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Home My WebLink About16304-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Ho. Z17481 Date November 3,. ]988 THIS CERTIFIES that the building ..... O.N..E..F.A.M..I .L.Y..D..W.E .L.L. I, N, ,G ..................... L ..... ]505 WEST MILL ROAD MATTITUCK ocauon o[ rroperry ................................. House No. Street ................. /Y~r~/o~ County Tax Map No. 1000 Section . . .1.0..6 ...... Block . .0.9 ............ Lot .. 0.8.: ! .......... MINOR Subdivision.. AI~ICE..REIg~E.R .............. Filed Map No ......... Lot No. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 29, 1987 pursuant to which Building Permit No... ].6. 3. .0.4.z. ............ dated . .A. qPP.s.%. ! .2 .... !.9.87 ......... was issned, and conforms to all of the requirements of the applicable provisions of the law. The occupancy foE whic t tiffs certificate is issued is ......... ONE FAMILY D'WELLING WITH ATTACHED GARAGE The certificate is issued toGEORGE KLII~E ..................... ................. of the aforesaid building. Suffolk County Department of Health Approval ...... 8, .7 =.S.O.-: ! .3 .2...a.p.r.i.l...1.1 .... ! 9.8.8. ...... UNDERWRITERS CERTIFICATE NO. N850103 JAN, 14, 1988 PLUMBERS CERTIFICATION DATED: MATT. PLUMBING & HEATING JAN. 13~ 1988 Rev. 1/~31 FORM NO. 0 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) 16304 Z Date.~~..~ .................. Permission is hereby granted to: ~..,...x......l..Y,.~.~ ............................................... A J, ~ .~. .....':t~~ ......... ~.,..,....~....~ ..... ,o at premises located at ..J. .......................................... ~ ............... ~...~ ................. cou.~ Ta~ Mop No. ,000 S.ct,on ....... I...~..~ .... B,o~k ...... ~....fl ...... 'at No......~..;.J. ...... pursuant to application dated ...... ...~...~.....~..~ .................. , 19..~....-J., and approved by the Building Inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11871 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 instaila- 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 pZOperty 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancv New Dwelling, $25.,00, Accessory,~10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50~ 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 .~.--7. [.~....~...~. 5.Updated C.O. $ 50.00 Date ............ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................... ,.. l,-.,L~ .......... House No. Street Hamlet Owner or Owners of Property ... ~'~::~'~11~. ...... ~ .... .~. ~. I ~..?~. ............... County Ta , Map No. ooo Section ...... .... B,ock ...... '. ...... ,_ct .... .Eh. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /b,~.~.4~..~... Date of Permit .......... Applicant ...~.G.~' .~.'...~..~....~'~'.: ..~ Health Dept. Approval ... ~.-~...--... ,~:~...~. ]~Zj.. abor Dept Approval ........................ Underwriters Approval . . . ~ ~ 1 J~..~ ..... Planning Board ..................... Approval Request for Temporary Certificate ..................... Final Certificate .................. ..... Fee Submitted $ ............................. Construction on above described building and pe.~it ~'ee,t~all app.,F~able codes and regulations. Rev. 10-10-78 ~000663 THE NEW YORK BOARD OF' FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~g ~,~ ~ ~ JOHn, STREET. ,~ ~O,~. ~W THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed below a~ introduced by the applicant ~med on the u~e application number in the prem~es of Harold & Bo~na Clark~ West Mill Road, Harold & Donna Clark, Ma~ti'~uc~ ~s exa~nlned on ,~ 7 ~ ] 9~ and found to be in cot~tplla~ce with the requirements qf this Board. OUTLETS SWITCNES 24 3 7 30 FIXTURES RANGES O'1/!~N$ EXNAUST FANS, DRYERS FURNACE MOTORS FUTURE APPLIANCE E$~ERB TIMEC[OCK$ SER¥ICE DISCONNECT S E R V I C Detectors Glenn Bradley Box 602 Laurel, N.Y. 11948 Llc. This certificate must not be altered in any manner; return to the office of the Board if incorrect, COPY FOR BUILDING DEPARTMENT. THIS 3.227 GENERAL MAN~ may be identified by their credentials. TOWN OF SOUTI~A~LD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION (please prin~) Plumber~~ ~ ~_~~l}Oq ~T (please print ) ~ ~ I certify tha% the solder used in the water .supply system contains less than 2/10 of 1% lead. Sworn to before me f. his ~ ~%. / Notary Pubi lc, t~, Notary Public K~lff A, IIAR1Y ROBERT H . WHELAN , P . E - P.O. BOX 590 BUNGALOW LANE MATTITUCK, ~EW YORK 1195R 51 October E)6,1988 Town of Southold Building Dep~rtment Main Road Southold~ New York 11971 Att: Building Inspector Ref. Kline and Clark Residence West Mill Road, Mattituck Permit No. 1630A-~ Dear Sir: During the course of construction on the above referenced residence the ceiling joists were changed from ~"X8"joists ~ 16" on center to R"X6" joists @ 16" on center. To adequately stiffe~ the ceiling structure over the living room a double ~"X~" strong- back was installed and spiked to each joist. In addition 5/A"XA" hangars tie the roof structure to the strong-back at every third joist. It is my opinion that the framework in this area ~s adequate to support the loads imposed by the ceiling, with limited attic storage and im in conformance with the general intent of the N.Y.S. Building Construction Code. If there are any questions with regard to the above please feel free to call me at the above referenced number. Thank you for your cooperation on this matter. cc: Boeckman Building Construction U~DATION UGH FRAME & FLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ' [~FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION FRAMING ,~FINAL REMARKS: 765..1802 BUILDING DEPT. INSPECTION' FOUNDATION 1ST [ ] ROUGH PLBG. ',~ FOUNDATION 2ND [ ] INSULATION 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ]FRAMING [~]~INAL DATE ~/'~/~ INSPECTOR ~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [~INAL REMARKS: ~//,/~.//~2~:~'~ ~"~ /~ - / DATE////?/~~ INSPECTOR ~'~/~ INSPECTION FOUNDATION :I. ST [ ] ROUGH PLBG. FOUNDATION 2ND ~SULATION FRAMING [FINAL REMARKS: DATE ' /' .,~ INSPECTO BUILDING DEPT. / -mSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~'RAMING FINAL · * INSPECTOR /,*- 765-~802 BUILDING DEPT. INSPECTION FOUNDATION IST [] ROUGH PLBG. FOUNDATION ZND [ ]INSULATION FRAMING [ ]FINAL REMARKS: ROBERT H . WHELAN ~ P.O. BOX 590 BUNGALOW LANE MATTITUCK, NEW YORK 11952 51 November 25,1987 Town of Southold Building Department Main Road Southold, New York 11971 Att: Building Inspector Ref. Klein and Clark Residence West Mill Road, Mattituck Dear Sir: On November 11,1987 the above referenced home was inspected by myself at the request of Boeckman Building Construction. The purpose of said inspection was to determine if the field fabricated truss was adequate to support the main gable roof rafters over the garage area. It is my opinion that the fabricated truss is adequate to support the loads imposed by the roof structure in this area and is in conformance with the general intent of the N.Y.S. Building Construction Code. Thank you for your cooperation on this matter. t H. Whelan, P.E. cc: Boeckman Building Construction 'FORM NO. 1 TOWN OF SOUTHOLD, BUILDING DEPARTMENT TOWN HALL . , 8OUTHOLD, N.Y. 11971 TEL..' 765-180:3 Examin~,~.~ .., 193.q Approve~-464~¢..~. . .~..., 19~2 Pe=it No. ].~.q~.~ ~ Disapproved a/c .................................... .............................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins 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 (~r 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 ~ 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. ..... ~c.~,~,~,,,Z. ~, ,4 .~w...~e.,~ ...... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ................................................. Name of owner of premises . lda~S¢~....~.~*. ,~--.~ .~'.~--~ · · · .~.. ~.~.~. · ~..~. ~.~--'~;. ~/,~ (as on the tax roll or latest deed) If appl~o/por~~ure of duly authorized officer. · . . ~-~/.~.-:~..,.-~-~w.,r:~ ........ .~.~[~.,.,~, ........ / (Name and title of corporate officer) Builder's License No ..... .~..~.~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License'No ...................... 1. Location of land on w. hj~h proposed work will be done .................................................. .......... .......... ...... ......................... House Number Street Hamlet County Tax Map No. 1000 Section . .l~..~. '~ .~ '~' ' .......... 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... .~.tN]~- .'''~ ........... .~...~.~.t.~ ................................. 3.Nature of work (check which applicable): New Building ......... Addition ~ ...... Alteration .......... Repair Removal Demolition ~ Other Work .ff./..Z .O. oB, e, oo i (Description) 4 Estimated Cost . Fee ~' (to be plaid on filing this application) 5. If dwelling, number of dwellifig units ............... Number of dwelling unit~ on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use ..................... 7. Dimensions of existing structures, if any: Front ........... Rear ........ ...... Depth .......... Height Number of Stories ' Dim io of t tue with lte ations or add'tions Front Rear ens ns samesruc r a r ~ : ........... Depth ...................... Height ...................... Number of ~tories ...................... 8.Dimensions of entire new construction'. Front ......~]; ......... Rear ........ i ...... Depth ~ .......... Height ............. Number of Stories ............ .............. ' ......... Co'5' ............ 9. Size of lot: Front..l.~.~. .............. Rear .... l...' ............. Depth ................. 10 Date of Purchase Name of Former Owner 1 l. Zone or use district in which premises are situated ............. ~ ....... i .................. 12. Does proposed construction violate 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 . .~..~,..a~t. p..4~..~. ,~... Phone No...~ZZ.,.--.2[ Name of Architect ........................... Aiddress .... ~..~?.~.: .~'... J... Phone No ................ Name of Contractor .~ ~. · .~Y,~'.. .. Address .............. ~... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ' S.S ................................................. being duly sworn, dep6ses and says that (Name of individual signing contract) auove nameu. he is the applicant He is the ............................................................. , ........................ ;... (Contractor, agent, corporate officer, etc.~l~ ~ ~ ~ >f said owner or owners, and is duly authorized to perform or have performed the slaid w~rlc and to make and file 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 the manner set forth in the application filed therewith. 3worn to before me this ............... .~..6( ..... day of ..... ~ ...... ,19 .F'Z / qotary Public, ...... ~...~:../~...~ County .~~...~I HELEN K. DE VOE ...... NOTARY PUBlIC, State ol ~w Ymk No. 4707878 Suffolk County.P~ Term Exp res March 30,19_ ~ (Signature of applicant) Oar q2.° ¢_4J 0o" F.-... '-12° Z~' oo" ~. ALICIS. fda, P-,G 6, t,4 klM, 4-0 PROPO~B.D ¢ s6,Pno PRO Po'5 I / EXP MAP OF HAROLD J. ¢' Al,ID P POP E,.R,T'f DON.INA OF...ORGE. I,,4. ¢' ALICE.. AT' MArT ITLJ¢ K. ToNNI OF ~ouTHOLD~ CLAR, K ~'KLIKIE HOTP.,~: ?t~6M~5~5 A~,E. 5Ho~4W AG L. oT 4. oN HI'NOR GU 15DIVI GtOW ~ON"TOU~ FROM '~UFPOL, K. COUN'F',f D,F',I,~. _~ SINGI ES TWO GO': I" RODERICK VAN TUYL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT I'HE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS .RESIDENCE WILL CONFORM TSCT¢ A.D,'..RDS OF T.E SU~OLK,f,C/~gJ~/T./,O& ~"~.~V'CES. M1L'1'~k~ ~b~ILY SERVICES -- FOR APPR/OVA)Z OF CONSTRUCT,ONO.LY ~/2 DATE: H.S. REF. NO.. APPROVED: SUFFOLK CO. TAX MAP DESIGNATION' DIST. SECT. BLOCK PCL, I0OO IO~, cl I~'o ~, OWNERS ADDRESS: 5 CE, LAI',tO DA. W, 15LIP, N."(, ilqqG DEED: L. ;J/A P. TEST HOLE STAMP LOAM ItL 1, ~NOI SEAL ~'~D Po R A~E> DO M M,A, u.. ~. r,,, SUFFOLK CO HEALTH DEPT APPROVAL STATEMENT OF iNTeNT T~E WAYER SUPPLY AND SEWAGE DISPOSAL SYS~ EN~ ,~OR,~' .,~ THIb --.RESIDrNLE - ¢'ILL_ EXPI~S TWO YE~E OF ~~ __j4 Z ~0'- SErvicEs FO~ APP.?VA)/ OF! CO,~STRUCT~ON ONLY -7/) r/~,¢ ~ APPROVED ~~ SUFFOLK CO TAX MAP D~SIGNATiON 4: DiST SECT 8LOCK ~Cz ~ OWNERS ADDRESS '~ CP~LAHO ~, ]SLI?, N,'Y, IIq~G DEED L ,q ,~ TEST HOLE STAMP .' ...... ' ' .... - I ~"~ t :~' ~ SY~E~ FOR THIS RESIDENCE WILL ,/ ' "0 CONF~M TO THE STANDA~ OF THE ~ ~,. ~ The-sewa[e d~sposs/~nd water supply ~ ~ ~ . t . . .~. sx,~ ~ ~,-. ~ - ~.. . . ., . . ~.~ .' ~ ~" Iocat~nhavebe~ni~sp~edbythis~pa~ t ' . ' . . ~X~'~ ~ ~ ~ '' ~ ,. ~UF~OLK COUNTY'~ DEPT. OF HEALTH ~ ~}; ~/~ ~h~s~d~d~a~f~ ''" ~ ' ' '~' ~[-'~'" :~ ~" ',, ~" ' 'SE;EVIcEs ~'FO-R~' APPROVAL - OF -,~ .~,, ,,, ~' ~.~. ~:: , ,' ,,', , ,.,, , , . ~' , .... , occuP~cvor. - ' ' W~mour c[~nm~fE OF OCCUPANCY u ;c~oN Mi~ERI~1¢'11 p ~" '~:,'~:'~=~ '::~ -':~ ', '- ~: " ,'~ ' ' '" " ........ ~ '~':~,'' ~' ' r ; , " ~ ~ ~ ,,, , '' 4 '; , , .... ' SUPPLY s~¢TEM cANNOT EXCEED 2; lO of f~ LEAD. ' ..... ~/~-dt~l~ :i - ...... ' , ~ .... ,tAMiN~d~ & PLUMBING , ION ~H~L ~E~' ' ' ~ ', r 4 i' ',1 CA~AQ~ .,. OND., .FAAILY PS 20 L ~ :" ON,~ FA/~I LY ,t!OUSE , ° C~OS'$ S -KC, T lOtS '°