Loading...
HomeMy WebLinkAbout13893-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13907 Date October 7 .................................................. 19...85 THIS CERTIFIES that the buriding...~eW. ~W~i~.%Dg ............................... Location of Property 145 Custer Ave. Southold House No. Street Hamlet County Tax Map No. 1000 Section ....0.7.0. ..... Block ....0.8 .......... Lot....0.2.7. .......... Subdivision..F..a.i.r.v.i..e.w..P.a..~.k .............. Fried Map No.. 3. .3 .8.8...Lot No .... 2. ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated Ap ri 1 12 ,19 .8.5. pursuant to which Building Permit No. 13 8 9 3 Z dated ...... .~]~.~.~...2.6. ........... 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 ......... ..... New Private one Family Dwelling ...... The certificate is issued to .............. ' f. M~RG. ARET .' (owner, ............... ~- of the aforesaid building. Suffolk County Department of Health Approval ........ ,8.5..Z..S.O..~..4 .8 .................... N703479 UNDERWRITERS CERT[FZCATF~ NO .................................................. Rev. 1/61 Building Inspector I~OB, M NO. ~ TOWN OF $OUTHOLD BUILDING DEFARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT frillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13893 Z Permission is hereby granted to: /] ....... .............. ........ ~.=......~.~..~... ............. ........ ~ff.~.~..~z..=...~...:.~. ..................... ,o ........... ~2.Zz.;F. ~.~.c~.......,~..~...~...~=./:~/~./.~..~...,~.;~c,,~./_f,,.~....~..~ ........................ County TaX Mop No. '000 Section ..~..~..~.. ........ Block ...~...~... ........ Lot No..~..~../Z. pursuant to application dated ......~..F/.~/..~....../.~... .................. , 1,~and approved by the Building Inspector. Rev. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink. and submitted ~'/l~ 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 electrica~ 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 p~'operty 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 requ ired to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ............. Old or Pre-existing Building $15.00 Date... ~/~/~.~. .......... Vacant Land ' Location of PropErty ........................... House No. Street Ham/et OwnerorOwnersofProperty ..~,.~.,~, ................................. OountyTa×MapNo. 000Sect, on ...... ;'Z.O .... B,ock ...... ...... Lot .... ....... Subdivision ..~..~. ~..~....~4~, .......... Filed Map No. ~. ~$~..Lot No...~...... ..... Permit No~ ~.~ .~ Date of Permit~l~.~'.Applicant.. J~l~,. ~1~~.*..~.. .......... Health Deot. Approval .$.~..~.~.~...~g ...... Labor Dept. Approval ........................ Underwriters Approval/~.70~.~.?..l~.J~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .... ~ .............. Fee Submitted $ .......................... (~)-~. I'd;ID 9 Applicant .......... .,,,ir ...........· ...... ~ ............... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.re August 6~1985 ~pplie,tio, No. on/ile 332189/85 T.,S CERT,,:.ES T.^T N 703479 only the electric~l, equlomer~t a~_ de~clibed below and introduced by the apRllca~tj%an~ed on .t]~ above a~olica ion tuber i~ the re ' ~a~ret ~u'c~ovich~ (;usher AVe., (Hex~tman Job)~ Sbu~o~ N.Y." wasexaminedon ..y ~9 , ].. ~ .XTURE 2~ OUTL~,S RECEP,A¢ ES 2'3 DRYERS [] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS SWITCHES INCANDESCENT FLUORESCENT 24 23 FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: Motors~ l~l G.P.C.I.~ 1 Smoke Detec[or~ 1 S E R V I C E OF CC COND. OF HI-LEG OF NEUTRAL 4 4 G & S Electric ~//~A~ Box 215 certificate must not be altered [n any manner; return to the office of the Board if incorrect. Inspectors may be identified by'~heir credentials. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~ ~.~?~ Z '(please/p~'ih t') (please printS' ( I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this /~7-day of ~ 19~. Notary Public, County NOTARY PUBLIC, State of New Yor~ Commls:~ion E×p{res i~arch 30, ]9~ IELD INSFEC~ION DATE FOUNDATION (1st) 3. STATE ENERGY ADDITIONAl COMMENTS: BUILDING DEPARTMENT BLDG. D.F.F. _ · ~ U H LD, N.Y. 11971 - TEL.: 765-1803 ~~~ a Examined~..~..., 19~ ~ Disapproved a/c ...... -~. ~ . T. .................... ......... .... ' ' ..... ~Buildi'~'I~;~t;;~ ........ APPLICATION FOR BUILDING PERMIT Date April 12, 19 85 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 tets 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 ar 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 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 ghall 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. ?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary inspections. Heidtmann & Son, Inc. (Signature of applicant, or name, if a corporation) P.Oo Box 932, Cutchogue, N.Y. (Mailing address of applicant) rate whether applicant is owner, lessee, agent,-architect, engineer, generai contractor, electrician, plumber or builder. General Contractor lame of owner of premises ...R.:..B. lq..t..kp.v.J: .c.h' ........................................................ (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 ......... 1.Q ............... Mattituck Plumbing Pinmber's License No ......................... Electrician's License No..G. &..S. El. Oct;....Collt;r. Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. </.5-- Custer Avenue Southoid House Number Street Hamlet 70 8 27 County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision "Fairview Park" Filed Map No. 3388 Lot 2 (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~':~.~- ~ ............. --~ family..dwelling, .-~(~. .................... ...... o ........ ~,¢.,~ ........... ~.~. o.n~ .... b. Intended use and occupancy ............................ ,.... ................................. 3. Nature of W~O~k~l~e~.l~hich applicable): New Building .. X .' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 60,0o0.00 o (Description) 4. E~timat~d ~:os~ .............. [ ........................ Fee .................................... ! ~' (to be paid on filing this application) 5. If dwelling, number of dwelling u~its .... ...........°ne Number of dwelling units on each floor ................ If garage, number of cars ...... i .o.B~ .............................................................. 6. If business, commercial or mixed !occupancy specify, nature and extent of each typ. e of use ..... ......... .......... 7. Dimensions of~.x~isting stmcturesi if any: Front..· Rear ....... Depth .' ......... He' ht XK , . o~ _ ~g ............... Number of Stones ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .~ ................... ~. Height ...................... Number of Stories ...................... · -' 8. D'anensions of entire new const~ction: Front ...59.'.':/*'.' ..... Rear ...59! .-.4'! ..... Depth . 26 t .......... Height .....1.4/ ........ Number of Stories . . one ...................... . Size o et: Front ' f ............ ........... , .......... a ..................... De I ..... r ........ I0. Date of Purchase ........... t ................. Name of Fo.m!er Ow. ncr ............................. 11. Zone or use district in which premises are situated reszdentxal · ' 16 12. Does~proposed construction vm te any zoning law, ordinance or regulation: .. no ........................... 13. Will lot be regraded ...yea... i .................. Will excess fill be removed from premises: Yes x No rp '~[ '~B~a~g~.qh So.Uthold 14. Name of Owner o remus e ......... Address ......... Phone No ................ Name of Architect ' Address Phone No Name of Contractor........Hiedtmann....~...........Son Address Cugchogue 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 bloc number or description according to deed, and show street names and indicate whether interior or corner lot. See attached Survey STATE OF NEW YORK, is.s COUNTY OF ................. Henry G. Hetdtmann '' ............................ ~ .................... being d y sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. A.g. ent He is the ........................ . ............................ , ................................... , : (COntractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this apphcatmn:; that all statements contained m this application are true to.the best of his knowledge and belief; and that the work will be performed ~n the mann.er set forth in the application filed therewith. Sworn to before me this i'~; .............. day df ........... , 19 Notary Public,. ...... ~ .......... County} \ ~ / '- // / UNDAJ. COOPER -- NOTARy PUBUCo State of New York ~ k_~ v ,, Si nature of a licant ! No, 48221~63. Suffolk Cour,~ / ' ~-----~y---~ ( g PP ) Term Expires March 30, 19~...~ ~'~ SUFFOLK CO. HEALTH DEPT. APPROVAL H. $. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY SUFFOLK CO. TAX M*P DESIGNATION: Ut authgriz~ aJteretion or additio~ SUFFOLK CO. HEALTH DEPT. APPROVAL H S. NO. ~-~0 STATEMENT OF INTENT ' THE WATER SUPPLY AND SEWA~ DI~SAL ~ ~ CONFORM TO TNE STANDARD~ OF SUFFOLK CO. D~PT. DF HEALTH 5ERVI~5. A~LICANT ~U~OLK COUNTY D~PT, OF H~ALTH 5~RVICE5 -- FOR APPROVAL CONSTRUCTION ONLY SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK ~L, ~O'=I'' ~OOo o~o ~ OwNERs ADDRESS: TEST HOL~E ~AMP ~p) ~ -, .-.,~..~a o~ SEAL VAN TUY~, P:C. LANO SORvEYOR~ ~EE~RT NEW YORK " : / t ti If copper tubing is used for water distributing sys em~ piping shall be r~f types K or L onl=y ~LUMBER CERTIFICATION ON LEAD CONTENT BEFOR~ CERTIFICATE' OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSZEM Ct, NNOT EXCEED 2/10 oJ' 1% LEAD~ AP~©~D AS NOTED NOTIFY H~ILDING DEP~TM~NT A~ 765 1B02 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 4. FINAL - CONSTRH~TION MUST BE COMPLETE FOR C, 0 ALL CONSTRUCTION SHALL MEET THE REQU]REMENTS OF THE N. Y STATE CONSTRUCTION & ENFRGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. .-1L I__-q I_ LL3 I 1 ~ cl.- ~