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Home My WebLink About14124-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy THIS CERTIFIES that the building .... 0.~...Ffi.~I..L7..D..~.E.L.L.I. ~9 ...................... 15~5 BREAKWATER ROAD MATTITUCK Location of Property ............................................................ House No. Street Ham/et County Tax Map No. 1000 Section . .. 1. Q ~ ...... Block .... 0..8 ......... Lot .... 0..2.0...~ ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated d. qO~..1.q .............. 19 .8.5. pursuant to which Building Permit No.1 ~. 1. 24 Z dated ... ,J .u~_.y.. 9 .................. 19 .~.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 D.AWN. D.RI$..W.%~g%g. MS...&..H.U..S.B.&~.D...S.H.~.~.Iq..~.5..L.L.5.A.~ .S ....... (owner, [~&~j~ ~tXl~fJfO~f~ X X of the aforesaid building. Suffolk County Department of Health Approval ..... ~ 5.-.S. 9 r.l.q 5 .......................... UNDERWRITERS CERTIFICATE NO ............. N.7.3. zt .8.7.5 ............................. PLUMBERS CERTIFICATE Feb. 24 , 1986 Building Inspector Rev, 1/81 FOF,,I~ NO. ~ TOWN O~ ~O~T~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OP THE WORK AUTHORIZED) N_° 14124 Z Permission is hereby granted to: ......... .~..~.~......:~..~ ................................ ........ .~.~.~.~ ~ ...... ....~. ........... ........ Z~..~../..~.~C.~..~..,..~....//..~..~. Z ,o ....... ~.~.~ ~c~...~........o.~.~....~..~..~. ~.~.../~c~.~..~.Zz~..~ ................................ County Tax Map No. 1000 Section .../..~.~:;~ ........ Block .....~'..~... .......... Lot No....O..~..~..:/...~.... pursuant to application dated ......... ~,~-...../...~.. ................... , 19.Z~...Tond approved by the Building Inspector. Building InSl:mctor Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 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 property 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 $15.00 3. CoPV of certificate of occupancy $1.00 :.~..~...~.~. 1~. ~..~.' 4.Vacant Land C.O. $5.00 5. Updated C. 0// $15.00 Da~e ..... New Building ...... ~.....~ld or Pre-ex~ing BFilding , ........ ,f~. Vacant Land .... ,. ~ ..... Location of Property.. ~..~.,. ~~..~ ................ House No. ~~ ~ Steer' ~ Hamlet Owner or Owners of Property . - - ..~..~~.~~..~ County Tax Map N,, 1000 Section.../~.~. ...... Block.. ~ ........ Lot..0.~.~ ~.. Subdivision ~ ~.~ ~... ~ ~].~.. ~F ileal Map N o ........ LotNo ...... ~ ..... ,ealthDe-t A-nroval -- ::'/~ LaborDe t Approval ...... .... ,,a..,.,,o.., ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ ............. .... .................. C~nstruc~n~b~vede~erib`dbuildlnga~:~/.r~tmeet~aH/~/~ic~b~/:de~a~dregui~tl~n~ ^p,,,cant : . .................. Rev. 10-10-7S THE NEW YORK BOARD OF FIRE UNDERWRITERS £0UOUgl I~UREAU OF ELECTRICITY ~"~g £~_85 JOHN STREET, NEW YORK, NEW YORK 10038 in the fotio~ing l~atlon; ~ Basement ~ 1st FL ~ ~,,~ ~'t. Section Block Lot was examined on and found to be in compliance with the requirements of this Board. OUTLETS SWITCHES FLUORESCENT 35 40 DRYERS OTHER APPARATUS: S E R oF cc, COND I c E NO OF HI-LEG AW.G OF HI-LEG ~uChold~ ~Y 11971 LiC#137E GENE~ALMANAGER 11 ~, ,.4 Pee t } ~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentlaisJ cOPY FOR qU, ILDING DEPARTMENT. THIS COPy OF CE RTl ~ICA"~ ,M U~'r S O,T~:~LT£~ED IN ANY MANNER LEAD CONTENT IN DRINKING WATER (To be executed by plumber) WHEREAS, Section 905.5 of the New York State Building Construction Code requires that the lead content in solder used for soldering copper tube soldered joints shall be limited to.~% when it has been determined by the Town that a higher lead content constitutes a health hazard and WHEREAS, the Town of Brookhaven on January 17th, 1984, adopted a resolution declaring that the use of solder containing more than 2/t0's of 1% lead content in interior plumbing, is hereby declared to be a health hazard and WHEREAS, the undersigned is the plumber responsible for soldering the copper soldered joints or. directly supervised the soldering of the joints within the job listed below, IN CONSIDERATION for the Building Inspector of the Town of Brookhaven issuing a Certificate of OccupAncy for the subject premises, the undersigned hereby deposes and states that the solder used in the interior plumbing of the below job contains no more than 2/10's of 1% lead content. TOWN OF ~OUTI~OLD p~_ 'r. I~T NAME Sworn to before me this ~9-l/~ day of J~ NQ'~A RY PUBLI C~ ~ Building Permit No. Job No. Job Name ADgANCE PLUMBING & HEATING CO., INC. 515 Route 25A MT. SINAI, N.Y. t1766 ,D i.N S I~E~TION ])ATE COMMENTS ~...,~_, ~ ...... [DATION (2nd) PLUMBING ~LAI'ION FERN, Y. STATE ENERGY C,ODE -- t"] ELD 1. f,'OU N D/~ FOUNDA~ ROUGH 3. iNS 4. ADDITIONAL COMMENTS Donald M. Hand, P.E. Charles G. Burton, L.S. James B. Behrendt, L.S. Roger P. Smith, R.A. BURTON, HAND ?. BEHRENDT Engineers · Architects Surveyors 144 Medford Avenue Patchogue, New York 11772 (516) 475-0349 · (516) 567-6300 July 26, 1985 TOWN OF SOUI'HOLD Town of Southold Building Department Main Street Southold, New York Re: Our File# 85-342 House Plans Dris & Williams Dear Sirs, We have recalculated the roof rafter size of the above mentioned project and have found that 2X10 roof rafters at 16" O.C. are acceptable over the two story area. ( see sheet 4 of 11 attached & revised this date.) Please make note.,of this ~n your field inspection. ~ R g~e~. Smith, R.A. Burton, Hand, & Behrendt RPS/jak attachments ~FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined 19 -- ^pproved .... Disapproved a/c .......... (Building Inspector) APPLICATION FOR BUILDING PEBMIT INSTRUCTIONS UgL__ ..... 8LDG, DEFt. Received ........... ,19.. Date , a. This application must be completely filled in by typewriter orin 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 petrol* 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 inspec.t, iogs. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. Name ofownerofpremises . /~.~t'c/A'~ '~'/4 ........ (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...~./.~, ~... ~9..~... 7 ...... Electrician's License No.../~../,~..~..0. ?..~..~ ..... Other Trade s License No../.~../.~.[.-~ . . .0...~. ...... Location of land on which proposed work will be done .... .~..~f~..~. ~ .~...d~. ~ .... .~.., ................ / V-A,/4-. ....... House Number Street Hamlet County Tax Map No. 1000 Section ..... .~..~..~. ....... Block °~2~ Lot.~ .47. :'..~. Subdivision ~'' '~"' '~'~"gU .&~.x/f...(Name) '3'~' f'ff' ........Filed Map No. / Y~?. ¢.~ ....... .)Y(.... Lot.. ~ .......... State existing use and occupancy of premises and intended use and occupaflcy of proposed construction: Existing use and occupancy b. Intended use and occupancy .... /. ................................................ 3. Nature of work (check which applicable): New Building .......... A dition .......... Alteration ,..: ...... Repair i~ Remb val . . . Demolition . Other Work ~ t __ ~, ~f ~. (escnpt~on) 4. Estimated Cost ~/~x [/~-o ~ ....... Fee '~ ,.ff..~. i "' I (to~paid-on fihngth~sapphcatlon) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars .... ~ ' ~" ......................... "l ................................... 6. if business, commercial or mixeld occupancy, specify nature and extent ( f each type of use ..................... 7. Dimensions of existing structurgs, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure W~th alterations or additions: Front ................ Rear .................. Depth ................... !... Height ...................... umber of Stories ...................... 8. Dimensions,;~u. of entire, new construction:r,~,~ r e,._.~...Fr°nt ............... Rem .............. De~th._. j .............. lO, Date of Purchase ...... ~r/..~-/yT.. ................. Name of Former Owner . .~..~./~.~fi...D~..,~. ........ 11. Zone or use district in which piemises are situated .~.~2/o~/,~--~ ". ..... ' ..... 12. Does proposed construction vi61ate any zoning law, ordinance or regular: on: ....~..Q .................... 13. Will lot be regraded ....... ~.../~. (9~ ............. Will excess fill te remoyed from premises:, '~ 14. Name of Owner of premises ,~ .~.. ~..D. Ig.45 ........ Address ~_~.q~..~9 ........... Phone No/~.~'~ .... '.ff. . Name of Architect . ~.~{0 .~..~...ff~zT. rY.~ ..... (?././A~d~:~.(P...'7 Same.ofContractor~../~./~d.z4~)da*41ress A3.~ ~t~...ff~...PhoneNo~.~c-~._~.?_.;r.i.~.. PLOT DIAGRAM " Locate clearly and distinctly all buildings, whether existing or propo,, ~, and. indicate all set-back dimensions from property fines. Give street and block number or description according to dee~ and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, S.S COUNTY OF .................. ................ being d~ly (Name of individual signing contract) above named. ' , of said owner or owners, and is d~ly authorized to perform or have perfo~ application; that all statements contained in this application are true to the work will be performed in the manrlerset forth in the application filed there Sworn to before me this .day of., Notary Public, . ........... County ...~..( ,osdsland says that~he is the.applicant ricer, etc.) rned the.s~[d work and to make and file this best of ~ig'e~'l~howledge and belief; and that the 'ith. THOMAS J WILLIAMS NOTARY PUBLIC, Slalo of No~t ~o~~ ~uoJified In Suffolk Co~anl~ ............... (Signature of applicant) R=18.50' L=54.5~ ,4/)o~, _ 0 .0 faciliti*~,a fer this loe~%to~ have been tnflpeoted by this dop~rt~ent a~d ~ou~d Ohte~ Of ~en~l Sngineerin~ Services SURVEY FOR DAWN DRIS AT MATTITUCK TOWN OF SOUTHOLD SUFFQLK COUNTY, NEW YORK NOV. 5, 1985 DATE: dUNE I~, 1985 SCALEr I''= 40' NO. 85'711 ~L. I/~-----~ Vfqtt iKI/~_ c~ V/'%l ikl/'~_ 4(X)OSTRANDERAVENUE ~1~. ~ I~UI~ ~ I~UI~ RIVER~AD, NEW ~RK RE= LOT NO. 2~INOR SUBD v SION FOR ANTHONY & II ~M ~ AND ~ND SURVEYOR N ~S UCENSE NO 12845 HELEN DRIS' ~ .... I HELEN ORl: ~J ~ HOWARDW. YOUNG, LAND SURVEYOR W ~ flE~ ~MTI~S ~ OR D&TA OlTmMO F~ OTHERS