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HomeMy WebLinkAbout16183-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildln§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16024 Date .4 .u.g.u.s. ~...7.,.. ! .9.8.7... THIS CERTIFIES that the building P o o 1 3095 Elijahs Lane Mattituck Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section I 0 8 .Block 04 .Lot 7. 18 Subdivision Elijahs Lane Est. .Filed Map No. 6065 .LotNo. 15 conforms substantially to the Application for Building Permit heretofore filed in this office dated · J..u .n.c..2. 2. :.. 1.9. 8..7 ......pursuant to which Building Permit No..1.6. ! .8,3.Z. ............. dated J u 1 y 8, 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 ......... Inground pool and fence as applied for. The certificate is issued to JO SE PH SULLIVAN ..................... ............... of the aforesaid building. Suffolk County Department of Health Approval ....... N./.A. ................................ UNDERWRITERS CERTIFICATE NO. PENDING 8/3/87 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 T(TWN 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) NO_ 1611B~ Z County Tax Map No. 1000 Section ........ J..~..~ ....... Block ....... ,~,,,~. ...... Lot No. ,,~x,~.~ ............. to application dated ........ ....~. ~....~..?J ................. , 19.'~...~., and approved by the pursuant 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 ,- ~ 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 pLCoperty showing a~l property lines, streets, buildings and unusuat 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. C. Fees: Additions $25.00 1, Certificate of occupancy New Dwelling $25.0.0, Accessory iS10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0-. 0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 o.oo 5.Updated C.O. $ 50.00 Date ...... ~ ~ . .......... Newc°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~..c~..~..~.~'.. ?;-,L7 .('..~.--~ .~.,..(:..,.~.~.L.~., .~ ~. (~t~-.~.'~;g.,.]..~.~(,'~. ~. ~.. ~(-. ~. t ~.~.'"..~. House No, Street Hamlet Owner or Owners of Property .~...&..[~-~ ~ .~. ~ [~,~N'I/~ ........................ County Tax Map No. 1000 Section ... J .©.~ ....... Block ............. Lot.. Subdivision .~t~.~..~-Aqt.~.~. ..~..5'.~:6'-~-F~5 ...... Filed Map No..(,p.~..~..~.--..Lot No... {. ~ ........ Permit No. I.(.~,[.~, .~....7~.. Date of Permit .~. [ .~.l~..~,..Applicant ~.Q..gt~..~.~...~..~!~.-~..S.~)..~.S. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. 'Z~ ~c~-, ~ ~ Applica~~.~..~~...~-"'T~ ............... Rev. 10-10-7e THE ~025045 THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS ~UREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the electrlcal equipment as described below and Ottroduced by the applicant n~med on the abOve application number in the premises of Sultivam~ 3095 Elfj~h,~ ~attituck~ u, as examined on JUly 3 0 ~ ~ 9~7 and found to be in compliance u.lth the require.,ents 9f this Board. FIXTURE FIXTURES RANGES OV~NS DISHWASHERS EXHAUST FANS OUT.TS SW~TCH~S FLU~ESCENT 1 2 DRYERS SYSTEMS NO. OF FSRT OTHER APPARATUS: E R V I C ~(~~) .~,HIS CERTIFICATE CO~RS COMPLIANCE AT T~E DA'~E OF Brite S%ar Electric 13 Willett Avenue S yv~ll~ N,Y~ 11782 1ic~3398-E MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be their credentials, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT B-E ALTERED IN ANY h%ANNER. UNDATION (1st) UNDATION (2nd) UGH FRAME & FLUMBING SULATION FER N. STATE ENERGY CODE FINAL · ADDITIONAL COMMENTS: ELIJAH'$ LANE 19 182.00' EL IJAH'$ LANE ESTATES Unauthorized alteralion or additiop to this s, section 7209 of thu New York State' Copies of this survey map not bearing the seal or embossed seal shall not ..... :,, :. or c~mi,colions indicated hereon . po'sen tar whom lh~ survey IitJ~, company, oowrnmentak agency and hereon, and to the cssignees of the I subsequent owners. 1974 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved ..... .~...., 19~. ?. Permit No.J.(q ( .~..~.~.... Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. Date .... .~5..'~..~. ........ 19 .~.? INSTRUCTIONS a. Ttds 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 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, ordinance>% building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaf~i,nspections. · (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber Name of owner of premises . .'~, .3..~>. ff...~..o..~., q.~. ~ .................................................... (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 .... O./.~d ................. Electrician's License No.. ~.J~ Other Trade's License No...~./..~. ........... . . ..~-"~. 1. Location of land on which proposed work will be ~.a~. ~ff-~/.'5·4 0.~...o..P~.. ~f~(f~..~ ....... ........................ Itouse Number Street Hamlet County Tax Map No. I000 Section ... ~.~ .......... Block .... ~ ............. Lot...~.'. f. ~ ......... Subdivision .~¢/~d.t~ .~...~~ ..... 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 .. ~...~f ~... ~4~W~J~1l~.tt~;.',. ~:.~ ........................ ,;"5' w,-',~ ', -:**~;, 3~ ~3~ ~ Yfl~} .~ b. Intended use and occupancy ,. 10. I1. 12. 13. 14. prope:rty lines. Give street and block interior or corner lot. Nature of work (check which applicable): New Building . ~.5q,.tmr~,to6 ?.o~.... · , · ................. Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... ~~' f./. D~) (Description) Estimated Cost Fee ~' (to be paid on filing this application) If dwelling, number of dwelling~units .... /. ......... Number of dwelling units on each floor..4~//~- .......... If garage number of cars i ./.¢./..~. . ] f business, commercial or mixed occupancy, specify nature and extent of each type of use t?/~. . Dimensions of existing structures if any: Front.../-J~, .c/. ...... Rear . .~.~: .~. ....... 'l~e;~'t~ i~'~ ~ii i iiii. Iteight ...,2.~: ........ Number of Stories .... t~ .O. -~.. ................................... : ........... Dimensions of same structure with alterations or additions: Front ....~.'ff..'~..q-~. ...... Rear .. ~ .............. Depth ~ Height --- Number of Stories. . .'.-'7 Dimensions of entire new constrUction Front ..... ~. ....... Rear ..... ~.O. ....... Depth ... 77..~. ........ tteight t'./d.r?/.2-¢,o. .'ff. (4... Number of Stories..4.4A~//-~q~ ..'W. O..... Size of lot: Front ..... /.~.Z,.,.¢¢¢...~ ....... Rea/ .... J.(~,O..,I ......... 't .......................... Depth .o9.5'.~ ,.~../ ........... / .......... Date of Purchase . Name of Former Owner Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: .42.~ ................. Will lot be regraded A~. ~ ~ t n,~ ,,? t._ . . Will excess fill be ' ; ~ ' ' ' ' ' ' .... ~ ....................... removea ~rom premises: Yes ~ ~ Name of Owner of premises .,-7~-iO?.Ot.,,~.~.ta'. ¢~. ~</. Address 3~. ~;r~.,~..6q .,~. Phone No. o~,.?, f.'-..'~...g~.... Name of Architect . o./.~. ........... Address .~..~.¢T. t.*-°~.~ ~ ~ Phone No ............... Name of Contractor .,~.u..,q.r~L. C..tae,~ ........... Address/.~.?O./J.~.¢/.~... Phone No..~...~. r.~'..~ .3.~.... PLOT DIAGRAM Locate clearly and distinctly all: buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether ........... ~..'~.~..~/?... ,~ .d .......... 19 .~.?. N°tary Public' ~ ~' ~ '~' '/' '~'C '~' C°unt//N011RY MARYPuBuc,Lg[ lttel REILL~0f ~ Y~I~ y- ~.~~ No 4815679 ...................... Qualified in Nassau County ,~ (Signature of applicant) tlaam~n ExpLtes September S0, l~LO STATE OF NEW.YORK, S S COUNTY OF....~..~.-c?.~!.~ .... . · .............. ~f.~ .~ .c[~.-~-. ~....~.~....~.&. ............. being duly ~woru, deposes and says that he is the applicant A (Name of individual signing contract) above named. : He is the (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 this 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