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Home My WebLink About12945-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..8.8.7 ........... Date October' I 1985 THIS CERTIFIES that the building ... ONE FAMILY DWELLING ........ .5b.5' ..Br~e.a.k.¥.a.t.e.r' Road Mattituck Location of Property House No. Street Hamlet County Tax Map No. 1000 Section . ] J .3 ........ Block .0. 3. ............ Lot 6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...a~r.cB..19 .......... 198.4.. pursuant to which Building Permit No...~.2.9.4..5.z ............. dated . H.a~.qb..2.8. ................. 19~.t!,, 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 ......... ·..O~e..f~.z~ ~..Z..d~d.e.!l..i.ng.,..i.n.c.! .u.d.i?.g..d.e.q~: .................................. The certificate isissued to C..H.A.R.L.E..S..R.....F.O.S.S.E..T.T..J.R.: & SUSAN C. STEINMETZ-FOSSETT [owner, ~: ~ztj( of the aforesaid building. Suffolk County Department of Health Approval .... 1.3.x S. ,0 :-.1.8. 4. .'...8./. ! .3./.8. 5. ................ UNDERWRITERS CERTIFICATE NO ..... N 683310 3 / 19 / 85 Building Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN HAL~ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 12945 Z Permission is hereby granted to: ....... ~..: ........ ~..~.~:.....~: .................. ........ ~.,z:..........~..~,,.~.~......~.~...z/?.~a ro ........ ~~Z.....~ .... ~.~.~ ................................. ot premises ,~oted at .,..~; ~~..~7~.,.~ __~----~ ~ ................................................................................................................... ~z~.~., ..: co~,~ ,~ M,~ ~o. ~o00 S~t~o, ..... Z/.~ ......... e~k ...... ~.~. ...... Lot ~o....~.C ........ 19.~0 and opprov~ by the ~,,~,, ~o .,~,~otio. d,,~ ..... ~~.....z..... ............... . Building Inspector. Fee $.., ././.~.. .......... 'Building Inspector Rev. 6/30/80 lOOOo THE NEW YORK BOARD OF FIRE UNDERWRITERS O1 BUREAU OF ELECTRICITy ~ 8~ JOHN STREET, NEW YORK, NEW YORK 100:3~ THIS CERTIFIES THAT only the electrical eqt~ipment as described belo~v and introduced by the applicant natned on the above appllca~ion nutnber in the premlses of Charles R. Fo~setg Jr., 54t5 Breakwater Rd. ~ Mat~itue~ N~ itt the following location; [~ Basement [~ lst FI. Lot ~.~e~in~do,, Mar~ 14, 1985 OUTLETS IEECEPTACLES SWITCHEE 37 38 DRYERS [~ 2nd Fl. : Section Block and found to be irt cotnflllance wi~h the requirements o~ this Board. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS FANS 37 FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMECLOCKS UNI~ HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS= S E R V I C E ECR~,F/COND'l A W.G. , p OF CC COND, ~/0 AW,G OF HI-LEG OF NEUTRAL 2/0 Alpha & Omega Electric Co. 47 Woodbury Rd. Fan~dngvllle~ N,Y. 11738 LiC 634 E This certificate must not be aJtered in eny monner; return to the office of the Board Jf jnco{yecf. Inspectors may be identified by their credentiaJs. COII"/~IIOII IlIUILOINa 011PA~t'MI~NY. THIS FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 I~LDG, DEPT, TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted i ~ 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 Hea[th 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing ali 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. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date...~.-..~.~'..'.~..~'.. ............ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,,~.~.~. .'~_¢~g~.?.~'..~-...~.O~O .j../~...~.?./~./..~...~. House No. Street Ham/et Owner or Owners of Property .. ~qA~[,~.% .~.: . .~..¢T~-~..% .TT..'~'~, ~ .~..~.%~..~.g..~., .T~.197.~.; ,l~.~.~z= County Tex Map No. 1000 Section . ././. ~. ........ Block . . .~.,~. ........ Lot..~-~ ............ Subdivision ................................. Filed Map No ........... Lot No ...... ' ' . Permit No../.i~.~.~... Date of Permit .~.'~-,~,~.Applicant .~(2-~/~..~.'...~i~...~.~.... ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit'meetsmtLapplicable code~s~nd regulations. FIELD I~SPECTiON COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION FER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ "~INSULATilON [ ] FRAMING REMARKS: [ ] FINAL DATE:,, INSPECTOR Examined C;7/" ~ ' 19'{ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . . '.~:. · '.'?;' · ...... , 19~Pennit No. .-: G ? Rece±ved - ..,19 Disapproved a/c ............ .. · :'...-: ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Ttds 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 6-r 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 t~nd fl~ building for necessary ips, pections. _.~ ,,, (Signature of applicant, or name, if a co~i~., ration) ~Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or"builder. Name ofowner ofpretnises ...... ASsr e, Fr -l , *.Sv.s.at .0. . ,.. · (a~ 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 ..... ~c"~ f~...,'7~ .......... Electrician's License No. ~.~:~_C~- ....... Other Trade's License No ...................... 1. Location of land ou which proposed work will be done .................................................. House Number . Street Hamlet County 'Fax Map No., 000 Section ..... l./..'~. ........ Block ...... .~? ......... Lot .... ~'~ ............. 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 occupancv 51~ [.5..' " 3. Nature ot'work (cheek which aplplicable): New Building ....... Addition .......... Alteration ........ Repair .............. RemOval .............. Demolition .............. Other Work .............. 4. Estimated Cost ........... /'i ........................ Fee ....................... ~ (to be paid on filing this application) 5, If dwelling, number of dwelling iunits ..... [ ........ Number of dwelling units on each floor ............... number of cars ' If garage ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing stmctur(s, if any: Front ............... Rear .............. Depth .............. Height Number of Stories Dimensions of same structure w'ith alterations or additions: Front ................. Rear ................. Depth ................... ~.. HeiSt ......... Number o~ Stories ............ .. t ....... 8. I)imension~,of~ptire new construction: Front .... 5~ ........ Rear .... Bfi? ........ Depth ...:~ ........ Height ~.~ ....... ~U~ber of Stories ' ' ~ ~ ............... d?" '~'~ ........... 10. 11. Zone' or rise district in which pr~mises' 'are situated" ...... ' [{.~ ~.t.. ~ ~t~.J~' ' ........................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .~ ..q:~r~ ...................... 13. Will lot be regraded .... ~.~ ................... Will excess fill be reinove~ ~om premises: . Y~s , Name of Architect ........................... Address ................. ~.. Phone No ............... Nmne of Contractor .' Address Phone No PLOT DIAG~M Locate clearly ~d distinctly ~1 bulldogs, whether existing or proposed, ~d, indi rte ~1 set-back d~ensions fron prope~y fines. Give street ~d bloc} number or desc~ption according to deed, ~d show ~ freer nines and indicate whethe interior or corner lot. STATE OF NEW YORK, ~ S.S COUNTY OF ................. ' ............................ : .................... being duly sworn, depos~ . ~d says that he is the applican (Name of individual sig}~ing contract) above named. He is the ..................... [ ................................................................. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dOly authorized to perform or have performed the sa. work and to m~e and file application; that all statements contained ~ this application are true to the best of his :mowledge and belief; and that th work will be performed in the mamier set forth in the application filed therewith. Sworn to beforeJne this Nota. Public . ~ .1 * County q~ ,__.~ ~OTAR( PUBLIC, S[a~,o NewYo~ : ...... ; ........................ N 1. r ojor¢~sk~ ~OUNTY DEPARTMENT OF HEALTH APPROVAL OF ¢ONSTRUCTIOI~ __ HS REF, bio ....... ?TMEt, IT-DATA FO~t APPRO~4. TO C~STRUC r COX NECK RO4D CHXR£ES ~ FOSSET~ JR ~ SUSAN C. STDNMETZ FOg AT I~,~TTITUCN TOWN OF $OUTHO~O SUFFOLK COUNTY, NEW YORK #~UTHO~IZEI) ALTERATION OR ADDITIOH TO ~115 DATE: OCT 18 SCALE: NO. 83 - 90 GUARANTEED TO SUSAN (2 ter , ~0ro , N~ G. Tr ', COX NECK ~OAD L 5-1~-84 ~ ~ ~ ~ SU~Y FOR z~. ~-~ CHARLES ~ FOSSET~ d~ ~ SUSAN ~ STEINMETZ FOSSETT ~ ~ewage 6in~o~l ~8 ~te~ ~ AT MATTITUCH DATE: taoilitie~ to~ thia ideation ~e ~ ~WN ~ SOUTHOLD SCALE: /"= 40' tnspeoted by %hie de~tment ~d fo~ -~ SUFFOLK COUNTY, NEW ~RK NO. 83 -904 OF H~LTH I~l¢EI. PURPOSe. AND ARE NOT fO BE USED'~TO ESTABL SH ~t~. I 2:3~'~'~a~' ~LIC~T, R~R[RTY ~INE$ OR FOe THE ERECTION ~ FENCES '~ ~: ~8 " NOT~ : I = MONUMENT ~ = STAKE~~' ALq~N W. YOUNG, PROFESSIONAL ENGINEER AND ~ND SURyEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG, LANO SURVEYOR ~p "l