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Home My WebLink About21796-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23048 Date J~3NE 20, 1994 THIS CERTIFIES that the building Location of Property 915 LEGION AVENUE House No. County Tax Map No. 1000 Section 141 Subdivision OWE FAMILY DWELLING MATTITUCK, NY Street Block 4 Lot Filed Map No. Lot No. Hamlet 15 conforms substantially to the Application for Building Permit heretofore filed in this office dated NO%-EMBER 10, 1993 ~ursuant to which Building Permit No. 21796-Z dated NOVEMBER 23, 1993 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 TO CONSTRUCT A OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD & DEBO~AHOLSEN of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93BO72 UNDERWRITERS CERTIFICATE NO. N315399 PLUMBERS CERTIFICATION DATED Rev. 1/81 JUNE 7, 1994 MAY 26, 1994 BHRTSAND PLUMBING & ~ATING MARCH 1, 1994 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ ~1796 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: / ~zz..,,~.~...~ ............................................. .... ~/~.,~.~ .............................................. ......................................................... CountyTaxMap No. 1000 Section.....~...~..~.. .......... Block ......... .~... ........... Lot No ...... ./..6 ............. pursuant to application dated ,,,,~'../././..,~ .................................... ~, 19,,~,~ ...... and approved bythe Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted 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. 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. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20;00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Bui)ding ............ Vacant Land ............. Location of Property..~/ ................................. House No. ~ Street / ~ . ~lam/et Owner or Owners of Property ....................... .... .......... County Tax Map No, 1000 Section .............. Block ............. Lot ............. Subdivlsion~ .~.~ .... , ...... Filed Map No ........... Lot No .............. Parrot No~ ~ ~ Date of Permit ~. ~.Applicant ~.~ .~ ~~. Health Dept. Approve .?.~..~.~ ........... Labor Dept. Approval ........................ Unde~riters Approval ......................., Planning Board Approval .................... ,. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~ ............... .~ ..... Construction on above described building ~r~ ~e~ Y ~~ ~ ' . , ...... ~ ,~I'HE NEW YORK BOARD OF FIRE UNDERWRITERS ~A<~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10035 THIS CERTIFIES THAT o~y the el~tri~ equipment ~ ~scribed be~w a~ int~uc~ by t~ applicant ~m~ on the a~ve appli~tion number in the prem~es of OLSgN, N/~~[ L~GZO~ RO~D, H~.T~I~UCK, inthefoBowinglacation; ~ Basement ~ IstFI. ~ 2nd ~3. ATTIC/OU~ Section Bilk Lot ~s examined on ~ 23r~994 and found to be in compl~nce with the N~onal Elect~cal Code. FIXTURE LE EPT I I FIXTURES RANGES ICOOKING DECKS I OVENS I DISH WASHERS I EXHAUST FANS RYERS E MOT UTURE APPU NCE FEEDER~ SPEC LREC'PT IME~:LO KS B ITHEATER MUL IOUTl~r DI MERS SERVI~ DI~ONNECT ~ ~. OF I S E R V I C E ' ' METER ' NO F C , ~T. ~P, "DE ~U,~. '~2W '.aW 3~3W 3~4W 'OpE,~COND OF%C~C~D. NO. OF HI-LEG I 100 CB t g I 4 OTNER APPARATUS: SgOKE DgT~CTORt "I 35 H}IEPPARD LAI~g ' , Per q~, ) , ~' ' '' This ceHificate must not be altered in any manner; return to the office of the ~ard if in~or~ect.' Inspectors may be dent f ed by the r credent a s coev FOR su~m~e OEPA.m~T. TInS COeY OF CEm~nCATE Date March 1, 1994 Building Department Town Df Southold TOwn Hall Southold, New York 11971 Re: Building Permit Nq.: Owner: ~mo~/~X~-(-~ Gentlemen: I hereby certify that the solder used in the water supply system for the captioned job contains less than 2/10 of 1% lead. Very truly yours, BERTSAND PLUMBING AND HEATING By Sworn to before me this 1st day of March .., 1994. Notary Pub! EtLEEN M. ROACHE Notary Public, $~ate of New York No. 4826~42 765-X~O2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] RO.~IG. PLBG. FOUNDATION 2N[~* [ I/INSULATION// / FRAMING ~/~ FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION AND [ ,].~,~U~TION FRAMING [/"'J FINAL DATE//~//3'//~f INSPECTOR ' 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: "'~' ~ ' /~ ~ - 7 -/' 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING ~FINAL REMARKS: 7GS-XS02 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] RO~G~PLBG. [ J FOUNDATION 2ND [~J' INSULATION [ ] FRAMING REMARKS: FINAL INSPECTOR .... ~ , . BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL DATE -'~h~'~/~Y INSPECTO~~-~ 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]/~UNDATION ZND [ ~ INSULATION [)/~/FRAMING',[ ~ FINAL REMARKS"-~ //~--~-~ ~---.~-~" ]65-1802 BUILDING DEPT. INSPECTION [.] FO/,UNDATION~ 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY C0'DE FINAL DITIO~A'L COMMENTS: TRANSM ITTA DATE: TO: FROM: 4/18/94 BUILDING DEPARTMENT TOWN OF SOUTHOLD EAST ISLE CUSTOM BUILDERS FAX NO.: 765-1823 MESSAGE: lqF,,: p~..RMTm ~0. 217~~ , , Attached is copy of under ,construc~on survey as required by your DePartment. An original will be mailed ko you today. SIGNED: 516 727 3411 TRANSMI TTA DATE: 4/18/94 FAX NO.: 765-1823 TO: ~U~LDIN~ DEPARTM]~IT TC~N OF SO13TEOLD FROM: EAS~ T~T.I~ ~'I~(:X~] BUTr.n~IR.q MESSAOE: Attached is cody of ,3.n~.er construct!on survey as required your DeD~t~nt. An oriainal will be mailed to vou ~av. SIGNED: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 Disapproved a/c ..................................... Beceived ........... ,19... APPLICATION FOR BUILDING PERMIT Date ............ ."'i'" 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s~ts of plans, accurate plot plan to scale. Fee according to schedule. plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets b. Plot 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 be~n 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing eerie, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..... !S. .......... (Signature of applicant, or name, if a corporation) 278 Jamaica Ave, Medford, NY 11763 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder ; ' Whalen and Mar.quardt Name of owner ,of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (N~e and title of corporate officer) Ri~h~d ,-O~pedisa~o, President IJUlKler s/~lcense No .......................... Plumber's License No .... ~48.7.R ................ Electric.Jan's License No..2.6.9.7.~. ................ Other Trade's License No ...................... n h p N.~S.' .L.e. gi St 17p' w/o P .i.f.i.c .s.t: 1. Location of land o whic reposed work will be done. on ac Mattituck ............................ .O. ................. ............... .House Number Street Hamlet .County Tax Map No. 1000 Section ........ 141 ....... Block ...... 4 ........... Lot ...... 15 ........ !... Subdivision .... I)escribe~. prop~rt:y ............... Filed Map No ............... Lot ............... (Name) State e. xisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land I b. Intended use and occupanc ....s.ipg,l.e..f.e~. }.ly..rig..e,ll..i.ng..~ ....... ; ................................. 3 Nature of work (check whic) applicable): New Building x. ' Addition Alteration Repair .............. R~moval .............. Demolition .............. Other Work .............. I (Description) I *' (to be paid on filing this application) $ If dwelling " ' 3 Number of dwelling units each floor · , number of dwelling units .............. on ............. If garage, number of cars .. i ................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................ 7. ,Di~. ensigns of existing struct,'ures, if any: Front ............... Rea~ .............. Depth. i ........ Height ............... Number of Stories ................................................. Dimensions of same structure with alterations or additions: Front ................. Rear ............. Depth ! Height Number of Stories 8. Dimensions of entire new construction: Front .... .46 ......... Rear ..... z}~ ........ Depth . .2,4; ....... Height .1.6. ............. Number of Stories .1 ................................................... 9 Size of lot: Front 7.5...6.3. Rear .7.3..87 Depth ~p.c. qx. 2.8.8. 10 Date of Purchase ~ Name of Former Owner 11. Zone or use district in which premises are situated .................................................. 12. Does proposed construction ~iolate any zoning law, ordinance or regulation: ..... no ...................... ! 3. Will lot be regraded ...... !/.ed ................... Will excess fill be removed from premises: Yes N 14. Name of Owner of premises .h~lat],~rl .o, rl4 l'q.a~c.qu~c.d.tAddress ................... Phone No ............... of Architect .Ri. cha. rd, Wandolsoki .... Address . .R'.z¥gr.h..e~.~.t .~ .....Phone No..7.2.7.-6.Q7.2. ..... NameName of Contractor ~.a.~{ .ii]i4 14u.'iti4m~ iBiu.'ili.~F,~i. Address. ~9O.f-Pr..d,. ~ ....... Phone No..7.~7.-~6.Q2.3.....~. PLOT DIAGRAM Locate clearly and disthlctly !all buildings, whether existing or proposed, and. indicate all set-back dimensions froll property lines. Give stree.t and blo~k number or description according to deed, and show street names and indicate whethe interior or comer lot. SEE ATTACHED SURVEY ,/ STATE OF NEW YORK, COUNTY OF SU~O~ ~ ..... $1¢I;L3t~ .~i~:~...ld-,gd .~..'~..a.. ~% ~ ......... being duly sworn, depose'g'~d ~ys tha{ he'm me appficanl (N~e ofindividuaisi~Mg contract) ~l, ,, , ,, ,, ~,,~ above n~od. ,~ ~ , ] th~ ! .'~ of ~qq~ ~q~ ~US39~ pu31d~rs/ In~., builder . He~ . . .... ~;., ................................. ,.. ................ (Contractor, agent, corporate officer, etc.) ~ said owner or. owne~, ~d ~s dgly au~onzed to perform or have perfo~ed the said work ~d to m~e ~d file thi~ application; ~at ~1 statements conta~ed ~ this application are true to the best of his ~owledge and belief; ~d that ~e work w~l be perfo~ed in the m~er sot forth in the application filed therewith. Sworn to befo~e this ' ] ~ ~ , ......... ' ....7 ....' ., [ ............ ,": '.' ~ ~ ..... , , w Rzchard~~S~a~ of aP" ] '-- OnOHinOS'JO NAAOm ~0 '9018 C> )0