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HomeMy WebLinkAbout15824-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16637 Date Feb. 5, .1988 THIS CERTIFIES that the building ...O.q e...f.a.m.i. ,1 y..d.w..e .1.1. i. n. g.. ...................... Locntln. nfPrnn~rtv 740 Longview Lane Southold County Tax Map No. 1000 Section O?.B. ......... Block 0,4 .Lot 50 Subdivision..M.a.p...o.f..T..ef.r.y., .W.a.t.e.r..s ....... Filed Map No. 290 1 .Lot No. 69 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Ma. r. c b..:~ § ,..1.9. (~ 7 pursuant to which Building Permit No. 1.5. 8..2.4.Z. .............. dated . ?..a.r.c.h...3.0.,.. ! .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 and attached deck. The certificate is issued to CHARLES &, CATHERINE ROWAN .................... x .................. of the aforesaid building, Suffolk County Department of Healtb Approval 87-S0-22 Feb. 5, 1988 UNDERWRITERS CERTIFICATE NO... N84379 I Nov. 18, 1987 PLUMBERS CERTIFICATION DATED:T & F PLUMBING & HEATING 9/12/87 '" /Buldng' '-i'-i--'I~t;; ............. Rev. 1/81 FORM 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) N~ 15824 Z Permission is hereby granted to: ,~ ...... ........ .... ..................... .~~...~......~.:~..:...~L.~..~..g...: ,~'-r,~_ ~q ~ ' ~ ~," ~ ~ ...... .~.~..,.....~.......?~....~ ................ ~ .............. ~ .............. ,~ ................................. at premises located at .....~...~....~.......~....~...~-~.....~..--~.....-~.-~~ ......... County Tax Map No. 1000 Section ..... ..~...~..,..~.. ..... Block ...... ..~....~. ........ Lot No ...... ~ ............ pursuant to application dated .... ....~.~......~...(~. .............. , 19~..~.., Building Inspector. Fee $....~...~...~..: ...~...~.... and approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN Of: $OUTHOLD 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 ~I I~iiiII 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. Commercia[ 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~opertv showing all property lines, streets, buildings and unusum 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. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 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 ~ .u~t~a c.o. ~ 50 .oo Date ...~..'..?"'. :..~..~. ......... NewC OhS truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . Xa e House No. ~J Street Hamlet Owner or Owners of Property ...(~)v~/~.~..'~,. [..~',~ ~..~.~-~../. '/¥..~...' .~.O., .~J. ¢~'~V ..... County Tax Map No. 1000 Section . . . ~;~ ~ ........ Block .... .~. ........ Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/~'~.~... Date of Permit,~,~/~O./~,, .Applicant .,~ .~,~xl. cA ./~.~l.~.~., ./.~.C.' ...... Health Dept. Approvml ........................ Labor Dept. Approval ........................ Underwriters Approval A/. ~.~,~.~t.. ~/ .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $... C~.,-~: (0..0 ................. Construction on abov descmbed budding and permit meet~,all applicable codes and regulations. Applica .......................... Rev. 10-10-78 OU~]D A TI~_ON OUNDATION (2nd) OUGH FRAME & PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE . ~DDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION [~/~OUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: // FRAMING [~AL INSPECTION ~oum~^~o~ ~ST ~ ~ ~ou~ FOUNDATION 2ND [ ] INSULATION DATE/~,~2 INSPECTOR ~ ~NSPECTION [ ] FRAMING [ ] FINAL REMARKS: o ///~ ~ ~ /~ ~ 765-1802 BUILDING DEPT. INSPECTION ] FO~UNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL ,., INSPECTOR 76.5-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. ~FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ *~j~FRAMING [ ] FINAL DATE_ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I~ULATION FRAMING [//,~ FINAL -u~/ DATE  765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [/-~N~LATION [ ] FRAMING [ ] FINAL DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION DATE_ 765-1802 ~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ~ /~SULATION FRAMING [/~ FINAL DATE [~; ~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] iNSULATION [ ] FRAMING [ ~FINAL REMARKS: _~/~c._, . ~ ~) DATE ////~ .~,d 119~o84 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~g 85 JOHN STREET. NEW YORK, NEW YORK 10038 .ov~,b~ 18, 1987 ~.~..o.~o.o.~.~ ~7,/s7 N ~3 ~1 D~te THIS CERTIFIES THAT Ro~an, Lo~ Vi~ Lane~ VBa~iew & Watereed~e ~ay~ S(~hold, N.Y. in the followlng location; .~ Bi,~ment ~ Ist a. ~ 2nd FI. Section Bl~k Lot FIXTURE FIXTURES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCEHT 17 17 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: Motors: 1.- lhp 3-G. F.C, 1. 2~-Bmoke Detectors E R V ! AWG. OF CC. COND ~ Schardan Electric ~ox 1077 Cutchogue, N.Y, 11935 Lie. 3540 GENEIIAL MANAGER This Certificate must notbe altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FORiBUiLDING DEPARTMENT. THIS COPY OF CERT!FICATE MUST HOT BE ALTERED IH ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 CE RTI F I CAT I O'N Date 9/12/87 Building Permit No. /~4-~- Owner C~L ~ ~OL~/~r (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~~r [~ture ) Sworn to before me this Notary Public, ~uK County Notary Public NO'f'AI~¥ PUgLIC, STATE OF NEW YORK SUFFOI. K COUNTy NO. 'S882037 PALMER ASPHALT COMPANY 196 WEST 5th STREET P.O. Box 58 BAYONNE, NEW JERSEY 07002 Telephone: (201) 339-0855 June 8, 1987 Mr. Jim Van Nostrand LINCH HOMES 321 County Road 39A Southampton, NY 11968 Dear Mr. Van Nostrand: Jerry Kemp at the H. Verby Company suggested I contact you in regard to the cross reference of materials produced by Palmer Asphalt with that of Seaboard Asphalt. Palmer Asphalt, established in 1932, is a manufacturer of cold process asphalt products used in roofing, waterproofing and dampprofing applications. Palmer produces material under our own BULLDOG brand as well as under private label. All BULLDOG products are manufactured in accordance with the applicable Federal and ASTM specifications. BULLDOG products compare very favorably with Seaboard material. Seaboard produces many varieties of similar mater[als under different labels to meet a price point. Some of their materials meet a specification and others do not. Without hesitation, BULLDOG products will, at the least, provide you with a comparable material to that of Seaboard. Enclosed please find a complete BULLDOG catalog with Material Safety Data Sheets attached. If I may be of any help, please feel free to call or contact Jerry at the H. Verby Company (S16-585-9100). Very truly yours, PALMER ASPHALT COMPANY V~/js EnG. · SINCE1932 · SYSTEM? CONF'OR: SOFFOL! (S}_ SUFFOL{ SERVI~ CONSTR: DATE-~ H. S. REF APPROV~ SUFF( DIST. OWN~RS~ ~ DEED: L~ TEST E: 'FORM NO. 1 :"TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 7. Examined . · U.~..~r.O. ., Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This application ~nust be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to ~chedule. b. ~lot pI~n shoo,n8 location of lot and of hufld~s on pro~ises, ~ehfionsh~ to adjo~n~ ~e~isos or pubic o~ a~eas, and gives a det~led description of layout of property must be drawn on the diagram which is pa~ of this appli- cation. c. The work covered by this application may not be commenced before issuance of Bufld~g Permit. d. Upon approval of this application, the Building Inspector will issued a Buildhg Pe~it to the applicant. Such pe~i~ shall be kept on the premises ava~able for inspection ~roughout the work. e. No building shall be occupied or used in whole et in p~t for any pu~ose whatever until ~ Ce~ificate of Occup~c~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building.Dep~tment for the issuance of a B~lding Pe~it pursuant to th( Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d otherappticable Laws, Ord~ces Regulations, for the construction of build~gs, additions or alterations, or for removal or demolition, as here~ described The applicant agrees to comply with all appficable laws, ordinances, bufld~g c~de, houses co~e~d r~g~latigns, and tc admit authorized inspecto, on premises and ~ bulldog for nocossa, inspoction~ d (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... Name of of premises ' owner .......................................................................... (as on the tax roll or latest deed) If~plicant is~ cg/p~ongsigna~re of duly authorized officer. Builder's License No ....... ~ ............. Plumber's License No .......... ~. ~ · · Electrician's License No. 3 ~9 ~ Other Trade's License No ...................... I. Location ofland on which.proposed work will be done~ .b.0..A/)..~. ............................ House Number Street Hamlet County 'Fax Map No. 1000 Section ...... ~: ........ Block ...... ~. .......... Lot .... ~.'~.0. ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ting fl. Exis use and occupancy ................................ : ..................... · ..... b Intended use and occupancy . . . . ·.. 3. Nature 6fwork (check which applicable): New Building . . .~.... Addition i Alteration I liti ~ Otb k Repair.: ............. Removal .............. Demo on ... .... .. ... erWor .......... : ~ (Description) 4 Estimated Cost ' Fee *' (to b~ paid on filing this application) / 5. If dwelling, number of dwelling units ............... Number of dwelling ufiits on each floor Ifgarag~ number of cars ,~ .............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7 Dimensions of existing structures if any: Front Rear ~ Depth Height I . Number 0fStories ' Dimensions'of same structure with altdrations or additions: Front Rear Depth .~ ..................... Height ....... ............. Number 6f Stories '- 8. DimensiOns of emtire new construction: Front ...... ~;~.~...' ..... Rear ..... o~ ...... .............. Depth .... ~..~."' '. '. '. Height '.../g~.. ........ Number of Stories ....... ~' :' ....... ~ .... ~' 'i ...................... 9. S~zeofl0t. Front ...... /.O.O.~.O. ......... Rear ..... /~..O. ...... i Depth .../~..O.:o.J ....... 10 Date of ~urchase Name of Former Owner II Zone or!use d ...... d . lstrlct m which premises are situate ........................ : ..... 12. Does proposed construction violate any zorn'ny law, ordinance or regulation: ' ' 'i" .......... ' 8'" . ..... .............. 13. Will lot be regraded ..... ' .................. Will excess fill be remoYed from premises: Yes 14. Name of Owner of premises .... Address ! Phone No. Name of Architect ..................... ....... Address .............. t~; No ............... Name Of Contractor .~..00. ~O/9.P-~., .~..,~..: ...... Address .~..O '//~./~°..FTC.! ."' Phone . ... Phone No.~.~'~..x.O.O..O..~. 15. Is this property located within 300 feet of a tidal wetland? *~es ..... No ,~... *If yes~ Southold Town Trustees PermitpE~be required. DIAGRAM Locate cl arly and distinctly ~1 buildings, whether existing or proposed, and. indicate all set-back dimensions fro~ property lines. Give street and block number or description according to deed, and show street names and indicate wheth~ interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ' ........... : ...................................... being drily sworn, de'. ~oses and says that he is the applica~ (Name of individual signing contract) above named. / He is the ....................................................................................... (Contractor, agent, corporate officer, et~.) of said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file thi application; that all statements contained in this application are true to the best of his knowledge and belief; and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to before me this~ .............. ...... ..... ....... ~. 4707878, ~ ~ ~ ..... (Signature of applies-t) %., SUFFOLK COUNTY DEPA,qT~Dqr OF . SINGLE F~,~.ILy DWELUNg ONLY The ~' ~= . , . ..... ,. R~.[;)EF~ICK VAN T,~U.YL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS Of THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. ts) APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO., ,..~"7- ~0-~ APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST, SECT. BLOCK PCL, OWNERS ADDRESS: TE~T HOL~ ~TA~P SUFFOLK CO. HEALTH DEPT· APPROVAL fo~ 70 .SU._FFOLK OOU~i ,.. mYER" ~:~'~,N, ,~,~'OMES INC. ,..'r. ~1901 sour~m~, ~Y ~8 (516) 203-0009 LYNCH HOMES INC. COl tn,TV ROAD 39A :?'::' ~ .58 LICENSED LAND SURVEYORS gREENPORT NEW YORK STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL t CONFORM TO THE STANDARDS OF THE UFFOL CO. D r¢: (s~ ~, ~'/~r~ t//7/~ - I- ~PPLICANT SUFFOLK COUNTY DEPT. OF HEALTH se.vic~s - ~o. ~..ova~ or CONST R ~t~¢~ DATE: kd~O~?. / SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK ~L. OWNERS ADDRESS: DEED: L.~gO~ Pm TEST HOLE STAMP A,~PROVED AS NOTED NOTIFY BUILDING DEPARTMBNT AT 766~1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: FOUNDA'rlON TWO REQUIRED FOR POURED CONCRETE ROUGH ;RAMING & PLUMBING 3 INSULA*FIOr,; 4. FINAL CO~J~TRUCTICIN MUST BE COMPl ETI: l~OR C 0 ~ QON,~*I RUCTION ~HAcL ~EE'F THE REQUIREMEN'r$ Of' ~ N~Y · tAI"E COI~TRUC*'n~ & ENERGY ~PANCY OR USE kS UNLAWFUL ~ CI~'I'I~TE OF OCCUIliIiIOY ,/ -f PLUMaER CER~'/F/CA ~'ION O,'V LEAO C0~£#~. a£FORE ~Oi. oER U$,EO /,4/ I 4\ Jl II 'L ~i' I O,J /--IT II IL____ ! .