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HomeMy WebLinkAbout18102-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18433 Date OCTOBER 1, 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 5350 BERGEN AVENUE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 07 Lot 43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1989 pursuant to which Building Permit No. 18102-Z dated MAY 8 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 ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM ZOLDESSY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-089987 - SEPTEMBER 1 1989 PLUMBERS CERTIFICATION DATED_ N/A Building Rev. 1/81 POEM NA f 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° 18102 Z Date ......•►•a•�..5.. .......................... Permission is hereby granted to: .:.. .... ° . ................. ................................................... ..........................................'........................................ .... ......................................... ....... ...................... at premises located at County Tax Map No. 1000 Section .......P.4.......... Block ....P3.......... Lot No. J .............. pursuant to application dated ......�. .. ....................... 191A., and approved by the Building Inspector. Fee :... OJ ding Inspector Rev. 6/30/80 I � ` rA j \ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL • SOUTHOLD, NEW YORK 11971 765 — 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY / Q DATE. . . NEW CONSTRUCTION . . . j..l..OLD OR PRE—E�XjISTING BUILDING. . . . . .VACANT LAND !ll. . . _ . . Location of Property. . !r?�. . . . . . . . 1 'C HOUSE NO. STREET H✓AML'E�Td . . }- Owner or Owners of Property. . . . . . . . . Cownty Tax Map No. 1000 Section [� y( . �. . Block . . ). . . . Lot . . . f :�. . . . Suadivision . . . . . . . . . . . . . . . . . . . . . . . Filed Map . . . . . . . .Lot . . . . . . . . . . Permit No. /.8/o4z . . .Date of Permit .��q�t ' -Applicant . .�.°. �?�7�t ( ,`f �.XJ✓ZJS Health Dept . Approval . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . . . . . . . Planning Board Approval . . . . . . . . . . . . . . . . Request for Temporary Certificate Final Certificate . . . . . . . . . Fee Submitted : $ • - - _ APPLICANT. . 7ev. 10/ 14/88 6Z.ee• 3a3 7'1 �© 1843 3 11850,1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 83 JOHN STREET, NEW YORK, NEW YORK 10038 il`PTIMiTrfi 01,.1989) t3T9Ca9t3)/39 N 458933'3 Date Application No.on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of WILLIAM Z01ONSSY, 53t,O BERGEN AVS, P0t,9# NYT 32, HATP1'TUCK, N,Y, in the following loco i- as, t ❑ /st F'l. ❑ 2nd F'l. GAS' Section Black Lot t it,,,p7j,l�`�� was examined on andfound to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKINGDECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS // INCANDESCENT FLUORESCENT OTHER AMT K W. AMT K.W. AMT KW. T. K W. 6 AMS. H P. g ( 2, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PTj TIME CLOCKS FELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT K.W. OIL H.P. GAS H.P AMT. NO. A.W.G AML AMP. AMT AMPS. TRANS, AMT H.P NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP TYPE METER 10]W 1,63W 303W 3,e 4LW NO.OF CC COND A W G NO OF HI EG A.W.G. A W.G. EQUIP. PER% OF CC.COND OF HI-lEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: PANF'liBOARDS:1.-3 CfR. :100 WSW. F LkiCTRIC TLiC..#.3577_R P,O,Y.LU$ 164 (!11TCHOQUPr NY, 13.935 GENERAL MANAGER per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. r 7j TEL. 765-18n2 TOWN OF SOUTHOLD OFFICE OC BUILDING INSPECTOR ;� 1 z P.O. BOX 1 1 79 TOWN IIALL SOU HOLD, N.Y. 1 1971 To WhOm This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons . An application for Certificate of Occupancy is not on file. No Underwriters Certificate on file . The check. is (ouLdat-od/nut On file . ) NO Health Dept. Approval on file . No final inspection has been made. P] CdSe contact our office on this matter. - Thank you for your cooperation. Ihri1di1,g Pcrntit )! d 0 2 G U IIui1c]inq Dept. No Plumbcr Solder Certificate on filo . ( all permits involving plumbing being issued after April 1 , 1984 ) ��y3 :'lELD ATE COMMENT -n \ 00 H 0 FOUNDATION FOUNDATION ( 2nd ) _ _ En 2 . ROUGH FRAME & d PLUMBING ti 3 . -=3 m INSULATION PER N . Y. y STATE ENERGY CODE x } r 4 . .-Iy FINAL ADDITIOPIAL COMMENTS : s s m x H 1 a ^6 H •� H O O m } ' r m - -v H M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] NSULATION [ ] FRAMING [FINAL REMARKS: ce DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FO 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR [�D L4BOARD OF HEALTH . . . . . . . . . . . . 3 SETS OF PLANS . ow FORM NO. 1 SURVEY TOWN OFSOUTHOLD CHECK . . . . . . . . . . . . . . . . . . . . . . ,<� ., ..__.;..... ., .. BUILDING DEPARTMENT SEPTIC roars . . . . . . . . . . . . . . . . TOWN HALL COUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 CALL . . . . . . . . . . . . Examined . . tY� . . . . .. 10� . MAIL T0 : ' Approved , , , , 101. Pennit No. 60a Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Bin mg Inspector) APPLICATION FOR BUILDING PERMIT Date . .J./�. . . . . . . . . . ., 15 G INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 diagram which is pan 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 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. yu (Signature of applicant, or name, if a corporarion) /fox �i�`f / ��'!�,�✓lT�-e<<. 1.� � . . . (Mailifig address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . � c , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises (y. L I " �P �S c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If a lie is a corporation, 'gn ture of duly authorized officer. (. . . . . . . . . . . . . . .. Name and title Of corp ate officer) 2JZ: .f Builder's License No. ... . . . . . . . . . . .. Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . 53v q . . . . . � �. . !I .. ... . . . . . . . . .�J�.. ��? e<< . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street, --77 Hat let l . . . . .. County Tax Map No. 1000 Section . . . . . ./0. • • • . . . ... Block . . . . . . . ./. . . . . . . . . . Lot . . . . .]/ . . - . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. Lot . . . . . . . . . . . . . . . (Name) . . . . . . . . . . . . . . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . I. : !IV.4 . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . .`: ���??✓j-�/ (_ P ( ch applicable): New Building . �� `' Addition . . . . . . . . . �t ati8 3. Nature of worn check which' Repair Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . OI * S1Tor . . . . . . . . . . . . . . 4. Estimated Cost . . . . . . . EYh� p: (Description) D +t� . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . %. . , , , , , , , , , . Number of dwelling units on each floor. . . . . . . . Ifgarage, number of cars . . .'. . . . . . . . . . . , • • • • • , 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . .7. . . Height . . • of e , . . O. . . . tures, if any: Front . . . . . . . . . . . . . . . Rear . ... . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Dimensions of existing structures, mber of Stones . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . Depth . . . . . . . . . . . . . . . . . . . . . . Ileight . Rear . . . . . . . . . . . . . . . . . . 8, Dimensions of entire new construction: Front , ' ' ' • • Number of Stones . Depth . . . . . . . . . . . . . . Height Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . Number of Stones . Rear . . . . . . . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . " ' • " " " " . . . . . . • • . . . . . . • • • • • . . . . . . . Name of Former Owner . . . . . . 10. Date of Purchase 11. Zone or use district in which premises are situated . . . . . . . . . . . . 12. Does proposed construction violate any zoning g law, ordinance or regulation:13. Will p • • • • • • • 14. • . . . . . . . . Will excess fill be removed from premises: Yes Nie of Architet be ct remises 2vt���s' . , . , , Address . . jzt;c.,lC, , , , • Phone No. . . . . . . . . . . . . . . . . . . . . Address .. Phone No. . Name of Contractor . f2 :�1 `! ! as , , Address . 1?? PTl7?ti,G<co. . . . aS IS .Is this property located within300 feet of a tidal wetlandTn *YES . ...NO. ?�. *If yes , Southold Town Trustees Permit may be required. ... i PLOT DIAGRAM Locate clearly and distinctly all buildings, 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 corner lot. J� !/�/'✓Y}���'+� S�-c/2 rim 7- �G/�o�S STATE OF NEW ,%ORK COUNT F SOS . . . . . . . . � • • • • being duly sworn,rn, deposes and says that he is the applicant of individual signing contract) above named. Ile is the . . . . . . . . . . . . . . . . . . . . !�. <� . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) tf said owner or owners, and is duly, authorized to perform or have performed the said work and to make and file this 1PPlication; that all statements contained in this japplication are true to the best of his knowledge and belief;and that the vork will be performed in the manner set forth in,the application filed therewith. wont to before me this . . . dayof. . . . . . . . . . . ., 19 ✓� votary Public, County HELEN K.BE V0E A.,,,icant) NOTARY PUBLIC,State of Now York (Signam o No.4707878,Suffolk Coun Term Expires March 30,19_�ZG ----- - - - - - SUFFOLK CO. HEALTH DEPT APPRUV AL 1 H.S. NO. '/ACAN'r 4x.9 BEQ.C.EN . AVENUE s.a t STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL IOO.O / 4SO TO COW NECK sR U. -+ _ 7 y.,: - n#y. -. SYSTEMS iOR;:.THIS .RESIDENCE WILL x... CONFORM TO. THE STANDARDS OF THE ' - �x SUFFOLK CO. DEPT.XOF HEALTH SERVICES. g MAR OF .PROPE QT Y `nNT SURIIaYED .FJ2 v ~ 2 # " `Y :' SUFiOI.IF. t[OUNTY DEPT OF HEALTH /`�' ( C SER fS ES , FOR APPROVAL- OF •`;r 4—�`�' �r•r...J J 1' CO r ION ONLY _ 'I �, •_ - zt 111 irFIZ WO Ky is r ti= i a &R&', ra50-206 +c': i ; °' MATTITUCIC E1 . APPRovEb r Tt7r/NOF.:so OLDWY ! �`' r` 6yi MI I� :.' { AIFFOLK CO TAXMAP DESIGNATION: ' :.J IX � .`.. .� III L• { Y Y - n t ) DIST SECT_ BLOCK 'PCL. Z F iN . aY:J i '!'-' ' Fool!- y 1 5 r t (�s. -•3"'-s in 'k.• _ _ sem'-tT3 _ ?C.4 _� "s ✓ J� R _ y - µ`Vk - } •. } E (t[• OW gN �ERS/IDDRESS h h. 4 y '.s,,,. ,r t., ;E' �t n 't �` �'FF.v t •s+Y'� S60 PE..HAA FAd'<WAY a _ ;y" art: 'F-j •,w THS7 HOLEX.-�@ ..;A v d.: 7`_ r � i..� ♦.Y. 'n.._ _ r M• �lyg'. } rJ �k � � .' .. E .-- C2 TTS 56 _ tr 141 ^ a Itl : { Y ze • DEED:C.SSe05�,0 P.SX)- ,99 CREE�r-.�" £ to - f t . j TEST HOLESTAMP s - • £ p> D 120N PIPE - jl d xt z: E--- •••...,. �� Y. L t. 5-rs 141 w :-y o �TD O TirinMwr w+r MHI Y.. ,.-, ty_., =4,; r:.: :.; �._. _. :..-:' � � �: :`1 _ 1 � ,- SAN w.wr www�•WwV� x. ,� ¢ - .. .gar./�wi�[Y LIMY•/ �i �'s 3(`* - � { x e���w5Z.1 i � �' � F.: E . LDA►t.. - rr•wrw�wS.e+�'Sp'*i 1 MENDOZ.ZA Y ANO 5AMD�' kw.r w�iwlrwiw� �. VAC i I usFrr.- Ee...,....F.�...•r w...r GIZAVEL k , MENA5ED NOV.274 F)ss a.y{ '. Atob:. 19x6 SEAL 1 Y NOTE c } _ y ti E fiVATlO1VS REF R.Tb MEAN 5!!h LEVEL OF NEN. . 1 - MRAVEL .,E ng 6UQVE .Q -- NDy ,I.s Vim '+ RODERICK VAN TUYL,►.C} . e A Q. �L T-...•ySL r ` r LICENSED LAND SURVEYORS GREENPORT NEW YORK LANO } E :I E, P I I AF jf yr' {3 PUNT j j' • } 1 OCCUPANCY on WITHOUT Ct SE IS UNLAWFUL r f `. . . APPROVED AS NC I FEE YQ_L_1 _ - v i i NOTIFY RUILDINC i IT - ,s9x�•I - 765-1892 9 .'+E FOLLOWINGLIT 1. FOUNDAT,OI� EDFOR POURED CO1gi2. ROUGH - FRAMIN(,j 3. INSULATION i 4. EMAL - CONSTRUCTIC ST '4dp_.___ — - BE COMPLETE FOR C.O - "`T"'=_ _ _ -. -- � ALL CONSTRUCTION SHALL MEET ..-., ..r. .. r F THE NY. J THE EMENTS 0 STATE COONNSTRUCIION A ENERGY —1 COOS. NOT RESPONSIBLE FOR o� V DgMNQR'CONB'TRUCTIONERRORS --- - __ .. ` ;r .i . • w