HomeMy WebLinkAbout14552-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTM~HT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUpANcY
No Z-23541
Date MARCH 13, 1995
THIS CERTIFIES that the building
Location of Property 405 SOUTH DRIVE
House No.
County Tax Map No. 1000 Section 106
Subdivision
ALTERATION
MATTITUCK, N.Y.
Street
Block 11 Lot
Filed Map No. Lot No.
Hamlet
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEHRH~/~Y 14, 1986 ~ursuant to which
Building Permit No. 14552-Z dated FEBRUARY 24, 1986
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 ALTERATION TO FINISH 2ND FLOOR ROOM & BATHROOM
The certificate is issued to STANLEY CHASE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. l/S1
N/A
H-044550 - MARCH 2, 1995
DEC. 6, 1994-MIKE JACUBI PLUMBING & HEAT.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERJ~AIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTtqORIZED)
14552 Z
Courl,¥ Tax Jv~op No. 1000 Section ..... /...0...~.. ....... Block ....... J..L .......... Lot No....g;~...~.. ............
pursuant to application dated ..... ~..~~......./..~.. ........ , 19.~O.~, and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
--- BLDG, DEP]:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of ail buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form),
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'3pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant~
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
March 7, 1995
Date ...................................... .. .
X
New Construction ........... Old Or Pre-ex/sting Building .................
Location of Property., ........ ~g~ ~qg~ Q~iY.q .......................... ~atti~uck ...........
House No. Street Hamlet
Stanley Chase
Onwer or Owners of Property ............................................................. . . . ..
County Tax Map No 1000, section..%Q~,.O.O. ..... Block...%l,P.0. ....... Lot...02O...~O0 ...........
Subdivision ................................. Filed Map ............ Lot ................
, 14552-Z ' Stanley Chase
Permit mo ............... Date Of Permit ............ Applicant.
Health Dept. Approval ....................... . .. Underwriters A~ .... ............................ v,1 attached
Planning Board Approw~l ..................... . . .
Request for: Temporary Certificate ........... Final Certicate..%X..i ....
Fee Submitted: $..~..00 ...
Town Hall, 53095 Main Road
P. O. Box 1179
Soulhold, New York 11971
Fax (516) 765-1823
Telephone (516) 765- ~ 802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No.
Owner: .AII ~l
(please print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
( umbers ~ature
Sworn to before me t~~
day of
~ Public' State of New
No, 4879505
Q~lifled in Suffolk CounW
WILLIAM D. MOORE
A~toraey at Law
315 Westphalia l~oad
P.O, Box 23
Mattimek, New York 11952
Tel: (516) 298-5674
Fax: (516) 298-5664
March 9, 1995
Town of Southold Building Department
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, NY 11971
Re:
Premises:
Allan Geschwind / Stanley Chase
405 South Drive, Mattituck, NY
Dear Ladies/Gentlemen:
Enclosed please find the following:
An Application for Certificate of Occupancy
Underwriters Certificate
Check in the su~ of $25.00 payable to "Town of Southold"
David Saland at Saland Real Estate 722-4990 may be contacted
to gain access to the premises.
We would appreciate your issuance of (1) the Pre-existing
Certificate of Occupancy and (2) the Certificate of Occupancy for
the subsequent work as quickly as possible·
If you have any questions, please do not hesitate to contact
us. Thank you.
Very truly yours,
Wii%'iam D. Moore
WDM/mr
Encls·
cc: Stanley Chase
Allan Geschwind, Esq.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
December 7, 1994
Moore & Moore
315 Westphalia Road
Mattituck, NY 11952
Re: Allan Geschwind
Prem: 405 South Drive, Mattituck NY
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 14552-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
85 JOHN ~TREET. NEW YORK. NEW YORK 10038
THIS CERTIFIES THAT
o~y t~ electrtc~ ~uipment ~ ~scdb~ be~m o~ int~uc~ by t~ ap~icant ~med on the a~e ap~i~gton number in the pr~m~s of
ST~Y CH~SIg, 403 ~OUTH DR~Vff~, ~ATTI~UCK, ~,Y,
u~s examined on F~U~ ~ 7 ~ ~ ~9~ and found to be in ~mplianve ~ith the N~on~ Elect~c~ Code.
)THER APPARATUS:
*NO VY~BU?i~ DEFECTS, "An electric~l
~urvey has been made of the e~posed
electrical equipment in the
premises indicated." "No obvious
unsatisfactory condi%lon was found~
315 %~;STPHALIA ROAD
P.O.BOX 23 erNSt tdANASa[
HATTITUCK, NY, 11952 11 ):
[his ¢e~ificote must n~be dltered in any manner; return to the office of t~ ~ord if incorrect. Inspectors may b~ i~entlfied by their credentlals,
copy FOR I~UILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
HIBBARD, 4~5 SOUTH DRIP, HATTITUCK~
in the following location; [~ B,sement ~ Izt Fl. ~ 2nd ~7. O[IT Section Bilk Lot
~s e~amlned on JA~[I~Y 3~, 1995 a~ found W be in ~omplianre with the N~aal E~ct~cal Code.
EXHAUST FANS
DIMMERS
JCAR INC.
20 WASHINGTON AVE,,
PORT JEFF. STAT., NY,
11776
LIC.#493E
6
GENERAL MANAGBR
Per _ -
This certificate must not be ahered in any manner; return to the office of the Board if incorrect, inspectors may be identified by their credentlo~s.
COPY FOR BUll. DING DEPARTMENT. THIS COPY OF CERTIFICATE M~ST HOT BEALTERED IN ANY MANNER.
FIELD INSPECTION
FOUNDATION
FOUNDATION
ROUGH FRAME &
PLUMBING
(2nd)
COMMENTS
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
0
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ~UGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
~RAMING []FINAL
, REMARKS~: .~ ~
//
DATE
INSPECTOR ~ .~.~.~
rail FEB I 81986 ![JJJ
TOWN OF sOUTHOLD
South Drive
Mattituck, NY 11952
February 11, 1986
Mr. Victor Lessard
Building Department
Town of Southold
Southold, New York
11971
Dear Mr. Lessard:
Thank you for meeting with me last week and helping me
thin~ through how to fill out the Building Permit Application.
Enclosed is my Application with the check for $50.00. I am away
on business through the 18th and I will call you when I return.
Again,
thank you very much. ~
AllT~n Geschwind
q.
0
ol
Examined ~,4,~... ~. '.&.q.
Approved .~r.~.~..~.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
.,lg h
., 19 ~./o. Permit No. ! ~.~.~.~.".&: .~'. ·
Disapproved a/c .....................................
'[OWN OF SOUTHOLD
Received ........... ,19...
(Building Inspector)
APPLICATION FOR BUILDING PERIVlIT
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 heroin 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.
(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 ...h~..1.ap...C?.s.o.h.w}.n.d .........................................................
(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 .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done.. ~1.0.5..S9..u.t~.' p.r.iy.e,..M.a.t.t.i.t.ug.k.,..Np.w. 79.r.k ............
House Number Street Hamlet
County Tax Map No. 1000 Section . . . .19.6 ............ Block ..... .1.1 ........... Lot.. · .2.0 ..............
Subdivision .... .S~.o.r.e..A.o.r~.s ...................... Filed Map No .... .4.1 ......... Lot . ?.l.o.t..D ........
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Finish 2nd Floor Room
b. Intended use and occupancy . . .B.a.S, .r..ochre. ..........................................................
10.
11.
12.
13.
14.
Nature of work (check which applicable): New Building ' . Addition.. ~ ....... Alteration X
Repair .............. Removal Demolition
.......................
(Description)
Estimated Cost $.8~ 500.00 F $50,00
* (to be prod on filing this application)
If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor ................
If garage number of cars
If business, commercial or mixed occupancy, specify~nat~ure and extent of each type of use
Dimensions of existing structures, if any: Front ..... ~..v.- ......... Rear ....3.87~ ....... Depth .. ' ~-~' ' '
Height ~OTQ ..... Number of Stories Two
Dimensions of same structure with alterations or additions: Front i Rear
Depth Height Number o fl Stories
Dimensions of entire new construction: Front ............... Rear ........ ~ ....... Depth ...............
Height ...... Number of Stories .. $..an. k9 .as ~7
Size of lot: Front .... .1.5.5:.8.9 ............ Rear'. i .1~.~:.~.~i i i i i i i i i ...... Jl~;~i~ ' ' ' ~)'.~'.~ .......
Date of Purchase . .NP?.~.r. .8.,. .1.9.8.3 ............ Name of Former O~v~;~' .Dq..n~.ni~ '~.' 'd~i~r~6 .........
Zone or use district in which premises are situated ......................... i ............................
Does proposed construction violate any zoning law, ordinance or regulation: ... ~9 ............. ' ........
Will lot be regraded ..... .No ..................... Will excess fill be removejd from premises: Yes No
NameofOwnerofpremises , ..3~.J-.a~..GO..s.cb.w.i.n.d Address .8.o.u.~ Dray. e_, . 'PhrmeNo (516) 298-5464
Name of Contractor ' Address ' Phone No
PLOT DIAGRAM
Locate clearly and distinctly ali 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 show street names and indicate whether
interior or corner lot. ~
F. x2ope of Alteration:
I. Replace 2 existing windows
2. Install 2 new skywindows
3. Install new full bathroom
Size and brand as noted
on floor plan
STATE OF NE~.YORK,I / /. :
cou ¥ OF .... s.s
Allan Geschwind ' p
................................................. being duly sworn, de ~oses and says that he is the ap ]icant
(Name of individual signing contract) -
above named.
. .O~n. er
He is the ................................................................................ ..........
(Contractor, agent, corporate officer, et :.)
- -- ~ and is duly authorized to perform or have performed thb 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
............ /..~/f.~. d a,V"~f · ~. '~ .Y~.F4. ~./..4/f~ .... .ff., 19¢ '- ' ~..
Notary Public, . .~. ? .~. )~..~.~.. ;2~.~./.~. 17~'/~u~y ~~~,~.. ~
Oa-11[llStl~l~.~-~ ~ ' (Signature ofap;1};ant)
., , , ~,:~mml~eion ~lq~lffi8 Ma,mn~,~u, ~'- '