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Home My WebLink About13384-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13284 Date March 30 1985 THIS CERTIFIES that the building . .O.N..E..F.A.M..I ,L.Y.. D..W.E.L.L.I..N.G ........................ Location of Property . ~030 REEVE RD. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 1. 0..0 ......... Block . . 0..3 ........... Lot ....1.5... 6. ......... Subdivision ............................... Fi]ed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 4u..n.e..1.3. .......... 198.4. . pursuant to which Building Permit No. ! .3.3.8.4...Z .............. dated ....A.u.g ....2.7. ................ 19.8.4., 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 ......... ONE FAMILY DWELLING The certificate is issued to .... .S.T.A.V.RQ.S...I Q.A.N..N...I .D.I.S. ~ .AN.fIJi. ~.Oj~l~.~ ............. of the aforesaid building. Suffolk County Department of Health Approval ... J .4.-.S. 0 r .1 ~.q ....... ¢/.2. ~,/, ~ 5 ............. UNDERWRITERS CERTIFICATE NO ........... ~16.7.%23~ ......... ~ 2,/.1.5/8/~ ............. SOLDER CERTIFICATION 3/20/85 Rev, 1/81 Building Inspector FOuM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13384 Z Date Permission is hereby granted to: , ~....~.~ .............................................. .g~~......o.......~.,... ~.~..~.~. ~ ~ f,,/.-:~-~ ..... , .......... .. ....... at premises located at .......................... County Tax Map No. 1000 Section ..J..~ .......... Block ....... ~ ........... Lot No..../...?...-. ............ pursuant to application dated ..~.L.~.~ ....................... , 19.~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, 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 topographic featu res. 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 instatla- 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 p~operty 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 $ :15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date .~ ~.~J..~.0.~ J.~.~.~, .... New Building ... ~. ....... Old or Pre-existing Building ............ Vacant Land ............. Owner or Owners of Property County Tax Map No. 1000 Section ... ] .O.C) ....... Block ...O..~. ......... Lot. 15. (o Subdivision..~. ...................... ./,../...Filed Map No. ~.'~ ~.0 .... Lot No .... ~o ......... Permit No. ! '.~.'~.~..[J[..~. Date of Permit .'7~'Z.~l?.CJ.Applicant . ~. [ .~.O..S.....Z,~.~.~..0.~..~-..~. ?.l.L...~.~ .~.. Health Dept. Approval.. ' .L/.. ~..O..~./.~..~...~.'~.~f~.~bor Dept. App rovaI ........................ Underwriters Approval....~.. ~, [ .I ~,~./~ ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~.. ............... Fee Submitted $ .... .~..~..~.O. .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant..~ ~,~f~, ~_~,~_~¢~,-~. ~/~ ~ ~.. ~-~_~.~.O. ,). .... lOOCq7]. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 8E JOHN STREET, NEW YORK, NEW YORK 10038 B. te D~,~* ~, z9~ ~.~..o.~o,o.~,,~ ~ N 67~234 THiS CERTIFIES THAT only the electrical equipment ~ described below and i~troduc~ by the applicant named on ghe able application ttumber in the premises of in tbe follo~vi~g ioc.tion~ ~ Basement ~ 1st FI. ~ 2nd Fl. ' Section Block Lot w~s exa~ni~wd on ~r 6~ 1984 and found to be irt co~npliance wi£h the requirements of this Board. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS SWITCHES FLUOEESCENT DRYERS SYSTEM~ NO, OF SEET OTHER APPARATUS: I~G.~. I. 2~-S~ke Detectors. E R V C AWG, 5 Ruland ~ectric Co. P. O. Box 143 ~t~ituck, N.I~. 11952 Lic. 242 This certificate must not be altered in any manners, return.to the office of the ~,oord if jnco~'rect. Inspectors may be identified COPY FOR BUILDING DEPARTMENT. THIS COPYOF CER~ICATE ~U~T NOT BE ~I..TEREO I~ ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date %/~ 0/~¢ ~ Building Permit No. Owner ~'fO~ V"'¢ 0 5 (please print) Plumber Co~s~ ~o5 (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~/~ day of "m~ · 19 ~5~. Notary Public,~ County Notary Publ{c UNDA d. COOP'~R NOTARY Iq,leU(:, State of New Ym'k No, 4822~63, Suffolk Courd~L/ Term Expires March 30, 19~ XF~ELD~INSI'ECTiON COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [~]/FOUNDATION 2ND [ ] INSULATION [ :] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765-1~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE: INSPECTOR 7G~802 BUILDING DEPT. INSPECTION [ UNDATION 1ST [ ] ROUGH PLI FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL ,.S,'ECTO.,. ,~C 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 .~ TEL.: 765-1803 Examine ....'~..~'...~.~.., 19~.~. Approve L~,'~ aT, 19~. ~. Permit No..]...~..~.?.L[ .~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19...~ Date . .~. ?/4.~.....[.3.. 9'" 19~t' INSTRUCTIONS ~s~' a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts 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 Iuspector will issued 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 building for necessary inspecqons. /t .... (Signature of applicant, or name, if a corporation) .o.g¥, (Mailing address of applicant) [ [ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluml~er or builder. .......... U k....C o. IT.8,h c..-re.-..g-- ..................................................... Name of owner of premises . .~.[~-~ .~.~.[~ .~. [~05 .... .~.D.~ .lO l~.t.D. [ $. .................................. (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 ..... t~5~ ................. Plumber's License No. Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done...~. ~. I~t;~e' ~q~t};r' Street ' Hamletj ............... County Tax Map No. 1000 Section .... 100 .......... Block ..... .~ ........... Lot...Lg.".~ ........... Subdivision ..................................... Filed Map No ........ ./~..'... Lot ............... ~ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy use and occupancy .............. t" .t'O,m.L 1>~...'~ I .[1.0.t/Sff_~ ................................ b. Intended 3. Nature of work (check which abplicable): New Building ...-~.'. .... Addition ..... ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... . .~..(~ QO.~. " (Description) 4. Estimated Cost ....... -. O.O .................. Fee ...................................... (to be paid on filing this application) 5. If dwelling, numberofdwellinglunits.,I,.~.o,~'ll.~.... Number of dwelling un!t. s on each floor ................ If garage, number of cars .... ~ ....................................... ~ .... :'/.. ?'..% :q. '.., .......... 6. If business, commercial or mixeld occupancy, specify nature, and ;extent of each typ? of urse~..: 7. Dnnenslons of existing structures, if any: Front ............... Rear .............. D~i>th'; '. :~.'...' ........ Height ............... Number of Stories ................................................. Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... i ' ' Height ...........~.'. ........... Number of Stories 8. Dimensions. of e.ntire, new construction. Front, . .~.~.',00!~ .... ..... Rear, .........~.q .t(>O~'. ' .......... Depth . .0,ia, I~.1' ',, ........ ........ Height . ~..~ Iq.um. ber of Stones , ~:'..::.., :-; ....- ..... 9. Size of lot. Front .... 1~.~.'0.0. ........... Rear .... I.~'/O~.0 ..... : ..... Depth.. .......... .:[h6,.-/l ............ l ........... ' 10.Date of Purchase ...................... Nam, e of F(~.rn~er Owner ................. ' ' ............ 11. Zone or use district in which premises are situated ......................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ..... /VO. ........................ 13. Will lot be r~graded ....... [[0 .......... ,.... ...... Will excess fill be removed from premises: Yes _ 14. Name of Owner of premises~l' lt'O~. ~.a.nj.c~l.$ .. Address ................... Phone No~ltk,. Name of Architect .......................... Address ................... Phone No .............. t.. Name .of Contractor 131100,5..;~,.~lg~ .......... Address P.,0,~oldZ.~. ~l~}}qor1'Phone No..~'/'l.-.~,."[.~ ..... 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 o~ ~tl~]k~ilS~according to deed, and show street names and indicate whether interior or corner lot. ~'lO, 00~ Lo1- 15-6 STATE OF NEW YORK, ~S.S COUNTY OF .................. ............................. ] .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... [ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e and file this application ;, that all statements cont~ned M this application are true to the best of his knowledge and belief; and that the Work will be perfomed in the m~ne~ set forth in the application filed therewith. Sworn to before me this j ........... '.~3-.......~ ~ ~__~ dayof; .... ~O~r~gY P~LtC, Slat0 of New York (Signature of applicant) ~[~ [xP~re,~March 30.11 17'0. $.1 -DRA INA GE ~tl .-,-,iF AVE