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HomeMy WebLinkAbout12898-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..........Z13200 ........ Date ......... .Feb.. .... .6 ............ 198..5. THIS CERTIFIES that tile building ...N.e..w.p.w.e..1.1.i.n.g..&..A..c.c.e.s.s..o.ry. ' 50 Sebastians Cove Rd. Location of Property 1085 East Mill Rd. Mattituck Hou¢e No. Street Hamlet County Tax Map No. 1000 Section 100 .Block 03 .Lot P(O 011.3 . Subdivision..G.e.o..r$r.e. & Jane Toumanoff ~:,.., as.- xT~ .Lot No. Lot 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 17 , 19 .8.4. pursuant to which Building Permit No. 12898 Z dated ....... ......Feb' ....... 29 ........1984...,wasissued, and conforms to all °fthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Private One Family Dwelling & Accessory .Garaqe DONNA MCLEAN The certificate is issued to ..................... iob$n'o;,'l~d~tb~' ..................... of the aforesaid building. Suffolk County Department of Health Approval 14-SO- 0 9 N658758 UNDERWRITERS CERTIFICATE NO .................................................. 5/17, 1985 AMEND C.O. to include deck as submitted on original plans Building Inspector Rev, 1/81 TOWN OF $OUTHOLD 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? 12S9S Z Permission is hereby granted to;--~..~ .'-7~ ~Z~) ..... ~:~.~. -z-~z~....-...~.....~ ......... ~./..~..Z/ ,~ ........ ~~..~....~~....~::~.c~6... - ~.~: ~ ...................................... ,,,~i,,, [~ ,, ..~/~ : ....... ........................ ~~. )'" ~:" -L': ......~ ~. ................................. ~;~..~. ~~ ~ ............. ~ .~ ~ _ ~ , .... ; .................... ~ ................. : .......................... ~ ....................................... ~:~. %~: ,.~..~ ~.~.:;......~ ........ ~ ............. ~ .............~ .......................... ~.~ ............~ <~..~ T.~ ~ ~. ~ooo s~<~. ..... ~.~ ........ ~k ..~ ........... :~ ~...~.~ Building Inspector, ...:: ....... Building I~tor Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, 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. Fina~ survey of property with accurate location of all buildings, property lines, streets, and unusua~ 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. B. 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 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.Vacan% Land C.O. $5.00 New Building ....~r~... ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~..O...~.~..~.~..~.~.(..'.O~.. ............ ;.t.. )~[.~ ~.('J~. ~ C k ............ House No. Street Hamlet Owner or Owners o f , roperty . . . : . .L. . . ........................ County Tax Map. No. 1000 Section .,/.........D4) ... Block ...~.~'........ Lot...~/.~......~ Subdivision...~'¢--.~r~ ~..~.m.`..?~...Filed Map No ........... Lot No...=~..~. ....... Permit No. ~.~9~. ~'.~ .~.~ Date of Permit ~ ~ .'~.~Applicant .. ~..~.../t.~. ~ .,~. ........... Health Dept. Approval ................ Labor Dept. Approval ........................ Underwriters Approval ~...~..~.~..~ ..~. ~. ....... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted . ¢ ........................ Construction on above described building a~r~mit~,m~eets, al~abl~_~es and regulations. ~ 2~O~% Applicant ~,/~ .L~,~T~/.....'~-~/~'~-... ~..4 .'. ~~~ .............. 10-10-78 :u,'o~5 THE NEW YORK BOARD OF FIRE UNDERWRITERS DT~ BUREAU OF ELECTRICITY ~ ~C,~'[,~'~JE~Z' ~ ~ 85 JOHN STREET, NEW YORK, NEW Y~RK 10038 THIS CERTIFIES THAT ,.,~/o,,o~,.,,o~,,o~; ~ ..~, ~,~,r,. ~ ~.,d r,. s~,,o~ .,o~ rot wasexa~ninedon~t ~ ~ andfoundtobeincompllancewlththerequirernentsofthlsBoard. FIXTURE FIXTURES RANGES OVENS 35 36 DRYERS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FRET OTHER APPARATUS: I-G.F.C.I. 2-Smoke Deter;tots 1-Post Lite E R V I C 1 AWG OF CC, COND NO OF HI-LEG OF HI-LEG NEUTRALS 1 Daniel A. Fogarty Jr. GENERAL MANAGER 1~ ~d Ave. cerfificete musf not be o[fered in ~ny monner; refurn fo fhe office o, the Boor~ i, incorrecf. Inspecto~s moy be COPY FOR B~ILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU~T NOTBE aLTERED iN ANY MANNER, FIEL~ INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 0 INSULATI N PER N. STATE ENERGY qO E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ~ .... Z. 2..., I .9~..Pe~mitNo .......... APPLICATION FOR BUILDING PERMIT Received .......... ,19... INSTRUCTIONS (Name and title of corporate officer) Builder's License No .... ~.~2 .~ ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done.., d~.~i ~.'~.~'..d.~.. J'~ t~. ~J't~....o. ~. ~Z'~...~. .~/~.~. ~ . ,~,., ~ ~ , , ...>e~. ~. ~. ~.,. ~.~:... &~ :,. ~. ~.. ~. z-z.~.~ .......... House Number Street Hamlet County tax Map No. 1000, Section ..... ].~C ......... Bloc~ ~, .O,J. _ .......... Lot..//i.ff~ .......... Subdivision ~/q~ .~..~'~C.~ .¢~1! e.. [~-~'(1[. Flied Map No ............... Lot .... ~ ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~: ~.~ .......................................................... b. Intended use and occupancy ... ~.~..~ ~./~. ~q.~ ~... ~... ~q~ .................... a. This application must be completely filled in by Wpewriter 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.fpf'~tmoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildi,qg c0tle, housin~/'code, and regulations, and to admit auth~rizedinspect~rs~npremisesandinbui~dingf~rnecessaryinspe~s.~..~/[~` --~-// / (Signa[ure of appll~t, or name, if a corporation) · ..4~ :~o...~.~;2~'-' e~- . d-.... (Mailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ~!~: .~.~.~.'r'..~ ........................................................................ Name of owner of premises .... ~ .,'~ .~ · ~. · ·J~'q ~ ~.o. ~/ ........................... . ............ /,. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. / 8. 10. 12. 13. 14. property lines. Give street and block humber or descri' Nature of work (check whxch applicable): New Building .. Addition .......... Alteration .......... Repair ..............Rem4val ............ Demolition .............. Other Work ............... ' d;..O (Des*ption) Estimated Cost ........ OO.O. ................. Fee .................................. (to be paid on filing this application) If dwelhng, number of dwelhng UnLts .............. Number of dwelling units on each floor ....... If garage, number of cars ..... i :~..~ .... If business, commercial or mixed occupancy, specifg nature and extent of each type of use ..................... Dimensions of existing structure~ if any: Front Rear ....... Depth ~'-. Height ~-- Numlber of Stories ------ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth% ~ .--t:IEf~h~ ~,T.._~_er of Stories Dimensions of entire new construction: Front ......... : ..... Rear ............... Depth ............... Number of Stories Height ................................................................... Size of lot: Front ..... ~ .c/, ~.~.._. ...... Rear ....,~ ,3. ~.~-% .'t..-- ....... Depth ,4~' ~)~'C/3' 'C4' · ''~ ~ ....... Date of Purchase .../.-.. ................. Na e of Former Owner . .~.~.:../..o. ?. i~.~ f( &'.,? 9~. ~.' ...... Zone or use district in which premises are situated ...... /~' '~'~ ............ Jl? ........................... Dogs proposed constructionsv/iol,ate any zoning law, ordinance or regulation: .. tr. O ..................... Will lot be regraded .... /Y~..[ ..................... Will excess fill be removed fr.o..m premises: Yes Name of Owner of premises . .~ ~..~;g t¢. ~.~ ..... Address . .~+'g.. ~..~'.z;. ~.7Y.~4. :~Phd~ne No. ~.~.gz-.bP.7. ~..... Name of Architect ..... }~ ...................... Address ................ r · · Phone No ................ Name of Contractor ..... ~.!~.~.'s- .~&., ..... .... Address .~. i~.~. Cz:' '..~. ~.~.~rO s~'.~.'~lthone No. . ~.4. $?-.g/. (.~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from and show street names and indicate whether interior or corner lot. STATE OF 'NEW YORK, , COUNTY om. ......... ~.~..... ~. ~ .... ,,1.©..P~.',~-. '5; .-.~,.. being duly sworn, deposes (Name of individual s~g~mg contract) above named. and says that he is the applicant He is the ....... ~. ................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this 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 Notary Public, ~..~'~..7 <~ ~.... ~ LIN~A F. KOWALsK/, . . .,,. .... / [~uTAR¥ PUBLIo, State of NOW ~ua!ified in SUffolk County .Con~m~ssm~ Expires J~arch 30, 198L~/ ROBERT W. ]OHNSEN General Contractor 4300 Soundview Avenue SOUTHOLD, NEW YORK 11971 (516) 765-1165 ~Z ~0 "r-~ O~ sTK. sET MILL .,~ CH/CA~O :~rt.~': LOT ~ LOT ~ ~ TEST 80RIN~ NYT~ o MILL TEST HOL~r donack associates 3J5 WeSt mcl;r~ r~verhead,new va:'k !1901 (516) 369-1717 dAN :! .!S84 ,:),,tNo 83-410 [f'Qq-~O0-O~-[[ ~ 5r'c~ [ .' 50' LOT MAP OF PROPERTY AT MA T TI TUCK TOWN OF SOUTHOLD SUFFOLK CO, N.Y. $ AS SHOfflN ON MINOR SUBDIVISION OF G~'OR~' 8 dANE TOI/MANOFF C£t? TIFI£D TO: CHICAGO TITLE IN,~. # 8.~08-OG- DONNA NOtE ' ELEVATIONS At~E IN CO. ASSUMED