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HomeMy WebLinkAbout14157-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14496 Date June 9 ., 19 .86. THIS CERTIFIES that the building .... .O.n.e,..~..e~.~..ly..d..w.e.l.l.J:n..9' ..................... Location of Property ..... 9 10 VANSTON ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. ! 000 Section . , .1.0. 4. ...... Block .... 1.2. ......... Lot 010; 2 Subdivision... ~a.s..s.a.u..P. 9.i.n.t. ............. Filed Map No..1.5.6. .... Lot No.. 19 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... J~.l,7. ~[ 2 .......... 19 ~1.5. pursuant to which Building Permit No. 1.4.1.5. .7.g ............... dated J.~l.y..2.4. ................... 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 family dwelling. The certificate is issued to .... ~.R:..&...H.R.S.....D.A.N. IlE..L' .S.A.R..N.O.~.S.K..I ....................... (owner, of the aforesaid building. Suffolk County Department of Health Approval .... 8. 5. :- .S.O.-7 } .2 .4 ..... .6./. ~./, .8 .6 ................ UNDERWRITERS CERTIFICATE NO ............ ~.7..4.7.2.8.8. ....... .4.43.0.{.8.6. .............. Plumbers certification 6/5/86 Building Inspector Rev. 1/81 IPOB, M NO. O TO~t,4 OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14157 Permission is hereby gronted to: ~/~ ......... ~¢z~.~..z~z.~...~.....-/~.~......~/~... ............. ~Z~. ........ .~..~o.~. ................. ........... ~.z-z~/..~...-.....~z:..)~.....z~. ?~¢ , ,o ............. .~. ©~. ~...x..~....c<..c.?:... ....... ~.6z..~........~..~ ~...~'.......z~z~.. ~.//x~_~.....~ ..... ............................................. ...%~_~.z.~-...~......~.~.a~..~..~/.:...../. ...................... at premises located at ....... 2~,,..~, ....... .~.~X%/...~./..--C~.~......../~..t~9..~ .......... County Tax Map No. 1000 Section .. ,/,',~,,..,~,, ......... Block ..... Z.~,,, ......... Lot No..~,,~.,,~,.:.,?., ...... puts,ant to application dated ........... ..~..0....~...~.. ........... /.~z~ ............ , 19.Z.~.~"'and approved by the Building Inspector. Fee $...~.7...7.....~ Building Inspector Rev. 6/30/80 '~FORM NO. 6 TOWN OF SOUTHOLD Buil~ling 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, propertv 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 sifnilar 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 o 0 0 3. Copy of certificate of occupancy $1.00 4.vacant Land C.O. ..00 5. Updated C.O. $15.00 Date ..~ ......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Owner or Owners of Property~..~ ~..~q~/ .............. Cou.ty 000 S c ion ..... Permit No. ~ ........ Date of Permit pplicant Z~. ~,. 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 ....... FIELD tN~PEC~T ION DATE ~O[JGN FRAME & PLUMBING J~,~SULATiON PER N. Y. STATE ENERGY C~ODE ADDITIONAL COMMENTS: THE 1000121 April THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 :~0,19a0 .,,,pllcatlo,,~o.o,,~,~ :~o~1~/8~ N 747288 only the electrical equipment ag described below and introdo~ced by the ~pplivant named on the above application number in the premises of Daniel, Sarnowski~ 910 Vanstea Rd., Cutchogue, N0'¥, in thefollowlng location; ~ Baseme~tt ~ 1st FI. ~j~ 2nd FI. Section Bloch Lot was exantined on A~)'~~ j. 1 ~9 4 ~, 19 8 6 and found to be in complia~ce u,ith the requirements of this Board. 33 ~9 49 35 DISH WASHERS EXHAUST FANS TIME CLOCKS MULT~-OLITLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: Smoke NO. OF HI-LEG E Paul. Burns 275 Town Harbor Lane $outhold~ N.Y~, 11971 ~NERAL MANA~EE must not be altered in any manner; return to the office of the ~oord if incorrect. Inspectors ma~,.be identified ~y their crede~tia s. , COPYFOR~UILOINGDEPARTMENT.?HI$COPYOFCERTIFI~ATEM~S'[NOT. BEALTEREOINANYMANNER. TO~N OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date ~-g/~/~ ~ /~' Building Permit No. l ~-/ /~'-'~.~- Owner (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. plumber s sxg ) Sworn to before me this ~ day of ~"~-1 Notary Public,, ~-~ County Notary Public ~ 76S-'~ 802 BUILDING DEPT. INSPECTION ['] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [*'~J~FINAL REMARKS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .,~./.c,,/.. 2~ 1 .9.9~.." Approved...~O...~..~....7_..~..., 19~..~. Permit No../.~/./..~.'.7. iDisapproved a/c ~ '- (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTR~IcTIONs Received ........... ,19.. · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets 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- bation. c. The work covered by this application may not be commenced befom'i~suance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall 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 hall 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 luilding 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. ~he applicant agrees to comply with all applicable laws ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. 0.~\ ~' ~ ~O~,NS ~-~ sP~, ~. .... ~.L,.~....~.'.~. ...................... I~Oil~i~ C entrectors ~ (Signature of applicant, or name, if a corporation) : ~25 Second Street ................ t ........ 3.t??.ct ........ ' Greenport, ~ew York 11944 (Mailing address of applicant) State whether applicant is. owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. z. 4 .................................................. Name of owner of premises . {~ ~., .'.~./~.~ l ~../'m'.....~.-....oC'.~../~..ffi. P..P~..~..~. ~. .............................. (as on the tax roll or latest deed) If applicant is a corp_qration, signaturg~of duly aqthorized officer. (Name and title of corpogate officer) Builder's License No ..... ~../Td ............... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... !. Location of land on which proposed work will be done .................................................. I ..... ~!~ ............ ~4 !?~'.rp. ~.. ~ .~.o. .... ~ ..... .C.~,..~.ew.v..~.~,~ ...................... House Number Street Hamlet County Tax Map No. 1000 Section ..... l..O..~.. ....... Block ..... J...~:-. ......... Lot....~97'.. [..~.-..'~.... Subdivision....~.5'ff,4J.Ld ...................... Filed Map No. 0.,.. I.q~..(o .... 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 ~' '~;~ "~*~* ' ' · · ' ' ' ' ' ' ' ' ' ' · ' ' '~'/~' 3. Nature of work (cll.e_ok wllibl~ applicable): New Building .. ' ... ',addition .......... Alteration .......... Repair W~ ~ ~1~' 'i'L~In°val .............. Demolition ... _.. ........... Other Work ............... 4. .o. po.., o. .o. .. Fee ....... ~[JO~JO~ qO i~'~, :~.~[ ~ ...................... .... ~ ............... ~ t (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... Number of dx telling units on each floor ................ If garage number of cars : 6. If business, commercial or mixed occupancy, specify nature and extent >f each type of use ..................... 7 Dimensions of existing structures, if any: Front Rea: ' Depth Height Number of Stories Dimensions of same structure ¢/ith, alterations or additions: Front . .............. · Rear .................. Depth ................... 1... Height ...................... lumber of Stories ............... '-- 8. Dimensions of entire ne_.w cons~mction: Front .... .~F~./. .... Rem .... ~.~./. ...... Depth Height ...Z~.. lQ../.'2u. . Number of Stories .... . .~../-~. ~) ...... 9. Sizeoflot:rront ..~.~::~...ieff. t~.~.../ ..... Rear... ~.2.~..'i"' iiiiii'b'e;[~'iiii.~i~.~.'~.'.~.'i/.iill'' 10. Date of Purchase .O,~..~,~'/~rse~'. .g~.~'.4 ...... ~ ;}~d~e Owner ~,. O~. ~.O~l. '. 11. Zone or use district in which p~emises are situated ...................................................... 12. Does ,proposed construction ~olate any zoning law, ordinance or regulal ion: . ~ ............... ~ .... 13. Will lot be regraded . .~0]~.., ......... ~ ........ .. Will esFess fill ? removed from premise~ ~ No 14. Nme of Owner of premises ~,. ~l~d.d$~g~ddress ~ q ~ ?~.~. Phone N~.0/} Nme of ~chitect ~ ~& S ......... ~ .................. Address .. . one No ................ Nme of Contractor .~x~.~ .................. Address ....... Phone No. ~7~XZZ~... R~BINS AND SPEED, INC. Building Centre~tors P~T DIAGRAM ~25 Second St?eet Locate cle~fi~s~[ bg~s, whether existing or propos t, ~d. indicate dl set-back d~ensions from prope~ ~nes. Give street ~d bloc~ number or desc~ption accord~g to deer ~d show street nines and indicate whether interior or coruer lot. STATE OF NEW YORK, COUNTY OF ................. S.S ........ ; ............................ being duly s' ,ru, deposes and says that he is the applicant (Name of ~ndiwdual s~gqlng contract) above nam ed. He is the ..................... . ................................ (Contractor, agent, corporate of mcr, etc.) of said owner or owners, ~d is duly authorized to perform or have perfor ned the said work and to m~e and file ~is application; that all statements con' ained N this application are true to the >est of his knowledge and belief; and that the work will be perfomed in the m~n ~r set for~ in the application filed thereu ith. Sworn to before me this ............. ....... d yo .............. NotawPublic ...... ~..~.~~... County \ / LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK'CO. HEALTH DEPT. APPROVAl H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS rESIDENCE WILL CONFORM TO The STANDARDS OF THE SUFFOLK CO. DEPT. OF heALTh SERVICES. APPLICANT SUFFOLK SERVICES -- FOR CONSTRUCTION ONLY DATE: h. S. REf. no.. APPROVED: COUNTY DEPT. OF HEALTH APPROVal OF SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. ~coo i 0.,4- ~2 P/o ~0 OWNERS ADDRESS: lb DEED: TEST HOLE STAMP SEAL -- j r/ RODERICK VAN TUYL, P.O. LICENSED LAND SU~V~ORS GREENPORT NEW YORK $-UFF~L-~ CO~'~---{EALTH DEPT. APPROVAL H S NO ...... FOR THIS RESIDENCE WILL the STANDARDS OF The THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS CONFORM TO SUFFOLK CO. DEP~ O~.HEALTH SER~CES. ~APPLiCANT. - _ ~ - SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOr aPPrOVal OF DATE: CONSTRUCTION ONLY SING~ FAMILY DWELLING ~Y SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL ~ {O~ ~2 rio ,~. OWNgRS ADDRESS: TEST HOLE STAMP / SEAL I I -I §iN~ FAMiEY DWELLING ONLY ~ 1 -~.O~'F'~-Lk.-C~. HEALTH OEP,~PPROVAL ' ' H,S. NO. SUi~FOI~ CO1/~TY HRAI~H The se~a~ di~o~al ~d faoilities for this !~eation tnsp~ted by this de~rt~en; a fo~ x. -~., ahi~f~of Gefieral ~gineeri~ S C D~T. OF ROD~RICK VAN TUYL. P.C. LICENSED LAND SURV~ORS GREENPORT NEW YORK STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE Will CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTh SERVICES. {S) APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL Of CONSTrUCtiON ONlY DATE- H. S. REF. NO. APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT BLOCK PCL. OWNERS ADDRESS: ~ --,. .~ :,_::~_ ~Z..y..~ ~__..~. TEST HOLE STAMP SEAL copper tubing is used for water distributing system; piping sho|I be of types K or L onJy , ~TiFIC~,~J, oST 'THE CO~bCS' NOT FOR C, O. s~-~ ~ ¸%, /2. ~ ,I Ni ?,