~ I TOWN o~ sou.,o.o ~~o~ .,m,.,~... ~o, I ~FFOLK COUNTY, N. I ~ALE~ I .50' FEB. 6 1979 ,y. APPROVED ~ f~OTED '