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HomeMy WebLinkAbout13809-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z144~3 Date May 30 ................................................ , 1986 THIS CERTIFIES that the building ....... a.d. .d .~.~.~o..n ................................ · .2?.: ........... ? ..... Location of Property/:/~$~ bio? .6.0 ...........~.... ~ .~,l.e.y. Street Hamlet County Tax Map No. 1000 Section .... 1.2.2. ..... Block ......... .3 ..... Lot ...... 5. 5. ......... Subdivision .......... .X .................... Filed Map No. ,..X ..... Lot No.. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · ~r. 9.h..2.2 ........... 198.5. pnrsuant to which Building Permit No ..... 1. 3..8,0.9. Z. .......... dated .......... Ha..r.c.h..2..8 ......... 198.5.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ...~d&~.~,9~..~.Q. ~.~.~ ~.~.~. 9.n.e.~f..a.m.~.l.y...dy.e.g..~.~.nx: ............................ The certificate is issued to .......... 1~. ~.H.A.~D...A...L..UHR$ . td~,,or,~&k~d,t; .......... of the aforesaid building· Suffolk County Department of Health Approval ................... UNDERWRITERS CERTIFICATE NO ......................... N. 7 ~..~.8.o. 5. ................. Rev, 1/81 Building Inspector FOK~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT ('rillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 13809 Z County Tax Map No. I000 Section ....... L...2~..,.2~.. .... Block ....... .~ .......... Lot No ....... ..~'.,.~...'~.. ....... pursuant to application dated ...... ....~.~.~........~:....~... ................. , 19..~..~'.., and approved by the Building Inspector. Building In.~tor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Halt Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~ 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 e~ectrical 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 pZoperty 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 $1 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ... New Building ............. Otd or Pre-existiQg Building ~ Vacant Land Location of Property ..................................... Owner or Owners of Property ................................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/3Y~.¢ZDate of Permit .~/~..~ .Applicant .................................. Health Dept. Approval ...... Labor Dept, Approval .... .................... Underwriters Approval ............... Planning Board Approval ...................... Request for Temporary Certificat~ ..................... Final Certificate ....................... Fee Submitted $ ...... . .~...~.~..~.~. Construction on above described building and permit mee~and regu~tions._ Applicant ..................... Rev. 10-10-7a FIELD INg?ECT~ION COMMENTS FOUNDATION (1st) FOUNDATION Z. (2nd) ROUGH FRAME & FLUMBING e INSULATION FER N. STATE ENERGY QODE ADDI[ KS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION (please p=int) (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 19 ~ ' Notary Public Notary Public, ~J~ County / ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING ~FINAL REMARKS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10035 THIS CERTIFIES THAT only the e~ trical equ~p~nent ~ ~scribed be~ and introduced by tl~ applicant ~ned on the above application number ~n the premises of Richard A. L~S, 360 ~or~h Riloy Avenuo, ~ox 312, ~atti~l~k, I ~ 3 35 in the following location; ~ Basement ~ 1st FI. ~ 2nd Fl. Section 2~, Block Lot . , A~ril t0, 1986 FIXTURE FIXTURES RANGES :OOKING DECKS OVENS DISH WASHERS OUTLETS SWITCHES 18 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 2-G~F.C.I. 2--~moke D~te<~tors E R V I ~ ~,e~ A.W. G NO. OF HI-LEG NO, O E COND' OF CC COND. C NO OF NEUTRALS A, WG OF NEUTRA£ Rb~hard 360 North R/l~y Avenue Bo:{ 312 · - .... GENEI~AL M~NAG,, . · ~1 I I ~ '~ . ~ ~ ~ N0I S ~RE INANYMANNER. '~J 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. '.~C~..c~..~.~.., 19~.~.~ Approved . ,~)~.0~.~..~., 19;~(. Permit No. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF SOUTHO[.B Received ........... ,19... Date ~arch 2~ 19~.5. a. This application must be completely filled in by typewriter 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 htJilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa4ncy shall have been granted by the Building Inspeqtor. APPLICATION IS HEREBY MADE to the Building Department for th~ '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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, an, d regulations, and to admit authorized inspectors on premises and in building for necessary insp~_ ~.~ (Signature of applicant, or name, if a corporation) ....... Bax .gl2...Mattituek, .~e~ .Yank .llq 52 .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder· owner Name of owner of premises Luhrs, Richard A, & Wf (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 ......................... Electrician's License No ........................ / Other Trade's License No ...................... · · . N. Riley Ave-'End of East Le~ion Ave ' 1. Locatzon of land on which proposed work will,be done ...................... - ......... ~ .................. ~, ~. ~\ Mattituck, NY ~11952 ........ ..... ................... ......................... House Number '~Street Hamlet County Tax Map No. 1000 Section ....... 1.2.?: ........ Block ....... ~. .......... Lot ....... .55. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..s.~n.g.l.e., f.a.m.t. 1..y. ~e.s.i..d.e.n..e? ............................................ b. Intended use and occupancy single family* residence ~-4 '..~..~ 3. Natur~e of work (check which applicable): New Building ..... ' ..... Addition x Alteration ~ Fi~ ~. olitio Oth W k Repa .-.: .......... Ran oval .............. Dcm n .............. er or ............... (Description) $12,q0q Fee 4' Estimated Cost ........................................................................... ~ ....... , ~' (to be paid on filing this application) 5. If dwelling, number of dwellin units .... ], .......... Number of dwelling units on each floor ................ If garage, number of cars .... i .................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structuies, if any: Front..22: .......... Rear ...22: ........ Depth .40: .......... Height . .20° ........... Number of Stories..l~ .................................................... Dimensions of same structure with alterations or additions: Front 2~3 '. .............. Rear .... 26 ............ Depth . .SQ'. .i.~ Height 22' .. Number of Stories .¢ ....... . Dimensions of entire new construction: Front..~: ........... Rear 1~. ' Depth 2~' Height . .2.2.' ........... Number of Stories .7 ..................................... ~ ................ 9. Size of lot: Front . .6.~.,.5.'....i ............ Rear ...... 7.0.'. ............. Depth . .~.~?r ................. 10. Date Of Purchase . .~e.q,..1.9.7.0. .................. Name of Former Owner .... ff.~.m.e.s., ya..s~.o.n. ............. 11. Zone or use district in which piemises are situated..Bo.~. ................................................ F2. Does proposed construction vi61ate any zoning law, ordinance or regulation: ...n.o. ........................... 13. Will lot be regraded .. Jqq...i .................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .~.5. e.h.a..rd; .A.: .L.u.h.r:~.. t,t,t .... Box 312 Mattituck m,~.,~ ~,~ 298- 5~9/~ Name of Architect .P?.n.n.y..L.u.m.b.e.r. ............ ' ":'~ '~3.~fi/56/ff; ......... ~' ....2"' ' i~¢~'0~.00 ..... ·. ^aaress .. ................. rnone rqo .............. Name of Contractor ' Address 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 block number or description according to deed, and show street names and indicate whether interior or corner lot. Please see attached survey which shows the proposed attition, The west side of the property has a clearance of 16'. The east side of the property has a clearance ell?' ~nd with the the new addltion~will have lil' of clearance, STATE OF NEW YORK, S.S COUNTY OF ................., ................................................ being duly sworn, deposes and says that he is the applicant . (Name of individual sig~ing contract) above named. , He is the ,. rr~ i ..:...~.'..' ....... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly 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 mare Sworn to before me this ........... ~ ?. ......... day, Notary Public, ~...~' . ..~.&. ~' ftEI EN ~, DE V0E NOTARY PU~UC, Sta~o of New York ~r set forth in the application filed therewith. .... ....... xC (Signature of applicant) ' ,%co1~: copper fu'~n US~ I~ ~VA TER SUPPL Y S~S2EM CANNOT _~ E~CEED 2/lo oj'1% LEAD. PLUMBER CERTIF]~CA~ION' ON LE,,4 D C©NTE/\rT BEFOR~ CERT/_FA_~/~ = ©2' ©C~Tr~ ~IFV B' H LDING DEPA~TMEN~ ,AT L 765 lsoo 9 AM TO 4.PM'FOR, THE ~' FOIJk~*~I3N TWo ~EQUIRED 4 Ff~=^l 'c'~' s,%?rc'i!Or~l MUST A~b "cr~/c%q, [CTIC~N SHALL M~ET T~E RE3I uqFMFNTS OF THE N, Y. S%~TF'COhI%TRUCTION & ENEPGy CODES. NOT RESPONSIBLE; FOR DE~I,GN OR CONSTRUCTION ERRORS X' 944 OW6 Ek£VA"n~rq~, 6~'os.~ ~.ECtrpl~i[ FrJuM~,~-'r, t,l,.4 , -I