HomeMy WebLinkAbout10820-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No ....... Zl0120... Date .... Bep~amber..2 ............... 19.80
THIS CERTIFIES that the building ................................................
Location of Property ....~0..G~'ea~; .Peconic. l~ay. Blvd,/A105. Laurel..Lane.. Laurel, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section .... .'l.~.5 .... Block ., .02 .......... Lot ..... OD.'[ ........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
·. Ju, ly..~0 ........... 19 80 pursuant to which Building Permit No ....... 't0820Z ........
dated ...... Augll~'l; · 8 ............. 19 80, 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 .........
................ · Deck..Addi~tion..t:o. ~xistin~ .Dwelling ......................
The certificate is issued to ..... Esta.t,e .of. Chal?ll~s,. J,. McNtJlty ...................
(owner, ,~
of the aforesaid building.
Suffolk County Department of Health Approval ............ ~1./.~ ..........................
UNDERWRITERS CERTIFICATE NO .................... I~/~ ..........................
~ Building Inspector
Rev 4/79
TOWH OF SOUTHO[*~ ~
BUILDING D~P,ARTJ~I N~
TOWH H~LL
SOUTHOLD, N~ Y; ~
(THIS PE~IT MUST BE KEPT ON THE PREglS~S UNTIL
COMPL~ION OF THE WORK AUTHORIZED) ~
10820
FULL
Z Dote . ~.*~...~ .........................
Permission is hereby granted to: ,
County Tox Map No. lO00 Section ...L...~..~..~ ....... Block ~.. ~(~?~ .......... Lot No. ~}'./ .............
Building Inspector. : ~
InspeCtor
Rev,
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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 featu res.
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 certdicate 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 or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date ...AAgt~..2.~,. ~9.80 ......
Deck on exis~cing
New Building b~ildi;~g... Old or Pre-existing Building ............ Vacant Land .............
30 Gr. Peconic Bay Blvd. &
Location of Property ;t~Q5. [,~.u~e]_. ~8~e ............................... ~e,~'~.~, .........
House No, Street Hamlet
Owner or Owners of Property Esta~ce of Charles J. ~cNu]t¥ (John F ~cNult¥)
County Tax Map No. 1000 Section 145 Block 09, Lot 001
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. Z..0.8.2.q..~.. Date of Permit 8./...8./',8.0... ,Applicant .~...~.~.l.i.a.~..E....~.c~ .~¥ ............
Health Dept. Approval . .': ..................... Labor Dept. Approval ........................
Underwriters Approval .-..-:..-..'; ............... Planning Board Approval
Request for Temporary Certificate ..................... Final Certificate
Fee Submitted $..$..5:.0.0. .....................
Construction on above described building and per[nit meets all applicable codes and regulations.
App icant .....................................
~.~.~e.~0.~a C~,O. ~ /~/~
FIELD INSPECTION
FOUNDATION (1st)
FOUNDATION (2nd)
2.
COMMENTg'
ROUGH FRAME &
PLUMBING
INSULATION PER N.Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Exam,ne ' . ..... ,19' ^pplicafio, No.
Disapproved a/c . . 'i ........ ~ .................. ""
APPLICATION FOR BUILDING PERMIT
Date .,..,5.u. ~._y..3.0. ,. ...... 19.8.Q
' 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 uot 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 necessaw inspections.
(Signature of applicant, or name, if a corporation)
30 Mone~ct Place
....... .G. re.e.n?,~*~.,. ?.,. 7....1~t7.40 ............
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... A.p. plic.ant, l~..le~.ee..o.f..su.bj.e, ct. pre..mi~e~ ........................................
Name of owner of premises . . E~.t.a%O. P.f...C.b..a?. 1~ .e.s...I.....Mg.N.u..1.-I;y . (J. 9.h.n..F.,..M.c.N..u.l.'[.y..). ................. (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. .Yi.. '.a-.1.1.i.~a.m. . .Fi. :. M. 9.N.u. 1.. ~Y~.'.
Plumber's License No ......................
Electrician's License No .......................
Other Trade's License No ......................
Location.9f land on which proposed work will be done ..................................................
.... . ,q~.....~r..~_..~oto:~..: .s.ay .~..v.e.n.u.e...(ha.u.r.e~..L..a.n.e.) ........ L..a.ure.~ ......................
House Number i~o$- /,~oo~.Et...-. (_.,q. Street Hamlet
County Tax Map No 1000 Section .... ~..~..~. ......... Block ....~>..~. .......... Lot...O.O.~ ............
2
Subdivision ................................ Filed Map No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... .S. eason, al. orte .family. ti~zel lilxg ...............................
b. Intended use and occupancy . 9p.e. ri. ~lo.c,k. Olq..sioasPJla 1. oJle. fami l Y. ~wi~l J_j_.rlg ..................
3. Nature of work (check which appliqable): New Building .......... Addition m~xxx .... Alteration ..........
Repair .............. Removall .............. Demolition .............. Other Work ...............
(Description)
4. Estimated Cost .. 9.(10. :-. %,000 ........................ Fee .................................
(to be paid on filing this application)
5. If dwelling, numberofdwellinguni~s...°B,e. ......... Number of dwelling units on each floor . .Qr~e ...........
no garag.e
If garage, number of cars .....................................................................
6. If business, commercial or mixed ogcupancy, specify nature and extent of each type of use .resJ~dert.t:Lal.
7. Dimensions of existing structures, if any: Front. 2.(1' ........... Rear . .20 ! ......... Depth .50 ! ...........
Height . ~'~,' ....... Numbe~ of Stories .. O.1lq ..................................................
Dimensions of same structure with hlterations or additions: Front .2.0. ~ ............. Rear . . .~O ~ ............
Depth ....6.2 '. ............... .'Height ...~-J..-~2.: ............ Number of Stories ...one. ...............
8. Dimensions of entire new construction: Front .. 211~ .......... Rear ...20: ......... Depth . .J. 2.~ ..........
Height open. deck .... Numbe~ of Stories ... ~ne .................................................
Size of lot: Front .... 532 ...... , ......... Rear... 50.~ ................ Depth .407! .................
Date of Purchase By. .will..i~. 1.9.43 ............ Name of Former Owner C. harl~,s. J.. ~/lc~u:Lty .......
Zone or use district in which premises are situated ........ A....
Does proposed construction violat~ any zoning law, ordinance or regulation: . .N.o .............................
Will lot be regraded ..... 2{0,.. i ................. Will excess fill be removed from premises: Yes No xx
Name of Owner of premises .J..OiaJa..F.....M.c. lq'gl.ty.. Address . ~Rq~'~l.~..1~'...Y. .... Phone No.208.--.4,6.38 ......
Name of Architect ........................... Address ................... Phone No ................
W
Name of Contractor .illJ,Rn~. ~l.,..l~<¢Iq'll~k~y ..... Address Ll~.u,~.el ,..1~ ~. 7 ...... Phone No.298.-9.405 ......
10.
11.
12.
13.
14.
. PLOT DIAGRAM
Locate clearly and distinctly ~11 build~gs, 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.
Also~see attached plan of open deck.
Present dwellin!g was relocated and renovated on said premises pursuant~
to Building Permit No. 8563Z, dated 5/4/76. Certific'ate of Occupancy No.
ZgOS1, dated 5/25/78, issued for said dwelling. Application for said
building permit and iattached plans thereto called for a,' deck o~ open porch
but a deck was not constructed at that time.
STATE OF NEW YORK,
COUNTY OF..SUFIT.O'f.I~ ....... S~S
Wil.liam E McNulty t b g dly ppli
................ : ................................ Pin u sworn, deposes and says that he is the a cant
(Name of individual signing contract)
above named.
lessee
Itc is the ....................... . ...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dulyl 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 in the mannerlset forth in the application filed therewith.
Sworn to before me this
Notary Public, .... ~ ~ vt.',mm. ...... m.C°unty
Netoty Publ e, Stero of New Yo~'R .............
No, 52-7135315 19~
~ommlssJtm Expires gsrch 30,
NoT'T~ BUILDTNG o~PARTMENT AT
7~-'1802 9 AB TO 4 PM FOR THE
FOLt.OWING LNSPECTIONS:
1. FOUNDAT ON - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FR~,"'AING & PLUMBING
4. FIN,"L - C''hNSTRUCTION MUST,
BE .r':'t'°' ,--,qr-_ FOR C, O,
ALL COb'qTql)CT!ON SHALL MEET
'THE R[OU~R~'&ENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
-- ' ~ / ' ' / SUI~F05K COUNTY H~ALTH DEPART~f~
~v[~e ~ot ~n~ mE ~ surveyor's ~ s[~co~[~oss[~ ~TER SUPPhY- PRIVATE WELLS
: SEALSHALL NOT ~E CONSIDERED rOeE A VALIO TRUE COPY - GUARaNTEeS NEAR~ST PUBLIC WATER- 5 MILES~
THE WATER 5UP~Y AND SEWAG[ DISPOSAL SYSTEMS FOR THIS RESIOENCE W'LL JOHN FMcNULTY
.- . . , , . _.,... .
LAUREL
SUFFOLK COUNTY, N Y ~o~
YOUNG & YOUNG, LAND SURVEYORS
400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK
DATE ~'~-~ SCA LE ,I ~ NO
MAR. 8,1976] I =50 76-94
· TEST HOLE ~ -, ~, ~ '/ -
REVISED:
NOV,23~ 1977
JOHN F. IVlcNULTY
L~URE L
SOUTHOLD
SUFFOLK COUNTY, N Y .o,~,.~ w ,,'o,.,,~, ,,'-~- .u,,,,~?o.
YOUNG 5 YOUNG, LAND SURVEYORS
' ,400 OSTRANDER AVENUE
, ,~ 'RIVERHE~NEW YORK '-
~:'' I''' '