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Home My WebLink About14432-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. Z.1.q86.4 ......... Date . September 10 19 86 THIS CERTIFIES that the building A d d i t i o n Location of Property 315 Fat Lane ~ Mattituck, N,Y, House No. 1 1 4 ~t~et 00 6 Ham/et County Tax Map No. lO00 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8.5p 14432Z 0 c t o b e r 2 1 , 19.. ursuant to which Building Permit No. dated .. [19.v.e.m. 12 .e.v.. 1. 9., ............ 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 ......... .......... F. ami.l.y..r O.o~..$¢.d.J~g. $ 9.n. .%.9..e.x.i.s..t.i.n.g..o.n.e.. f..a.m.i. 1. y....cl.w.e. 1..1.i.n.g. 1' .&..d.a. gk. The certificate is issued to ......... W..a.l.t.e..v. 5..R..o.by.n.. r..v.u.p.s..k.i ........................ (owner, I~e~ ~t,Zt~t~ of the aforesaid building. Suffolk County Department of Health Approval N/ UNDERWRITERS CERTIFICATE ~o N ? 6 4 2 8 B Rev. 1/81 Inspector 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) Ne 14432' Z Date ...~.~..~ ............. ~ ..... , Permission is hereby granted to: ...... ~.~.~:~ ..~...~.~..,;~.,....~ ..... ~..~...~.r...~....~ .......................... ...... ...~...~....~....:....~...~.~.=..~..:.~:..../..~..~.~- c , ~- ~f) ~q~, . .. ~ :~..~ ,o ...... ~c~..~.~.~.....~...~.......~....~m.o,~....~ ............. ~.~.~.....z~. ~......~ ..~... / .... ~c~ ................. : ........................ .;= ....................... : .................... .~.... ............. ' County Tax Map No. 1000 Section ..... ,<../...<X<.. ......... Block / O Lot No. ..~..~....~.. pursuant to application dated ..~...~'~..~.~..Y~... ....... ~.. ............ , i92.~., 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 This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the foHowlng; 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. Su bm it Plann ing Board approval of comp leted site p lan 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~Coperty 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. ~..~es: ~ertificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancv $ ] .00 4.Vacant Land C.O. $5.00 5. Upda.ted C.O. $15.00 NewUons tr~uc tion . .f?%... Old or yre-existing Building $15.00 Date.../Z.~j?..~..(~.~. ?-...?~./..~..~..~ ............ Vacant Land ............. Location of Property ...................... ............................ House No. ~ Street Ham/et uwner or uwners oT ~ roperty ..................... .z..: ;' ./.'... ¥.- ............ ~2~ ' ' i~ /ii County Tax Map No. 1000 Section ...././..~. ....... Block....--/..L./. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit Uo./~.~..'~.: .~.. Date of Permit . .Applicant . .~..~.~...7~.. Health Dept. Approval ...~... .................. Labor Dept. Approval ...................... Unde~riters~pproval '~' ~Z~-'~ .... ~ ...... ; ........... Planmng Board Approval ................... Request for Temporary Certificate ..................... Final Certificate ........ ~ ............ Fee Submitted $ ............................. Construction on above described building~nd, pe~mit r~e~ts ~l._ap~licable codes an~l~gulations. ............. TOWN OF SOUI'HOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 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. /~/ The check is outdated. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. b~t/C c u se.z) DI THE NEW YORK BOARD OF FIRE UNDERWRITERS ~;g I BUREAU OF ELECTRICITY ~,u~t,t~.~: ~-'5, .[~bEB JOHN STREET, NEW YORK, NEW YORK 10038 ~.,~ ~,,~.,,o. ~o. o~,,~ N 764283 only the el~trlcaJ equipment ~ ~scribed below and int~duced by t~ applicant ~med on the a~ve application number i~ the prem~es of ~s exa.dned on &~g~ ~ O l ~ &9~b and found to be in compliance with the reqt~ireme~ts qf this Board FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 6 9 5 6 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVIC~ DISCONNECT OTHER APPARATUS: S E R V C E ~'.0. ~ox 1309 g:i. ctL~344~ GENERAl. Per_ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ma), be identified by COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED NANY MANNER FIELD INS~ECT~ON COMMENTS , , ~ FOUNDATIO~_ (]st} FOUNDATION (2nd) ?? / ROUGH FRAME & PLUMBING INSULATION FER N. STATE ENERGY ~,ODE FINAL ADDITIONAL 76S-1802 BUILDING DEFT, INSPECTION I' ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PI. BG. [ ] FOUNDATION 2ND ~,~ INSULATION ~(~ FRAMING [ ] FINAL ]65-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION' 2ND [ ] INSULATION ~)~FRAMING [ ] FINAL REMARKS: DATE INSPECTOR __~~, Res ~uilding Pex~lt 1~o. 1~J432 Thanks fo~ your p~ompt response to m~ ~equ®a$ for an inspection on m~ new foundation. Enoloae~, for [eu~ x~cox~s, is ,an updated sux~ey whioh your Depa~-~ent · ~equi~es. 1~o,, the looks ef it, all is in order. ~ossib~e~ ~ ~ou h~ve an~ que~ionso BLDG. DEPT. TOWN OF $OUTHO[D i I t- 'Town OF $Obrr~OL~, N.Y, $,4 MATT tTL3 TOWN OF Examined/~/d~... ,/. ~. ..... , 19F.~ Approved ~d~.. [. 7 ...... , 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~4DUTHOLD, N.Y. 11971 TEL.: 765-1803 1 .9~.. Permit No./~. ~.5~--'--'--'~. Received ........... ,19.. · (Building Inspector) 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 g 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 constraction 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~~ ~ . /) Q'NL . (S'~plicant, 6r name, {iS/a coi~poration) ........... ih' ili;i .......... State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises ...W.a..1-.t.o.v., .J:..K.r..u.p.~.k.i.s...J..~...a~..d...Rg.b..~...A.,...K~.. p.s.k.i. .................... (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 ..... f ~-d~-~. · ....... Plumber's License No ......................... Electrician's License No. / I 1. Location of land on which proposed work will be done. : ..................... ........................... 31~ Pat La~e Ma~tituok House Number ~ Street Hamlet County Tax Map No. 1000 Section .... ( ( .~. ......... · Block ..... [.O. ...... r .... Lot... P .............. Subdivision....D.O. 9.v..P.a.v..k .(.J.o..s.ep.h...D.o.e?.ko~i ) Filed ~ap No. MA,..x9.-4326... tot. :th. ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy ot proposed construction: a. Existing use and occupancy .... .~.i.n.g.19..F...a..m...i.l~y. Residp.n.qo' .-...Fg.ur.. 9.~.e.u.P..ant.~. ........ b. Intended use and occupancy . Fmmzly Room 5'o~ Sznttjlo Pal~l.v .R. esi~lence- Pou~ .0.c.c~parxts 3. Nature of work (check which applicable): New Building ..... ' .....Addition i'...,X:~fi.... ,Mteration ~ .X~...., .... Repair .............. Removai .............. Demolition ......... ~ .... Other Work.. ]~.o~l~: ........ . , (Desc~ption) 4. Estimated Cost ...... ~ ~ ~ ............... Fee ............................ ~' (to b~ paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelhng u tts o c eot .... ~ ........... Ifg .~ arage, number of cars ................................................................. 6. If business, commercial or mixed occupancy, specify nature and ext~nt of each t?e of us~ .... ~ ............... 7. D~ensions of existing st~ctures, ifany: Front...~5~ ......... Rear ...6~~ ........ Dep . .~7.~ ........ Height . ~.t ........... Number of Stories ...... ~ ................. D~ensions of same structure with alterations or additions: Front .~oo~ ~o~... Rear .................. Depth ...................... HeiSt ...................... Numbor ~f Sto~es... ~. ................. Dimensions of entire new construction: Front . . 3~ ~6'~ ....... Rear .... 3~.~fi'~ ..... Depth ... 1~~ ......... Height . ~ I ...... Number of StoHe~ . . . ~ ........ 9. Size of lot: Front ¢9.0~ ........... Rear..~9~ ............... ~ Depth .~¢~. ~ .~¢~.~ ......... !0. Date of Purchase .................... Name of Fenner Owner ~ ... ~9~ .~gg~ ........... 11. Zone or use district in which premises are situated ....................... ~ ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .. [ ............................. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises ~. fi,. X~p~d~. 3].~. ~ .~.. Phone No. ~16.)..298~.~026 Nme of Architect ........................... Addres~g~.~O¢~s ~Xa.. Phone No ................ Nme of Contractor .......................... Address ............. [ ..... Phone No ................ PLOT DIAG~M Locate clearly ~d distinctly fll bu~d~gs, whether existing or proposed, an& ~ndicate fll set-back d~ensions from prope~y ~nes. Give street ~d block number or description a~ord~g to deed, ~d s~ow street nines and ~dicate whether inte~or or corner lot. STATE OF NEWff~;~I~, r,, S.S cO, OyN)r¥ · .~..~..(f~.. ~.'../~f.~'.~. i.V.' .................. being (Nfime of individual signing contract) above named. duly sworn, deposes and s that he is the a ,licant He is the ............................................... j .............................. (Contractor, agent, corporate officer, etb.) of said owner or owners, and is duly authorized to perform or have performed thC said work and to make and file this application; that all statements contained in this· a~0plication are true to the best of his knowledge and belief; and that the work will be performed in t~t¢ manner set forth in the application filed therewith. Sworn to' before me this ............ ~/~dfif...: .... davro f .... ~..2~..~...f-?:~.. .....19 .~.'T Notary Public, ~?.~ ,~,,~,~,~ ......... Coun't)' ~. ~ ~ ~-~',x4 - ~ ~ ~ / ...... ·., '· ' · .... ' · ' I g I4¸ ~'65 lB0'~ 9 A~A TO 4 PM FOR./~ FOLLOVVINg INSPECTIONS: J Z t ,7 4 - I , FLOOR PL~%N ,. 765-1802 9 AM TO 4 PM FOI~ 'THE~ FOLLOWING INSPECTrONS; L]. FOUNDATION - TWO FOR POURED CONCRETE Phone 477-0400, ~ Main ROd