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HomeMy WebLinkAbout18186-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18346 Date AUGUST 31, 1989 THIS CERTIFIES that the building ADDITION Location of Property 365 BAYER ROAD MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 139 Block 3 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 30, 1989 pursuant to which Building Permit No. 18186-Z dated JUNE 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to 3AMES & JOSEPHINE SELLARS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-088244 - AUGUST 24, 1989 PLUMBERS CERTIFICATION DATED JULY 24 1989-HARDY PLUMBING & HEATING -•Z Bu' i g Inspector Rev. 1/81 sows xo. a 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° ~ 81. $ ~ Z Date 19.bt..~ Permission is her y granted to: ~ of premises located at ~ ~ ....Q../..................................................... ..........................................................................qq..................................................................................... Caunty Tax Map No. 1000 Section ....13.l......... Block Lot No.....~( pursuant to application dated ..........~!.~1.311 19~I~., and approved by the Building Inspector. eo Fee $..1.~. ....9....., ildin for Rev. 6/30/80 V ~ ~ 4 u ' D D TOWN OF SOUTIIOLD AUG • 2 g~q BUILDING DEPART2lENT 3a3 'a6 7~ TOWN HALL BLOG.pEp7; SOUTIIOLD, NEW YORK 11971 TOW~e N OF gpUTHOLD 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE--`F~G• ~!/-O-I.... NEW CONSTRUCTION ~ A~j~b~ OLD OR PRE-E%ISTING BUILDING......VACANT LAND....__., Location of Property.... ~ 6~,..-. HOUSE NO. STREET HAMLET Ovner or Owners of Property....:.jk.?yt~,f-S ~~~L~~.7,~~-_ 1 County Taa Map No. 1000 Section / / Block , _ Lot" Subdivision Filed Map ........Lot._........ P e r m i C N o. 8.1. {l _(f/ p Q-tj ...Date of PermiC ~?~a j,Applicant ..:~1E?, 6~ II ..a..N..... Health Dept. Approval Underwriters Approval.............. Planning Board Approval Request for Temporary Certificate -7 Final Certificate _ _ Fee Submitted: ,OCs~~~. -V~ • • . APPLICANT...... rev. 10/14/88 Q.ec. 38f 3 y ~ o ~ IB34t, i ~ ~ , ~ FORM N0. 6 TOWN OF SOUTHOLD BIIILDING DEPARTMENT ae i` 'e' TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS ' A. 'This application must be~~,filed in typewriter OR ink and submitted to the Building Inspector with the follo;+ing; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual gatural or topographic features. 2. Final approval of Health Dept. of water supply aad sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. ' 4. Sworn statement from plumber certifying that solder used in system contains less ' than 2/10 of 1Z lead.' 5. Commercial buildings,~,industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning BoardApproval of completed site plan requirements. B. For existing buildings (P,rior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in vr~iting to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information kequired to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vacpnt land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If a~ICertificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCC~TPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Access~ry buildings, $25.00 -'Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 S. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial rev.,, 10/14/38 II I TEL. 7G5-1802 S~FF~U, C o~•p TOWN ~r S(3t.TTFYObPJ iZ ~c OFFICE OP Ii[JILDIIdG INSPEC'T'OR o ~ti'~~ ~ P.O.I30X728 u' ~ ; ~ TOWN HALL yO~~1 ~~~`t- SOUTHULD, N.Y. 11971 C E R T I F I C A T I O DI Date ~ Suildi~q Permit No.~ Owner S l ~ (please print) Plumber ) (pleas pz•int) i I certify that th~a solder used in the water supply system contains less than 2!10 of to lead. " (plumber' signature) C~~....~~.~~~-e..~ Sworn to before me this ~7~_day of ~V ~ n 19~. _ f l - - Notary ublic Notary Public,JV~~OC-K County MElANIE V. BRCINN Notary Public, Slate of New Ya1c No. 49087t2 Quaflfled N Suflo9c County Commiatkn Ezpiraa Od.19, t989 r1ELD II:SPEC:iU:i ~Illnir. i;0a`4MENTS ~ `1 ~ ~ t. H \nV O rOUIlDAT20N (1st) ' N rOUNDATI0t1 (2nd) m - C z r-, o ~Ll 61 ROUGH FRAME & C~ .PLUMBING ti ~y~ 3 . m .:pU c~ IIdSULATIOPI PER N. Y. y STATE ENERGY COpE ~ r FIidAL 1 0 z ADDITIOPIAL COMMENTS: m " ~ x ~o \ N A • 9 H \ O Q a r H x d m -o H C ~~h c9h~. CONSTRUCTION MANAGEMENT CONSULTATION Box 208 ~ ~ East Marion, New York 11939 "1 (516) 323-2676 ~ ~ ~ JOHN C. BORN, PRESIDENT .Y 's 9 fig. Q~ ~ r,m ~ ~ ~ ~ ~ ~ key ~Zr ~ ~ ~ ; I o "C M n ~ ; ~~c-_--r-----...__ ~ N rte{ ~`CC R1 i ~a O ~ O O ~ ~ m3 a in A ~ ¢ ~ ~ ~ ~ ~ \ [ , Z ~ ~ 7 ~l ~ o t'Jy~o N _w A 1~ ~ 1 rr > T ~ N ~ ~ i ,1 n ti lA ! i 1 !~I ^J ) i ~ i~ j ~ )M i - - _ i i I D ~ ~ I ~ 2A ~ ~ ~ °1(~ i _ ip'~ ~ a ~ f A c, ~ C7 vj J~h C 7~~h c9h~. CONSTRUCTION MANAGEMENT CONSULTATION Box 208 East Marion, New York 11939 (516) 323-2676 JOHN .,BORN, PRESIDENT t F 1 ~ ~ ~f f T _ ~ t• ~ ~ ~ ~ s x ! o / J J j I ~ 1 ~ i ~ ~ I N A i ~ ~ 1 ' ~ ~ ~ ~ ~ I A X can N ~ i ~ i- ~ n I .~s ;Qf jo i ~ I ~ ~t r v," ~ 1 ~ I C:_ ~ J i ~m( f A I y.~.. to c,_ . _ ~ , , ,e_:._._.. ~I ~ f J ~ w..__ - rJ i v~ I w fl D r' my ~ 70 tiC' ~ Oj z ~ ~ to ' ~ , ~ i- ~ tp I u~i ~l ~C~ 765-1802 BUILDING DEPT. INSPECTI®N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [~RAMING [ ]FINAL REMARKS: ._.G~~ DATE ~ ~ O V ~ IN§PECTOR tig~, l 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: , DATE INSPECTOR . . i° G THE NEW YORK BOARD OF FIRE UNDERWRITERS 1,O17Q9,13 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 AUGLJS'P 2A.7~9t3T9 ~3~S9~1S~J8~ tI Uk38~~~ Data APPlicotion No. on file THIS CERTIFIES THAT only the electrical equipment as deacrih¢d below and introduced by the opplicant named on the ahoUe application numher in the premises of 3RCT11'IS S~"I~l,AR~S, 35fi P,fiYF;}? ROATt, 19n`f"PT.'PItCK, o N,4`. ~ in the following location> ? Boxement ~ /xt F!. ? 2nd F'l. .Section Block Lot (i'ffrf7~.ri "Ir L}~t ° ~~iG and found to 6e in cmrrplianre with the requiremenGx q(this /ioard. wos examined un FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASNERS EXHAUST FANS gOUTLETS INCANDESCENT FLUORESCENT OTHER MAi. K W. AMi N W AMi. N.W AMi K.W AMi. H P `S J Il DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL DNIT HEATERS M SYS EMS ET DIMMERS AMi. K. W Oll H. P GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT AMPS TRANS. AMT. H. P. NO. OF FEET AMi WATTS t, 3 ~ S@RVICE DISCONNECT NO.OF S E R V I C @ METER NO. Of CC COND A. W G A W. G. A W G. AMi. AMP. TYPE EQUIP 1,e' YW 1 R JW 39 ~W 3q dW pER 9 OF CC COND. NO. OF H4LEG OF H4LEG NO Of NEUTRALS Of NEUTRAL OTNER APPARATUS: LA13NI)~i~t & 13A`I'II i'tDflTTI<,)TS ~rN1'AY-•t G.-t~.i1.7.-1 L~z~E%cc-~+-~ ~~"l PIaT(fr R. 33URAIa L7t;,~ur42-~ 2"Y5 T<SIdN NAR6lJR t°APIk; S{1TITI1~tLAr NY, :I 7.971 GENE.R(~L MANAG@R "7. f~, r dye This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ma~be rd' E'ntified by their credentials. COPY FOR BUILDING DEPARTMENT. TI115 COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. , . `a. L ' ~'7 ~ v~ J ~ ~ A! ~ ~ a~ J l ~ U ~ ~ ~ ~ ~ s~ p.~ ~ 3 p ~ v~~ a L v, ~ - - '-}-----~--e~-q-- s ~ ~ o o U aW j~ ~ ~~~~a~ Q ~ W ~ ~ ~ ~r ~ ~ ~ v' ~ ~ a a... i JV~i~'~ ~s Q v~ ~ ~ ~ v~ fi d ~ ~ ~ ~~U ~ 3 ~ ....f`_ Y . ~ r., R ~ ~ Q s ~ 4? ~ ~ ~ ~ ~Q ~ !1 ~ ~ ~ j i 5. ~"$"5~~30" ~ /50.4 5~ a Q. O ti XF s~ s~ ~ ~ O0 .L° N 0~ i ~ O 0 ~ k i / ~ Nos 9V' ' ~ ~ 4v o ~ ~ ...~__,,,ts.,.,__,...,_ _ 'v, . o ~ ' ~ Y ' ~ ~ \ Q 6` e~~ d ~ ~ ^oY i~~ 0 io: o; f~c >z ~;n- 7.03 ' - w N ~ z N n ~ ~ ~ i_ ~ r h z~ O Z o ~1~ ~ ~ ~ i~C~ ogO .»yy~4y'.•'L~'k`'>p.i •r'r''~: ~ ;r.`s : ~1~~::eIFr.•%'r'::~:::b i.. _ _ . y h;' „ ~ - .........J - ' . - ; ~ ~ i ..i: r . n ' GC.4~.H\i_y.~'N:: ?.t~~.vA:'S^;•M<.y'. <i'i +i'w. 'i~ a?J.!.~.a ~ _-_...~_.-r V ~ ~ ` o.y i ~ ° i rY i ~ ~ ~ ° i of f ,i ~ P ~ ~c o I v N I C jL a !R4q ~ R i ? 4t ~ ~ p f J \N ' ,,III 2 ~ . . (w ~ ' ~ i ~ ~ ~ li I I ~ ~ ` T .~i.._ , ~ I I ~ y t ' Y fN Q i -o ~ Y i , ~ ~ ~ ~ y ~ I J ~_.._3 ~J; 4~ X11 I i I O ~ ~ ~ i ~ ~ ` N U f I I ~ i, - I _ _ - 'I~ v - ~ o-- _ ~ r. L, i t '3 V ~ Ca u a ~ ~ C L• J IL M 4 T 0 VGA I t~ ~o N ~ ~~a~ f I f " ~ ~ ~ s / ~ 4i I~ Q I N i ~ii1_~ .r' : r I ( f I i i I ~ N p 1~ I it ~ iI ~Y ~ o I. to . ~ .:,I 11 C~ •J I .~I N I i v~ . V ,L I ,V~ i i ~ 1 ____i Y S.,_ 1 _~Z..._._....._....~.____._~......___.._.,_._.._.__~__A_______-.-.-y BOARD OF HEALTH 3 SETS OF PL.1NS . , FORM NO. 7 SURVEY ~ ~ . TOWN OF SOUTHOLD CFtECK ..............f~~, , , , , BUILDING DEPARTMENT SEPTIC FORrt TOWN HALL SOUTHOLD, N.Y. 11D71 NOTIFY J . - G ,Q~j TEL.:7G5-1802 CA Examined . ~0~4``//........., 19 y~ MAIL T 0 Approved ..~~b....... , 198. Permit No. ~~j.~!5~~.,Y' • Disappraveda/c GinoI ector) APPLICATION FOR BUILDING PERMIT Date ...S{ .~0. 15 INSTRUCTIONS / ~ a. Tltis 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 o~ 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 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 far the issuance of a Building Permit pursuant to the Buildin; 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 inspect ~t building for necessary inspections. ~~~1~~~ (Sig Lure of applicant, or name, if a corporatton) • % "<'j a t (Mailing address of applicant) << ~b 1 S tl.~. :'alt a'<, F State whether applacaMth i~ d~~er~y,les~e~,t~,~~rchitect, engineer, general contractor, electrician, plumber or builder. ..............;t;r,,~P±4Vsa '4 .a>?°'r:" tea;*a ~ . . ;v.' h"" Name of owner of r~°r~lises , a.<.r . , i .l X ~ tt.~4 j lAH? Gs•1a;38AIi11't~iQi~ -L"` (as on the tax roll or latest deed) [C applicant is a corpeylaG~egT, s3~ha'~1~`1Ii19~a~hotrized officer. • •f'sJ~1~N:I e`t{)~tJi)f91' i,,l,.)~ 3?`~1x ' me ae~~>1tl~~Mfdk3f{So~'3T~`o'~`~ii;~e~);»'I;' 't Builder's License No. ~ i .a~r7:°i ~ k:....... . Plumber's License No. ~.p. ~~':u:"!'~.~!'`~~'. M!`4tTrRUC_K Electrician's License No. V~.1:. ~u2n~,~ S~pyj'1Jq!.b Outer Trade's License No . . 1. Location of land on which proposed work will be done. ' Flouse Number Street Hamlet • ~ • County Tax ~fap No. 1000 Section ...../.n-'..~• • • • • . • • . Block , , , , , , , • • , , , Lot , , , , , , , , • Subdivision MAT?: n+,c;t<• • ~.I.GMT$, Filed tap No. . , . ! .l.a....... Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy d N • ••I,~, , , ;~w r: l..c-r N G ......pp . b. Intended use and occupancy ©P!C. •~~•I • • ~t7~: • •N,ELJ , ~!~tNAfC. /~tbm• • . y.. 3. Nature of work (check which Re air ~PPlicable): Ncw lluilding • P " • • • • • • • , , • , . Removal . • • • • Addition . rVtcration Demolition Othcr~Vork„ 4. Estimated Cost .........I.SII~,1Z~ , , , , , , , • • _ • • (Description) Fee 5. IC dwellin" h units , (to be paid on Cling this application) „ number of dwcllin If garage, number of cars " • " " Number of dwelling units on each floor , , 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structurCs, if any: Front . Heigftt . Number of Stories , • . Rear Depth . Dimensions of same structure with alterations or additions: Front • Depth . ' . Ilcight . , ............Rear . ' 8. Dimensions of entire new construction: Front , ' ' ' ' ' ' ' ' • Number of Stories . • • • • ~ • ' ' ' Height Rear . . to7.r'~.': .Depth . 9. Size of lot: Front , • ~ ~ Num,bcr of Stones , , , , , , . • • : ' • • • , , • , , . 10. Date of Purchase ..........L.,•....... Rear......... ........Depth ..............Name of Former Owner GuSm>4y • . 11. Zone or use district in which ~ ~ • • premises are situated , , , , • • k; ,tz~~L~,g,~,~ 12. Does proposed construction violate any zoning law, ordinance or regulation: • 13, Ni11 lot be regraded • .NP . 14. Name of Owner of premises , aua• • • • ' ' ' ' ' ' ' • • 1Vdl excess fll be removed from remises: Ycs Name of Architect ~¢~~px~~' ' S~~$• • • Address . ,~qK~2, RA. p1~¢gR,, • , P1 one No. , No Name of Contractor .tiTPI~N ,~p(11J . • ~ ~ ~ ' ' ' ' • • • Address ....Phony, No.. • ~ ~ • ~ • ~ • ~ ~ • • • • IS.Is this property locaged within •"'AddressOO~AX~oB,~~;~j~i.%I,phoneNo. °~0?3:.~471v .I *If yes, Southold Towni,Trustees Permit may bearequiredetland? *YES..,.NO. 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 n,trmber or description according to deed, and show street names and indicate whether interior or comer lot. III~'rrxKaf~D P~~- y'~~4,J AP D AS N01'Ep DATE o $.RN.'~,:~ Cy FEE: $Y: / NOTIFY S IL I G OEPARTMEN A I, 786.1602 9 AM TO 4 pM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE ~ 2. ROUGH . FRAMING m PLUMBING I, 3. INSULATION II 4. FINAL - CONSTRUCTION MUST SE COMPLETE FOR C.O. ALl CONSTRUCTION SHALL MEET I, THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION 1~ ~N(~Y I CQOEB. NOi RE$PON$1 FOR i ~ DESIGN OR CONSTRUCTION ERRORS I ST,1TE OF \EtV II' =OUN'CY OF. S.S . ,,~To . o/L~... ~ (Name of individual sip bntract) ,nim• cl • ' ' ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant hove named, is is the nN...~~-`T'o't2 y (Contractor, agent, corporate officer, etc.) • ~ • f said otvncr or owners, and is del autltorizcd to perform or have performed the said work and to make and file this •~pliration; that all statements contained 'in this applic~[ion are true to the best of his knowledge and belief; and that the ork wdl be performed in the manner set forth in tltc application filed therewith. 'wont to before me thi ~ 9 .day of.. .I.. \ / 1 -JUDITH T. TERHy County Notery public, State of Now ~ ~n No. 82-0344983 York I , , , •l N V " • • Commi>~(fo~ in Suffdk County~I C~ . ~pireaMay91, ig~/ (Signature ofapplicanq ,7 I