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HomeMy WebLinkAbout18878-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19853 Date APRIL 16, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1690 CAMP MINEOLA ROAD MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 5 Lot 3.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 13, 1990 pursuant to which Building Permit No. 18878-Z dated MARCH 14, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & DECK AS APPLIED FOR The certificate is issued to FRANK & NETTIE WAS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-07-APR. 9, 1991 UNDERWRITERS CERTIFICATE N0. N-151845 - SEPTEMBER 27, 1490 PLUMBERS CERTIFICATION DATED MAR. 13, 1991-MATTITUCK PLUMBING & HEATING Bui ing Inspector Rev. 1/81 n~oaai xo. s 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 18 a 7 8 Z Date 19.~Q Permission is hereby granted to: ~ ~-...G.~-...~:..~.4.. to ..c,.:..~C-:...~.....~: .~,.Q,f...`~~:~:~Q.....?..~~....~~...... ~,I,:~,,.a.. ~ . of remises located at d.......4: ............................z.....~.~~...... ~ 9.C7 County Tox Mop No. 1000 Section ~.~:2:....... Block Lot No....r~z.:?:--:........ pursuant to application doted 19.9.0, and approved by the Building Inspector. Fee ..l. u ing Inspector Rev. 6/30/80 Form No ~~C1,/(i»~~~`~~ 1jj(~~ TOWN OF S LD lJ l_~ ~ ` ~G sr BUILDING D ~ MI~ ) 2 ~ i ss TOWN ~ _ 765-1 _ 'CG;L".'~4 ~i~~ APPLICATION POR CERTIFICATEYOF OGGUPANCY 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 Cede Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 3, 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 consenC 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. v. 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 S years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1~5~.~0~0-/iii~~~Commercial $15.00 / Date ........T~/.~/{~ ';ew Construction...Y Old Or Pre-existing Building....f../ Location of Property./.li•,/~, C~i°},/,~P, %~7~/(~~O~i3.(~4Pe~:iT ....................~;'tTT*............. House No. Street Hamlet lnwer or Owners of Property./~~~.~.~...~..~~•~•.T~•~•••~•~~•••••••••••••••••••~••••••••• County Tax Map No 1000, Section.~?~v~! ~.a....Block... .J`f..........Lot.',.,4>.U O a subdivision....~i...O ............................Filed/Map............Lot...../(................ ?ermit No.. ~.~.4.~A. ~ • •Date Of PermitM~~~.N..t~1~l~DApplicant~?~~~.~.~. •:'•L. ~ r.~~. {ealth Dept. Approval ..........................Underwriters Approval... Tanning Board Approval :e quest for: Temporary Certificate........... Final Certicate...v.,..... 'ee Submitted: $....~s....o Q~ ec • ).SUS ~ ~ ~lZ. , oC,!~~ . e 0 ~ I ~ gs 3 APPLICANT TEL. 7G5-1802 o c~~FF~1J~ C0~ TORN OF SO~JTB(Ob.~ f ; " '~'~j;~• ~c OFFICE OF IIUILDII.7G INSPECTOR t P.O. [3OX 7Z8 v' ~ ~ TOWN HALL `'O c'' ~ `C SOUTHOLD, N.Y. 11971 ~~pl ~ yb~ C E R T I F I C A T I O N Date 3 3 Building Permit Nox.~~,~~~ Owner ~'/?/~/7/~~ 9~ /y f~ (T?~ lslsf~ (ple/ase pripn/t) l~ Plumber ~a-~,t~~~~ V l uan~i~ fic.:.-~ !~r/~. (please print) ~j y I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. , iplumber'- e ~p Sworn to before me this /h/~2T 1/7~ day of ~f ~ _ ~ Notary P is 1lotary Public, County EOttH F. JAGK90N " Notary P^b,1'~~%~ Q 7~s'~ FDIiH R ~ualifiu..''.Cu,r.'.:~aunry ~b rblk Twra Expires Feb. 18, 1992 7 THE NEW YORK BOARD OF FIRE UNDERWRITERS PA,ey 1 l 19511 2 BUREAU OF ELECTRICITY ~ '1 I` 88 JOHN STREET. NEW YORK. NEW YORK 10038 Date SkP'fEt98FR 27,)99(1 APPlicotionNo.onJile (~4311291'lj9fl W 1$]flb5 THIS CERTIFIES THAT only the ahTCtrica! equipment v described helots and introduced 6y the applicant named on the shoos application numher in the premises of 1600 - RANK WAS, 2bf3p fpMP MINIOLA RD„ MA1'T3 iUi:K, N. Y. in the follouinq huotion; ®Bosetnent ® I st Fl. ? Ynd Fl. GAR /ATTIC ((I I I T ,Sw~tion Blork Lot uoa a:amined on SE P 7 E MtiE R 1 a . 1 940 and found to be in compliance uith the reyuirementA of this Btwrd. RXTUR! RXTWES RANOlS COORIN60RCK5 OVENS DISH WASHERS EXHAUST FANS OUTLETS AtXES SYYITOIES INUNpESCENT flU01lESCENT OTNEP AMT. K.W. AMT. K.W. AMi. R.W. AMT. R.W. AMi. N.P. SG B 52 5lT 1 H.7 1 11.k i 1.2 3 t' DRYlRS RIRNACE MOTORS FUTLME AMl1ANCE IEEDdS SPEUAI RK'FT TIME CLOCKS RNl 11111T IIEATiRS MUlT1AI1TlET DIMMERS AMT. K. W. ql N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N. P. SYSTEMS AMT. WATTS NO.Oi IHT 6 F' ) 2 12 1 317 1 t SERVICi DISCONNECT NO.OE S E R V I G E AMT. AAV. TYPE ~ 11 ]`M 1 ,e SW ] R 3W S / IW ~(~CONG. Of CC. CONC. NO.OF NIIEG Of ~ NO. OF NEUTRALS a NEUGNAL Y. 2(ip CB 1 X 1 2/0 1 1 /p OTHER AF?Al1ATU5: '7.0 AMP. GE.NERATIIR TRANSF~F:'k SWTTf.H-1 a MO~fORS:3,-1/2 H.P. PANELBOARU5:1-14 CIR. tll0 G.P.C.I;-8 ~,MOKP DETf.Ci'6R:-1 ~ / ¦ 5AGk. 8 LAOEMANN iNf._ ! Il;.N3635~~~ ~'l P. O.HOX 17h8 SUUTH(~L.D, MY, U97I ~ OMrRAtMANAOM . 11 111.n l Psr AI; Thit nrKfiearo qwd tat be aMsrad in any manner; roturn to tM offin of the Board if ittcofratt. Inspectors moy be idantifwd. lhair crodentials. Al IN ANY MANLIER. ~~~Fa~.~ `~5~~~, ~0;~ TOI~'C1 OIL SOUTITOI.D ;i,rr~jC?;~~ r~ OI~I'ICI: ()p GUILDING INSPECTOR c=_-, ^,w ?'~t'•" P.Q. [SO'C 117 9 i';'~`ti~~ ~ TONN IfALL v% o, S~.?i ~,C SOIJTItOi.D, N.Y. ] 1971 ~y.'.~ April 9, 1991 Frank fi Nettie Was 1690 Camp Mineola Rd. Mattituck, N.Y. 11952 'Po P7hom Thi? c4ay Concern, 4;e arc unable to con;plete your Certificate of Occupancy because .of the follocoinc reasons. /^J An application for Certificate of Occupancy ~s not nn fil.c. / / *!o Undererriters Certificate on file. / / t'hc clu,cF: .i:;(rnt~datec3/nit on file.) / / D:o ttcal.th Ucpt. Approval on file. _ e D:o final insl'~ect:ion hay bccu made. Pleasr. contact our office on this matter. Thank you for your coo~cration. I;u.ildir;g I'crm.i.t It _1 8 8_ 7 S Z Building Dept. ''`'h/ / tlo Plumber Solder: Certificate on file. ( all pr.rtaits involving plumbing being iasucd after :1pri.:( 1,1984 ) 1 , ~ m ~ y ~OUt1DATI011 (1st r-, ~ ~ ~ - T c ti ~ ?OUt1D0~TI0;1 (pnd) m 17 2 . . ,ei~u~ -~-w .'.OUGH FRAFSE & Z I ~ o l3` •PLUMBING '~5 G ~ a 3. m n IIlSULATION PER N. 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[ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: DATE Jam" INSPECTOR i ~ l~ 765-1802 BUILDING DEPT. INSPECTION ( ] FO NDATION 1ST [ ] ROUG61 PLBG. FOUNDATION 2ND [)INSULATION [ ]FRAMING [)FINAL REMARKS: ~ _ ~o No% ~ ' UMI~ 0!~ DATE INSPECTOR ' 765-18®2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH LBG. [ ]FOUNDATION 2ND NSULATION [ ]FRAMING (]FINAL REMARKS: DATE ~ INSPECT D ° ~ ~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~tOUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: ~ ...e,~-~ DATE ~ ~ INSPECTO G / 765-1802 BUILDING DEPT. 1 NSPECTION [FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [)FRAMING [ ]FINAL REMARKS: DATE ~ 6 INSPECTOR Z ~ 765-18®2 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] ROUGH PLBG. 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Ntrw SurPCr~K ~ v „ y < A~Vtr NUD ` i~, f ~ « Ir- ~ > ~ ' ~GN(, tB 4~.r LJ _ ~ < p CONCR FOUN<'A ~ h ~ \ ~ t Yj f i..~ L a ~ ~ t r < ® 8 N~ U _ F ~ G ~i pp ~ ~ ~ ..r~ll t' ~ tL 9Q E'- tai 2 ~ Z N _ d.1 ~l.I_1~r-'~ ~A:~ _ e - aT ax{f ~ ~ It , a ~ >V ] A I. 7 d.. l5• p N.T•QT'QQ" tL^. - f39.C77 ~ ~ ~ ~ Itl' ~ ~i f~' `iuilw,`c ~~V~ a C j !'St/~ICICi•1 ~R~IDENCFa 8 i~ ~ ~ ~ l ~ ~ ~7 ( _ _ ~ ~ S` Y APR 171990 ~ h ~ ~ ~ , NLDG. DEPT. 4 I a TOWN OF SOUTHDLD _ ~ t ~ t/ BOARD OF HEALTH yy~~ 3 SETS ~PLAriS?I'!.... FORM NO. t SURVEY TOWN OF SOUTHOLD CHECK .?.~:.~a~........... . BUILOINGDEPARTMENT SEPTIC r•oart TOWN HALL $OUTHOLD, N.Y. 11D71 NOTIFY; /1C}(1 TEL.: 7G5.1II02 CALL /C~ ~ 19~Q MAIL T0. Examined nn ,~pp ~~'f 8, ~1,5, ~ . Approved ..~.~5~1 . ~7:.., 19gb. Permit No............ . . DisaPProveda/c h 11J1 ~ ~4~ 1 ~ ~ 3 ~ `'viii (Bin ding Ins ector) ~ p 6d.t:G. UE:PT. APPLICATION FOR BUILDINGPERpA1T ?C'v''Nt)r-SC2Ui'tiC3f.0 Date . ~~f~•e...x.. 15 ~:d INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or jn ink and submitted to the Building Inspector, with 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 bvIlding 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 insp t~io~n-s/~ (Signature oP applicant, or na e, if a cor n) hid a'D Q~ (Mailing address of applicant) I State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. •~~G~-x.,~~..?~...~.................................. Name of owner of premises i! ~~;~-Z.•G?!.... . (as on the tax roll or latest deed) If applicant isacarpora[ion, signature of duly authorized officer. (Narnae and title of corporate officer) ,~'~~j Builder's License No . ~;'~~'/~;!`~~'~%~'O~"``r'O~ Plumber's License No . ~ Electrician's License No. Otlrcr Trade's License No . . I. Local%ion of land o`n'/w_hich proposed work will~bje~d~one; F[ouse Number G~ Street. ...Hamlet County Tax htap No. 1000 Section • . • • , . Block ~ Lot .'-3:.°`~... , , ~ , , Subdivision Filed ~1ap No. Lot . (Name) State existing use and occupancy of prerises and intended use and occupancy of proposed construction: 0 a. Existinguscand occupancy b, Intended use and occupancy / !`~M' ~ • ' ' . 3. Nature of work (check which applicable): New Building Addition Alteration , . Repair R~mo,val Demolition ...........Swimming pool... , . Tennis Court Accessory Euilding........,.Fence .......Other Work..........., 4. Estimated Cost . ~3~~. ~ Fee , . 5. `'If dwellin number of dwellin u (to be paid on filing this application) g nits Number of dwelling units on each floor . . ' If garage. number of cars . l . . . 6. if business, commercial or mixed ' occupancy, specify nature and extent of each type of use . . . . . . 7, Dimensions of existing structures, if any: Front . . , Rear Depth . Height , Number of Stories . . Dimensions ofsame-structure wrath alterations or additions: Front Rear , Depth ......I, . Iicigltt Number of Stories , 8. Dimensions of entire new constr+rction: Front , , 7~ , , , Rear . , ,7.9. F T...... Depth : ; Hcight~,~r , Number of Stories . . 9. Size of lot: Front 3. A..F?t Rear X3,9, ; , , , , , , , Depth . P.~ 77.!°,! • 10, Date of Purchase , , 9.7.,`f . . ...Name of Former Owner . l I. Zone or use district in which premises are situated . , t2. Does proposed construction violate any zoning law, ordinance or regulation: , 13. Hill lot be regraded , I , ,will excess fill be removed from premises: Yes . , No Y IA, Name of Owner of premises!U~~rT!C ~ ;`,.P19,N,K, ;t~/,~S, Address'~~?SQ.!•~E.~4 C~.t9RC'•. Phone No..~.9~:: ~ 6. , Name of Architect . , ,Address ......Phone No . Name of Contractor Ltl(~L,/,~-,~:~, , ,Address r5.4. fJ ?`I~`"a,L-:C? ..Phone No.. IS.Is this property loca,'ted within 100 feet of a tidal wetland? *YES....NO.?..~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all' bui]dings, 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 comer lot. I r STATE OF NEw YORE, S,S COUNTY OF . (flame of individual sip ' ' ' ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant ' ^ning contract) , above named. , Fk istltc (Contractor, agent, corporate officer, ete.) of said owner or owners, and is dNly authorized to perform or have performed the said work and to make and tle this application; that at! statements contained in this application arc trot to the best of his knowledge and belief; and that the igork will be performed in the manner set forth in the application fled therewith. Sworn to before me this , ..dray/of..~1.a^.-C.,~ 19Q~. Notary Public, , , /;mow.. . ~11.'.~~ County ~ o HELEN K DE ~E j' NOfABY PUBLIC, State of Nob York • • • • • • • • . • • . 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