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HomeMy WebLinkAbout11314-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z13317 Date .~.p.r. ~. ]:. ....... 3. ..... 1985 THIS CERTIFIES that the building ...... bJ.e.w..D.w.e.l. 1. ~.n.$ .............................. Location of Property . .1.5.0.0. ............ L.a.t.h.a.m..L.a.n.e. ..................... O..r.~.e.n.t ....... House IVo. Street Ham/et County Tax Map No. 1000 Section .... 0.1.5. ..... Block .... 0.9. ......... Lot .... .09.i: .3 ........ Subdivision ..... L.a.n.d. :s..E.n.d. ................ Filed Map No...59..09....Lot No .... .3 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 4u.1..v. .......2. Q..., 19 .8.1. pursuant to which Building Permit No...ll..3.t~.Z. .............. dated ..... 4qg.. ...... 5. ............ 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 ......... ..... u.?..~.~.~?.~.t.? .o.~. ~..~.~.m.~.?..~.¥~. ~.~. ~:~., ~/.~..~.~.~.c.h..e.d..qa..r.a.g.e., .~..S.e..c.k .............. ~)er glans date 7/8/81 The certificate is issued to 'BOEH~ER, AT~I~CE of the aforesaid building. Suffolk County Department of Health Approval ........... .1.17.8.0-60 UNDERWRITERS CERTIFICATE NO ............ Iq680497 Rev. Building Inspector FOI~g NO. ~ , Tow~ O~ SO~T~O~ ' BUILDING DEPARTM~EN~r ~ TOWN HALL SOUTH'OLD, N. Y~ BUILDING PE~I~ (THIS PERMIT MUST BE KEPT ON THE PRE~I~ES UNTIL FULL COMPL~ION OF THE WORK AUTHOR ZED), N°. 11314Z Vote ..... ~, ..... Permission is hereby gronted to: ~o ................................... Z ............ l ................. , ................ ~....~. ................ , .............. at premmes located at ............. : ............................................. ?,,? ................. ~ ......................................... / ~ L..;....~ ........... L~ No. /, CounW Tex Mop No. I000 Section ................ ~ ...... Block ........................ pursuent fo epplication d~ted , , ~tU/'/ ~7~() ]~..~. ~nd epproved by the il~dl Bu ng I~pector. Fee $ ......... .............. ~ ~/ ~::¢ , Ouildin~ I~ctor Rev. 6/30/80 THE NEW YORK BOARD OF FiRE UNDERWRITERS BUREAU OF ELECTRICIT~ ~bbru~ry ~7~ 1~8r~r8:5 JOHN STREET, NEW YORK, NEW ~ORK 10038 N 680497 THIS CE~IFIES THAT only the electrical equipment as described belo~ and introduced by the applicant na~ned on the above application number in the premlses of Willi~ J. B~er, ~m ~e, ~ Ferry ~ ~d,, ~nt, N.Y, ' m theyollotving locati,m;_ ~ Basqqg~nt~,~ 1st FI. ~ 2nd Fl. Section Block Lot was examined on ~D~ ~ ~ ~ anti found to be in compliance with the requirements of this Board. ~ 44 47 28 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT S E R V I C NO OF CC COND PER ~ OF CC CQND 1/o OTHER APPARATUS i~nelb~ards; l~-llcir, 125an~. 1~ T~ A/C Unib, 2-2~ lbn A/C Ullits A '~/ O NO OF NEUTRALSTM A W G OF HI LEG OF NEUTRAL G & $ Electric Box 235 ~o~thold, N,¥. 11971 578 TH~s ce~tlficote must not be altered ~n any manner, return to the office of the Board ~f may be their COPy~FOR BUILDING DEPARTMENT. THIS COPY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 ex~sting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~Coperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: I. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4,Vacant Land CoO. $5.00 $15.00 !. New Building . .~ ......... Old or Pre-existing Buildi~,g ............ Vacant Land ............. Location of Property . (/..~'...0.(~) ............ ' Ham/et House No. ~. .~ ~,~ Street Owner or Owners of Property . ...('¢~-...~.~('./~...~. · ................................. County Tax Map N o. 1000 Section . .~. f..~.. ...... B lock ...~...~. ....... Lot...~..~../.'..(~. ~..~' ........... z...Filed Map No ........... Lot No .............. Permit NO./. ~/.~../.~...~-. Date of Permit ......... Applicant ................... Underwriters Approval ~..( .~....~.~.Z ......... Planning Board App ov ...(.£ ................. Request for Temporary Certificate ..................... Final Certificate X ................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & ?LUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS ~~,~ , NEU YORK STATE DEPART}~NT OF ENVIRONI~NTAL CONSERVATION Regulatory Affalrs Building 40, SI~Y Stony Brook, NY 11794 (516) 751-7900 Robert F. Flaeke Commissioner A COPY OF THIS AUTRO%!ZAT.~ON I.~dST BE A~AILABLE ON PROJECT SITE Ms. Alice Riker 26A Graywood Road Port Washington, New York 11050 TWNL # 15274-0073 TIDAL I~ETLANDS NOTIFICATION LETTER APPROVAL Dear Ms. Riker: This is to inform you that we have reviewed the notification letter (or permit application) filed on May 5, 1981 and have determined that it will not be necessary to file a permit application (or secure a tidal wetlands permit) to construct one family dwelling, associated septic system, garage and driveway on parcel with Tax # Dist. 1,000 Section O15, Block 9 Lot 1.3 north side of Latham Lane, Orient, Town of Southold, Suffolk County. Assuming you have obtained all other necessary permits, you may proceed with your project adhering to the special conditions (if any) found on this letter° All work is to be done according to plans submitted 5/5/81, within 185' of Latham Lane. This project must mmply with all local flood.plain ordinances. No distrubances to laud (filling, excavating, grading, etc~ Or placement of additional str~ctur~ closer than 180' to mean high water until~ ad~tional ~pp~c~t%on and prior appro- val is obtained. /~ -/~!~. ~ Septic system is to be between Regional Pe~t Administrator house and road. 6/2/81 Date Issued 6/30182 Expiration Date cc: U.S. Army Corps of Engineers NYSDEC Law Enforcement - Region I FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined ....... <./'./':- .~ (.. ~., 19 .'~.~ Approved '~" ~ ~ I Pemfit No. Disapproved a/c .............. p ...................... ....................................... · .... (Building Inspector) ~ APPLICATION FOR BUILDING PERMIT Date. 7.;.3.9. ......... , INSTRUCTIONS a. Tlus application must be completely filled iu 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 Flan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or public stre~ or areas, and giving a detaded dcscrilmon of layout of property must be drawn on the dia~am which is part of tiffs ap[ cahon. c. The work covered by this ,apphcation may not be commenced before issuance of Building Pem~it. d. Upon apprc:al of tins apphcat~on, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept on tile prennses available for inspection throughout the work. e. No buddL~g shall be occutned or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Bu~dJng Inspector. APPLICATION IS t IEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Budding Zone Ordinance of tile Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the constr~ction of buildings, additions or alterations, or for removal or demolition, as herein describe , .... (Mailing address of applicant) State whether applic:mt ~s owner, lessee, agent, architect, engineer~ contractor~, lectrician, plumber or build, Name of owner ofprennses .... l ..... ~ ......................................... (as on tile tax roll or latest deed) If applila~ is/g corp/5'~tion,ll~gnature of duly authorized officer. Builder's License No .......................... Plu nlbe r's Licen se No. C,"'...~.~.~,(/~..~... l tric,an's ,cense,o. ¢.0.... Other Trade's License No. · Location of land on wluch proposed work will be done.~ . ,.t ~. . .~.,.~~ ........... .... ~. .~ ....... I. ~ ~?f.. ~.o.. lea=. ...... - ....... '...~,~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~. I~t~nd~ u~ a.d o~pan~v ..... ~... ~.~.~.. ~. ~. ~ ~ .......................... Nature of work (check ' ~. ...... Alteration .......... which applicable): New Bui/ding ...-- Addition .......... Repair .............. Rez!mval ............Demolition .............. Other Work ............. tS.e..e, ,Description, Estimated Cos (to be paid on filing this application) If d,velling, number of dweiling~nits ............. Number of dwelling units on each floor ............... If garage, number of cars .... ~. ................................................................ If business, commercial or mixed occupancy, specify ~ature and extent of each type of use ................... Dimensions of existing structures, if any: Front.. :.. j ......... Rear .............. Depth ............. Height ...... -. ..... ~... Number o£Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ...................... Iteight ......... , ........... Number of...St°rios' ........... : ....... Dimensions of entire ne,,' construction: Front. .~ .... Rear..~.~-~. ...... Depth . .~'~2 ...... Height . 1.~.~ .......... Nul~nber of Stories .... 1 ~ ............ ~ ......... ~, ............ S~e of~ot: ~ront .... t~r ............. Rear i iii~'.i ............... D~pth . ;~.O1~ ............. Date of Purchase ....~ ...... 2 .................. Name of Former Owner .. ~ ....................... Zone or use district in which prbmises are situated .... ' ............................... ' ............... Does prnposed constrnction violate any zoning law, ordinance or regulation: . ~.~ ...................... Will lot be regraded . ~ ' ................ Will excess fill be ~emovcd from premises' Yes Name of Owner of p_remtses .~.~q~.~ ........ Address .... -. .......... "r.. Phone No...~....~ ..... Name of Arclutect .~/F~-.~OJktTfl.~.t.~.( ........ Address .... .~.~rrtt.~.~.. Phone No .... ~. ........... Name of Contractor .~'~t~t~ ..... ~ ~ ......... Address .pg.. Phone No.t~.~.~ PLOT DIAGRAM Locate clearly and distinctly all [buildings, whether existing or proposed, and. indicate all set-back dhnensions from according to deed, and show street names and indicate whether ). I. 2. 3. roperty lines. Give street and block munber or description terior or corner lot. 0 U iN~i-~y.. 0 F ~~,_4~. S.S (Name of indMdual signing '.contract) )eve named. is the . ~ ...................... .................................................. ~cont actd~gent, corporatu ofhcer, etc.) said owner or owners, and is duly a~tho~rform or have per, formed th~ said work and to make and file tiffs )phcation; that all statements contained in this application are true to fl~e best of bis knowledge and belief; and that the ork will be performed in the m~ner set.. forth fl~ the application filed therewith. worn to before me this ........... ...... .... o..of ¢~) SUFFOLK CO. HEALTH DEPT. AFI~OVAL ~) H. $. NO. ,M,~, o, ..... / ~ ~ '¢~ ~ ~,, // rH~ WAT[. SU~Y AND SEWAGE OI~AL ~ ~ ' ~ " O ,~ '~ ~ ~[~ F~ THIS RESIDENCE WILL ~1~ ,~/ ' ~. ' t/ ', CONFO. TO THE .TANOARDS OF THE / C~RUCTION ONLY &-II-~ DAT~: , , . / ' , / ~O~H~ cbs .' /~ . -'-- -'. ~ GREEN~RT NEW YORK EXCAVATION NIA ,'ff ,/ R;L~.E?~.,CK VAN t.~_.YL. P'¢~I LICENSED LAND GREENPORT NEW YORK SUFFOLK CO. HEALTH DEFT. APPROVAL H.S. NO. STATEMENT OF INTI~NT THE WATER SUPPLY AND SEWAGE DISIK)SAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (si APPLICANT COUNTY DEPT. OF HEALTH APPROVAL OF SUFFOLK SERVICES FOR CONSTRUCTION ONLY DATE: H. S. REF. NO.: APPROVED: SUFFOLK CO, TAX MAP DESIGNATION: DIST. SECT. BLOCK ' I~'CL. tO00 OWNERS ADDRESS: DEED: L. ~V/al p. TEST HOLE ' -- o~. ~ SUFFOLK CO: HEALTH DEPT. APPROVAL H.S. NO .... ~T ~/ ~ "' '" w SY.EM5 FOR THIS R~IDENCE WILL / ~[~ '~ r' ~ CONFORM TO THE STANOARDS OF THE / ~FF~K CO. DE~. OF HEALTH , /, ~FFOLK COUNTY ~PT. OF HEALTH ~X SERVICES FOR APPROVAL OF ~T[: / H.S. REF. ~.: / / ~= ~, ~ ~.~. B = ~o~u~ ~ SUFFOLK CO. TAX MAP ~5~A'TION: - DIST. ~CT. BL~K ~L. ~ OWNERS A~RE~: · ~ ~ , ~, / ~ , ~'* / /~ , i~ ~. ~ ~ / ~ ~ ,," ' ~ ~EE~PO~T ~EW YO~K 0 .. jul, · . ~,~, ,' ~;,,~,. :-.,-! .... .& ! , ~E~FK VAN~L. P.C~ GREENffiRT NEW YORK SUFFOLK CO HEALTH DEPT APPROVAL H S. NO. //"~O°'1~O _S_TATEM~ENT _OF~ IN_TE__N_~T THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT. OF HEALTH SERVICES. (s~ APPLICANT SUFFOLK COUNTY SERVICES FOR CONSTRUCTION ONLY DATE: DEPT OF HEALTH APPROVAL OF APPROVED: SUFFOLK CO. TAX MAP DESIGNATION; DIST. SECT BLOCK PCL. t 0(7..~ Ot~ 9 OWNERS ADDRESS: 2/Z - DEED: L. ~,/',e p. TEST HOLE STAMP SEAL F~©~4 T APPROVED AS NOTED DATE:/ 7--'1 C ~.~_~lc'~ NOTIFY BUILDING DEPARTMENT AT ,765-2660 9AM fo 4PM FOR REQUIR- ED INSPECTIONS= 1. BEFORE BACKFILLING FOUNDA' TION OR START FRAMING 2. FRAMING INSPECTION 3. BEFORE COVERING PIP~S OF ANY KIND 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION M~ST MEET REQUIREMENTS OF N.Y. STATE CODE AND TOWN HOUSING CODE & ZONING ~L L L EV~xT I C)h,l _ ~ ii/ , ,/q.l~, ~UT ~A~,~I, FLR 3oi ~o~ 5'TU CATTo AT'P,. ,a3L0' LIVIK3~ R..O_Q I,A 5'.4"-L ~ ~t o" : COVEr~ED POR] ~c..o 2 2"'. ~" RAFTER~q6Y~ L?o m3 %F_CTI otd 12" EbAL- C ~ 4,oE,,8 _DRE 5Stag ~3' ? MASE'ER. ATTic~ WAL W- =o~: f:Z~EDRQo~'b ct_o_ ~ ET FL©OE' PL,,NM FULLY !EXCAVATE /TyP) 4fl'-4" PL ~x~ ,L %1 ,..~,,:,. ' . . - .., . ,.,-. ~,/.~,,, .,,'.~ . , ;'.J::::'~ .', , , ,. , , ~ FLOO~}VE~ ~f(A(~E OR C~A~L,.SPACE , MAX MUM PERMITTED