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Home My WebLink About13973-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z !/41.?.~J .... Date Jan. 21 ... ......................................... , 19 86 THIS CERTIFIES that the building .... .0.n.e...f.a.m.~. 1. 7..d.w.e..1.3..i.n.~ ...................... Location o f Property ...... 3 .~ .5.0...~ .1.d.r.i..c .h..L.a..n .e ................. .L.a.u..~ .e .1 ............. House No. Street Hamlet County Tax Map No. 1000 Section .... 1.2. ~ ..... Block ..... 0.1. ........ Lot ...0.0.2.; 1. .2 ........ SubdivisionL. a..u.r.e.~...E.s.t.....~.a.s.t...S.e.c.... ! .... Filed Map No. 7870 .Lot No. 3 conforms substantiaJly to the Application for Building Permit heretofore filed in this office dated .... ~aV..1.7 .......... ,1985. pursuant to which Building Permit No. 1 .3.9.7.3. .g ............... dated . Hay. 23 .................... 1985., 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 ......... .... Ome..~ ~ ~,t.l.~'. ¢~.e. ], $ ~_,n.g, .................................................... The certificate is issued to HILARY WOWAK ..................... k .................... of the aforesaid building. Suffolk County Department of Health Approval ....8 5 - S 0 - 7 4 .J.a.n...~ .6... ! .9.8.6. ............ UNDERWRITERS CERTIFICATE NO ........... .N.7.~. 5. ~ .5?.....D?. c. :..q.q. ~. J .9.8. 5. ........... Plumbers Certificate 12/18/85 Rev. !/81 Building Inspector FO~I~ NO. ~ 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) NB 13973 Z Permission is hereby granted to: County Tax Map No. 1000 Section ........ L..~...~ ......Block .... ..~...~ ........... Lot No....~.~..~.~..~.... pursuant to application doted ........ .....~...~.....~..~. ................. , 19..~.~.~ and approved by the Building Inspector. Fee $ ....................... Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFI'CATE OF OCCUPANCY Instructions BLDG, DEPT. TOWN OF SOUTHOLD This application must be filled in Wpewriter OR ink, and bubmitted I ~ 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 featu res. 2. Fine{ approva~ 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 buiJdings, 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. 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 Vacant Land ............. .5% \- Location of Property. ~ .'~0 ..... ?,:~. ....... ?...¥- ............. . .~--..~. ?. ....... House No. Street Hamlet Owner or Owners of Property ........ .~.~ .~..~.'-~ .... .(~o ,~J ~ County Tax Map No, 1000 Section \~'~ Block O ~, Lot .... Subdivision ................................. Filed Map No ........... Lot No .............. ot''~'~ ."~--.. Date of Permit __ 1 .< .App,,cant Permit N ................................ Health Dept. Approval..~. ~.-..~. · .~?..\.~. ........ Labor Dept. Approval ........................ Underwriters Approval ..................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ ............................. Construction on above described buildin§ and permit meets all applicable codes and regulations. .................... Rev. 10-10-78 z/¢/73 :[oo.~:~o THE NEW YORK BOARD OF FIRE UNDERWRITERS O~, BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 100:~8 .ate~'~ '~, ~ ~.~,,~,o~ ~.o.~,,~ ~07/~ N 7 2 5 9 5 3 THIS CERTIFIES THAT only the electrical equipment ~ ~ser{bed be{~ and introduced by t~ eppli~nt natned on ~he above application number i~ the premises of ~ll~y ~lw~, 1350 ~'i~ ~. ~ ~u~ez, ~ Y i,~ the following Ioe,tion; ~ B~ement ~ Ist FI. ~ 2nd n. Seetlon Block Lot w~ examlned on I~ ~ e ~ and fon~ to be ln compllance ~v~th the requlre~nents of this Board. FIXTURE OUTLETS DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 52 4 TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS ~ERVICE DISCONNECT OTHER APPARATUS: S E R V I C NO. OF HI-LEG 3/0 chem~ir~ J~. Co~ Ave Mattituck~ N ¥ 11952 Lic 953 E ~ ~G~NEI~AL MANAGER must not be altered in any manner; return to the office of the Board if incorrect, Inspectors moy be identified by their credentials. ) IN 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 W~.\ ~ 0-~'-~ ~J~O~ ~ ~C. (please print) P u er0'(,o (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to befor~me this /~ day of Notary Public, County (plUmber s s~gnat~ ) Notary P. ubl ic z~ F1ELD INSFE~T~ON FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY qO E FINAL ADDITIONAL COMMENTS: 76S-180~ BUILDING DEPT. INSPECTION [ ] ROUGH PLBG, FOUNDATION XST FOUNDATION AND,[ ] INSULATION FRAMING [ ] FINAL DATE ,INsPEcTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,r $OUTHOLD, N.Y. 11971 TEL.: 765'180,3 ]xamined .~, .c~. '.~ , 19 ~.~. . .~%.~-.~., 19~.~. Permit No..I..~ .~..~..~.~. ~pproved )isapproved ale ..................................... "" ................... "? (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, with 3 ,'ts 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 tall 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 ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, 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. ~ .-- .... ; .... ''' iii'gh;i]r'e';i nam'e, if a corporation) ~D, Bg~..3.~....Miller. P3.ace.,. N.Y~..1176~t. ...... (Mailing address of applicant) whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ Owner Hilary Wowak )whet of pr6mises .......................................................................... (as on the tax roll,.or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... (~:~\~6 ') Laurel Estates East, Sect. 1" Location of land on which proposed work will be done .................................................. ~ Aldrich Lane Laurel, N.Y. House Number Street Hamlet County Tax Map No. 1000 Section . .J:2..5:.0.0. ......... Block . .0..1: .0.Q .......... Lot...(lO 2 o 1).12 ........ Subdivision .L.~.U..~9.1-..~..~g.a.'q.e..~..E.~.~...8.Oqg....1,. .... Filed Map No. .7.$7.0 ......... Lot... 3 ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Vacant Land a. Existing use and occupancy ..................................................................... Build one family dwelling b. Intended use and occupancy .................................................................... 3. Nature of work (check which app!icable): New Building ...XXX .... Addition .......... AJteration .......... Repair ; ............. Removhl .............. Demolition .............. Other Work ............... (Description) ~ ~ $70 000 00 4 Estimated Cdst ' ' Fee (to be paid on filing this application) 5..If dwelling, number of ~welhng u[uts.., tag .... Number of dwelling units on each floor.., ope. If garage number of cars 6. If business, commercial or mixed occupancy, specify nature an~d extent of each type of use ..................... 7. Dimensions of existing structures~ if any: Front ........... . ....Rear .............. "Depth. .............. ' Number of Stories Height Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth Height Number of Stories 8. Dimensions of entire new construction: Front. ~.4.9.. ft ........ Rear . .4.9...~.t... ...... Depth . ~ .8..t~'¢, ...... Height J-.~ ~-]: Number of Stories ' 9. Size of lot: Front .... 100..~. · .! .......... Rear ..... 100. ' Depth 401~ *. 10. Date of Purchase 5./.9,/85. .' .... . ................. Name of Former Owner .lull. a..San. Andror~'.Saland. 11. Zone or use district in which premises are situated .................................................... 12 Does proposed construction viola%e any zoning law ordinance or regulation: 13. Will lot be regraded ... ~s...' .................. Will excess fill be removed from premises: Yes N, 14. Name of Owner of premises . .Hi.l. alry. l~2wak. · · Address Box · .B8.~ .Mi.l&.elr. pP.j~one No. 744~,4847..~.'~ X Name of Architect .Robe~ .Baesol[t~o ....... Address F.l. ush.~}g, · N...¥, ·. Phone No ............... Name of Contractor ......................... Address ................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from proper{y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, I COUNTY OF... 8u~ol~ ...... Hi.l. ary Wowak . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ,, ,; (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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .......... .~)~]~ ......... day o~...Ma~. ............. ., 19.815 Notary PuJ~c, ........ .~-//f~"~..q..~ .~ ............ County ,,?% ~UFFO~ COUNTY DEPARTMENT OF HEALTH SERVICES FOR APP~VAL OF CONSTRUCTION OF Single Family Resideflce Only HEALTH DEPARTMENT- DATA FOR APpRO~/AL TO CONSTRUC T SUR~Y FOR HILARY WOWAK LOT NO.5" LAUREL ESTATES EAST, SECT I" AT LAUREL SOFFOLK COUNTY~ NE~ NOTE ~m=. MONUh4ENT '~]~:STAK~. SUBDWISIf:N HAP FII_[O iN TIlE OFFIC~ 01: *I'HE CL~-ITK OF SUFFOLK COUNTY ON APR 4,1')85 AS FIi E NO 78'/'0 YOUNG YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGtNE[ AND LAND SURVEYOR N Y.S UCENSE NO ~2 HOWAROW. YOUNG~ LANDSURV[YOR N.'~ S. LICENSE NO 45893 SURVEY FOR HILARY WOWAK ~.FI:O.I.~ COUN1Y DEPARTMENT OF H~L'fH SERVICES LOT NO.3" LAUREL ESTATES EAST, SECT. I" APPROVAL OF CONSI'RUCTION OF AT LAUREL DATE' FEB. 22,198.5 FOR, Single Family Residence Oi~ly TOWN O~ SOUTHOLD SCALE: I" :50' ~ J-' ~,~0 SUFFOLK CO~,.TY, .E" .ORK .~.. 8~-,. DATE 9,?/'~"Y~ HS REF..0. : 7z7Z SURVEY ~l A VIOLATION Of' SECTION 7209 OF THE HILARY WOWAK ~ APPROVED NE,,, YORK STATE EDUCATION LAW SURVEY~)R'S INKED SEAL OR EMBOSSED SEAL SHALL RGUARANTEES INDICATED HEREON SHALL RUN (~NLY TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CORSTRUCT T~E flERSO~ FOR WHOM THE SURVEY ~S PREPARED AND (~1 HIS BEHALF TO THE TITLE CONPI~NY, GOVF~qR- N NEAREST WATER I~A N~MI. -~ NSOURCE OF WATER: PftlVATE __puBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED N SUFF CO. TAX M AI~ .ST 1000 SECTION 12, ILO CK O I.LOT 2,12 HERE., RRB TO T.E R SS,GREES O E '~HE L END,RG!!t' ~'~"~'~.r~',' NT~EI~ il~ 140 OWELLING$ WITHIN I00 FEET OF THIS RROPERTY INSTITUTIC~I, GUARANTEES ARE NOT TR~SFERABLE TO ADDITIONAL IRSTITUTION$ OR SUBSEQUENT ""'" ~°'" ~ j fi] YOUNG YOUNG~o.~.oE. ~v~[ ~,~,~,¢-P.. DyI 0'1, ~t"l~qT[L' ~ 8 RIVERHEAD, NEW YORK NOTE' Il= MONUMENT ~=STAKE ALDEN W. YOUNG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FILED iN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y.S. UCENSE N0.12845 SUFFOLK COUNTY ON APR. 4, 1985 AS FILE N0.7870 HOWARD W. YOUNG~ LAND SURVEYOR #114E LOC~T~ OF W~'LL(WI,~PTIC TANKIST)& CE!~.ed~)OLS(CP)SHOWN I~EON N.Y.S. LICENSE NO.4§Bg3 &RE FROM FIELD O~RMi~TIONS NAO OR DATA OITNM~O FROM OTHEtIS BRANDIS & SONS IRC, 1046 5Ulr~'O~[ OOU~' H~f,A~I'U DEPA.~T~,~ SURLY FOR ....... HILARY WOWAK ~ ~A~ 1 ~ 1~ R.D. ~. ~~ Y LOT NO.3" LAUREL ESTATES EAST, SECT. I" NOV. 16,1985 JULY 22~1~5 AT LAUREL DATE= FEB. 22,1985 tn~eot~ b~ thio d~p~,mt~ut ~ remind _. SUFFO~ COUNTY, NEW ~RK NO. ~t~ O~ ~ ~ W COPIES ~ ~15 S~VEY NOT ~&R~G NOT ~E CONSIOER[D TO ~ A VALID TRUE COPY NGUA~ANTEES INDICTED HE~EOH ~ALL ~UN ~LY HE~ DEPARTMENT-DATA F~ APPRO~ ~ C~STRUCT ~e ~R~ FOR WHOM THE SU~EY tS PREPARED N~EM A~ ~ ~[LLIMi WITHIN I00 FEET OF T~l PROPERTY INSTITUTI~. GUARANTEES ARE ~T OTHER THAN THOSE SHOWN HEREON1 ~ A~ITI~AL INSTITUTI~S OR SUBSEGUENT ~c, ~ ~ ~ OS~NDER AVE~E NOTE: I= MONUMENT ~=STAKE ALDEN W. YOUNG~PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y.S. UCENSE N0,12845 SUFFOLK COUNTY ON APR. 4, 1985 AS FILE N0.7870 HOWARD W. YOUNG~ LANO SURVEYOR BRANDIS & liONS IN;, t046 f ,,1 [~\ / I [ . I ,.,,/ , ¸%1 APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 I[ copper tubing is Used for water dlstri_b_uting sys, ern; piping shoJ[ be of types K or L 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: l, FOUNnATION _ TWO REOUIP. ED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ON LEAD CONT~N BEFORE CERTIFICATE OF OCCUPANCY ALL r~IqTp,JCTION S}4ALL MEET DES, / ~OT RE~NSIBLE FOR DESIGN OR CONSTRUCTION ¢11 L __ L PIE-~ - L_E~_ -- --= = I j ii 11 V~F~T L L L