HomeMy WebLinkAbout18413-z
~ FORM N0. 4 ,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19436 Date OCTOBER 11, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 365 RACHAEL ROAD MATTITUCR NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 108 Hlock 4 Lot 7.45
Subdivision Filed Map No. Lot No. 3
conforms substantially to the Application far Building Permit heretofore
filed in this office dated AUGUST 14, 1989 pursuant to which
Building Permit No. 18413-Z dated AUGUST 28, 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 ONE FAMILY DWELLING WITH ATTACHED WOOD DECK
The certificate is issued to TOWN OF SOUTHOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-31 - 9/29/90
UNDERWRITERS CERTIFICATE N0. N-148501 - SEPT. 11, 1990
PLUMBERS CERTIFICATION DATED MAY 24, 1990 - HARDY PLUMBING fi HEATING
7
1 / 2 ~~L /l..-
Bui ding Inspector
Rev. 1/81
¦osae< xa a
TOWN OF SOUTHOLD
6UILDING DEPARTMENT
TOWN BALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°- ~ $ 41 ~ Z Date ..GZ....~..`z.....~~ .9...~J...9'
Permission is hereby granted to:
. ...Ll
ra ............rel.........~~....'~1~....~I~.9.~....~.~~.: .....1~...~~'~'........... .
.
7 / ~r-
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at premises located ot .......„,t....G~....7........,,~ .......l..L...... .
..~'.1...-~....
County Tax Map No. 1000 Section .....1 a~xJ....... Block ....~..~yl...... Lot No. ,1~rf...li~'"3
pursuant to opplication doted ....G~~/........~..,,1 19~G, and approved by the
Building Inspector.?~
Fee $~:tC(/.,'.~t~(f.
y..
~ ~....:l!......~~.............
Building Inspecto~..
Rev. 6/30/80
'r1ELD I;:S:'EC:iO:J i~ll6icq~~ tiOMMENT°
_
FOUIJDATZON (1st)
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FOUNDATIOfJ (2nd) m~
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P,OUGH FRAME & ~~'y
PLUMBING
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3. ~
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IIJSULATIOAI PER N. Y. rr~ ~ y
STATE ENERGY
CODE x
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FIiJAL /
ti z V
ADDITIOP3AL COMMENTS: x~
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THE NEW YORK BOARD OF FIRE UNDERWRITERS r'FI<;
J~Ot)r3(~$ BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
S7i;k'I'.d';P'tl?H:K '11,1~ll~ft b~IC]6t'i±`ik#~1(#i`3 kl7 12?FC,(11
Date Application No. on f(le
THIS CERTIFIES THAT
only the electricalequipment as described 6ebw and introduced by the applicant named on the above oppdicatiort number in the premises of
`PS):'I 1~h,Ak,' litlF,hlH~,ftG.. ;;/:5 ~.':CJrAIJIr';°r Tt~. ~3:;ot7'7, 31ii`C~3, MA`C'T:C`~'i1GK., (d.Y,
in thefo(lowing locationg ~~asofnent (st Ft. AT3`T~;t(SEJ'd' `}Pt}; Oe'~ f''I, i}!,.
2nd Fd. Seetiori Hloclc Lot
P,fFGLIt'~' 3 ,'I iL)~
was examined on aced found W be in compliance with the regeeiremertts of This Hoard.
FIXTURE ECEPTACLES SWITCHES FIX7URE5 RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OURETS INCANDESCENT RUORESCENi OTHER MAT K W AMT K. W. AMt K,W AMi K. W. AMT. H P
~ ~li ftr
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECYAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMi. K. W Oll H. P GA$ M. P AMT NO A. W. G AMT. AMP AMi. AMPS TRANS. AMi H P SYSTEMS AMT WAtTS
NO.OF fEET
i i l7 T.
SERVICE DISCONNECT No. of S E R 4 1 C E
AMi. AMP. rypF METER 1 qW i %JW 3 %JW 3,0' 4W NO OF CC COND A. W G NO Of H4WG A' W.G NO OF NEUTRALS A W G.
EQUIP. PER % /~OF CC COND OF HbLEG OF NEUTRAL
Ilfl I ~ '-t ~ ti
OTHER APPARATUS:
r~oro~ y.z- .`z~l rf,rf.
i; .,fiat;"-. C: ~h
SAIOhr: 1~IC`I,'~;C'C't~Rt-~
r
~r~~srflr~.~r~ 'c.srocr~ Tr~<~.~ts,~~s~
! t?SCI t+il:"Pfl'PCtLFU RVp~fti7[7RJ
f3lIHF;@1.CA, Ia4. 11.71f> GENERAL MANAGER
7.1
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PCY
This certificate must not 6e altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR SUILOING ®EPARTMENT. THIS COPY OF CERTIFIGTE MUST NOT BE, ALTERED 1N ANY MANNER.
~Y ~r ~ 7S5.i8d2
BUILDING DEPT,
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ _ INSULATION
[ ]FRAMING [!i1"FiNAL
REMARKS: ~
d
DATE INSPECTOR
l ~ 7~ l-~ 765-1862
BUILDING DEPT.
INSPECTit?N
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
] FOUNDATION 2ND ] iNS CATION
FRAMING rr FINAL
c]
REMARKS: I v ~ ~--f
DAVE d^ ~ INSPECTOR
~'},~~~J ~~l J ~ TEL. 7G=-1802
J' G~. ~ . _.i
~ r
a ~ . OF'FICF.OI'B,UIL•DU~IC T-:~ISPEG=I:OR
v% .
loo SOUTHO~D, V.Y. 1:197%
"Lt
C E R T I F I CAT I. O. N:
Date MAY 24, 1990
Building Permit No. 18413
fr~~ (
OFmer TWO BE1RS C~~e~,~~"~~
(p tease print) ~
Plemb82 HARDY PL. & HTG. NORTH, INC. ~ ~f9J~ ~
(pleiiSC- pT].Rt) ffjf}'
• .40U7F7CtLf
...,f
I certify that the solder used i.n the water supply system
contains less than 2!10 of 18 lead.
(plumber's signatu e)
Sworn to before Ame this ~ nn +~~,n,~~
day of ~/~~~~d~~./ ~L"~'7r~`3"'-,,._
19 "P~ ll
l Ilotar~ Public
Nota: Poh_ic, ` S(J1GFpLl~- County
ANtLANIE V. F;Fdfi`VYN
Ndary PubGa 3tata of New York
No, A90$712
GiueNlfed in $uNotlt Cou
Oommkrlon Expka Oct. tA, T9 9 ~
_
1.
• BOARD OF HEALTH
3 SETS OFjPL~1NS
FORM N0.1 SURVEY ? •
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORPI
' TOWN HALL
SOUTHOLD• N.Y. 11971 NOTIFY
TEL.: 765-1802 CALL James. t,. (1s=(lahvn.... .
Examined .v"r!7~• . l N ~,'~J MAIL T 0
pp Town Hall, Main Road
Approved lr~~e~t It.~. Permit No. (,Q,~~,~-Z- Southold, New York 11971
DisaPProvedac
JIJN 2 2 1989
(Building Inspector) i
BLOC. DEPT.
APPLICATION FOR BUILDING PERMIT TOWN OF SOUTHOLU
- Date ,May•8,•1989•••• ly•••
INSTRUCTIONS
a. Tlus 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 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 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.
' Town of Southold - Community Develop.
(Signature of"applicant, or name, if a corporation)
Town Hall, Southold, NY 11971
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWNER
NameoCownerofpremises ,TOWN. OF SOIITHOLD
(as on the tax roll or latest deed)
IC applicant is a corporation, signature of duly authorized officer.
James C• McMahon, Administrator, C•D•
(Name and title of corporate officer)
Builder's License No .
Plumber's License No. ~~.3 ~ .
Electrician's License No. .8~~~~........... .
Other Trade's License No . .
Location of land on which proposed work will be done. '
. ~J. ~a.~ ..~f}CXfI;~L 5 ~!~........./.1."~!9.-Tr1 T.U.C.
~ .
{ouse Number S(t~reet Hamlet ~j
'ounty Tax Mrp No. 1000 Section .....~Q Block ...Q~ , . , , • , , , , , , Lot ~ .
ibdivision Filed [\tap No. Lot .
(Name)
ate existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existinguscandoccupancy VACAN•T•••-,•••••„•••„•••••••••••
ntendeduseandoccupancy Single-Family Residence
-DAUIS - 7RA l~. SAS T
3. Nature of work (check which applicable): New [3uilding , x,', , , , ,Addition Alteration
epair Removal Demolition Other 1Vork .
p (Description
4. Estimated Cost .....p y~.~ Fee . IJ,a; yed, Town • Pro jeer
(to be paid on filing this application)
5. If dwelling, number of dwelling units , , , ..1 , , , • Number of dwelling units on each door . , j•1,/ A
ICgaragc• number of cars .NlA . . • • '
6. IC business, commercial or mixed occupancy, specify nature and extent of each type of use . N./.A , .
7. Dimensions oCcxisting swctures, if any: Front , , N?.p , , , , , , , Rcar . NlA. , , , , , , , , , Depth . !y/A, •
Height N/A , , , . , Number of Stories ..NlA ,
_
Dimensions of same structure with alterations or additions: Front . f1,~A Rear .NIA..... •
Depth..NlA .................Ilcight.NfA .NumbcroCStorics. N/A
' 8. Dimensio~s oJer) tre new construction: Front , > • • ~ ~ •
g+ • ~ Rear ..3~~......... Depth ..v~.~i
' Height .?13 •a?.~y. , Number of Stories . . ,e(, , , , ~ ' ' ' ' ' '
9. Size of lot: Front , y,'S~;~O Rcar /(.?:5!~~,f', ,,~0.(0%' • ~ ~ •Depth ~v.S::s.'7. y/(j~ J;7~•
I0. Date of Purchase ' ' ' '
~ . Name of Former Owner .•~9F?~f~ ANT
y......... .
11. Zone or use district in which premises are situated .,9:R,~,5,1,~'.U1.4 ,q¢~,R~C,yc;1A/ri3G , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: ,N 0, , • • ~ ~ ~ • • • ~ •
13. Will lot be regraded
• • • • • • • • • ..........will excess fill be removed from premises: Yes t
14. Name of Owner of premisesT.owa.Af,,$p,t{thq~d,AddressMd}n';Rd. Southold
. Phone No.?4-1892
Name of Architect ..NSA.. Address 1`l/,A . , , /A ~ ~ •
Name of Contractor.TWp.,Qgars•Bui.lders, ~~1c7ressP.O„Qpn„~117••Amagp}~~~~.329r.Qg3p,,;,
15.Is this property located within 300 feet of a tidal wetland? *YES....NO.X...
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or comer lot.
SEE ATTACHED SURVEY
STATE OF \E1V YORK, S.S
COUNTY OF
James C• McMahon
bcingdulysworn,deposcsandsaysthatheistheapplicanr
(Name of individual signing contract)
above named.
Ilcisthe „Community Development Administrator '
•••,•(Contractor,agcnt,corporatcofficcr,etc.)•..•••~••••~•~~••~~••~•~•~"
of said owner or owners, and is duly authorized to perform or Itavc performed the said work and to make and ale this
application: that all statements contained in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Swom to before me this
..............fit .......day oC.... ~ 0 19 F
`otaryPublic, ,,,,Suffolk ~~(/~County ' 4 n
Nl1gRY ~ S~
M~IM~ YaY ~yt(-,
Ns Q07l77~~,, SuMalk CawMyo .
TustaOirulircM34 --•%~r (Si;nature of app icant)
SUFFOLK COUNTY DEPARTA~NT OF HEALTH. SERVICES
( VACANT 1 E FOR APP VAL OF CONSTR(U~CTION ONLY
- s.4 DATE / ~ REF. NO`S C r ~ 3
yip
~ N 2B' 86' 47"E L 0 T 4 '9
~ zaa.aT ~ APPROVED S
~
~t~'. J ~ y~1~ ~i ~ ~ ]1.6 ,C, C.~. ~,~i7~..1 Aid ~~1~'`fi~
a~ 'o'`~~\ - 's ~ A~ ~ •3 XPIRESS'vvti.`yC ~-S t=hs~r ~ilLa"~`'~ v.
~ ~ `r 0.~' ~ ~ ~ v~ Q-`J j~ w IROIIIN 7N.TY LOAN
yG'j ~ L PALE MDrll BANDY ~q9
Q~
' ~ ~qR'~ ~ 8LT E ~J
i$, ~ ~ 1~ f
yi x~ ~ ~ E ~.9~ej
L 0 T 3 ~ ~ ?i'` ~ ~ PAU eeorN
1' S0 ? ~ ~0', couuE aANo
i F ~ ~ L
~~F i.r ~ ' _ .Q~~
r ~ r sa~ ~,t~ N ~EeT ~V SURVEY OF
~ ~ Q PROPER T
P~~ y ~P~~' v A T MA TTITUCK
~.~es~~r ~ ~ got 2 TOWN OF SOUTHOLD
S.UFFOLK `COUNTY, N. Y.
~ ~ ~Q~ 1000 - 108 ~ A4 - P/07.2
~o ~,lo PLEASE NOTE ~ Sole 1 40
a9 ~ \ Re i`` V Oct 13, 1988
\1 d ~ /q+ uirges peptic tank ~
\ cover t0 I ;il f;'Rl ar Wi"~ l ""~r.,.r -'c d,.r rnt;a!
~ do e9 grade. ~
2 ~ 9C+ t^ 1
C .,~1j: ai ~r:~aRi o: w; V17 .Ile ~j2r(Ti :O
~ °j~. ~ y~ ~Al~'EA 32,579sq.ff '
4' ~~O Or{F•~ LTT ~~rNlp TPROIO~Lpn ~ i r~ 4/ n~ 2
' 4 ~ ALL/A
~ F011K /Mt~tAM~ face v% s6 o~a
>v l9gg 7(0 5 /~9 ~
_ '~i'SfPT OF 5~~ . ~ rG
TAo wloi o~/~ ooI s¢r SFR ~ ~ 'AL N.Y.S. LIC. NO. 49668
NOTE ~ P RT OF PARK t RECREATION AREA PrVwod b o¢¢w/¢n¢o dtA tM soNAooor + tooro ~ II~r ioo/dro¢o ¢o~o%M ~~~'fS ~ F
A/AP OF ~-NAH'S LANE ESTATES SEC / NwrMr/s Ilor Nfro priwrs u uMdrMd l+ ~~rr ~
~ e /Ao L./.A.L.& aN q~rorod oo/ odgprod ro Mo o%do?M o/ Tb S1Mole Cooolr P YOBS, P. C.
FILED FES. /4 /974 FILE NO. 606a AT THE fN aoM o¢o eS TM IWir yort Sh/o Coal pM~'/+~M! N MsMM Sw?14r+, + f l - O '
OFF2E OF TFIE SUFFOLK COUNTY CLERK. AgoeldAro. N~ X 9
7>to hoolNoo o/ roN o01 o Mow A¢r¢¢n oro Aw IwN R A Q~
oeo¢rroNow od w A~oir INoiI hao oH¢ro. ~ O .Y. l/97/
' 88 - 344 f31
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"~7 1990 .
'y ~~iO ~ N 28' 85' 47"E LOT 4
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~ S.G. DLL, _
'Q r~ 6a•. ~"di Tr ~p ,~s HFALi~I ~VIi~Si.
? /
\ ZQ 3' ~YS m .b ~ 3Zl
~/2 ~ 0.9' TN u 4/ ~
C/ / \ y. ~QQ 1~~y~~ W~ 4~_
%e LOT 3 a` ~
g1 00'
91 ~ / 01
ti9 e , Rs45' q1'
a~ ~~F F 222 a 5 P L~ gy.
F~ is• / PRE
~ Pte. ~4 tea. ~<v SURVEY OF
R~G~r~ Q PROPER T Y
" ~ P~,R~ ~ v A T MA TTITUCK
~.~g5.~~, ~o~ 2 TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
Q~ 1000 - 108 - A4 - P/07.2
,~ti ~ ~~o~f v Scale 1" = 40'
a9 ~ Oct. 13, 1988
~1 5a ~ Junr fa, 1a8a (r•Walon J
~ Sept. 1, 1989 (found. /oc.J
9 Feb. 18, 1990 (final )
Zo 1 k HS ~-SO-81
~j m ~F~`"/~li~ P~ AREA- 32;579sq.f1. -
' ~'1~' ~ ~ ~ CERTIfIED TO
N~ O ~ E~~~ PAVa~AeERe- wPROPTS PAUL HOLD SAV/NGS BANK
Q SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
`J~ 0~ FOR Tl~ NORTH FORK Nof/sMla _ - l N
~ ALt/ANY;E rn ,~tN LE F ICY DWELLING ONLY ~~~5
~QN
n~rti
S(i,Q
DA~tt.li.S. REF. N0. ~]SQ33~ ~qy
The sewage disposal and water sapply facilities fcr this ~ y, a `
bcatlon have Deere inspected by tnis Department andlor ~ ~,,.~~z z
NOTE ~ P RT OF PARK /RECREATION AREA Prepared Jn ee .nrdenu r/lA /Ae mGrlmrm Ultllf age es aap~d fouo to b rsfactpsy, ~ * •S. LIC. NO. 49664
MAP OF ~IJAH'S LANE tSTATES,SEC I slondards /or Hlb srrreTs si esfoAasA+d ~e„ys,,,, ~ ,
FILED FEB. l4 l974 FILE N0. 6063 AT THE Al /Ae L.AA.L.S, end o proud end odop/rd P qS S, P. C.
OFF2.' OF T/~E SUFFOLK COUNTY CLERK. for sreA use Ap TAe Nir YorA .lele Lond Chief of wureau of Wastewater anaQement f~/
T/!h Assoelellon, q D.
' A/A/N
SOUTHOL~r N. Y. l197/
' 88 - 34 4 (31