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Home My WebLink About15711-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.1.6.0..7.2 .......... Date Au'gust 18, 1987 THIS CERTIFIES that the building Poo 1 Location of Property 425 Miriam Road Mattituck House No. Street Hamlet County Tax Map No. 1000 Section . .0..9 .9 ....... Block ... 0. ! .......... Lot 3 5. 1 Subdivision CAPT. KIDD ESTATES . .Filed Map No. 1672 .LotNo. 25,26,27 conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. F.e.b.....1.9. ,...1.9.8. 7. .... ~ pursuant to which Building Permit No.. ! .5 .7.1. ! Z. ............. dated ...F.e.b.....2.6.,.. ! .9 .8.7 ............. 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 ......... .... I.n.g.rp.~n.d...s.w.~.m..m}.n.g.p.o.ql...a.n.d...f.e.n.e.e...t.o..c..o.d.e.. ............................ The certificate is issued to THOMAS & ELIZABETH TWOMEY (owner27~YeE ~JrXtl~JJtX X X of the aforesaid building. Suffolk County Department of Health Approval ......... N../.A .............................. N813693 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A ~"~B '~din~ Rev. 1/81 FOB~ NO. ~ 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) Permission is hereby granted to: .... .~..J......~~ .................................. ~.' ..4. ....... ...~..~... "~...~.~..~....d~.~. ~. County Tax Map No. 1000 Section ..... ..~.....~....~. ..... Block ...... .?....~ ........ Lot No. ~.~.~..~/ pursuant ,o application doted ....~...~.~.....J...~ ........... , 19...~....'J., and approved by the Building Inspector. Fee %....:w ................. Bullding Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted .-~ 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 featu res. 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 property showing all property lines, streets, buildings and unusual natura~ 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 $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5/00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°ns t'ructi°n ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................................. House No. Street Ham/et Owner or Owners of Property ...................................... County Tax Map No. 1000 Section ............... Block ...... .~ ...... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.'/. ,~7. ~.?/. ~-,. Data of Perm,t~. :?..~.~..~.Kppl,cant .~..L~'. >.~....~./.~ .~...?..~'.Q/~ ~ ... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .N0,--. ,~'!-f~..~, f.~.. ...... Planning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building arj~ permit meets alLappli~able codes and regulations. Applicant . .~. .................. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink. and submitted m~ 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 thebuilding. 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 p~:Operty showing all 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: Additions $25.00 1. Certificate of occupancy New Dwelli,ng,$25.00, Accessory'i$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0-. 0 0 3. Copy of certificate of occupancy $ 5.00. over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50.00 Date ...... .8/.6/.8~ .............. NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... .M$T$~. ,~p~¢~, ,N~,~¢;L~,~¢~.~. ~ ..................................... House No. Street Ham/et Owner or Owners of Property ....~p.m.~p. ,~, p.m,ey ............................................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision....C.~p~.e..l.n..l~. ¢.cl..~.s.~.a.%.e.s .......... Filed Map No. 1.67.2 ....... Lot No.25.,.2.6. .&. ,27 ..... Permit No. ;L57,1.~,8 .... Date of Permit ,2/,2,~/.~7...Applicant ...~.~.e.~,~.~.d.. ,S,m,~.t;,~ ................... Health Dept Approval Labor Dept Approval .... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ..... ~5,.PQ ................... Construction on above described buildine ac~ln~Tm~t meets all applicable cee/es and regCations. Applican .............. R~harcl Smith Rev. 10-10-78 ,.~, /~z), --- ' ................... ....... --,,,,, - ,( h~2, ,t ', ,,Er NOTE', · :I~ONUMENT SOgDIVISIOH MAP FILED IN THE OFFICE OF THE CLERK OF sUFFOLK COUNTY ON JAN, 19,Ig~9 AS MAP NO, ~'*-' ,~ ,: '~ ~ SURVEY THOMAS TWOMEY LOTS 25,26, CAPTAIN KIDD ESTATES MATTITUCK TOWN OF SOUTHOLD SUFF. 'CO. N.Y. SCALE: 1"=40' DEC. 4, 1968 PROFESSIO'NA~. ENGINEER AND LAND SURVEYOR~N,Y,~).LIC, NO, IZ845 RIVERHEADo N.Y. ~[- <;~' ~P~,~TE FOR C.O, THE ~:QUi~EMENTS ~ tf~'~Z N.Y STAT~: CONSTRU~ ,~. NOTE: ·--MONUMENT SUBDIVISION I,{AP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JAN. 19~1949 AS MAP NO. 1672. TOWN OF SOUTHOLD SUFF. CO. N.Y. SCALE: 1"=40~ DEC. 4, 1968 PROFESSlOT~A~L:. ENGINEER AND LAND SURVEY-OR,N.Y.8~LIC. NO. 12845 RIVERHEAD, N.Y. OUNDA'TION (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING LUSULATION FER N. Y. STATE ENERGY CODE FINAL .n · ADDITIONA'L COMMENTS: NOTE: ·: MON UN~IFNT S~9DtVlSiON 14AP FILED IN I'ME OFFIO~ OF TH[ CLERK OF SUFFOLK COUNTY ON JAN. t9~1949 AS MAP NO, t672, SURVEY FOR T HOMA,S TWOMEY ..... LOTS 2.5,26, CAPTAIN KIDD ESTATES MATTITUCK TOWN OF SOUTHOLD SUFE 'CO. N.Y. SCALE: I"= 40' DEC. 4,1968 PROF/SSIO'NA!~_. ENGIN~--[R AND LAND $URVEYOR.N.Y. 9.LIC. NO, IZ845 RIVERHEAD, N,Y. 765'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~'F'~NAL REMARKS: DATE, THE NEW YORK BOARD OF FIRE UNDERWRITERS 1025023 BUREAU OF ELECTRICIT~.~ ,[~1~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS o~y the electrical ~uipment ~ ~scribed be~ a~ int~duc~ by t~ .p~icant ~med on the a~e applicat~ number in the premises of TW~y, ~/S 425 Ma,/an ~oa4, Mattituck~ NY in thefoltowlng location; ~ B~sement ~ Ist Ft. ~ 2nd FI. Outside .%odo, St~ Lot was examined on at~d/ound to be in compliance u'ith the reqairetnents qf this Board. May 28, 1987 FIXTURE OUT'TS SWITCHES 1 FIXTURES RANGES OVENS FANS INCANDESCENT FLUORESCENT DRYERS MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: .t.-G.~ .C.I. NO OFECCCOND,pi~,e, A' W, O. OF CC. COND MO OF HhLEG A W G NO OFNEUTRAL5 A,W,G, OF HI.LEG OF NEUTRAL 121 8heap Pasture Road This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ~er~fiedVby their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE-MUST NOT BE ALTERED IN AllY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ', TEL.: 765-1803 BLDG, DEPT, '7 , Tow. o~ SOUT~O~O Approved ~a~,%..~. ~., 19 ~ ?. Permit No./..'5..-.'7.././..~.. Disapproved a/c .................................. ./~ ............................ ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... INSTRUCTIONS a. This application must be completely ill/ed in by typewriter orin 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 or in part for any purpose whatever until g 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, b_,u.)lding code, housin,,g;~od.~, and regulations, and to admit authorized inspectors on premises and in building for necessa,~/~ c'(~'-' (s~'~ 'a ¥o;~;/a't;o';)' ' ' ...~.2./. ~. ~. ~:,~... ~..¢.~../5.~..~.~./.~. ~. · · · (Mailing address of app{icant) ?/0/0 P' State whether applicant is owner, lessee, agent, architect, engzneer, general contractor, electrician, plumber or builder. .......... .... ..... ............................ Name of owner of premises . .'-~..~.~.~..~.~... ~..cO.~.~.e¥ ................................................... / (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized 6fficer. (Name and title of corporate officer) - Builder's License No ........ .~../' ............... Plumber'~ License No .......... ./[/./,~. ......... Electrician's License No.. o~..~. 9.~.. Otlier Trade's License No ...................... Location of land on which proposed work will be done .................................................. ........ . .. . . .............................................. House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision...~.q~..~./.~...~./..o/cl. z~'~./~Yf..~. ...... Filed Map No.../.~.0~,~ .... Lot c~C../..°2.~ ~. a~?..~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' a. Existing use and occupancy ........ ,' . .-P~---. ............' ......'.. ..... .. - ..~ ~'--. ........... b. Intended use and occupancy .... /~'..~..~..,~...o~...././'/.~/~,aO,/~¢,(...,~6~//Fff277../.?~,i .... · ;,' ,,:, ;~ ......... / 3. Nature of work (check which apphcable): New Building .......... Addition .......... Alteration .......... Repair .... .' ......... RemoVal .............. Demolition .............. Other Work 4 Estimate~[~0 [ ~ ..... , ~(~5 Fee ................................. · . ............................. (to be paid on filing this application) 5. I'f dwelling, number of dwelling m tits ............... Number of dwelling units on each floor ................ If garage, number of cars ......................................................................... 6. If business, commercial or mixed, ~ccupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Numb ~r of Stories ........................................ Dimensions of same structure witl alterations or additions: Front ................. Rear .................. Depth ..................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new constru~ tion: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..................... Rear ...................... Depth ...................... 10. Date of Purchase ............................ Name of Former Owner ............................. 11. Zone or use district in which prerr ises are situated ..................................................... 12. Does proposed construction vioh any zoning law ordinance or regulation: 13. Will lot be regraded .................. ' .......... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ......... Name of Architect Address P' N ........................... : ......... none o ................ Name of Contractor. ~¢)~/oC~. !~/.r/C/.. t~.ctd ./J. 77Z~ddress ~,~,f~ ;~...f, .~.~...~,, ./.. Phone No..~. rd'.~/.~. ~./.O. 15. Is th±s property located withi;fi 300 feet of a t±d~'~'qac6/~'~flrarf-~/'e~j~ ..... No ..... *If yes, Southold Town Trustees Permit maybe required. ~ I PLOT DIAGRAM Locate clearly and distinctly all b~ildings, whether existing or proposed, andAndicate all set-back dimensions from property lines. Give street and block n~ tuber or description according to deed, and show street names and indicate whether interior or corner lot. ~TATE OF NEW YORK, .curry OF...6 ..... S.S ............... ~t'C.J~. ~....~../~./..~.~. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing :ontract) :bore named. is the ............ n:. . . . . c , . a. .r:. . .............................................. (Contractor, agent, corporate officer, etc.) }f said owner or owners, and is duly at thorized to perform or have performed the said work and to make and file this pplication; that all statements containe~ in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner scl forth in the application filed therewith. .worn to before me this ........... /.~. ........ day of... ~.~-..e Z~ Ftd~' F.,,~. .... , 19.. o.-/.~/~.¢ ~ iotaryPublic, ,, ~.~.fT/..~/./?~ .:.Count ~,///¢ ~.. ' 2 7 ..... Y Oual fled n Suffolk Cour ty Commi~ion Elqoires ~ 0-~ ~?c~ (Signature of applicant)