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HomeMy WebLinkAbout19073-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219375 Date SEPT. 20 1990 THIS CERTIFIES that the building ADDITION Location of Property 455 SUNSET LANE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 03 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Filed in this office dated MAY 11, 1990 pursuant to which Building Permit No. 190732 dated JUNE 4, 1990 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 TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ANNA LOCKER (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NlA UNDERWRITERS CERTIFICATE N0. N148412 SEPT. 11, 1990 PLUMBERS CERTIFICATION DATED FRANK S. MEYER AUG. 23, 1990 Building Inspector Rev. 1/81 iPOSffi NO. TOWN OF SOUTHOLD 1UILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (PHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDD Permission is hereby granted to: .......~~......~:.~a~ x...y. ~ °1 to ..4~:.".:'.:A~+l!:~s5~.....Am....A.~Q.~.~,~:sr~.~'.s~....(~.......~.G ~~.~..4-i.`.:^~ ...(~"3'S:R. V ...`.\T......... . •y...~T...e.:. IFS . u •uwe..uu; uuu.u.... . u• o. at premises locate at ......`~~.5~,.......a?;c.".-~S~rA.bsp.... ...............4~4r'L~~~L~CA~............... County Tax Map No. 1000 Section .........f.~~S........ Block .......4>..+3....... Lot No..~..~ pursuant to applicntion dated ..4~..~ 19gS~., and approved by the Building Inspector. f Fee ......,~.1~~ Building Inspector Rev. 6130/80 Form No. 6 v~~a~ TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN HALL ~ i_.~i ~ 1J l ~ , ~~t~(lnp 265-1802 11 . ~„~..`~~m,.. ^ k~ p , APPLICATION FOR. CERTIFICATE OF OCC ~ YS~Q ' g ` ~r' ' J. This application must be filled in by typewriter OR ink E~~~~~lding inspector with the following: for new building or new u e: TOWN UFS<Jt1TH0Lb 1. Final survey of property with accurate location of a ui ings,-prop~e~rty 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, 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. 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 , t 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 Co 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 Updated Certificate oY Uccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 M Date ~'2:t;'I', , 2 d i ~ 0.C) p ::ew Construction......... Old Or Pre-existing Building..:lp®lhlfln~,,.,, Location of Property......~SS Su¢.t3~~'„(1V~ .......................f~:~T.~?~~~5'........ House No. Street Hamlet Onwer or Owners of Property.... A~?'~'!~ County Tax Map No 1000, Section.....~1°~......Block....~.rid........Lot...~:ery~ • Subdivision ..................................,.Filed Map............Lot.............':........ Permit No....'~a?3,~„Date Of Permit..~..,~~...`,,~,.Applicant..~U~~'7vh~./,~'.~,~ICS~ f(ealth Dept. Approval....~4! .................Underwriters Approval........................~ . ?lanning Board Approval... „.~A //yy i tequest for: Temporary Certificate........... Final Certicate....:`~..... 'ee Submitted: $ „ 2~ ;Q ~ yQS 3~ ~~~D~y~ APPLICANT ~ . c 6 Z ~ y.~~~-~. rl::LD IGSI'ECTiUN ~~DASc ~ COMMENTS r9 1 t . ~ ~B d~ ~ r~ s H J H (/7 FDUI7DATION (1st) o c FOUNDATI0IJ (2nd) _ ~ ~ 2. z~~ 0 P,OUGH FRAME & © PLUMBING y H 3. ~ ca INSULATION PER N. Y. • • STATE ENERGY CODE a ca 4. y . FINAL n , ' I z ADDITIONAL COMMENTS: x ` r~ x ro r H xl ~ ' ~ H H O ~ Z 1 ~i • a r X~X y ~C..3 x o ra •v H w ..~...~..k~. n::~~,~ TEL. 765-1802 gO~VFFOIIY~O~ TOWN OF SOUTHOLD ~Z„~t OFFICE OF BUILDING INSPECTOR P.O. BOX 728 ~ TOWN HALL t'y~ ~ ~~,~~q O,y~ol ~ SOUTHOLD, N.Y. 11971 L- , e '''~~ll a FP i 91990 ` ',`l~ ~ ~meaw ,`~~~t ~;`~,E.~7 C E R T I F I CAT I O N Date x-23 ~C1C~ Building Permit No. /cJC)~`;~ Owner /aNyUg hCaL~2c~~Z (please print) Plumber c(, YV1e~P~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. (plumber's signature) Sworn to before me this day of ~~,~A-- Notary Public Notary Public, Sv f= F~ ~ ~ County NOTARY PU8~16~STATEAO NEW YORK aN0.52-0578405-SUFFOLK COUNTY COMMISSION E7(PIRES JAN~Y, 19y'~ 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 ~ 1035040 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date -~"EPfBER 11,1990 gpp(ica[ionh'o.onfi(e 69946390/90 Pd 148412 THIS GERTI PIES T`~q7~ only the electricot equ._.ment os deacrihed 6elom and introduced 6y the applicant named on the ohove application number in the premises of ROBERT N. TC:aa 455 SUNSET AVENUE, LIL #4, MATTITUCK, N.Y. in thefolltnainp loon no•n; ~ Basement C /xt Ff. ? 2nd F'L OUT Section Btork Lot teas examined on -~_;;1ST 23,1990 andfoandto be in complianee with the rvynirementr q(Chis Board. FI%TURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES eW1TCNE5 INCANDESCENT FLUORESCENT OTHER PMi K W AMT. K.W. qMT. KW. AMT. K.W AMT. H P 6 4 _1 6 2 F DRYERS FURT~ACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELL UNIT HEATERS MULT60UTLET DIMMERS AMT. K.W GL - a GAS X.P. AMi NO. A W.G AMT, AMP AMT AMPS TRANS. AMi H.P SYSTEMS AMT. WATTS ` NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMi AMP Tyi>< METER L ]W i a, 9W R ~ DW T CW NO OF CC COND A. W G NO OF HI.LEG A W G' NO OF NEUTRALS A W G' . EQUIP. PER% Of CC. COND OF NbIEG Of NEUTRAL 2 - I CB 2' K 1 3/0 1 3/0 OTNER APPARATUS: SERV.CHARGE & :RING FOR ADD.-1 ~ G.F.C.I:-3 i _ I TRU.M,aN H. COOK ' LIC.#743-E C/~~~ RR#1 _~90 CHAMPLIN PLACE " GREEYF`JRT, NY, 11944 GENERAL MANAGER - Per 1 This certificate must Lkf be altered in any manner; return to the office of the Board if incorrect. Inspectors ritay-tie i entified by their credentials. 1~©?3 '~-1862 BUILDING DEPT. INSPECTION ( ]FOUNDATION 1ST ( ] ROUGH PLBG. (]FOUNDATION 2ND [ ] iNSU TION [ ]FRAMING [ FINAL REMARKS: 0 DATE INSPECTOR ~j? 765-1802 BUILDING DEPT. .INSPECTION [ ]FOUNDATION 1ST [ ] 1R H PLBG. [ ] FOUNDATION 2ND [ INSULATION [)FRAMING [)FINAL REMARKS:~J~ UGL-~-Ldy~2.~_ DATE ~°3 ~ INSPECTOR ~ ~ ~ ~~-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( ]FINAL REMARKSo DATE ~/~~INSPECTOR B0.1F0 OF HEALTH 3 SETS OF PLdtiS • . FORPA N0.1 SURVEY TOWN OFSOUTHOLD C11L•CK BUILDING DEPARTMENT SEPTIC FORM R//.+?, , , , , , , , . ' TOWN HALL C`sv~tcs,~ $OUTi10LD. N.Y. 11~J71 NOTIFY ; 5`~ Q 6 TEL.:7G5~1U02 CnLL 19gv r1nIL ro.. Examined ~ ©X ~-12~ • approved ....:i..ti-~!y.R. 7t 19/•x. Permit No..~.4,0,7;~+';'~, (~'C.ri::R)~G..N~ .~l~S'~ Disapproved a/c . . (Building Inspector) APPLICATION FOR BIJILDING PER~AIT . Date ..:~f't/......., ISlrs. INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the IIuildin~ Inspector, with 3 sets of ptans,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 diving a detailed description of layout of property must 6e drawn on the diagram which ispsrt of this appli- cation. e. 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 appGpnt. Such permit shall be kept on the premises available for inspection throu~ttout 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. • •(Signature of a plicant, or name, if a corporatwn)~ - - (Mailing address of applicant) ~ ~ ~ ~ ~ ~ s2 Stale.~,,{whether appl/i~ca~nt~is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ Name of owner of premises .....~NNA l-~c.K~"~ (as on the tax roll or latest deed) - I, [f applicant is a corporation, signature of duly authorized officer. . ~ ~ . • ~ ~ ~ (Name and title of corporate officer) Builder's License No. tti% t~'i~l!4• • , . Plumber's License Na . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done; e3 Ts 5 e.°t• ~ ~ YCZI't9~ Fiouso Number .y...Street........ ..............Hamlet...................... , CountyTa~,\tapNo.100f)Section ....Il.~~••••••••... Bluck Lot...~`3.,,,,,.• Subdivision • . ° . , . • Filed Afap No . Lot ' (Nanic) • . • . • State esistin~ use and occupancy of premises and intended use and occupancy of proposed construction: ` - ~ a s. Existin; use and occupancy ~ • • ~'Q`•"'"-LY.. i?w~t_r amf~ b. Intended use and occupancy • • • • • r~~: • . ~ 3. Nature of work (check which applicable): New OuildinS • • • • • • • Addition • • • • • ,Uteragon • Repair Rpmaval Demolition ............Swi;nning Pool............ Tennis Court Accessory ~uilding..........Fence .......Other lJork............ tea. Estimated Cost , ~ .L. ~ SAC? Fee ' (to be paid on filing this application 5,, If dwcllin;,, number of dwelling units L , , Number oC dwelling units on each Cloor ICgaragc. number of cars IJfQ.., . 6. If business, commercial or mtxcd occ' • ~ ~ • ' ppancy, specify nature and extent of each type of use ..M(~ . . 7, Dimensions of existing structures, tf any: Front . Rear • - Depth , • • . . . Hci_ht Numbet df Stories . . Dimensions of same structure with alterations or additions: Front Rear . . Depth IPeit;ht Numbc of Stones • . S. Dimensions of entire new constniction: Front , ~ B i Rcar ....l........... Depth ~'f?' Iicight ...1.~ Nwnber df Stories ~ . 9. Size of lot: Front Rcar Depth . 10. Date of Furchase ~41,`al, , .Name of Forrncr Owner . . 1 Zone or use district in which premises are situated , . A ..R~ . . P P l2, Does ro osed construction violate any zoning law, ordinance or regulation: ..N!~. • • • . . l3. ,Will lot be regraded Y'~, • , , ~Viil excess fill be removed from premises: _ Ycs Nab, 14. Name of Owner of premises ~ ! ,~;c^~ ;tZ of ; , , ,Address . J!~."~jl^.~f~ .......Phone No . Name of Architect ,Address . • Phone No. . . Name of Contractor LUC:~,~.~.Y A, C~l~'~~ks:; ,Address ......Phone Na. ~i,.5.34bi IS.Is this property located, within 100 feet of a tidal wetland? =Y):5....NO R *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRA6S Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property tines. Give street and block nutrjbcr or description according Io deed, and show street names and indicate whether interior or corner lot. r STATE OF \EW YORK, COUNTY OF f'w7~~Z , , S.S • • • • • • • •~uc,~'n.t~ !d ~ ~'t•°•~'~~ • . • • • • • . , , being duly sworn, deposes and says that he is the applicant • (A'amc of individual si;ning contract) , above named. (Contractor, agent, corporate o(ficcr, etc.) of said owner or owners, and is duly tiuthorizcd to pcr(orm or have performed the said work and to make and Gle this application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. MELANI@V.BROYVI~ Sworn to bciorc me [his nn NotaryPtrbYr:,StataolNowytxk . I . ........day of . , l :1 19 ' 1kd~ln Su~l(oRt12Counly t ' ~ Cpnmkebtt Etgdta Od. t9, t9~1 \otary Public, ~AQ~ , ~~;~;1/1h~;~, County C~ ~ ~ - (Si;naturc of applicsrrt) t I 618136 MAIN ROAD (N.Y.S. Rte.25) m now or formerly Nicholas Papadopoulos 3 & Mary Papadopoulos o N N O N j S.88°37140~~E. 200.00 W I PRIVET NEDOE I ' I I ~ QI I Q W O of of ~ ~I ~ vl a I 3~ 10 Q PPOP09E0 O IO ; ADDITION ; 0 0 - ~ m ~ m m SA. .9.0' 65' 996' 20.0' n ~y - m ~ ~ N t ~y ° Y 4 W 55 aw° 3 O ° mLL~m Area = 26100 s. f. o O w N mEm N i ~ ~ N 3.1' 24 N m s. N m N Q O N z _ m.zz z' o Z ~ ~ m ~t-CHAIN CI NK FENCE (n ~ I R _ _ _ PR1ICETJIE006.s ~s I 3 ~ ~ - - - N.88°37~40~~W. 200.00 - now or formerly Edward B. Sawicki & Beatrice A. Sawicki I I I I I i j i I i SURVEY FOR NOTE: ANNA LOCKER ¦ =MONUMENT I SUFFOLK COUNTY TAX MAP AT MATTITUCK DATE MAY 10, 1990 DIST 1000 SECT 115 BL 03 LOT 13 TOWN OF SOUTH OLD SCALE I~~=40' f SUFFOLK COUNTY, NEW YORK No. 9o-oss3 I N UIMUTN01112l0 ALTERATION OR A001 TION /O THIS I SURVCY R A VIOLATION Oi fECTION 7209 OF THE { NEW YORK STATE EDUCATION L1W tY' OF 'V~ NCOPIES OF TNIf SURVEY NOT fEARW6 7Mf LAND 1P w/. SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL S O I NOT BE CON310ERED TO BE A VALID TRUE COPY D w. 9 ^N~TENEFfO~ VINOM THE SUMEY SLPREPAgEO ro `OG ~ k AND ON NIS BEHALF TO THE TITLE COMPANY, 60VEdN- O I, ( MENTAL A6ENCY AND LENOIN6 INSTITUTION LISTED I HEREON, ANO TO THE ASS I8NEE5 OF THE LENDI NB INSTITUTION, 6UARANTE((S ARE NOT TRANSFERABLE TO ADDITIONAL iNST1TUtI0N3 OR SU BSEOUENT OWNERS ' N01lTANCfS SHOWN HEREON FROM PROPERTY LINEf I TOC%If TIN6 fTRUC TURCS ARE FOR A S?ECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLIfN '~r~ y0* PROPERTY LINES OR FOR THE ERECTION Oi FENCEf LANG V i YOUNG 8s YOUNG RI~VERHEAD"NEwAYORKE i ALDEN W.YOUNG,PROFESSIONAL ENGINEER I AND LANG SURVEYOR N.YS.UCENSE NO.12843 ' HOWARD W YOUNG, LANG SURVEYOR N.YS.LICENSE NO.45993 BRANOIS S SONS INC. I