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HomeMy WebLinkAbout16432-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY NO: Z-28448 Date: 05/17/02 THIS CERTIFIES that the building ADDITIONS Location of Property: 120 PINE STREET (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 141 Block 1 Subdivision Filed Map No. __ Lot No. __ MATTITUCK Lot 27 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3~ 1987 pursuant to which Building Permit NO. 16432-Z dated SEPTEMBER 7, 1987 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 DECK WITH RAMP ADDITION AND ADDITION TO AR EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS CERTIFICATE OF OCCUPANCY REPLACES CO# Z-20228. The certificate is issued to A CHARLES ADAMS, JR. (OWNER) of the aforesaid building. S~FFFOLKCOU~q~"fDEPART~qTOF}t~kLTH~PRO%5~L N/A EL~t-£KICAL CERTIFICATH NO. N 203923 09/17/91 PLUMBERS CERTIFICATION D~rmu 08/16/91 PERFECTION PLUMBING Authorized/Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20228 Date SEPTEMBER 19r 1991 THIS CERTIFIES that the buildin~ Location of Property 120 PINE STREET House No. County Tax Map No. 1000 Section 141 Subdivision ADDITION MATTITUCK~ N.Y. Street Hamlet Block 1 Lot 27 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3r 1987 pursuant to which Building Permit No. 16432-Z dated SEPTEMBER 7~ 1987 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 ADDITION TO EXISTING ONE FAMILY DW~xJ.INGAS APPLIED FOR. The certificate is issued to A. CHARLES & ALISON ADAMS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - 9/18/91 PLUMBERS CERTIFICATION DATED AUG. 16~ 1991 - PERFECTION PLUMBING. Rev. 1/81 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_o l~zJS, 3 z Permission is hereby gran~l to_.' ~ ~ /'~ // ./..~.~....?...~....~ ......................... ,o_,_, ot premises located at .J..~.. ........... ~...~.~..~;....._..._....~....~ ............ County Tax Map No. 1000 Sect,on .... /...~./. ........ Block ...... ...C~....~. ....... Lot No ....~..'] .......... pursuant to application dated .~~......~.. ............ , 19.~....-~.0 and approved by the Dudding Inspector. Fee $.1 ~.-~.!..,~..-~.-... Building Inspector Rev 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the bullding inspector with the foliowmng: for new bumldlng or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Fznal Approval'from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used zn system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple reszdences and simmlar buzld~ngs and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed smte plan requirements. B~. For existing bulldmngs (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lmnes, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certzfmcate of Occupancy is~--dcnzed' ~h~-~ulldlng Inspector shall state the reasons therefor in writing to th~~ t'./ C. FeeScertmficatel. of Occupancy - New~n~j~25.00, Additions to dwelling $25.00, Alterations to dwellmng $25~w~fing pool $25.00, Accessory building $25.00, Addztmons to accessory bumld~in~.00.~----- -- _Businesses $50.00. 2. Certzfzcate of Occupancy on Pr~--~lstlng Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......... ./.__.~./. ~. f/. ............. New Construction ........... Old Or Pr e-existing ~B?ilding.. ~i~7 ~ ...... i~......C~....._C. Location of Property.../.%~.C~. ....... ~-.~t~q-,...~-~-~:~'i~.-~-- .... ZZ-%?~-~ ~- .................. House No. Street Hamlet Onwer or Owners of Property. . ~. . .%~ ....... ' ....................... County Tax Map No 1000, Section ..... .~.] ...... Block .... g~.{ ........ Lot...(~.(~.~.~ ............ Subdivision ................... Filed Map ..... Lot .... Permit No. J~.~.~.~..~v...Date Of Permit ................ ipplicant..B~...~£~..~ ....... Health Dept. Approval ..................... Underwriters Approval ....................... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate...~.. Fee Submitted: $ ~ ~ -~ .................. TOWN OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTttOLD. N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. [ (~ q$P--, (please print) (please print ) i certify that the solder used in the water supply system contains less than 2/10 of 1% lead. n to before me th~s ,ot ry (plumber's signature) Notary Public · CL,NRE I- GLEW . .. Nolary Pubho, Stme o~ N~ No. 48795~ ~lOn ~ges O~em~ o, · = -i£LD i~,S,ECTiuN IIDATE iI dO~C~TS FOUNDATION [1st) (2nd) ROUGH FRAME & PLUMBING I~SUL~TION PER N. Y. STATE ENERGY CODE FINAL ADDITtO~AL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] ~OUNDATION 1ST |~//~OuGH PLBG. []//FOUNDATION 2ND [~ INSULATION [v~ FRAMING ,r ] FINAL I N SPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION [_ ] FOUNDATION 2ND [ ] INSULATION DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST t- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [' u'J~INAL DATE ,NSPE. OR~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS t000~4 BUREAU OF ELECTRICITY T-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 S~'l'i.;l~B~t~ ] 3 ~ ] 9ql 34'h')q~9~/9:1 ~ z~ I~2.~ ~te Appl~ati~ No. on file THIS CE~IFIES THAT ~y t~ e~t~ ~u~t m ~H~ ~ a~ i~t~c~ by t~ ~t ~ on t~ a~ ~t~ num~r in I~ following I.~ationl · ~ ~t ~ I,t FI. ~ ~ FI. 0[1'1' ,~tlon Bilk 8gPT~ ~ ~ 0 ~ ~ ] 9 9 t and found to be in co.lpllance with the r~uirements of th~ ~rd. (:O~KIN~ DICKS O~tNS W WASHBIS TIME CLOCKS IELL IUNITHIATIIISUNIT HIATIIIS MULTI.O~TLIT v I SANOSTROM {,;i,gcrRw IN(; P.o. BOX 145 AOIIt",BOGIfi,:, MY, 11951 EXHAUST FANS MMMII~S I This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BIJILD~G DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY I. M,~P OF OE$C R/BED PROPERTY ~ T MA TT/TUCK TOWN OF SOU THOLD SUFFOLK CO, N Y ,aREA= G, 611 SO FT OR 0 5815 ACRE 0 donack associates 31:5 west mare street r~verhead,new york 11901 (516) 369- 1717 JU_f 25, 1984 JOB NO 84-603 IS,~O-~41-©l 27 SCALE I"= 30' CER T/FIE O TO AblERICA N TI TLE INSURANC£ COMPANY TITLE NO 07/06459 RIVERHEAD SAVINGS SANK AL/SON L ADAMS ~o 63 . \ FORM NO I TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC TOWN HALL NOTIFY $OUTHOLD, N Y 11971 TEL.' 765-1B02: CALL MAIL Examined ~~ "/ , i9~1~ Approved~ .~'?'~u~, '"), 19%]. Permit No Disapproved a/c ............. (Building Inspector) APPLICA-~ ION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ..~,;~. 3 SETS OF~LANS ....... SURVEY CHECK [[~1~-]]]~ FORM ............. : .'Tb. 9no... TO: fxv 257 Date JT/~ . , 19' a Th~s application must be completely filled m by Wpewnter or In ink and submitted to the Bmldmg Inspector, wi sets of plans, accurate plot plan to scale· Fee according to schedule b Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or pubhc sh or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this a, cation c. The work covered by ttus apphcatlon may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Bmldmg Permit to the applicant. Such pe shall be kept on the premises evadable 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 Occup. shall have been granted by the Bulldmg Inspector. APPLICATION IS HEREBY MADE to the Building Depa;tment for the issuance of a Bmldlng Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmanc~ Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herein descn The applicant agrees to comply with all apphcable laws, ordinances, l~ufldmg co.de, ho.using code, and,regulations, an, admit authonzed inspectors on premises and in building for necessary,,~aspectlons~,~.4~O ~.~ ~Ck.' ~ (,~(~ ~ ,.,o . (Signature of apphcant, or name, ~f a corporation) (Marling address of apphc~(,~it) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bml .... Name of owner of premises (as on the tax roll or latest deed) If apphcant m a corporation, s~gnature of duly authorized officer (Name and title of corporate officer) ALL CONTRACTOR'S IulU~T BE SUFFOLK COUNTY LICENSED Builder's License No P/T'- ~:~ . Plumber's License No Electrlcmn's License No Other Trade's License No Location of land on which proposed work will be done. ltouse Number Street County Tax Map No 1000Secnon 141 Hamlet Block . 01 .. Lot Subdivis~on Filed Map No .... Lot (Name) State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ~C100-~ · ( ~ ~.~ ~--~..~__. ~.~ ......... b. Intended use and occupancy / 3. Nature of work (check which applicable) New Building . Repair .. Removal ,. Esnmated Cost .49..0.Q 0.: 9P ......... ~9 10 11 12 13. 14 ..... Addition.. ~ .... Alteration Demolition ...... Other Work . .. (Descnp.tion (to be paid on filing this application) If dwelling, number of dwelling units.. Number of dwelling units on each floor ..... If garage, number of cars ........................................... If business, cominercial or mixed occupancy, specify nature and extent of each type of use ................ D~menslons of existing stractures, if any Front ....... Rear ......... Depth ...... I4e~_a~t'~. ~.~ ,;~J~. Number of Stones / ;IpJne~J~j~tr~cture.. -~,~ with alterations or additions Front 4.4.. 50 .... Rear.. 4.4. ,Depth . .49,9.0~.: ~.~ . . . Height .. 14 .......... Numb~ of Stones . .on.e ......... 8 D~r~~}r{~construct~on. Front ........ Rear~-d~. ....... Depth ~-~-.-i .... :Height - /Tl"~'./~.~j[fl~. NumberofStones...J. .............................. ~Sl~<3~9,t'~rv'0fl~,39 ....... Rear ~.32;:~4 .... DepthN/s .~.~0..&..S/.s..180. l~a[~ bi~_7~r~.~_..~:~./.8~ ......... Name of Former Owner . H. or.t.o.n ......... 'Z6~e~o~ use~c~ i'~'{vhlch premises are situated r~s a.d~nce ................. Does proposed construction violate any zomng law, ordinance or regulation ................... Will lot be regraded .~.~. ..................... Will excess fill be removed from premises: Name of Owner of premises Adams ....... Address J, 20 P~.ne .St. · .... Phone No..29.~78.91~ .. Name of Architect ............... Address ......... Phone No .......... Name of Contractor ........... Address .......... Phone2b[o ........... 15. Is this property located wzthin 300 feet of a t~dal wetland? *Yes ........ -- ~ *If yes, Southold Town Trustees Permzt may be required. PLOT DIAGRAM Locate clearly and d~shnctly a/1 buildings, whether existing or proposed, and indicate a/l set-back dnnenslons fro property lines Give street and block number or descnptlon according to deed, and show street names and indicate wheth interior or corner lot. STATE OF NEB' YORK, COUNTY OF. Suffo.lk S S Alison L. Adams (Name of individual signing contract) above named ·. being duly sworn, deposes and says that he is the apphcan He is the ............... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and ~s duly anthonzed to perform or have performed the said work and to make and file tN application; that all statements contained m this apphcat,on are true to the best of his knowledge and belief, and that th work wdl be performed in the manner set forth m the apphcatmn filed therewith Sworn to before me this ( ~ . .... ... dayo .. .. NOISY ~BUC, ~e ~ ~ ~ ............... N* 0~F1~89363 (Szgnature of apphcan t/~. Pkx'