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Home My WebLink About13132-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .g.~ 3.9.~.J ...... Date ...... N..oyp. m.l? .e.~..~ .............. ,195..5. THIS CERTIFIES that the building new dweZZ±ng. Location of Property ....2.~.Q ......... ~.o.' .~.~. ~..~. Mattituck House No. Stre3i ' ' ' h3r~/ei County Tax Map No. 1000 Section .... ~.~.5. .... Block ......... q. ~ .... Lot ..... .2.4. ......... Subdivision..D.~p..H.o..19..q~..e.e.k..~..s.~.~3. e..s..Filed Map No..q:.2. ~.6...Lot No .......... 2.3... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ~I~y..~. .......... 1 OB.q:. pursuant to which Building Permit No ...... q. 3.? 3.2.g. ......... dated ..... ~aY..q.6 ............... 19 .~.~., 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 ......... ... l~miva.~e, or~e~£amily. ~well/~g ............................................ The certificate is issued to J0t:l~ J. MI~SlxlER (Jg2VL~S ROG~gRS) ..................... ..................... of the aforesaid building. ~#-S0-87 Suffolk County Department of Health Approval . .~ ........................................ ~697985 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FOB, M NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, No 1', BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13132 Z Permission is hereby granted to: ~ ..~.~.~.~_.~..~.z'.,...~... .../..~.~ ....... ~ ................................................. ...~:7.~.~.~,,...~..~......z.~ ....... ~o ....~Z~..~.~..o. cZT........c2,~.~.....~../~A/.z.c,.~....~..~ac[~/../~ ................ ............. : ..... .~../. ........... ~ ......... , ....... =.~ ....................................... ./.....~~~.....~ -~...~:~.....(,~_z~..~,.27~.~~-~ /,:- ? ~.--' ' .............................. z~.z...~..45,' ' ~ ......... Coun,~ Tax ~op ~o. ,ooo Sect,o. ..... /...z~T ....... B,o~k .... Z.~ ......... Lot No....~.~... .......... pursuant ,o application doted ...ff.~t~..~......o....~'... ....................... , 19..~..-~.~ and approved by the Building Inspector. Fee $,,/~-.~....~ Rev. 6/30/80 FORM NO. 6 [~ k. TOWN OF SOUTHOLD ~ ~ ~- , APPLICATION FOR CERTIFICATE OF OCCUPANCY' ' [G~ ~ Instructions ~ ~ This application must be filled in typewriter OR ink, and ~bmi~ed ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final ~ey of property with accurate location of all buildings, prope~y lines, ~reets, and unu~al natural or topographic fea~ms. 2. Final approval.of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical in~allation from Board of Fire Unde~riters. 4. Commemial buildings, Industrial buildings, Multiple Residences ~nd similar buildings and tions, a certificate of Code compliance from the Archit~t 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-conf~rming uses, or buildings and "pre-existing" land uses: 1. Accuram ~ey of p~perty showing all property lines, ~reets, buildings and unu~al 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 safeW inspection of buildings or premiss, or other pe~inent informa- tion required to prepare a ce~ificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5°00 $15.00 Date ....... New Building ..~. ......... Old or Pre-existing Building~...z~'~z~2~ ............ ~.. :acant Land., .. ............. . .~. ~, ~, ~'~¢-~A Location of Property -) Owner or Owners of Property ~J ~2~./~.,..'~...'./././/.~-~ .~..~..~..>...'.~.'~..~ .~..'.. J~...~.~.~ .~. · · County Tax Map No. 1,~j0~, cti0~n ...> ........... Block ............... Lot ................ ....... Permit No./. ~./. ~..~.. Date of Permi~ ~-.//.(~1~..Applicant ........ : ......................... Health Dept. Approval. ~/.~/..~.~...~:..~..~.~ -- ...... Labor Dept. Approval ........................ Underwriters Approval ................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~...(~....~'...~,..~ ~..L~. ~. ...... Construction on above described building anp~pe[j~ all.j~plicable codes and regulations. 10350 .8 THE NE W YORK BOARD OF FIRE UNDERWRITERS ~ ' BUR~EAU OF ELECTRICITY ~-kl / 85 JOHN STREET, NEW YORK, NEW 1003~ YORK THIS CERTIFIES THAT only the electrical eqzdpment as described below attd irttroduced by the applicant named on the above application numb, er tn the prerntse~ of John ~iesne, r, w/$ DoDnO Dri¥¢, ,150' s/o New Suffolk Ave., Matt~tuek~ N.Y. in the following location~ Baseme, nt 1st FI.} [] 2nd FI. Section Block Lot was exatniaed oa t~[%~n~ 2 0 t ~ 9--~ and found to be in compliance wlth the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 19 19 DRYERS SYSTEMS NO. OF FEET Special Roe'pt.-' 1-30,'amP.~ Motors- 1-1 H.P. Smoke Detector- 1 / 1-50amp o V C A.w-O. NO OF NEUTRAL~ OF HI-[~G OF NEUTRAL 35 Shopped Laner'~ Smithtow~, N~Y.~ ~'1788 ,. '. GE . This certificate must not be altered in any ,Manner; refur~ to the office of the Board if Incorrect. Inspectors may be identified by%~..credentiols. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date October 30, 1985 Building Permit No. 13132 Owner James and Lillian Rogers (please print) Plunfoer North Shore Plumbing (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this 3v'c~ day of ~--~7--~-~,~ , 19 ~/. Notary Public, ~~u County signature ) Notary ' Public ~LIA HULBgR~ ~.,~r~ Pablic, State of New ~6. 52-7~1575; S~folk FOUNDATION ( ls t) ..... FOUNDATION (2nd) PLUMBING -_ ,~, ZNSULATION FER N. Y. '' STATE ENERGY C,,OD E m ADDITIONAL COMMENTS: 7GS-X80Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PI.;BG. FOUNDATION 2ND ~ INSULATION FRAMING [\]'FINAL REMARKS: DATE: ~ INSPECTOR BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] ROUGH PLBG. []FOUNDATION ZND [ ] INSULATION []FRAMING [ ] FINAL DATE INSPECTOR ~ 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ....... ~U... ~"i ............. j~.)..)... , (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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 ~remises 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 build~)r~)code, housing code, and regulations, and to sp . ( ~ admit autliorized inspectors on premises and in building for necesT~t .~6~~.~...~.. ~ ,ignaturg/4f'apl~licant, or namea j'~f~ c)>rpor~,~,jj6n) .... (Mailing address of applicant) State whether ap~p~cam'~'ls owner, ler~ee, agent,~rc_hitec~t,.engineer, general contractor, electrician, plumber or builder. ,:,,7., ,,~ ~ ./~..~.,.~_/cgm~-~A--~>D , ....... .~.c5.. ·, · ~J: '1:1':' '~'<~' ............. :)>t" ' '/' '.'" 2~Z,"" '~)"1'" Name~of'owner of premises .(,: .J~..-d~ ...................... ~// U (as on the tax roll or latest d~) If a~cant/Br~c~F~oj~o~nn, s~ignature of duly ~t~orized_{~['ice~ ·/~../ffZ.~~.K.<.~...<~~'~' Builder ~ License No .... ~ ................... Other Trade% License No Location of land on which proposed work will be done .................................................. .. 0. .......... ............................ ...... House Number Street Hamlet Block % ~' Lot .~..~ Filed Map No. ~.~. ......... Lot .......... State existing use and occupancy of premise~ intended use and occupancy of proposed construction: a. Existing use and occupancy .~/)~..~ ..................................................... b. Intended use and occupancy ~..~7.y ........................ ........................... 3. Nature of work (check which apphcable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ; Fee '-' (to be paid on filing this application) 5. i~ dwelling, number of dwelling ~nits ...... ....... Number of dwelling units on each floor.. If garage, number of cars ..... ,i ........................ 6. If.business, commereiai or mixed occupancy, specify nature and extent of each type of use ..................... 7: Dimensions of existing structures, it' any: Front ~ Rear Depth ......... Height ........ . ....... Num~ber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... j.. Height ....... ,,..,,,./. .......... Num~.ol~ Stories ...................... 8. Dimensions of entire new construction Front ~. L5 Rear .~. s~..~.~. D~*h Height . / .... ' .... ,l ....Number of Stories... ~ ii i, ii i,i.',.~i ..... ' ' "i. i ...... ,v~,... 9. Size of lot: Front ..:2/;~J.~.. .... i ........... Rear... ,/./...~'..~ ............ Depi~'i .~.' ?...~'.'iii., 10. Date of Purchase .L~./'..~ 4)../.~.. ...... ; ......... Name of Former Owner ,..~',~:~..'/,-/.~ ~'..~..~.: ...... 11. Zone or use distri,ct in whicttpr~mises are muated ........................ /, ........................... '12. Does proposed construgtion viol~te any zoning law, ordinance or regulation: ../1/~,). ......................... 13. Will lot be regraded ' .~t~.. '~rl ',,',~ ......... s,. · ._a~. Will exc.~e,~ fill be remo~v~ed from premises: Yes rNa,/ 14.Name of Owner of pr~,n]i~.~.f~,~e'~:O~ ~ ~_,~t((~Address 7. ~.~..Y.~sO. ff..~//.ff/7..2k'. P3~one No: ?.~ Name of Architect .~..~..t~..~'r.'~. 7)~'.~. .(~?. .~. . Address/'~/g/-'~. '~.g qff[F~;~Ighone No 7~..7..--"/..~../y Name of Contractor ...(f~..~. q~.. ~)'~/~tY~.' f~. ~nC~ddress 7~;~. ~ .O.~./~.~277~. Phone No.-~5. ff..~. ~..~.2~ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK., ,~. i, COUN~FY OF..~.~./~-r9 a_,&- .S.S · . ~.tg.~.Z¢(... :?.... ~)'~'~ ~. ............... being duly sworn, deposes ~d says that he is the applicant . (Name of individual signing contract)' above named. ,~ ~ .... ~ He is the ...................................................... . , , (Contractor, agent, corporate officer, erg.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the ~id work and to m~e ~d ~e ~s application; that all statements contained M this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~net set forth in the application filed therewith. Sworn to before ~this ~ .. . ' - .......... ~ ............. day og .....~. ......... 19 ~ Yor~ '~~' f~ '[' '"P* SI nature of a licit . ~¢o. ?s¢o.l .......... Ouahhed r~.So//oi~ County ~ ( 'g PP ' ) C0mmfssfon~ Exp~ros~ ~atch, 30 , l0 ~ , N~W Services S UFFO LK A V~ S: ~? ~19'2~ LOt 2,~ Zz._~' N. 87019, 20" ~. LOT 24 SURVEY FOR JOHNN MIESNER AT MZITTITUCK TOWN OF $OUTHO SUFFOLK COUNTY, SCALE: I'°, 40' ~PR/L 21,1984