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Home My WebLink About10772-zWf, - FORM No.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y., Certificate Of Occupancy 10170 October 2, 80 No. ..' . R .............. Date................................,19... THIS CERTIFIES that the building ............................................... . Location of Property J. 3Q ..Hamilton. Aye..,, ,,,,,,, , , , , , , , , Mattituck House No. Street Ham/et County Tax Map No. 1000 Section ....... 1 0 .....Block .... 9? ..... ... .Lot ................ Subdivision ..... 7 ........................ Filed Map No. ..7 .....Lot No. ..... ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated July 10 80 10772 Z ...................... 19 ... pursuant to which Building Permit No. ..................... dated ....July 11 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 ......... ... Addition. to .rear..of, ................ The certificate is issued to ...Clara Wells Foster • • (owner, Imaximmmxx of the aforesaid building. Suffolk County Department of Health Approval .......:` ................................. . UNDERWRITERS CERTIFICATE NO..... N. 4942.06..... , ..... , .. I ... , . Rev 4/79 s .'.... � ....... Building Inspector S4. _.... _... . FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P -REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ry %r ,% N° 10772 Z Date ......... V..U.�.�....��....................... I9.V...0 Permission is hereby granted to: ................ ,![Ctl.GUA.IItT ...4 ....................... . .:............... ro...�a.�,,.sl«c.�.GT.......lw✓.�ra.r..��r�.� ...- ..�.�. �.r��:!.�l�j../,o o.<-�.l....1,d.:.. . r.,r.G...... .... ( at premises Iota/ted at .............................. (...... k..44'.Q....... G(�1lZeC1..L�/ ..................... .......b ................ pursuant to application dated ..... Building Inspector. Fee $..�J�_...... .... .J...... ........................... ..... .... .................. ............................ I..G!..................... 19C.., and approved by the ............................... Building Inspector FORM NO. 6 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 prepare a 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 ... /�l.�®............ New Building ............. Old orP/re-existing Building ../ ......... Vacant Land ............. Location of Property .. g Sv..... f��/�� r4N /7.l�rr ............f/T.T/, T. f/G/C ....... House No. Street Hamlet Owner or Owners of Property ..fir = �Il� /f...A0.4 / L.`a' ... 4.S rAlz............... County Tax Map No. 1000 Section .... Block ....0!4�....... Lot..0.0.5r Subdivision . .... r- Filed Map No. ..� `.:....Lot No. v` ............... ........... Permit No. Date of Permit . 7/!1;/AP.Applicant .l1 g.—.r g, , {°/2/ gS/,N�? , , , , , , , T.. Health Dept. Approval ... ..—I ................Labor Dept. Approval ......................... Underwriters Approval . W. 4. 9.—J dry .........Planning Board Approval ........ I ............. Request for Temporary Certificate .....................Final Certificate .11.................. . Fee Submitted $ . X: .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant. �Z:.'.". .��+,r�? .................. Rev. 10-10-78 1opl{'�J&IVg910 THE NEW YORK BOARD OF FIRE UNDERWRITERS LYM BUREAU OF ELECTRICITY, 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date a. r(:Pte0l7G`?Y.' 23, 1.9&) 068194 Application No. on file N 4-04206 THIS CERTIFIES THAT only the electrical equipment ,,,,,q,��u.ip ymy�eentNas descr,]iibed below and introduced bq..�y�{.�t��th}�.ehpa he nt ny,�m�ped on the above application number in the premises of VJ,CL.B.gL dVrFS. t$:5•, .b/ i ia.lts>zt Ave, 1'1' L4�C LV�Fo in thefollowing location; ❑ Basement E-01stFl. ❑ 2nd Fl. Section Block Lot was examined on Sapic"zr 18, 1980 and found to be in compliance with the requirements of this Board. FIXTURE OUT OUTLETS RECEPTACLES SWITCHES FIXTURES RANGES tOOXING DECKS NygyOpY OVENS DISH WASHERS EXHAUST FANS INCANDESCENT FLUORESCENT AMT K W AMi K W AA1i K W AMT K W AMT H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT TRANS HEATERS MULTI -OUTLET NO OF FEET DIMMERS AMT K W OIL H P GAS HP AMT NO A W G AMT AMP AMT AMPS AMT H PSYSTEMS AMT WATTS 1 30 SERVICE DISCONNECT NO.OF METER EQUIP S E R V I C E AMT AMP TYPE 1 q 3W 1 R 3W 3 % 3W 3.g dW NO OF CC COND PER $ A W G OF CC COND NO OF HI -LEG OF HI LEG NO OF NEUTRALS Of NEUTRAL OTHER APPARATUS: 1 -tie F.1. Peter kA)&) is Main 1W. � GENERAL MANAGER sotitbold, N.Y. 11971 Lica 137 H Per This certificate must not be altered in any manner; return to the office of the Board if Incort'ect. Inspectors may be identified by }heir credentials n n al COPY, FOR BUILDING DEPAR MENT. THIS COPY_ OP. C R IFIC/T .O f�(OT BR'A47ER D IN ANY MANNER. FIELD INSPECTION DATE FOUNDATION (1st) _I FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N.Y. STATE ENERGY CODE 4. FINAL W -N o - monumI--r* R R CONKS -1W I . G7,0A0 i MAP OF i.AhlD �""`' M&,TTI-TUCK, N.-Y.:'7-Survevlad`Sept-1; 1948 �� • ,� � � Grsertport;lVewYor ry Y W FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined �/ �/ . !�...... 19 yy� Approved Ay...It....., 19 v.�Permit No./4. ,JU.�1 Disapproved a/c ......... ................. ... .... Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.,l,Wd....... Date ... .(elliA.y... 19 $�? 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. ................ (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. DAZA.......................................................................... i , l �' Name of owner of premises ...�.k . 1. /�... W � �. 4 h Z ...eIeS.T4.-�- ............................... (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. .. /,.0 .................. Plumber's License No. ...411"-W �-......... . Electrician's License No............. Other Trade's License No . ..................... 1. Loc t* f land on which proposed work will be done . ................................................. .AY.A............ A/AT-77T0CA::L............................. House Number Street Hamlet County Tax Map No. 1000 Section.....''.//. l7`'4.......... Block .... ............. Lot .. d�°J.J........... . Subdivision .................... ................ Filed Map No. .. ........ Lot ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....x; .L'- SI- D -6A).%-/. A 1 ........ • ........... . b. Intended use and occupancy /4 L„. !i%%��l7Potx<� .�U�..... . 3, Nature of work (check which applicable): New Building .......... Addition ...t... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ........ 0 ........................ Fee . lam:........................... . (to be paid on filing this application) 5. If dwelling, number of dwelling units ...../......... Number of dwelling units on each floor. :r :............ Ifgarage, number of cars........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... ► ........ . 7. Dimensions of existingstructures, Number, if any: Front ... Rear ...+`�. .......... Depth . �i_% I ......... � Height 6 7 of Stories .... /...2 ............. .....................0........... . Dimensions of same structure with alterations or additions: Front .. ,.3 .t........... Rear . J.4 ............. Depth ...... Z......... Height ......l.G.............. Number of Stories ...... . D 7 �.......... g ..../..2......... Nu construction: Front .Rear .l........ Rear ..l.d..........DeptE .lam........... 9. Size of lot: Front ... , , . er of Stories .... 1........ . 8. Dimensions of e1)tire new Height,5p 0....... ..............0.............. ........... ... � ............. Depth ../, ila............... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed constructioniolate any zoning law, ordinance or regulation: ................................ 13. 14. Namell oofregraded premises ��. 11 F. ...... • • • Will excess fill a rem premises: Yes � AA ..o.STo AN4 _ ... Address ..aggIAtp� >wRTTh-rill ..... Phone NoA!?V:-7,V4'5U... Name of Architect .......... . ......... . ...... Address ................... Phone No............... . 5JAI`l ........... Address ASA .uWATAFL, t? ... Phone No. Name of Contractor . ,. J4[S S yv rNOL �! PLOT DIAGRAM D 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. S&4 /�TiA'ey� P nia7 l�w�� STATE OF NEW YORK, COUNTY .... S.S ........................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heisthe........................................................... ............................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 manner set forth in the application filed therewith. Sworn to before me this .......... .�...... .day of'... . ............1 19 .0. V Notary Public,iv Ilk ' LINDA F.e f ALSK! ,— NOTARY PUBLIC, State of New YAAf�V/�� INa. 524524771 .../....... .. .......... ............ . Qualified in Suffolk County .T(Signature of applicant) Commission Expires March 30, 198, 4 I?w 7 -7- TI _T.MATCH GxrS'r. L T IT T 7, r r. "1 Tb J, , "-III IV 17, g al I j SOUTH ti 4 Is Is - j 0, _41r It P'W� I is RJJJ a� k / /Cil _ �Ir �xc I�. _13.MrJt�'Y .-:� r. � '��U p��y. - 0 t,2-, 6 1 /V r -LO r=A,-r Et Ey. x � f- V, sal 10 r mv Isr S VED 1. XA fL rz Q FdOl T Al JZ B 1 9 o f5 DOE - is -- BY -rM T FEE, He AR Ft Bull -DIN 4 P F q NOTIFY 9 AM S1. r, ITO T 765-1802ING ;NSPECTI RE IRED FOLLOW KrION I FouND RE -f E BING FOR POL)RED I G F VR 2 ROUGH ION MfjS _7 3 INSul-ATION CONSTROC FINAL FOP, C 0. MEET compl- SHALL bF -TI'E col"15l" ALL ENERGY THE REP -f 101, PLoT 6 d SaAL)L 601z; �iwc LF FOR ST -rE CDN SPON51b A RE TION EPRoi CODES. No 05-f Ruc OR CU ............ DESIGN ... zxa t�it 8 ef Ili U 4P N A 16 MIT'11TOCAC; 41Y c ls T L� 4 ss N S oFF, Vqp T5. (}cTN 51nE5 R{F _ I 1z' %�/f.ti OtlC h��4�7 ;'ij' SVR F2. 2x8 rG" e.c.' - — _� � I` I R,�GII ✓bLiS,. ".. F'd cri oR• _ tl ' Cra:T YU. �RnSS tiFC• St /%G " a R � ' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE` " r OF OCCUPANCY f r "n I1, T ISI Wr ti u 0 9 n ASI IHOTED ° L y p (gyp a.� �r; fp�PROVED '?I / VA' % Id BY : " TMENT AT D. ,:,. :� i ^ I li X4;.44 3 y++`'u °�'^ ✓ ', tr "^'�'�t4 i t "� FEE: BUILDDEPA NOTI ING TO'4 PM FOR y,, 765-1802 4 AMr r `" a N n ' ` ri ING INSPECTIONS:REQUIRED 4", FOLLOW oI DATION -TWO �, e as :' i�Flr,+ a aryJ.i4' FOUN CONCRETE GING .;� X} FOR POURED PLM ,-/' ,�.At !x` • + , ,,y�r (s fECT FRp,MIh1G& +i n/' iK �I"'' �. ROUGH - + '" +navel , , : Y' �,, QST ¢ �. -. F °t r 4 + —qsn Sn'ue. 3, tNSUI ATlON CONSTRUCTI;DN � M SE Cewpf FTE FOR C.0. SHALL MEET ALLCONSTRUCTION THE N.Y. REQUI,REMENYS' OF & ENERGY N STATE CONSTRUCTION RESf+ON51®LE ` EQ6ES NOT STRfIGT10N pkri.?F�cau.g r:`3`�Af•.�` Pf v r , I .4 L-AQNVFjr2. DRAwl) 6YIN s 7E i ----�-�'-- - I �rJtx� Rs SNOwti�7, ; c7 � oK S oFF, Vqp T5. (}cTN 51nE5 R{F _ I 1z' %�/f.ti OtlC h��4�7 ;'ij' SVR F2. 2x8 rG" e.c.' - — _� � I` I R,�GII ✓bLiS,. ".. F'd cri oR• _ tl ' Cra:T YU. �RnSS tiFC• St /%G " a R � ' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE` " r OF OCCUPANCY f r "n I1, T ISI Wr ti u 0 9 n ASI IHOTED ° L y p (gyp a.� �r; fp�PROVED '?I / VA' % Id BY : " TMENT AT D. ,:,. :� i ^ I li X4;.44 3 y++`'u °�'^ ✓ ', tr "^'�'�t4 i t "� FEE: BUILDDEPA NOTI ING TO'4 PM FOR y,, 765-1802 4 AMr r `" a N n ' ` ri ING INSPECTIONS:REQUIRED 4", FOLLOW oI DATION -TWO �, e as :' i�Flr,+ a aryJ.i4' FOUN CONCRETE GING .;� X} FOR POURED PLM ,-/' ,�.At !x` • + , ,,y�r (s fECT FRp,MIh1G& +i n/' iK �I"'' �. ROUGH - + '" +navel , , : Y' �,, QST ¢ �. -. F °t r 4 + —qsn Sn'ue. 3, tNSUI ATlON CONSTRUCTI;DN � M SE Cewpf FTE FOR C.0. SHALL MEET ALLCONSTRUCTION THE N.Y. REQUI,REMENYS' OF & ENERGY N STATE CONSTRUCTION RESf+ON51®LE ` EQ6ES NOT STRfIGT10N pkri.?F�cau.g r:`3`�Af•.�` Pf v r , I .4 L-AQNVFjr2. DRAwl) 6YIN s 7E i ----�-�'-- - I �rJtx� Rs SNOwti�7, ;