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Home My WebLink About13452-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ~fi.5.4:¢. ~. ......... Date ....... .FI.~2r. fl.{I- ................... 19~.5' THIS CERTIFIES that the building w.-22e~..dJ4~l~Lj,r*~ ............................... Location of Property .5G. 5 ................. .33~.7ff~..~'' .~.q~..d ............... ~..~..~.5,~..ug.k' .... House No. Street Hamlet County Tax Map No. 1000 Section .... .'13.9. .... Block . . .Q3 .......... Lot .... .O~,q, ......... Subdivision .......... X. .................... Filed Map No...X. ..... Lot No...X. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ,S~.~V~.~..~J~ ....... 19 .~.q:. pursuant to which Building Permit No... ~ ~.~.~..2..Z. .......... dated ....B.o~. 9 .m.t>.e.~... ¢.~ ........... 19 ~.z[., 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 ......... .... .a .~p~_.v.~e..q~e.-~.~r~$~7..4~.~,~.2A- .~. ......................................... The certificate is issued to ...... .G..2[~...S?.g..~., .n.?~..Q: ...................................... (owne~'4e'~e~ of the aforesaid building. Suffolk County Department of Health Approval .fl~.-:~..0:-.~2¢.~. ~/..~./~.~. ~..S.~.e.]~ .Ig~.~..4.-..O. qs..~.a ~ 2P.E. UNDERWRITERS CERTIFICATE NO ........ ~..~.q.q.~ ................................ Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~3452 Z Permission is hereby gronted to: ........... ..~7.: ........ ~. 7~z¢ ................ : ............... ............ · /.~...-...~.7 .................................... _ . ......... ~..g~.e.~e: ....... ~.,........//,~ ,o~--~ '~ ~ f.~~......~:...~~..~.....'.~..~.~z~; ...... ~ ......... ............... ............................. County Tax Map No. 1000 Section ....~..~...C~.. ......... Block ..~.~.. ........... Lot No..~..~.~.. ........ ~uon, ,o o~,,co,,o~ do,~ ...:~..F.....Z~~'~'-- ....................... , ,,~..~' o~ opp,o,~ by ,he / Building Inspector. Fee / '~ .... '~' ......... '~i~ig~' I,~,:[;7 ...................... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,?,~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ±n ~icate A. This application must be filled in typewriter OR ink, and submitted~ ,,V,, ,:t:o'~he 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 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 pz~operty 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 procare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 Date ..... .9.. .T~ ......... New Building ....~," ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .5..~.~) '~) .t~.~.u'~ . . .~...~.. ~ House No. Street Ham/et Owner or Owners of Property ~-' .¥.[ .~.~.. (~...~-~..~ .... County Tax Map No. 1000 Section .~.~,- .~ ......... Block ............... Lot ............ Subdivision ................................. Filed Map No ........... Lot No .............. No,\~:~,~ ,G', ~,,, Date of Permit ~ I;Z,~I~,~, ,Applicant . ,C,2, .L ,~,%%' ,~,~-, 1~..~, ,~,,,: Permit Health Dept, Approval ...... , ,~,-,-,-,-,-,-,-,~%.', ............. Labor Dept, Approval ........................ Underwriters Approval ....... :~ .............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted$. ~) . .~ /l~ / Construction on above described building and permit meets all applicable codes and regulations. BLDG, [)EP~ I'OVVN OF ~OUTHOLD THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000-~.~0 BUREAU OF ELECTRICITY ' ~kl 85 JOHI~ STREET, NEW YORK, NEW ,YORK ,10038 THIS CERTIFIES THAT o~ly the eIectrlcal equipment as described below and introduced by the applicant named on the above application nu ember itt the premises of Glastar Ltd., 565 Baye~ Rd., Matt~tuck, N.Y. in the following location; ~ Basement ~ 1st Fl. was examined on March 5,1985 FIXTURE OUTLETS 16 tECEPTACLES 33 SWITCHES 25 16 DRYERS MOTORS ~ 2nd Fl. Section Block and found to ~r~compliance with the requirements of this Board. RANGES OVENS SYSTEMS E R V I C NO. OF CC CONO A,'~N O NO OF HI LEG A W. G NO. OF NEUTRALS A, W O 1 4 1 4 OTHER APPARATUS: Future Appliance FeedermT 1-2-14, 1-2-12, 1-3-10, 1-3-8 G.F.C.I.- 1 Smoke Detector- 1 BufldinE Permft No. 13452~. M.A.T. Electric~ P. O. Box 129 We~t I~lip, N.Y.~, 11795 lic.2566E GENERAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspector~ real/be identified by COPY FOR BUILDING DEPARTMENT. THIS COPY IEDIN ANY MANNER. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY GODE FINAL ADDITIONAL COMMENTS: METRO PLUMBING EAST Aquebogue, long Island, New York 11931 (516) 7224032 BOB WADDINGTON April 1985 Glastar Ltd. Tuthills Lane Aquebogue, New York 11939 TO WHOM IT MAY CONCERN: REF: One family house (Bayer Road, Nattituck) All domestic water piping was soldered with 91 present Code. Solder to meet addington Lic. # 857-P Sworn to before this 23rd day of April, 1985. Notary Public I~A~ETTR CORNINE NOTARY PUBLIC, State o~ New York $~qfolk County No. $2-5792800 ~-'~ Commission Expires March 30, }9~c~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y, 11971 TEL.: 765-1802 ·~'-~ %~ ~ Rece~_ved .. Exam]n ed . .--/??~ e.. ........., 19... ~ Approved ~/~.~ ...... 1~ Pe~it No. ~~ ' ~l.S~oved a/c / ....... .~~. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This 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 al~pli- 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 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 inspections. ....... ~'../~,r.../?..*....&.,, ?: .............. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ~..e,: ~:~../.....C~. 9..~. ?..~.~. ~/.: .......................................................... Name of owner 9f premises.. C~..~2~. · .... ~ ...... ~~~~ ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ... ..... ............. ~ (Name and fi'tlc of corporate officer) Builder's License No ..... .~.. ?..~.'. ............. Plumber's License No .... .~..c.r~..~f ............. Electrician's License No..~ ~..~. .............. Other Trade's License No ....................... 1. Location of land on which proposed work will be done .................................................. ltouse Number Street Hamlet County Tax Map No. 1000 Section137 mock ~ rot ........................................ ¥ ;+:: ~.~. · · Subdivision ./~."J.c(.~./. 7t-','c ~ /~/~Fr. /~/'~' Filed Map No ~3 ~/aP~.o~. Lot ....... (~'ahi~) .... ~ ....................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~/P b. Intended use and occupancy ......... -.-,.-.... ...... ./~.. ................... ~ ......................... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ... ~ ... Addition .......... Alteration .......... Repair Removal Demolition Other Work ~ esc n) Estimated Cost .... (~C)'' ~t..o,o. .................. Fee ........................ ~ ' (to be paid on filing this application) If dwelling, number of dwelling: units.. ·· · · ·......../ Number of dwelling units on each floor ............... If garage number of cars ~ If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. D ' epth .................... ,... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .. ~..~..~. ....... Rear ...??. ......... Depth ...,~.,5'....r(.q ?... ightr. ' · He ... c .. Number of StonesRear ~.~.. ~, ........ ~'.. Size of lot: Front .... ~ v~..~ ! ................... Depth /.~. ?. ..... Date of Purchase ' Name of Former Owner Zone or use ...... situated d~stnct m whmh premises are ..................................................... Does proposed construction vie'late any zoning law, ordinance or regulation ............................... Will lot be regraded ........ ! .............. Will excess fill be removed from premises: Yes , Nol/ Name of Owner of premises .. i ................. Address ........... Phone No. 7,~..oQ.';-.~O.].... Name of Architect Address Phone No Name of Contractor . Address Phone No PLOT DIAGRAM Locate clearly and distinctly ali 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 NEW YORI~, .... S S ........ ;~:~Zf};~;Xfs~;~;:c;~ .......... being duly sworn, deposes and says that he is the applicant above named. He is the .... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ autho~zed to perform or have perfomed the said work and to m~e and file this application; that all statements cont~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~n r set forth in the application filed therewith. Sworn to b6fore me this 8~ ~, ~ ,>f New York HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT N NEAREET W aA ~Ul. -~ H EOURCE OF WATER, PflI~TE ~,~.~PUBLIC # SUFp co. ~ mST ,~ sEctlo. ~ ~CK ~ ~Ot ~ N~E~ A~ ~ ~LLI~S WITHIN I00 PEET OF T~S PROPERTY OTHER THAN THOSE SHOWN HEREON. N THE WATER SUP~Y A~ SE~E DI~AL SYSTEM ~ mis R~iDE~ WILL C~FORM TO THE STANDS OF THE SU~K CO~TY DEPARTMENT NorE : · = MONUMENr 0 = PIPE SUBDIVISION MAP FILED IN rile OFFICE OF THE CLERK OF SUFFOLK COUNTY ON 'dULY .Pt, 195S AS FILE NO. 1184. BRANDIS & SONS INC, 1046 SURVEY FOR '~/ '69 L.Ot plot MARCHS, 1985 dULY 20 , 1984 REVISED: APR. $, 1984 ROY STAKEY t~ART OF LOTS IVO. G1 8 G2 , "AMEIVDED MAP OF MArT/TUCK HEIGHrS " AT ~fATTITUCK DATE. DEC. 5, 1983 TOWN OF SOUTHOLD SCALE: / ' -' $0 ' NO, SUFFOLK COUNTy, NEW YORK GUARANTEED TO: USLIFE YIT£E YOUNG a YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND'iLAND SURVEYOR N.~S. UCENSE N0,12845 tAI~WARD W. YOUNG, LAND SURVEYOR N.~$.LICENSE N0.45893 h 83- 1042 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK