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HomeMy WebLinkAbout11428-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12.432 Date April 25 198.4 THIS CERTIFIES that the buildh~g .-'.-:r~W..c~w~ ~-.[.:i, i3cj ...... ' ......................... 1505 Leeton Drive Location of Property ........................... Southold Houso Vo. "' 'S'tle i ....................... County Tax Map No. 1000 Section .. 9.5.9 ....... Block . ,. 9.1 .......... Lot .... .0.1.7. ......... Subdivision ..... ~X. ........................ Filed Map No....X ..... Lot No.. X conforms substantially to the Application for Building Permit heretofore fried in this office dated Sap%ember 16 , .................... 19.8..lpursuant to which Building Permit No... ,1.1.4 ¢ $..74 .......... .dated ....O.c rob.er. 20 ............. 19.8. ~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ....... .a..p.r~ .iy.a.%.~. 9.n.e.r.f.a.m.i..ly' .d.w..e.l.l.i.n.g .... (*$.e.e. below) The certificate is issued to ....... C.]~JI.FFORD & VIRGINIA SMITH (o wner,'f~e-or-tF~l~m) of the aforesaid buildiug. Suffolk County Department of Health Approval .1...l .-.S.O.-; 6. .3.,..2. ./.1.5./.8. 4. t..R.o.b..t....A. :. Vi 11 a, P.E. UNDERWRITERS CERTIFICATE NO .... N 626755 Rev. 1/81 Building Inspector *EXCEPTIONS TO N.Y. STATE FIRE PREVENTION & BUILDING CODE: 1. No heating system: does not cover occupancy beLween 15Lh of September & 31st of May of following year, Sec. 1000.lb, 2. No vehicle storage in building: no fire separation provided for dwelling, Sec. 717.3f-1. TOWN OF SOUTHOI~ TOWH HALL sOUTHOLD, l*l~ Y. BUILDING P~ER,~IT (THIS PERMIT MUST BE KEPT ON THE PRE~,ISES UNTIL ~ULL COMPLETION OF: THE WORK AUTHORIZED) , No. 1-1~28 Z Do~e,~.~,,c./.:.~,~&~.../- ~ ....... , ~.~../ Permission is hereby granted ..... ~~...~..~~.to:/.,.,~.~'~' ...ZZ ...... .~.&~.....~.~ ..:........ ............ . ....... ,. .~,~... .~ ~o ..... ~..~~...~....~.~.=~....,~.~z~...,, , .......................... ................ ~ ....................................................... ~"'"' ............ "'?"~ ................. U ....................................... coun~ *~x ~,p ~o. moo s,,,o~ ....... ~!oc~ .~,..0.~ ikot ~o....~l ......... B~ilding I~spector. .......... Rev .6130180 FORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .................. Date ................................. 19... THIS CERTIFIES that the building ................................................ Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fled in this office dated ..................... ,19... pursuant to which Building Permit No ...................... ,dated ............................ 19..., 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 ......... .... ¢" " ' '(' ' ' ' ' The certificate is issued to ........................................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 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 topograph ic featu res. 2, Final approval of Health Dept. of water supply and sewerage disposat-(S-9 form or equal). 3. Approval of electrical instalIation 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 requ ired to prepare a certificate, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling ~r 3. Copy of certificate of occupancy $1.00 land use $/s'/$5.00 Date New Building ............. Old or Pre-existing Building(Z) ........... ~/Vacant Land ~ ............ Location of Property . !i,-~.'-~l~.~ ................... ~. ¢'-.41:,.'~-~. ?.~. House No, Street ~ Hamlet Owner or Owners of Property ~LI../':;./.~?~ ~ ~. ?/: ~. ,F~L.~.~.~_~- ~ ~ .//..~:1.,. ~ ./],,, ! ~/.'7.- .'/.- / ............... County Tax Map No. 1000 Section . ~),,~!'~. ....... Block ...(~; / ......... Lot... ]~. :/, .~. ...... Subdivision ................................. Filed Map No ........... Lot No. /~.-/ ......... Permit No. ~. / .~'/.~':: ~Date of Permit ~ ].~)~). ~.Applicant .,.~ {-J .~',O.'~.:~ .,~.~t. i ~?:/. ............ Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval ..................... i..Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificat~ ....... Fee Submitted $ ............................. Construction on above described building and permit~meets all appl~'~and regulations. Applicant .~.,~',~~ ................. , ..... FIELD ~NSPECTION 1. · FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY o C,ODE FINAL ADDITIONAL COMMENTS ,Application Received 19 Disapproval Issued --! Pe~it # 19 FORM NO. 16 APPLICATION FOR DEVELOPMENT PERMIT In the Town of Southold 1. Type of Development Proposed: Addition and/or Alteration[] Other (specify) 2. Elevation Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement feet (b) In a V Zone, bottom of lowest structural member fee'--~-~ 3. FIRM-~Flood Insurance Rate Map, Zone designations ~. Location of Property: New St'ructure (including storage tanlcs~/ Flood. Proof Below Base Flood Elevation[~ inches ~ inches County Tax Map No., District, 1000, Section~'~O0 Block~/~O Subdivision Filed Map # ~ Lot(s) 6. P~ermission to be granted: ~_~Q~ner as above'New ~Under Contract]~ Lessee ~ Contractor 7. Approval from ether(s) before Pe~it is issued: DEC W~LANDS (Town Board)__ HEALTH SERVICE ZBA BUILDING PERMIT PLANNING BOARD O..w~er~L~, New Own~ O~ntract~, LesseeS, Agentl--I, Con- t~actor~, and agree-to comply with all applicable sectional the Code of the Town of Southold; County, and State and to admit authorized ~peotors to premises authorized to perfo~ o~ have performed the said work ~d bo ~ake and file this application~ that all statements cOntain- ed fn this application are true to the best of my knowledge ~d belief and that the work will be perfo~ed in the manner~et forth in the application filed therewith. s~ o~ ~ ~o~K ' ' Appllc~t, s mailing FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ ~.~/~ ./7'.~...,ff....~:.. To C~'..~.~.~..~.~-~.. ~ . .~r... ~a~ . .c.e~.~ .......... PLEASE TAKE NOTICE that your application dated .... ~...~,~ ........ 19~/~. for pe~it to construct...~(~ .~((~..~~.~., .' .................... at h~s~ ~o. Street Hamlet corny T~ n.~ ~o. ~ooo s~tm ... ~.~ .... .~o~k ...~ ....... not . ~/~ ...... SubdMsion ................. Filed Map No ................. Lot No .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~',~ ~('00~)3~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW "(ORE lO03,e THI~ CERTIFIES THAT only Z~te electrical equiptnent as described below and int~duced by the applicant named on the able application number in the prem~es of in ~he followlng location; ~ Basemen~ ~ 1st Fl. ~ 2nd Fl. Sect~ B~ Lot was exatnlned on and found to be in cotnpliance with ~he requirements of this Board~ FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SW~TCH~S NCANDESCENT FLUORESCENT DRYERS SYSTEMS NO.OF FEET OTHER APPARATUS: 1-G.F. I. R V t C A.W.G NO OF HI-LEG A,W.G. PER ~' OF CC CONO OT HI-LEG 1 2 E OF NEUTRAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors~ may be identified ~PY FOR B~ILDII~G DEPARTMENT. THIS COPY OF cERTIF CATE MUST ~jO~BE ALTERED N ANY MANNER TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 March 14, 1984 Clifford Smith 11 Edna Court Valley Stream, N.Y. 11580 Dear Mr. Smith: I have checked with Mr. Horton as to why you haven't received your certificate of occupancy. He said that he has tried to do a final inspec- tion of your house but has not been able to get in to do it. If you will let us know when someone will be there who can open the house or when you will be there, we will be able to issue the certifi- cate for you. Yours truly, Building Department ~LDI~N W. YOUNG YOUNG. % YOUNG 40o ~O PR AVENUE RIVP. RHff,~.D, NP.,W TO~ ~z~ HOW~%RD W. YOUNG L~ ~n~yo. September 18, 1981 Building Department Town of Southold Southold, New York 11971 Attention: Mr. George Fisher Gentlemen: Pursuant to recent conversation with Nr..~Clifford Smith, I have amended his survey and am enclosing herewith four ($) prints for your use.Th~s' survey indicates elevations which are referenced to mean sea level datum. Very truly yours,~~ Howard W. Young ~ HWY:kbf eno. cc: Mr. Cl~ifford Smith + print 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ....... .i ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ,/. ,/.4/~..~ '.~., .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre{ or areas, and giving a detailed description of layout of property must be drawn on the diagg'am which is part of this ap[ 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 pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) .... ¢l ilin adci;ess ;3appliCant) flY O State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of premises ........................................................ (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 .......................... ~'~lumber's License No ..... ~..g~../.~f~..c)..~.~../.~... Electricians License No, . ?.'.fi/..~t.?.~O.C./r~. (~.. .~. 0~ 1.4-) Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ............. ........... .......... ..................... House Number / Street Hamlet County Tax Map No. 1000 Section . .O.~..q ........... Block O 0 / Lot 0 I~. 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 ................................................................... b Intended use and occu n pa cy ' 3, Nature of work (check which applicable): Repair Removlal ~. Estimated Cost .......... 5. If dwelling, number of dwelling uhits... If garage, number of cars ...... ~ ...... 5. If business, commercial or mixed !occupan 7. Dimensfons of existing structuresI if any: Height ............... Number of St~ Dimensions of same structure with alterat Depth' ' Heighl ~. Dimensions of entire new constrtiction: F Height ............... Number of Sb %w Building .......... Addition .......... Alteration .......... ....... Demolition .............. Other Work .............. (Description) Fee .~..~. ~ .~.~,.0. ~ (to be paid on filing this application) ........... Number of dwelling units on each floor ................ :y, specify nature and extent of each type of use ................... ~ront ............... Rear .............. Depth ............. nes ............................................ -7..': ...... OhS or additions: Front ................. Rear ................ ...................... Number of Stories...':; ............... font ............... Rear ............... Depth ............. files ....................................................... 3. Size of lot: Front ........... : ..... 1. Zone or use district in which preraises are 2. Does proposed construction viohite any z, 3. Will lot'be regraded .......... i ...... Name of Architect"/~---....~.~'. ~. ~.~. ~ .t/~. Name of Contractor .'~.' .... .~.~'~..t~ .ff.. .... Rear ...................... Depth ..................... Date of. Purchase ............................. Name of Former Owner ............................. Locate clearly and distinctly all !buildin~ lin~s Give street and block humber tterior or corner lot. f FATE OF NEW YORK, . OUNTY~~ )eve named, e is the . said owner or owners, and is duly authc ~plication; that all statements con~amed tn 'ork will be performed in the manner set fo] worn to before me this situated ..................................................... ~ning law, ordinance or regulation: ................................ ........... Will excess fill be rem_overLf~om premises: Yes No '5..'.~. 6.~JSt.. Addressl/~.~.* .~.~..5~t~,~,44Phone No. ~. ¢. ~.'~. P.~..7.. ! ~...~. ....Address ................... Phone No ................ ......... Address ................... Phone No ................ PLOT DIAGRAM whether existing or proposed, and, indicate all set-back dimensions from description according to deed; and show street names and indicate whether ~ ............ being duly sworn, deposes and says that he is the applicant tact) (Contractor, agent, corporate officer, etc.) , fized to perform or have performed the said work and to make and file this this application are true to the best of his knowledge and belief; and that the th in the application flied therewith. state et now ~/orl~ ' g ' (Signature of apphcant) N0. Suffolk Cl ,~:~_- lerm £xpire~ March SO, ~UFFOT:K ~O~Y H~T~ ~P~R~ SURLY FOR v~e n~wa~e disposal a~ water Supply AT SOUTHOLD OAT~: MAY 26, 1981 ~ci.~z~):~s fo~ t~' LS loc ~ion have been ~WN ~ SOUTHOLD SCALE: I"~O' inspected-hr tbi~ d~pa~'tn~nt ~d fo~- p.~ 'SUFFOLK COUNTRY, NEW YORK NO. 81-229 ~10 bO ~at ~ctO~ ~ ~-~ ~U~UTH~RiZE0 ALTE~TJON ORADDITION m ' $URV~R~$ INKED SEAC OREMBOSSED SEAL SHALL , , , N6UA~AN~E~ INDI~T~qHEREDN ~ALL RUN ~LY ~ HE~ DEPARTMENT-OATA FOR APPROVAL TO C~STRUCT ~ ~R~ ~ WHOM THE SU~EY Is AND ~ HI~ ~HA[F ~ T~ ~TLE CWP~Y, 6OV~N- N NEAREST W~ lAIN__MI.. N SOURCE ~ WATER ~I~TE ~PU~IC ~ MENTAL ~ENCY A~ LE~DIHG iNSTITUTION LISTED ff ~FCO~TAXMAP ~IT~SECTION ~(? B~CK oo/ LOT o/? H~E~ ~O TO~E ASSIGNEES OF THE LENDING ~E~ ~ ~ WELKINS WITHIH IOO FEET OF T~S PROPERTY INSTI~UYI~. GUARANTE~ ARE' ~T T~SFERABLE WI~CC~FORM TO T~E ~TAN~ROS OF THE SU~K COUHTY DEPARTMEHT ~EXI~TMG ST~UC~RKS ~E FOR A SPECIFI~ OF HbLTH S~ICE~. PURPOSE AND ARE NOT;TO BE USED TO ESTABLISH ~LICMT~ PROPERTY LINES OR FOR THE ERECTION ~ FENCES &DDRE~S "" ' ~ ' ~L. ~ ~ OS~NDER AVENUE AN~ ~ND SURVEYOR N.Y.S. UCENS~ NO. 12845 W. YOUNG, LAND SURVEYOR ? SUFFO~ COU~ffY DEPARTMENT O~ HF,~I. TH SERVICES HEALTH DEIN(RTMENT-DATA FOR APPROVAL TO CONSTRUCT , -, ~o, m,,..o ,.T,o, o. ,~N ~,o~-~._~ C OTHER THAH THOLE IHOWN NEREON. SURVEY FOR CLIFFORD SM!TH 8~ VIRGINIA SMITH AT SOUTHOLD DARE: MAY 26) 1981 TOWN OF SOUTHOLD SCALE: I", ~0' SUFFOLK COUNTy, NEW YORK NO. EDUC & T(~grOt~ INSTI~OTI~. 6UARAHTEE~ ARE ~T TWSF[RAILE /.~ ~ '~ TO A~ITI~AL INSTITU?I~i OR SUBSEQUENT ~ '~. ~.~ ~ OS~NDER AVE~E ii 1YOUNG s YOUNG YORK / q~/ AND~ND SURVEYOR N.Y.S. UCENSE / i I1 HOW~.O w.~ou.~, L~.D suave~o. ~ N.Y.S. LICENSE N0.4589~ SURVEY FOR CLIFFORD SMITH & VIRGINIA SMITH AT SOUTHOL. D DATE: MAY ~ 1~81 TOWN OF SOUTHOLD SCALE: SUFFOLK COUNTY, NEW YORK NO. #U~AUTNOJ~IZEO ALTERATION OR AODITION TO ..o,,,,._..,,.o~_..~,,,..o HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT TIlE WF..qlON FOR WHOM THE SURVEY IS PREPARED ~"~ ~'~ ~ A#O. #It D[~ALF TO T#ETITL. CONpANY, 6OVI[RN- / ~ ~.~i 7,~. ._ ..........,_,OD_ o._..o_ T---.., '" YOUNG s YOUNG ~OS~NDERAVENUE RIVER~AD~ NEW YORK · = MONUMENT ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR NY_S. UCENSE NO. 1~845 HOWARD W. YOUNG, LAND SURVEYOR ~ L~T~ ~ W~L(W),~IC TANK(STI&CES~QLS(~I~N ~E~ N.Y.S. LICENSE N0.4589~ ,:l ApPROYED AS NOTED NOTIFY BUILDI~N~ PM FOP- THE 765-1802 9 A~A TO ~ f i I .... l'j i ~,, .... - ® .%.