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Home My WebLink About15012-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15688 Date April 24, 1987 THIS CERTIFIES that the building ...O.n.e...f.a.m.z.' .1 y..d.w..e.l.! i: .n.g.. ...................... Location of Property .890. .~.!k~.~..a.S ~.9.a? MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section . 1. ! .3 ........ Block ...6. ........... Lot .p./.o...1.4 .......... Subdivision ............................... Fi/ed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a.y..3.0. ~..1.9.8. 6. pursuant to which Building Permit No .... 1,5.0. [ ~ g ............ dated ...~.u.n.e...2 .~.,.. ! .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 family dwelling, with deck, and walled enclosure. The certificate is issued to JOEL KROIN ..................... [ d ~n'e'r, y~g~7~ ~;~,~g ..................... of the aforesaid building. Suffolk County Department of Health Approval 86-S0-I I Feb. 27,, 1987 UNDERWRITERS CERTIFICATE NO ............. N. 7. .9 9.0.3.9,. A?.~. :..2.3. :. j.9fi. 7. ........... PLUMBERS CERTIFICATION DATED: April 16, 1987 J Buildj~ Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER'AlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 15012 Z Date .... ~ ..................... 19.~.~ ) Permission is hereby granted to: ...l..~.......~......e.~.....~...: .............. .~.~.~.~...~.:?/.:....!.~2.~ .... ~ ...... o, premises located at ...~.,1~ ......... ~..~.....~.. .............................. ~..~ .~..... ...... County 7~? Map No. 1000 Section ....... 1.1...'-3. ........ B~ock ..... ~k .... Lot No ...... ./. ........ pursuant to c~pplication doted ....... ~.~...,..~.~.. .............. , 19.,~,.~., and approved by the Building Inspector, Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. / 5 Owner 7~'-O¢ L--.- /6~' ~--.'01 /k~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Swor~ to before me this Notary Public, ~{ ~-~oL~County GkADY$ CL~ARY NOTARY PUBLIC, Sic~,' :, :'oW York No. 4700601, !~ ' ,unl'y Term Expiles, ]ooo~18 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ e5 ,JOHN STREET, NEW YORK, NEW YORK 10035 ..,~ ~y ~'a. ~7 ~..,,.,.,~o.~..o.~.~ ~:~56u~ N 790030 THI~ CERTIFIE~ THAT ~u~ ~ ~ I~. 890" ' u~sexarnlnedon J[~ ]'~ [~ a~dfou~dtobe nco p ance~th~herequirement~ffthlsBo~rd. FIXTURE OUTLETS 38 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 29 22 DRYERS FURNACE MOTOES APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE DISCONNECT S E R V I C OTHER APPAE, ATUS: ,~otors, 1-1hp 2--G. F. C, I. 2-~r3ke Detectors Tr~'k IAghting 27' 0" Electric Water }~ttom: NO OF CC coNo. ^.w o [ NO OF .,-t~O I ^ W O ~ pER ~ ~0OF CC CONO OF HI-LEO NO OF NEUTRALS OF NEUTRAL P. O. Box 135 I" Sayvill~, N'.Y. 1178:2 LiC. 14~ ;~ GENAR~LI~ MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERF_D IN ANY MAN~3F' FIELD INSI~ECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL ~OMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [] FINAL ,,,,,,,,,,~s: ~~ COUTO & SONS CONSTRUCTION, INC. 16 CEDAR OAKS AVENUE FARMINGVILLE, N.Y. 11738 (516) 736-4428 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ '~INAL REMARKS: ~,'~/ ~ DATE ~ ~/~/~//~/~ INSPECTOR '~//~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. ~ll ~ ~ ~ [] FOUNDATION ZND [ ]~/SULATION '~/~~ REMARKS: . ,~ , DATE ~//~ INSPECTOR // 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ ] FRAMING REMARKS: [ ] ROUGH PLBG. ] INSULATION ] FINAL DATE INSPECTOR 765-X802 BUILDING DEPT. INSPECTION ~F~DATION 15T [ ] ROUGH PLBG. [~'*~' FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [] FRAMING~ ~ FINAL DATE BUILDING DEPT, INSPECTION [ ~FOUNDATION lST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: O,, FINAL INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .~..~..~.,,3 .... 19~ Approved . ..~ j,t~,~.q_..~.a.., 19~...~. Permit No../.~.. ,-~../.~...~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS J TOWN OF ~)~J'r~lotD Received ........... ,19... r>ate .... 4~. ;)(? ....... 19... a. This application must be completely filled in by Wpewriter 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 ~t 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 inspections. .... G.q .q'.r.0. .%?. d?. (Signature of applicant, or name, if a cor,,poration) 5 o ...... /. ...... ..... (raaii[ng ~d~ress ;~'~pplic}nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................................. Name of owner of premises .,, .~..C'! ,~..L-:.` .K.g.C?./..~. ................................................. (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, ~.~. 9..~....~. ..... ~...~.... ~Lj}~OL~ ~ Electrician's License No...! .~.'.3..~... il.--... ~ ~. Other Trade s License No ...................... 1. Location of land on which proposed work will be done .................................................. House Nmnber Street Hamlet County Tax Map No. 1000 Section ..J.'.~. .......... Block ('~ Lot ?/~ !~ Subdivision.., ............... /. / O,~ D'°'.Z..i~.~.~ ....... Filed Map No ............... ~- Lot ...... V77 ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~ O..~. ~ .......................................................... b. Intended use and occupancy ...'~.b.f~,. -..gC.~c.->.i.b..c~.&J..c-...e-;~. .............. 3. Nature of work (check which applicable): New Building .......... Addition i Alteration Repair Removal Demolition ' Other Work ~ /.0. O...C)~.. ~o (Des6ription) 4, Estimated Cost .... f. . · / ................... Fee .......... , ............................ (to be !prod on filing this application) f ii 5. If dwelling, number of dwelling units ............. Number of dwelling un s on each floor ................ If garage, number of cars ............................................ ' ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... pth 7. Dimensions of existing structures, if any: Front...... · ."----. Rear ... "'--. De .. ......... .. Height .--Tx.-. .... Number of Stories i .... ' ............. Dimensions of same structure with alterations or additions: Front ...... ~ i. .... Rear .... . .~7-~,...~. ........ Depth ....... ..---7.1 ........... Height ..... ...~.~.~ ........... NumbercffStories. .. ~'. ; ............. 8. Dimensions of entire new construction: Front .... ??,'. .... .... Rear ....~'~..,zl ...... .............. Height .............. ,. Nt;~ber of Stories ............... ~ '~c~.'. ......... i ............................ 9. Size oflot: Front ..19-~..,.~. ............ Rear...c~./~.'7~ ............ lDepth ..~7.~:.~.. ......... 10. Date of Purchase .............. Name of Former Owner ~ ...... 1 1. Zone or use district in which premises are situated. . 12. Does proposed construction violate any zoning law, ordinance or regulation' . i ..... 13. Will lot be regraded ....... .~t..t.~ .,~ ............... Will excess fill be r~mov6d from premises: ~ No 14. Name of Owner of premises . j~/~0, t..,?I. ~..3'9.69 ...... Address ~.45..~..~..~.'~...~t7.I .~..(¢ Phon~No.~l¢.-.c]~.~ 7. Name of Architect ~.'tr.~..o.itffl~//. .17'~.,t~.~. ..... Address $.J.~.,~tYqq~. ¢'.l~.~ql, q't~#~o~n~l~ ~. ~ . . ~. ~.~ .-. Name of Contractor .C,q .03~..-r.~..'?..~OP..5~... ~.M.E.... Address ./{,.Cq.D~. 03qs.; .~q-. ~oh~C~o.U~. 5../(~.q7. 15. Is this property located withinl.00 feet of a tidal wetland? *iYes ..... No ..... · If yes, Southold Town Trustees Permit may be required. . 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 sh6w street names and indicate whether interior or corner lot. STATE OF NFj~..YOiLKv~ .. ,, CO ......... (N~me of itn21igid~aat'signing contract) above named. sworn, deposes and says that he is the applicant He is the ............................................................ i ............................. (Contractor, agent, corporate officer, etd.) of said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file this application; that all statements contained in this application are true to the best of tlis 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 ............... ~..O ....... day of .... )"/'/Oe.d ........... , 1 9a~. Notary Public,.'... ~-~.¢t~...~....h .~....~..~. · County ...... i... ~ (Signature of appliqant) _..~1~~- : FP~L~FOLK COL HEA~TH DEPT. -'....... ~ ~ ~'~ ~. ~. 4 THE WATER ~LY A~ ~WAGE DI~AL CONFORM TO THE STANDARDS 'OF THE OF 0 oz>c ~ ~ ~ ~ , ~/ ..>~ .~_ -~ , , ~' m~ /~ t~, r~ ~ : :~ ''~ / /~ ~ . ~ ~ Z.:~ ~ t . ,,, , ' ~, , · ' ' ,!,,,~:-- , ' ' m' ~; ~'~ ) ~r~.:",~ '~ ~ ' ' '~ ~ , ~', ~' ,~ ' ~5'~''~'~'''' '~?'"'~"~' , ~,, m '.., --. .... ~: -~,. , , '-; '--- FH~ """~ ' ' "' ........... ~.. ., - ..... .~~ ' ¢%¢'~(D~ ~'¢~-¢~:> ~ ~ ~r:~,, , :."L.*¢" 'GREE~RT N~ YORK ~ :,- ........ ~--. ~~*.::f,:~Z:.. ;~ :-,... ,,: .~ ;,~ ... ..................... ~,, SUFFOLK CO. HEALTH DEPT. APPROgAL H.S. C~ORM TO THE STANDARDS ~ THE , , -,, ,, S~FO~. COUNTY O~. ~ . HEALT~ SERVICES FOR A~PROVAL OF ~FFO~ CO..TAX M~ '~ , ' -, .... ' ,, ~.~: .' .... .......... ' '~ .... "' 24 ' , / o/: ,, / '~' / SUF~i~OLK CO. HEALTH DEPt. APPROVAL H.S. NO. ., STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS /~ESIDENCE WILL CONFORM TO //~//~T/~/~DARDS OF THE SUFFOLK CO.~ HEALTH SERVICES. SUFFOLK COUNTY DEPT, OF HEALTH SERVIEES FOR -- APPRO~L OF CONSTRUCTION ONLY DATE: APPROVED: ~ suFFoLK CO. TAX MAP DE~ : - mST. ~CT. ~L~K PCL. Z4~ W'. ~4TM -ST,. LICENSED LAND SURVEYORs GREENPORT NEW YORK ,+ 125./E~ OF v./A~ % ,%%., ~,, / - 1~72 az7, 04 ~L jA,~4~q (VAC^ -r) LImNeD LAND SURVEYORS GREEN~RT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL h. S, NO. STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISR~SAL 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. NO.. APPROVED: SUFFOLK CO, TAX MAP DESIGNATION: DIST. SECT. BLOCK PEL. OWNERS ADDRESS: DEED: L.-7~ 76 p, ~.~ ,':-~, ,a,c:,:,zc-.' ' TEST HOLE STAMP SEAL FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions row 'o 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 features. 2. Final approval of Health Dept. of water supply and sewerage dlsposai-(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: 1. Certificate of occupancy New Dwelling. $25.Q0, Accessory I$ ]0.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $].0.00 4.Vacant Land C.O. $ 20.00 .¥ ./~. 5.Updated C.O. $ 50.00 Date ..... ~. 7..~.~. ........ NewCons tz~uction ...... Old or Pre-existing Building ............. Vacant Land Location of Property .~.~..~. /v'//~./__.~--~_~ /~,~) . .,~...2~..~..?../_/.~..~. House No. ~ Street Hamlet Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .............. Block ............. Lot ........ Subdivision ................................. Filed Map No, .,7 ........ Lot No .............. Permit No ........... Date of Permit .Applicant OTO' HealthDept, Approval ......., .. .,..........LaborDept. Approval ....................... . :. ..... ...................... Bequest for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. ~' DO Construction on above described building and permit meets all applicable codes and regulations. Applicant Rev. 10-10-78 - OCCUPANCY OR : IS UNLAWFUL 7_ .. USE ..... WIll-lOUT CERTIFICATE - OCCUPANCY '- SOLDER USED IN WATER, ._ SUPPLY SYSTEM CANNOT - : ,,..: ~ EXCEED 2/10 of I% LEAD. ?:~_~ -- ~ ,~,.., , .~ ~ . ,, ' ; ~ PLUM~R ~ON ' ~ ON ~ ~ ;EFORE =: CERTIFI~TE OF OCCUPANCY [ ,, , , ', ~ A~OVEB ~ ~ , , ~_ N~ BUILDING D~A~M~T AT ~ L~'',1 l..[, .: .~ .~ , .ou~....-.~. = , , ~ ~. FINAL CONSTRUCTION MUST : ' ~ COM~ FOR C.O. , ' ALt CONSTRUCTION SH~ ME~ ,. L " ", "~ ' ' "' ' ' THE REQUIREMENTS OF ~E N.Y - C~ NOT ~NS~E ~R III