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HomeMy WebLinkAbout11042-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ~.1.t.~ .1.8 .......... Date ...... l~Og.ey.qbe I'..3,0 .............. 19.82 THIS CERTIFIES that the building . .c.o.~.¥~?.s.~9I~ ................................... _~ ..... ,. r~O0 Center Street Mat tit~lck Location u, --,~vc,~y · ·. -: ........................................................... House No. Street Hamlet County Tax Map No. 1000 Sectio~ .1.2.3. ........ Block ...0. 2. .......... ~ot ...0..1 9 ........... Subdivision X .. ·Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...F.o.b.~ t.t~ ?.y.. ,19 ...... 19 .8.1. pursuant to which Building Permit No.. ! 1. 9.4.~...7, ............ dated .... .~.a?.e. ,h..3 ................ 19 .a.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 ......... ....c.o.n.¥ .e r:~.~.9 ,n' .o.f...F,.a?.a.g,e..t.o...b?.d.r. 99.m' .&.. ~?.o.~.a. ¢.e. ?..og.m' .o..n..e.x.~..~ .e.i.n.~ ....... dwelling. The certificate is issued to ...... 9.e.qi?. g~..~.~: . .&..~.a..r 9.1.y..n.. ?....D..up.r.e.o. .................. (owner, ~.~ mt~a~8 of the aforesaid building. Suffolk County Department of Health Approval ...n./.~. .................................... UNDERWRITERS CERTIFICATE NO ........... ~. 5. .~.7.~. $ .............................. Building Inspector Re~,. 1/81 ro~ ~'o; TOWN O~i TOWN HALL SOUTHOLD, N~ Y. BUILDING (THIS pERMIT ~UST BE KEP~ ON TH,E P~EMIS~S cQMPLETION OF THE WORK'AUTHORIZED) 11042 Z UNTIL FULL Permission is hereby granted to: . ....... · .~.~.~=..~.,.....~'~ i ........ ~o.....c.~.~....~........¢~.~..~...?.~. ....... :..:~,~..~...~~ .... ............ ~.~ .......... ~..~ ....... ~Z~.~... ~. .,. ......... at premises located at. co~ ,o~ ~p ~o. ~o00 s~,,o, ..... ~.Z.Z. ..... ~o~k .~.C...~ ....... ~o,,o. ;...~.~..~ ....... pursuant tb application dated ....... ~.~~,....g.~...:,....., 19 ., and approv~ by the Building I~spector, : Re~,~6/30Z80 FQRM 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 subn~ tted in duplicate to the Building Inspec- tor with the following; for new bul]dings 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 building~ 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. 8. 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 New Building ............. Old or Pre*existing Building(X) .........., =/Vacant Land" Location of Property .q~??~q.)~ .... ~Z?'~'~/''' '~"~/"~:' ~ :. ~//~' Z- Hou~ No. Street Namlet Owner or Owners of Property .......... ~.,: . ;. ;- ........................ County Tax Map No. 1000 Section ../~ ........ Block {~ Lot.. Subdivision ...................... ...........PiledMapNo ......... ..LotNo. ' Perm t No. ~/~{~ . . Date of ~ermit 4.~[~) .... A~¢licant . . e.. ~...~,~, .... Health ~o~t. Ap0rova~ ........................ kabor De0t. A~proval ...................... ~.. Unde~riters Approval .~D,..,~ 2 2/b'~ , ,Planning Board Approval Request for Temporary Certificate Final Certificat~ Fee Submitted $ ............................. Construction on above described building and permiCmee~s all ap~cabl~odes and regulations. _ ,.--. . ~ : :: ,. - .,~ , 1 3502 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~-- 83 JOHN STREET, NEW YORK, NEW YORK 10038 Oate Rovembe~ 18, 1982 .~p~,Uc,tionNo. o,,yue '192808-82 N 583745 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number ~n the premises of George Dupree~ 71C Center St., Ma~ituck, '~.Y. in the following Io,'ation; [] Basement was examined o. November 12, 1982 FIXTURE OUTLETS 2 RECEPTACLE5 8 [] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. SWITCHES FIXTURES RANGES OVENS DISH EXHAUST FANS FLUORESCENT 2 DRYERS FURNACE SYSTEMS NO. OF FEET E OTHER APPARATUS: Electric R~om Heaters:l-2.0 K.W., 1-~ka~ke Detector E R NO OF CC COND A W G, PER ,~ 1-1.25 K.W. I C NO OF HI-LEG AW, G, OF Hi-LEG NO. OF NEUTRALS Three "C" Elect. inc. Rt. 1 Box 4~M Sound Ava. Riverhead, N.Yo, 11901 Lic.~3327-E Per This certificate must not be altered in any manner;, return to the office of the Board if ~incorrect. Inspectors may be dent find by their credentials. O Y, ~R BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU$;~ NnT .n :n'.Tn,,~r~ ,,. FI%~LD z~NSPECTION FOUNDATION (ls%) FOUNDATION (2nd) COMMENTS e ROUGH FRAME& PLUMBING ! ! ,! INSULATION PER N.Y. STATE ENERGY co E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined ./~./~.'.. ~) .... ,197./.~ Approvea ~.xl-'~'./..'~........~, .. Disapproved a/c ..... . _ ..~. .......... (Building rfispector) APPLICATION FOR BUILDING PERMIT Application No ~/(~ ~d~x'// 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 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. (Mailing address of applicant) /y,~,j ',.0--- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ....................................... ; ...................................... . ....... ,q,'. I Name of owner of premises las 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 ...... ~. ~.~../~. ........... Plumber's License No ......................... Electrician's License No .... .~..~(~ .~. ~ .......... Other Trade s License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... . ............. . ..... . . .x¢.)i ........................... House Number Street Hamlet County Tax Map No. 1000 Section .... /.. '.2:...~. ......... Block ..... .Q ~ ........ Lot....~../. ~ .......... Subdivision ~ ~' Filed Map'~'°~~-~ ....... Lot..'~ ....... (Name) 2. State existing use and occupancy of premises and intended use arid c;dcupancy of proposed construction: a. Existing use and occupancy ..... ~..~ ~c4~.~ ~.. :.~. .........:: i... ~ ................................... b Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........ Repair .............. Removal .............. Demolition .............. Other Work ............... /.~..~-. ~. (Description) 4. Estimated Cost ....... ~.~.'-'f4~. .~. .................. Fee ............................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of cars .... ~ ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth..., ........... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... tteight ............... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Depth ...................... Date of Purchase .... q~.r. ~,~. ................ Name of Former Owner ............................. Zone or use district in which premises are situated ......................... Does proposed construction violate any zoning law, ordinance or regulation: .... i ~D.' i i i i i i i i i i i i i i i i i i i i i i i Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address .................... Phone No ................ Name ~of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 10. 11. 12. 13. 14. PLOT DIAGRAM 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. STATE OF NEV~ir'~K~, . S S COUNTY OF .... ' . above named. being duly sworn, deposes and says that he is the applicant He is the .......................... .g~...~-s.,,.~.~.z..~. ................................................. (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 ~ed therewith. Sworn to before me this .... , ..... ..zT ..... Nota_ry~.ubli.c, ......... ~ ...... Term Exp r GRUHILL'S TEAM OF THE or Ours E~PI~RTS PROUDLY PRESENT GEORGIAN ALL OF THE SPECIFICATIO(NS LISTED BELO~ ARE INCLUDED IN THE PRICE: Poured Concrete Foundation Frami~5, aS2,~ 16 i~ches o.c. Dual entry Ce,~amic tile bath Vinj~ a~best~s tile in kitchen Co~dre~ f~xtures in Bath Com~etc interior~painting 2 coats Cedari~ ~kes all aroused ~'~×ter~or t~im 2 coats oil base pain't Br~'~ ~ 'chimney Hot r~'ater Baseboard Heating A!~E ('~pper Wiring Wo ~ ~' ~ heathing S~ou~!~ust Driveway - 500 square feet Wel:_ and jet pump to 100 feet deep You-~ r_hoice of gas or e£ectric stove Wood cabin,ts your choice of color Al~ c~ectric fixtures including C o i ? er wiri~ g 100 ~mp. 110-220 Volt electrical servic~ Dou~ie hung wood windows A~i electric circuits grounded Furl' y insulated Gym seal finish on all floors Washrng mac~inc hookup and dryer outlet Ga;~ag e included cesspools included Bak~ white enamel storm windows and doors included ~ oui~ide electrical outlet included 2 out~,"..de wa~er faucets included Stained interior woodwork Cedar shakes all around INCLUDED: Energy saving requir~ments as ~, per Public Service Commission OVER ~15 YEARS IN THE SAME LOCATION 335f~ P,O,UTE ~ql2, N, EDFOF~5~ ~(.¥. PHO))E: ($16) 732-1070 D~T~ECTIOrN'S: L.~.E~:~ez, swa~ ~a,s~ t~ R,cc. 7i2 (exit ~64~ t<~.,.~/~ ~ m,<.~c to mo6els. <'~,;~J~ic~ East ~<, Rte. 'I12, go Sour~h ? m,~ ~o models. 0~; ~Sunriso ~ighway East to, R~e. ~112 ~o north for 5 mil~6 ~n'~mod~ts. OR; Po~tio~ road Ea~ to Rle. ~i2 go north for i mile to models.