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HomeMy WebLinkAbout20201-z ~ FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Nall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22058 Date DECEMBER 24, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 705 BAYVIEW AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 10 Lot 1,2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 7, 1991 pursuant to which Building Permit No. 20201-Z dated OCTOBER 11, 1991 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 ONE FAMILY DWELLING WITH ATTACHED TERRACE WITH POOL AS APPLIED FOR. ' The certificate is issued to HELENS LEWIS & MIRIAM PENRAAT (owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-84- DEC. 18, 1992 UNDERWRITERS CERTIFICATE NO. PENDING PLUMBERS CERTIFICATION DATED DEC. 18 1992 - MATTITUCK PLUMB & HEAT. uil ing Inspector Rev. 1/81 108DY NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N a 2 0 2 0 1 Z Dnte ./~,1.1 19~. Permission is hereby granted to: ~.~o ~ to G~~ft.sleG~c'c.. . c~~G'Ya~-C..... ~7.. ~ ' at premises located at . County Tax Map No. 1000 Section Block .......t0......... Lot No....... pursuant to application dated 19...~,~ and approved by the ' Building Inspector. Fee S• 1~~ .r~..,a uild Inspector Rev. 6/30/80 m.w.w..~.w.w.s.\~u~r//"/ym"'°.c,y, pa '1 L'~f)'-fir ((/,'7.s ~ i. „~...,~,ab-,~,a.~.,, 7, r Form No. 6 4' a{~ ~~~'~~P TOWN OF SOUTHOLD ~ ~ 199~L i BUILDING DEPARTMENT ~ ~ 1 TOWN AALL ~~-`.'~:it~'f. ~s 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. S. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. ,For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. , 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2, Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.0/0, CoGmmercial $15.00 Date iz/~~~{,~ New Construction...... Old Or Pre-existing Building . Location of Property... 705 ..............~'~~//('ecJ.~tl..........~!y:`?.?`~:~«!~-........ House No. Street Hamlet tt// / , Onwer or Owners of Property.. 17e L2.rJ~. LP~(S 7. f19-4/f, ..~~J/L/I/~ f , . County Tax Map No 1000, Section... .``f®~? .....Block.... ~~.........Lot.... © ~.z:........... Subdivision...~?~/'?-/C/~°cu/~Z,,.GSt89YE's ,Piled Map............LotC.......~:~.......... Permit No..Z~Z~~,,,,,Date Of Permit..~b/C6,~7~,`..,,,.Applicant.~Xf4Cc.~-y?1!;ZZ~';c';5,,,,,,,,, Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate..........: Final Certicate...~ Fee Submitted: c~.~c.. y.s s a.~ ~ ~c:~ ~ ® ~,aa p5S" ` ~ APPLICANT c~vFF~(~~~, ~ TEL.7G5-18p2 ~v ~1•, TOWPI OI'' SO~JTE30LD • ~ ~ OFFICE OF BUILDIIQC INSPECTOR w`~' rn P.O. BOX 728 0 cTs " r T01VN BALL -~~Ol ~ ~,~Q~- SOUTHOLD, N.Y. 1 1971 C E R T I F I C A T I O N Date~,y ~q Building Permit No. a4~_ ' Owner lic~~ri~ ~.cw. ]please print r P`nfaa ` Plumber ~-~--~,-~~G~~ I II (Please print)) l~ v~ + lt~o.~; ~~c~ I certify that the solder used in the water supply system contains less than 2/10 of 1g lead. (plumber's si u . Sworn to before me this 6/~ 7r`t day of ~caEiY/l~~ ~ Notary l~.r' is tlotary Public, p County ' kDll{i R.,{~gtBpN ~ ~ Nor Yak Trrm E~iw~ kb. te~os~- ' ' SIIffQLK CAUNTY DEPAP'fiYtEP1T 4f FIE 3ERUICES . EC $IPt~~~Jlf A~IfltiilR t~W,tX Ths aewege disp~at and nm~:r suppty 42cii~ies for th5 bcation have heen inspected !sy this #!~purtmc~tt turd/or 4 ocher ncies nd feu to ix>, t~ti5f~~Vory. Chief @ureau of Was~Y ~llanagement ~ 1, N6°~95d'E'/r/Z.Bi Z`e ~ t On~ Z Pg ~ aA W 4 ~ S ~ ~ n , ~ g ~ - ~ ~ rOm~r I~ O ~ ~ e ~~SgD ~A ryD 3G ~ 7G'--~~ vG ,yt. L[~.,T yQ N~~ ~ ~ o h ~~1 O ~ O o ~ ~ \ z 4 x n pp * i ~u~,;,:?;i a ~ w ~ 6 C " ;rid a c-.=Y}~:~~~:f"~ CC s sa 999? 3 a ~ - DEC FpP MlW Y D~~ LO TCT?~v.?-J/ 6`'~ \ ~J.~i. CPT. U~ 3 ~%v,~~~~ E{E",LTN Sf.RV1GtS n~,ov~r~~,e •/i'~'«.v~ Lt-wrs ylie%Q.e~ P~'.ue.9.s~r .4.vrrbvr ~ G,es~.9.v.~w.~,e-.' ter•2A/it~cu•,SdBOr?r~iav °%t~.~,eer~r~cz Eer.•vr~s" 1.,~.uv~u ~y~ Lacsrraur. Marr~rucr.Tir,~ ,rro~~ns've~tfl. N '~ry~' 6unzrvreF.o~•.~airr~~.s>~i~~Jxu'K~Ti~y~TiL~E'Gr~.~cgvr~e•~o w: ~2~ ~~~f-~~~~ • f/rFFOL.e C2-NrlJ/T.9X~AN~o• /600-/dG /0-O/•Z I ftiA~ s~.ev~v aGrog~,e2,f/yyL Go aA/ NT5 riow.v rXV r ~ i 1cLJ i;~::: c".:J;i ~~Jn: E j~ :;i::[i•tLNT~ { i . j ,dcR.aua LL m ~ , ~ ~ ~ 'OUtJDATIO"! (lstj G/ ~ ~ ~ouuDATlon (2ndj _ - z. I ~ ° o rr^,OUCH FRAi~fE & Z _ r' ~ •PLUhIBINC I'~ / ' I ' 'J ;'st to O.laf r• i > ~ ^ n C~~\" 'IIlSUL„TIO~! PER N. Y. -a STATE Et1ERCY II CODE I 14 r ~ 4 . I m H A o ADDITIOPIAL COMMENTS: ~ x ' t*T x . ~ H A ~ ~ _ H ~a ' O 315 CENT RA[ PA.~"iK V1 E';-i, NFVe` ` t7fdl;, Pd t00'd~ ~ lE-.4 ~`2eP73-4649 fi{l`C (}i7X 569, `irCiDk~ iv f. iii%, CTSK'sL, ryl } Et aT*i_. St$^:~43~f-H39 ' A i3 C H 7 E C; i 5 M t. B E A-"- ra K f tC ~ Q ~ ~ i,.~~..S,x.~,R dial ~~."~~L.=~~~tVleff ?,€r'~~~s'~o ~ ~ ,,ufvF: z, i yu ~ ~',t', a JUN - 31992 feF tls:iiJ <'p~,f6yLiY 5 SOUTFiHC1,!' TOWN F-~„ f3t!1[PIM% Gt-PART?il~Ni .4T 7 int~}~[ 1 ~JN rry~t . ;SAR Y F { S!~ Uk.AR Mk, f 15N~ kr"., FEPvRAil.°.1.'r,..'r!;`.. ISGU;P .'"i BAI"~li-`t! A`e"r:NU[ ih MAl'TAT'tJC'K.. (;khdkt~F.l. Cf)t~'if~.ACtJ!~ .?9}iP# i,CHi<;1f7t~'CCi Y .i;t?R , iNiS (R/a,~'~iN 0f- -(Hc. :~•.ili_i?{fti;, !+i~, wt:~1,. A.: ;;.;L ? kOC;P' u07>~" A('`~cJ? ~_U;vi!N:vU:; ~~d~i'CC~'.C~PaS <<A`::Y T:~ :'-~t.i AFf'jZOVAL. T}i[. (tll~~i-i~;~~LT3{;}.-, WhS WCi_L {'{i,IfRCG t1Nfa `+ll~;: IiUll'{ ACCUkL`1PdG its 4aLA1~: Y i :f)q%~~ Q.~ ~7 4 'ti ~ ~Ak~~:~ ~ .'Y' + ti'~~'' fi,f:l.f~~. s - - , a i s ~ f t p] Oti` . th~tha Standarde.tor A oval and ~ ~ o . ubaurtaoe Sawa e Dts o ~ i . ~R~m RASld2no®s and will abldb by hem ~ ~ Jtions 86A orth th~gra n and on the dir±tlfruot. Aertnit tp ~ " s x ~ipnattre t; o+"?""" .L.uxfi.,. ~ai~ K- j ~ ~p'~ SCE /Z.~ ~i~ cc~ ;u°~ o . ; , Qu~(I~CJj ` ,10~ ~Y~' ~ ( ~,o ~ 1.3`~ ~ ~ ~,a~..- 1 ~ ~Q ~K ~ ~ . ~ ~a o ~ ~ ~ a ~ p o y ~ ~ ~ ti d ~ ~ ~ ~ o~ W ~ ~ ~LLW~ll1 Q ~ ~a Rn M w } ~ ~3, ~ ~ lv ~ L ~ c aL z~:~'" y£D lAgO ce S ~ vGQ~a ~ . ~e hgyoo ' ~1 'OTC `3690 ~ .'„"'r'~~,,+d'~ls~i~Y.~.B~:°., tor.~.~f~id.~au "~CtYic .~T,vr~s ~ -r-~.,_.:: ~ ~ ~ ~ : PLEASE IUOI'E ~ ~ . ~1~~,rz,'1'~«; ~,~r~w'',~.r,..,~/•Y. ' ~`~~ICyt:~l.Stett],tS-[lDI.3A.. ~rr?'a~ .~aa r T , I WELL COVENANT REQUIRED ~ PRIOR TO FINAL APPROVAL. ' ~ I/, ~y ~ b~~,,~~ ~ ~,.a,F, "~.*v.u.atsbssu e._`.,...n d._.~ -,o z..... .ti v ._Wed..dt~<n,=~:.au,h.h.x.,,~Y..r~.:aa _wnt L~~~.: Ae " .rt.n1o V,-,,,.,.,.~r~ ~~Lc~'~,~~1.~:~..~a1a BO,1RD OF HEALTH i e• { . ~I~ ..`,'l. `u, I1 d' FORMN0.1 3 SETS OF PL.1aS i ~~o0 6 f ;j 1~,~'a !3 TOWN OF SOUTHOLD SURVEY _ _ . 'r'{~ OCT ' ~ I99I ~ ~~e BUILDING DEPARTMENT C1iCCK . . . ,l ' "i'` TOWN HALL ssrrlc roRa . "~,tg~ ° ~ ~''~t SOUTHOLD, N.Y. 11971 6sl a f'si.F 9-. c C i SVaP~ C~~ ash+.;ir~z,E.kp/ TEL.: 765-1802 tlDr I FY ; Examined ~0 19Q/. CALL ' hIAIL TO: Approved . 19/,l. Permit No. _ . Disapproved a/c (B (ding Spector) APPLICATION FOR BUILDING PERMIT Date 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 .ets 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 Buildin~Inspector will issued a Building Permit to the applicant. Such ermit .}call be kept on the premises available for inspection throughout the work. f.;3/~,!SQ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall leave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ft~e applicant agrees to comply with all applicable laws, ordinances, b ilding co e, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i •p do s. ........G:~:~~~:'ave.-.............. " Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~G/ r L ~ NN C+ . \ame of owner of premises . ~y . 1, ~s~~! P~^~!a!f~ . (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. 1r3U> S' , , , , , Plumber's License No . . [lectrician's License No . . Otl~cr Trade's License No . . Locatioan-7of land on which proposed~/work will be done . . IJouse Number Street Hamlet County Tax Ma//pyy~~No. 1000 Section Block Lot ....~/.Z Subdivision ..!'(A~r ~WiC'~- ~~~5, , , , , , , Filed Ma No. Lot ~ p ...(1`lamc) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Y!'~/"!.z,~~, , ,~~!.,,(,~'t~~~' _'s~. ~j~ . 3. R'et>~i of work (check which applicable): New Building ' / • • • • • Addition Alteration . P Removal Demolition Other Work . n' a (Description) 4. Estimated Cost ,~~,`~~,r A?o. • , Fee gli (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 , 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front , . , , ~ ~ • ~ • • ' ' ' ' ' ' ' ' ' ' ' ' ' Height Rear Depth............... Number of Stories . . . . Dimensions of same structure with alterations or additions: Front ~ • ~ • ~ ' ~ ' Rear.................. De o h ! ..Height ......................Number of Stories . 8 Heinh tsions of entire new construction: Front , , . ; , ' ' ' ' ' ' ' Rear . .Depth Nurr~ ber of Stories . ~ ' ~ " " " ' " " " " " • " 9. Size of lot: Front v Rear ......~-;s'~• • • • . • , • . " " " " " " " " ' ] 0. Date of Purchase • ~ • • ~ ~ ' ' ' ' ' Depth , ~ ;7', G ` P P ~ 9~~• • • • • .......Name of Former Owner 1 1. Zone or use district in which premises are situated . . . . . 1 ~ Does ro osed construction vtol~ate any zoning law, ordinance or rem c7 • 13. Will lot be regraded bulation: ' ' N~'• • • • • • • • • • ..Will excess fill be removed from premises• Yes No~ 14. Name of Owner of premises ~W,iS,~P•u~.?~`, ~ ta~E~~~`}f ,b~/a2~1 2./Z~Zq .Z32. Name of Architect / ~ • • • • • • • Address. 7i. Phone N~ \ , ; , , ~~~4-7:.. ; • ..Address ,G,2e DS ,•'~~'`•°Y~4!~hone N~S`!~,t l`'~~ sdr3,~j . . Name of Contractor~hN. Sr!~??+r:-nu,e r„ , • ~ ~ jyg 5d,. G3u i5. Is this property within 300 feet of a tidaldwetland? " " Phone No. ~ Yes........ Na..1l° If yes, Southold Down Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all (buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and black number or description according to deed, and show street names and indicate whether interior or corner lot. TATS OF NEW Yt~R ouNTV of ~~~1< s: ' ' ' ' ~ ~ t a • • • , being duly sworn, deposes and says that he is the applicant' (Name ~of individual ianin 41 n•~ g ~ contract) Dove named. c is the ~Cw`~ c~ 11 . (Contractor, agent, corporate officer, etc.) ~ ~ ~ ' • ' ' ' ' ' ' ' ' 'said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. vom to before me this ~ ay of ~ ....d.~.~~... 19 Ql.l Mary Public, , - Su~jl~ ~4.,......-~-.... .County L~~h~~~~-~ c ROBERT I: T6e~ w, ..1~~?.~-' 2 . . NppO~T,;RYPUBIf~o~ (Signature of applicant) Yirm 'Mt+r 31, 9~- _as - ~~l 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: - i ~ DATE INSPECTOR Y _ _ h . a_ j 765-1802 BUILDING DEPT. SPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [)FRAMING [ ]FINAL REMARKS: G~y~ r 4 DATE ~ INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ) ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: _ 1 `L ` DATE 1 ~ ~ ~ INSPECTOR " \