HomeMy WebLinkAbout14314-zFORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
NoZ74316 Date March 25 1986
THIS CERTIFIES that the building ........ Qn.e., ?.a.m..i .ly..d.¥p.l.!~..rig ..................
Location of Property ......... bB.0. R EE.V.E.R.Qg D .................. MJi. T. T..I .T.U.C.I~ ........
House ~Vo. Street Hamlet
County Tax Map No. 1000 Section .... J.0. O .... Block ... 03 .......... Lot ...... 1.5.: .3 .......
S ..... Sea Aire Estates .... 6780 3
uou~vJs~on ............................... m~eo Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
·. $~.p t ...t~. ......... ,19 .~ 5 pnrsuant to which Building Permit No...~ .4.3. ]. 4. .Z .............
dated .... .S.e. p .~ .e~b. e..p..2.5. ......... 19 .8.5,, 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 .........
·. O~e. f~sn% ~-y..4W~ ~-.1.%r~g..i.n ~ .1.u.d.%n. g..~. ,.2..c.a.r., g.a.p.~, gp.. ........................
The certificate is issued to ..... .D. ao¢.e.% ..aB.cl..~ .a.~?.%c. $.a..E.g .a.n .........................
(owner~e~e~c~o,~t~t~
of the aforesaid building·
Suffolk County Department of Health Approval ............. ]. 5 .- ~.0.~ ~ .4.6 ...................
UNDERWRITERS CERTIFICATE NO ..................... iq 772.4.~ 3 ~ ....................
Plumbers Certificate 3/24/86
Building Inspector
Rev. 1/81
~ ~0. ~
TOW'N OF Sou'rHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N_° 14314 Z
Permission is hereby granted to:
.~.~ ........... I .............................. £.~ ..........
.~..~..o...~.....~......~ .............................
. . l~£z.~
.....~..~.~ ...... .~..~. .........................
,o
at premises located at ..~:.....~.....~.....~..~-~ ......... .~.~~. .............................
County Tax Map No. 1000 Section ...... L..~...~. ......... Block ....... .~)..~. ...... Lot No ...... J..~..:...~.. ......
pursuant to application dated .... ~~~......J'.~ ............. , 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
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted .- aammmma 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.
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 requ ired to prepare a certificate.
C. Fees:
1. Certificate of occupancv $5.00
2. Certificate of occupancy on pre-existing dwelling $15.0 0
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.C. $5.00
5. Updated c.g. $15.00 Date ........
New Building ..... /~. ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .............. '.
House No. Street Hamlet
Owner or Owners of Property . . .~..~J~. '/.. T. ?P~..~.'.'~/¢:F. ..... ~'.~. ~ .~ ........................
County Tax Map No. 1000 Section .... ,/~. ~. ...... Block ...~). ~ ........ Lot. O. J .~.~, .~ .......
Subdivision..~.~. ~~.c¢ .... ~E~-~'~. ....... Filed Map No. ~ .~..~.Q...Lot No .... ~-~. ........
Permit No. :.'..~.z..i.2,. Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval .......................
Underwriters Approval ........................ Planning Board Approval ....................
Request for Temporary Certificate ..................... Final Certificate ......................
Fee Submitted $ .............................
~.noo~se THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
.1~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
.¥.'iea.o,,No.o,,f.e ~7040~/8S N 734832
THIS CERTIFIES THAT
only the electrical equipment ~ ~scrlbed below and i~troduced by t~ applicant named on the above application number in t~ preo*ises of
oea a~re Lane (paper s'E~ ) ,Mattituck
in the following loca~ion; ~ Base,nent ~ 1st FI. ~ 2nd [~. Section Block Lot
was examined on YP~b~]~"~ ~ t ~ ~ ~ ~ and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES OVENS DISH EXHAUST FAI4~
OUTLETS
DRYERS FURNACE FUTURE APPLIANCE FEEDERS
TIME CLOCKS
MULTI-OUTLE1
SYSTEMS
NO. OF FEET
DIMMERS
SERVICE DISCONNECT
OTHER APPARATUS:
S E R V I C
NO OF CC COND A,W G NO, OF HI-LEG A W.G.
PER ~' OF CC COND OF HI-tEG
NO, OF NEUTRALI
OF NEUTRAL
4
CeDte~: Mor~.ohes,
11934
l!c~847
GENEI~AL MANAGER
this certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by th~ir credentials.
3UILDING I
MANNER.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No. /~3/~
Owner /"),~,n .e- fPz:t.1%".,'c./~_
(please print)
(pl~se print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
~day of [~A~C~/
19~ .
Notary Public,~O~[JOL[~
Not~r~ublic
County
DANIEL ~. ~ORA
NOTARY PUBLIC, S~e of New Yor~
No, 52 - 464~504, Suffolk Counly
I"IELD INSI'~CTION. . bul'tnl:l~ xo
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved . .~..~....~...~.~.., 19.8.~. Permit No. ! ~.~. l .~..~...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Application No ..................
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 regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
. .&.'C~h. :ii. £~ .~...¢o.r.p.~ ..............
(Signature of applicant, or name, if a corporation)
. . 2¢.. . .......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... . oc l .... ¢.o n:f.c, vt. r .c ...............................................................
Name of owner of premises .....~X..}q.i.g, [.. Cq~.d...~¢~.'fCl'C. i0C.. ~.~dtn .....................................
(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 .... /.~.q~.: .~.-~. .............
Plumber's License No .... .~..~.~...~. .............
Electrician's License No... ~.~..'?..~. ............
Other Trade's License No ......................
1. Location ofland on which proposed work will be done. ~/$ ~e~ ~V~ . /~ '
House Number Street Hamlet
County Tax Map No. 1000 Section ... ~ .......... Block .~ ............. Lot ..... ~ .l. ~ ~.~. ....
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~G&n 'F
!,, 3,,,,.Nature of work (check which ap licable): New Building ...... Addition .......... Alteration ..........
' Repair ....., .......... Removal .............. Demolition .............. Other Work ....... : .......
i~ ~1 [ I q:l~ a ! (Description)
~i,i4. EstimatedCost?.~O ~
~a~.i , ~ ~ ,- .... .................. Fee ......................................
(to be pad on filing this application)
~Tf a'~elling, number of dwelling ~nits ....../ ...... Number of dwelling units on each floor ................
If garage number of cars ~. .......... ~ .~ ....
6. If business, eommerci~ or mixed occupancy, specify nature and ~xtent of each type of use .....................
7 Di ting ~ ifa F pth
. mansions of exis structure, ny: rent ............... Rear .............. De ...............
Height ............... Number of Stories ........................................................
D~ensions of same stmcture with alterations or additions: Front ................. Rear ..................
Depth .................... [.. Height ...................... Number of Stories ......................
8. Dimensions of entire new eonstr~etion: Front .~ff~'.... Rear ~ Depth
..... ~g, ~ ......... 3~ ..........
Height ........ Number of Stories ~ ............................................
9 Size of lot: Fron{ /~Of. ' '~;ar ...... Depth
....... ~ ............ /~o~ .................................
10 Date of Purchase " Name of Fo~er Owner
11. Zone or use district in which premises are situated ................................................... ..
12. Does proposed eons~ue~on viol~t~ any zoning law, ordinance or regulation: ................................
W~l lot be regraded ......... , .......; .......
13. N~e of Owner of premises ~. .... Will excess fill b~ removed ~_~remises: Yes No
14 .... ~r~ ~ .~ Address ~P..~. ~-.ff~'~one No ................
Name of Architect . ~.~ .~./~n.~ .......... Address .~ ~'Fv~ ....... Phone No ................
N~e of Contractor~UI .~a~U .~ .......... Address ~'~./~.,..~&~.. Phone No. 7~. 7[~.~4 .....
PLOT DIAG~M
Locate ele~ly ~d distinctly fll[build~gs, whether existing or proposed, ~d~ indicate all set-back d~ensions from
prope~y lines. Give street and block aumber or description aeeord~g to deed, ~d show street n~es ~d indicate whether
interior or corner lot.
STATE OF N~W-~RK, z
COUixrrY O~ ..
......... Y~...../4;;~..UC.<~ G.~o4 ~ .................. being duly sworn, deposes and says that he is the applicant
(Name of individual signjing contract)
above named.
He i Ih
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly 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; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
[~T/~R¥ Pl/llt~ ~.~11~¥1~I (S'gnarure ct applicant)
; TITLE NO, TI284-4644
~U~'OL~ "countrY' ~,C~';~.'r;:T 0~,, .~,LT., S~VlCCS DANIEL U; EGAN ~'PATRICiAM EGAN
~; _ ~ , ~ LOT ~. ~ "SEA-AIRE ESTATES"
VAL OF CONSTRUCTION
~,~~~.,).~~.~..'~su~ro~.cou.~,:.tw~.~.~..,: ~' : ~ ,o.~ ,~-,,~
~*~-~ ~ ~ ,..~e WITHIN oD Fr~T'OF' ~S ~hOkE~Ty '
.OF H~LTH;~ CgS;~ I '' ~ ' '~" ® '"'~"-':' -~:~-~ i~t'-- ~ ~- "-'
.~ ;:,,, ,; ' :,.,, ~: ,,,,', , ,;;.," ~:~ ~,;I~.:~,!.~,~ ~.~l~ ' ~AO, NEWYORK
J
,. '' ', TITLE NO. TI284~4644 I
*APPROVED ' '~ * ' ~ ,, ~su~v~v e~w~o, ~sgczm.,' v~Oe~,~ TCOR TTLE GU~ANTEE
, . r ~ * , NEW yORK~TAT~ E~CATI~ LAW ' '
-- A A ' ' ~ ~ ~ ~R WHOM THE 5U~EY 15 PREPARED
DEPARTMENT D TAF~ PP~O~C~$TRUC~
N'N~ARIST W~ MAIN 'MI + NSOURCE ~ WATER' ~I~T[~P~I~ MENTAL AGE~CY AND LENDING INSTITUTION LISTED
CO. T~MAP mI~O~ECTI~K aO~ LOT~ H~E~, ~D~TO*~E'ASSIGN~S OF THE LENDING ,
SINGLE FAMILY DWELLING ONLY
t~e ~e~a~e disposal ~,~ eater S~:ppl.~
facilities for tht; lo(,a'~ion ha,ye been
[nspeot~ by %his dopa*~u% ~d fo~
KO b~ ~tf~fao~O~ -
H~AL~ OE~AE~M~N~-OATA F~ APPRO~L TO C~S~U¢~
ADDHESS
NOTEI A=STAKE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
SUFFOLK COUNTY ON FEB. 8,1879 AS FILE NO. 6780.
BRANDIS & SONS INS, 1046
TITLE NO. T1284-4644
~9
z
po~v' ?
~AR ~ BI~
SC, SEPT, OF
SURVEY FOR
DANIEL L. EGAN & PATRICIA M. EGAN
LOT NO. ~, "SEA-AIRE ESTATES"
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
JAN. 50,1986
NOV. 22,1985
DATE: NOV. 21, 1984
SCALE= 1" = 50~
NO. 84- II 44
RUNADTHORIZED ALTERATION OR AOOITION TO THIS
SURVEY IS A VIOLATION Of SECTION 7209 O~ THE
NEW YORK STATE EDUCATION LAW
RCOPIES OF THIS SURVEY NOT KARI~IG THE LAND
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL
NOT IE CONSIDERED TO BEAVALID TRUE COLaY
NSUARANTEES INDICATEO HEREON SHALL RUN ONLY TO
THE J~RSON FOR WHOM THE SURVEY IS PREPARED
AND ON HIS BEHALF TO THE TITLE COMPANy, GOVERN-
MENTAL AGENCY AND LENDING INSTITUTION LISTED
HEREON, AND TO THE ASSIGNEES OF THE LENDING
INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS
#DISTANCES SHOWN ~EREON FROM PROPERTY LINES
TOEXISTING STRUCTURES ARE FON A SPECIFIC
PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
GUARANTEED TO'
TICOR TITLE
NORTH FORK BAI
DANIEL
YOUNG a YOUNG
ALDEN W. YOUNG, PROFESSIONAL ENGINEER
AND LANO SURVEYOR N.Y.S. UCENSE NO. 12845
HOWARD W. YOUNG, LAND SURVEYOR
N.Y.S. LICENSE N0.45895
400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK
t? ?5
Z
(b Z 76~, ,g4 7 / q
'434 1
.36 ~I 03
I I
If copper tubing i~ u~td
for wa~r distributing
~/.tem; piping .hall be
of tybe~ K or L only
SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 of 19G LEAD.
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERTIFICATE OF OCCUPANCY
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
NOTIFY t:IUILDING DEPARTMENT
765-1802 9 AM '[L~ 4 PM FOR
FOLLOWING INSpFrJT(ONS:
1 FOUNDATION -,WO~ ~EDUIRED
FOR POURED C,G~]CRL~ D:
2 ROUGH FRAMIf,;G ~, %~
3. INSULATION
4. ~:~NAL CO~STRUCTION MUST
RE GOMPLETE FOR G.O.
ALL COi"]STRUCTION SHALL MEET
THE REO-U[REMENT$ OF THE N.¥
STATE GONSTRUGTION & ENERGy
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTROCT~OF,~
JOB No
$1DF-
~ L~.V~T~ON
I
1
1
No
SHEET
- - ' -- I'11¢
I
~LJIL
t50'-%3'-0N .... C 0 L 0 N l
~IOT 'TO ~CAL.~
AL' ~Cor ~i:TUNILL COIdST. COI~. E L £ V AT I 0 hi S ~HI~T
CKD MY SCALE OF' D W I:~ E.
2
~OSTON
COLONIA, L fc::,~ GR/jWILL CON~I':.
1:: 0 U N C) /~, T \ 0 W J I
h,%l,.~. ... . . ..... .. :....