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HomeMy WebLinkAbout11035-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location o f Prop ertyHouse''' 5.0.No. It' I[ ~:',B ~;. I~ .t;.v. e · t.,.. a n.d..56~/e~, e q u a'~h. ,~ :/~e.., C u.t,c h o g~ear~/e~. ¥. Coupty Tax Map No. 1000 Section ....1 ~3 ..... Block ,.. 0.7 .......... Lot ... 0 2.7., 2 ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated · · tt,31~vu~.v~/· ,1 g ....., 198~. pursuant to which Building Permit No ..... 1, i~35..Z ......... dated .. ?~b~ .ua.r'.y · 2t, ............. 19 .~ 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 ......... ....... [~.r:ivag,~ .0ne-Fam&2,y · D~.t.ell;lm.$ ........................................ Thecer cate is issued to ...~,mces D:]t.¢~J),lesseeortonanO tiff ........ ~ ...................................... of the aforesaid building. Suffolk County Department of Health Approval ......... .F,,/~ UNDERWRITERS CERTIFICATE NO ....... g.5~ 2 68g .................................. Rev. 1/81 No. J:1035 Z FORM NO. 2 : TOWN O1~ soUTHo[ BUILDING DEpXRTJ~i ~ TOWN HALL SOUTH'OLD, Nr. Y. BUILDING PERMIT{: , (THIS PERMIT MUST BE KEPT 0N THE PRE~IS:~S UNTIL ~ULL COMPLETION 0F THE WORK AUTHORIZED) ~0~* ..., ........... :...~ .............. Permission is hereby granted to: .......... .... ............... ................. .... /.Z ....... .................... ,o ..~.q..~z~e.c...z. ....... .~.~..~.......~,~.~.~.~.¥...~.,~/.z.,~9.....~.'~. .~- ......................... ~ ./. cw ~ c ~ : ~. . ,~. .~. .c. ~,z~. . . . . . . ~,. . .~. ,. . ,~ ~;~ Z,, at prem scs located at ,~....~...~.........~/.~.....~'~---~'~'"'"~z"~''~'~'''?T'(';''~L'~/~'~: ...... - ?:/// CouOty Tdx Map No. 1000 Sect.on .../.~,.~ ........... Block .~.~,,~,, .......... :,Lgt No, ...CH.~'.~.,..~.~... .......... J ..~-.~/~./~( /.~,~.'.i~. ~ , 19 ~, and approved by the purs?nt to appucarmn ao~,u ..-..,......- --..~........ ...... ~....~ ...... ~.. Buil~lng I~spector. Fee ~...~...t. ............... :' Building ~lnspector~ FOI~M NO. 6 TOWN OF $OUTNOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Insfrucfions 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 topographic features. 2. Final~ approval of Health Dept. of water supply and sewerage dispasal--(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. Submit Planning Board approval of completed site plan requirements where applicable. 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 and 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. B. For 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 June 17, 1981 New Building ...... .X.. ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property S/.E corner Pe.qu&sh Ave. & First Street, Cu~chooue, N,Y. Owner Or Owners Of Property Frances Dickson Subdivision ................................................................ Lot No ............. Block No ............. House No ............. · 2/18/81 . Inland Homes, Inc. Permit No....?:..1..O..3...5.-..Z.. Date Of Perm,t .................... Apphcant .................................................................. Health Dept. Approval ....... .~/.~,.~../..8..[ .................... Labor Dept. Approval ................................................ Underwriters Approval ...... ~1',~.~.0~ ....................... Planning Board Approval .~ ............................. Request For Temporary Certifica~©, ....................................... Fincd Certificate ...................... .y...e..s. ............. Fee Submitted $ .~5,00 Construction on above described bull( Applicant Sworn to before me this meets all Robert E. Hiltz, and regulations. ~ INC, ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8,5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the e~ctrlcal equlprnent as described below and introduced by the appllca~t named on the eb~e application number in the premises of ~Y~ces Dic~, F~s~ St., Cut~, N. Y~ was examined on ~y 2~ , ~9~ and fouttd to be in compliance with the requiretrten~s of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: Motor~; l~hp 1 E R V I C NO. OF CC. COND PER,e' OF CC. COND, NO. OF HI LEG OF HI-LEG NO. OF NEUTRAL AW, G, OF NEUTRAL Richard gelyea Yom~g Point, ~.O.Box 372 Mattituck La~rel, N, Y. 11948 This certificate must not be ~ltered in ~ny m~nner; return to fha o~fice o~ the Board ;f ~ncorrecf, Inspecfo~s m~y be COPY THIS COPY OF CERTI[: NOT BE, IN ANY MANNER. FIELD INSP~ECTI~N FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Application No..Z ./~..o~. ........ Disapproved a/c ......... .~ .'... 7: ...................... __ ~Z[''~ .... (B~ilding In;pector) ''' ~-'///~'Y~/~"'~_..~ APPLmCATmON FOR BUILDING PER~IT DateEeb. ~L8 ........... , 1981. INSTRUCTIONS. a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according to sghedule. 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) Box 117, Mattitmck, N.Yol1952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . . .F.~a..n.o.e.s...D.:i..qk.$ .o.n. ..................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......... R.o.b.~.~.~...E....H..5..1.t.z...-..PX~..s.. .......... (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.5.1.7.'.P. ................... Electrician's License No. 2.17.8..-.E ................ Other Trade's License No ...................... Location of land on which proposed work will be done..1.s.l[..S..t.l:.~.~.t...&..P..e. {j.u.a.s.h...A.v.~.n..u.e.~..C. :u.tp.h. ggg.e..... House Number Street Hamlet County Tax Map No. 1000 Section . J.03 ............. Block .7. ................ Lot. 2.7..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 .... .V. ac&r,t ....................................................... :. b. Intended use and occupancy . .1..-..F.~.m.i.J:.y...D~..~1..1.i.n.~ ................... · 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ...x~. ...... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... / z~ 7 ~ (Description) Estimated Cost ~0 ~ 000.,,00 ......................... Fee . T./. .................................. , (to be paid on filing this application) If dwelling, number of dweilin dnits .... 1. .......... Number of dwelling units on each floor ................ If garage, number of cars ..... [....1 .............................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structure~ if any: Front ............... Rear .............. Depth ............... Height ................ Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i · Height ...................... Number of Stories ...................... Dimensions of entire new constrUction: Front ..... 15.7. ....... Rear ....5.7. ......... Depth . .g.7. ........... Height . .2.8.~ .......... Number of Stories ......... .2, .............................................. Size of lot: Front ..... 200...' ........... Rear g00 Depth 70 Date of Purchase ~ ... Name of Former Owner Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lotibe regraded ...... ¥9.~. .................. Will excess fill be removed from premises: Yes XNo Name of Owner of premises . ?.~..a~..o.e.d...D.:J..~.k. ~..o.n. Address ................... Phone No ................ Name of Architect .......... 1 ................. Address ................... .Phone No. of Contractor Inland Homes~t Inc. ........ Box llT~Mat~:ituc~:- ,, '29.8;-~J6961 .... Name ............................ ~uur~ss ................... rflone 1'~o .............. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or interior or corner lot. description according to deed, and show street names and indicate whether . STATE O~W YORK, ~ '~ " ' ' COUNTY ~ ~ :df: ~ ~ 8.S ' ~ ~~ ~A ~.~.~ ~ ............... b~ing duly sworn, d~pos~s and says that h~ is th~ (Name of individual sign!ng contract) above name~. C.°n'czac~oz He is the .................................................................... ..................... (Contractor, agent, corporate officer, etc.) of said owffer or owners, and is dulk authorized to perform or have performed the said work and to make and file this applic.'ttion; that. all statements contained in this application are true to the best of his knowledge and belief; and that the work will ~e;perfohfied in the manne~ set forth in fhe application filed therewith. Sworn to before me this ........................ day of ..................... , Notary Pub/it, . .$u.fif. Olg ....................... apPliCant) Inland Homes,! Inc. ~ ~ / /~,, ~ ~ ~ ' ~ ro~ so~t $UPFOI~ ComITY MEALTH DEPAMT~NI SURVEY FOR ERANCES ~ICKSON ~ AT CUTCHOGUE DATE: DEC. ~, 1980 ~he ~e~ ~SposSl ~n~ ~e~ $~ppl~ ~N OF SOUTHOLD SCALE: I"=~0' inspeoted b~ thts d~me~ ~nd foun~ . SUFFOLK COUNTY, NEW YORK NO. 80-646 )~U~OTHOR1ZEO ALtERAtION OR AOOIrlON ~ ~IS SURVE~R'S INKED SEAL OR EMaOSSED SEAL SHALL HEALTH DEPARTMENT ZDATA FOR APPROVAL TO C~STRUC T AND ~ HIS eEHALF ~ THE TITLE C~P~Y, ~OV~N- *EL I ~~ ~ OS~ANDER AVENUE . YOUNG ~ YOUNG .,v~.~o,.~. ~= STAKE PLACED ALDEN W. YOUNG, PROFESSIONAL ENGINEER ANO LAND SURVEYOR N.Y_S. MCENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR N ~ L~T~ ~ W~L(W), SEPTIC TANK(ST)~ CESS~OLS(CP) $H~N HER[~ N Y S. LICENSE NO 4589~ IO0 %.... ,. / SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FoR APPROVAL OF CONSTRUCTION ONLY APPROVED C~-/X'~/L'"~; · ( HEALTH DEPARTMENT-DATA ~APPROVAL TO CONSTRUCT SURVEY FOR FRANCES DICKSON AT OUTCHOGUE TOW~ OF SOuTHOLD SUFFOLK COUNTY, NEW YORK F..XC,AVATIB INSPECTil]~ REQ[JiJt[iJ DATE: DEC. 5,1980 SCALE: 1":30' NO, 80-646 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK M UNAU~'HORIZED ALTERATION OR AODITION TO THIS ~ SURVE~ · ~ VIOLATION (~SECTION 7209 OF THE NEW YORK [/,TATE EDUCATION LAW , gCOPI~S ~ THiS SURVEy NOT BEARING THE LANO SURVE~R/J INKED SEAL OFt EMBOSSED SEAL SHALL NOT BE[:CO[~$1OERED TO ~ A VALIO TRUE COPY ,Li,j] YOUN q G 8, YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND'LAND SURVEYOR N.Y.S. IJCENSE NO. 12845 HOW6RD W. YOUNG, LAND SURVEYOR N.Y S, LICENS£ N0.45895 , PROJECT LOCATION PROJECT NUMBER /r]3 ITEM DIMENSIONS Sq. FP. "U"FAC. 0 T BTU BR M'ARRS U zn-ss Ivan_ `!3> 3Y`I q 20.53 lu FlLfi CnL=SS ?Yrr,_ . .sr xY r 37, Su /1a9 LZ 2$l1 (711,5 /' 2t% 6h /9 , vqc - !!5nb,55 /F'cpm /,o ti f, 11,05I'r ZXoNfIL? LS ! 6FA ro 4VeT wru- /qq a 5,lvhLL 3x 54Y };ZS*,;y1 ti` SS • c q L ,, 2v�1 pFILt GGe�y 1 x07x f Lk 2-, /, a9 61,-- 28L/G YFIL� NS ' Z�C/'M /•0 f( CL J J� 6FA6S !ibLL VU-5 2Ib pp-_r .4ta,,S 7-Y 7 v r per ROOF -- CEILING /y , 03G2 FLOOR PERIMETER N�/( gOTITFRg. ✓L7 40y 4 hlK/ LO 33 /25 70r L /F'vSS tvb(tis 1120 sheet No. Iof G]L.L5S /30 USE IS U AWFUL D,���* s BY- MORE NOTIFY O I902IFEEP�NTO 4 p ��.yyzppp � . Li u,,,n OCCUPANCY Y FOLLOWING INSPECTIONS; a. FOUNDATION - TWO REQUIRED t FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING P. INSULATION - 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C. 0, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. / - ESTATE CONSTRUCTION, & ENERGY. 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