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Home My WebLink About13393-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.1.3.3..1.0 ......... Date April 2 198.5., THIS CERTIFIES that the building ....N.e..w..D.w.e..1.1.i.n.c./ .............................. Location of Property 250 Lloyds Lane Mattituck House No. Street Ham/et County Tax Map No. 1000 Section ...Q .9,9 ...... Block ...0.3. .......... Lot 004.5 Subdivision...H.o..n.ey.s.u..o.k.l.e...H.i,l.~s. ........ Filed Map No. 7019 .Lot No. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.~.c~: ..... .2 .B ...... 19 .8.4. pnrsuant to which Building Permit No. 13393 Z dated ....... A.u.g., ..... .2.9. ......... 19 .8.4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which ttfis certificate is issued is ......... Construct Private One Family Dwe. lling The certificate is issued to WINDSWAY BUILDING CORP. (owner, of the aforesaid building. Suffolk County Department of Health Approval , 14-SO-178. UNDERWRITERS CERTIFICATE NO N 682119 Building Inspector Rev. 1/81 l~o~wr NO. ~ 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? 13393 Z Permission is hereby granted to: .~..d.~ ~ .....¢....~.....~..:~.,...Lt.a.~.~ ...... County Tax Mop No. I000 Section ...... .~....°i..01. ...... Block ........ ~. .......... Lot No .......~. ................ Building Inspector. Building Insl~ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Halt Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG. DEPT. TOW SOU_T.O _D 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 approvat 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. B, For existing 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 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .............. ..... Vacant Land ............. New Building . .. ~'... ...... Old or Pre-existing Building ; .> ..................... Location of PropertyHouse ................ No. t .... Hamlet County Tax Map NoOWner or Owners of PropertYl000S ction ........, ~" ............................... ' '~' ' '~B~ock f~'~}~.'~'Z i''''~.. ..... Lot..~.), .'~.. ....... Subdivision . ~..~. ~ .~r.~l~, .F. · ,~r~"~. · · .... Filed Map No..rT..Q! .~ .... Lot No, ~" [.~..~.~J ~- Date of Permit Applicant Permit No .................................................. Health Dept. Approval [L~ ~ ~ ~q~' .Labor Dept. Approval Underwriters Approval ....................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~eo c~ ,~-g~ Applicant.S.... ~ .~.....~....'~...~. ..... ...................... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. / ~ (please p~int) Plumber~//~ ~ ~ ~ ~ L , (please print) Date I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's sig Sworn to before me this day of Notary Public,~l~ Notary Public County eu.~ ~.o~',~s~ .... Oualffi~ in ~dk ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 10 0 0 7 71 EUREAU OF ELECTRICITY ~-kl 85 JOHI~ STREET, NEW YORK, NEW.YORK 1Q03~ ..,e ~,re~, 11,19~5 ~..~..~o.o.~,,~ ~/~ N682119 THIS CERTIFIES THAT only the electrical equipotent as described below a~ introduced by the applicant named On the aboee application n~mber i~t the premises of ~iud~ ~ay Bui~dtug Corp.,~/S Lloyd Lane, ~00' ~/0 Reevez Ave., Mat~uck, N.~. , was examined on Ma r C h 5,19 8 5 and found to be in compliance wi~h the rqquirements of this Board. FIXTURE FIXTURES OUTLETS SWITCHES FI.UO~ESCE~T 48 ' 49 42 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATEES MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I Fut~te Appliance Feeders- 1-2-14, 1- Smoke Detector Track Lighting- 24~ 0", ~1 1/tee A W G. ~ NO O~ HI-LEG OF CC, COND 4/0 C OF HI-LEG NO OF NEUTRALS AW, G OF NEUTRAL 4/0 1-2-12,1-3-8 Ruland Electric Co. P. O. Box 143 Mattituck~ ~.Y.~, GENERAL Per 1 This certificate must not be o]tered in on}, moaner~ ret~m to the o{fice o( lhe Boord ii ipcokrect, [nspectois mo¥ be )denfitled by lheir credentiols. COPY~FOR BUILDi ~ DEPARTMENT THIS CO~'~ ~J ANY MANNER. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING INSULATION FERN. Y. STATE ENERGY Q~DE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPEI TION [ ,] FOUNDATION ZST [ ] ROUGH pLBG. FOUNDATION [ ] ~2ND v/INSULaTION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR BUILDING DEF~q'. ~ ~*' PECTION r R£MARKS: FOUNDATION ZST [ _ ROUGH pLBG. [~j/FOUNDATION 2ND [ ] INsuLAT[ON.~ FRAMING [ ] FINAL D^T£ ~,.sPECTOR '~/C 765-t802 BUILDING DEPT. INSPECTION [ ~//(OUNDATION 1ST" REMARKS: [-] FOUNDATION 2ND [ I iNSULATiON [ ] FRAMING [ ] FINAL r INSPECTOR 76S.1802 BUILDINO DEPT. INSPECTION' [ ]FOUNDATION 1ST [~/ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION I'll/FRAMING I" ] FINAL DATE. INSPECTOR , por~ [.o¢~0 sa.ft. ,r,. P,re¢''' 40' R=ISO00' DATE APPROVED sUFFOLK COUNTY DEPARTM[~NT OF HEAl. TH SERVICes FOR APPROVAL OF CO,~,,lr~Lh..T ON ONLY SURVEY FOR WINDS WAYBUILDING CORP. LOT 5, "HOAI~'YSUCIQ£ HILLS" AT M~TTITUCH TOWN OF SOUTHOLD SUFFOLK COUNTY, NE~ YORK 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ...x-'~3~..'rT.. D, 3 , 19b'.]. Permit No ............ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins application must be completely filled in by typewriter or in ink and submitted 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection througfinout 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, build.'.m.g/eode, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe/, ti~,m. / f ~'~ , /? ...... /~../2/./Pa' ./_,Y. ~../.~.4 ~.:~: L,~. ,. ....... (Signature of applic~tit, or name, if ~,co~oration) .... .... ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... ......... ;'". .... ',' '/2 Z;52;i .... Name of owner of premises. ~..~2'/~..~f.~..ff./e .a~?,~a,s 'o'n'~hehe' t'a'x'~/~' fi~) ....... ~ ............... If appli~ra!io~2~sign.~e of duly ~th~.zed officer. .../c. ....... ..... (Name and title of corporate officer) Builder's Licensee No ......... ~ ................ Plumber's ~icen~e No.. ~.. '.~./..~4.~. ·:. · .~/ Electrician s License No.....~..~/O.....~?.~ Other Trade's License No ...................... /,] ~ ~ J 1. Location of land on which proposed work will be done... ~.~/..~.'?rT.....~. .... ~//'~..~.~. ~t;~}e' ~q'u~r~'~r~' '~"..~..t~.. ....... Street' .~..../~.~..,'?.~...~(.5~... ..................................... Hamlet~' County Tax Map No. 1000 Section .................. Block .... 4 .~ ........... Lot.. Subdivision ............... Filed Map No ............... Lot ............... (Name) 2. ~tate ~xisting use and ~ccupan~y ~f premises and int~nded use and ~~cupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which a~plicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... -- ,~ ' (Description) 4. Estimated Cost /c~. v.l.~...f~.. "' (to be paid 6n filing this application) 5. Ifdwelling, number of dwelling units ...t~.. ...... Number of dwelling units on each floor ................ If garage, number of cars .... i. ~ ................................................................ 6. If business, commercial or mixgd 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 cons~ructmn: Front ...... Rear .. ~..lee. ........ h ......... /¢ Height of Stories · ..... .......... :...::... .............. 9. Sizeoflot: Front ..... g(Y. 4'.~.'.,~.. ..... ~ear .... /.~.,~.¥,~ ........... ~enm ..................... 10. Date of Purchase .~,~.~.//~ .~'~(~C' i i ....... Name of Former Owner . .~.,~/4~.~....~.~Y?~.~.(?. .......... 11. Zone or use district in which p~emises are situated ............................................. 12. Does proposed construction violate any zoning law, ordinance or re iation: ... ' ~X?~.. iiii ................... 13. Will lot be regraded ..... ~.,q~,.~. · · ;~ · · ;. .... ; .~ ....Will excess filLbe removed from premises: Yes 14. Name of Owner of premises P~'.¥iffodY4/,~qYd/r/.q,,.~ .°771. Address ~.~,~. 6/.~.,~70.. o..~.~.~.Aq'. Phone No. '7~.~'-~-"2~ ~. Name of Architect ........ ~../f~'d..~a-. Address ................... Phone No ................ Name of Contractor ..... it. 'i ............ ~: .... Address ........ ~.,. ......... Phone No... 4, ........... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NRW~0RK,/_ i S S COUNTY i: .'..~.~.~./~.~.'~../~ ~_13[1~ ( ( ..... being duly sworn, deposes and says that he is the applicant above named. (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 conthined 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 filed therewith. Swom to before me this ~ ~ ~' ~1~.~- ~ t~ 0 SU~ FO~ FOR APPROVAL OFLO,, ,q ~,~¢' ...., iON ONlY AT M~TTITUC~ DATE: AU~ ~WN ~ SOUT~OLD SCAnt, DATE I~ ~t:. ;~o. SUFFOEK COUNT~, NEW'. ~RK NO. APPROVED su~v~ ~ vl~f~o~ ~ S~CflO~ 7ao~ ~ "' ' ' HEAC~ DEPARTMeNT-DATA F~ APPROVAL TO C~STRUC T ' ~[ ~ RK '~'WH~M-~,~ SU~EY IS ~(K ~ K WELLiNS WITHIN I00 FEET OF TWS PROPERTY ~ST~T~TIC b. GUARA~T[~ *ARE ~T TWSFERABLE , ', ~H~R TH~;THQSE ~SflO~H HEREON. 'TO A~C ~AL INSTITUT[ ~S O~ SUBSEQUEHT N THE WA~R~SU~Y~ SE~GE OlS~AL SYSTEM ~ THiS R~OE~ OWNerS " N DISTaNCeS S~N HE'iRON FR~ PR~ERTY UNES WILL c. FO*. ~ THE STANWOS OF THE SUFF*KC OUN T* DEPAR*MENT TO E~ ,,TiK. S*RUC~R~, ~E FORA SPECIFIC '" : yOUNG 8YOUNG h~, ,, "; ~ ~ ~ , , .~ RIVER~AD,. NEW YORK SUDDIVI~ION MAP,~IL~O IN ~HE OFF/CE ~F.~H~ CLERK OF AL~EN~.: W. YOUNG,: PROFE~IONAL ENGINEER ~UPFOL~ COUNT~ ON OC~ I~, IDB~ ~S PIZE NO. ~019 AN~ND sURVEYOR N ~S UCENSE NO. 12845 . HO~ARO W. Y~UNG~ LANO SURVEYOR ~ ~ L~ ~ ~(W), ~lC TANK(S~a CES~OLS(~) IGN HERE~ N.Y. ~, LICENSE N0.45893 'i :i eof, ..~.~D.~, ' ~XTM ~o,~' . %~.'t' ' ~ Are ' .,e'° bbO~ ~ - ~: ,-'-~ FAMILY DWELLING ONLY ~ SuR~ ~OR ~ WINDS ~AYBUILDING CORP suFFOL~ Q,)UNTY DEPARTMENT O~ HEALTH SERVICES LOT~, "HONEYSUCKLE HILLS" FOR ~pp~OVAk OF COr!5'~RucTION oNLY ~T ~r/~c~. DATE:, Ir ~ J I ,,, ,~. , NGUARANTJ~I INDICTED HE~ON ~gL HUN .~' ..... ,- ~.~ ~ /~,-/~[~ ~ P~PERTY LI~ES OR ~n THE ERECTION ~ ~ 4 ~ : ' L ' , L ~ ' '~ I J HOWARD W, YOUN~ LAND SURVKYOR ' ' I~~ICTIN~~SI~)IH~ KRE~ . ~ ~)' N.~S. LICENSE N0,45~93 : 181985 ~..141~ ~I WINDS: WAY BUIL DING COB~ . ~, _~. I AT MATTITUC~ DATE: "EAL~ OEPARTMENT'OATA F~ APPRO~ TO C~STRUC T / :~ ~"~-~ q :g G~'~"t:~. I~1~ ~F~,T~P~T/eeo SECTION ,997,~CK o3 tOT ~,S I ~A~D~ ~EAS~ON~SOFTHELENDIN~ / [ ~ ~t~ ~(~.~ ~ ~1~S WITHIN I00 FEET OF THIS PROPERTy [' IM,T}~TI~. GUARANTE{;-ARE ~T T~SFEflABLE / ~ ~ ~ ~ ~ J ... ......... - ' / P~PERTY~LINES OR FO~ THE ERECf ON ~ FENCES '' ~. . ' /lli~ :"~ I~V~t m{~ G V~IIKI~ ~OS~NDER AVENUE , ~ [ /~4~ ~ /~UI~ RIVER~AD,~NEW YORK S~D/VI$/ON MAP F/4~O IN rH~ OFFIC~ OF rH~ CL~K OF [~~[ ~N- W. YOUNG, PROFESSIONAL ENGINEER SMFFOLKCOUNrYONOCE/8,/~B/~$F/LENaXO/~ I1 ' ~,~I~.~.~O~NOSURVEYORNY. S. UCENSENO. 12845 ~L~T~W~(Wi,~ICTA~(IT)aCE~OLS(~)~NHENE~ II ~W ~ ~ [ NYS EICENSt NO 45893 ~E ~ FJE~ ~TI~S MD ORDATA OBT~D F~M OTHERS' [ / : ' ' ' ~ '