HomeMy WebLinkAbout14851-zFORM NO. 4.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z15299 Date February 24, 1987
THIS CERTIFIES that the building .... 0¢~..f.a.m.i .ly..d.w.e.1.1 .t.ng: ........................
Location of Property ,... !8.5.5...Id..E.D.A.Y.. 6V. E.~.U.E ........... .I~..T.T.I.T.U.C.K...' ...................
t~ou$o No. Street Hamlet
County Tax Map No. 1000 Section . 113 .Block 9 ..... Lot p./o 8
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... M~rch. 27',. J9~6 .... ' . pursuant to which Building Permit No. 1485 IZ
dated .. kg.ay..7 ,..1.9.8.6 ................ 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. f~m~[¥. ~lw~/-;[~-~g..t.n.c.~.u.d.ipg..d.e.cK. .........................................
The certificate is issued to WILLI/~vl AND DIANA WALTERS
(owner, ~t~JX
of the aforesaid building.
Suffolk County Department of Health Approval 85-80-50
UNDERWRITERS CERTIFICATE NO N786505
PLUMBERS CERTIFICATION DATED: Feb. 12, 1987
'l~ii~i;~:in~ lc't;; .............
Rev. 1/81
FORM NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o 1~$~1 Z
Permission is hereby granted to:
~:~..,.~.;...~..~ ...................
......--~.~..x.... L~.,[ ...................................................
....
' ~,~.i~.~. ~~.~. ~:~:
*t premises located ot ...L?...~.~..~. .......... , ................
County Tax Map No. 1000 Sectio~..../../...~. ......... Block ...... .(~.~ ......... Lot No..J~..;...~. ...........
pursuant to application dated .... .~.......~... ..................... , 19.~J..(e..., and approved by the
Building Inspector.
~ee ,..~.~l....~.~ .....
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 OCCUP
Instructions
FEB 201981
A. This application must be filled in typewriter OR ink, and submitted .- aaammmm 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,I streets, and unusual
natural or topographic featUres. ~
2,Final approval of Health,Dept. of water supply and sewerage disposal-(S-9 form Or equa )
3, Approval of electrical insta'llation from~Board of Fire Underwriters. '
4. Commercial! buildings, I~dustrial buildings, Multiple Residences and similar bdildings and installa-
tions, a certificate of C0d~ compliance fr~m the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicabl,e.
B. For existing buildings (pri0~ 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 natural or
topographic,features. , ~ :
2. Sworn statement of ownbr br 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 ~ certificate.
' Additions $25 O0
C. Fees: ·
1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 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°ns gr'uc ti°n ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property /
House No. ~ . --. Street ~ ~ /Yam/et
O ner or Ow ers of Property ,
County Tax Map NO. 1000 Seclion ...l ./..~ ....... Block ..... f ........Lot.. ..~..~.~. -~. ......
' !
Subdivision ................ ,,~ ................ Filed Map No ..... Lot No ..............
'yo~'/' 7:. Date df Permit Applicant
Permit No../ ...................................................
Health Dept. Approval ...... ; ................. Labor Dept, Approval ........................
Underwriters Approval.....,,......,.....,...,PlanningBoardApproval ..................... ,
Request for Temporary ~ertific!te ..................... Final Certificate .......................
Fee Submitted $ '
Construction on above described building and permit meets all applicable codes and regulations,
~lPPlicant ....................
Rev, 10-10-78,I
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY'
85 JOHN STREET, NEW YORK, NEW YORK 10038
~ Date ~ppllcatlon No.o. flie 4~7704/86
T.,S CE"T,F ' XT 1 87 N 786505
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
Bill Walters, 14eda. y Ro~, (off Wesphalia), ~4attituck, N.~
in the followlng locatlon; [] Basement [] Ist FI. [] 2nd ~1. Section Block Lot
t~s examined on D~c~l~r 15t 1986 and found to be in con~pliance teith the requiretnent s o. f this Board.
FIXTURE
OUTLETS
57
~ECEPTACLES
57
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
SWITCHES
40 57
DRYERS
FURNACE MOTORS FUTURE APPLIANCE FEEDERS
TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER AP~RATUS:
l~tors~ 1-3/4hp
1-3, 1-5, 1-7 Ton A,Co Units
$-P air handle~rs
2 Smoke Detector
S E C
NO. Oi~ERCC~COND, A.W.O. NO OF HI-LSG ^ w a, NO OF NEUTRAL,. A, W O
OF CC CONO OF HI-LEG OF N~UTRAL
2/0 3,. 2/0
R V I
BOX 215
Southo].~, N.Yl1971
LiC#578E
GENERAL MANAGER
11
Per_ ~ ' ~
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 BUILDIHG DEPARTMENT. THIS COPY OF CERTIF CATE MUSY~HOT BE ALTERED IH ANY MANHER
HENRY J. SMITH & SON,
PLUMBING, HEATING & FUEL OIL
MAIN ROAD
$OUTHOLD, N.Y. 11971
(516) 765--3690
~rlc.
CERTIFICATION
D a t e Februar2L_12~__l_9_87__
Building Permit No._l_~8~ ........
0wner_wil~i~_N~_l~e~s._~estphald~_J~ad.M~ttituck
Plumber Henri J. Smith & Sonz Inc.
I certify that the solder used in the water supply
system contains less than 2/10 of 1~ lead.
~/~ Henry P. Smith
Sworn to before me this
l~t~__day of
1 9_S2__,
Notary Public, Suffolk County
' B[I~NAD£¢TE L. 'rAPHf~
,NOTARY PUBLIC, State of New York
765-180~)
BUILDING DEPT.
INSPECTION
FOUNDATION ZST ~ ] ROUGH PLBG.
~ FOUNDATION ZND [ ] INSULATION
I' ] FRAMING [ ] FINIAL
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ~ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
I*~F~MING [ ] FINAL
~ .~/~ *~.,,~/ . BUILDING DEPT.
~y INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
765-XS~Z
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
REMARKS:
[ ] FINAL
7GS.'IBOZ
BUILDING DEPT.
INSPECTION
FOUNDATIONIST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
( ] FRAMING
REMARKS: //~
[ ] FINAL
DATE ~/~r/~ INSPECTOR
FIELD INSFECTi0N
1.
FOUNDATION ~~(1 st_~)
FOUNDATION (2nd)
COMMENTS
FRAME &
PLUMBING
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved....~/)..C~.~. ...... 19~..~. Permit No. 1 ! .-~'...
Disapproved a/c .....................................
-
2~S ~d~'~ (Building Inspector)
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
'~ets 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 demolitionzas herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing 9pde, ~id regulations, and to
admit authorized inspectors on premises and in building for necessary i~~ /////-/.x-/ /~ ~ ,(, / . .
~f~ig_natu~ of applicant, 6//tiame, ii a corporation,~
....
(Mailing address of applicant)
State whether applicant is ovinm;, lessee, ~snt, arc.hjtect, engineer, general contractor, electrician, plumber or builder.
...... ............... , ............. : ........
Name of owner of premises...(~../..~r...~.. ~ .~././~... ~..~ .~..) ..... ,-~.........., .......
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 .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
· ..... ........... .............. :
House Number Street Hamlet
County 'fax Map No. 1000 Section ..... ./../.~..~. ........ Block ....... ~ ......... Lot .... ./~,./..~...~. .......
Subdivision...~.~..(O...~f. ?.?~../~. {_~.~.~?..~./..~/~.~.//~. ..... Filed Map No..../..~...C~. ..... Lot..//.~...~. .....
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... .~..~..g2,//../%d.~.. ...............................................
b.
Intended
use and occupancy ......... .~?~.~/~ · .........................
3. Nature of work (check which applicable): New Building ...... Addition ..... Alteration ...........
Repair .............. Removal .............. Demolition ........... ... Other Work ...............
~ (Description)
4. Estimated Cost .......... .~..~..~J..~. .................. Fee .......... , ............................
'~ (to be Paid on filing this application)
5. If dwelling, number of dwelling units ....... ' ...... Number of dwelling units on each floor ..... I. .........
If garage, number of cars .../M.I~ ..................................... ~ ........... l ...............
6. If business, commercial or mixed occupancy, specify tnature and extent of each ty~e of use ../~l.~. .............
7. Dimensions of existing structures, if any: Front.. ~J[.~ ......... Rear ....... i ....... Depth ..............
Height ............... Number of Stories ............................ : ...........................
Dimensions of same structure with alterations or additions: Front ............ ! .....Rear .................
Depth ...................... Height ........... ., .......... Number off,Stories . .~x.... ..............
8. Dimensions of entire new construction: Front . ..... . .'~. · · · · Rear . .Tr'.~.'., ....... Depth . .............. o'O'
Height .... ~. ?.~. ...... Number of Stories .... ..~. ..................... ; ...........................
9. Size of lot: Front ..... ~..0.O,~ .... /.gO~.. Rear ...... /..~. '. .......... Depth .... St'~./ . .
10. Date of Purchase . .'TC~_-~J!J..~?...~/fi.l~. ........... ~ame of Former Owner~-O~r~ ~:~O. ~ ~ ~.~.'(l~i i i. i.'
11. Zone or use district in which premises are situated .... ~".~ ................... ........................... i
12. Does proposed construction violate any zonin~ law, ordinance or reeulation: . .~,).O. ................... .....
13. Will lot be regraded ....~.~...:...... ~.;....~ .~ ........ Will excess~fill be removed from premises: Yes ~
14. Name of Owner of pr~mises .[~ih~2~. '.~x&(~al~Address~0, .~.~. t.Y..l^ ~ .~.c~u Phone No..7(~.~. :~.~.-~...~.
Name of Architect .(,w~rr.~t"l~,..,~ ....... Address ./~l, Ox~ ~.~.~t~i~one No ~f~.~.' ~'~/~:~,
Name of Contractor...~qJt .~..~.'...~... ....... Address ............... ~... Phone No ..... ~ ......... i
15. Is this property located within 300 feet of a tidal wetland? * yes ..... No .h~...
· If yes, Southold Town Trustees Permit may be required. ' ~o,~
PLOT DIAGRAM ,~Q ~ c~'[~_~q,e_w,~.'?~ ·
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dnnensions fro~n~
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF .................
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named. :
He is the .............................................................. i ...........................
(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
.............. . ...... day of ............... 19 ~
Notary Public, ... ~.. ~ .............. County
(Signature of applicant),
T--~1~""1%'~7r~.~. .~..-~ ' '
. ~,0,000 si ·
'RE: LOT .3 MINOR SUBDIVISION FOR
JOHN M. DIVELLO I~ FRANCES C, DIVEt. I..O
NOTE: Z~ =STAKE e=IRON ROD WITH CAP
ONLY
...... .- ..~,i~. v ri~&LLING
:)uffOLK COtllqTY Di:pARTMP-N1 OF HEALIH
ONLY
FOR /,¥4;f',ovAL OF CoNST. RUCTION
~,PpROVED~~
HEALTH DEPARTMENT'DATA FOR APPRO~ "O CONSTRUCT
WE s TPH4L 14
/
SURVEY FOR
WILLIAM J. WALTERS, Sr. G DIANA S. WALTER
AT M~,TTITIJCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
~o
JOHN M, DIVELLO ~ FRANCES C. DIVELLO
D~PAR~EN~ OF HEALTH 5~RVI('~ SU~Y FOR
WILLtA~ & WALTERS.Sr. ~ DIANA S. WALTERS
COU~TY
oNLY
FEB.
~0~ APf);~c)vAL O~ CONSTRUCTION
- AT M~TTITUOK DATE: NOV. 18,1D85
50'
SCALE:
OAT~~~ ~UFFOLK COUNTY, NEW ~RK NO.
~PPROV~O~~ ~ NEW YORK STATE E~CATION LAW
~E ~R~ ~R.WHOM THE $U~EY IS PREP&RED
HEAL~ OEPARTMENT-DATA F~ APPRO~ TO C~STRUC T ~.o ~ Hl~ ~LF ~ THE TITLE C~P~Y, GOV~N-
~ ~F CO. TAX MAP ~9~9 SECTION ~1} ~CK ~ LOT~ g H~E~, AgO TO ~E ASSIeNEES OF rile LENDING
H~E~ A~ ~ ~ELLI~ ~ITHIN IOO FEET OF T~S PROPERTY INSTI~UTt~. GUARANTEES ARE ~T T~SFERABLE
TO A~ITIONAL INSTITUTI~S OR SUBSEQUENT
~LIC~T, I ~ iOD ~ P~PERTY LINES OR FOR THE ERECTION ~ FENCES
. YOUNG YOUNG RIVER~AO, NEW YORK
NOTE: LOT NUMBERS SHOWN THUS: LOf Z REFER TO "MAP
OF PROPERTY OF WILLIAM B. COOLING "~ FILED IN THE ALDEN W.YOUNG, PROFESSIONAL ENGINEER
OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AND ~ND SURVEYOR N.Y.S. UC/NS/N0.12845
MAY 10,1921 AS FILE NO. 745. HOWARD W. YOUNG, LAND SURVEYOR
M~ L~T~ ~ ~L(W),~IC TANK($~I CE~S(~) ~N ~[~ N.Y.S. LICENSE N0.45893
~RANDIS & SONS INC, 1046
S~NG!.£F,~MiLYDWE'LLINGONLY :'- ;:':' ~:
DATE fr~.~ t ~ )l~,-J' -- //
~OC~'TION r-~.~,¢E BEg'4 'ePEGTED BY THI E -' .....
- .... S .EPAR[MENT AND // .~ I
I
I ~'"l , _~. I1'11 ' :, ",~:~ ........... a
D~-~: ~ ,I ~ ~,
~-~o,~,~,,~2:. I i ~ 'HI ~N N~ , , . : ~ F~UNDAT ION NOTE S:
~OT~ Bu~'~.~0 4 pM ~ ~ , ,',
USE IS UN~WFUL "~~ L ~~ ~~ [ ~ / FLO*.~ I SLABS
~ ' ~ ..... ~ ............. ] ..... ~ i~ ?, COhCRETE I~AB~ tZLC HAVE EXPANSION
: ~ .... ] ~ ~ ~ J, I~ ~-'~ ~ I '~ ~: REQUIRED.
WI~O~ CERTIFICATE -~ ~ ~'~ * ~: ' , ~-' I
, ~ [ ~,~~; i i ' I ~ J 8. DOUBLK ALL FLOOR JOISTS AROUNO OPENINGS & BELO~ ALL
· r ........ ~ ,~ ' ~ ~ BEARING AND PARALLEL PARTITIONS.
OF OCCUPANCY ~u~Y ~EM ~NOT , , I ~ ,, ~ ,, ~ L~ , . ,, , , i
~CEED 2/10 d f% ~AD. 7-~ ~ I~'-~' ~-~ ~ ~-~ ~l -~
PLUMBER ~E~IFI~
~ Main Road P.O. Box 1412 Sou )Id N.Y. 11971
4. #V,A~' E'IM,~XPHEHT I~S,T [D~,FGRN TG S~CTZ,~# &l~.13 OF THE
~tz~,
STATE ~G'RGY
7. THE [XRE~ACES SHALL BE CONSTRUCTED, IN CORPLIA~E gITH
SEC~ZON" 40Z.4 Cd) OF Tfl~ gEV YORK STATE ENE,~GY ~O,PE.
GARRETT A. STRANG
architect
Main Road P.O. Box 1412 Southold N.Y. 11971
516 - 765 - 5455
NOTES
15, ~LL N~D~I,I II~ERS ARE TO,BEAR ON A RZNINUfl Of 2-~'x~''
16. PROV~JDE~I~2." A~STOIE RESIST~NT GVPSUH OQA~D ON VALES AND. CEILINGS
18, ~ALL Z~SULATZQM ~LL ~ 3~'(R-11) KRAFT FACED 8ATTS ~'~T~ VAPOR
6~"'CR-ZE)KRaFT FACE~ BATTs AT ATTZC AND 6" (R-19)KRAF.T
19. CONTRACTOR ~O PR~VZOE ~J LAYER O'F BUILDING PAPER BET~EN SU~
FI#ZEN
ALL ]raDo~s SHALL IE IJ~S~.U~,ATES GLASS, VINYL CLAY klT.~ $C#t£NS ~
A~ ~A~OFAC~A~EA iT A#NE~BEN. O¥IEN SHALL PROVIGE SA~EGU&~O~, P:LkNTERG,
I#G~S4 O~t ~GGTECT[VE NEARS TO .C~US~D
CA,P
C~NTi*CTOi ]i T'i CLI~ ~LL DOff I MI~OU ~ASS & LEAVE ALL FLO~I, ~
PLETION.
GARRETT A. STRANG
Brchitect
Main Road RO. Box 1412 Southold N.Y. 11971
516- 765 - 5455
GARREETT A. STRANG
architect
Main Road P.O. Box 1412 Southold N.Y. 11971
516- 765 - 5455
GARRIETT A. STRANG
architect
Main Road P.O. Box 1412 Southold N.Y. 11971
516- 765 - 5455
J+
=b
Main Road P.O. Box 1412 Southold N.Y. 11971
516- 765 - 5455