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Home My WebLink About13120-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z1318.0 Date January 28 19B5. THIS CERTIFIES thnt fha hnilctln~ One family dwelling Ix>cation of Property ,. .... ?.2.7.5. Ole Jule Lane Mattituck Mouse tvo. Street Hamlet County Tax Map No. 1000 Section . .17.2, ....... Block .... ~. .......... Lot 13,4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .... .~.ay..! J .......... , 19.8.4. pursuant to which Building permit No. 13120Z dated ...~. a. y..1.2. .................. 19 S..~., 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 lneludi.ng deck. The certificate is issued to ...W.~. 5..i).a.m...&..J.a.c. g u e 1 in e Wi 1 s b e r ~ (owner, ~YOX ~'l~X X of the aforesaid building. Suffolk County Department of Health Approval 14 - S 0- 104 #N. 670499 UNDERWRITERS CERTIFICATE NO ................................................ Plumbers Cergificagion 1-4-85 AI~I~IDED 3/19/90 to include deck. Rev. 1/81 Building Inspector l~O~,lt~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13120 Z Permission is hereby granted to: "~...o..~....L~. ~£~ .............................................. County Tax Map No. 1000 Section ...... J...~....~¥,~. ..... Block ......... ~...~. ...... Lot No..../,..~./,..~.. ....... ........ ..~. .... ! ....... ! .................... 19....~:.. and approved--by the pur~.ont to op~,cotion doted .Y..~ ~ l ...... ~ Building Inspector. Fee $...'.'0....~. ....... :L ..... BulFding Inspector 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. Final survey of propertv 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 P~anning 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 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 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. F~es: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15,00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 I ~ : ,~'. ~.~. Date ..... .~ .............. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~ ~. ,~ ' · ' ............ .~,. , , ,~, ~-1, ................... House No. Street Hamlet Owner or Owners of Property . .'.~,/;, . ,~.~.~ ....... ' ~ ..... ~ .................... County Tax Map No. 1000 Section .. [ .;~.. ~ ...... Block ............ Lot..)..~'¢..,..~. Subdivision ................................. Filed Map No ........... Lot No .............. I. ~ t .~.(~, Date of Permit ~'.~ ~ '<~Applicant Permit No ........................................ ~Z~ ~'O ~,/.C~. App Health Dept. Approval ..... .~, ............. Labor Dept. reval .......... ,.; ............ Underwriters Approval..,~.. ~ ,~.@.~, .~. ,~ ........ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes a~d r~egulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK 10038 · .,s ~aa;,.,as ;..v N 670499 WJ. llimn Wilsl~r~ E/8 0lc Jm~e l~a. ne, Off N~v S~folk Avenue, ~ttltu~k~ N.Y~ ~ Basement ~ Ist FI. ~ 2nd Ft. Section B~ock Lot location; was examined on D~3r 13, 198~i SYSTEMS EXHAUST FANS E R NO O[ CR~¢OND, A W.O. OF CC* COND 2/0 V I C NO. OF HI-LEG OF HI-LEG OF NEUTRAL OTHER APPARATUS~ 5k)tors: L-3/4hp, 1-1bp. 1-G.F.CoI. 1.-S~ Detc4~r. ~%ttit~k~ N.Y. 11952 ~c. ~certiflcate must not be altered in ~ny manner, return ,o the office of the Board ,, incorrect 'nsoectnr, m~~.. :~. '~. -~ ~~~ · copy ~OR B~m~e D~.~.TmE~T. TInS CO.V,O~ CE.~ ~C~T~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. { ~ (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 ~ , 19{~-. Notary Public,~ County Notary Public F I EL~ ';'I :L~?i~ ECT I ON [OU:~DATIO~I ( ls t) PLUMBING '~,USULATION PER ~. STATE EN :,RGY C,ODE ~. ILAL AI)DIT'[O~]AL COMMENTS: Memorandum from... BUILDING INSPECTORS OFFICE TOWN OF SOUTtlOLD TOWN HALL, BOX 728, SOUTI1OLD, N.Y. 1197 765-1802 January 16, 1985 Deer' Jacqueline: I am returning your check because you have dated it 1/7/84. You could change it and initial it or make out a new check. Also everything is ready in your file for your C.O. except the final Board of Health approval. This would have a green stamp on it. Please get these things to us and we will issue your C.O. Thank you. Yours truly~ Helen De Voe, Sec. 765-1802 BUILDING DEPT. INSPECTION* [ ] FOUNDATION ZST ~ ] ROUGH PLBG. FOUNDATION 2ND [~INSULATION FRAMING [ ] FINAL R£MARKS: INSPECTOR' 765-~802 BUILDING DEPT. INSPECTION · FOUNDATION IST ~ ~-~/~oUGH PLBG~ ~ ~RAMING REMARKS: FOUNDATION 2ND [ ] iNSULATION [ ] FINAL DAT~ INSPECTOR 7GS-'~802 BUILDING DEPT, INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 7GS.180~) BUILDING DEPT. INSPECTION~ FOUNDATION 1ST [ ] ROUGH~ PLBG. FOUNDATION 2ND [ ] INSULATION r~ [ ] FRAMING REMARKS: '~ [ ] FINAL DATE 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DE?ARTNIENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL,: 765-1802 Disapproved a/c ..................................... ................................ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date .......... .'.'~.711: .... 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. c. The work covered by tins 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 auth°rized inspect°rs °n premises and in building f°r neces~,s~X_..~ ("_~- .~..~~.~_.~. (Mailing address of applicant~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · con r,. .... , ..................................... Name of owner of premises .~).l'/].f."O'-J~'... J~..~q(J..~./.'~-P--... ~..[.J..~...q ............................ (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 .......................... Plu~nber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... ......l.... ........................ House Number Street Hamlet County Tax Map No. 1000 Section ]c~c~ .............. 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 occupancy .................................................................... / 3. Nature of work (cheek which applicable): New Building .....~..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ .... (Description) 4. Estimated Cost .... : ................... Fee ...................................... ,I *" (to be paid on filing this application) , / 5. If dwelling, number of dwellin units .............. Number of dwelling units on each floor ................ If garage, number of cars .... i · · ~ ................................................................ 6. ]f business, commercial or mixed occupancy, specify nature and extent of each type of use ... 7 ~.: .............. 7. Dimensions of existing structures, if any: Front .-7 Rear - ' Depth -- Height ----- Number of Stories ':'. Dimensions of same structure with alterations or additions: Front Rear Depth ...... TTT... .......... !.. Height. ..... '7 ................ ~ ~9~ Number of Sto,.ries. ~..--~.. ~-~j'/~5~, ........ 8. Dimensions of entire new constructton: Front .. /~.C) /. .. Rear ... ~..q3.t./{~. .... vepth .O... ........... tleight ............... Nu.mber of Stories ..... l .............................. 9. Sizeoflot Front ~..cP~..~.ll~ Rear~q,~.''~ ~..O ~.~ .. De~thc~)~, r53' + )./~,o~ 10. Date of Purchase ./V. ?.~;xC~'.t.l.q~?,3.~ . ........... Name of Former Owner ~'~.t~q~sS.~..~.~O~('.¢}d. (AJ/Jcs.~ 11. Zone or use district in which pr~m~ses are situated ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ~r'J~) ............................ 13. Will lot be regraded . .(~G-5.... ,4" .................. .~/ill excess fill be removed from premises: Yes 14. Name of Owner of prent/ises l,(~t;l!,Orp .*~qct..~.t..,'l.~..t.~lt~d~se~..~...~O~f ~qO~ ~[.~..,.. Phone No. ~/~; ~ :.D~ Name of ~ch..,~ec.~t ~./90~(.1~, ..~:/e.../~(.0,40 ........... Address ~/O~ .'~.c~. [ ........ Phone No ..... ~ .......... Name of ~var~['~ . .(,X~tt.~x3t.~ .~... OOt l~;lg~. Address ~.q/3C~. !.~.e~. ~//.~-~t~fifPhone No. ~1~..')$.q~.D..~-(o PLOT DIAGRAM Locate clearly and distinctly all: buildings, whether existing or proposed, and. indicate all set-back dimensions from 1 I · · · property lines. Give street and b ock.number or description accordmg to deed, and show street names and indicate whether interior or comer lot. STATE OF NE~ YQgK~ COUNTY OF .~'(d-J~.J~ .... ... ~.S (Name of individual ~i'gning contract) above named. He is the..~O.O~.~. ....... . ................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... day of,..._~ t~, .~. o..~ ............. 19. Notary Public, . ..... ~_-~4...~.'..~)..~..-.~..d~..... County NOTARY PUBk,e. State o, t~ow No, 4707878, Suffolk County Harold O ?ene WHsberg , T LzJ 0 COUNTY DEPARTMENT OF ~I.{EA,.L't'H ,~ICE$ f APP~OVA~ OF CONSTRU~OI"J OJ4J,¥ ¢ HS REF. j W,~m W~.SBERG SCALE- SUFFOLK COUNTY, NEW ~RK No. ~ ~ H~rold ~ Irene Wil~ber ~s WILL / W ..... x , ~ MATTITUCK ~__~" i DATE: APRIL 30, 1984 NOTE, I =MONUMENT~6.,: ~KE ALDEN W. mUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HoWaRD W. YOUNG~ LAND SURVEYOR ~ L~T~ ~ ~L(W), ~IC TANK(ST)e CE~OLS(~) ~N ~E~ N.Y. S~ LICENSE~ NO. 45893 BRANDIS & SONS INC. 1046 L/J [ now or formerly ' ! ~ ~ Harold ~ /reno Wilsberg -~ t SUFFOLK COUHIY DEPARTMENT OF H~L~ ~ICES WILLIAM WILSBERG HAY FOR ~pR~VAL OF cONSTRUCTION ~Y AT MATTJTUCK DATE: APRIL ~WN ~ SOUTHOLD SCALE~ I" DATE .... HS REF. HO.~ SUFFOLK COUNTY~ NEW ~RK NO. " ~E ~R~ FOR ~HOM THE SU~EY IS ~HEALTH OEPARTMENT'DATA F~ APPRO~L TO C~STRUCT A~D ~ HtS BEN~LF ~ THE TITLE C~P~Y, H~E~ A~ ~ ~[LLi~I ~ITHIN tOO FEET OF T~S PROPERTY tNSTtTUTt~ GUARANTEES ARE ~T T~SFERABLE OTHER THAN THOSE SHOWN HEREON. TO A~ITIONAL INSTITUTI~S OR SUBSEQUENT ~blC~T, P~PERTY LINES OR FOR THE ERECTION ~ FENCES NOTE= I =MONUMENT, ~ = STAKE ALDE~ ~.YOUNG~ PROFESSIONAL ENGINEER ~ ANO L~ND SURVEYOR N.Y.S. UCENSE NO. ~ I HOWARD W. YOUNG, LANO SURVEYOR BRANDIS & SONS INC, 1046 i i Il now or forrner/y Harold ~ Irene Wilsberg 38,; 39,2' EL= 9.6 SURVEY FOR HEALTH DEPARTMENT-DATA FOR APPROVAL TO cONSTRUCT N NEAREST WATER Jla N,,~.~ * N SOUl, CE (~qr WATEF~, INqrp,.i~,TE ./PUeLIC __ AODRESS NOTE: I=MONUMENT ~ = STAKE BRANDI$ & SONS INC. 1046 DEC. 14, 1984 AUGUST $, 1984 ~ILLIAM WILSBERG M~"¢' zs, ~,~e,a. HAY to, /984 AT MATT!TUCK DATE: APRIL ~0, 1984 TOWN OF SOUTHOLD , SCALE: I" = ~0' SUFFOLK COUNTYt NEW YORK NO. 84-2~4 GUARANTEED TO= NORTH FORK BANK ~ TRUST COMPANY SECURITY AvE E , O: NG a YOUNG ALDEN W. YOUNG~ PROFESSIONAL ENGINEER _{~ L~NO SURVEYOR N.Y.S. UCENSE NO, IZ845 ~w, YOUNG, L~NO SU.VEYO" N.Y.S. LICENSE ~0.45893 7~ ~>~ t . 7 eCL O' ~"- 0" V-¸ 7 fi copper tubing is used for water distributing system; P ping shell be of types K or k only SOLDER U'SED IN WATER · ' M CANNOT sUPPLY SYS~E EXCEED 2/10 of 1% L$A~Dc' cERTIFICATION pLUMBER_ ,, T BEFOREs., cERTI~'~ u,~- ,., z 4.v ,,,, .,T / RES !DE NC E WILLIAM & J~cQUEL'INE FOUNDATION PLAN $, MIoC ~ATPt ENTWY 'I L AV uTIL3T¥ FL._ %.L,I L DETAIL t,,J T S IP SECT REStl FLOOR FOR " 8, ¢AC( "~INE SECTIONS ', '1' ~q b /t2 'L E' El V l, 1- 0 t'~ LE F 'T