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Home My WebLink About14763-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15532 December 23, ' 8.6 No .................. Date ............................... 19 .. Addition to existing one family dw.elling THIS CERTIFIES that the building ................................................. Location of Property . 3.95. .S~bast.i.an'.s. CoVe Road Mattituck, New York House No, I 0 0 O~C~reet I I . 2 Hamle~ County Tax Map No. lO00 Section ............ Block ............... Lot ................. Subdivision .... .M/.o.. S..e .b.a.s,t;. $ .a.~..C..o y.e ...... Filed Map No .... .2 .2.6..Lot No....2 .......... conforms substantially to the Application for Building Permit heretofore fred in tls office dated ~p£il J0 19 ~ursuanttow~chB~ldingPermitNo 14763Z dated .... AR [ )).. ! ~ ~ ............. 19..{ ~ was issued, and con~rms to aH of the requirements of the applicable provisions of the law. The occupancy mr w~ch tls certificate is issued iS ......... Addition to existing one family dwelling. * The certificate is issued to ..... PETER STOUTENBURG Of the aforesaid building. Suffolk County Department of Health Approval .......................................... N781719 UNDERWRITERS CERTIFICATE NO .............................................. .. .. (:~NOTE: Garage voided from permit) -'~"'Y'~l~'uilding Inspector Rev. 1/81 I~ORM NO. ~ 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) 1~? 14763 Z Permission is hereb/granted to: ......... ~.~.~ ........ ~..:.%......!.!..~..~.. ............. County Tax Map No. 1000 Section ..... ./...':~ ...... Block .... ..~..,,~ ....... Lot No ..... )..[:..~ ...... pursuant to application dated ........ ~,~......,~...O. .............. , 19...~..(~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 NOV 2 I IgS APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink. and submitted in duplicate 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-g 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. SIJbmit Planning Board approval of completed site plan requirements where applicab!e. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre~existing dwelling or land use 3. Copy of certificate of occupancy $1.00 Date November 19, 1986 New Building ............. Old or Pre-existing Building ..... ~ ...... Vacant Land ............. Location of Property ~?~..~e..b.a.s.t..i,a.~..C..o.v.e..R. 9.a.d' ............... .M.a..t .t.i.t.u. 9.~ ............. House No. Street Ham/et Owner or Owners of Property .P.e.t.e..z,..S.t.o..u.t.e,n..b.u.r.gh. ...................................... Co~ntyTex Map No. 1000Section., .l.0.0. ......... Block0.~. ............. Lot Subdivision .S.e..bp~s.t..t.a.~..C..o.v.e. ............... Filed Map No. 2.2..~ ....... Lot No .... .~. ........ Permit N0.1476,3~, · ·. Date of Permit .~/16~.8~.ApplicantE o¥I~.o O~Jg.~t. ~ 1; ,. TOe,..FOr, ~.e Ce r S toute nburgh N/,A. Lab D Appr al ~/i Health Dept. Approval ....................... or ept. ov ........................ Underwriters Approval ...................... ; .Planning Board Approval. .............E/A ........ Requesz for Temporary Certificate ..................... Final Certificate ... ~, .................. Submitted $ ~.'.0..0;~. ....................... C onstrtJction on ab ove described building a~./l~.~e c odes and regulations. Applica~..~~. ~..~..~P~e s. ~ rz~ir o nme la.1~-78 .E. ,a.s.t.,. I~c. ? THE NEW YORK BOARD OF FIRE UNDERWRITERS ~LOO~Lf09'~ BUREAU OF ELECTRICITY ~'~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,~ ~ m. ~ ~,,"~"~.~"~"~ ~/~ N 781719 FIXTURE SWITCHES 2 ~ DRYERS MULTI-OUTLET SYSTEMS NO. OF FEET APPARATUS~ E R V I C E AWG OF CC. COND NO, OF HI-LEG OF NEUTRAL Per 'his certificate must not-be altered in any manner~ return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIPICATE MUS~ NOT BE ALTERED N ANY MANNER. FIELD INSi~ECTION COMMENTS FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL C NTS: 765-18~2 BUILDING DEl)T, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL 7GS-'~80Z BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /£ [ ] FINAL ~, /._. REMARKS: ~ ].~0 ,, , ,' .... DATE ~1/~/~ INSPECTOR' ~(~~ 76~-X80~ BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~]~NSULATION [ ] FRAMING FINAL 765-180~ BUILDING DEFT, IHSPE 'I'IOH []FOUNDATION 1ST []ROUGH PLBG. []FOUNDATION 2ND []INSULATION []FRAMING []FINAL REMARKS-' .,~~~ .~J DATE //~--~// 'NSPECTO 76S-1802 SPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: Environment East, Inc. R. R. No. 3 - 3075 Indian Neck Lane Peconic, New York 11958 516-734-7474 Attached Underwrite~'s C. ertificate pertains to Permit # 1~763'Z, issued 4/21/86 to Environment East, Innc. for Peter R. Stoutenburgh. F FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1803 ~ ' ..).~ ..... 19~.~. Examined. (~ Approved ..... ).~.., 19~..~. Permit No. ! .q.~.~.~..~. · · Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT town Or 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 regulation_s, and to admit authorized inspectors on premises and in building for necessary inspections. . ..... (Signature of applicant, or name, if a corporation) / .... (Mailing address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ~.~' ./~..~....~. · .~.f~.~. ~..~..W'.~.~. .......................................... (as on t/he tax roll or latest deed) ~~~n, signa tu re of duly authorized officer. Builder's License No. t~,.[% .~..$.ff.~. ....g...C: .~..l,4-... Plumber s License No ......................... Electrician's License No. Other Trade's License No ...................... ;~ ~ / 1. Location of land on which proposed work will be done~ .~.ff.~.~?.x. .~/..c?.,q..~..~.o?.~...~?.,?.. %. ...... ............................................................................... ltouse Number Street Hamlet County Tax Map No. 1000 Section . .../.O. ~ ........... Block . . . .~. ............. Lot .... .//{ ~.." .. Subdivision .~..~'.~.. t3~O.~.U .30,)...(',(.~.0..~ ..............Filed Map No...~)~.;~..(,.~ ..... Lot ...;~ .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: · /2..,/. a. Existing use and occupancy ........ .~ .~./~iO. )~. ·~ ...... .~. ....... '7,../. ~..t~.~ .......................... b. Intended use and occupancy ,~ t~ II~fwel4 ........................................ ~i.4~11~o~6~ ;~,~i.~Xr ~ 5.,~ ·: ...... 3! ,~a~t~re of work (check which applicable): New Building .......... Addition . ..)f. ...... Alteration .......... Fee .... E If dwelling, number of dwellin~ units ..... / ....... Number of dwelling units on each floor ................ If garage,.number of c~s .... ........... [. ....................................................... 6. If business, commercial or mixqd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any Front .... ~( ~ ....... Rear .. ~ ! '. ........ Depth .. ~.q' .......... Height ... ~ .......... Number of Stories ...... .g ................................. , .... , ........... Dimensions of same structure With, alterations or additions: Front .... ~t ~ ......... Rear ~./.~ IJ.~q<q~... Depth ..... ~'. . ~. Height ...... ~ ............. Number of Stofie~ .... ~ ......... 8. Dimensions of entire new const.mction Front ..... ~(..., ..... Rear .... t~ ....... .. Depth . ~'. ~e~ght ..... ~ ......... Number of Stones ..... ~r~.~*. ~O/~: ...................... 9. bize of lot: Front ..... ~q. [ ............ Rear ...... ~X~ ...... ' ...... Dep[h: ... g~9'. ..... 10 Date of Purchase ' Name of Fomer Owner 11 Zone or use district in which p~emises are situated 12. Does proposed construction vi01ate any zoning law, ordinance or regulation: ...~o .......................... 13. Will lot be regraded ........ ~..~ ............... Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises .. ~ .................. Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Nme of Contractor ~ Address Phone No PLOT DIAG~M Locate cle~ly ~d distinctly ~! bufld~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from accord~g to deed, ~d show street nines and indicate whether property lines. Give street and block, number or description interior or corner lot. STATE OF NEW YORK, iS.S COUNTY OF being duly sworn deposes and says that he is the applicant (Name of individual sign'ing contract) above named. .................... ' ' ~;~, 'cor~;ia't 'e 'o'f~i~;;, 'e't~.') .......... .............. of said owner or owners, and is duiy 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; arid that the work will be psrformed in the manner set forth in the application filed therewith. Sworn to before me this /F__) ~ dayof ~ .,19~ Notary Public ................ ~'" ~~in ~x~lc~,~ O,~ ~~ County ....... - N o._ ~8221~ 8la~kl~Y~r ~m rr.~plr~m i)ec~ndi~r Il, t~ ? APPROVED Ail '~OTIFY BUILDING DEPARTMENT AT vB5-1802 [} AM TO 4 PM ~R THE FOL[ OWING INSPEC~ONS: FO~NDA~I[)N ~O REQUIREO FOR ~OURED CON~ETE ' , i iL_L_ ,( ILL // ,I WITHOUT CERTIFICATE OF OCCUPANCY AI~ROVED a~ I~OTEi~ NO~ BUILDING 76E-1~2 9 AM TO 4 ~M ~R THE FOLLOWING INS~c~o~: 1 ~UNDA~oN ~;~ ~R ~URED ~NC; 2 ROUG~ FRAMING 3. INSU~ION & P-~MBING 4. FINAL CONSTRUCTIO~ ~ COMPETE ~R C.O ALL ~ON~TRUC~ON SHAL~ THE REQUIEEMENTS OF STATE CONSTRU~ON ~ ~NERGY CODES NOT ~N~;~LE ~;R;GN OR CON5~bL'~,~; ~ffiRORS,