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Home My WebLink About15843-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...glY.%31 ........ Date ...&u gu$.t..26.,..1988 ............ THIS CERTIFIES that the building ......... 0 n e..E a mi.Ly. D w.~l 1 i nB ................ Location of Property ..475..A.. J....Ma~.t. ers..Road. Laurel House No. ' ' 's't/e~ i ....................... County Tax Map No. 1000 Section .... 1215 .....Block .... 9 .......... Lot .... 18 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 30, 1987 pursuant to which Building Permit No.. 15.843Z ............. dated .... .A.p. r. i. .1. .2. ,. . .1.9 .8. 7. ........ was issued, and conforms to all of the requirements of the applicable provisions of tile law. Tile occupancy for which this certificate is issued is ......... One Family Dwelling The certificate is issued to Kim& Brady Ulmet ................ ?o¥.bi,'~&'~do'dr'tbb;'0 ................... of the aforesaid building. Suffolk County Department of Health Approval ...8.6.7.s9.-.2..0.5 ..... .Augu. st 25, 1988 UNDERWRITERS CERTIFICATE NO ..... H.Q .0.4.2,9.{ ........A.u.g.u.s..~..4.:..t .9.8.8. ............. PLUMBERS CERTIFICATION DATED: McShane's Plumbing August 22~ 1988 Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALl. $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ·(~~. .; ......... .~. NO_ 15843 Z Date ....-~.~.,fF.~:~.~. ~.. ................ Permission is hereby granted to: ......... ..~.~.~......~~.....~.~.:.....t.~.~.~..1. ,o at premise; located at ....~. ~ .~'~.......-.~, ~ ~,, ~~ ............. County Tax Map No. i000 Section ...... ]....'~.....~. ...... Block ...... ..(~.....~ ........ Lot No ....... ~....~.. ........... Building Inspector· Bal1~ing 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 Ja~ 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 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 $25.0OALTERATION $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, ove~ 5 years $10.0~) 5.Updated C.O. $ 50.00 Date ................... '~)../~' /,~.b. NewConsl;ruc%ion Old or Pre-existing Building Vacant Land Location of Property ?/.?.~... ,~, ,'..~.'./.~../)..'~...~../' ~ .... ~1:2..~.: ............ .~.~.O..~, ./ ..... J-JouseNo. ~ ~ ~ ,~/t'~ Street ~//I//~ Owner or Owners of Property . ,J~., __/~d~,~ , County Tax Map No. lO00Section .../,~, .~. ...... Block ..... ,~/.~, ..... Lot .... /.~,. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit N~.~ ~¢'~/-~ Date of Permit cant ...................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ?.~.: ?.. (~)~. ................. Construction on above described building and permit meets all applicable codes,and regulations. Applicant ....... ,~.-- .................................. Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~3 ~ Owner ~1~ ~ ~(~:~ /~/~C t (please prat) (please prin't ) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. S~o~ to before me this day of ~ c~7~P~~-~-~ 19 ~7' Notary Public, (plumber'S signature) Notary i~ub 1 ic ~ ..County THE NEW YORK BOARD OF FIRE UNDERW] , ~A<m~ Ri)()~i85 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 1OO3B THiS CE~IFIES THAT ~y t~ ~t~ ~U~nt ~ ~cd~ ~ ~ int~ by t~ ~nt M~ ~ t~ a~ ~t~ numar ~. t~ p~m~ of in the /ollowing Ioc=tlon; [] Basement [] I*t FI. and found to be in compliance with the rPquirement~ of this Board. 5~ 47 5] 58 DUdMEItS 60 A~P 9'RIiNSFER SWT[TCM-] R v I C E 4/0 KlM Vi,MET 475 A. J, MASTER ROAD BOX 213 LAUREL, NY, ~1948 Per_ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified their cce,~n;;ah. ~ l[qli{t ~ DEPAJtTM~[J~r. ~ ~ OF CERTIFICATE IdUS? NOT BE *LTER~J~ ~ ~R. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. INSULATION [,~FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ]INSULATION / [ ] FRAMING ~ ,[~J/FINAL REMARKS~ ~ DATE INSPEGTOR ~//~ ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION ;ZND [ ] INSuLATIoN [ ]FRAMING / .[~INAL i~ REM~ARKS: ~ ~- ~ ~ DATE ~/ ~ ~ INSPE~OR ~ DATE'-~/F'~ IN'PE~OR ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING ~/ ['~"FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~/INSULATION FRAMING FINAL / / INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARK S~, U-~ l.__r 1' DATE /~" INSPE~OR /// 76S-1802 BUILDING DEPT. ~/-~ ~IN $ PECTIO N FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [L~RAMING [ ] FINAL ~/ / 1 .... ~'~r~' ,, // / j ~/ . ... /~./~/~*~----~ BUILDING DEPT. IINSPECTION {. J FOUNDATION 2ND [ ] INSULATION [~RAMING ~r ] FINAL REMARKS: ,,,/ DAT II ,.. 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST FOUNDATION FRAMING [ ] ROUGH PLBG. ZND [ ] INSULATION [ ] FINAL DATE ~/~//~7 765-1802 BUILDING DEPT. INSPECTION' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [r'~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ .,~//~/~.~ OUNDATIO.~ OUNDA~ION ~ (2nd] OUGH FRAME & ?LUMB ~f'NG ~NSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: c) L ~E/' LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER 1215 INLET LANE GREENPORT, N.Y. 11944 1516} 477-16,52 CO0 ..... ~ATEP: 4)5'-/ ...... .-. OOOO ~a~F.F_. I;;'A'1'5 ......... -- .. ' ' ' - ': . O,A. = tO" F , I.A. = '"/O°P : DESIGH. ALLOWED DESIG}-4 ALLOWED ~EHAC!V.$ 5UbS¥STEI'4 AR~A. ~ : U -U .~TU~ - . ~lU~- .. KTE~IO~-W~LL (G~o55) / ~ 0,%1 .." 2&~.'~ . .. KTERtO~_. WALL (OPAQUE) - 1, 3 ~ ~ z I ~ . O. 08 · ~,~o , ~OZS 5 z 0.40 ~7 o '' ~ 128993 M~P OF AREA .' 34,25? $.F (O.?B$S AC.) NOTE: ELEVATIONS IN ASSUMED DATUM The ~ ~'~p~y ~nd ~we~e dtspesa systems for th~ ~ wiU conforr~ t~ the s~anu~s,/s of tt~e ~u/t~ Coun~ sealand . riverheod, new york 11901 (516) 569-1717 3ec. 17, 1986 dob N· 86-1591 1000-126-09-18 Scale: I"- 50' NASSAU SUFFOLK 8LUEP~:tlNTING ~ I~,~. ocscR/e~o ~Ro~er~ I ~ ~ ~ ~ ~ ~ ~ row~ o~ sour~oto I ?, / T t o.o,~ I ~ ~: ~li ~ ~ ~'/~'~: :~-~.:.:1 I ~ ~!~. ~ -*' ~ ~ I AREA: NOTE: ~VATIONS IN ASSUMED DATUM ~$~c m-ii-a? NASSAU SUFFOLK BLUEPRINTING JDS 128993 jOri MAP OF DEsCt?IB~'D Pt?OPEt?TY SITUATED AT MA T TI TUCK ~ ~ TOWN OF SOUTHOLD ~ ~ SUFFOLK CO., N. Y. TEST HOLE DA FA (AS P~ c~ 15 ~ ~...~.~ CERTIFIED TO: h i , , -I~ ~:?:~.~,~, ~*l '~°'.'~g~wmm~II 17191 north ocean avenue ~o. ~s~ y ~ationhave~eni~ectedbythisDe~e.ment~me~ord, n,eW ,yo ~o~ othe~aes a.d~ufld_to be sa,sfa~. I I ( 516) 758 - 5952 ~f purmuof Wa~r M~flagem~ II ~". ~ ~.~ Job Ni 86- 591 NOr~: ~L~VAT/ONS /~ ASSUM~ VA~UM ~v~c ~.;;~[~ 1000-126-09-18 ~cme. I - ~u NASSAU SUFFOLK BLUEPRINTING ODS 128993 MAP OF DESCHIBED Pt?OPEHTY SITUATED AT MA T TI TUCK TOWN OF SOUTHOID SUFFOLK CO., Al. Y '¢~d TEST HOLE DA TA ~ ~ ~seaI - .. ~.8 ~~ engineering p.c. -- - ,-~ . ~.:~ I10 west moin street ~ [b~, ,~ · II riverheod, new york I1~01 ~ ~1~ X ~ I~ (516) 369-1717 NASSAU SUFFOLK BLUEPRINTING JDS ,/ FORM NO. 1 TOWN OF SOUTHbLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-180:3 APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 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 Btdlding 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. (Signature of applicant, or !]~ame, ¢' a corpo?~tTofi) .... (mail,zig ~ldress of'applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... z2. w..oe,..,7 ............ ....................................... Name of owner of premises .... .~.~: .hQ...~..r)...?/..~.'~. ...... .~.. i '.~. '~ i i .~.' ." i. '.~?./~11 .e.~ ........... (as on the tax roll or latl~t deed) If 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 ....................... House Number County Tax Map No. I000 Section ..... /..a~. ........ Block .... .~..~. .......... Lot ..... /.'..~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occu. pancy. Of premises and intended use and occupancy of proposed construction: a. Existing use and o;cu'pa~cy' .'..'./~./O ~0.~.~..C/,/59../.~.~. · ......... .' ....................... b. Intended use and occupancy ........ .... :,.~. ...................... ......................... 3. Nature of work (check which applicable): New Building .......... Addition ~ .... Alteration ...... Repair .............. Removal .............. Demolition ........... ... Other Work .............. ' ..... i (Description) 4. Estimated Cost ..................... Fee ........ , ............... (to be paid on filing this application) If dwelling, number of dwelling t)nits .. t~)~ ~.~ 5. · ...... Number of dwelling unit on each floor If garage, number of cars .... ~t~.~.. · .............. If business, commercial or mixed occupancy, specify nature and extent of cae h typ of use ..................... Dimensions of existing structures, if any: Front ............... Rear ....... 7. Height ............... Number of Stories i ...... Depth ............... Dimensions of same structure with alterations or additions: Front ............ i .... Rear .................. eight . Numbs- ,,~ Depth ..................... H ..... '! ............. ~ o[~,,~ .......... 8. Dimensions of entire new construction Front ~. Rear ~ ~ ~ - *'-~ '~ ...... i i ..................... ........ Height .......... Number of Stories ...................... ; ...................... 9. Size of lot Front ............. :' ....... Re~ ...................... Depth ... I0. Date of Purchase ........ ......... , ....... Name of Former Owner . .; .............. . ....: :... 1 1. Zone or use district in which premises are situated .... .... 12. ' ..................... i..~.. ............. . .... . .... Does proposed construction violate any zoning law ordinance or regulati 13. Will lot be regraded ............................ wm excess nu oe removed,from premises: Yes No 14. Name of Owner of premises .................... Address ................ i. · · Phone No ............... Name of Architect ........ Address ............ Phone ................ Name of Contractor .......................... Address ........ : 15. Is this property located withinl.00 feet of a tidal wetlandS' .~.~.PhoneNo... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, ind]:cate all set-back dimensions from property lines. Give street and block hlanibe? 6r description accor,ding to deed, and ' · · ' interior or corner lot. . . . . . show street names and indicate whether rATE OF NEW~'O~/~, OUNTY OF.. ,~..~.~q"O. [,' .l~..... S.S ........... .K. (Name of individual signing contract) being duly swor , deposeS[a~d,~ay.s J;hat~e~lsrthe apphcant rathe ................ .. ~j~ ~~ [ ~ (Contractor, agent, co¢orate officer etc :~ ['~ ~1 ~ ~ ' ' ' ~rk will be performed in the manner set forth in the application filed therewith. vorn to before me this ..... ~..Q · .'~. ......... day ~f..~ .~ ~ .~..~ .......... , 19 .~.~ 'tary Public, · '~' · · 'C"A'~ '~ · ~.Q'tt~gq~ ..... County NOTARf dUBLIC, Sl~te of Now ~..~l~ ....... Qualifide in Suffolk CounlZ No, 52-2275900, ~'erm Expires ~ l ~ a/~.~ (Signature of applicant) ?q 7'1 ~' ~'" 7' ?,l If ~l~per tubing is used for rotor distributing ~terN piping shall be of tyl~e K or L only SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATIOr; ON LEAD CONTENT BEFORE CERTIFICATE Of OCCUPANCY A~PitOVED AS NOTED NOTI~ DUILD~NG DEPARTMENT AT 7~-1~2 9 ~ TO ~ PM ~R THE FOLLOWIN~ IN~P~C~ONS FOUNDA'rlO~ ~(') ROUGH FRAMING ~ F OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY F4u d pAl-l~ 1--t F F (e) %1o .~-14--~ .4~ 4~'.011 ~)01.0Il .i ULM~I' r-! 1-- F_. L p VA T I~; h-[ !r .... 1 iEU ?.._V_. A f% I% L F-~ ',,/A-F I 0 U L r-1 ~ 'T- ~- L..~VA'¢i c~nl5 r~ LL,- Ji IF! , ~P-FT F,L&VATIOId ~14d¥ F~ L~VAT'I ,~ bl 4'I~HK ~