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HomeMy WebLinkAbout13087-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13062 Date December 13 1984 THIS CERTIFIES that the building .... .N.e.w...D.w.e.1.1..i.n.g. ............................. Location of Property ...2.0.4 .5. Marratooka Rd. Mattituck House No. Street Ham/et County Tax Map No. 1000 Section ...1.2.3. ...... Block ....0.2. ......... Lot 03 Subdivision .... X .Filed Map NO. . .Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A. p.r.i.1. ..... 2. 5. .... ,198..4. pursuant to which Building Permit No ....... .~.3.0. 8..7.Z ........ dated .......... ?..ay. ...... 3. ...... 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 ......... New One Family. D..w.el.l.$.n~. The certificate is issued to HARO.L.D. & ALICE CARR (owner, ?ess~%:,-o~ of the aforesaid building. Suffolk County Department of Health Approval ....... 14-S0.-76 UNDERWRITERS CERTIFICATE NO... Pending Building inspector Rev. 1/81 ~O]B.3g NO. Ii TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPd~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13057 Z Permission is hereby granted to: .... .~..~.~....~.......~ ..................... ....~.~.z~m~..,...m.~.,.../...~.~..~.m ...... ~ ~ .............. ~1~;'"~"~""~"~'/~"~'"~ ......... ~":i ....... ~ ............ : ......... ";' ......... at premises located at ..-~_.~.'.'~.~....~.!.,~...e~.....~..~...~. ....... ...~.~ ..... County Tax Map No. 1000 Section ..... /,.,~,,..~. ....... Block ...... ~ ......... Lot No. ~ pursuant to opplicotion doted ..... ~.....~....~..~. ....................... , 10.~..~.., ond approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions This application must be filled in typewriter OR ink, and submitted-~t~P~7,1[cctc 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-iS-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 peoperty 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 bu ildings. 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 3. Copy of certificate of occupancy $1.00 use--Pre-Exist~ng C.O. $15.00 Vacant land C.O. $ 5.00 Date.... ,~?"$~.~. ././.'./. ~¢,~.'. ....... New Building .. ~// Old or Pre-existing Building Vacant Land Location of Property ........ .~. ? .~. '.J' ............ ~ .~. ?~..~,~.T'.~.~ .~.. ~..O ........ ~ .~?/.~.~.~./~.. House No. Street Hamlet Owner or Owners of Property ..... /~.-/.~ ~..~. ~..D .......................................... County Tax Map No. 1000 Section ...... t/?-..~. .... Block ...... ~.: ...... Lot ...... ~. ........ Subdivision ................................. Filed Map No ........... Lot No .............. l Permit No. / '~ ~,~. ~ '~- Date of Permit ~.Y' .Applicant ¥..~. · .'~'~-:~. · · Health Dept. Approval ..... ~~~~ .... Labor Dept. Approval ........................ Unde~riters Approval ..... ;~; ? ~ ~ ........ Planning Board' Approval .................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. ~(~ ~,/-~¢[I cant .... ~ '~'-- ~ .. ....................... ... .. · .. · Rev. 10-10-78 HAROLD T. CARR TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit Owner Plun~ber (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumbe~' s signa~e) Sworn to before me this Z/ da ofE a, Notary Public, Notary Public County DANIEL ~. NotARY pUBHC, $~ate of New No. Commission Enp~r~ Ma~¢b 30, FOUHDATION (~st) COHHENT$ FOUND~TIOH 2, (~nd) ROUGit FRAME & PLUMBING I~ISULATION FER N. STATE ENERGY C.ODE FINAL ADDITIO~AL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~00] ~8~L BUREAU OF El* ECTRICITY ~-- BS JOHN STREET, NEW YORK, NEW YORK IOO318 D.t. FF, BRUARY 12,1991 ~p;,Hca,~onMo. onfil. 01127591/91 N ~'1~947 ~OL9 CARR, MARR~TOO[~ ~O~D, P)EE ~, ~TTITUCK, in thefollow{ngt.cation; ~ Babe,Rent ~ I.t Ft, ~ 2nd FL GAR/ATTiC/OUT ,~ectlo. Bilk Lot 4' F . ~_ ~ 1 30 1 3 600 SERVI~ Di~ONNECT ND. OF S E R V I _ ~ E ~.F,C.] :-4 SMOKE DETECTOR :-1 $93.55 gOPY PUHILLO LlC.#2300E PAT LANE OD 9,95 HATTITUCK, NY, ]1952 '~.,.' AMOUNT PLEASE REMIT BY CHECK OR MONEY ORDER TO THE ORDER DE THE NEW YORK ~OARD OF FIRE UNDERWRITERS AS CASH SENT EY MAIL WILL gE AT RISK OF SENDER. 11 THIS IS YOUR gILL FOR SERVICE RENDERED AND I$ NOT A CERTIFICATE OF COMPLIANCE. THIS gILL PAYABLE AT THE NEW YORK OFFICE, 85 JOHN STREEt', NEW YORK, N. Y. 10038 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [] ROUGH pLBG. FOUNDATION 2ND [ ] INSULATioN [ ] FRAMING [ ] FINAL REMARKS: ~ .~ ~, 76S"1802 BUILDING DEPT. INSPECTION~ FOUNDATION 1ST [ ~ROUGH PWG. [ ] FOUNDATION 2ND [ ] INSULATION [ '~FRAMING [ ]FINAL REMARKS: DATE iNspEcToR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION '~ST, [ ] ROUGH P~BG. FOUNDATION 2ND [~INSULATIoN FRAMING [ ] FINAL REMARKS: . DATI~ ACTION OF THE /' d',i,N~ ,~Ai{D {)~, A~ ~,'.~1 ~ I q, ['~t[: I'OWN OF SOUTHOXi) To Request f~,r the apical,. that a spec~ exception ( ) be a~Xiua~ of ~ F. Ol~, /.,,,' ~ d~fhculties or unaece~xY ~ ,? ~ lb) The h.~rd';ll ~ ' alike in th~ hn~. ,,:!' ~ ~ be doniod and Deed 'FORM NO. 1 TOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN HALL ,SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~..~..~ .... . .~.o~.~ 'X~., 19~.t.~.Permit No. ~ ~o~-~ .~ Approved .. · ~ · · .... ........ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERIVIIT Date...f/&(~ ....... 19... 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. e. 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. ....... (Signature of applicant, or name, if a corporation) .... .~. 9../)..~...~.~;.t,... ~.~. .~r?.,.r.~.q~. : .~.y. . u?.s?. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ /.~..lr..~ .c.~....,~t...~..,~:~.e:,. .............................................. (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 ~rade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section /%- 3 ~ Block ~ '~ o o Lot .c~7.3..~.o..o ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 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 .................................................................... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .............. Remloval .............. Demolition ............... Other Work ............... ~ - (Description) Estimated Cost . .7.%?.0.~ ............................ 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 ..................... .... if any Front . .~.... Rear Depth D~menslons of ex~stlng structures, .................................... Height Number of Stories Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth i Height Number of Stories ' Dimensions of entire new construction: Front . . .*..~f.~. '~ ...... Rear ....'.'.~.?.' ........Depth .~. ?./.~.". ........ Height ............... Number of Stories ..... 7z. ................................. ., ................ o. . / ow ' ' pth(.~..>- ~lze of lot. Front ...................... Rear .... /..o.o ............. De ................. Date of Purchase ..... f/.~../~../. ................ Name of Former Owner ...........................~qp c~, ,~ Zone or use district in which pr,emises are situated................F~es,o~'r~- .................................. ... Does proposed construction violate any zoning law, ordinance or regulation: .~, o Will lot be regraded ....~/.'Y.. i ................... Will excess fill be removed from premises: e(q~_) No Name of Owner of premises ..'~, .~.%?...c..~-.~ p,. ..... Address ~. ¢.~..,p..ap?-?.o? y.,4..~.. Phone No. A .~: c.'c-f..6.~. ...." Name of Architec ~' . 'r'so~,-~,~,~,J, .. Address ~,.~,o~ ,~'~. one No. ~.~.~- Name of Contractor .O. ?..~. ~(~... ....... Address ;os' ~,~,~r=o ~,o,~ . Phone No..'k~..'7/?.~. PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockinumbar or description according to deed, and show street names and indicate whether interior or corner lot. -' ./ STATE OF NEW YORK, COUNTY OF ~ I) t= Fo t, e,. ..... ..5 ......... s.s /4,q.~,,o~-O 'r . C.',~-f~iO, gd ly ppli ........................................ ; ....... beinu sworn, deposes and says that he is the a cant ~ (Name of individual signilng contract) above named. He is the... ' O,c~.~&, i (Contractor, agent, corporate officer, etc.) f satd owner or owners, and is duly 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 manne~ set forth in the application filed therewith. Swomto before r~e this I _ ........ day of ....... 1 Notary Public, ................. County v v ~ -- [ Notary Public, Stale of New York .................................... [ No, 52-4518967 (Signature o.t' applicant) ; Qualified in Suffolk County Commission Expires March 30, 1988 {1~ ~o "~ Z m T 'Ir .J t, h o 'N ~,,,) LL © ol'eo /'% <' d