HomeMy WebLinkAbout17745-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218008 Date MAY 8, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 465 TARPON DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 053 Block 05 Lot OS
Subdivision SOUTHOLD SHORES Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JAN. 4 1989 pursuant to which
Building Permit No. 177452 dated JAN. 6, 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 AN EXISTING ONE. FAMILY DWELLING __
The certificate is issued to BARRY WILLARD
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N069702 MAY 2 1989
PLUMBERS CERTIFICATION DATED JOHN E. WALTERS PLUMBING 4/27/89
Building spector
Rev. 1/81
gosas xo. s
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)
~0 V~.. ~ ~lfJ Z Date ...~..4~?.'!'K........~!'..........., 19...1
Permission is hereby granted ta: / ~~ Q ~ ~
.. ~.:.~.... ~ 8.7 .....................................
..~~........ ..~.~:-...: ~.:y..:.... r .c 9. ~.~......
~~ .~u.~.~,..~.~..~....~..~-<.... ..........................................
... . .........
ct premises located at ...`7:~0..J~..'......11...4~.~.11~.....,~..~l.Q ........ ........ .......... ...............
....... ..........................................................................................................................O.S ..............
~~ ....~3.....1.~?.4Q.4.~uc~l............. .......
.....
Cvunty Tox Map No. 1000 Section ......Q.~.,~...... Block .......~.r~....... Lot No..........r...........
pursuant to application doted ....~.1.1~Hr.!ti:.....~ .............. 19~.~., and approved by the
Building Inspector. ~Vf
Fee $..~.... ~...
. ........................ ........................
Building Inspector
Rev. 6/30/80
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TOWN OF SOUTIIOLD
BUILDING DEPARTSIENT
TOWN HALL
SOUTIIOLD, NEW YORK 11971
765 - 1802
I~ 8M
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE.. Y!*e`-~Fv f.......
NEW CONSTRUCTION .......OUuLD OR PRpE-E%ISTING BUILDING. ~.pACANT LAND...._...
Location of Property....6~/l'. ~~~f/.0/7~ ~/~l(/~_ , _ ... ;S'O07~aL~.~'~ ....... . .......
UOUSE NO.//~~ // STREET •• HAMLET
Owner or Owners of Property..Ull~h~i~Q .~/~.x,,,,,,,,,,,,,,,,,,,,,,,,,,,,
County Taa Map No. 1000 Section .,~.~. Block ..~... LoC .s~~.....
Subdivision_.s10,gq~/p0,~~,~,/~Q/'{~S._ Filed pMap ........LOt...._..._.//,~.
Permit No. l~J.'~~Z,Da[e of Permit .~~:~p,~,,,ApplicanC :L~Q~~.QFII~~,~'
Health Dept. Approval .................. Underwriters Approval..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate .......
Fee Submitted: $ ....................
~;
~, ~
~~~
5 ~~~~9
e~ z/64Q~
rev. 10/14/88
oS~EFUC/r~p TOWN OF SOUTHOLD
o Gym
r? < OFFICE OF BUILDING INSPBCTOR
~ " z P.O. BOX 728
v' ': ~ TOWN HALL
'~~l ~ ~~~t- SOUTHOLD, N.Y. 11971
C E R T I F I C A T I O N
Building Permit No. / 7J~/,S Z
owner ~!/i.C~~, D ~.~.k'(/
(please pint)
Plumber ~~{a ~~ ~~NGUJ ~LUkI~~~ ~'~l`~
(please print)
TEL. 765-1802
Date ~ p~ /
t
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
Sworn to before me this
,~~_day of
19~.
Notary Public, County
®~---
(plumber's signature)
o c f~
Notary Public
~E9'11~ L WAlTER3
ROTARY PU81C, Stete of New Yarn
Ra 52•{1QS50. SuNoik County
.Taal EgInR MN{~M1rt 80. ~~
d=
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1001071 BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 10038
Date MAY 02,1989 Application No. on file 61598289/89 N 069702
THIS CERTIFIES THAT '
only the electrical equipment as deacrihed hebfo and introduced by the applicant named on the ohove application numher in the premises of
ILL BARRY, TARPON DRIVE, GREENPORT, N.Y.
in thefo/lominp location; ^ Ba.¢ement ® l.¢t F'!. ^ 2nd Fl. .Section Block Lot
uos examined on APRIL 17, 1989 acrd faund W he in cmnplianre uilh the requirements q(thia Ilourd.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHW ASHERS EXHAUST FANS
OUTIETS ECEPTACIE$ SWITCHES I NCANDESCENT FIUORFSCENi OTHER AMT. K W. AML. N. W. AMi K W. AMi N W AMT H P
3 6 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS $PECIAI REC'PT TIME CLOCKS gEtt UNIT HEATERS MULTI~OUTLET DIMMERS
AMT.
K, w.
On
H. P.
GAS
H. P
AMT.
NO
A. w G
AMT.
AMP.
AMT.
AMPS.
TRANS.
AMT
M. P. SYSTEMS
NO. OF FEET
hMi.
WAttS
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMT. AMP. TYPE METER
EQUIP. I ~, tW ~ !f JW ~ g 3W R,e' 4W NO. OF CC COND
PER 9 A. W. G.
Of CC. COND NO OF HbWG A. W C'
Of HLtEG NO. Of NEUTRALS A W G.
OF NEUTRAL
OTHER APPARATUS:
G.F.C.I:-1
SMOKE DETECTOR:-1
. ~ ~~2~4~ /~ -E'~
~7~~
/~
G & 5 CONTRACTOR LIC.#578 E
G
BOX 215
SOUTHOLD, NY, 11971 GENERAL NA ER
11
~~ ~ 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.
c'li:LD II:SPcC:lU:i (~llATE ~ ~OMMENT°,
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FOUI7DATION
(1st) (
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FOUNDATIO2J ( 2nd ) _ m
2. _
02 / ~ d ,C.
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ROUGH FRAME & fw ~C.- ~ v
PLUMBINC;~
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3. /
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IIJSULATIOII PER N. 7(/ .. ~
STATE ENERGY
CODE
x
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4 . '`
Z ZD ,p~ ~~ ry
t'~ ~ V Gam. (.C.'~~ .~..
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FIi~AL
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ADDITIOIIAL COMMENTS: ~,
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765-1802
BUILDING DEPT.
~~
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [~NAL
DATE ~ ~m/INSPECTOR G~~,
y .. r'
REMARKS: , I~ ~ Cc , , c~ (~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ]FRAMING [ ]FINAL
DATE v~ a_ <~`~INSPECTOR
•. -,,,
REMARKS: , ~ .--~-~.,
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ ROUGH PLBG.
[ ]FOUNDATION 2ND [
[~RAMING [
REMARKS:
.~~~~~
] INSULATION
] FINAL
j ~~ys
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ~ FINAL
REMARKS: 1 ~~~-Ltd
p~
DATE ~ ~ 0 INSPECTOR
_ ~ ;
171y5~~'-._C~ - __
THE NEW YARK E1~AR® rte' EIItE± l1N~ERW~RfTERS PACx a
luolo7l - - - -
' .'WREAU OF lLtCTRICITY
a4~Sit~;h~":t:r: 'r•, ~'. ~ is JpAM1~~*TII[ET. NEW YORK. N
FW YOpK W6D6
,
MAY 02,1989 6159B2B9/$9 N 1169'10`1.
t>ra AppBcatton No. on file
TNtB CtRTIF1E8 THAT
only tAeeleetKiod equipesent w dweri6ed 6eba and twtrodroed by Hu eppfloent nerved on tke ekow uppliwNw wrrrntrer in eke premieee of
ILL $ARRY, TARPON URIV$, GRh:
IS
N
PURT, N.Y.
]]
..
,,
in the fo/breirrR l°riY~IYL ~ Beeeraent LJ IKt Fl. ^ Ynd FI. srrtkrn 81oek Lot
rtcx
119977SSYY
,
row eiemined on
and found to 6e in romplioncr uitk the nyuiromenM of tkia Bwrd.
llRfltr XTtIRlS CODKRID OSCKf _..__ _. ___ DIEM
Mini fMllitSNS -
. _
_..
fClM rluolMCeur OTXER NAT. K. W.
AMT
K. W. MAT. K.W. AMT. K. W. AMT. N. /.
3 6
Dry'M{
RIBIAC! MOTORS
11111tH A/MIANCS IYRMS
SNpAI RRC`IT
TMY C-OOtf
SN1 _' _
YINTRMTRM .-__
~ r
L
AMi. K. W. On K r. OAt M. r. NAT. rq. A. W. G. AMT. AW. M1T. AMIt. iWN. AMT. IG 1. AMT. WATTS
ti
SMV1q OMf:OIMrCT N0.01 S ! R V 1 C E
AMT. AMr. TFP! KpiY 1 / [w t / tw t.e tw t/ Aw no. o~C,COND. .~ G NO. or M4LEG of • ~~ w. a u! u _ y r eu~iiAt
n1nT YlM1ATYk
G.F.C.L:-1
SMUX$ DBTSCTUR:-1
G ti S CONTRACTOR
BOX 215
SOUTROLO, NY, 119')7.
'~ ~ This urlificots mull not M oltered in
L1C.R578 B
return to tM. offin of the
WILDING DEPARTMENT. THIS COPY OP
~~
tirlAl
11
Per
if intorrM.. Inspxfors moy ba irJenfifiad by _ ,.
GTE MUST NOT BE ALTERED IN ANY
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
EOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .. ........ t4., 19~~.
V
Approved ....~d..~j , lv,, 199. Permit No..L7. ~~~',L-.
Disa roved a/c (J
BOARD OF HEALTH .~........
3 SETS O~PLANS ............
SURVEY )}~
CHECK ~.-.8~`p ...............
SfiPTIC FORM ................
NOTIFY //~` 22 r~
CALL ..~tp..7.:: `..l~l.Rd.... .
MAIL T0:
PP .....................................
q~, .....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date ....~~~/ ............. 19~`J.'
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 Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises avai]able 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 moval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, buildin ode, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary in;pe i s. ~ / ~,_~.-~
orauon)
!Y. a. t~b~l. 6.x';1,.. ~l?r~~:.vnq~?:r~~Y ~e >~,~...... .
(Mailing address of applicant)
State whether app]icant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . ~J:~:-~: C~ R J?... !3.(:~.~ ~ ~ ............................................... .
(as on the tas roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
..............................................
(Name and title of corporate office7r)--
Builder's License No. ./~... ~,~19~'. ~ri- •~~.,~.,. • • • % J~~~,
/ Plumber's License No. ..7p~1~,l.. ~~~G~."~3-"",'~-/~~~~~"~"
/ Electrician's Liccnse No. L?. G.~..~~~~~`~! ...
/Ot}ter Trade's License No . .................... .
Location of land on which proposed work will be done. .l/.-b1. )`/~~~an! , (~~ . S~y,~'7--ha L~;sy
.....................................................................
House Number : Street\ ~~~~~~~~~~~~""""""
Hamlet
County Tax Map No, 1000 Sectinon/ ........rJ.~-•~ ....... Block .....J'~, • • , , , , , , , Lot . , s.T~ ............ .
Subdivision .~b.d'~.f~o1:(~. S(-~c2. c~S ............. Filed boa No.
P .............. Lot...............
(Name) 3'
'-. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~1 ~-SJ.ClE'v': t t~~. • • • • • • • • • .
.......... . ..................
r/ a~
b. Intended use andoccu anc .... e/~`~t~~.~:':..~J,~,~,`~~a~~
P Y ~1'C 5d.y . tt! rE!r,..J 8ia+'Pr~$ .............. .
.~.-6`i
3. Nature of work (check whichapplicable :New puildin '
Re azr ) ... • . • • ~ ' ' ' • • • • • • • Addition .. !~/... Alteration ........ .
P • • • • • • ........ Removal ....... Demolition Other 1Vork ............. .
4. Estimated Cost .....;~~,~ ~ (Description)
(J..drd ...................... Fee................
......................
5. If dive@in nurnber of dwelliri lto be paid on filing this application)
g g units .... ~ ......... Number of dwelling units on each floor ............... .
If garage, number of cars .. ;k :............ . .. .
6. If business, commercial or miffed occupancy, specify natufe and extent of each type of use ....... , ,', y, , , , , , , , , .
7. Dimensions ofFxisting structuYcs, if any: Front .....;5(~, , , , , , , ,Rcar ...... . . ....... Depth .a.C'/, , , , , , , , , , .
Height ..~~ .......... Number of Stories , .
Dimensions of sa ne structure With alterations or d lions: Front
~ .. 7c~ ........... Rcar......
.p
D~ th ....,2/4.,......... Nul ... IIeight ... ~ .../ ........... Number of Stories .....~ . .
8. Dimensions
traction: Front ...~,?,~ ......... Rear ............... De th , . j , . , ... , , .
9. Size lof Iot: F one net ~~~Fnber of Stories ......./..... P J.`~.......... ,
.... ............ Rear ...../®20 .............. Depth ... 1.7.:.......
10. Date of Purchase , . 5'~B~ • ...... .
P ...................Name of Former Owner .~C'1,!/ii}QQ.~,ryz,-~~~ ....... .
1. Zone P r pse district in which demises are situated , , , , , , ,
12. Does ro osed construction 41ate any zoning law, ordinance or regulation: /!!~d ........................... .
13. Will lot be regraded ~ ~• , . ,Will excess fill be removed fr m premises: Yes No
14. Name of Owner of premises /,~.'~4/~22. ,/J~2R.j!, , ,Address .~6.J."T RPPC/..L2R,,5'f,~ Phone No..'S~"7.7••,Cd?$~, , , ,
ame of Architect .
...... ..................Address .-_':', .............Phone No..."_:... .
Name of Contractor ~,4'IYIJ!/~lj~,/~,.~q,~,ta~~ pddress p96rd 6&?~!;-,t?p~,NPrr, Phone No. ~.>x:l~d3...
15.1s this ro ert loci- /'
P P y $ted with in,~g0 feet of a tidal we[~aud? *YES....NO
*if yes, Southold Towjn Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly alj 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 whethen
interior or corner lot.
~ - ----
bq'
-~
___.._~_ ~d~? ____
STATE OF NEW Y
COU TY OF . :....... $'S
.. eo ai
~... . ~e~L7~~,5.
~Kd g {rg contract) ' ' ' ' • being duly sworn, deposes and says that he is the applicant
(Name of indrvtdual sr m
above named.
He is the .
,'', (Contractor, agent, corporate officer, etc.) ~ • ~ • ~ ~ ~ ~ ' ' ' ' ' '
of said owner or owners, and is duly authorized to perform or 7tavc performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner~sct forth in the application f}!cd therewith.
Sworn to before me this
~.
.............~.. ....,~.,d/aylof.I. ................., 19~'~
Notary Public, , , , , ,1~, G,L~~~~/+v......... .
pf~~~ l/ ! .Count _
~ tf„ (Signature of applicant)
7~`/