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HomeMy WebLinkAbout14820-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z15833 Date June 10, 1987 one-famil dwelling. . ................. THIS CERTIFIES that the building ............... Y .............. Location of Property 3460 Wes.tlq. halia Road Mattituck County Tax Map No. 1000 Section .... 1.1..4 ..... Block 1 . .Lot 10 Subdivision ........... X. ................... Filed Map No ..... X....Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated April 22, 1986 14820Z ....................... pursuant to which Building Permit No ...................... May 3~ 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 ......... NeW one-f~mily dwelling with attached one-car garage and porch. CHESTER JR. & MARY BERRY Tile certificate is issued to ........................................................... (owner, ~Z/~ of the aforesaid building. 85-S0-146 Suffolk County Department of Health Approval .......................................... N804027 UNDERWRITERS CERTIFICATE NO .................................................. 2/11/87 PLUMBERS CERTIFICATION DATED: *Block sliding doors not to open without deck or~ / ~tilding Inspector Rev. 1/81 ~ORai 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) 14820 Z Permission is hereb/gronted to: ..~.~...x....~..~,~ .............. ~.,,,,'. ........ /0, , [I ........ ~ ........... ..q .......... ~.~.~ ............ ,o ......... o, prem,~es ~o,ed ot ...~.~..~.~......~.~..~.%.~.......~.....: ...... ~.~....~... .............. County Tax Map No. 1000 Section ...... 1..!...~ .......... Block ....... .,~...) ......... Lot No....J....~. ............... pursuant to oppiication dated ..~...,..-~...._'~.. ........................ , 19..~....~.., and approved by the Building Inspector. 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 A. This application must be filled in typewriter OR ink, and submitted m~ 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 pz: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 ~'N__e? Dwelling $25.O0, j_ cessory ,~10.00 Business $50.00 2. Certificate of-Occupancy on pre-existin~g $ 50-. 00 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 .. t' ' ' NewCons tpuc bion ...... Old or Pre-existing Building ........... VacantLand ............. Location of Property ......... ~ ....................................... House No. Street /-/am/et Owner or Owners of Property ~,'//.X'~.'/~.~;~...~..F:... ?.. ~./~.__~ ¢.. ,~.,¢./~y ................. County Tax Map No. 1000 Section .... //~..~'/. ..... Block ...... X ....... Lot ..... ./~..~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. [.~.2,0.'~.. Date of Permit .......... Applicant ........ : : ..... Health Dept. Approval ~;,~' ~LJ - ~ d~ .Labor Dept. Approval Underwriters Approval .Z~ .~. ~.~J..~..~'.~. ....... Planning Board Approval . Request for Temporary Certificate ..................... Final Certificate .. Fee Submitted $ ZS . Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION / FRAMING [~] FINAL 1000174 THE NEW YORK BOARD OF FIRE UNDERWRITERS P~¢' BUREAU OF ELECTRICITY V 85 JOHN STREET. NEW YORK, NEW YORK 10038 ,,,re April li~, 1ps? ,"pp,,,~a,,o,,~'o.o,,.~,b. ,,1.3?5~].-se N 804027 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Chester Berry Jr., Matt~tuck, N.X~ in the following loca~ionl L~Basement L_~ Ist Fl .~sex.,.i.edo,, April 9~ 1987 FIXTURE f~ FIXTURES OUTLETS ECEPTACLE! ' SWITCHES 24 27 DRYERS FURNACE West Phalia Rd., Meday Ave. & Itome Pike~ [] 2nd FI. Section Block Lot a.dfo~zttd to ~e itt co.tpilance -'ith the re(lulrements ~ this Board RANGES OVENS 24 FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET EXHAUST FANS DIMMERS SERVIC~ DISCONNECt OTHER APPARATUS: Motor/s: 1- lhp 1-G.F.C.I. 1-Smoke Detector S E R -V- OF CC. COND, . C NO. OF HI-LEG A, w, G NO. OF NEUTRAL A. W, G. OF HI-LEG OF NEUTRAL 2/0 EECO ~leC. CO~p. (Cliff Cornell) 325 Willow Point Rd. GENERAL MANAGER Southold, N.Y. 11971 Li~o2816 F'~ ~, 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be idenfif~d by their credentials, COPY FOR BU LD NG DEPARTMENT. THIS COPY OF CERT FICAT;~ MUS~NOT BE ALTERED N ANY MANNER TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL S()U'F[tOLD, N.Y, 11971 TEL. 765-1802 CERTIFICATION Building ~rmit No. 'T. Owner [please (please print) Date 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 No~a~ ~u~lio, ~,?~/~,~, co~ty No,ar,/Public, State of New York No. 4~752 ~ualifi~ in Suffolk Coun~ Co~io~i E~ims Merch~O~ '19~ Notary Publi~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR . P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 June 2, 1986 TO: FROM: SUBJECT: Judith Terry, Town Clerk a/c Southold Town Board Victor Lessard Executive Admin. Refund--Chester Berry Jr. Chester Berry Jr. applied for a Building Permit for construction of a new dwelling in Mattituck. Because of the cost of that dwelling he resubmitted new'plans for a smaller house before starting the original house. The fee difference is $112. He would like a refund of this amount. FIELD INSFECTION COMMENTS __ ~-~ FOUNDATION Ilst) FOUNDATION (2nd) FRAME INSULATION ?ER N. Y. STATE ENERGY CODE FINAL 765-1~02 BUILDING DEPT, INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING FINAL REMARKS ]65-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST []ROUGH PLBG. FOUNDATION ZND []INSULATION FRAMING []FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING .~FINAL ~ ~ ... ~ ~ ~ . ~ ~- _ 'FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 {_ ...~....~..~. ., 19'~..~. Permit No..{.~.~...g'.?.~. · Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date .................. 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3~, sets o£nlans, accurate l~ot plan to scale. Fee accordir~g_~ ~c_h.edule. "~. Plot plan showing location of lot '~d'0f 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 occupi4d 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 auth°fized inspect°rs °n premises and in building f°r necessary i~l~t,~:2//~'\ z~ .~ [) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, gener_al contractor, electrician, plumber or builder. Name of owner of premises ...,.~ ,....-......~... '~' '('a} 'o'n the tax rol[~q lat~ deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~.~7...//..~... ........ Plumber's License No .... .~. J/9.. i. Otkcr Tra~e's L~.cense Nc...[~J..~. f.....'~ ]. Location of land on which proposed work will be done ................. g. · · , ...... House Number Street Hamlet County Tax Map No. l OOO Section : i !.~. ......... Block I Lot 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 . . .~.~ .................................................... ...... b. Intended use and occupancy...(~f~%~...; .~ .O~.~...~ ..................... 3. Nature of work (check which applicable): New Building .. '. .... Addition ! .......... Alteration ~ .......... Repair .............. Removal .............. Demolition ....... I Other Work.. ~ .~(Do sg~iption) 4. Estimated Cost ........................... Fee ......... (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ..... /. ........ Number of dwelling u~its. - -°n. 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 .......... i ....... Rear .................. .~,~.Depth ...................... Height .................. Number bf Stories ...... ....-.... ...... ~/~.)/bimensions of entire new construction: Front ~.~. ~'..~. ~.. Rear..,,S&~. ~.. ...... Depth' , cg/* ..... Nh]re.her nf gtn~g ~ 9. Size of lOt:of Front ./~Q".~'/~'~ ......... Rear ................... ~.C~pth ...~4~, ~, ~ ............. ... !0. Date Purchase, . .................... Nam~of Foreleg Owner! · >~u,~. · · ~.~.'~/ ........ 11. Zone or use district in which remises are situated 12. Does proposed construqtion violate any zoning law, ordinance or re~lation: .~ ....... 5~ ....... ~ ....... 13. Will lot be regraded . B ~ ............ ~ ............. Will excess fill be remo ~ed from premises: (YesJ No 14. Nmne of Owner of premises ~.~ .~(~ ~,. Address ~>... N~e of Architect . ~ ...... ....... Address ..... ..... Phone No ................ Nme of Contractor ~2 ~¢~%~' .... Address .~d... r'~ .~ ~ ~ Phone No. 7¢~.. ~-Z ~.. P~T DIAG~M Locate clearly ~d dist~ctly ~1 bufld~gs, whether'existing or proposed, ~d,.indicate ~1 set-back d~ensions from prope~y fines. G~ve street ~d block number or descnpt~on accordmg to deed, ~d show street n~es and red,cate whe~er interior or corner lot. STATE OF NE.~ ¥~.,.[Uq, I,, S.S counTY OF ...... ....(7.~..~.~. ~...~.0.~... ~..~..-.~.,. ...... being duly sworn, de (Name of individual signing contrgct) above named. ~oses and says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, et~.) of said owner or owners, and is duly authorized to perform or have performed th~ 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. Sworu to before me this .............. ~.'~.. , ..... day of ..... ~ ........ , 19 7.6 Notary Public ..... ~-~eg~... '.~. '...~..Ct..~..~.. ..... Coun ~ ta~'~i/~]i'~ 1~22J./ } (Signature of ~dl~icant) / L ~0 b weft..: o ~ < . ~. '5, pool ~ L~ -lZ'~ ..... 4 ~ 3SUF~0LK COUN~WHEALTH EPARTM NT : ~ t3 ;t$iNGLE F~ILY DWELL~G ONLY HID REF NO~ ~'~O'- L~TION HAVE'BEEN' INSPECTED BY THIS .UEFAff/~=m/ AND' ~NDTO BE 8~TISEACTORY~ . - ', .- ' ~ief of Wi~iewate'r Manage~ent'Secflon E L. E ~65-1802 9 AM 'TO 4 PM FOP, THE FOLLOWING iNSPECTIONS: ~. FOUNDATION - TWO REQgIRE[~ ~. ROUGH -FP. AMING & pLUMBING 0~ INSIJLATION ~, FINAL - CON'£TP~UCTION MUS'~i .~LE~E cOMPLETE FOR C.O. ; I~E REQUIREMENTS OF THE N,Y. ~'ATE COibISTROCTION & ENERGY CODES. NOT' REsPoNSIBLE FOP- DESIGN OR CONSTI:~'UCTION ERROP`S' If copper lObing is u~d for ware? distributing sys~ern; piping shall be of types K or L only 'i' : PLUMBER CERTIFICATI02t ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY DI~R US]~I)IN w-AT~R L~M cANNOT SO SyST ~AD. I , FLO©T--Z,.,. --~ L,A hq d Phone 477:0400 ~ Main Road I 40I (b" Phone 477-0400 Main Road GREENPOR1~,NY !1944 ow~. C~O_~ ~C~"~', r~,,,<~.~ ,