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Home My WebLink About14386-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy z14765 August 5, 86 No .................. Date ................................. 19... One family dwelling with attached garage. THIS CERTIFIES that the building ................................................ Location of Property 980 Greton Court Mattituck~ New York House No. Street Hamlet 107 2 3.05 County Tax Map No. lO00 Section ............ Block ............... Lot ................. ..... M/o Greton Ests. 6447 .10 uoalv~mon ............................... Filed Map No ......... Lot No ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..0. 9.t.qb.e..r' .1.5., ..... ,19 .8.5. pursuant to which Btfilding Permit No. 14386z October 21 , 85 dated ............................ 19 .... 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 with attached garage The certificateisissuedto Earl Bedrick & Diane Bedrick ..................... ?oh;go;, .................... of the aforesaid building. S ff lkC tyD p t of HealthApp I 85-S0-173 u o oun e artmen rova .......................................... UNDERWRITERS CERTIFICATE NO ........... ~ 761364 Plumbers Certification Dated:July 30~ 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) NO 14386 Z Date .... ~ ............................... , 19.~.~ Permission is hereby granted to: .....'Z~......x...~..o.~o ............................................... ~ .. ...'~~..,..u.,~.,....u.'t.~:.~ ....... ,o a, p,e,,,,ec,~,,,ed o,...~..~..~......~.,"~'~...~ ......... .~.~ ................... ...... .~. ............ Lot No.....~. ................. County Tax Map No. 1000 Section ..... L.~....'~. ......... Block '~' pursuant to application dated ..~..~..../..~'~.. ............ 19.~...~..C and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department ~ cE~ f;,.~ r-~ n n Southold, N.Y. 11971 ~J IFF) .. ill ll APPUCATaON FOR CERTaF,CATE OF OCCUPANCY Instruations -~~~ %DEPT. ..... TOW~ This application must be filled in tvpewnter OR inK, and suDmltteo ~ ~ to the mr with the following; for new buildings or new use: 1. Final ~ey of propertV with accurate location of ail buildings, property lines, ~reets, and unu~al 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 Unde~riters. 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: I. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 occupancy $1,00 4.Vacant Land C.O. $5.00 5.Upd~%ed C.O. $15.00 Date ...... .%l.~..;..'~d. J~-~.~... New C on struc b i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,~8C) ..C_q, re o,r!. Qour - House No. Street Nam/et Owner or Owners of Property ......................................................... County Tax Map No. 1000 Section J 07 Block '2% Lot...~,: ,C), ,0,~" Subdivision....~.F,~ ,JQ ,C~, ,f~.,, .~,~, ~ ,0, ,~, ,~:..~,..Filed Map No. ,(0.~.~, ,~,...Lot No.. [.~. ........ Permit No..J.~..~.. ~.~. Date of Permit/,~,12~,/~,,~,,Applicant .%,1.~.~i..~.....~....(~..rt.'.~..~.. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~.. '..-~. ...................... Construction on above described building and permit meets all applicable codes and regulations. Applicant...~.-..~..h..~...~.. ....~-,~¢',~.L.. ..~.... ................. Rev. 10-10-78 co% lC/TI, ~· IELD ~NSi:~CTION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION ?ER N. STATE ENERGY CODE COMMENTS ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~11~ BUREAU OF ELECTRICITY ~i~ 85 JOHN STREET. YORK, NEW NEW YORK 10038 1986 N761364 THIS CE;IFIE~ THAT ~ examin~ on ~y ~1 ~ and found to be in compliance u'ith the requirenle, ts of th~ ~. DRYERS FURNACE MOTORS FUTURE APFUANCE FEBO~S TIME C~CKS ~EII%~I ~ S E R V I ¢ OTHER APFA~ATU$: 1-G.F.I. a~r. hony J. hEr:La ~wos~y Av4mue calv~ton, 1~ 11933 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANy MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. /~ Owner ~r~/~A ~~--- (please print) Plumber ~ ~'~/~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. FLOREtlCE A, PAVLAK NO[ARY PUBLIC, S~ate of Nevi York No, 47~8148 Qualified m Soflolk Coonty ~ Commission ExplCes June 30, ]9~ (plumber's signature) Sworn to before me this · ~O~day of ~~ , 19_~. Notary Public, ~ ~ County Notary Public BUILDING DEPT. INSPECTION ~ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ['~INSULATION [~ FRAMING REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION! FOUNDATION 1ST [] ROUGH PLBG. ]/FOUNDATION ZND [ ]INSULATION ] ~I~AMING · [ ]FINAL DATE II ~ ~ INSPECTOR ~ r ~ : 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION iST ~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~ FRAMING []FINAL REMARKS: , ,, ~, ~, ~. , DATE ~//~//0~ INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .O~..~.}.., 19 Approved ..O~ ..~.1 .... 19~..~, Permit No../.9..~..~.~..~'.. Disapproved a/c ..................................... Received .......... ,19... (Building Inspector) APPLICATION FOR BUILDING PERNllT Date.. ~.~-~-../.c~. ...... 19 ~.tS' 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 {~ 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, b, uilding co0~T139a~sing code, and regulations, and to admit authorized inspectors on premises and in building for necessary~sp~ns,~, ~r .... ~ (Sighature of applicant, or name, if a corporation) - . .................................... //?..5.a (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ....... ............................................................................... Name of owner of premises .... .~'.0.~. !..QQ.d....~../.~../'/..~'... O.~. 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 .... .~" '~-' ! F .............. Electrician's License No....~...~J..~. ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section .... /.0~,.~ ...... Block . .O.~..~O. ........ Lot .O~,.OD.~ ...... Subdivision ...... ~.~O.O..~0~ ....... Filed Map No...O.~.q~ ..... Lot.../.O ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: gOcon lon a. Existing usc and occupancy .................................... ................................. ['['x "'X b. Intended use and occupancy .......................... 3. ~dfk (check W ~ Repmr .............. .Re~r 4. Estimated C0i~ .!.:..~..f~_.~ 5. If dwellilii'/n/n~er of ~i¢;llin 1 /~11. 12. 13. 14. pplicable): New Building ...~.'..... Addition .......... Alteration .......... loyal ............. Demolition .............. Other Work .............. ~. (Description) !~. ....................... Fee ...................................... ~ (to be paid on filing this application) units ..... ]. ........ Number o f 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 ...::..' 7 ............. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories . .~. ..................................................... Dimensions of same structure Mth alterations or additions: Front ................. Rear .................. Depth .................. I · · · Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .... .~]. ~. ...... Rear . .~t.J .......... Depth . ..'~. t. ......... HM~ht ~.~] t Nt,:mhev of Sto'%o Sizeoflot Front ~,.B. ID~ ... Rear...;~C]].t. ............ Depth ....~.J..5.' ............ Date of Purchase .... t~.O ./.~..~.,..I.~ 8.4 ......... Name of Fomer Owner ~dOat~. ~O~ CC. ~O.~P..... Zone or use district in which premises are s tuated ........................ ~ ...... j. .... Does proposed construction viglate any zoning law, ordinance or re~lation: .. O.O ............... Will lot be regraded ...OD. ~ ............ ~ ....... Will excess fill be removed from premises: Yes ( N~e of Owner of premises .~ ~ ~ ~ f~¢.~.. Address~P,.~(~Ot.~.~~ Phone No. ~.~.Z~.~ Nme of Architect ... * ......... Address ........... Phone No... ~' ~(~ Add ..... ;; ............. Nme of Contractor ............. ress ............ Phone No .... *~ ......... PLOT DIAGRAM Locate clearly and distinctly all 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. Jee atino hed_ . STATE OF NEW YORK, COUNTY OF..,,,b-'~ .~..F"~ .6~ .~. S.S !)! ....... t.c:gbeing duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ....... 0~.O..TQ.~,~../07..0_<~ ................................................................ i (Contractoi, 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 in the manner set forth in the application filed therewith. Sworn to before me this : NOTARY PUBI. IC, ............. : ........... . ..... ~vo. ti~.4~$t4Ot~ //'//3 ~ . ,,.., ~ , · / (S~gnature ofappJicant) ' COMMISSION £XPIR£$ MARCH 30, t~7r~ , . # i..01- I0 SUFFOLK COUNTY DF~ART~[~NT OF HEALTH FOR APPROVAL OF CONSTRUCTION ONLY ~AT~. ~ ..._~. ~;0. APPROVI~D ~ SINGLE FAM LY u~u-,- ' Z ,1 t' £ LoT got I0 SUFFOLK COUNTY, N, Y. ~CALE~ i"z ~0' ~L,'G. /g, 198G DEC. 15, 1985 ,. f t41ol SURVEY FOR EARL gt DIA NE BEDRICK AT MA TTI TU~K TOWN OF SO~THOLD / LoT LoT I0 ' $ ' t ~5 O0 % SUFFOLK COUNTY HEALTH SINGLE FAMILY H.D. REF. NO. DATE '~ ~ -~g~ THE SEWAGE DISPOSAL AND LOCATION HAVE BEEN Chief 010/f 'MENT .FACILITIES FOR THIS I'Ht~ DEPARTMENT AND ~ment Section SURV£Y FOR EARL 8 DIANE BEDtWCK ~f~ MA ?"TI TUCK T~N OF $odTHOLD ~FF~K COUNTY, N. ~ 765-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST []FOUNDATION 2ND []FRAMING ROUGH PLBG. INSULATION FINAL , '," ,' ' '," ' ' ' ~:~ ~JtLOING DEPARTMENT-AT -' · ,,, '~ ,,'~" : ;~' ~ . ' ' ' '"~1~'~ 9 AM TO"4 pM EOR THE ,, ~' ' ' ' ' '~' ' ' ' D ..... ;~G&PLUMBNG , )Bt[~ ~.'- ' ' ' ' C 3 ~ T~b :~ION ~ALL'MEET ' ~", }ES NOT RESPONS BLE ~R · t ,'}',, ' . "". , , ,,.' ' .;,,.";,' " i' &' 11 1. I i A A %'1 rj