HomeMy WebLinkAbout16411-zI:ORM NO~ 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
Certificate Of Occupancy
No. Z-16799 Date April 14, 1988
THIS CERTIFIES that tbe building ONE FAMILY DWELLING
Location of Property 260 Elijah's Lane Mattituck, N.Y.
House No. Street Ham/et
108 3 5.6
County Tax Map No. 1000 Section ............ Block ............... Lot .................
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
August 31, 1987 16411 Z
..................... pursuant to which Building Permit No ................... '...
dated ...A.u.g..u.s.t.. 3. ! .,.. ! 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 .........
ONE FAMILY DWELLING WITH ATTACHED GARAGE & ATTACHED WOOD DECK
The certificate is issued to WILLIAM & EILEEN VILLANO
..................... ?o¥.~;, '~;x'~,~Iox'x ...................
of the aforesaid building.
Suffolk County Department of Health Approval ...... 8. ? r.s.qz ! .4.9..z..~.PY. ~..~..7.,.. ! ?.afl. ......
UNDERWRITERS CERTIFICATE NO....N.0.0. ! .7 .5.9.. Z..A.p.r. J:..1..~. ,...1.9.8.8. ...................
PLUMBERS CERTIFICATION DATED:March 18, 1988 - Bertsand Plumbing & Heating 'Inc.
Building Inspector
Rev. 1/81
~o~ ~TO. ~
TOWN OF ~OUTi-IOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
No_
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
16411 Z ,:)ore ...~~.....~.1 ........... , ,~.~..7
Permission is hereby granted to:
at premises located at ..c~..(.~.~ ................................
County Tax Map No. 1000 Section ...... L.O...~. ....... Block ..... ,,(~.,.3 ......... Lot No...,.~'.:...~. .........
pursuant to application dated .....~d~j.~.~.....~.! ........... , Jg..~..~.., and approved by the
Building Inspector.
Fee $ ....................
~ "~EI-uilding I nsl~'t'~'l~ ........................
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPAI
TOWN OF ~OUTHOLD '
Instructions
A. This application must be filled in typewriter OR ink, and submitted eml~mammm 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 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. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25 .00
1. Certificate of occupancy New Dwelling,$25.Q0, 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 $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
New Cons truc t, ion ...... Old or,~Pre-existing Building ............ Vacant Land .............
Location of Property.. g ~...~... .. ~.....//.~'~. ~?.... ~..,~.. '. ~.. '~/7~'~ ~' ._.......)... ~F~. '.''~ ....... ./¥?--~,.,~. ~..
House No. / Ham/et
i ., Street
Owner or Owners of Property .. ........................................
County Tax Map No. 1000 Section .......... Block .............. Lot ..........
Subdivision...~../~.~.~. (~.~./~/~ ~../~/¢~.~$....Filed Map No ........... Lot No. ~. ..........
Permit ,o../~4%L~.//.. Date of Permit q~/~ ~.Applicant..~.~.. ~..~(~-?~...Y//~.~.~.~ ......
Health Dept. Approval.. ~/".?/~ ............. Labor Dept. Approval .....................
Underwriters Approval...x//j,,/~.~ .............. Planning Board Approval .....................
Request for Temporary Certificate ..................... Final Certificate . ~ .................
Fee Submitted $ .9c~.~ ........................
Construction on above described building and permit me, ts all applicable codes and regulations.
App,,cant -2 .......
Rev, I0-10-78
.3q3qo
TOWN OF SOUTHOI. n
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
~, E R T,,I F I C A T I O N
Date
Building Permit No. /~ t~ I ~
(please prin~) '
(please print)
I certify ~ha~ ~he so~de~ used ~n ~he
contains ~ess ~han 2/10' of 1~ ~ead.
Sworn. to before me this
· /f~ day of
Notary Public,
EILEEN M.
No,
Ouallfi~d in SuffoL ,:ounW
C,~mmi~inn ~xpire~ Jam,
County
Notary Public
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] I~LATION
/
FRAMING [~ FINAL
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] ~ULATION
FRAMING r~] FINAL
DATE...~,/~///,,~
//
INSPECTOR ~-'-~ ~ ~
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING . [ ~FINAL
DATE:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION ZND [~SULATION
[ ] FRAMING [ ] FINAL
REMARKS: ~,'
iNSPECTO~-~~
//
BUILDING DEPT.
SPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [~SULATION
FRAMING [ ] FINAL
INSPECTOR~
~OUN T ~IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ *] FRAMING [ ] FINAL
DATE · INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FRAMING
REMARKS:
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FINAL
DATE
/
765-1802
BUILDING DEPT.
INSPECTION
[~FOUNDATION 1ST [ ]
[ ] FOUNDATION 2ND [
[ ] FRAMING [
REMARKS: "~'*~
ROUGH PLBG.
INSULATION
FINAL
DATE
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8002912
BUREAU OF ELECTRICITY
~ f~"" ~' 88 JOHN STREET. NEW YORK. NEW YORK
10038
APRIL 04,1988 53682588/88 H 001759
Det~ /Ipplication No. on ~ile
THIS CEK'TIFIE$ THAT
~". VILL~O. 260
~ ex~mi~ ~ a~f~nd to ~ in ~m~iance with the ~i~men~ of th~ ~.
~1~ DI~ONI4~'T S E R V I C I
2/0
ELEC. ROOM HEATERS:2-2.0 K.W.,5-1.5 K.W.,l~l.25 K.W.
ELEC. R~M BEATERS:3-.75 K.W.
gb~C. WATER H~TE~S::2-7.5 K.W.
G.F.C.I:-6
SMOKE DETECTOR: -2
WI{. VILLANO
850 BONGALOW LANE
MATTITUCK, NY, 11952
certificate must not be manrmr; return to the office if ie, cerr~-t, b~ by their credentials.
COPY FC~ BUILDING
, , w',v','~Ti~''',?-'~ ~'x~f ? ..........
Examined ~W ~l ln~
Approved ...... ~Y.. ~ ~ 19 ~ 7 Pe~it No.
BOARD OF HEALTH
3 SETS OFdPL,fNS
'FORM NO. I SIYRVEY . . . ~. ....
TOWN OF SOUTHOLD CHECK ..........
BUILDING DEPARTMENT SEPTIC FORM .............
Tow . L
SOOTHOLD, N.Y. 11971 ~87 ~
TEL.: 765-1803 GALL ...........
~L TO:
Disapproved a/c .................................
/7
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application.must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wlth 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 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 authorized inspectors on premises and in building for necessa~ .-~ .~ ~:..-~. I },' 0Pa.~,~ .~. ~¢,'~t~. ~.~.~/JT~"' ._
(Signature of applicant, or name, if a corporation)
.q..5. ! v': /
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........ .... 6.0;. 1 ' ............
Name of owner ofpremises ffJ.t..¢~...'~..~.J.,[[i~l{~l~ e ... .~[[.~...J~.. ....................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) -
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder'~ License No ....
Plumber s License No.
Electrician's License No
Other Trade's License No..x~. .....~T'(..~...~.. ........
1. Location of land on which proposed work will be done ..................................................
' ....
~ I;;r"'--' ' Stree; Hamlet
County Tax Map No. I000 Section ....... l.O..~ ...... Block ...... ~. .......... Lot ..... -~..~O .........
Subdivision..~. ~...~-'..~..~. ~.~.(4..¢7....~.C.C~. ........ 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· .VI2 C03Q.Ii- .... ..L~.tt~d.~. ........
b. Intended use and occupancy .. . / ~ At ...............................................
3. Nature o[ work (check which applicable): New Building Addition Alteration
Repair .............. Removal .............. Demolition ............. Other Work ...............
I~ ,,, (Descrip~tion)
4. Estimated Cost . ..5"
· I . " (to be paid on fihng this appli~:ation)
5. If dwelhng, number of dwelling u~mts..~)../~..~.., i ..... Number of dwelhng units on each floor.. ~.4/~. ........
If garage, number of cars . .rO~J:.! ............ : ..................... ...... . ................ ,. ............
6. If business commercial or mixed dccupancy, specify nature and extent of each type ~of use . .". ~..~',~'...'.'.'.~ .......
7. Dimensions of existing structures, if any: Front.. iA/fR-. ....... Rear . 2 ...... ,.. .... p?pth '2 .. .............
Height Number of Stories '
Dimensions of same structure with alterations or additions: Front ~. ~/..~-.... . ........ Rear ..................
Depth ...................... ! Height ...... I ................ Number of Stories ......................
,
8. Dimensions of entire new construcltion: Front .. '. . Rear . .q.q. ~.: ...... Depth ~..' t ~ ........
Height .. ~ ~. ......... Number of Stories ................ i ....................
· ~ , t I
9. Size of lot: Front .[q~:..5~. ..... . ......... Rear . ~.~"~. ~ .~ ............. D,~pth .~,,~ . .,~.~. ~-.O ...........
10. Date of Purchase . .~.E,~ ./ ..... ~r'~. ......... i .... Name of Former Owner . .~"~ .... /~./.,/ ................
11. Zone or use district in which premises are situated !...' ....... i ,..{~'x~[.~.'P, iq~[ ........................
12. Does proposed construction violat6 any zoning la~, ordinance or regulation: ..,~t.~. ...........................
13. Will lot be regraded ...¥~.~ ..... i ............ i .... Will excess fill be removed from premisel~ ~ ~'~ No
14. Name of Owner of premises ~1.11[~. ~'.~,/e~l..[~ ~ Address~}tAl~tl¢tld~ ~gUO,/t?~ Phone No..r~h"/
Name of Architect ............ ~ ............ i · · Address ................... Phone No ................
Name of Contractor . .~.~/. t~'...i ........... i.. Address .... : ........... Phone No ................
15. Is this property located wi!thin 300 feet of a tidal wetland? *Yes ..... No ...~..
· If yes, Southold Town Trustlees Permit maybe reauired.
PLOT DIAGRA~
Locate clearly and distinctly ~l b~ildings, whether existing or proposed, and~ndicate M1 set-back dhnensions from
property lines. Give street and block n~ mber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, S.S
SOUNTY OF .................
............................... i ............. i ..... being duly sworn, deposes and says that he is the applicant
(Name of individual signing! contract)
.~bove named, i
i
?lc is the '
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly ~.uthorized to perform or have performed the said work and to make and file this
~pplication; that all statements contained ha this applic ltion are true to the best of his knowledge and belief; and that the
~0rk will be performed in the manner set forth ha the a[ ~lication filed therewith.
~worn to before me this
....... .... '~'/"3~"/~ -' day~f~f ~.i~.~,. i~/'
',lotary Public .... ~.../J.~. .... C un
NOT'AllY gUIItl0, State ef NOW,Y0~k (Signature of applicant)
. No. 4707878. Suffolk Counq, p 0
~ f~m Iix~ms No,ch 30 19
I
SINGLE FAMILY .lNG ONLY ~'
EX:PIBRE~T~NQ YEARS FROM OF APPROVAL
:~UFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE~
FOR APPROVAL OF CONSTRUCTION ONLY
HEALTH DEPARTMENT ~DATA F~ APPRO~L TO C~STRUC T
NOTE~ g= MONUMENT
SUBDIVISION M~P FILED IN THE OF THE CLERK OF
SUFFOLK COUNTY ON OCT. 7,1977 AS FILE NO. 6609.
SURVEY FOR
WILLIAM VILLANO & EILEEN VILLANO
LOT NO.2"GREENBRIAR ACRES"
AT MATTITUCK
TOWN OF $OUTHOLD
SUFFOLK COUNTY, NEW YORK
now or formert¥ Edward sandber9
DATE* "JUNE 23, 1987
SCALE: 1"=40'
NO 87 ' 69O
YOUNG s YOUNG
ALDEN W. YOUNG~ PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S, LICENSE NO. 12845
HOWARD W. YOUNG~ LAND SURVEYOR
N.Y.S, LICENSE N0.4§893
400 OSTRANDER AVENUE
RIVERHEAO~ NEW YORK
MA~N ROAD
, ;~ · . / ._ SURVEY FOR
,SUFFO[X C~UNT~ DEP/~TME~OF HEAL~'H~ WILLIAM VILLANO ~ EILEEN VILLANO
~ ' APR ~E FAMILY DWELLINg ~ LOT NO.2 "GREENBRIAR ACRES" SEPT.MAR' 17,3' 19871988
.~DATE0 7 lgS~H.S.REF. NO. , ~-.~/~ AT MATTITUCK DATE JUNE ~5, 1987
The sewage disposal and water supply fa~ ~ ~ ~WN ~ SOUTHOLD SCALE: I% 40'
location have been ms~cted ~y this Oepa~flt~/~ SUFFOLK COUNTY ~ NEW ~RK No. 87 - 690
~ THE WATER SUP~Y &~ SE~G[ DI~AL SYSTEM ~ ~lS ~IDE~ OW"ERS
" I YOUNG YOUNG
NOTE: ~= MONUMENT ~ = STAKE ALDEN W. YOUNG, PROFESSIONAL
SUBDIVISION M~P FILED IN THE OF THE CLERK OF
SUFFOgK COUNTY ON 0CT.~,1977 AS FILE NO. 6609. ANO LAND SURVEYOR N Y.S. UCENSE N0.1~845
HOWARD W. YOUNG~ LAND SURVEYOR
~ L~T~ ~ ~L(W),~IC TAHK(~T)a CE~OLS(~) ~N ~ N.Y. S: LICENSE N0.45893
BRANDIS & SONS INC. 1046
FIELD INSPECTI~
FOUNDATION
(ls'c.)
FOUNDATION (2nd)
COMMmi4'IS
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
ENERGY' CODE C.A. LCOLATION5
~.) H~TING EQUIPM~ ~Y) MEET 7813.23 - 75% EFF.
2) HEATING CONTROLS TO MEET 7813.13
~ANGE 45 TO 75 DEGREES F.~EIT.
3) WATER HEATING PER 7813.31 THRU .38.
4) PIPE INSULATION 7813.19
5 ) WIS~)OWS - DOUBLE GLASS.
5) CONST~RUCTION TO MEET N.Y.S. EMERGY CODE.
0.17'
o.o~ ~
0.58. g 15°
o.~o 8?0
005 ~. ~LO
0.o/0 io o ~3
J~o i io
TO THE BEST OF MY K~OWLEDGE,
BELIEF, AND PROFESSIONAL
JUDGEMENT THESE PLANS
IN COMPLIANCE WITH THE CODE.
4 F~l~(Ai ~r:~STRUCT~ON MUST,
ALi. ;,0~;~1'~ ,JCT~ON SHALL MEET
'¸%
V~LLIAN , EILEEN
GREENPORT, N,Y. 11944
' SM' st.~
Lpg-( ~ 0'!
Phone 477-04t)0 '~' Main Road
GREENPOR']', N Y 11944
VILLt F~ Pq 0 E, ~'N,