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HomeMy WebLinkAbout19878-z • ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20341 Date NOVEMBER 12, 1991 THIS CERTIFIES that the building ADDITIONS Location of Property 845 ROSEWOOD DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 2 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 14, 1991 pursuant to which Auilding Permit No. 19878-Z dated MAY 21, 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 ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to DENNIS D. & JANICE M. CLAIRE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. NH-025232 - OCTOBER 28 1991 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 aeT\ tOEM 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) N o 19 8 7 8 Z Date ...4.~/~1 i4...c~.C Permission is hereb mnte to: r y g i ~ ..~,d...... ..~'.z..~........~1...`~ l/.3~ to ..~'nliS~...... ..I/cs:??:l... ......G'fr.~~~.1~..,~'r.. :.~~...J.~?.:. of Premises located at .........C~~S....14 ~.L~u;............................................................................ County Tox Map No. 1000 Section Block Lot No.. Pursuant to application dated 149., and approved by the Building Inspector. Fee 5....5:1.{'...:'~~... c=„~` ..............+~1................... ' Buil np Inspector Rev. 6/30/80 -~..oi.~ .Za ~c 113 S3' 4 ('r:~ ~ r'.'•j..!`,,, r .i,.,,.. ,.,~.V,~ Form No. 6 'rh;.r,~.~ ; °77 ~ /i~.S~Z ~ ~ fl ~ ip TowN of sooTlfoLD ~ ~ ~~91 BUILDING DEPARTMENT TOWN HALT. e~I_t;sa, f)1"ta"P. 765-1802 7O~rb'Itst'ii~;>fD',.7 ti"d"Sf,~ :..,~,,..~m~ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property caith 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 elecCrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19 lead. 5. 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. :S. 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 S. Temporary Certificate of Occupancy - Residenti{al~ $,1J5.00, Co/mmercQia/l $15.00 Date .I.V.QY..~.y.F.~.k.1 ':ew Construction......... Ol/d Or Pre-existing Buildin~g../ (~.`;~~/,J' ~ ` Location of Property.....~Ll~r.....,~-.©~{~f!C~~4K.,.,~/;j~~.,.,/••L[~.~6•!C•e =c~. House No. Street Hamlet j~ . _ jam. Unwer or Owners of Property....: f.~'.!/. ~l ;S, , ; , , „t~C,!_ I (•~L°. ~...~~1~/'e County Tax Map No 1000/, Section.~e+~.~....Block....../././....Lot...~~ . Subdivision.~d~~l-!~~jD.Q~G:.~~~?P.S'......... ...Filed MaP•~2,i•f.`P~..Lot...lJ~ /.1.6.. C ~ ///JJJ ~ pcrmLt No..... Y• DDa~t~Qe Of Permit S./p~,~/,~~, , , ,Applicant.. ~C'Y7f`J,t,S, , ~~,//~~~,<y;-~, , , , Health Dept. Approval... /.v,1 ~............`.../..Underwriters Approval.. ~~,c ~7..~C~'~, , , , . , , , Planning Board Approval.,~~/ i:equcst for: Temporary Certificate........... Final Certicate./0........ !~ee Submitted: $...o~ 5'..~ ~3 ~ I APPLICANT y~ THE NEW YORK BOARD OF FIRE UNDERWRITERS pACx 7 _ 80~846U _ ~ BUREAU OF ELECTRICITY 83 JOHiV STREET, NEW YORK, NEW YORK 10038 OCTOflBR 28,1997 74555797/9'1 N 01`+2..+: Date Application No. on file = THIS CERTIFIES THAT only the electrical equipment as descri6sd below and introduced by tAe sppil~ront named on the o6oue application number in the promises of DFNNSS S. CGAT.RE Jk., 845 kOSF:AcX1;? pkTVF:, MAT'CS:Tt1t:R, N.Y, @anptppc Ol1T 7 "t in thefollowinR lncaOa~~~ l7.e1.Y41. ~ 1st Fl. ? Ynd Fl. Sertiun Bloek Lot reas esomined un UUI~ !~~~~11ii ! and found to be in complionce with the reyuiremenM of thin Buard. _ BXTUR! AGEL fYY1TGR5 RXTURK RANOlS COOKRID tNCKS OVENS DNEI WASNMS EXNAUST FANS OUTIETS INCANatSCKNT nU011EtflNi OTNEn NAT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. P. _ 4 7 1 r DRYERS RNNAC! MOTORS FUTUR! AlRIANC! IMRERf f/iC1Al MC'sT TIME ttOCK4 ERL UNI7 MIATEK MIATI.O{ITIlT DIMMERS S AMT. N. W. Olt N. P. GAS N. R AMT. NO. A. W. G. AMT. AMI. AMT. AMPS. TEAKS. AMT. N. P. ~ ~T AMt. WAT1S yi i SlRVKE! DISCONIIlCT tq.lli S E R V I C ! i - z~ AMT. AMP. IrPt ~ 1 / fw 1 / ]w ] / Sw ] / AW RR dCONG. CC COND. NO. Or 1N-tEG Of ~ NO.OF NEUTRALS O' 'NEUTMI 2 Oi11ER M?ARATUS: G.F'.C.I:-l. TNACK 1,TGNTING:-8 DENNIS I?. CI,Af.kP: .Jk. 845 R(?5Rki)()D DR. i NATTITUI:K, bY, 1.7.95:', p~u ~p~ - 77 ~ s ~.V ~ = Psr This cerlificah nllM not bs altered in an manner; rNurn to file office of 1M Boord if inmrract. Impactors may be identified their crademiolt. ° 1111 DEPAR .71115 OF CERTIF A4 rtrtirr,~ TEIr. 7GS-1502 S~~Fa~x~,~. 0~0 , opy TOWN Or SOUTIIOLD ~if;`~:~ ~ OPPICG OP BUILDING INSPECT-OR ~ - ~ ,~`S:. '~"~`k;~S` rn P.O. BO;C 728 `n ~l'~'"~'~ r TONNfIALL O4y~1 ~aQt' SOUTIIOLp, N.Y. 1 1971 OCTOBER 28, 1991 DENNIS D. CLAIRE, JR. 6 WF 845 ROSEWOOD DRIVE MATTITUCIC, NY 11952 To Whom This May Concern, We arc unable to complete your Certificate o~L-~Occupancy because ,of the following reasons. /lam/ An application for Ccrt•ificate of Occupancy is not on file. (ENCLOSED) 1 //~No (Jnderwriters Certificate on file. /1// The check is( /not on file.) $25.00 No Ilcalth Dept. T:pproval on file. No final inspection has been made. Pleaae coritact our office on this matter. Thacrl: you for your cooperation. Dui]di.nq Permit 1 9 8 7 8 Z Buildi.n<I Dept, No Plumber Solder Certificate on file. ~ , ( all pcrmitti involving plumbing being i ~sucd after i~pril 1,19II4 ) ~1cLD I~:SPCiiUti ~UniG ~ ::OCthIENT° ~ m ~1~1 I ~ H "C1 _ _ H FOUIIDATION (1st) ° 'A• m~ FOUNDATIOtd (2nd) _ - z . 9 --off z o P,OUGH FRAME & PLUMBING 3. ~ m ra H IIdSULATIOPt PER N. Y. ' STATE ENERGY CODE ~ 4 , r~• FIidAL ADDITIONAL COMMENTS: x~ UT x H 9 M H O Z x(-~ h7 • r • - xx`~) ' mom/ -o H ' 1 ~p~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] iNSU ON [ ]FRAMING [ INAL REMARKS: JZ e DATE G~ ~ INSPECTOR C~~~~ 765-1802 BUILDING DEPT. f NSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. [ J FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: 9~ .~..~L~~-M~'U _ ,;i ' DATE l1 ~ INSPECTOR C 765.1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: c z~/L~.iCQ/(D~ r DATE ~ ~ INSPECTOR 765-1802 BUILDING DEPT. 1 NSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. [)FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ . _ ~f t DATE (L/ 7 INSPECTO " 1 opt oR~~E 00 ma ~a. 1 a~l,n9 V' o00 5 d'' ~ ° 2 o26,go1,~ ~ ~..m s a 4 5 .n ,c ~ ~ / ~ 3 L 1 + ~ ~ gyp, L 0 r 1 I '-M ~1 e{,{: ~ High Nitrates -Water not to be used for .preparatipn-of baby formula .or consumptio ,~~6~' 1~ ,by infants under 6 mos. of age. 1'~ a K= N ~ M a+ c ` ' ~ V OJ 1 d, i 111 d , V } tl 1`g'Q,. ~ t~ 2 filtlOLR OOU1li! E~ALTH DZPARl1Qw; / N 23001 R S r~~NJdL 15.981 a. REt. # ~..s!!~ SNP ni"" !hs aeea6a disposal pad eater snppl~ ~p/F ~ f aa111tlas !or this Iooation hova bsn laspaated br tb1/ da ltmept aad totlAd to ba saListaotorf. ~ J 0 1 !1 ) 1 _AA , Chipt of Caaerai Entlansir~ Sar?Sau SURVEY FOR REFERENCE DENNIS C~AIRE,JR. OF NEyy M/OROSEWOODESTATES ZE y FILED JAN.24,1969 ar MQrrirur,K S~P~gEkL q /rw O'fli~- MAPN0.3240 TOWN OF SOUTHOLD 4 GUARANTEED TO SUFFOLK COUNTY, N. ~ ~'x:>'~ as %~`~1{, SCALE ~ I 40' NOV. 75 l977 JUNE !5,1976 is 28725 FaQ\ ~ JULY 2S, 1978 SFO IA~D SV~\ LAND SURVEYOR N.Y.3. LIC.NO.Yd7td RIVERNEAD N. Y. \ ( _ µ h ~ l.y n rt1 b G~ tt~, ~ ~,a~~~~~~ , , ~ "a ~ Nm•~d~oMor~ ~ Z a ~,D ~ W ti~ t~ ~~f ~~a ~m~°~~ ~ ~ r r ~ ~ r fl of a ~ Bbl t^) ~od~ ; _ o~~ H, I I N ~ h N ,y f co ~ ~ w ° ~ ~ E ~ ul r--- i ! - ~U C } i~ a I ~ - - r'~ d ~ ~ ~ r r ?i R I II z ~ ~~~'yyy I ~1 I Imo' U4 p ~d -r-, ~ to • m'~~d nV ~I ~ ~ ~ T ~ ~ ~ ( ~ Rt} 6 T i d • ,c ~ m 1 t` L", I o -i oa ~ ~ C o i77 oa ~y ~ b C~ 'r/ Iii„' ryFE'H 1 I _ it TI, ~ ~ 80,1FD OF HE,\LTIi FORM NO. 1 J SETS OF PL.1 :JS - - - . TOWN OFSOUTHOLD SBIiVEY BUILDING DEPARTMENT CItCC}: - - - - - , , TOWN HALL SEPTIC CORN _ _ ~l SOUTHOLD, N.Y. 11~J71 Cvup-~2e~~r7 TEL.: 7G5-1F302 t:OT 1 F'f ; xamincd 19~~. CALL .t~~ _ - • ~ . PIAIL "C0 : Pproved . 'S ~ „ 1y7./, .Permit No. , , • • • • r~~.~d~ isapproved a/c _ - . 4 ~ - - . . . . i ~ ~ (Buildi Inspector) F MAY 161991 ,l" APPLICATION FOR BUILDING PERMIT t54-. . - - ; ; ~ ~ Date 7Clvzi~! tJF ~ai~.S',; ;tii sr ..,i I9 q INSTRUCTIONS ' a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. 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 11 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 Il 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 lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. applicant agrees. to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tit authorized inspectors on premises and in building for necessary ms~~ons.~ , (Si! on~licantcor orarion . P ) r~7Jr/1 O~S2Gd D-ej d . (,s, +J dk' 7 ~ S'~....ti (114ailing address of applicant)~~ ~fj~~ to whether appli~~ca~~nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. G-~.........:...... ne of owner of premises , , .4 /!7. !'1l.S ~ (as on the tart roll or latest deed) ~plicant is a corporation, signature of duly authorized officer. ' (Name and title of corporate officer) Builder's License No..~/~c.~,/f Plumber's License No. Electrician's License No. .~Ge-~`?,~~ ~3'{„Z L ~~/v~]~ Otltcr Trade's License No . . . . . .acation of land on which proposed work will be done . . .........,j ~~s" ............../.~D.~S-.~.4~c~~?c~• rye 'ouse Number Street • ' Ilamlct ounty Tax iVtap No. 1000 Section , . ~ ~ , , , , , , , , Block . , Lot. ibdivision ~ fC,P ~S, , , , , , Filed Map No.. , . , , . (Name) ~~Q..... Lot t/.,3........ . ate existing use and occupancy of premises an~d%intended use and occupancy of proposed construction: Existing use and occupancy .....~~~f~.:K~L~.:~' 'e~ts~,#~ • • ~ 5®f)•(;~Ett~', ii2t~i~'eAF°3RS.. Intended use and occupancy ~~'.S'C~~l.~fr.. ~,~Cp~~~ ~e'r3!'-,P~,~r±~ • "y a~~JFa 1 ? 35d ~YPS'Wi9f1.lR. ,,,,,,~1, ~ra€r+~aWa~ ~tit~xaYtin_aaut,~nae~:''! i 3. \atureoCwork check ~ / ~ ( which aPplicahle): New t3wlding ,Addition , , , , , Alteration Repair al. ' Demolition , k~~j Remov Other 1Vork . 4. Estimated Cost , , (Dcscnptron) • Fec 5. If dwellin;,, number of dwelling ' ~ (to be paid on filing this application) If garage, number of cars ° units ',il , • , , • , , Number of dwelling units on each floor . . G. If business, wmmcrcral or mixed ~ • bCCil 9RC tl...Y n• Y. s tectF na e and extent oC each t pe of use . . 7 Herigh~sions of existing structures,,if any: From . , , , , ' ' ' ' • ' • • • . Numbrrr of Stories I • ~ Rear ~.J Dc,pth v~`t~' `la . ' Dimensions o mc~stnicture witf} alterations cr addi~yiot5s: Front ~ • • • Depth , .~..~e........ , Height 0.7..~............ Nunn bc~of StoriesR~ Z . 8. Din~cnstons of entire new constntotion: Front , , , , ~ • • . • • . ' Hei~ftt ls, , I~• • Rear I~......... Deptft 9. Stzc of lot: Front ~ Rr of Stories „ ~ ~ umtt ...j ? . 0. Date of Purchase 1l d (Rear ...h~Q/ . . . Depth ,/.~,5, , , , , . , , , , . ~U.Y•'• • • • F Name of Former Owner ,~y~fq.elis9, , ,~[~O,/ir7~,4N-s~!...... . I • Zone or use district in which prom+ses arc situated 7~ ~Q Does proposed construction violatq any zoning law, ordinance or re••~ • • ~ • • • ~ ~ ~ • • • ~ • ~ ~ ~ ~ • ~ • • • • • • ' ' ' ' 3. Hill lot be regraded I nulation: , , , , , , • , , . • • 4. Name of Owner of remises H~D ~ • 1Vr11 excess fill be removed from pr miles: Yes No P ~y<S.o;~P(Zr.ce,..C.~Q, /1`~dress ,?4: ~D'xl.13~.O.yq?F~ ¢~'r~ No. ~P~'^.~/.~a?. . If es you 4 Address ...................Phone No. Name of Contractor • feet of ar tidal wetland? ~ " " i. Is thi~ Y S tho d To '''Address ...................Phone o. pro ert within 30wn Trustees Perm' YCS" " " " No " " it may be required. ~ I~LOTDIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all.set-back dimensions from roperty lines. Give street and block nur~tber or descr}ption according to deed, and show street names and indicate whether rterior or corner lot. SP,~ S'ceYt/C'~ ~OSe tc~C9000 i J~Y'r s-~ %ri~ri;ar i'~ 8,~~ ~e`I n~ ~8.'~ _ ~F' h -~,~e[II~~-P / / ~ (araly~/ ~ O 7~ LCl~fts I - et~'G M cb I / ti a . d i i . 1TGOFNG R'~~r~ I l~n°~ INTYOP./n.•. S.S/~ ~I • • • being duly sworn, deposes and says that he is the applicant (N:unc of individual signing contract) 'c named. , s the ~~!'1 £'.!/~~~/1.Ik~~'RC~4r . (Contractor, agent, corporate officer, etc.) • • " " " " " " • ' iid owner or owners, and is duly authorized to pcr?forrn or have perforated the said work and to make and file this 'cation; that all statements contained f~t this applic•'tion arc true to the best of his knowledge and belief; and that the tvrll be pcrforrtted in the manner set forth in the ap~tlication tiled therewith. n to before/~mc this • , ..dap of .1 19 Y Public, .4.,~;~„~-~-!~~i • • . • I • • i County ~.o~w I y`• . N0a'~'~~~Nwv' ~NedMButfoNt (Si tureofapplicant) ~nttwlon 45tpNN OeoenwM 1111..E