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HomeMy WebLinkAbout14889-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15030 Date. October 23, 1986 THIS CERTIFIES that the building Qy%~. f a.m. ily dwelling. Location of Property 480 Tuthill Road ~ Southold House No. Street Hamlet County Tax Map No. 1000 Section ...0.5.5. ...... Block 3 .......... Lot .17 & 18 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~.~¥..1. 4. ........... 19..8.6pnrsuant to which Building Permit No. dated . .~.a.y, .1.4 .................... 19.8..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 ......... .O. ne .f.a. mily dwelling includi.ng attached 2 car garage. The certificate isissued to JAMES & NORMA NUNEMAKER (owner, of the aforesaid building. Suffolk County Department of Health Approval .... 8 6.--.SOy 6.4...1..0/.1.6./..8.6 ......... UNDERWRITERS CERTIFICATE NO .............. Pendi~q..1.O ./~.3./. ~ .6 ......... i ....... Plumbers Certificate 10/20/86 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERtV~tT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14889 Z 19.~..~.. Date Permission is herebt granted to: · ............. ~.~.....,u....¥.,...l.t.~...4...~..~ ......... o, premises located at ...~...~.~.......~..~......~....~..' ........ .~~4....: .......................... County Tax Map No. 1000 Section ...... ..C~....~.~..~..~.. .... Block ...... .~. ...........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 Towu 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 ~a ~ to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unu~.~al 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 cf 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 iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZOperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of own,er 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: 1. Certificate of ocGupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5,00 5. Updated C,O. $15.00 $15.00 Data .............. New C on $ t~ r u c t i on Old or Pre-existing Building Vacant Land Location of Property ..... · .......................................... t¢ouse No. (~ Street Harn/et Owner or Owners of Property ../~. Z. ~.. ~ ' County Tax Map No. 1000 Sect,on~'/, .~...--.~. ....... Block., ~ .......... Lot .... ./?. ?../K... Subdivision ................................. Filed Map No ........... Lot No. Permit No./.~/. ?..0~?..Z, Date of Permit ./?~..~.Applicant.,. ,~,~-~--J.f~ ......... H IthD pt App I .~. -,~(7- /~/-/ ~;a e rova ...... Labor Dept Approva~ ................... Underwritars Approva ............... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificata . ..~. ................... Foe Submitted $ ............................. Construction on above described building ano perm't meets all applicable codes and regulations. Applicant .................................................... 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. /~ Owner ~l~ ~0~ (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumb~'s signature) Sworn to before me this ~tday of ~3~ , 19 ~ Notary Public, County Notary Public ~AROLO T. CARR NOTARY pUBLIC, Stata of No. 52~578405 Con,~ ss/on ixp~ Mm~ 30,19'~ 7 ~¢~$ MAYOR GEORGE W. HUBBARD TRUSTEES JEANNE M. COOPER GAlL F. HORTON DAVID ~, WILLIAM ~1. LiEBLEIN SUPf. OF U11L!TIES JAMES L MONSELL 2~6 THIRD STREET GR~ENPORT, SUFFOLK COUNTY ~EW YORK 11944 September 30, 1986 Mr. Norman Wagner Suffolk County Health Department SuffolkCounty Center' Riverhead, N. Y. ]1901 Dear Mr. Wagner: .lhe following water service line was connected to the Public Water Supply by the Village of Greenport during September, 1986. The installation was done according to our rules and regulations and, to the best of our knowledge, meets with the Suffolk County Health Department standards. UTILITY OFFICE TEL. (516) 477-1748 POWER PLANT TEL. (516) 47%0172 James Nunnemaker - Lots #1 & #2, Tuthill Rd, Yennecott Park, Southold - Job#1986-74 - Installed 9/9/86 - Ref.#86-SO-64 - Walter Croon - Old Jule Lane. M~$tituck- Builder. If I can be of further service, please contact me. Very truIy yours, James I. Monsell Superintendent of Public Utilities JIM:lkm CUSTOm CgSSPOOI. S 298-9660 CESSPOOLS - EXCAVATION -- BULLDOZER -- CRANESERVICE FILL - BACKHOE SERVICE P.O. BOX 1132 MATTITUCK, N.Y. 11952 Health Department Ref. No. ~--50-~? Name of Applicant ~ ~~ ~ 'Phone Property location /~?/~,~---'-~/', ~::f<~--~-, ?~//~-(~--,,~'(z~ Subdivision ~.~/~t~_~ Type of system installed: Lot No. Septic Tank Type ~pr~_cas~ equivalent, block) Leaching pools f~/ Number.~d-~J~e_of poo~ls Type ~ block) I hereby CERTIFY that the private subsurface sewage disposal system described above has been installed according to current criteria of the Suffolk County Department of Health. Date G Signature Title FIELD INSI~ECTION FOUNDATION ~s{lst) COM~'~ E~TS FOUNDATION ~~(2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: ,? BUILDING DEPT. IHSPEC:TIOH [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARK S; FINAL DATE INSPECTOR ~:~'~'~'~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION IST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL DATE INSPECTOR 76S-'"802 BUILDING DEPT. ~O~...ATISPECTION ION ~.ST [ ] ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION FRAMING £ ] FINAL R£MARKS: , (~~, .._~.~_.~___INSPECTOR BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [~/FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL REMARKS: ,,, ~,/~/,,~ z65.xsoz BUILDIN~ DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE ~////~~o/ i NSPEC. rOR/~--~:, 7GS-t802 BUILDING DEPT. INSPECTION ]FOUNDATION SST [ ] ROUGH PLBG./'~, ~ ~,~j ] FOUNDATION 2ND [ ] INSULATION ___'~ [~I~MING [ ] FINAL REMARKS :* ~~ _ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined....~Q..~ .I.c/.., Approved ..... .o~ .... , 19 Permit No. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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 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, ordinances, building code, housing code, and regulations, and. to admit authorized inspectors on premises and in building for necessary ins~jpeqtions. ... a, ................ (Signature of applicant, or na.rne, if a corporation) (Mailing address of applicant)v State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~.~.}~e~.~... ~. '0/0~.~ .~.~..~.. ...................... (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 ......................... Electrician's License No ....................... Other Trade's L~cense No ...................... 1. Location of land on which proposed work will be done .................................................. .................. !(1<.. ............ 9 .................................. House Number Street Hamlet / ? County Tax Map No. 1000 Section .... ~.~..~. .......... Block .... .~. ............ Lot .~ ......... Subdivision ..................................... 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 b. Intended use and occupancy / t4/ 0 ~ ~ Z~.~ ............ 3. Nature of work (check which applicable): New Building .......... Addition .. ! ........ Alteration ........ Repair .............. Removal ............. Demolition ............. Other Work ............... 4 Estimated Cost .~.Z:~.,.ooo 5. If dwelling, number of dwelling units .... ~ If garage, number of cars .... & ............... (Description) (to be Paid on filing this application) Number of dwelhng umt.s on each floor ................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. ........ 7. Dimensions of existing structures, if any: Front ............... Rear ....... i ....... Depth ............... Height ............... Number of Stories ............................ ! ............................ Dimensions of same structure with alterations or additions: Front ............ i ..... Rear .................. Depth ..................... Height ........ Number ofiStories ............ t ......... '--8. Dimensions of entire new construction: Front....f..g ~ ..... Rear . .~.f..'..i ...... Depth . .~. Height .... '.&..~/ ....... iS/umber of Stories .... ]'/'//~' .................... i ............................ 9. Size of lot: Front ..... ~.~-?. [ ........... Rear ....~.~../ ............... Depth.../.?~..~ .............. . 10. Dateofeurchase ............................. Name of Former Owner .~J'ol~o.~:..F-..~..~).c:.o ............ 11. Zone or use district in which premises are situated ........................ ,~ ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ..... .~'~'~' · · .x ·: ............ Will excess fill b,e removed frctrn premises: Y~es-~'5 No 14. Name of Owner of pren~ses :.~1~t~ .~.t~hl~lg.l('e_~... AddressO:.0. ~..~.~q~i~ .~t,, ...~...~('. Phone No. ~.~'. g-.~.."~ I Name of Architect ...~.~..~.. J~-~edg, ....... Address ~-t~l?~r-r~.~... Phone No..~17. 7.-.q~.~. r)... Name of Contractor .. ~)t°r(4~P-d4. (..~O~. ...... Address . ~'1~.. ! .... Phone No... ~.ff.'~: ~>~..~... PLOT DIAGRAM ~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from 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, depqses and says that he is the applicant (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 s~aid work and to make and file this application;that all statements contained in this application are true to the best of hi; 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 .............. /,W ....... day of ...... ~/-/~.~_. ....... ,19 ?..~ Notary Public, .... ~.. ~ .~.6r..~.~.~. ·. County . / (Signature of applicant) LICENSED LAND SUI~CVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H. S, NO. STATEMENT OF iNTENT THE WATER SUPPLY AND SEWAGE DISPOSAl SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO ThE STANDARDS Of thE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: h. S. REf. APPROVED: ~ ""~ ;SINC,.,~I..E FACcHLY i::14~ I I,Nc~ c~,, v SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT, BLOCK PCL. OWNERS ADDRESS: ~ED: k. ,~'~ P. TEST HOLE STAMP :.'MAR I~6-1986 ',,SUFFOLK COUNTY HEALTH DEPARTMEbT ~ SINGLE FAMILY DWELLING ONLY H.D. REF. NO. ,~ · THE SEWAGE DISPOSAL AND WATER SUPPLY FACILITIES FOR THIS LOCATION HAVE BEEN INSPECTED BY THIS DEPARTMENT AND ~FQUND TO BE S~TISEACTORY-, . . ' Chief o~~te~nagement Sectioh k~~ SUFFOLK CO, HEALTH DEPT. APPROVAL H.S. NO. ~'~-~O"~''j~ .STATEMENT OF_ INTENT / THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT, OF HEALTH SERVICES. (S) ii . APPLICANT SUFFOLK COUNTY DEPT. OF HEA'LTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE: APPROVED. SUFFOLK CO. TA.X MAP DESIGNATIE~N: DIST. SECT. BLOCK PCL. DEED: L.~C& P. TEST HOLE ' ' ' STAMP SEAL " '~- '~,"--~ '-~",~'-k~G & PLUMBING A~,~ : ~'¢'~¢i)~:T~ON SHALL ME~ TF~; ~Et~:J¢;;:;;~E~T5 GF THE N.Y C~DE~ ~,~OT ~NSIBLE ~R ~F~G~ 9~ C~NST~UCTION ERROfl~, SOLDER USED IN WATER SUPPLY SYSTEM CAIViVOT ' EXCEED:2/fO ~ I~ LEAD. PLUMBER ,. ,,,.. ~..,1.70.~ ON LEAD C,.. .,":EFORE CERTIFICATE O: ;::,JUPANC7 ,I F -7 Phone 477-0400 GREENPORI, N.Y Main Road 1194'4 Phone 477-0400 Main Road . 1944 GREENPORI', N Y~ 1 , .