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Home My WebLink About12940-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-25965 Date: 09/10/98 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1250 VILLAGE LANE MATTITUCK (HOUSE NO.) (STREET) (HA14LET) County Tax Map No. 473889 Section 107 Block 11 Lot 7 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 13, 1984 pursuant to which Building Permit No. 12940-Z dated MARCH 19, 1984 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 WITH ATTACHED GARAGE & DECK AS APPLIED FOR. * The certificate is issued to EILEEN A. ABATE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-SO-27 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *THIS UPDATES CO Z-12893 DATED 10/11/84 N-658862 N/A I0/17/1984 d~ Inspector 09/06/84 Rev. 1/81 FOII,~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CCCv~PLETION OF THE WORK AUTHORIZED) 12940 Z County Tax Map No. 1000 Section ...... ~.,...~...,.~. ..... Block ......... /,..L ........ Lot No ........ ..~ ............. Building Inspector. Fee $ .................... Building ns~ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD · Building Department · ' Town Hall Southold. N.Y. 11971 765 - lg02 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted ,= ~ to the Building Inspec- tor with the following; for new build'rigs or new use: 1. Final storey of property with accurate location of All. build!age, 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 electrical installation from Board of Fire Underwriters. 4. Commercial buildings. Industrial buildings/Multiple Residences and s~milar buildings and Installa- tions, a certificate of Code compliance from the Architect or Engineer responsibte for The I~uilding. 5.Submit P ann ng Board approval of con)plated site plan requirements where applicable. B, .For existing buildings (prior to April 1957)0 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 ~ond tion of buildings. 3. Date of any housing code or s,a. fety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certihcate. · C. Fees:' .1. Certificate of occupancv $.25:00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwe. illng $ 50 .. 00 3. Copy of certificate of occupancy $'5;00, over 5 years $10.00 4.Vacant Land C.O. $.'20.00 5. updated C .O. $"50.00 Date ~S~p£~mber. 10,. 1998 ........ C.O TQ REFLECT ~E~ NewC ~"' "~i~n UPDATEIk' axis[lng aUlla'ng ' V cant Land 1250 Viliage .Lane ' Mattituck Location of Property ................................................................... House No. Str~#t ~lamlat Eileen A. Abate Owner or Owners of Property ' 107 11 7 Tax Map No 1000 Section Block ' Lot County ............................................... .... Filed Map No Lot No Subd~vmon .......................................................... Permit No Date of Permit Applicant Health Dept. Approval ........................ Labor. Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... 50.00 Fee Submitted $ ' Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... GARY FLANNER OLSEN, P.O. BOX 7O6 CUTCHOGUE, NY 11935 FOBM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Tewn Hall Southold, N.Y. Certificate Of Occupancy Z12893 No ............. . ... . October 17 Date .......................... THIS CERTIFIES that the building . .P.~. ~y.a.~e...O.n.e...P.a.mfi.]:. y. Dwelling Location of Property 1250 Village Lane Mattituck House I~1o. Street: Hamlet County Tax Map No. 1000 Section ...19.7 ...... Block 11 .... Lot. 0..07 Subdivision...v.i.l.l.a.g.e. .~.a..nP.r. ............ Filed Map No. 3.6.6.9 .Lot No. 36. conforms substantially to the Application for Building Permit heretofore fried in this office dated 129~'0Z ....M.a..rgk ...1~ ....... ,19.8.4. pursuant to wlfich Building Permit No ...................... dated ....... [qi~jc.q~ .....1.$ ........ 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 ......... Private One Family Dwelling ANTHONY ABATE The certificate is issued to ........................................................... (owner, Je.csee.or-tena)~) of the aforesaid building. Suffolk County Department of Health Approval 14-SO-27 UNDERWRITERS CERTIFICATE NO ................. ,N,6,5.8, 8, ,6 ,2 ......................... Building Inspector Riv. FORM NO, 6 TOWN OF SOUTHOLD 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 submitte~,'~!~c;ta 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 electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial build ngs, 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 app(icable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property 'lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owne~ 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling land use 3. Copy of certificate of occupancy $1.00/ --Pre-ExistinM C.O. $15.00 Vacant land C.O. $ 5.00 New Building ....X. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. l '.Z..~.0. .............. .V. ~..L-.~.~.,, .L.~. ......... .~..~:T~..T~;.,.' ..~..~.6 ..... House No. ' Street Hamlet Owner or Owners of Property .... ~ ~..~..~..-~.~ ?.~.~/...-~-..~..~...~..A:T.~.' ....................... County Tax Map No. 1000 Section ..... J,O, ~. ...... Block ...~,[ .......... Lot...7. ............ Subdivision...V,~.J~!,,~.~...~...(~. ?..l?.o.~. ............ Filed MaPNo. ~.~..~p.<~...Lot No...J..~. ........ Permit No. I[z.~j.~.q~,... Date of Permit .~..j)~[ .~.d.,..Applicant.. ~.{~. Health Dept Approval '~ I ~J-~O-~,~7 Labor .............. Dept. Approval ......................,, Underwriters Appr6val ~,~ ~ ~--.~ .~.~..~. ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~. ............... Fee Submitted $ .~.,.o.__~.o ....................... Construction on above described building an~4~ermitj~qeets all appliceJ~le codes and regulations //n // ' · ¢ ................... . ........... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy ~- ~Ot~Z~ ~, 19~Z~ 85 JOHN STREET, NEW YORK, NEW YORK tO03~ Date /~pplicatlo. NO. oaf". aT~ea-~ N 6 5 8 8 6 2 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of AnSh~uy Abate, Village I~me off Rt, 25, Near HiEh School, ~/s Just before ben~ i~Ekl. int~efof'o~'n~oo¢lat'on, [~.,e~nt [~ ',trl. [~'~,d r,. ~ttic,outside Sect,on mo~ rot was exa~nlned on AllgUd~ ~7 ~ ~9~ and ~ourtd to be in compliance wltb tbe r~qulrements of this Board, FIXTURE FIXTURES RANGES DISH WASHERS EXHAUST FAN~; OUTLETS SWITCHES FLUORESCENT DRYERS OTHER APPARATUS: 2-~ke Detecto:c~ E R NO OE CC, e. COND. A.W G OF CC, COND V I C E NO OF HI-LEG OF HI-LEG NO OF N~TRAI OF NEUTRAL G & S Elec. P,O, l]ox 215 Southold ~ N.Y. 11971 Lic, 578 E This certificate must not be altered in any manner; return to the office of the Board f ncorrect. Inspectors ma be identified ' OPY FOR BUILDING DEPARTMENT. THIS COPY OF CER~ F!C~TE ' UST NOT B~ ~ T, ERED N ANY MANNER. 765-3.802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND~ ~'{]//~\ INSULATION FRAMING [ '~ FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL ,REMARKS: i INSPECTOR ~EL~.iNSPECTiON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL _. _ . ~.~DITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 19 Approved...X~x.c~,&..\ .~.., 19.1. Permit No..I.~'. ~ :.~..~.. Disapproved 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 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 or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regt~!atio~_s., and to admit authorized inspectors on premises and in building for necessary inspections. _~ ~ ~ ~ ...m. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~: .. 'tax' Jo'li &; If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No...~..4 .~... ~ ........... Electrician's License No. ~..~..g.* ~ .......... 1. Location of land on which proposed work will be done. q~/l~v~~..~..~~< .~ .... .... House Number VStreet t Hamlet County Tax Map No. 1000 Section ..... t.~...~. ....... Block .... ~.~. ........... Lot .... 7 ............. Subdivision . . ~/]~. ~ ........ Filed 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 ................................................. 3. Nature of work (check which applicable): New Building ...)~....., Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition . ~..c>.~. :¢.~Q. .... Other Work ............... ~. ~?..,~:~..~. ?. (7 !~ (Description) 4. Estimated Cos ·.; ......................... Fee ...................................... (to be paid on filing thi~application) 5, If dwelling, number ofdwellinglunits ........ Number of dwelling units on each floor ~'~'~'2'/~' If garage, number of cars . . 6. If business, commercial or mixdd occupancy, specify nature and extent of each type of use 7. Dimensions ofemsttng structurgs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions " ' Rear of same structure w~th alteratmns or additions: Front ................................... Depth ................... ;.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new constrUction: Front. ~ P...., ..... Rear . ~:O. ......... Depth .~. ~ ......... Height . .-.~.// ........ Nur0ber of Stories../.. ~ ............................... ~, .................. Sizeoflot ifront ~.O..O.,_..~ ............ Rear ....-4~..o. .............. Depth /.~..~. ................ !)ate of Purchase . ~/.;~o~.ff. .................. ~,~a_me offfo~r_~O~wner ...~..~...'~. V~I~. .............. Zone or use district in which pr~mises are situated../. ............................................. Does proposed constru~qction vie)ate any zoning law, ordinance or regulation: ~ .......................... Will lot be regraded . .kq4'. ....... ~/ ........ a ..... Will excess, fill be removed from premises: ~'-~ Y. es_ ' No'L- Name of Owner of premises ~ .~Address ~ .... Phone No.~.{. ?.~.,~.~.~ ~.~ Name of Architect ............... Name of Contractor ~ Address Phone No 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly al1 buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number o.13 description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~S.S C O.U. NTY OF .......... . .....~' above n~dual sig!ing contract) ...... being duly sworn, deposes and says that he is the applicant He is the ..... ~ ....................... i (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 mann6r set forth in the application filed therewith. Sworn to before me this ........ /(.3..~. ......... day o~...~.~ .......... 19f.~. Notary Public ...... 5~-~--'A~.... . x ...... County '""~" HELEN K DE VOE ~" . ...... NOTARY ~UBLtC, S[ale of New Yor~ (Signature of applioanf) , No. 4707878, Su%lk Couoty -- Term Expnes Nl8rch 30, i~ 0 · ,r Z 8 0 W Il;