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HomeMy WebLinkAbout14994-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy Z-15359 March 18, 1987 Date ................................. One family dwelling with attached THIS CERTIFIES that the building .. ~'a'~ fi ih' ' ' &' h't't~ fi~h'dd ' i:'e'd/' ' ~t'e'~R ............ 2053 ROW Off Cox Neck Rd. Mattituck, N.Y. Location of Property/~ ~ ~7o] ....................... ~/e~' ............................ s Hamlet County Tax Map No. 1000 Section 113 .Block 7 .Lot P / o 19.6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 7, 1986 14994Z ...................... pursuant to which Building Permit No ...................... Juno 19, 1986 dated .............................. 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 FAMILY DWELLING WITH ATTACHED GARAGE & ATTACHED REAR DECK THOMAS & CHRISTINE HILLIKER The certificate is issued to .... (owner, ~[~'~2~{~X of the aforesaid building. Suffolk County Department of Health Approval 8 6 - S 0- 2 1 UNDERWRITERS CERTIFICATE NO. Iq 795354 PLUMBERS CERTIFICATION DATED: March 5, 1987 Building Inspector 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) Permission is hereby granted to: .....-~...o....~.....~..?....~ ........................................... ~~.~...~.-.~. ,: ~ ~ ~. , --~ to . l ....................... ;' .... pursuant to application dated ..~.......~.. .......................... , 19 ........ , and opproved by the Building Inspector. 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 m ~=,==~a~a 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 Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engini~er 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 property showing all property lines, streets, buildings and unusual natural 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: 1. Certificate of occupancy New Dwelling.$25.Q0, 'Accessory,S10.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.90 5.Updated C.O. $ 50.00 Oate ....................... NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land ............. Locationof Property~.~.~Z.. ~2'O..~.I ~ ~ ~ Z~ ......... ................... . .... .... House No. Street Hamlet Owner or Owners of Property County Tax Map No. 1000 Section .../d .3. ....... Block.. ~ ~ ....... Lot. ~/~...~.'..~. .... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. .. Date of Permit~./4~. Applicant ............................... Health Dept. Approval ........... Labor Dept, Approval .................... Underwriters Approval .... .-'7. ?. SY.. 3.....~-..t~.....plannin§ Board Approval ...... ~ .............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ,,~. O-r,D Applicant.. 70/...~Y..':w:'~-?...~ ~ ......................... Rev. 10-10-78 765-1802 BUILDING DEPT. INSPECTION [~UNDATION ~IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date · print) (please i print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this ~-/~'//~ ff-x~_~ ~/~day of ~ff-~ C~_~, ~~ x . LOI'TIE U. Ro~INE Publ County NOTARY PUBLIC, State of New Yo~'~ No. 52-3334625 - Su~Jk Count' / CommJssJo~ Expires March ~0, ]gf~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000418 8.~ JOHN STREET, NEW YORK, NEW YORK 10038 ~ l~ebxuary 24, 1987 445045/86 .,,,,. o,, N 795354 Tom & Chris Hilliker, Cox Neck Road, ~ mi No. of Sound Ave., Mattituck, N.Y. in the foltowlng locatlon; [] Basement ~ Ist Fl. [] 2nd Ft. garage, Section Block Lot 37 39 DRYERS SYSI'EMS OTHER APPARA.TUS: Motors: 1-!hp~ 1-3/4hi~ 4-G.P. 2 Smoke Detector E R V I C NO OF dC COND~[ [,~0A.W G. NO OF HI-LEG E Alexe.uder G. Hubbard Box 222 OENE~At MANAgeR ~ue~e, ~LY 11931 11 This ce~ificote must not be oltered in on~ m~noer; return to the off{ce o( ~he Bourd }~ incorrect Inspectors moy be identified by their credenfio~s. COPY FOR BqILDING DEPARTMSNT. THIS COPY OF CERTIFICATE MUST NOTBE.~ ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE LAWRENCE M. TIJTHILL D LD Y Southold, N.Y. 11971 (5i6) 765q955 June 10, 1986 Mr. Victor Lessard Executive Administrator Building Department Town Hall Southold, NY 11971 Re: Minor subdivision access road John and Catherine Simicich Dear Mr. Lessard: Please let this confirm the following/action taken by the Southold Town Planning Board, Monday, June 9, 1986. RESOLVED that the $outhold Town Planning Board accept Inspector John W. Davis' report No. 510 regarding the final approval on the access road within the subdivision known as "John and Catherine Simicich" located at Mattituck. Enclosed is a copy of that report'for your review. Please contact this office if you have any questions. Very truly yours, BENNETT ORLOWSKI, JR., CHAIq~MAN SOUTHOLD TOWN PLANNING BOARD By Diane M. Schultze, Secretary enc. To: From: Re: Bennett Orlowski, Chairman Southold Town Planning Board Report No. 510 John W. Davis Date: May 27, 1986 Access Road for J. Simicich & Katherine Simicich, Minor Subdivision at Mattituck 5/~3/86 Made inspection of road beyond first 600 L.F. follows: (See report no. 497) as Distance from Cox Neck Road Depth of Surface Course Road Width 700 ft. 3" ]6 ft. 800 ft. ]~" 16 ft.± 900 ft. I~" 17 ft.~ ]000 ft. 2" ]6 ft. IlO0 ft. 2~" ]6 ft. |200 ft. 3" 16 ft.l ~250 ft. ]~" ~6 ft. In addition to correcting the depth of the recycled concrete (3 areas as shown above)~ there was additional work to be done on the shoulders. 5/23/86 I went over the road length with A. Foster and showed him where the addit- ional work was required. He said he would make the corrections that day. Some additional top course material was stockpiled on the site. 5/27/86 I inspected the access road today. The additional work has been done and I would recommend approval of the access road. John W. Davis " To; APR Bennett Orlowski, Or., Chairman Report No. 497 Southold Town Planning Board From: John W. Davis Date: April 3, ~986 Re: Access Road for J. Simicich & Catherine Simicich, Minor Subdivision road at Mattituck. Comments: No profile was submitted for this road as requested and there was no notification as to start of grading operations which are about completed. The road profile as constructed could have been improved. Stone blend is being used for the surface course and according to the road contractor (A. Foster), the first 600 ft. from Cox Neck Road is completed. Inspection as of above date indicated some incomplete shoulder work on the sides in the 600 ft. The stone surface course (600 ft.) appeared stable and usable except at Cox Neck Road where it has been loosened for a short length (10 ft.±) by traffic turning in and out of the access road. The surface course (recycled concrete) depths and road widths as follows: Distance from Cox Neck Rd. Depth of Surface Course Road Width 5'± 2~" 20'± I00' 3" 16' 200' 3" 16' 300' 3" 16' 400' 3~" 16' 500' 4" 600' 3~" 15' A. Foster, road contractor for the subdivision owners, and also owner of Lot No. ] wants the first 600 ft. of the access road accepted now so that owner of Lot No. 2 can get a building permit. As there is remaining work to do in the 600 ft. length I cannot recommend final acceptance of it. However, the road width at present is suitable for building construction equipment. BLDG, DEPT. TOWN OF $OUTHOLD' John W. Davis : ~* ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N,Y. 11971 ~ TEL.: 765-1802 /'1 Examined . ~ ..... 19~..~. Approved . .~A,,~-~./.~}..., 19~..~.. Permit No..1.~. ??.~..~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. Tiffs 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 schedhle. 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 buildLng 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 insp,~ctions. /~ /., · (Signature of applicant, or name, if a corporation) ' (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plum lder. Name of owner of premises..~.~5-- .... --____.~. '..~.~. t .*.]..~...r~.. ................................. , ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co orate officer) Builder's License No ......................... Plumber's License No ..... '~.:...~.q.~.~5-.~ ...... Electrician's License No .... .~ .~T~..~. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · o..53 ...................................................................................... House Number Street Hamlet County Tax Map No. 1000 Section . .]..].--.~. ........... Block . .a .~...7 .......... Lot. ~.~.O~.f.".~. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) x ~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .V. ~C..~../~-..~.... :_ ..................../""'a ...................... b. Intended use and occupancy ...~.~.../~.~.~../. ~'~..l~.....~. ?/~..~.'~..'. ............... ,3. Nature of work (check which applicable): New Building ......... Addition .. Alteration ~ Repair .............. Removal'. ......... Demolition ............ ~.. Other Work ........ (Description) 4. Estimated Cost . . .~Q~..I ~ .................... Fee .......... ~ (to be aid on filing this application) - .~. ' 5. If dwelling, number of dwelling units.. Number o f dwelling unit; on each floor If garage, number of cars . .,,-tv-. ......................................... i ......................... 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 ' - ' Dtmensmn.~s of same structure with alterations or additions: Front ..... ~. i ... J .... Rear ............. Depth . .~ 2....,- .............. Height ...;~.o. ................ Number of Stories .. 8. Dimensions of entire new construction: Front ............... Rear ........ ~ ...... Depth...... ' .t ...... Height ................ Number of Stories ............................. j ........................... 9. Size oflot: Front ....¢{.~.~. ............. Rear..~2./..t~. ........ Depth ,.~.~.O . : . 10. Date of Purchase ../..&/t.~.~,~.~7' ................. Name of Former Owner ~O.~q .~'.' ~'.~,~ ii;! ~ 11. Zone or use district in which premises are situated .................................. '. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ¢ ~.~7. 0 ................ i ....... 13. Will lot be regraded ...~...o. '. ........ ~r,. · ·., .....Will excess fill be removed from premises: YeS 14. Name of Owner of premises .~'~'~¢t~d./'~.~l~.~.~¢Sttddress . ~.oJq ./~ ¢.a~.. ~..r~. ~ .Y~l~one No..'7. ~-~L~ ~i~.o. Name of Architect ........................... Address .............. · ...... Phone No ................ Name of Contractor . ,.~ ~ ................ Address ............... ~... Phone No ..... .t! ......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shov¢ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S -' ................................................. being duly sworn, deposes and says (Name of individual signing contract) above named. that he is the applicant He is the ............................................................ (Contractor, agent, corporate officer, etc.) i of said owner or owners, and is duly authorized to perform or have performed the s~id 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 .............. 7 ......... day of ..... .~7..~ ...... '., 19 .~.~. Notary Public,... ~....~... ~.~...d~. ..... Count. y. ~ .~./. ~e~q ~p~res i~reh 30,1~.~ : (Signature of applicant) C i , ~L~'~;?' .) .: ~g~' ~p~A~'.~.~'~-~.~.~ ~.o,~,,,~ ~o,* ' ~,, ~:; N'~AVE'B~' - . - HIS ~ ~ Chlef~f Wastewa.te~anag~e ~t~ - ~:~, ~ ~ , ~,, v- __ .~ ?2%0. . · _ . ~'~. / o~ / I%~'~ ~ _- ~ SURLY FOR ~ HILLIKER 8 CHRISTINE HILLIKER /~/, 23, 198'7 ~.Z, 1986 AT MATTITUCK DATE. ~WN ~ SOUTHOLD SCAUE: I": lO0' SUFFOLK COUNTY~ NEW ~RK ~0. 85-774 ~UTH~IZED ngTEnntlO. On nOOIr~ON m mis OUARANTEED TO: SUHVEY · A VI~ATION ~ SECTION 7209 ~ THE NE~ YORK ST*TE E~CATION LAW THOMAS HILuI~~'~~ NGUARANTgES INDICTED HEREON ~ALL RUN ~LY ~ ~E ~R~ FOR WHOM THE SU~EY IS PREPARED HEALTH DEPARTMENT-DATA F~ APP'RO~ TO C~STRUCT AaO ~ HIS BEHALF ~ THE TITLE C~P~Y, GOV~N- ~,. ~~ & ~ OS~.OER AVE~E YOUNG YOUNG ~,~t~,~ ~o~ NOTE: I =MONUMENT ALDEN W. YOUNG, PROFESSIONAL ENGINEER RE'LOT I"MINOR SUBDIVISION PREPARED FOR ANOLAND SURVEYOR NY.S. UCENS/N0.1~845 dOHN SIMIClCH~JR. ~CATHERINE SIMIClCH" HOWARD W. YOUNG~ LAND SURVEYOR BRANDIS & SONS INC. 1046 THOMAS HILLIKER a CHRISTINE HILLIKER gUN~ ET 1986 NOV. ~5~ 985 AT MATTITUCK PAT[: AUG. 20,1985 ~WN ~ SOUTHOLD SCAL[: I"= I~' SUFFOLK COUNTY, NEW ~RK NO. 85-774 N~UT~IZ[O ~LT[~ION O~ *DDITION ~ ~IS GUARANTEED TO~ SURVEY ~ A VI~ATION ~ SECTION 7~O9 ~ TU[ THOMAS HILLIKER MEW YORK STAT~ [~CATI~ LAW ff COPIES ~ ~IS $~VEY NOT ~A~ THE LAHD CHRI~INE HILLIKER NOT BE CONSIOERED TO ~ A VALID TRUE C0PV CHICCO. .6U*.ANTEE~ INDICTED HEREON ~L RUN ~LY HE~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ...... ~ ~.~ ~ w.o. THE SU~E~ ~S · ~F ~. T~P ~0 SECT)~ ~ ~ ~7 LOT~.6 ~E~, AN~ TO ~E ASSIGN~S OF THE LENDING N~gK AK W ~[LLIMI WITHIN I00 FEET OF TWl PROPERTY INSTITUTI~. GUAnAHTEES ARE ~T TWSFE~AIgE "" YOUNG 8 NOTE = B =MONUMENT ALDEN W.~N~ PROFESSIONAL ENGINEER RE= LOT I"MINOR SUBDIVISION PREPARED FOR &NO ~ND SURVEYOR N.Y.S. UCENSE NO. ~OHN SlMIClCH~JR. ~ CATHERINE SlMIClCH" HOWARD ~.YOUNG~ LAND SURVEYOR ~ ~ ~T~ ~ ~LiW],~IC TANKIS~I C[~(~) ~ ~[~ N.~ S, LICENSE NO,45893 SRANDIS & SONS INCo 1046 THOMAS HILLIKER ~ CHRISTINE HILLIKER NOV. ~5~1985 ~UFFOLK COUNTY DEPARTMENT Of HEALTH SEEVICE~ &T MATTITUCK DATE: AUG. 20,1985 FOR APPROVAL OF CONSTRUCTION ONLY ~N ~ SOUTHOLD SCALE= I"= I~' SUFFO~ COUNTY, NE~ ~RK NO. 85-774 N ~UTH~IZED A[?E~TI~ O~ ADDITION ~ ~IS GUARANTEED TO OATE~.~- ..... HS REF. NO, :~ SURVEY ~ A Vl~AtlOH ~ I[CTION 120~ ~ THE NEW YORK STAT[ [~CATI~ LAW THOMAS HILLIKER M CO, lES ~ mis ~vEY NOT ~A~We THE LAND CHRI~INE HILLIKER ...... NOT l[ CONIIDE~D TO K A VALID TnUE COPY CHICA~O TITLE INSU~O. N~ANAHTEES INDICTED HER[ON ~L HUN ~LY ~ HE~ DEPARTMENT-DATA ~ APPR~ TO C~STRUCT AND ~ HIS K~LF ~ THE TITLE C~Y, GOV~N- '" ,.,,,, - , YOUNG * YOUNG NOTE, E =MONUMENT '1 ~ - ~DEN W.Y~N6~ PROFESSIONAL EN61NEER RE, LOT I" MINOR SUBDIVISION PREPARED FOR~q~ ~0 ~NO SURVEYOR N,Y.S. UCENSE NO, 12845 dOHN SlMIClCN~JR. ~ CATHERINE SIMICICH' ~ ~ ~ HOWARO W. YOUNG~ LAND SURVEYOR ./ t SINGLE FAMILY ~ ~ '~" © ~U,~FOLK COUNTY DEPARTMENT OF HEALTH SERVICI-~. IcOR APPROVAL OF CONSTRUCTION ONLY gATE~_ HS REF. NO~ SURVEY FOR' THOMAS HILLIKER ~ CHRISTINE HILLIKER AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK #t.I~AU?HOJ~IZED ALTERATION OR ADDITION TO THtE VIOLATION OIr SECTION 7:'09 OF THE NOV. P..5 ~lg $5 DATE: AUG. 20,1985 SCALE= I" = I00~ NO. 85 -774 GUARANTEED 'FO: THOMAS HILLIKER CHRISTINE HILLIKER THE I~R~ON FOR WHOM THE SUI~/EY iS PREPAREO HEALTH DEPARTMENT'DATA FO~ APPROVA4. TO C~STRUCT ANO ~ HIS K~LF ~ THE TITLE CMMY. GOVM.- *~[. A~ ~ ~ELL,...ITfli* IOOFEET OF T..PROPER*Y INSTITUT,~. GU~ANTEES A*E ~T T. SFERA.~E _J YOUNG YOUNG I ~~OTE ~ J =~ONU~ENT II ~~l & ~ I HOWARD W. YOUNG, ~AND SURVEYOR J ~M~L~CTMI~ICI~I~iWN~[~ J~ N.Y,S. LICENSE N0.45893 ~? ~/BUILDINGI DEPT. INSPECTION [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ' RF. MAR#$: [ ] FINAL FIELD INS['ECTION FOUNDATION FOUNDATION ROUGH FRAME & ~LUMBING INSULATION ~ER N. STATE ENEROY CODE COMMENTS FINAL ADDITIONAL COMMENTS: ONLEAD CONTENT BEFORE FOR POURED CONCRETE . ' 2. ROUGH FRAMING & PLUMBING ' ~ 4. FINAL - CONSTRUCTION MUS~ . . . ~'~ ~ , THE REQUIREME~S OF THE N Y. , ,, CODES NOT RESPONSIBLE FOR . :~ ' DESIGN OR CONSTRUCTION ~[RRORS' ~ [ [- :', ' ........... : ', "~, ', ........ , '.,' ,, T' '" ' '' ~' '' , ,, ~ : ....., , ,, , . , .~ , · 1 //// /,,'/ ~F