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HomeMy WebLinkAbout11431-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. Certificate Of Occupancy No...z.u. 3. 9.° ......... Date .., .O.e.c.e.m..b.e?..!7 ................. 19 .8.2. THIS CERTIFIES that the building ............................................. ,.. Location of Property 450 Jockey Creek Drive Southold House No. Street Ham/er County Tax Map No. 1000 Section . .0.~..0 ....... Block ...0..5. .......... Lot ...0.0.9. ........... Subdivision...X. ........................... Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · $.ep.b.e.m..b.e.p..3.9 .... '.., 19 .gfi. pursuant to which Building Permit No.. '] ~.' .1.4.3.1...Z ........... dated .... .c.c. t:. 9 .b.e.r~ . 2. .3 ............ 19.8.1., 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 ......... .~.p.p.%¥.a.t.e. one-family, dwelling. The certificate is issued to WILLIAM KNOELLER ..................... /o¥,'~;,'/&:~'~/r~ha;'d ..................... of the aforesaid building. Suffolk County Department of Health Approval .1.1.': .89.-.5.8.,..ltl./.! .6/.8.2.,..~.o.b..~....A.:. y).l. 1..a., UNDERWRITERS CERTIFICATE NO. N 56396 Building Inspector Rev. 1/81 FOBM NO; ~ Town o~ ~uTHcLD BUILDING DEPARTMENT TOWN HALL~ SOUTHOLD, N~ Y. BUILDING P~R~iT (THIS PERMIT MUST BE ~E~ ~ ~HE ~E~I~ ~1~ ~ COMPLETION OF THE WORK AUTHORIZED) N? 11431 Z 0o~..~~'~ ..... ' ........ ,~ ~or~issio~ ~ hot,by omnted to: ~ ~ ~ ....... X~m...~z.....~...~, ....... ~7......~....~.~.~~ ~ ..~..~&.~zc~.~...~....~,~.....~~:~....~..,::..:..:.~:.,. . ~ ............................................ ~.z/~,~...~:~~¢~ ......................... tit p~emises located at .. :. . County T~x Map No. 1000 'Section .... 0.....~.0 ...... Block ,.'.~.~ .......... pursuant ia application dated .................. i..:i, .... Building Inspector. · at No...~ ......... '~', and approved by the Re, v, FORM NO. 6 TOWN OF SOL!THOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao 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. 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 .. ~ne 7, 1982 New Building ...t~e.~l ....... Old or Pre-existing Building(Z) ....... ~/Vacant Land ............ Location of Property /~.5.Q ,T~Rk. e3'..C.~.e.e.k. Dt£ve, S&aC.b.o.[d, bT..~.. House No. ~t~eet Ham/et Owner or Owners of Property ~/i11~.am Knoelle: _,_ County Tax Map No. 1000 Section 070, Block0.5. Lot. 009 ' Subdivision ..... lT~,q~;~,b.e.d. ................... Filed Map No ........... Lot No .............. Health Dept. Approval . .Yea .... "~/~. Labor Dep Ap val ............... ,. · Underwriters Approval Ye~l Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .... g.t.~.a.[. ........~ Fee Submitted $..5.00..~ ................... Construction on above described building and permit~meets all apl~cabl~co~l~ eS and regulations. Applicant ...... ,~._..,~_~,,..~., ~.,~ ........ / .... ~...~ ............ R~. 10-10-~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 100096~ BUREAU OF ELECTRICITY · ', ~1~ BE JOHN STREET, NEW YORK, NEW YORK 1003~ THIS CERTmlEStV~AT2T'8' 1982 Wilita~ Kaoei].er, S/$ .Toc~e7 C~ D~d. ve, 413' ~/0 ~ t~ct., Sou~.olct, N.Y. in thefollowlnglocation~ ~ Basement ~ 1st FI. [] 2nd FI. . Section Block Lot was examlncd on ~y ~ , ~ a,~d /ound to be in compliance witk the requirements o/ this Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES FLUORESCENT J.7 z2 DRYERS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E R V ~o EC.C~,CON~. O~ ~:C.~O~). OTHER APPARATUS: ~ocors ~ 1- lhp, 1-G.F.I., 2-Smoke De~ector A W G NO OF NEUTRALS A, W G OF HI-LEG OF NEUTRAL 1 .5 W.T. 516 (~ter Rd., ~le, N.Y. 11782 L:Lc:88gg This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectois may be identil e~fl~he~r credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CER?[FI~ATE!JVI~US~ NOt BE ~TERED IN ANY MANN~.. - FIELD, INSPECTION FOUNDATION (]st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1130:2 Examinet~..~... ~' ... 19°C-/ ^ppro edOC77..Z. ..... . ern,,, /Z Disapproved a/c ..... "~ ........................ ,? ' ,. , (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No ............ Date Sept. 3..0,] 1981 19 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 plaffs, hccurate plot plan to scale. Fee accm:ding.te schedille. 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 diagram which is part of this cation. c. The work covered by this appticatlon may not be commenced before issuance of Building Permit. d. Upon apprcval of this application, the Building Inspector will issue a Buildiug Permit to the applicant. Such pern shall be kept on the premises available for inspection fl'.ronghont the work. e. No building shall be occupied or used in whole or in part for any purpose whateYer until a Certificate of Occupan shall have been granted by tim Building Inspector. APPLICATION 1S I tEREB¥ MADE to the Building Department for the issuance of a Building Permit pursuant to t Bnilding 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. Law Bros. Homes, Inc. (S, ig~:ktu, re of.a~licant, or name, if a corporation) Istip Terrace, N.Y. (~ailing address of appiicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Contractor William Knoeller Nmne 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) Boilder's License No. 3006-1tl Phnnber's License No. 400.-P. Electrician's License No. 889-E - Other Trad'e's License No ...................... /-/~--O 1. LocatiOn of land on which proposed work will be done....89.'..s.i.d.e..Jpc, k.e.y..C.r.e.e.k..D.r.i.v.e.,. 413.39' East of.Main goad. Southold, N.Y, House Number Street Hamlet County Tax Map No, 1000 Section . Iflflfl 070 Block fl~fl 05 Lot 0~9 . Subdivision ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use ant] occupancy of proposed construction: a. Existing use and occupancy Vacant pro. peEt. y, b Intended use and occupancy i family, dwell.in~ I. Nature of work (check wbicl, applicable): New Building .. x Addition Alteration ..... Repair Removal Demolition Other Work ' Estima!ed Cost ........................................... · ' : ' (to be paid on filing this application) ; It' d~elling' number of dwelling milts one Number of dwelling units on each floor · numberofcars ' 1 car attached It garage, . ....................................................................... i. It' business, co mere a or mixed occupancy, specify hature and extent of each type of use ................. L Dhnensions of existing structures, if any: Front...~9.rl.e ........ Rear .............. Depth ........... Nmnber of Stories Height ................................................................... Dimensions of same structure with alterations or additions: Front Rear . Depth ' Height Number of Stories I. Dimensions of entire new construction: Front . 56! ........... Rear . .5.6.'... Depth 2.4. Nuniber of Stories .1~ ' Height ................................................................ ~ Size of:lot: Front .. .1.0.0.... , ....... Rear 106.28 . Depth .... 1.8.0 .............. .......... ~ ............... ;' Edith M '' ) Date 6fPurchase .... 9/.81...~ e of'~o ncr Own Terry t Zone or use district in which pr&hides are situated A ... !. Does proposed construction violate any zoning law, ordinance or regulation: .gq... ' ......................... t. Will lot be regraded ..... .Y.e.s.[ ................... Will excess fill be removed from premises,go ~x~-c%s f:l-ll~lo t. Name of Owner ofpremlses .W.m+. g.noeller Address 3995. Dado HoJ. e Dr Phone No 265-2414 Name of Architect .,lakn .llo~e,lr.t.y....; ....... ; . . Address (lq~t;q~t~qr.t.. ......... Phone No. 4.2.1-1651 Name of Contractor .L~w..g. ro. sl. Hp.m.e.s, ,Inc.. Adaresslslip Terrace, N.Y. Phone No. 581-4020 PLOT DIAGRAM Locate clearly and distinctly all~ buildings, whether existing or proposed, and. indicate all set-back dimensions fi'om roperW lines. Give street and blockinumber or descdp'tion according to deed, and show street names and indicate whether · ter/or or corner lot. . . . . , ,- TATE OF NEW YORK, ~S~y- OUNTY OF.. Su.f£ql.k. ' j S.S ........ i .... lk~**¢t-b .A, .Ah~:am~ .................. that he ~s the applicant (Name of indMdual sighting contract) }OVC named, e is the .:. President qf L. aw Eros. It?ne?,. .Inc. (C cfi ~ ) I ontractor, agent, corporate o c r, etc. f said owfier or owners, and is duly authorized to perform or have performed the said work and to make and file this >plication; that all statements confained in: this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth h~ the application filed .d~erewith. worn to before me this otaryPub!ic, ................ !...'...~.OJc~.~.F~, County , , , ~_ , ," ; NOTARY PUBL C Stab; of NewYork , / ' "' rSinnature of I No. 01C04708794 Suff Qntv,.,--. ' ' " JOCk~Y O. OF' ~Eh Nitrates,- Water mot to be used.for preparation of -baby formula or consumption by infants under 6 mo~ths of age. ROOERICl~ VAN TUYL, P.C. LICENSED LAND SURVEYORS GR£ENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK SERVICES -- FOR CONSTRUCT ION ONLY DATE: H. S. REF. NO.. APPROVED: COUNTY DEPT. OF HEALTH APPROVAL OF SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. ~ooo O-tO 5; ~. OWNERS ADDRESS: DEED: L. P. TEST HOLE STAMP ' ' SEAL N755~4 q - ~O0.O ROGER I'CK :vAN TUYL P.e. LICENSED LAND S~V~RS ~EEN~RT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL h.S. NO, STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. {SI APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOE APPROVAL O~ CONSTRUCTION ONLY DATE: H. s. a~. NO.: APPROVED:_ I lI ..... SUFFOL~ CO. TAX ~e 6~=m°~ ~muno~ ~J~ NOTE: Test well indicates nitrate contamination. Treatment and filing of covenant will be required prior to building occupancy. RODERICG VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. Of hEALth SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION DATE: ARPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PEk ~oOO 090 ~ ~ OWNERS ADDRESS: t/-70 "' DEED: I. P. TEST HOLE STAMP SEAL q q SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO, ~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF hEALTh SERVICES -- FOR APPROVAL OF CONSTR LICT ION ONLY DATE: H, S. REF. NO., APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. GEED: L. P. ~Z~ H~E Iii S*~I I ro ~HIs su~w~ ~s A WO~AnON Of SEAL FtTO N T EL EVATIOf4 K 1'4 0 E'L LI~ P-,,.. / R~L u? /4/_0,/ DECK KIT, PASSAGE 7 £0I~ ~Z0 ' ~ILC..O 5. R. =2 t/ ZZG'' FLOOR- PLAN 17LO" cL. 0 D 0 UNf:iNLS,,HE'D ATTIC-FULL ~UF5 FLoo~, TO 4-;0 I;?-.oof HE~GHT~, ATTIC FLc)o~ PLA~ KNOELL~,~¢ 7~2Z-81 RIGHT ,~DE: ZLEVAT~©N 6 7 8 9 10 5 II III EL I~VATI C)~ A