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HomeMy WebLinkAbout16566-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ....... qn.e::f.a.m.i, ly..dy.e.l.l.i.n.g... ..................... 1565 Jacobs Lane Southold Location of Property ............................................................... House No. 79 Street 6 4.3 Hamlet County Tax Map No. 1000 Section ............ Block ............... Lot ................. 8236 3 Subdivision .... ..........Cr°wley Estates .......... ...,.. .Filed Map No ......... Lot No .............. conforms substantially to the Application for Bnilding Pern~it heretofore filed in this office dated October 23, 1987 16566Z ..................... pursuant to which Building Permit No ...................... dated .... ........Oct°ber .............. 26, 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 ......... 0ne-lam±fy dwell±rig. The certificate is issued to RIVERSIDE It0MES, INC. {ownor,~) of the aforesaid building. Suffolk County Department of Health Approval .. 87-S0-136 5/26/88 UNDERWRITERS CERTIFICATE NO .... N008734 PLUMBERS CERTIFICATION DATED: 5/11/88 T.R.T. Plumbing & Heating Rev. 1/81 TOW~ OF $OUTHOLD 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~ 16566 Z Permission is hereby granted to: ..... L).~.....~.~.....~... ~...~ .... ............. at premises located at ../...~........~.. ~ ........................... County Tax Map No. 1000 Section ...... ..~..-]..~. ...... Block ....... .~l,.(~ ...... Lot No....~!...~. ............ pursuant to application dated .... .~..~..~ ...... ...~..~ ............ , 19.~..~.., 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. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF Instructions OCCUPA~ A. This application must be filled in typewriter OR ink, and submitted -- Imm,mm 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 F [re Underwr[ters. 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of prOperty showing all property lines, streets, buildings and unusual naturat 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: lo Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3 Copy of certificate of occupancy $ 5 00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruct. ion x OJd or Pre-existing Building Vacant Land Southold Location of Property 1565 Ja6obs bane ......................... House No. Street Owner or Owners of Property Riverside Homes, Inc. 6 County Tax Map No 1000 Section Block Lot S ..... Crowley Estates 8236 3 una~ws~on ................................. Filed Map No ........... Lot No .............. .1 .5 10/26/87 Appli Riverside Homes, Inc. Permit No. 6 66 Date of Permit cant ........................... 87 SO ]_36 Health Dept. Approval ........................ Labor Dept, Approval ........................ N 008734 Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....\./. ·. ............... ~ 25.00 ( -/~ Fee Submitted ~ ........... :% ..... :~,~. ' Rev. 10-10-78 codes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003B -- APRIL 05,1988 51695087/87 N 008734 Date ~pplication No. on j~le THIS CERTIFIES THAT PAGE THILBERG, W/S JACOBS LANE 450.43'N/O, SOUTHObD, N.Y. 1105 ~ examin~ om andf~nd to be in com~ian~ ~ith the requirements of th~ ~rd, THE NEW YORK BOARD OF FIRE UNDERWRITERS AGE 1 '[0J501~ BUREAU OF ELECTRICITY SS ,JOHN STREET. NEW YORK, NEW YORK 10038 O...' AP~I~ 05,1988 ~p~t~.~o. no.o.f~ 51695087/8~ ~ 008734 THIS CE~]FIES THAT ',' THIhDERG, W/S JACOBS ~E 450.43'N/0, SOUTHOhD, N.Y. i. ,~/o..~ h,~.t~o.~ ~ .~.~.t ~ ~,~ ~.~ ~.d r~. s~,,. .~ ~t lips ~sexamf~ ~RC~ 28,1988 andfoundtobeincompliancewiththerequiretnentsof~hlpBoard, ~yv.a~ '% I I FIXTURES [ ~NGES [C~KtNG DECKS I OVENS ~DISH WASHERS  ~. tw. , ~ {.. ~.w.~ DRYERS li'J: ~RNACE ~tO~ [ ~TURE A~ANCE ~E~RS SP~IALREC'PI TIMECL~KS~ ~tt UNIT HEATERS ~nVl~ m~NECT I ~. OF ~ b ~ _~. C o.~.c~:-~ MULTI.OUTUiT DIMMERS SYSTMS ', i NO,,O[ reit ~t. watts , St[ZTWrOi/H, ,,¥, 11']88 ,~7~?" This certifiCQte must oUt be cdtered in any man.er; return to the office o~ the Board if incorrect. Inspectors may be identified blU11~eir credentials. T.R.T. PLUMBINI HEATING LTD. P.O. BOX 46~' MASTIC N.Y. (516) 3990921 May 11, 1988 Building Department Town of Southold Town Hall Southold, New York 11971 Re: Gentlemen: I system for the captioned 1% lead. TT:eac Building Permit No. 16566 Owner: Riverside Homes, Inc. hereby certify that the solder used in the water supply job contains less than 2/10 of Very truly yours, TRT PLUMBING AND HEATING Terrence Taub President Sworn~o before me this /~ day of May, 1988. NO. I~emmb~lon BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~ 765-1802 BUILDING DEPT. INSPECTION; FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~"sULATION FRAMING ~ ] FINAL DATE , INSPECTOR INSPECTION~~ [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-t802 BUILDING DEPT. INSPECTION,; [ ]/~UNDATION ZST [ ~ ROUGH PLBG~ [//J/FOUNDATION ZND [ ] iNSULATION FRAMING FINAL REMARKS: - /-~ DATE: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [/ROUGH PLBG, [ ]//~OUNDATION 2ND [ ] INSULATION [ ~]~ FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ]/~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: .... DING DEPT. CTION [ F~OUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~r ] FINAL FOU~DATION FOUNDATION ( 2nd ) ROUGH FRAME ?LUMBIN~ COMME~T£ INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: Riverside Homes, Inc. P. O. BOX 274 1159 West Main Street Riverhead, N. Y. Phone: 516 - 727-3395 Octebe~ 21, 1987 Building Depamtment Main Stmeet Southeld, New Yomk 11971 Re: Let 3, Map cf Cmewley Estates Jacobs Lane, Bayview Gentlemen: We mecently applied rem a building pemmit on the captioned pmemises. Enclosed please find 2 copies of the coPmect plot plan'. Si~~el~ely, /~ Enclosures THE NEW YORK BOARD OF FIRE UNDERWRITERS 103~018 BUREAU OF ELECTRICITY -- 85 JOHN STREET. NEW YORK, NEW YORK 10038 JULY 12~1988 52538487/87 N 021~76 ~ ~pplicati~ ~o. on ~le THIS CE~IFIES THAT ~y t~ ~t~ ~u~t M ~H~ .ONN~,I,Y~ N/S JACOBS hAN~ w examin~ ~ and found to be in ~mpliance with the r~ui~menta of th~ B~. FIXTU~ RXTUIIIS OVE~S raSH WJ~',l~l~ IX['M~ST FAN~ 22 38 23 22 DIYIRS KJRNACE MOTORS KITUI~ A(~LIANC! HIDERS TIMIC~X:KS UNITHEATEBS MULTI-O4JTEJT DIMMERS SYST~4S NO. Of FBT SERVICE [XSCONN~CT S i~ R E '-~ V I C ~/0 1 1/0 This CHARBONMEAU, PETER 35 SHEPPARD LANE SMITHTOWN~ NY~ lA be a{lered {n any ~nner; return ~o'the o~{ce P~r may be identified by their credentials. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~.~.~ .~..lo, 19~.?. Approved .c~...~-.t,..&.[~., 19~.?. Permit No. ].(~.~.'~..'~..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ' .,19... 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 b'e drawn on the diagram which is part of this appli- cation. c. Thc 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 necessary inspections. ~..V.~.I3S. !p~., ~.O.~.S.,. I.~.C: ......................... (Signature of applicant, or name, if a corporation) . ~9~. ?: 9~. U:.%. ~ ?7 .~. 8!¥ .~.~.~ .~.~P, ?.~. !!.99! ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ............... OWNERJDUIgD~ .................................................................... Name of owner of premises .. ~IVSR.~IO~. UO.M.E.S,..I.~.C .................................................... (as on the tax roll or latest 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. 20/40P Electrician's License No. 2697E Other Trade's License No ...................... I. Location of land on which proposed work MI1 be done. I~yS. Jacobin Lane,.,.~SD...~3.'. ~TO. i,I~... 13~¥y£.ei~..Kd ...... ....... ................ .............. House Number ! Street Hamlet County Tax Map No. 1000 Section .... .79 ............ Block....~..¢ ........... Lo~...~.: .~. ...... Subdivision... 9.~9.%.~Y..~.s.~.a.r.~.s ................... Filed Map No. 8236 Lot 3 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy VACANT LAND SINGLE FAMILY DWELLING b. Intended use and occupancy .................................................................... 3. Nature of work (check which gpplicable): New Building ..........XX. Addition ....... ...~ Alteration ...... Repair .... 2.~ ...... Removal .... ~ ~. ~J · ......... Demolition .............. Other Work .......... '.~.~ (Description) 4. Estimated Cost ........................ Fee ...................................... (to be paid on filing this application) 5.If dwelling, n of 3welBng units .. · .~ ........... Nmnber of dwelling units on each floor. 2 - 2 If garage number of cars 6. If business, ' ' ~ commercml or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front . .......... Rear Depth...; ........... Height ........... Number of Stories ......................................................... Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth .................. ;... Height ...................... Number of Stories ................... Dimensions of entire new construction: Front .60, Rear 60 ~ n~-'~ 28 ' ' ' ' Height .... ~.' ........ Number of Stories 2 . 9. Size0flot:Front..1.8.0..33.'.; ............ 'l~;;~_...........1)b 10. Date of Purchase 12/23/86 Name of Former Owner ??.a.df~..Cj~.o.wZey 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation' No 13. Will lot be regraded · .y~,s .... . .................... excess fill be removed from p~em~ses: Yes 14. Name of Owner of premises .ILI.V~B.I~).M .H.O.M.E.g.,.I.N.C..Addressp..~.~O~. ZT.4.RI.V. MR}iF&I;Phone No..5.~.6,~7.2.7,-x3.3.9.5... Name of Architect .R'IC'H'A'R'I> ~.A~I.DGIXXS-K.I. ........ Address RLV. ERM~AD.,..i~ ...... Phone No..5. t6.nT.2.7.-:3.3.9.5... Name of ContractorR. i.V.~R,q.i.i~ ~ ~OMF~,.I.~C ........ AddressSAMM .&S..&B. qv.~. ...... Phone No..5.~6.-.7.27-.3.3.9.5... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc~k number or description according to deed, and show street names and indicate whether interior or corner lot. BEE ATTACHED SURVEY STATE OF NEW YORK, COUNTY OF ..... ~.U?.F. QhK. ..... i S.S El&zabmgh. g....ct~r~p~gr~ ........ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigBing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make~ and file thisi application;that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth' in the application filed therewith· Sworn to before me this .ff.. ¢.r~...day ~f.. ?..c...'(. ........... Subsurfl~e Sewage Disp~al Systems will abide b NOFFOLK COUNTY FOR SIf~IGLE FAMILY DWE[ Lb' 'q O,~'' '- '"' ~t'~ ~ EXPIR~-$ TI~O YEARS FROM DA1 ~ OF , ~PROvAL ~ giverhecd, New York 11901 l j ~ ~o~ ~ ~'~ ~ I ~$1' 35' ~O"W ~ ~ ~ 68Z36 017 C ONLY _ MAP OF CROWLEY ESTATES tilt t~fOl~. : TOWN OF SOUTHOLD~ SUFFOLK COUNTY~ NEW YORK The water supply & selvage disl)o.~l sys- tem~ for Ihh t~uid(mce will cc~ ~anda~d~ of d~ Soffofk County SUFFOLK COUNTY DEPARTMENT OF HEALTH SER¥1CES FOR APPROVAL OF CONSTRUCTION ONLY DATE H$ REF. NO.. APPROVED. /Vo b/ MAP OF LOT 3 MAP OF CR©WLE¥ ESTATES FILED DEC. i2~ 1986 FILE NO. AT BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY~ N.Y. I000 - 79 - 06 - 4.3 Scale I' = 50' Oct. 15, 1987 (Dwelling) (Dwelling/ {VaccTnl] Prepared in accordance with .Ihe minimum standarch for title ~ as edab/id~cI b) the L L A. L S. and approved and adopte,~ t~r ~l~ um by The New Yo~ State Land MAIN ROAI~ - SOUTHOLD~ N.Y. 11971 87 - 819 CERTIFIED TO, FIRST AMERICAN TITLE INSURANE COMPANY OF NEW YORK RP,,C'RHEAD SA VtNGS BANK _LACK H, THILBERG KARFN M, THILBERG B.~.I~ # 87S0136 4'0,,?)././ /?ODD SURVEY OF LOT 3 MAP OF CROWLEY ESTATES FILED DE~ 12, 1986 FI~E NO. B~36 A ?' BA YVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 79 - 06 - 4.3 Scale I" = 50' Oct. 15, 1987 Dec. 18. 1987(under const.) April 14, 1988 (final) for ~uch ~e by The N~ l(~'k ,~b~ L~nd '..~ ,¢ ;~.~.~ P~d - y~ ENGINEERS, P.C MAtN ~OA SOUTHOLD~ N,Y. 11971 ET - 819 OCCUPANCY OR USE ~S UNLAWFUL WITHOUT CERTIFICATE OF OC.CUPA~C¥ G, R t t'c;ED JN wA*TEH ~DE '"-.,;-,.c~ cANNOT S~,opL¥ Sybtr'"; ., % LEAD' o"'"'"'cD 2/10 m ·" J