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HomeMy WebLinkAbout18587-z FORM N0. 4 TOWN OF SOLITHOLD BiJILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-20693 Date MAY 1, 1992 THIS CERTIFIES that the building RENOVATION Location of Property 1200 WESTPHALIA ROAD MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 114 Block 7 Lot 14.1 Subdivision Filed Map No. Lat No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 20, 1989 pursuant to which Building Permit No. 18587-Z dated OCTOBER 18, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy far which this certificate is issued is RENOVATE PARTS OF EXISTING ONE FAMILY DWELLING DAMAGED BY FIRE AS APPLIED FOR. The certificate is issued to ROBERT & SIDNEY OLMSTEAD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-103458 - NOVEMBER 16 1989 PLUMBERS CERTIFICATION DATED APRIL 30 1990-MATTITUCK PLUMING & HEAT *NOTE: THIS UPDATES CO Z-19004 DATED Y 1, 1990. -D ~.~1.L~---. Building Inspector Rev. 1/81 r, FORM NO. D 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) ~~J~7 N ~ Z Date /Q/ G . ~ ~iJ ~ ~C ~~Q~G~~~~ Permission is hereby granted to: -yc.. ..P.. r o ~..y. .....:.I . to ..............6%~ ...~....r . cY premises lacated at Caunty Tox Map No. 1000 Sectio~~,n//~/...`...~.~.~...... Block Lot No./.k.I pursuant to application doted . U`..~.......1..~ 19.~.~and approved by the Building Inspector. Fee ~s/,.~1^~~.... ~ll.~..~ Building Irspector Rev. 6/30/80 i FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19004 Date MAY 1, 1990 THIS CERTIFIES that the building RENOVATION Location of Property] k~0 WESTPHALLA ROAD MATTITUCK, N.Y. J House No. Street Hamlet County Tax Map No. 1000 Section 114 Block 7 Lot 14.E Subdivision Filed Map No. Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 18, 1989 pursuant to which Building Permit No. 18587-Z dated OCTOBER 20, 1989 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 RENOVATE PARTS OF EXISTING ONE FAMILY DWELLING DAMAGED BY FIRE AS APPLIED FOR. The certificate is issued to ROBERT & SIDNEY OLMSTEAD (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-103458-NOVEMBER 16, 1989 PLUMBERS CERTIFICATION DATED APRIL 30, 1990-MATTITUCK PLUMBING & HEATING ' i ing Inspector Rev. 1/81 Form No. 6 ~ ~ TOWN OF SOUTHOLD , O ' BUILDING DEPARTMENT ~ ` r Q' ~ TOWN HALL ~ pPR 3 O 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 1~ 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 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 $15.00, Commercial $15.00 Date ...~I~~~~ New Construction........... Old Or Pre-exirs~ti~ng Building.. p c Location of Property.... ~.~.Qb.......... fN~~ ~~h~;(: ~5....+~ ~.~'b-~.l:~.tl~ House No./~' ( Street Hamlet Onwer or Owners of Property.. ~,-!.~r;;~~'~G~GI~ ,,,~-2¢,.`-~7y,,,,,,,,,,,, ,,rr.... County Tax Map No 1000, Section... J ......Block....~./.%.-.........Lot..~44~:~."Y..~.~...... Subdivision .Filed Map......... .Lot.. ~~jj ~ ( i Permit No...~.0.? g~.....Date Of Permit..~~~~,($~.....Applicant!~U~~9'.1.. ~t?'.~~~?~-~~ Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate.~... . Fee Submitted: $ ~~:.U~ C O G ~ F `C PLICANT TEL. 765.1802 ~~5~~~~~-~O_~ TOCUN OI' SOYJTBOb.D f'a~ < OFFICE OF BUILDII.7G INSPECTOR o P.O. BOX 728 u' ~ :3~ TOtiVN HALL ~O/, e~' ~`r SOUTHOLD, N.Y. 11971 . ~ J z-~ Oj ~~J ~soi~o C E R T I F I C A T Y O 0406• DEP°i. TLNN~ OF S®~-IC3t Y1 Date 4 3 o C3 Building Permit No. (~~g ` Owner ~ S R- P (please print) Plur,.ber umb~ e~.~ l_.C~c (please print) I certify that the solder used in the water supply system contains less than 2J10 of to lead. , (plumber' s' re) Sworn to befor^_ me this ?7~/retiEl~ff day of /~PRfL L~ 19~. Notary is tlotary Public, e G/ ~oG.~ County EpITH F. JACKSON Napuy FubBc, State of New York No. 49207b8 QtWlled in Sullolk County Txm Expires Feb. 18, 1892 Horton onstrnction o. Inc. PA. Box 1442 Mattituck, NeW York 11952 516-298-S3p8 Oct, 18,1989 Town of Southold Building Dept. To whom it may concern: It is our intention to restore the house owned by Sid and Robert Olmstead on Westphalia Road, Mattituck to its original condition. No changes in floor plan will be made. Thank You. I GeYry L. ~or~ Horton C nstruction Co. Inc. it ApPRtWED AS NdTED aAr~~~~n~~r~~~Z FEE: ~ ~ ~yE;PAR7AAEN'f A~ ~ NOTIFY BUILDMiQ 0 785-1802 8 AM 'TO 4 PM WR THE FOLLOWING INSPEGTIONS: 1. FOUNDATION - TWrI REQUIRED ~ ~ FOR POURED CONCRETE 8. NSU~AT?ONAMING i PWMBtNG 1~pg p 4. FINAL - CONSTRUCTION MUST ALLBECO STRUCTION SHAL4 MEET. ~ THE REQU{REMENTS Of THE N.Y. STATE CONSTRUCTION & ENERGY COEaES. NOT RESPONSIBLE FOR LcSIGN OR CONSTRUCTION ERRORS Mi ! I~ii'rll GMT TESTtNq BEtyORR~, r. THE NEW YORK BOARD OF FIRE UNDERWRITERS i>Ar.F: 1 1000221 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date NOYFNBER lti,1989 ApplkationNo.onjile 6542$089/$H N 1.0:145#i THISi CERTIFIES THAT oily the alettrlcd equipment a olucribed 6elors and Introduced 6y the applicant named on [he afPOOe application numher in the premises of ROBERT OGNSTEAD, 1240 SfFIS`i' F'HAI~IA RO., POGR 1.3-13H, NA'PTITUCK, N.Y. in thefollolrinp locaNon• L'I Bosement 1=f 1st Fl. ®Ynd FI. ~ .Section Block lot uw eromined un NO~BNBiSR 0"1.,1.989 andfoundto 6e in compfjance with the reyuirements of thu Boord. NXTINE ApK fYVITCMRS XTURES RANGES DECKS OVENS DISH WASNlRS EXHAUST FANS OUTIETS INCANDESCENT FLUOeESCENi OTHEn AMT. k. W. T. k. W. AMt, k.W. NAT. R.W. AMT. N.P. 9 13 12 q DRYERS fLWACE MOTORS wTUM AMDAtIp IEEDEES sFEaAI REC"K TtttE ClOCK4 uu U1Ki INAtERt r1uAT1.O11T1ET DUAMERS AMi. K. W. dl N. P. GAS H. I. AMT. NO. A. W. G. AMT. AIM. AMT. AMTS. TEANS. AMT. N. P. SYSTEMS AMT. WA1TR ra. a IElT 1 JU1. F 1 fERVKi DISCONN[CT tt0.0! 5 E R V 1 C E AMT. AMI. TYPE ~ 1 / TM t / TV J / TV ) / AW NO.Oi CC. COND. A. W.O. NO. OF NFIEG A. W. G. NO. Oi NEUIRAlS A. W. G. PER 1 OF CC. C D. OF IDdEO OF NEUTMI OIKHI ANARATUS: R&Y71IR FIR)r, DANAGR-i NOTOR5:1-0.:11 B.F. G.F.C.I:-3 SN01(& DRTBCTOR:-1 IiETTNSR P,a.f;CTRLC 1,IC.}643 F. BOX 482 RTVSRNBAII, NY, 1.1.901 ORtYAS MAWAOR 1:1 i,7 Per - This tarli&aN mwt not be aherod in any monner; return b tM offin of the Board if incorrect.. Inspetlorr may ba identiRed by (hair credemials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT !E ALTERED IN ANY MANNER. lELD I.:SP°~:IiJ ii ,R ;f~Unic, COtKMENT° a~' ~ -a • m C- - y vA. 'OUt7DAT20N.__. (1st) Iv ~ ti 'OUNDATIOtJ ( 2nd ) _ - m z 0 1., TOUGH FRAME & V,j PLUMBING H 3. ~ m LIJSULATIOfI PER N. Y. STATE ENERGY CODE m m r 4. y` FIi1AL bl M C..O, z ADDI IOMAL COMMENTS: x 1 ~ ~ Lsi' f ~ ' C c rx~~~, ~pHI~~~ \v m a r H • ~ T b ^e H ~~~d~ 765-1802 BUMLDING DEPT. f NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ lNAL REMARKS: i DATE 1 NSPECTOR ar~an anstr~ct~an Ca. ~~c. P.O, Box 1442 Mattituck, A1ew `r~rk 11952 516-298-5308 Oct, 18,1989 Town of Southold Building Dept. To whom it may concern: It is our intention to restore the house owned by Sid and Robert Olmstead on Westphalia Road, Mattituck to its original condition. No changes in floor plan will be made. Thank You. ~ry L. F~ortpn Horton ClJnstruction Co. Inc. APPROVED AS NOT~ED~ DATE: ~ .'F~ ~ B.P. k -F.f.~..'..'-=~'~- NOTIFY BUILDING DEPARTMENT AT ~ ~ , a~, ~ 765.1802 8 AM TO 4 PM SdR THE ~'„<u9~:,"~,i'a~~``ati =.t~ ~ ~s a FOLLOW?NG lNSPEC710NS: 1. FOUNDATION - TWO REQUIRED ` ~ °s;. `,j ; ~ „v'." f 3 FOR POURED CONCRETE ~ ; ~ ' ' a `r~ ~ ~ la 2. ROUGH -FRAMING !4 PWMBING ~rra rF'~.r s~~;-^^~~~~_: ~a~ as f~ ~'~'•='a 3. INSULATION ~ ° q ~ ~ ' ~ ' a 4. FINAL - CONSTRUCTION MUST ~ BE COMPLETE FOR C.Q. ~ ; ~ ' `;;r`~>~,! ALL CONSTRUCTION SHALL MEET ~ w ~~'~~'~~d~t:,i ~~~`:w`~ THE REQUIREMENTS OF THE N.Y STATE CONSTRUCTION & ENERGY C0~3ES. NOT RESPONSIStiE FOR DESIGN OR CONSTRUCTION ERRORS !~l,UMBd1VQ 11HDERWRBFt ~1PIGITE Au a4uM131NO WA67E lie WATEq LINES FIELD TESTING BEI JRE CO~ERiNG 'r" 0 BOetRD OF HEALTH 3 SETS OF PLANS ,~FORMNO.1 SURVEY TOWN OF SOUTHOLD CHECK • • • • • • • • • - BUILDING DEPARTMENT SEPTIC FORM . TOWN HALL NOTIFY ~OUTHOLD, N.Y. 11971 CALL TEL.:7G5~1802 ' MAIL T0: Examined . ~.~~l6/./~`. 19 ~ ~ Q f~`~ Approved r/,~.~ 19~~Permit No.. / Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT c~ Date ..~.a/ 1~......., 199 J. INSTRUCTIONS a. Tltis application must be completely Cilled in by typewriter or in ink and submitted to the Building Irspector, with 3 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 diagtam which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Buxding 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 s9ta11 have been granted by the Building Inspector. APPLICATION IS HEREBY hfADE 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 Re=tilations, for the construction of buildings, additions or alterations, or for removal. or demolition, as heFein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regularions, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Ivtailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the tax roll or latest deed) If ap a~cappt is a corporation, nature of duly authorized officer. Jy ~ ~~t%v~ (Name and title of corporate officer) ALL CONTRACTOR'S MUST~1£E UP~OLK COUNTY LICENSED Builder's License No. LS{" 1'~ .I.: ~ ...p..... . Plumber's Liccnsc No.~~r~-`C~~~J(.~ 1.~.c.vvYr1~~^q~ Electrician's license No. :1.\.~~?.. ~:?L-`?Y~ v\..J Otltcr Trade's License No . . 1. Location oC land on which pr posed work twill be done . . .~:'~CJb......... ~.eS~plnclcc~.~.~'.` ..............~a:~.:~?c-~c'............. House Number i Street Hamlet County Tax M1tap No. 1000 Section ~ Block Lot .(~(A,~~,'~-, , ~ , Subdivision Filed i\lap No. Lot . (Name) State existing use and occupancy oC premises and int mlcd use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy ............~~~~J-~ ~ 7~ c~~,,~ t1j 3. Nature of wor check which a plicable): New Building Addition • •a~~~k'°~?• • • . Repair Removal Demolition h ~ ~ „~,D;S,ri~2io 4. Estimated Cost ..........L`:9~,~4 . Fe . . (to be pai,=•e•~~. 'Y is application) 5. if dwelling, number of dwelling units Number of dwelling units on each floor . Ifearage,numbcrofcazs b. If business, commercial or mixedi,occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front Rear Depth . Hcig}tt ...............NuntberofStories........................................................ Dintcnsions'of same sitvcture with alterations or additions: Front Rear . , Depth • ' .Height Number of Stories • . 8. Dimensions of entire new construction: Front Rear • Depth . Height Nutttler of Stories . 9. Size of lot: Front Rear,..................... Depth 0. Date oCPurcltase, ................Name of Former Owner . 1. "Corte or use district in which premises are situated . 2. Does proposed construction violate any zoning law, ordinance or rrgulation : . 3. Will lot be regraded ..................Will excess t'i11 be removed from premises: Yes No 4. A'ame of Owner of.premises ...............Address ...................Phone No............... . Name of Architect ~ ...............Address ...................Phone No.. . . Name of Contractor ~i Address .......Phone No.... . 5. Is this property located within 300 feet of a tidal wetland? *Yes No *If yes, Southold Town Trustees Permit may be repaired. PLOT DIAG1tAM Locate cleazly and distinctly all tjuildings, whether existing or proposed, and indicate all set-back dimensions from ~roperty Lines. Give street and block n{tmber or description according to deed, and show street names and indicate whether lterior or corner lot. ' ~2/ ' y /~r~~.yC.~f o, i TATL• OF NE1V YORK, S•S _ ~1;;,-r~r . , • , k~© t°--~daY being duly sworn, deposes and says that he is the applicant (Nam of individual si~ninrt contract) -ovc named,, is the ..........Lt. ~~~C.-......~. Pv (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed fire said work and to make and file this plication: that all statements containgd in this application are true to the best of his knowledge acid belief; and that the xk will be performed in the manner sCt forth in the application filed therewith. corn to before me this ~ ~`C .1~/~/..L ....da~y/of ~/C/~C~~.21~...., 19 Mari' Public, ~f~-:..lt•', v~....... Count gyp'/ NEI.ENKOEVOE ` (Signature oC applicant) NOTARY PUBLIC, Steto of New Yo'rN No.4707878, Sutlolk tbunly ' 1@rm Expices Mareh 30,19.