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Home My WebLink About13796-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.%41,3.5. ........ Date ........... J. ant]ary. 6. ........... 1986. THIS CERTIFIES that the building ,-.-.new, .dNelling, G..acceasor.y..gara,ge ........ Location of Property ... 8.6.2.5 ............... .~.ickh. arg..~y.~toue .......... .Ma.tti/:~.ck.. House No. Street Hamlet County Tax' Map No. t000 Section ... ~.O.7 ...... Block .... 95 ......... Lot ·.. OQI...~ ........ Subdivision ..... Z ......................... Filed Map No...~ ..... Lot No.. X. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .~..arck .~0 ...... , 1913.5. pursuant to which Building Permit No... $~.7.9~..Z ........... dated ...... ~arcl~ .26 ............ 19135., 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 ...a ...... The certificate is issued to ..... .R.I.q .H~..Rp..~,...&..P..~?.R.I.C..I~...~.:..G.TkI. 8..K.E.R' ............... (owno~, lF~ ~r-t~rt~nO of the aforesaid building. Suffolk County Department of Health Approval 85.-~8.9.-3.1 ,.. 1.2./.5~/f35.,.. Sg.ephen..~.~..C.o.s*ca, Po ~. UNDERWRITERS CERTIFICATE NO ........ ~.~.2'7. $ 221. ................................. Plumbers Certification 12/31/85 Building Inspector Rev. 1/81 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 13796 Z Permission is hereby granted to: /.) o ~..~,...~Z~.....~.~.,.~.: ....... ........ · , ! ~ .~..~,~,-....~...~ ....... t....~.~ .............. ,o .~..~...~.~~..~.~...~......~~ ~.~ ........ ~ ....... ~..~., .................................................................................... ~t pr,m~es ~,tea ,t ..3.&&~.......~.~~...~.... ....... .~.~ ................. County Tax Mop No. 1000 Section ....... /....~...7. ...... Block ......... .~.'~.. ....... Lot No ....... .~.~..~... ....... pursuont to application dated ........ .~..~...o~,...C~....~. ................ , 19.~...~... ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Bu ildlng Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted 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 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 al~ 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 safetv 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date New Building .... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...:~).~..~.'.~'.....~.t..~.~.~i,~..~..v.~%... ~ ......... ~A~.L..~..J~...~i .J~U.'.~-. !~. ...... Houae No. Street Ham/et Owner or Owners of Property . ,~ .~.~.-~ .~; (c~, ............ ~ ,~.c, 5~ q~t .c.~. ~....~,~...,~ j¥~. tf' .............. ..... County Tax Map No. 1000 Section ..... I.Q ;7. ...... Block ...O. ;.~. ........ Lot .... [.,..~. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~?. ...... Date of Permit .. ~. .Applicant...'~..,.~..C.~..(,.0. r~.%.{.~.q c. 5.~ ~.~. ........ Health Dept. Approval...~:.~.~.0..-.-~..]. ........ 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 ............................ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. t 1971 TEL. 765-1802 ~ Tow~ o~: souE_oqt D CERTIFICATION Building Permit No.~ Owner ~ t C~ ~',~ ~d ~ (please print)- ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~l day of ~e¢~b~- Notary Public, <3~}~/& (plumber' s signature) FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE Ye FINAL ADDITIONAL COMMENTS: THE NEW YORK,,BOARD OF FIRE UNDERWRITERS BUREAU OF EI-ECTRIGIT~ 0(~50~ 85 JOHN STREET, NEW YORK, NEW yORK 10038 THIS CERTIFIES THAT in the following locatlon; ~ Basement X~ 1st FI. ~ 2nd a. saraqe Section B,ock Lot was examined on DOC CJ~E: ~ ~, ~ ~ ]. ~ 8 5 and found to be in compliance with the requiremen ts of this Board. FIXTURE FIXTURES RANGES COOKING DECKS ~ OVENS SWITCHES FLUORESCENT DISH WASHERS EXHAUST FANS OTHER APPARATUS: ~.~..C.I. 2~ Smoke Detectors- 2 E R v I C E /'"GI~NEI~A ~UtM* N AGER lhi$ certificate m~st not be oltered in any manner~ retarn to the offke of the 8oord if incorrect, moy be identified~ their credentials. · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Ap proved.. ~/i0~44~..~. (o.., 19 ~ .~'. Permit No./..~7. ~.~..~..~- Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT mR 2 01985 TOVV!J" '"' Received ........... ,19... Date ......... 19 INSTRUCTIONS a. This applica.tion must be completely filled in by Wpewriter or in 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 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 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. Tile applicant agrees to comply witi~ ail apphcabi~ iaw~, ordinanc~es/'bt~dihg'code, i~ousing code, and reguiaaons, and ~o admit authorized inspectors on premises and in building for necesslr~ inspecti~ns,,-~ /) /) /q (signature of a~piic~n~; o~ name, if a corpor, atjon~~'-- State whether applicant is owner, lessee, agent, architect, engineer, gener~al contractor, electrician, plumber or builder. (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. ~.~..~.'.~.[/~..1 ...... Electrician's License No....~_..~.. ~..~..~r~. .... Other Trade s License No ...................... I. Location of land on which proposed work will be done .................................................. ' ,qwr ..........'... Number ................ Street ................ Hamlet ' ~ ltouse County Tax Map No. 1000 Section .... /..~. ~. ........ Block ~ ' Lot... ~..~. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) . 2. Stateexistinguseand~ccupancy~fpremisesandin~deduseand~ccupancy~fpr~p~sedc~nstructi~n:.~..~q~..~ a. Existing use and occupancy .................................................. , :. '.b. Intended use and occupancy ............ .. ........ 3. Natureofwork(checkwhichapplicable): New Building .... Addition., ........ 'Alteration .......... Repair ........ - ...... Removal ............... Demol n .............. Other Work ............... 4. Fstimated Cost ................... Fee ....... , .............. (to beI paid on filing this application) s. if dwelling, number of dwelling unit~ ~..~...~. Number of d~ning anit~ on ~a~h ~oo~ If g 7~O arage, number of c~s ...................................... ~ ............. ,, .... ....~ ...... d 0 fly f h ty~p 6. If business, commercial or mixe ccupancy, spec nature and extent o oac e of use .................... 7. Dimensions of existing structures, if any: Front ....... Rear l Depth Height ..... Number of Stories . ~ D~ensions o~e structure with alterations or additions: Front ..... ~..;; .... Rear. :'~...' .......... Dep~ ........ .~ ............ He~t ........... /~.~.~ ....... Number of Stones ........... ~.t ....... 8. Dimensions ~ire new construction: Front... ~..~.' .... Rear...~q~]ffff.... Depth . ~. ........ Height ....t.~ .......... Rumber of Stories ......... ~...~ ..... ~ ................ i2. Does proposed co'nstruction violate any zoning law, ordinance or regulation: ...~ ........... . ............. ~..~ 13. Wal lot be regraded ..... ~P ..................... Will excess fill beremo~6d ~prem~ses:~ PLOT DIAG~ Locate cle~ly ~d dist~ctly ~1 build~gs, whether ex~sting or proposed, ~d. ihdicate ~1 set-back d~ensions from prope~ ~nes. Give street ~d block number or ~escHption accord~g to deed, ~d sh~w street nines and ~dicate whether interior or comer lot. STATE OF NEW YORK, COUNTY OF ................. ~/bo -~( , l ~O' I (Name of individual signing contract)' above named. being duly sworn, .depbses and says that Itc is the ............................................................ (Contractor, agent, corporate officer, etc. of said owner~or owners, and is duly authorized to perform or have performed the application; that all statements contained in this application are true to the best of hi work will be performed in the manner set forth in the application filed therewith. Sworn to before me this HEt. EN K, O~ VOE "~ No 4707878, Suffolk fiounty~,o~' Term Exp,es March 30, ~aid work and to make and file this k~owledge and belief; and that the ........ County~ .~/ ~.~/-- .., :f.° -I L' ":"' ' ' (Signature of applicant) RICHARD GLISKER & PATRIClA GLISKER ~TFOLK COUN~ DEPARTMENT OF H~ALTH SERVICES AT MATTITUCK FOR APPROV4L OF fiO~TR~Jg]'lO~ OF ~WN ~ $OUTHOLD SCA~E: I" Single F'amdy i~esidence Ody SUFFOLK COUNTY, NEW ~RK ~o. e~ -97 SURVE~R'S INKE(; SEAL O~ EMBOS$ED SEAL SHALL ~. ~,.. "" ~m~ , h] YOUNG ~ YOUNG RIVER*AD, NEW YORK AL~N W. YOUNG~ PROFESSIONAL AND LAHD SURVEYOR N,Y.S. UCENSE NO. 1~845 HOWARD W. YOUNG~ LAND SURVEYOR ~ ~ ~L(W),~IC TANKIIT)B C[~S(~) ~N ~E~ N.~. LICENSE N0.45893 BRAND,S & SONS iN(;* 1046 , ~"" u~'~',~r"°~ ~ %. S SEPT 4, 1985 ~ ~ ~ ~ ~UR~Y FOR ~UNE 5, ~985 RICHARD GLISKER & PATRICIA GLISKER MaY 2o,19e~ ~T MATTITUCK o~f[, FEB. 19, 1985 ~be ce~ ~spoe~[ ~ ~a~e~ s~Z~ ~N ~ SOUTHOLD SCALE. I = 50 ' fact'litiesfor this location ~ve been Inspected by this department ~d found, SUFFOLK COUNTY, NEW ~RK NO. 85- 97 [0 be ss[l~se[o~. ~ ~ ~~-.j4 ~ ~u~lZ[O AL~E~IO~ O~ ~OO~T~O, m m~S GUARANTEED TO= ~__ '~' ~' %3 ='' SURVEY '4 VI~TION ~SECTfON 7209~ TH~ AVIN~~~ Chief of General Engineerin$ * CORIES ~ ~15 $~VEY HOT ~A~G THE LAND LAWYERS TITL~~P~c~ HEAL~ DEPARTMENT-DATA F~ APPRO~L TO C~STRUCT ~E ~R~ FOR WHOM THE SU~EY IS PREPARED "" I YOUNG YOUNG RIVER~AD, NEW YORK NOTE I = MONUMENT ~ = STAKE ALDEN W. YOUNG, PROFESSIONAL ENGINEER ASO ~ND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG LAND SURVEYOR · ~ L~f~ ~ ~C(WI,~C f~lIfIa C~I(~I ~ ~[~ N.~ S. LICENSE NO. 458~. ~ REAP, F' L F' VA--i OWNERSHIP OF DOCUMENTS PROJECT NO.~ THESE D,~,AWIF!GS AND SPECIFICATIONS AR,E I,NSTRUN~ENTS ~,E AN,D S,ffr%LL R,EM,\IN TH,E PROPLI/TY OF li-IE AR£HITEC1 ,CIH,ER l I I,: J~L~OJLG[ FOR~IICH TH,EY A,I~,E NIAJ~E IS EX,L. CU [,ED OR NOT. TH~EY A,f~E NOT TO BE USE, D ON Ally OI'HER, p,RO,JECT EXCEPT BY WIUT~EN AUTHI~RIZA¥10,N OF THE A,ltCHtTECT. THIS pROJECT IS TO BE LOCAl'ED AT ,, I 4"4C-'N6 4, LA~ A¢,9\~ PLAN CX~ CC JOl'I "C .14LJN~ I:::lz01vt F L 0 0 P, b h t t IZ 14 J[ d' F=,~ T 1 0 i',d LEON ROSENTHAI- e_se suN.'_S~'-~W~Y c .t~T YALID'FO~ BUIL, DII~ P~MIT WITHOUT, i,':;BABYLON' ' '