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HomeMy WebLinkAbout14377-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No.. Z 15.006 Date October 17~ .......... 1986 THIS CERTIFIES that tile building ........ .O.n.e...f .aj~.i. 1. y..d.w.e..3..1.i.n.g ................. Location of Property 850 Topsail Lane ~ Southold, N.Y. - House No. Street Hamlet 79 7 17 County Tax Map No. 1000 Section ............ Block ............... Lot ................. . M/o Leeward Acres 5599 17 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · O. 9.t.°.b.e..r..9., .......... 19 .8.5. pursuant to which Building Permit No... ~..4 .3.7.7...Z ........... dated .q c..t 9.b.e.r.. ,]-.7., ...............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 ......... One family dwelling The certificate is issued to Jack & Laurie Steiner (owner, I~ao~oK ~oz~l~lflx of the aforesaid building. Suffolk County Department of Health Approval 8 5 - S O- 7 9 UNDERWRITERS CERTIFICATE NO.. P e n d ing Plumbers Certification Dated: September ~5~ 1986 ..... ............. Rev. 1/81 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) N_e 14377 Z Permission is hereby granted to: ~ ......................... ...~..~...~....~.:~.,....lJ.~..~. ...... , o, p,e,~,,, Ioca,ed o, ..~.~....'..~..~...~..~..~..~..~...~-..':......~~~--'~' ~ Cou,ty Tax Mop No. 1000 Section ...... .~...-'/...~ ....... Block ..... ..~...~. .......... Lot No ..... J...~. ............... pursuant to application dated .... ~)..~....~. .................... , 19.~.~./., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m mmammmm 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 etectrical 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 p~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 $5.00 2, Certificate of occupancy on pre-existing dwelling $15.0 0 3, Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 // /.~. 5.Updated C.C. $15.00 Date .... /.2. .~ ........... NewConstruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... .~..~ .O.. / ' ....... l .t . . . . n ¢._ ....... /. d. . . . House No. Street Ham/et Owner or Owners of Property ...~. ~C~...e/. ...~QL.U.K./~ ~.~....-~J./~...' ~ C... . .............. County Tax Map No. 1000 Section .0 .~...~.-.~.~.... Block . .0..~"..0.~. .... Lot..O.~..~.'.(~. Subdivision ................................. Filed Map No..~.~.~?...Lot No .... .~..~. ...... Permit No../.Z/~?.? ~.... Date of Permit I.Q/I?/?5...Applicant...~.Q..C/.~. ~...~.~.~ .~./.~;. ~ ~.~.~. ~.. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above ~ '~' ~ described building and, permit meets all applicable codes andJ'egulations. App cant Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. (please print) Plumber ~' ~C~O~ (please print) 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 ~ day of~ Public, County Notary ~ u ~otary Public R~G~NA ~. MATTH~W~ NOTARY pIJ~3klC, $~ate of New York Na 52-4636665, SuffoJk County COMMENTS FIELD INSPECTION 1. FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N, STATE ENERGY CODE ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PLBG. ? FOUNDATION ZND [/',]~ INSULATION FRAMING [ ] FINAL REMARKS: INSPECTOR (.." , / :. 76S-~802 BUILDING DEPT. INSPECTION FOUNDATION '~ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION £ ] FINAL [ ] FRAMING REMARKS: 7GS-'1802 BUILDING DEPT. INSPECTION" [ ] FOUNDATION 1ST /[~ RouGH'PLBG. [ ] FOUNDATION 2ND [ ] INSULATION /~FRAMING [ ] FINAL REMARKS: DATE ~ , ~ Examined. ~~..[.~., 19 ~.~" ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y'. 11971 TEL.: 765-1802 Approved fiD~. ~..~.., 19~.~.. Permit No. J.q~.~.~..D~ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 necessa~,._.x._..~/,}~_~z/insp~tions. ~, ,~ ~ (Signature of applicant, or name, if a corporation) . (Mailing address of applicant) f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. p. .a.e. r,. .... . o©zp.¢, roc4. o Name of owner of premises....x~.C .~..~..L ~. O./J:e-....~.e,./?er-- ............................... (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..~ .P.~.~'~..O.l..'~.©/~dZt~/...f.(~: .d..L~..6~..(~..4~).~, House Number Street Hamlet County Tax Map No. 1000 Section ....... .~.. ~. ...... Block .... ? ............. Lot ..... ~.../.~. ...... Subdivision ~ ~ .... Filed Map mol ......................... .~.. 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 .................................... ~':{:~': ~," '.~;*'"' .'x ................ 9. 10. 11. 12. 13. 14. Nature of work (check wl~i~fiapplicable):' New Building ......~ Addition ...... .... Alteration .......... Repair .... ~'~...~: ,~:.. Removal ............ Demolition ...... Other Work i -~ (Description) Estimated Cost ~fi'~ 0 ~).O Fee .~..~..' '''] 63 ~ ~ (to be paid on filing this application) If dweliing, number of dwelling units .. ~])3q./.~-,... Number of dwelling units on each floor ................ If garage, number of cars .. ~ ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dnnensions of existing structures, if any: Front ............... Rear ...... ' ...... ;. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... i... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories .................................................... .... DateSiZe of lOt:of PurchaseFr°nt ......... ./~.C, .il .~ ~?~-% ............ Rear ...................... Depth , '~'_k222.U2~' :' ' ' ' ' ' ' ' .. ........... Name of Former Owner . .~c.q.~,t~o~c-r' · · · · · '" Zone or use district in which premises are situated ................................................. Does proposed construction violate any zoning law, ordinance or regulation: Will lot be regraded ........ ! .................... Will excess fill be removed from premises: Yes Name of Owner of premises ..................... Address ................... Phone No ................ Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ...... 1 .................. Address ................... Phone No ................ l,ocate clearly and distinctly a~l buildings, property lines. Give street and block number or interior or coruer lot. PLOT DIAGRAM whether existing or proposed, and, indicate ail set-back dimensions from description according to deed, and show street names and indicate whether STATE OF NEW YORK, i S.S COUNTY OF ................. ............................... being duly sworn, deposes and says that he is the applicant (Name of individual slggmg contract) above named. , He is the ..................... I .................................................................... ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly authorized to perform or have performed the said work and to make and file this application; that all statements con[ained in this application are true to the best of his knowledge and belief; and that the work will be performed m the mann,er set forth in the application filed therewith. Sworn to before me this i ~2h~,~ (Signature of applicant) Lot :59 / Lot 41 / ~,/ o,. ~ ~o/ '~o, .d . / ' . < e/o , SINGLE FAMILY DWELLING ONLY SU~Y FOR ~CK STEINER ~ LAURIE STEINER SUFFOLK COUNTY DFPA~Th~]?=T C'F H~).LTR ~E~VIC~ LOT NO.40" LEEWARD ACRES AT BAYVI~ AT BAYVIEW D~TE: APR 19,1985 FOR APPROVAL CF CC;~<.d~UC]ION ONe? ~N ~ S~THOLD SCALE: 1"~50' DATE -~/~"S REF. NO.~5 - ~ T~ SUFFOLK COUNTy, NEW ~RK / ~UTH~IZED ALTERATION O~AOOITION ~ HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT mE ~R~ FOR WHOM THE $U~EY IS PREPARED YOUNG YOUNG ~NOTE: I = MONUMENT~J ALDEN W. YOUNG~ PROFESSIONAL ENGINEER SUBDIViSI~ MAP FLED IN ~ OFFICE OF ~E CLERK OFSUFFOLK AND LAND SURVEYOR N.Y.S. UCENSE NO. 1~845 COUNTY ONJUNE4~71AS RLE NO. ~9 HOWARD W. YOUNG, LAND SURVEYOR . ~ C~tm ~ ~L(W),~C ~4NK(S~ia CE~OL$(~) ~N ~E~ N.Y.S. LICENSE NO. 45893 BRANDIS & SONS INC. 1046 ; SUFFOLK COUNTY HEALTH DEPARTMENT SINGLE FAMILY DWELLING ONLY ~ , H.D. REF. NO. ., ~?,5--.(:~c~ ': ~'? , ,, ' DATE_ ~[I~ -0-{-~-, .... THE SEWAGE DIS~AL AND WATER SUPPLY FACILITIES FOR LOCATION HAVE BEEN INSPEGT~ BY THIS DEPARTMENT AND i FOUND TO BE SATI~AG~ORY. Chief of W~st~water ManMan~emsnt Section ~t 39 ~ Lot 41 / ~u~Y F~ ~CK STEINEE B LAURIE STEINEE LOT NO.~" LEEWARD ACRES AT BAWIEW" dULY I4,1986 JAN.~ 1986 AT BAYV~W 0~[: APR 19,1985 ~WN ~ S~THOLD SCALE: ~"=50' SUFFO~ COUNTY, NEW ~ NO. SURVEY I A VI~ATI~ ~ SECTION ?20e ~ THE NEW ~NK STATE E~CATI~ LAW ~COPI[S~ ~4S ~VEY NOT MAR~G THE LANO SUNV[~'S iNKED ~AL ON [MeOSS~D ~AL SHA~L ~T BE CONSIO[~O TO M A VA~D TRUE COPY NGU~RANT[[S WDi~TED H[NEON ~L NUN ~LY ~ H~ D~PARTM~NT-DAT& F~ APPR~ TO C~STRUCT ~ KR~ FOR WHOM THE SU~[Y IS ~L. ~ ~ ~ ~NDER A~WE YOUNG YOUNG NOTE: I = MONUMENT ALDEN W.~NG, PROFESSIONAL ENGINEER ~ M~ FLED ~ ~ ~F~E ~ ~E C~ OFS~ AND ~NO SURVEYOR N.Y.S. MCENS[ NO. 12845 C~NTY ONJ~4~71~ ~E NO. ~ HOWARD W. YOUNG~ LAND SURVEYOR ,~ ~ ~W),~IC TA~I~eCE~(~) WN ~[~ N.Y.S. LICENSE N0.4589~ OCCUPANCY OR USE IS UNLAWFUL WIn-lOUT CERTIFICATE OF OCCUPANCY PM, M~ C~[ITIFICA TION CONTENT BEFORE CEIIrlR~E OF OCCUPANCY ~OLI~ U~ IN WATER aUPPLY &'Ya'TEM CANNOT EXCEED 2/10 of I% LEAD. APPROVED ASNOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE ;OLLOWING INSPECTIONS: 1 FOU~'~DATION TWO REOUIREO FOR POURED CONCRETE 2 ROUGH FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIPEMENTS OF THE N,Y STATE CONS]'RdC'T:ION & ENERGY ~)_ DES, NOT RESPC~'~ff-'L~: FOR 17, ..I .i