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HomeMy WebLinkAbout17865-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218556 Date NOVEMBER 13, 1989 THIS CERTIFIES that the building ADDITION Location of Property 1930 SIGSBEE ROAD MATTITUCR House No. Street Hamlet County Tax Map No. 1000 Section 144 BLock O1 Lot 14 AMENDED MAP OF MATTITUCK PARK Subdivision PROPERTIES, INC. FILED MAP NO. Lot No. 39 conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 22, 1989 pursuant to which Building Permit No. 178652 dated feb. 24, 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. The certificate 1s issued to MARGFJERITE & ALPHONSE THOMAS (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N084691 AUGUST 3, 1989 PLUMBERS CERTIFICATION DATED N/A uilding Inspector Rev. 1/81 IOHM MO. 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~ 017865 Z Date . 19.R..~ Permission is hereby granted ta: :,Y, ..l.. a~~s ~ a.rr.... ct premises locateda~t~...1...9..,~ra.....~s.!~Fds.. ~....~.9MX~dA~4:~ . County Tax Map No 1000 Section ~ Block ©.r'......... Lot No . pursuant to application dated ..~r~Xl'!-~S:R~ ?-.z-.... 19.g~.., and opproved by the Building Inspector. Fee ~ 1.~~..: /C.,c~v ~ Buildin t for Rev b/30/80 ` TOWN OP SOUTIIOLD .'~~-jQ-j O ff BUILDING D):PART:IENT 1~~ ~ OUTIIOLD,IINEW YORK 1197[ 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY nnTE 9. , / 1.~ 9.. . NEW CONSTRUCTION .OLD OR PRE-E%ISTING BUILDING......VACANT LAND...__... Location of Property.!/~~........`.~~.~~.~r,~.~r'~-...~Q:~..!'.l~.I.J.~V~C~.7~'.~~.. HOUSE NO. STREET IIAMLET d ~ ~ Owner or Owners o£ Property/?2.I°+.U.,~leil~.'t'./~ LJ~~d/y~~_._ s County Taz Map No. 1000 Section 1.~."I. Block . _ Lot ~ . Subdivision..... .~J...... Filed Map ........Lot... p Permit No.~Z~~°.`.2..._.Date of Permit ac~~7.,e/~..Applicant F...1~°'1/~....... Health Dept. Approval //Underwriters Ap/p roves l~!_'......._.. Planning Board Approval Request for Temporary Certificate Final Certificate ~ , Fee Submitted: $_.~J.^,.~! APPLICANT~~ '~'~.~~~.-c~........ eo z~~SS~ JPe.`~t 3 ~S~ I~11 ' 91~D ~f/r 3/~ ; ____9~ BLDG DEPT. TOWN OF SOUTHOLD rev. IO/I4/88 i M FORM NO. 6 TOWN OF SOUTHOLD BIIILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRIICTIONS A. This application musC be Filed in typewriter OR ink and submitted to the Building Inspector with the following; for oew buildings 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 of 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 solder used in system contains less than 2/10 of IZ lead. 5_ Commercial buildings, industrial buildings, multiple residences and similar buildings and insCallations, a certificate of code compliance from the Architect or Engineer responsible for the building. i 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: I. 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 Citle company which shall show single and separate ownership of the entire lot prior to April 4, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state [he reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: I. An application for vacant 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 Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCCUPANCY - New Dwelling S25.00, Additions to Duc,iliug $25.D0, nlteration to Dwelling $25_00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $SO.OD. 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 $50.00 Commercial ~~ry~7 R1R' ' rev. 10/14/38 gyn. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 AUGU3? 03,1989 Application No. on file 61450189/89 H 084691 E THIS CERTIFIES TFIA7' only the aleetricd sgttipment M dsscr76ed 6slols and introduced 6y the oppltcont named on the e6ose appNcation number in the premises of ALPHORSE THOlfA3, 1930 SIGSBEE RD., MATTITUCK, N.Y. ~ - in thafdfomiriR lac.Rian;Y ~ Basement ~ IAt FI. ? Ynd Fl. .Sertion Block Lot waa esasntned on JOOLL ,1969 end found to 6e fn rnmpliance ufth the rryufrementx of thw Board. RXTUEF - R%TURK RANGES tOOKINO acRS OVlNS OPiN WAEKNE EI(KAtKT FANS tRITIRTf A~ tCEM ~ fIUDMSCENT GTXER AMT. K. W. AMi. K. W. AMT. K.W. AMC N. W. AMT. N. I. 4 6 5 4 1 F ;6f1Yrs lUpiACR AgTORS TUTUER At7UANCE IpOERS SsKW ElC'si TIME ClOCRS pLl UNIT NEATERS M s~ ~TIET DYAMERS AMii - K. W, ql X, P. GAS X. I. AMT. NO. A. W. G. AMT. AMI. AMi: AMIb. TRANS. AMT. X. ~ RRT AMT. WATn - lIRVIQ OBtONEBCT NO.Oi 5 E R V 1 C E AMT. AIN. Tnt. 1,~ 1w 1 / SW S X SW KW or~c ;COND. oP C COND. Xo. q HbIEG Oi NO.OI NEUTRALS Of 'NWEUTGMAI QTtIR AMAEATUE G.F.C.I:-i -s'° l PAUL R. BURNS LIC.II282-E 275 TONN HARBOR LANE 30U?HOLDT NY, 11971 T+RN~ItAi App 11 Prr This dAiticaM.mutt not bs altered in any monnar; return to tM offiu of the (bard if incorrect. Inspectors moy be identified by thin wsdsntiak. FOR e1HLDING DEPARTMENT. THIS COPY OP CERTIFIGTE MUST NOT !E ALTERED IN ANY MANNER. : ?.::LD Ii. E ::lv~~ ~~U niL ~I v:KM ~.NI~ ,o 1 . „ 0 > O. ~ n ~ a H y FOUI~DATIO:d (1st) ~ _ / i Gf/ ~ r o c FOUNDATIO:J ( 2nd } 2 !i ~y:~ m 2. _ `o P.OUGH FRAi1E & r PLUMBING b iy 3. ~ ~ m m I17SULATIOh7 PER N. STATE ENERGY CODE x~ T 4 . y FIi~AL ~ _ ~ o. E ~ 4 ADDITIOfIAL COMMENTS: ~ r x -a H . 9 H H O z x m A r ` H x v m -c H h ~ j Z N_ Q ~O O F- m O a 2 m J ~ J WN W a >~...G ZT ~\5 v,~ w ~ WoT>Z CGS o N2cr3a ~ 2 ~ ° ~o~ZO ~~vaaf a i ~~WMG yNc Qo 3$ d ~ ~ w f..) C7 N y 2 W 0~ p ~ d LL ~ Y ` - ~ _ _ _ ~ ~ O T a J ~ w w a o, a a.~ =OZ NO p I- a w N ~ ` }Z Wop[~O~ -~ci z V- J a ``i QQ~ ~~p~ aQO~ vO tnaJAa~hfn NZ 5• Y _ O T ~ ~ y 4 l' V N ' _ n E ~ w 2Y ~ _ In u> •,-qt5'~ d° . ' A \1 t/'' ~ 3 a vi awm ^NN ~ i x oii WWW Sn ~ ~ ZOf1 o ~ ~pr ~ f ~ Q~Z -N ~ 'T M ~ ~ u ~ / WSJ .L i~~ WI-O Q V • FN 5~~ ~ W22 ~ mor 0o29,µ. H~s~a9 ° NZ M~<<~~ n. ow°w d a JaJ , obg\ ui o o,: ~ M z oio l / ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] R UGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]]/FINAL REMARKS: ~~~~~X DATE ~ Y INSPECTOR ~~~~s~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ( ] F NDATION 2ND ( ]INSULATION [ FRAMING ( ]FINAL REMARKS: p~ DATE ~ 0 INSPECTOR J 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ~ ROUGH PLBG. ( j FOUNDATION 2ND ( ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: C~ Iii.9~r Q~ DATE INSPECTO 765-1802 ~'~'~~ILDING DEPT. INSPECTION [ ] FOUN AT N i5T [ ] ROUGH PLBG. [ j ~ NDA ION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: O, G~~ i ~ ,a'~ J DATE Z INSPECTOR BOARD OF HEALTH 3 SETS OF PLANS FORM N0.1 SL3RV EY TOWN OF SOUTHOLD CHECK . BUILDING DEPARTMENT SEPTIC FOR*I • TOWN HALL SOUTHOLD, N Y. 11971 NOTIFY ~ ~ - rF e~ ir, TEL.. 765 1802 CALI,~ . L•~amuicd4'~ 1t~~. 19a`~ MAIL T0: ApProvedVy".""x4.~.~' j.., 19$01 Pcrmtt No ~ ~ Disapproved aic 2'G 1989 ~ ....C~~~~ jl (f"`-'+u~' TOWNLOF SOUTHOLD (Building Inspector) APPLICATION FOR BUILDING PERMIT I Date .."(.Z.'1........, 15 INSTRUCTIONS a. Tlus apphcahon must be completely filled m by typewriter or m 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 adlommg premises or public scree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of ttus app capon. ' c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of tins application, the Building Inspector wdl issued a Building Permit to the applicant Such perm shall be kept on the premises available For inspection throughout the work. e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bwlding Permit pursuant to ti BuIldin, Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe~ Tlie applicant agrees to comply with all applicable laws, ordinances, budding code, housing co =and regulations, and t admit authorized inspectors on premises and in building for necessary inspection. D 0'L`-r ~ (Signatu~t applicant, or name, if a corporation) vI .....lea „~n....~~z • ~ ~(IvQailin'iadcj;ess•of applicant) u t dc. ~ /V 1145 L State wh/e~ther apQoplicant is owner, lessee, agent, architect, endneer, general contractor, electrician, plumber or buAde. ......!?,Ut~~4,f.~ Name of owner of premises ~ S~ f 1^o vtCr S ~ • q f~ U 4 f t-~-~ • 1 h o tM G 5 .IZ... (as on the to ol! ar latest deed) [f applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No ..I~.. t G N Plumber's License No . . Electrician's License No v~. • - Ot}ier Trade's License No . . 1. Location of land on which proposed w k will be done . . i G ...1.9.3 S.15 s Y) ee...... ~1.a`7~'t ~tJC . House Number Street + Hamlet County Tai 11ap No 1000 Section ! ~ Block Lot . Subdivision Filed ntap No. Lot (Name) State c~isung use and occupancy of premises and intended use and occupancy o-f{proposed construction a. Exis[ing use and occupancy ? i 5.~•t • • • • ~G `1'~ 1 • S i~l'~ r'~ ?r ~ J ~ N C e• b. Intended use and occupancy ~ i•`' ` • • • L L`•' 1 3. Nature of work (check which applicable) New Building AddiUOn . ,1ltcrauon . Repair Removal .....(~.....v Demohuon Other work . . q r (Dcscnppan 4 Estimated Cost 1 J • Z ~ • • •'•Q• • • - • Fee + (to be paid on Ghng this apphcahon) 5. If dwelling, number of dwelling units . ...l....... Number of dwelling units on each floor . If garage, number of cars . 6. If business. commercial or mired occupancy, specffy whir and extent of each type of use 7. Dimensions of ,exutmg structures, tf any. Front Rear 2.Z-.. Depth ~ , , • , Hcrght . Number of Stones Dimennons Qf same structure with alterations or additions Front Z ~ Rear , . Depth 1~ Hetgttt j Number of Stones . Dimensions of entire new cons[rucrion Front Rear Depth . Heiglit ...............rN~ tuber of Stones . 9. Size of lot. Front ~ Rear Depth (`.f:'~ .~lr~....... . 10. Date of Purchase ..Name of Former Owner . . 1 I Zone or use district in whicli premises are situated . 1~. Does proposed construction violate any zoning law, ordinance or regulation 11j.u . . ]3. Hill lot be regraded f....... 1VAl excess fill be removr,Gl,from premises: Yes C 14. Name of Owner of premises . .'~~.~IMG S, Address ..j.4 3r.. S~C~~'t...... Phone No. -~.ci !t4 . Name of Architecty. Address . Phone No . Name of Contractor ..~-aJ lov,~„~oKS~`;~c ~cy, • • , .Address j z ~ Sc;n .1~~~..// Phone No..2 5 ~ :.~7.?7. • IS.Is this property located with in 300 feet of~~ti~d'a~'weCland? *YES....NO.~C. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distirictly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro property fines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. STATL• OF \E1V YORii, S.S COUNTY OF . • • • • • • • • • • • • • • - • • • • • • being duly sworn, deposes and says that he is the applica (Name of individual signing contract) above named. Iietsthe (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or }lave performed the said work and to make and file tt apphcatton, that alt statements contained m this appltcgUOn are true to the best of fits knowledge and belief, and that tJ '•vork will be performed m the manner set forth m the apphcauon Glcd thercwitli Sworn to before me this .........~o`,.. dayof... .:~~v .............19.~~ \otary Public, - . , , C~Q;G: , . • , County ~ ~~Q'^ HELEN H ' f 'z 1 . \T 1/.:`:. ...":'Y.r.~= . 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