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HomeMy WebLinkAbout14726-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate O[ Occupancy No.Z15755 Date ...... ~gY..1.~ , 1987 THIS CERTIFIES that the building ..... p 9.r.m.e.r.. ?.d.d..~ .t.i.qn. ......................... Location of Property ...9 .7.0..V..x.~.~Aq~...~A~.~.. MATTZZUCK House No. ' ....... 'S'de3i ....................... h; iol County Tax Map No. 1000 Section ... I .1.6 ...... Block ...0..6 .......... Lot . .0. ! .5 ............ Subdivision VILLAGE MANOR .Filed Map No. 3669 .Lot No. 18 conforms substantially to the Application for Building Permit heretofore filed in this office dated M a r. 28, 1986 pursuant to which Building Permit No. 14726 Z dated May 2, I986 wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy ~r which this certificate is issued is ......... Dormer for bathroom & finish 2nd floor ~ story. The certificate is issued to HENRY & JOANNE KUHN ..................... ?o¥,~), '~¥;q~X X X .................. of the aforesaid building. Suffolk County Department of Health Approval ...... .N./.A. ................................ UNDERWRITERS CERTIFICATE NO. ~ 8 0 6 9 3 0 PLUMBERS CERTIFICATION DATED: 5/ 13/86 Building Inspector Rev. 1/81 FOEM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEP,~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTFIORIZED) 14726 Z Building Inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR Town Halt Receipt NO. 5 ] 99 ] Southold, NewYork 11971 ..... .................... ~ec~ ............................. ~~......~ ....... ~......~ ................................... ~ ................ , ~ ~,,~rs ~....~..~ ding, ............. .......... ~.. :...~..~..4;.~.~...~ ...... Fee for Fee for r_.yC-,~tificate [] H,t.C. []Building Permit ~J of Occupancy [] Misc. ting" 'al or Building Inspector Fee for ~ Yard Sa,e [] [] ....... ,,4.~..~.6. ................... )rrna- C. Fees: 1. Certiflcate of occupancy $25.00 -- ~.UBINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.woant ~.~ ~.o. ~o.oo ~/ 5.Updated C.O. $ 50.00 Date .......... New C on s t ~ u c ~ i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property. ~<~.. House No, , Street Hamle~ Owner or Owners of Property . C...... ,D .... ~.~.~ ..... ~ .................. County Tax Map No. 1000 Section ......... Block ............ Lot ......... Subdivision.. ,,;'2 ............................ Filed Map No ......... Lot No PermitNo./~..?Z~ .~Date of Permit//~/'J//.-%./'.?.~...Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .................... .~.~o.o.... . Construction on above described building~-m~ per,~m~ it meets all ap~i.~'able go,les and regulations. Rev. 10-10-78 ' THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001381 BUREAU OF ELECTRICITY ..re ~.y l. i987 .,,.,.,ic,..,,.N,,...f.~ 4o497e/a¢ N 806930 THIS CERTIFIES THAT Henry B. Joanne E. Kuhn, 970 ~illage La~e~ Mattit~ck~ in the/ollowing location; ~ Basemen~ ~ Ist Fl. ~ 2nd ~7. Section Bilk Lot ~s examined on A~ ~ 23, 1987 andfound to be in compliance with the requirements ~f this Board. FIXTURE SWITCHES FIXTURES OUTLETS 5 ~2 9 5 RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TtMECLOCKS tAUl. lt -OUTLET SYSTEMS NO. OF FEET SERVIC~ DISCONNECT S E R V I C E , 1--G. F.G.I~ 1-S~a~ke Detector Jo4y Pumillo ~x~ Per GENER Thi~ ¢ertHicote m~t not be offered in any manner; return to the office of the Boord if incorrect. Inspectors may be ~dent,fled by tfle~r ¢redenhals COPY FOR 8L~ILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUS~,NOT BE ALTERED IN ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date ,~/~_¥/~7~___.. Building Permit No._/~72~_~ (p~ease print) _(please p'~f~t ) ~/ ~ I certify that the solder used in the water contains less than 2/10 of 1% lead. supply system Sworn to before me this (pl~u~ber' s signature) BARBARA STEPNOWSKI Notary Public, State of New York No, 4844752 Ooalified in Suffolk County ~.. (~m~l$ion Expires March 30, ~l~ 19 P(,,.~. -- Notary Public Public ,~~--,, County Notary FIE6D INSPECTION DATE COMMENTS FOUNDATION ( 1 st) FOUNDATION (2nd) PLUMBING ADDITIONAL COMMENTS: ]~ ~-~4JFFOL~ COUIlTY CLEE~'~ OFFICE AS JAAP N~ 3669 $CALE.40 ,I'' {) ":12ON PIPE GUAIZAI4TI;E0. TO TIlE $OIJTNOLO S/~Vt AND TO TIlE U.S. LIFt, TITLE IktSU£JiI~I~='C~/RPAH¥ OF I4&W ¥OI2K. SUEVE. YED, ;t~L¥ EODEEtCE VAN TUYL,RC. 765-1802 BUILDING 'DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH 'PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~_~MING [ ] FINAL DATE INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspecror) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS eiv~ BLDG. DEPT. 1 TOWN OF S0OTHOLD ,._~9 .. 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, hgJ~ing code, and regulations, and to admit authorized inspectors on premises and in building for neces~. ~. ~ '~'(~'~~p'li~a'n~ or name, i' ' ' ' ' ' "' ' 'f a 'c;;~;;a'ti~) .... ........ (Il'ailing add sf pp ' ) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .......... n ........................................................................ Name of owner of premises. ~..~.~. ?. ~... 8,.. ~.(,,t, ['~.l~...(as on the tax ~''roll .~..t~.(~Q~.(~..~.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 License No ...................... Location of land on which proposed work will be done ................... ..., ............................. ..... q. . .................. .......... . : House Number Street Hamlet County Tax Map No. , 000 Section ...... .//..a.~.. ...... Block....4,. ............. Lot.../.--5.'7 ............ 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 ........... f"~ r3nk [ .~..~..~....C~. ~ . [ .k]....~...hQ .~.//.[.N..~r-- --t-~ ~[~ ........................ b Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration .~. pal . Re r .............. Removal .............. Demolition ........... ,... Other Work ............... 4. Estimated Cost ........................ Fee .. . ..................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..................... 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 . . Depth Height ............... Number of Stories ............. Dimensions of same structure with alterations or additions: Front ' Rear Depth ...................... Height ...................... Number of iStories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ ....... Depth ............... Height ............... Number of Stories ......................................................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase .............................. Name of Former Owner .~ ............... ............. 11. Zone or use district in whic remis~s a e sitffated ....................... i 12. Does proposed construction violate any zoning law, ordinance 9r regulation .... i ............. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14 Name of Owner of premises Address ' Phone No Name of Architect Address Phone No ' Name of Contractor Address Phone No * yes ..... No ..... 15. Is this property located within 300 feet of a tidal wetland? * If yes, Southold Town Trustees Permit maybe 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 shin, street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that (Name of individual signing contract) above named. he is the applicant He is the .............................................................. . .......................... (Contractor, agent, corporate officer, etc.) i of said owndr or owners, and is duly author/zed 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 . J~o~ waterldistributing ' : , ~i em~ piping shal be "PLUMBER CERTIFICATION ON LE~ CONTENT BEFORE, CERTIFICATE OF OCCUP~CY SUPPLY SYSTEM CANN J[ PLA, QF -A~ : JC NE','/ / ~OTIFY~BU[LD[NG DEPARTME~'~ AT '?~5:1802 9 A~ TO 4 PM, (=OB THE FOLLOWING INSPECTIONS' 1. F©U~IDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3, INSULATION 4, FINAL CON'STRUCTION MUST BE COMPLETE FOR C O, ALL CONSTRUCTION SF~ALL MEET THE REQUIREMENTS OF tTHE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CQNSTRUCTION ERRORS. ON . ~,~t ,' ,,.,., ,,. .. , , . , , , ,[, ~, ~m ." /, , "' ' , " ' :' '~ ""~"~ ~ ~ ~ - f ' j ' CERTJFICATE OF OCCUPANCY " ' ' , , ~ .............. ~ ~ ~, ~ ........... , ...... , ~xC~EDZMOofl~LEAD. :. .......... .. ................. ., . ...... . _. '., .J - . , , L, L ' "':: , , , - :- , ~ :~ I, , t ~. .~ ., ~ % ~ , -, ,~ ~ NOTT~ BUILD ' L =: JI ' ' ' '1 : LI ? ' ~ ' ~ ~ ; ~ ~ .... " f'~ FOLLOWING NSPECTIONS: _ :' ' ' ,~ . , ' ' -~' , '" ' ' r~ ,ii,:': ?' ' '*' ' ~ ~ ~ .~ ~ -~~' ~ R ' ~. F~HMDATION - TWO REQUIRED ; ~ ' "fi,*"' ~ , " ' ' ' ' ' ~' - ,"1 "' ' / ~ ] r ] 4~/~ ~ ~xl',T, v/~kl~W~'~ ~ ' ~OR--V'~OURED CONCRETE " ' ' ' ' ' ' '" ' " -" " ' ' ' " I: 'i ~ ~ ~I6T, [ ~ .... ~ ~" : ~~ ii ' 2, ~UGH'- F~MING & pLUMBING ,. , , . , ' ' , : ;~ ~ ~: ~ I ~T~ ~ ~,-~7' ~ ~ ; - ~ ' 7' , I , ~' NSULATON ' ' ' ' '~ ~ ~ ' ' ' ' ' "], ' ' ' [ ~' W~gf~}~~ N'~, t, ~ ~ ' , ~' ~INAL - CON'S~RUCTION MUST i.,, . , -, . - , :, , , I ~ ~5~- ~u--~ ............ ~-~- -., 4~ :.~{~, V.rAL~ -~ r THE REOUREMENTS OF THE N.Y, ' ' ' , , ', ' - - - : · ~ '1 ' ir' ~ ~ ' J~I~ iii : ~ ~l ~ ~ATE ~ONSTRUCTION & ENERGY ~ mi CODES NOT ..:. ~ .:.:.- . : . .'-' ... - .. . ,..: . . . _ .... ~: ~,', ~-:.:~ . ~ , , . ' :~ ': ': , . , ', , ~a~~/~x-~'~/~-' -- _ .. ~"~; ~ ~ ~ ~ / ~ ~ ~5o[ ~ / o~' / / ~, -' ' . ,.~,~ X / ~, I I~, - ' ' ' ' i~ :l ,, , ,