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Home My WebLink About14199-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z14597 Date July 3 ' ., 1986__ No. one-family dwelling THIS CERTIFIES that the building ................................................ L ....:___~ ....... 6130 ' Sound Ave. Mattituck House No. Street Hamlet County Tax Map No. 1000 Section 1 2 1 . .Block 4 .Lot 5 Subdivision X .Fried Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore fried in this office dated June 24 19 8.5. pursuant to which Building Permit No. 14199Z dated ......... .~.u.g.u..~ ?.. ~. 3. ........ 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 ......... Private one-family dwelling. The certificate isissued to CHRISTOPHER & JULIA DANTES ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval .................. .~.5. Z .~ ?.-.1. ~..8 ............. UNDERWRITERS CERTIFICATE NO. N 704 576 Building Inspector Rev. 1/81 IFOu'mr NO. 0 TOWN OF SO~THOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14199 Z Permission is hereby granted to: ..... . . . Z .-. . . . . . . . ./. . . . . ..7. ...Zz/~.~z~,.~...,...~..~. .......... z~..~Z.&... ,a ......... ~.O..~..~...~..c.~ ....... ~....~..~.~..Z.~.~. ...... ~.~.././~.~Z.~ ................... pursuant to application dated .... ~,"~/~,~. ........ .~,.,~,,, ................. 19~.,,,,~,~ and approved by the ~]ulldlng Inspector. / Building Inspector Rev. 6/30180 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY J ~L_.____~jL~ Instructions A. This application must be filled in typewriter OR ink, and submitted i Imam~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. B. 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 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. $5.00 Date . /.7./. ~.dff.(o ..... New Building ...~. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property. G [ ~O....5. OX ~. J~.. ~ ~.E, .... to, ,~,~T~':T. ¢.0. I.~ W.- ~...I.l.~ ,-~. .... 4 House No. Street Owner or Owners of Property . ~.~. tk.~i~.$.-iT~.~. ~.~...J~... ~. ~ .J~ i J~ ..... ~./~..N.T~.I~o5 ........ County Tax Map No. 1000 Section .... /~ ....... Block .... L~ ....... Lot .... ~.O.~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. f .z~ .l.~..~..~. Date of Permit ~l.l.~. } .~'.~...Applicant. ~ ,//X~. $1-j9.~.. g,. 1~. ~ ~ Health Dept. Approva[ .Labor Dept. Approval ....... Unde~riters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate ..................... Final Certificate . .~ ................... FeeSubmitted$..~ .... ~..~ ......, ~~~' Construction on a~ove'de~ribed building and permit meets ail a~co~es and regulations. · ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY AUg~et J-3~, .I~9~]5 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the e~c trical equipment ~ described be~w a~d introduced by t~ applicant named on the able application ~umber in the prendses of in the foltowing location~ ~ Baseme~t ~ 1st Ft. ~ 2~ FI, Outside Section Block Lot was examined on A~ O~ ~ ~ and found to be ia compliance with the requirements of this Board. FIXTURE OUTLETS DRYERS FIXTURES RANGES SWITCHES NCANDESCENT ~[UORE$CENT OVENS DISH WASHERS EXHAUST FANS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS NIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: i~G.F.C.~. OF CC. COND. OF HI-LEG NO. OF NEUTRALS A. WG OF NEUTRAL 4 L~#717~ GENEI~A/ MANAGER must not be aJtered in any manner~ return to the oHke of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR EjUILDING DEPARTMENT. THIS COPY OF CEIR~IFIC~TE,M U~$T NOT ~E AL'[ERED !N ANy MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ]~/ Owner ~_~;'~.~ (please print) Plumber~ (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 2~R day of ~1~,~¥ , 19~ Notary Public, $o~ff~L~ County Notary Public MAUREEN KELLER #§TARY ~"UBLIC, State o~ NY 4782652, Suff~l~ Colllm, Expires March 30, FOUNDATION COMMI,N i ~ FOUNDATION (2nd) ~OU(H FRAME & PLUMBING !NSULATION PER N. Y. o2ATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 4 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING [-""] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE, F~i ~' iNspECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000~9t BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK ,10038 ~ate t~'At~:ry 14, 1~6 370398/85 ~pp,icat,on ~o. o~i,e N 731013 THIS CERTIFIES THAT [', W Cot. [~ald Awyaue, laurel, N.Y. in the following location; [] Basement wasexamlnedon ,]~.[1'~,~,~ 9~ 1~ EIXTURE FIXTUEES OUTLETS ~E~,EriACLE$ SWITCHES 21 33 ~ ~1 DRYERS FURNACE FUTURE APPLIANCE FEEDERS [] 1st FI. [] 2nd Fl. Section Block and found to be in compliance with the requirements of this Board. RANGES OVENS TIME CLOCKS UNIT HEATERS SYSTEMS NO. OF E Lot EXHAUST FANS DIMMERS SERVICE DISCONNECT OTHER APPARATUS: Motors: 1-~lhp 1--G.F.C.I. ].-~a~oJ~e Det¢~tor S E NO' Oi~E~,~CON D. R V I C A W, G. NO OF HLLEG OF CC. COND, 4 A, W, G NO, OFNEUTRALS A. W G, OF HI-LEG OF NEUTRAL ~1 ity Fitectric 10 East ~t~_in STRICT Sr~thto~ N.Y. 11.787 Lic~ 717~ GENEI~AL MANAGER Per_ , ,, certificate must not ~e altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by theii:' credentidJs. ~UILDING DI ¥ MANNER. Memorandum from.. · BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN [-]ALL BOX 728, SOUTIIOLB 765-1802 N.Y. 11971 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ~OUTHOLD, N.Y. 11971 TEL.: 76§-1802 xamined .... ,ppro ed ...... Iisapproved a/c .................. '.~. ................. APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This application must be co~npletely 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 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 issuanc/e-o,f a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County, New York,/ahd o~her applicable Laws, Ordinances or ,egulations, for the construction of buildings, additions or alterations, or for r,~moval Or demolition, as herein described. 7he applicant agrees to comply with all applicable laws, ordinances,, b_~uil~..g/~ode, h~{tsin~ code, and regulations, and to dmit authorized inspectors on premises and in building for necessa~/id/~cti~. ": .' .................. : ...... (Signatu~f applicant, or name, if a corporation) · N (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~/-]~L~'.~. O..~/-,/6/Po. ~ .~JT'. L/J,t~ ~ ......~)A:.:.~J,,/7~..6'--~ ....................... (as on the tax roll or latest deed) [f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No.. ~.6~. Electnman s L~cense o. Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. . I~;~i ~q;}nbelf. Street Hamlet -- County Tax Map No. 1000 Section ... ].g2, [ .......... Block ....... O1~. ........ Lot....O.O..~T. .......... Subdivision ................. ~, .................. Filed Map No ...... )~ ....... Lot ..... )q ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~.~. bt/,'1 .... ~.~9~/~ .............................................. b. Intended use and occupancy ...... /~.IP i .1~/¢~7.~. ..... ~.0.KOLC'. ....O~//~..~ ................. 3. Nature of work (check which abplicable): New Building .... 'Y~... Repair . ~ ~ ~:[~.. Rem?al .............. Demolition 4. Estimated Cost .... ~ .O.t~.O ............. : ......... Fee 5. If dwelling, number of dwellin~ units ...... ! ........ Number of d' If garage, number of cars .... ;: ........... ! .................... 6. If business, commercial or mixed occupancy, specify nature and extent * 7. Dimensions of existing structures, if any: Front ...... .'- ........ Rem · 'A( dition .......... Alteration .......... .......... Other Work ............... (to be paid on filing this application) 'elling units on each floor...-' ............. ~f each type of use .... .~ ........ Depth. ~ ......... vorn, deposes and says that he is the applicant 'ricer, etc.) med the said work and to make and file this best of his knowledge andJ>ot~f; and that the ............ STATE OF NEW YORK, ' S.S COUNTY OF ................. ................................................ being duly s' (Name of individual sighing contract) above named· He is the ....................... i ................................ I (Contractor, agent, corporate o: of said owner or owners, and is dUly authorized to perform or have perfo] application; that all statements contained in this application are true to the work will be performed in the man,er set forth in the application riled there, Sworn to before me this NOIAR¥ PUBLIC, State 'x No, 4707878, Sulfolk]Ooun~,, ~,. lem Expires Nlatch 20, 19.-~7 ' Height ..... .-. ........ Number of Stories .... .- ................................................. Dimensions of same structure with alterations or additions: Front .- ............. R ·. ear .............. Depth .... .- .............. .... Height .... .~ ................ Number of Stories...-:' ................. 8. Dimensions of entire new consiruction: Front .... ,.~.O/ ...... Rear....'~.~. ~ ...... Depth . .~.~4/, Height . ~ ~, ! Numl~.er of Storleq . . ~1~ ....... .. ................. 9. Sizeoflot: Front ...... /.~.7~ ............ Rear ..... ~,~.O.O..... ...... Depth ...................... 10. Date of Purchase .... .~7/.&l./.~.,~. ............. Name of rorme~ .Owner ...,Cng... z~,~c~e,[ ......... 1 1. Zone or use district in which pr~emises are situated ...... ~'$t'~ ~.7 ~ ,4~g.....': ........................... 12. Does proposed construction violate any zoning law, ordinance or regulat [on: ...,tt/J0 ..................... 13. Will lot be regraded ... A7 ~. i .................... Will excess fill ~e removed from premises: Yes 14. Name of Owner of premises r~/g/$~.~7, ~... ah ~ .~.~.~$ Address t4~.(l~. :7.~../d~ Phone No. -K~ q:/.'Z.,.~.O.4.... Name. of Architect . ~..O/'/~.. ~-t*.~,~ ~)j ,49. ~. ...... Address~/.-~,o2 ~J !~y. ~/,~ ,,~hone N~.~) 7~.~? Name of Contractor ... O/~.a~.~0~, ............. Address ............. :. ~..~hone No ................ PLOT DIAGRAM l,ocate clearly and distinctly all buildings, whether existing or propo~ t, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to dee( . and show street names and indicate whether interior or corner lot. .q'~ ~ -( \ \ EXCAVATION SUFFOLK CO. HEALTH DEPT. APPROVAL H. S, NO. STATE"w'tENT 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 COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY A~ROVED: "SUFFOLK C'O. T~X ~P STAMP ont¥ to the pef~o~ for wfl~m tPd~ tllJllR~ SUFFOLK CO. HEALTH DEPT. AI~OVAL ~ STATEMENT OF INTENT CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. ........................ A~LICANT SUFFOLK COUNTY DEPT, OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY SUFFOLK CO. TAX MAP DESIGNATION: OWNERS ADDRE~: HEALTH SERVICES RODERtCK VAN TUYL, P,C. 2. HD Z 13 la. ' I! AS NOTED · AT THE FOLLQWING I 1. FOUNDATION - TWO REQUIREDIL FOR POURED CONCRETE ROUGH - FRAMING & PLUMBINGI~'' 3.INSULATION 4. FINAL - CON'STRUCTION MUSTi~ BE COMPLETE FOR C. O ALL CONSTRUCTION SHALL MEETLY-. THE REQUIREMENTS OF THE N. Y STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 0 2. HD FL I~'T FL,L_ "~¢1.01I ¢ ~ FOOTtt'~ TO ~gA~ O~ U~DI~TUR~ ~0~.~ ~ UHDE~ P~U~DING FIXTU~, TO ~ P~oP~FY ~.~, coHSTRHCTI~N Toc,~dPPT~I,f~ CA . PL ,H :'. 1/511 = I Loll L/,,.N ~' R,'TI ?i5o7, 734- sNITCH ¢ ) ;50L-O~1 T'F~ -- ,Lop~ %1 ~IT(~HKH jp..L ~n FI R~T (~II , ,¢'.~.. ¥-0'1 If copper lubing is for water distributing system; piping shall be of types K or L only PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT ,EXCEED 2]10 o.f 1% LEAD. · t 4x~ =i ~EF..,OND ,FL.~:;~" PLAN ~(-/~,I.,.E.: Y4-"= V~T o~ ~l-co~y Io~-o" I I ~.x~ ~p.~ I~~1 I?~ Ill ~sp. ICK (-.,oL ~ M 1,,I '.~IF-dJTIOH ¢ LIVII,,!~ / 6. HRI'5 537; t. _ .t '1 537-175L ~ V~HT I i I-- ,~ cHAH~- - fY2. TIttE~ VOL., ~Vl~4Oovv~ - U = . o6~ FOP, P.. = 5TU/~F =%,o 15' lb, FELT IH~Ut-, 15ATT Iq.oO ~EFLEOTIV E ,%~R 1.00 ~,U~ VALUE R=1'5.57 : 1%,57 U: .074- .07~ FLOOR "KI '3 I~" PLYWOOD; ~1 TOT/M. ,P.. 1'5, 12. ~o~ V/~,LI¢ F_ ISTO/~ISF 3.2,5' U = .OIR (,,SI &) 537 ~ iI752-