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HomeMy WebLinkAbout12982-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13280 Date March 22 ., 19 .85. THIS CERTIFIES that the building ......... .N.e.w...D.w.e.l. 1..i.n.g. ........................ Location of Property ...7.4.5. ............. .G.r.e..t.o.n..C. 9.u.r.t' ................M.a..t.t.i.t.u..c.k... House No. Street Hamlet County Tax Map No. 1000 Section 107 .... Block 02 .Lot 003.8 Subdivision .... .G.r.e..t.o.n..E..s.t... ............. Filed Map No. .6.457. . . .Lot No....9 .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A. l?.r.i. 1. ....... .5 ....198..4. pursuant to which Building Permit No. 12982 Z dated ...... .Ap.r.i..1...5. ............ 198..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 ......... New Private One Family D. welting The certificate is issued to ...... HEILAND, CHARLES H. fo wn er, ~e~e~o~ ~q~) of the aforesaid building. Suffolk County Department of Health Approval ...... 1..4.-.S.O. 7 .5.8 ........................... UNDERWRITERS CERTIFICATE NO .............. .N. 5.7.3. .07.7 ........................... Building Inspector Rev. 1/81 FOBM NO. 2 TO~N O~ $O~THOL~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12982 Z Permission is hereby granted to: ........ ....... .z.~o..~....~.~ .... ......... ~/,.~.~./..~z..~.~.~...6:....W.... ........ /.~.~.~z. · (.~.~,~.~.~..zC..~..;Z.. ........ ~.~.<~':....~,~ ....... ~/,,~../.~ ................... at premises located at .................................................. ............................................................................................................. ~../..~../../.zZ/~-~..:.~..~ County Tax Map No. 1000 Section "'/"(~)'"7 ......... Block ..... ~....~..~ ..... Lot No...(~..~.~..~... ~u,suon, to opp,,cot,o~ dot~ ..... ZY~./.:......~ ........... . ,,.~ond op~,o~ b~ the Building Inspector. Fee $..../..~ ......... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department '~own Hall Southold, N.Y, 11971 APPDCAT~ON FOR CERTIFICATE OF OCCUPANCY Instructions OF 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electricat 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 existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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. C. Fees: 1. Certificate of occupancy $5.00 2. ~:ertificate of occupancy on pre-existing dwelling $15o 00 3. Copy of certificate of occupancy $1.00 ,~ 4oVacant Land CoO. $5.00 /~d~" ~ Date .......................... New Building .... {'~.. .... O~d o~ P~e-gx~s~n~u~d~n~ ............ Vacan~ k~nd ............. . Houm No. .Street -- Ham/et Owner or Owners of Property .. ~1~''~ ~//~ ~ County Tax Map No. lO00Sectio, ../.~..2 .... Block ..... ~... Lot...~A...~.~'~... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./~.~ .~Date of ;ermit. ~:~pplicant..~/~::... ~:':/~ · Health Dept. Approval ....... ~ .............. Labor Dept. Approval ........................ Unde~riters Approval. ~..~. ~.~.~.?.~ ........ Planning Board Approval ..... ~. .. . .......... ~equest for Temporar~ Certificate ..................... Final Corfificato ....................... ..... ............... Coa,truction on above described buildin~ an~per~'it meot~ all~lic~plo co~s and ro~ulations. R~, 10-10-7~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~1~'~ fL/&~' [ If~ (please print) (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 ~j , Notary Public,~ County Notary Public NOTARY PUB!.iC, Stale of New York No, 4707878, Suffolk Coun~ ~ern~ Expert,s lv~ar h 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~L00138~L BUREAU OF ELECTRICITY [-~3~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..~e :~,.~ 3~ '~gs~ .~,~llc..o,,~o.o.~,,~ ~76~:~s/s~ N 673077 THIS CERTIFIES THAT Charles Hei]m~d~ Greton Court, Y~ttJ, tuck, N.Y. Gz~nd Avenue in the followlng location; [] Basement [] 1st Fl, ~ 2nd FI. Section Block Lot was examined on ~)C~C~t~ '~0 > 1~8~ and found to be in compiiance wi~h £ke requlrements of this Board. 43 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: R V I C NO OF CC COND. A, W O. NO. OF HI4EO PER ,~ OF CC, COHO NO, OF NEUTRALS t~at Lane ~ttituck, N.Y 11952 l~. This cerfificote susf not be oliere~ in ~ny m~nner ~e*um .... CO?y'~OR B~LD!NG DEPARTMENT. THI~COPY.0F, CERT~F~T FIE~D INSPECTION COMMENTS FOUNDATION ( 1 st ) FOUNDATION 2. ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N, STATE ENERGY ~DE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST~ ~ RouGH PLBG. FOUNDATION 2ND [ ] INSULATION ~ FRAMING [ ] FINAL REMARKS: ~,~' ~ ~~ ~ ) BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION ZND INSULATION FRAMING [ ]FINAL · INSPECTOR ..... DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 · ..... /.,:::? Examined ... Approved .~'./.~. ........ 19.0%'°~ermit No.. 43 *' _ Received .......... ,19... Disapproved a/c ............... ' ............ .<<? ...... ~/~ /,' ............................... APPLICATION FOR BUILDING PERMIT Date 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 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 oj. demolition, as herein described. The applicant agrees to comply with all applicable laws ordinances buildigg code h?~ing coqle, and regulations, and to admit authorized inspectors on premises and in building for necessary i~(~ond.~ ~[ /q~~._~ '- .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ .................................................................. Name of owner of premises .......................................................................... (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 ..... .~. ................... Plumber's License No ......................... Electrician's License No ....................... Other Trade s L~cense No ...................... 1. Location of land on which proposed work will be done .................................................. . . . ............. .¢. . .:. ........... :.. ................. House Number Street Hamlet County Tax Ma~ No. 1000 Section .... \ .~..w/ ......... Block ...~..~... .......... Lot.. O ~, ~ Su bdivision . ~.~ .~.~.....~..v%. ~-. ~ .~.c:~'-e...q. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. x,stmg use and occupancy...V'.~C~Y.X..~.. ~ ff.. ~x & b. Intended use and occupancy..~ .v3. %/~,..~..~ ~ / ~.~ t._.,J -~ [ ~ ', ~,, ........ 10. 11. 12. 13. 14. Nature~ofwork (check whicli applicable): New Building ...... Addition .......... Alteration .......... Repair . ............. Removal .............. Demolition .............. Other Work ............... Estimated Cost .......... ........................ Fee ........................... (to be paid on filing this application) " J Number of dwelling units on each floor If dwelling, number of dwelling l~nits .............................. r7 . If garage, number of cars ..... ~ ................................................................... If business, commercial or mixed occupancy specify nature and extent of each type of use ..................... .... ' if any' Front Rear Depth DimenSions of existing structures, ............................................ . -. Height ............... Nu~nber of Stones ................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... I.. Height ...................... Numrbftf, of Stories ................. Dimensions of entire new construction: Front...~>[~ . . . ~ ..... Rear...'~ .ti. ......... Depth . ~iiii ...... Height ...... ......... Number of Stories ..................... Size of lot: Front ... ~... ~].~f ........ Rear ..... /..~./. ............. ~Depth . c>~.. I~. ......... Date of Purchase .... ~./~ .r'}/.~.~. ............... Nqim qr Former Owner .~.~..4~(.~C~.. k~ L~..~.~ .......... Zone or use district in which premises are situated ...... i ~ ............................................ Does proposed construction violate any zoning law, ordinance or regulation: ............................. Will lot be regraded ......... i ................... Will excess fill be removed from premises: Yes No Name of Owner of premises .. ! Address Phone No ................ Name of Architect ......... ~ .................. Address ................... Phone No ................ Nmne of Contractor .. ~.... Address . ,~: one No. . . PLOT DIAGRAM Locate clearly and distinctly allI buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. '1 t STATE OF NEW YORK, IS.S COUNTy OF .................. ~ being duly sworn, deposes and says that he is the applicant (Name of individual sigfiing contract) above named. He is the (Contractor, agent, corporate 6fficer, etc.) of said owner or owners, and is duly authorized to perform or liave performed the said work and to make and file thi~ 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 filed therewith. Sworn to before me this ............ ...... day o., .......... Notary Public ......i ~.."~-J.. ~.'...~..¢~. Countyf'L 0 '~ f.~... ~.~ -'~ / N0 47078'/8, Suf~ol[I (~0tmly_<~ (Signature of applicant) 6RA ND AvE. N U E. O LOT 7 %rio vACANT Z .o pARK MAP OF LOT 9 'GRE TON ES TA TES ' FILED SEPT. 20, 1976 FILE NO. 644 7 A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK CO.,N.Y. ·; STAKE ELEVAT~O^/S ARE REFERE~VCEO TO AN AS~UM£O 0.54 vAcA.NT~ r.~ pLAYGROoNu CERTIFIED TO: CHICAGo" TITL~ INSURANCE COMPANY MARY A NNE-~H~iI- A N D donack associates 313 west moin street riverheod, new york 11901 (516) :¢69- 1717 MAR.22, 1984 Job No. 84-482 1000-107-02-0:3.8 Scole:l"=40'  t~ilitioo for thio looation b~vo bern ~- ~00'~ ~a~e~'%ed by this de~}~nt ~d ~o~ S8~oos LU I VACAN~ AvE. N U E. ~ t~de eevase di~ooal and vate~, supply "W. pARK pLAY O R oU N"' Z 0,54' MAP OF LOT 9 'GRE TON ES TA TES' .FILED SEPT. 20, 1976 FILE NO 644 7 A T MA TTITUCK TOWN OF SOUTHOLD SUFFOLK CO., N.Y. · = MONUMENI' SE T ELEVATIONS ARE REFERENCED TO AN ASSUM ED , D,4 TUM. CERTIFIED TO: CHICAGO TITLE INSURANCE COMPANY MARY ANNE HEILAND donock ossociotes 31:5 west moin street riverheod, new york 1190i (516) ~69-1717 I FEB. I, 1985 Job No. 84-482B 1000-107-0~-05.8 Scole= 1"=40'