The URL can be used to link to this page

Home My WebLink About12980-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . Z12534 Date June II AA4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. lY. . . THIS CERTIFIES that the building . . . . . . .addition .to. dwelling. . . . . . . . . . . . . . . . . Location of Property . . . ,7655 Mpin Road Mattituck House No. Stree! Hem%t County Tax Map No. 1000 Section . . . . . . . . .Block . . . .6 . . . . . . . . . .Lot . . . . . . 30 Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . x. . . .Lot No. . . . . x . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . >'.Sll . $. . . . . . 19 84 pursuant to which Building Permit No. . . . . . 12980Z. . . . . . . . . dated . . . . . . . .April . 5 19 84. ,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 . . . . . . . . . addition to existing one—family dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . .ANDREW A. . k WILLIAM C. GOODALE (owner,�ealee erter�entl of the aforesaid building. N/A Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . N645693 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rw.1/81 M= NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) M12980 Z Date ......... . ...................... 19. . . Permission is hereby grant :.... ..�....¢............. ?'31 .. ....... .. ! to !v. WN . sx.....la ... 4 - ic (�... . .. ... ......... ................ � � �at premises located at a.� ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section .....J.?....... Block ......Q.!?.... .. Lot No. ....... .. ....... pursuant to application dated .........\fA%&&k....al................ 193.1.., and approved by the Building Inspector. Fee S..G�.a�t. .... Building Inspector Rev. 6/30/80 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 submitted in duplicate 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 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. 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 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . . New Building Aca Old or Pre-existing Building(X) . _.. .�c. , 'Vacant Land . . . . . . , . . . . . 735J Location of Property . ...7655 , Main Road, Mattituck, New York 11952 . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . .. . . . . . . . . . . . . . . House No. Street Hamlet Owner or Owners of Property . . .Andrew E. and AJ Lliam C.. Goodale.. . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section .122 . . . . . . . . . . Block . 0640, . , , , , , , , Lot . . 038, , , Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map Noy. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. J.a-.g1l72ate of Permit y�':f14!1 —Applicant ,, y-+4/�f`�%^'�!!�4. Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . .,. . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . Request for Temporary`Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . �. . . . . . . . . Fee Submitted $ . . .J r 1�� . . . . . . . . . . . . . . . . . . Construction on above described building and permitmeets all app! c ab I q_c odes and regulations. Applicant . . .,�. _ . . : . . . . . . . . . Rev,10-10J8 1000343 THE NEW YORK BOARD OF FIRE UNDERWRITERS �a BUREAU OF ELECTRICITY _ `9 Y ' 1 984 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date Application No.on file 2O54/84 93 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 Audrew Guodale, NIS kit{. ;45, A$ray Ave. & Factaay Dr. , Mattituck, N.Y. in the following location; ElBasement LT 1st Fl. ❑ 2nd FI. Section Black Lot was examined on flay Us 14 and found to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKINGDECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INC RES ANDESCENT[FLUOCENi M."D ANT K.W. I Mr. I K.W. "T. I K.W. AMT. I K.W. Mr. I H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. 011 H.P. GAS H.P. AMT. NO. A.W.G. AMi. AMP. AMT. AMPS. TRANS. AMi. M.P. SYSTEMS AMi. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. rypE METER 1 tW 1 3W 39 3W 30 4W NO.OF CC.COND. A.W.G. NO.Of HLLEG A'W'G' NO.OF NEUTRALS A.W.G. FOUIP. PER d OF CC.COND. OF HI-LEG OF NEUTRAL 1 100 (I3 X 1 2 1 2 OTHER APPARATUS: Woci le cleat. Cont. _ rut 1, box 15A A9a.1n Aid. F Mattitu t iv.Y. 11UW AdCN7S:iG GENERAL MANAGER _ Per This certificate must not be altered in any manners return to the office of the Board if incorrect. Inspectors may be identified by their credentials. WILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FIELD INSPECTION IDATE �I COMMENTS Q O FOUNDATION ( 1st ) _ c U. FOUNDATION ( 2nd ) _ 2 . — I — � J o Ru ROUGH FRAME & PLUMBING S cr (° 3 . o m ' m H INSULATION PER N . Y. STATE ENERGY CODE x a 3 r r^. 4 . 14 FINAL ADDITIONAL COMMENTS : x m 'a C H x W� H op 0 ,^ O Y' m a r t H S � d a m 13 H 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 ;xamined....~-2~..~..., 19~ ~. .. · ,pproved ·....~.~-..~.., 19~.~. Permit No.. (.~'..~. ~'Q..~ )isapproved a/c ............................ ' ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relatior~ship to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~.tion. 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 tall be kept on the premises available for inspection thronghout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc~ ~all 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or .egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to flmit authorizedinspectors on premises and in building for necessary in~ .~~ ....... ~ (Signature of applicant, or name, if a corporation) <o. ..... ......... /-~ (Mailing address of applicant) ;tate whetlier applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ............................ . ........................................... qame of owner of premises . ..---~.~ .~.'~TLA~...~.....~...~..~...&'~.[:'..~..~. (as on the tax roll or latest deed) f 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 T rade's License No ...................... 7 S ~-~-~'%--"- House ~'u~l}~r' ....... -- ' 'Street Hamlet ...... Subdivision ~n Filed Map No. ~ Lot .~. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ..... . .'~.>...qT~....~'. ................................................... 3. Nature of work (c,~,eck which applicable): New Building ..... ' ..... Addition . .lr'~ ..... Alteration Repair ....... ~'f'~-, .... Removal .............. Demolition .............. Other Work ............... ~ .~, ,~ ._ (Description) 4. Estimated Cost ....~ ...................... Fee....-~...~.. '.~'. ........... : ............. '" (to be paid on filing this application) t'-' 5. If dwelling, number of dwelling u!l,its ..... .~.\[ ...... Number of dwelling units on each floor ................ If garage, number of cars ...... ~.. ~J...~. ~/~ ~..~ .-~.) ...... '. ......................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . .~.<3/4 bf ~3g.c.(.~:.C.... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height . Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories 9. Size of lot: Front Rear ...................... Depth ...................... 0. Date of Purchase i~.'.'~i~i~i,i ),i.~1601.i ....... Name of Former Owj~er ............................. I. Zone or use district in which premises are situated .... .~ ~{. M. ~ g..¢.t, ib.~ .............................. 2. Does proposed construction violate any zoning law, ordinance or regulation: .. K].O.: ........................ 3. Will lot be regraded ......... .M. ¢1.., .............. Will excess fill be removed from premises: Yes No ~. Name of Owner of premises . .t~...t~x'~.~ C/. ~. :... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Nmne of Contractor .......................... Address ................... Phone No ................ PLOT DIAG R.adM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ,roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. ,TATE OF NEW Y. DRK, ..... ~....~..gT..~'. '..k,~..~...'.'~. :... ~ .~. ~. ~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have 15erformed the said work and to make and f'de this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'york will be performed in tile manner set forth in the application filed therewith. iworn to before me this 4otary Public .... ~ ......... County ('"x ?~0D',RY F;.;2! ig. ~c~:~te o[ New Y0r~ ..................... i,:,', 4?07?: ::~, Eu:I;,Ik Cour*ty..~- (Signature of applicant) 765-1802 9 AM Y0 4 PM FOR THE' FOLLOWING I~?ECT ONS: '~ ----D ' I FOU UATt~'-T~VO REQ~JIN~,~' 2. ROUGH - FRAMFNG & pLUMBIN ALL CONqTR~JCTION SHALL MEE~ STATE CONSTRUCTION' & ENERGY CODES. NOT REsP0NS BLE'; FOR DES GN OR CoNSTRU~TION"~RRO~g, PLAN NO,