HomeMy WebLinkAbout18429-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219225 Date JULY 19, 1990
THIS CERTIFIES that the building ADDITION AND ALTERATION
Location of Property 7305 WICKHAM AVE. MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 107 Block OS Lot 6.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUG. 14, 1989 pursuant to which
Building Permit No. 184292 dated AUG. 25, 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 ADDITIONS TERRACES, BALCONY AND ALTERATION TO EXISTING ONE
FAMILY DWELLING.
The certificate is issued to ADRIAN H. COURTENAY III
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N140204 JULY 13, 1990
PLUMBERS CERTIFICATION DATED K & K PLUMBING & HEATING-NNE 25, 1990
Buil ng In ector
Rev. 1/81
rosai xo. s
TOWN OF SOUTHOLO
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 4 ~ $ °t G g Z Date 19~/•
Permission is hereby gr ted to:
to ~a?r.~.?.irfaac~ ~.2e.'/.r~- .~....:.,...~e'.^.°`.9..~4.~7~
r......
.
ct premises locafed at .........c,d ..............~`~c:.....
L~%.*~r..~......................................................................
County Tox Map No. 1000 Section .......1~?..t'~......., Block Lot No............~cr..'.,1...
pursuant to application dote 19.~, and approved by the
Building~/ In~s1pector. ~~T~~/
Fee $..7'.~T.~..
c~~v
Buil i g 1 to
Rev. 6/30/80
i
Form Ho. 6
(~..~M
' TOWN OF SOUTHOLD ~ ~.~!!:°~I.-5,f
BUILDING DEPARTMENT
TOWN HALL ~ 2 Fj
765-1802 1
APPLICATION FOR CERTIFICATE OF OCCUPAN'CY.'J~~;:.`.~'r`~
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(5-9 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 17 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 $15.00
Addition/Alteration Date 21 June 1990
New Construction.. X~X..... 01d Or Pre-existing Building
Ma
Location of Prrpert},. 7305 _ Dbiokham Avenue ttituck
House No. -~-~_~~~~_~~~-JaStreet - Hamlet
Onwer or Owners of Pro ert Adrian H Courtenay III
P Y
5 6.1
County Tax Map No 1000, Section.....1~~......Block ................Lot.............._....... '
Subdivision ....................................Filed Map............Lot......................
Permit No. 184292 11 Aug 89,., PP Stephen C Thomson AIA
Date Of Permit.... A licant.............................
N/A
Health Dept. Approval ..........................Underwriters Approval......................
/ i
Planning Board Approval..,,N A
XXXX
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: 25.00
yoo~~ -
~/9~ .
5,.r APPLICANT ~ '
TEL. 765-1802
oS~FFOt~-~ To~rr or so~T~aoa,m
,i;.
O~_'' OFFICE OF BUILDIiQG INSPECTOR
o " a rn P.O. BOX 728
~ ~ TOWN HALL
001 SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Date ~~aslR~ r
Building Perm(^it' No. ,$y~q~-
Owner_ C.uyc~en~~
(ple\/ase print)
Plumber ~ 1~UYY~~1 ~ ~Q~~{tcl
(please print) ,~~5`
4L2.Y~~-~ ~
I certify that the solder usecl in the water supply system
contains less than 2/10 of 1% lead. '
(plumber's signature)
Sworn to befor me this
n.Ti ~y ~qra~ Nsw vak
day of No, g3 2182100
19 ~ . Giq?Mied in Sutfodc County
Notary Public
Notary R3~blic, Ceunty
a
i
~ ~
ENIC 0. KOCH
Notary Public, State of New Yolk
No.52-2162100
Cluallfiea in Suffolk Couri~
Term Expire Janwry 31 1>~2 ,
H
U
w
U 21 June 1990 ~ "
z ~ I ~,~1N 2 5 1990
Town of Southold ~,~°`"`"'{".z~...._....
~ Ell.[3.; E.F.`7
~ Building Department ,TUW~~G i~F v!;t',' ~_,`~=i-
O Town Hall ~ w
x 53095 Main Road
~ Southold, NY 11971
Re: Certificate of Occupancy Application
Permit No 184292
Dear Inspector,
302 ELIZABETH ST
Find enclosed OUT a lication and fee check THIRD FLOOR
Pp New YORK NY
for the Certificate of Occupancy for Permit 184292. ~ooi2
212 353 9720
The Underwriters and Solder Certificates will FAx
212 228 4771
be filed under seperate cover by the electrical
and plumbing contractors in the very near future.
Thank you for your cooperation.
Very truly yours,
Stephen C Thomson AIA
STJbf
encl as noted
STEPHEN CARTWRIGHt THOMSON AIA
yrrrr,T_~, TEL. 7C5-i fi07.
'Yp a. ~1.,'e, Z'0~~'N OF' SOUTIIOUD
y +j[1 ~~,,v~~i~~ :.c.~ Or('ICii Of• I1111LU1NG IIJSPC•.CTOR
1 ~ { .O. 1lOX 7..8
l U' `~^l~ % T' 'I'O1ViJ IfALL
1S
p, a cy SOUI'tIOI,i),N.':. 11971
~~(~a
June 15, 1990
Thompson Architects
302 Elizabeth Street
New York, N.Y. 10012
RE: ADRIAN N. COIIRTENAY III
To ti•7}iom This May Conoern,
t9e are unable to complete your Certificate
of Occupanry because of the following reasons.
An application for Certificate pf Occupancy
tis not nn file. (ENCLOSED)
j~?J~ao Under:~riters CertiEir_ate on file.
I!V/ The check .is {cjcixtxc§ac~osci/not an file.) $25.00
Ita 'lealth Dept. approval an file.
I:a final inspection hay been made.
Ple.tse contar_t: our office on this matter.
Thank you foz your t:oopcration.
3uilcl:i.ng Permit II ~ $ 4 ? 9 Z
fi
[luilcli .g [)r_pL-.
^**J / t1o 1`lumber Solder Certificate on file.
( all permit:; involving plumbing being
.is:.uecl afL•cr April 2,19fl4 ) -
:'lELD i::SPEC:iU:i ~~Uni~ ~OMM€NT° \
i.~ ~
H
_ H
FOU1dDATION ( t) I m
vri'~
FOUNDATIOIJ ( 2fid ) _ -
v
2.
~ ~ O "W
P,OUGH FRAME & ~
PLUMBING
- ti
y~
3. ~ ~
m
• H
IIJSULATIOf1 PER N. Y.
a
STATE ENERGY
CODE
x
.~a.~-c
FIiJAL r
•
0
p~,ADDI OPIAL OM NTS: x
to
b\
H
y\
o~
O
a~
•
x~
v
cv
-c
H
/ G ~ /~C 765-1802
Q / / BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]~LATION
[ J FRAMING [ FINAL
REMARKS:
DATE INSPECTOR
.-~1~~
`~~L y 765.18<f2
BUILDING DEPT,
INSPECTION
(]FOUNDATION 1ST [s'~ROUGH PLBG.
[ ]FOUNDATION 2ND (]INSULATION
(]FRAMING [ ]FINAL
REMARKS:
L
DATE ~ INSPECTOR
ti~ 765-1802
V~~ BUILDING DEPT.
INSPECTIQN
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ]FRAMING ~ ( ]FINAL
REMARKS: t~k.~-~,c~..!'~:
DATE / ~ 7 D INSPECTOR T
_
~q 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
~RAMING ( )FINAL
REMARKS: ~.~-t~ r~'K-
DATE L Z INSPECTOR ,~J„
~lO1O3dSN1 31tla
~SH21tlW321
'ItlNI~ [ J JNIWtltl~ [ J
NOI1tl1nSNi [ J aNZ NOI1tlLINAO~
'9l~ld H9nO~Jf [ ) 1SY NOI1tlaNn ~ fry
NC)I1~~dSN1
•ld~a ~Nla~ln~l
` Z08i-591 f~~~
THE NEW YORK BOARD OF FIRE UNDERWRITERS FAGS 1
1OD1071 BUREAU OF-ELECTRICITY S
I SS DOWN STREET. NEW YORK. NEW YORK 10038
3ULY 13,1990 932589/89 N 1@020@
Date ,+nplicotion No. o ~
THIS CERTIFIES THAT 1'aRNIT NO @29~
only tks electrled equipment a. dsscrifred 6ebw and Introduced 6y the spplleant named on the ahoae application numhsr in the promuRn of
A. COURTBNAY, HICKAN AVE., NA7'TITUCK, N.Y.
in the oBorein location; ®Baeement GAR/ATTIC/OITT
f ~ JULY 03 , 1990 ® /rt Fl. ®Ynd FI. Section Block Lot
area eramined on and found to 6e in compliance with the reyuiremente of this Board.
g1fTYM RXTUEf'f RANOES tOOKIN00ECK5 OVENS 016MWAfMEES FFXNAUfT Al/f
OUTIETS hWS SWITCXES INCANOlS[EM PIUORESCEM OTHER NAT. K. W. AMT, R. W. AMT. R.W. AMT. K. W. AMT, M. r.
76 45 59 52 14 1 1.2 1 1.2 3 F
DRYERS RIMiACE MOTOES lUTW! •enIANCe FEES SMICIAL EEC~i THE CIOCKE EEtI tNai puns etIRTFOUTIET gEEI~
srETfEIK ,
AMi. K. W. Oll M. P. GAS X. P. NAT. NO. A. W. G. AMi. AW. AMT. AMTS. 'TRANS. AMT. N r. 11D.0E ~ J AMT. I YY41111
n _ - ~ _ ors bno
SERVKE DISCONNECT NO.OF f E R V 1 C E- ~p~ -
AMT. AAV. TYPE ~ 1 J tW 1 / JW ] L ]w ] / RW ~rER
1CGN0. OF CC. i:G~ D. NO. OI XIAEG A ~ NO. p nEUTRAIS Of
NWIUTRAI
1 200 CB 1 X 1 4/0 1 2/0 -
OTIIEE APMlATUS:
2 1/2 TON A/C UNIT-1
3 1/2 TON A/C UNIT-1
1/3 NF AIR HANDLERS-2
ELEC. ROON NBATBRS:2-1 K.W. ~
DISFOSAL:1-1 K.H. -
G.F.C.I:-5
SNOKS DETECTOR:-2
G & S CONTRACTOR LIC.;}578 B
BOX 215
SOUTNOLA, NY, 11971 OEIIEIK M~W~oNI
11 ,t!~'
This drfificaN mint not be altered in any manner; return to the office of fhe board if iMOrrM.. Intpectorc P.ha idsMifia`H 'r c Miak.
COPY FOR bWLINNG DEPARTIAENT. T1E5 COPY OF CERTIFICATE NNlST NOT bE tiLT~{D RtAN'P AIA.
H
U
w
F
~ 11 August 1989
U
z Mr Thomas Fisher, Inspector
~ Southold Building Department
~ 53095 Main Road
x Southold, New York 11971
H
Re: Building Permit Application
Courtenay Residence
Wickham Avenue, Mattituck
Section 107: Block 5; Lot 6.1
Dear Mr Fisher, 302 FuzAaeTH ST
THIRD FLOOR
Find enclosed the following building permit appli- IVeW YOftR Nv
cation documents for the subject property: IOOIz
212 353 9720
FAX
One (1) Application for Building Permit zl2 zza 4771
Signed and Motorized
Three (3) Sets of Plans - one (1) stamped
One (1) Blank Filing Fee Check
We are planning a construction start date of Sept-
ember 4, 1989, and are currently in the process of ob-
taining contractor bids for the project. Upon selection.
of the contractors we will submit to you their respec-
tive home improvement license numbers.
Please inform me as soon as possible of the filing
fee amount and if you anticipate any delays in getting
the building permit before September 4.
If you have any questions or require further infor-
mation or documentation please call me directly and we
will promptly provide it to you.
Thank you for your cooperation.
Very truly yours,
~ ~~iGr'~'L~-,
Stephen C Thomson AIA
ST/bf
encl as noted
cc: A Courtenay
STEPHEN CARTWRIGHT THOMSON AIA
D ~ ~ tlfl f2 BOARD OF HEALTH .a 1~ . ,
V L5 I 3 SETS OF PLANS
FORM N0.1 SURVEY
aus i e ree~ ' .:o:~:: .
+ TOWN OF SOUTHOLD CHECK , ,
BUILDING DEPARTMENT SEPTIC FORM I
BLDG, DEPT. t $OUTHOLD, NAY.L11971 NOTIFY Stephen Thomson AIA
TOWN OFSOUTHOLD .212 .353 .9720 _ , ,
TEL.:765~1802 CALL
MAIL TO Thomson Architects
Examined ' ' • • • 19 ~ 302 Elizabeth 'Street
i ~~!~°d?9~ Third Floor
~~pprovcd . v/.~?.,~........., 19~/. Permit No.. New York NY 10012
Disapproved a/c
uildi n ector)
APPLICATION FOR BUILDING PERMIT
Date . 11 ,August, , , , , 1y89 ,
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
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 Buildin; 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, g cousi ~ code, and regulations, and to
admit authorized inspectors on premises and in building for necessary 'o s.
(Signature of applicant, or name, if a corporatton)~
Thomson Architects
.302• •Elizabeth• .Street ..NY...NY...1001.2...
, (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Architect New York State RA#15616
Name of owner of premises Adrian H Courtenay III
(as on the [ax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.....NIA .
(Name and title of corporate officer)
Builder's License No. Pending, • , , , , , , , , ,
Plumber's License No. Pen~lincd , , , , , , .
Electrician's License No. , , ,Pending • . , • , , , , , •
Other Trade's License No. . ,Pending , , , , , , , , , ,
1. Location of land on wh~i7ch proposed work will be done . .
•.•,.•••.,••......1305.•.• Wickham Avenue ..••,••.,••••Mattituck.•••.•••••••••.••.••
House Number Street. Hamlet
6.1
County Tax Map No. 1000 Section .,,,..107••.,•,,., Block .....5............ Lot
Subdivision Filed slap No. , Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy , Single ,F~mily, Residence .^t~~~~ ~wbayy~yO,g~
b. Intended use and occu ancy , Same, with, ~,cjdj.ti,Qkt, and .Alteration r++w'BA.+~
~ i
~Ia - y_.j a,.
3. Nature of work check which licable :New Buildin E~. .
p ( `~PP g Addition XX ~wle~~
Re air . . Removal Dumolition Othc ~
(Description •
4. Estimated Cost ~65.r.40Q . Fee ,-7, ,
(to be paid on Cling this application)
S. If dwelling, number of dwelling units , , one Number of dwelling units on each floor .
Ifgara;e.numbcrofcars two
6. If business, commercial or mix~d occupancy, specify nature and extent of each t pe of use . .
7. Dimensions of existing structures, if any: Front . ,48, feet Rcar 47 tYeet ,Depth ..38, feet
Height . 2.4 . Pe€.k Number of Stories , ,one and half 2 ' ;
Dimensions of same structure tyith alterations or additions: Front ..9 ,fe,@~...... , Rear , ,47 , feet
De th...3,&.P~€.~..,..., 24 feet (
p . Ilcight . Number of Stories .one, and half ~ ~ 1
8. Dimensions of entire new construction: Front , .Q , , Rear ,12 , ft, ,6 • in, Depth . , ft .3: in
Height ...7,1:.... . Nu~~ ber of Stories , ,one • • .
9. Size of lot: Front ...359,.,10 ft Rear, 653.85 •ft~'~~~~ .'Depih~..}i659;77~ ft~~~~~~~
10. Date of Purchase ..,.12..~7~?,~}a~ry,1983 rd ~
, , Name of Former Owner , .Ste7-~.a .$~~.~Q . .
11. Zone or use district in which premises are situated , , , A-G . .
P P
13. ~Yill lot be re raded , , ~ late any zoning law, ordinance or regulation: F(4 O
a
14, Name of Owner of stremises V$s ' ' ' ' ' ' ' • • • Will excess Fill be removed from premises: $ No
p ~ixi,gin, C,ot)rt~}~~YAddress , ,S,ee , $eloy+, , , , , , ,Phone No .
Name of Architect ...Stephen, ,'~homson. , , , , ,Address .See ,Below, , , , , , ,phone No .
Name of Contractor . , , Pend riq ......Address .Phone No..... .
1S.Is this property looted with in~00 feet of a tidal wetland? *YES..,,NO....
*If yes, Southold Town Trustees Permit may be required.
i PLOT DIAGRAM
Locate clearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block'inumber or description according to deed, and show street names and indicate whether
interior or comer lot.
Owners Address Mill Hollow Corporation
19 West 21st Street
New York NY 10010
Architect Adresss Thomson Architects
302 Elizabeth Street Third Floor
New York NY 10010
Sc~e Plot (Plan on Drawings - Sheet No DA-1
I
~I
i
I
STATE OF NE1V YORK, S.S
COUNTY OF
(1\ame of indiv dual~'snit~n ~ ~ ~ ' ' ' ' ' ' • • • being duly sworn, deposes and says that he is the applicant
g contract)
above named.
He is the Arel#itect
. . .
(Contractor, agent, corporate officer, etc,)
of said owner or owners, and is duly',authorizcd to perform or )taut performed the said work and to make and 61e this
application; that all statements contai~ted in this application arc true to the best of Itis knowledge and belief; and that the
work will be performed in the manner ~SCt forth in the application filed therewith.
Sworn to before me this ~
• .....,~~.......,,.~/day of.~~.~~~.....„19.~f
Notary Public, ~-?Ui~i~C...... • County ~
A. NldclkY r
MIMI~~ M N York .
Na4d940h2 ~ (Signature of applicant)
duNlMd In BuBOItt Cqummyy
CAIIMMiMIOq Ekplrea May ,~1,19.L~(