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HomeMy WebLinkAbout15004-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z- 17006 Date June 20, 1988 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1025 Tuthill Rd. & 1250 Yennecott Dr. Southold, N.Y. h3[do Wd ........................................................ Street Hamlet County Tax Map No. 1000 Section 055 ...Block 04 .Lot 26 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 10, 1986 15004 Z ..................... pursuant to which Building Pemfit No ...................... dated .... .J.u.n.e..29~,..I .9.8.6 ........... was issued, and conforms to aH of the requirements of the applicable provisions of the law. The occupancy for wtfich this certificate is issued is ......... ONE FAMILY ~WELLING WITH ATTACHED WOOD DECKS & GARAGE AS APPLIED FOR ' The certificate is issued to ROBERT & ROSE BROIiN ..................... bY.b/, ..................... of the aforesaid building. Suffolk County Department of Health Approva[ ...8.6.-.S.0.-.2.7..-.g.u.n.e.. 1.7.,..1.9.8.8. ................ UNDERWRITERS CERTIFICATE NO.. 71.0.1.5.8.5.7..-..J.u.n.e. 10, 1988 PLUMBERS CERTIFICATION DATED: May 13, 1988 - Henry J. Smith & Son, Inc. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING D£PART/v~ENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~5004 Z Date. ! Permission is hereby grante~cLto: ..... ......................... premises Iocoted .t .] ........... .~,.~ ......................... ~ ........................................... County Tax Map No, 1000 Section ....... .(~...~.~....'~..... Block ..... ..O...~. .......... Lot No ...... ..~.....(t?.. ......... Building Inspector. Fee $....~...L~...~...,........~ end approved by the 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 OCCUPANCY Instructions 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 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 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 p~operty 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupa,cy New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.0 0 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 .~$}~.1.~.3 ................ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. ....... ............ , Location of Property ..... d, ~.1¥ t, (5. ti [~. ............ House No, Street Ham/et ! Owner or Owners of Property ............... ,...~. . .... County Tax Map No. 1000 Section '~'~ ~' Block .~. Lot Subdivision .V~ .t~.0.~.- .~'~.¥[i..(.)(~.~ 17. ............ Filed Map No. Permit No, . ) .~ ~ Date of Permit .Applicant . Health Dept. Approval .',t~.% ......... App ........... Labor Dept. royal ........................ Underwriters Approval . .¥~.-. .................. P~anning Board Approval . . .,~ ................. / Request for Temporary Certificate ..................... Final Certificate .. I~ ............... Fee Submitted $ ............................. Construction on above ~!~)/ /' /~I~ ~.~.~~ described building and permit rgeets all applicable c~des and ~.egulations. Applicant .:.?~>'.~ ~ .~;~-; .~.. ~'.. ,~ ............ / Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 000010 BUREAU OF ELECTRICITY ~-- 85 JOHN STREET. NEW YORK. NEW YORK 10038 ~i~N~: J0~198~ 507~8~87/87 l~ 01%85'I ~te ~ppl~a~ion No. on ~ile ~ exami~ on andf~nd to be in ~mpllance with the ~quirement~ of this ~rd. RXTUEE FIXTURES RAG OVENS DISH WASHERS 7,'1 44 70 SERI/K~ D~CONNECT S E R V I C E MOTORS: 1-1. DETECTOR OF CC. COND. 1 2/0 ROBF~'T ii. MAI,CB BAYPORT~ NY~ 1t'105 This certlficoto must not be ahered in any monner; return to the office of the Board if .{I P~r may be identified by ~heir credentials. HENRY J. SMITH & SON, PLUMBING, HEATING & FUEL OIL MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765--3690 lrlc, CERTIFICATION Building Permit No._~Z_ ....... Owner Robert and Rose Brown Plumber Henrx. J. Smith & So%~_~S~ I certify that the solder used in the water supply system contains less than 2/10 of lZ lead. .... ~ ~: §~' - Sworn to before me this _!~h_day of __~ ..... , Notary Public, Suffolk County ~'IELD INS£~ECTION FOUNDATION (1st) COMi4ENTS FOUNDATION ROUGH FRAME PLU~- INSULATION PER N. STATE ENERGY CODE ? FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION 2ND [ ~SULATION [] FRAMING [,'"] FINAL 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST r ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [//]~'INAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ .] FOUNDATION 2ND [~]/~NSULATION FRAMING FINAL REMARKS: / DATE /0//~/~ 7 INSPEcToR~//~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 15T ~ROUGH PLBG. FOUNDATION FRAMING REMARKS: 2ND [ ] INSULATION [ ] FINAL DATE INSPECTOR ~'~ ~ INSPECTION [ ]FOUNDATION 1ST F] ROUGH PLBG. - / [ j/F~UNDATION 2ND []INSULATION ~/] FRAMING []FINAL REMARKS: DATE INSPECTOR ~-~ ~ 765-1802 BUILDING DEPT. - INSPECTION FOUNDATION 1ST ILl'ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined..~. ~ .~fi~....~..O.., 19 .~..~ Approved.. ~..'~..~.., 19~. Permit No./.~..~... ~..~ Disapproved a/c ..................................... ................................ .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. , Date ..... ~ .............. 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 necessarT, inspections. .~. ~. · .~..u~.....j7~o...,..~.~.. ~..~.. ................. ,~ ~7 (Signature of applicant, or name, if a corporation) ,~ o.,~ u,..~-~..7...!!....~.~. ?.o..,,.~..p....?.q, ............. : ..... ~o~.~.. ~.~:.~,.. II 7(,~, .... ...... i~Llin~ add~:~ss '; ~ ' ~l;t;1 leant ~ ....... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder· .... ©...~:~... .... .,....~...c_(~. ..................................................................... Name of owner of premises . .~.o.%. ?.~..-r...+...~?..5.E.....~...% .0. ~ .~. ........................................ (as on the tax roi1 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..2 ........................ , - Other Trade's License No~ ..................... / ~) ,~,,~'- /,~ ~-~ 1. Location of land on which proposed work will be done.. ??. '.T../~ .I. ¢.~.. ~ p.,...~ ~.~. ~.~.q~. ~.. ..... House Number Street Hamlet County Tax Map No. 1000 Section .O~.~ ........ Block.. ~.~ (~ ~.. ~'. .... Lo;'[ .~¢.'~...' Subdivision ~ o~.~6~egq~...?~... Filed Map No. ~-18.7. .. Lot J 7 .......... ~ .... (~'a~e) .................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~.g~.?~ .... &P.¢ ......................... ~ ................... b. thtcn~d usc and occupancy ................ F ....... ~ ~=" ' ' ' ................... 3. Na~ur~ (~fwork ieheck wh'i~l~ aPphcable): New Building ~ ....... Addition .......... Alteration .......... ' Repair . Ill~ .~. ,~,.. · ~emoval .............. Demolition .............. Other Work ............... ~:i' /"' (DeTcripti°n · ' ~ Oe~~ 4. 4st m t .... ............................. Eec .................................... . ~--,.-.~.~k~~ ' ~ ' ~-~ ! (to be paid on filing this application) 5. If dwelling, number of dwellin$ units .... /. .......... Number of dwelling units on each floor ................ If garage, number of cars .... ' .................................................................... 6. If bus~ness, commercml or m~xed occupancy, specify nature and extent of each type of use .. ~ .............. 7. Dimensions of existing structures, if any: Front...N.D.~.~ ...... Rear .............. Depth ............... Height ............... Nu~nber of Stories ........................................................ ...... Rear Dzmens~ons of same structure w~th alterataons or addmons Front ................................... Depth ................... !... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .. ~ffT.~. ......... Rear . .~..6. ......... Depth . ~ ~.. .......... Height ...,;~...~........... Number of Stories..· .c~ .................................................... 9. Size of lot: Front ... & (/'. l~. ~..~ ..........Rear ..... ~..q.7. ~ '.7. 3 ........ Depth ~.. ~ '7.c/m7 .f'..~../.~?.:.~f. 10. Date of Purchase ...6./..~.~./.~.~'. ................. Name of Former Owner .~. ~.~ .~.~..~. 11. Zone or use district in which premises are situated ................................................... :. 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~. O. ....................... '. 13. Will lot be regraded . .~..Q..., .................... Will excess fill be removed from premise~ Yes . ~(~I~ 14. Name of Owner of premises ~.o.~. e.~.~..%~.o.~.~..' .~.~.o..~.~Address/I Ht~ .,P.e?.~e~.P.c. .~.~0rv~one Name of Architect ......... ": ................. Address ................... Phone No ................ Name of Contractor .. ~'. £.~..ff. ................. Address ............. . .....Phone No ................ 15. Is th±s property located w±th:!_nl;00 £eet of a t±dal wetland? * Yes ..... · ~ yes, $outhold ~own T~;ustee$ ?erra±t may be requ±red. : PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloe~c 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 ................ i · ~ ....... ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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 ~ ............. /r~.. ........ day of ............... 19 ~..~ Notary Public, . ..... ~..~.. ~../.~..&~. ..... County ~Ot~/~ ~ ' ' (Signature of applicant) DENCE WILL ~M TO THE H. ~. REP. ~: ~ OF H~LTH. SERVI~~ IlI CO SEMEN T The ~ewa~e dispa~l ~t~d w~Br ~ ~ ~ JUN 15 1988 N/F MOFFAT - 5 = $.C. BEPT. OF HEALTH SERVtCES , .t 1aT 47 ON MAP OF YENNECOTT PARK FILE N-° BIBYi FILED: OCT 9, 19GB SITUATED AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK CO., N. Y. NASSAU SUFFO[K BLUEPRINTING CERTIFIED TO: SOUTHOLO SAVINGS BANK PECONIC ABSTRACT CORPORATION FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK FOR: ROBEt~T B ROSE BROWN land surveying co. 1719 north ocean avenue .suite c 'medford,new york 11763 (516) 758-5952 Apr. 24, 1987 Job N2 87-1714 1000-055-04-26 Scale: I% 50' JDS 128993 ~'~ 4926~ '-.,.,LAND EA SEMEN T J NIT MOFFAT LOT 47' ON MAP OF YENNECO T T PAt?K FILE N£ 51871 FILED: OCT, SITUA TED AT SOUTHOLD TOWN OF SOUTHOID SUFFOLK CO., N. Y CEBTIFIED TO: SOUTHOLD SAVINGS BANI( PECONIC ABSTRACT COHPOt?ATION FIRST AMEHICAN..TITLE INSURANCE FOR: land surveying co. 1719 north ocean avenue suite c medford, new york 1176:5 (516) 758-5952 Apr. 24, 1987 1000-055-04-26 Job N~' 87-1714 $cole: I"= 50' SUPPLY sYSTEM CANNOT EXCEED 2/I0 of 1% LEAD. OCCUPANCY OR ,pLUM BER~CERTIFICA TION ON LEAD CONTENT BEFORE , ', cERT~IFICATE OFOCCUPAIVcY MUST OCCUPANCY If.eDger tubing i~ used - . ~.. FINAL fbi, wate~ distributingr~ system; piping ~hai! ~be -Road iI' 4??-o4OO Main Road q.Y~ 119:4'4 Zq Lo" . -GREENPORT, N Y. 11944 DETAIL A, '-C -.,< If copper tubing is used ~or water distributing ~¥s~em; piping shall be nf types K or L onJy ON LEAD CONTENT BEFOR~ ~gRT: ,'[~ '4 TI~ 0t,' OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNO~ EXCEED 2/10 of 1% LEAD- FEE. _&qj LC_.B¥: , NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR TH] FOLLOWING IN?ECT t. FOUNmATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - C~FCSZRUCTIGN MUST BE CGMPLFTE FOR C O. ALL CONSTRUCTION SNALL MEET THE REOUIRrMENTS OF THE N Y STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS · iI OCCUPANCY OR ii Phone 47 ;.0,t00 Main Road CREENPORF. N Y. 11944 j j ' aL CW -T ,,,,sE CON B ,},::,.:, ..?! N ~,A,T I Ohq IHt