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HomeMy WebLinkAbout17755-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildinq Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18084 Date JUNE 6, 1989 THIS CERTIFIES that the building ADDITION Location of Property 165 RUTH ROAD MATTITUCK NEW YORR House No. Street Hamlet County Tax Map No. 1000 Section 106 Block 07 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11 1989 pursuant to which Building Permit No. 17755-Z dated JANUARY 11, 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 GARAGE & STORAGE ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to MICHAEL GABAIEL (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-073189 - MAY 25, 1989 PLUMBERS CERTIFICATION DATED N/A ~/~1.~/ Building Inspector Rev. l f 81 vows 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) N~ J ~. ~ I J 5 Date 1.........., 19.....1. ~ Z Permission is hereby granted to: I , I~~. ~..,;..~...a....~ ................................... ro ...~A`^r:9.lk:l:5.t,~..41...... .......... sL.~...'c-...0.f.Qc~.-S:~-S~x\..Q.t2.....~::/.~....... ct premises located ot ..«~....~~.t~~,,.....L.~?~,dR:......~. ............................... Caunty Tox Map No. 1000 Section ...~.~~.......... Block .....~~.......... Lot No..a3.... pursuant to application dated ....~ . ......... ......Irl.................., 19.~.~., and approved by the building Inspector. Fee $.. ~.. /l a ....... ~. ~ 5~"~.-~. ..........,...... Building Inspector Rev. 6/30/80 _ ~~ t TOWN OP < BUILDING TOWN SOUTIIOLD 765 SOUTIIOLD DEPART?IENT HALL '"~I . $'Q NEW YOILK 11971 ~+~~ - laoz r°w~r4~.nP_ APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE..._.. . NEW CONSTRUCTION .......OLD OR PRE-E%ISTING B}U~ILDING..Y~...VACAN7T-'LAND........ Location of Property...~~~,...;,,,,,~V_~,'.L,,~.~...._~~`_I l (.I UC~. IIOUSE NO. ~p`'~~ STREET( nnUAMLET Owner or Owners of Property...!.' ~~~~~~ ~-/ /C1~ County Tax Map No. 1000 Section l ~t? Block ..1.... Lot Subdivision ....................... Filed MGap ........Lot.~./J........ Permit No. ! .~~ ~S..Date of Permit '' ~t1.~~, (~~ _ _~~~, 11 .Applicant .... .,.,,, Health Dept. Approval .................. Underwriters Approval.............. Planning Board Approval ................ Request for Temporary Certificate .:..... Final Certificate ................ Pee Submitted: $.. ~ ~ .~,...,. . APPLICANT.... ~~!~:!~..../ ~GL~~?-('il........... ~~' ~ ~y~~ ~n z. 1%~~'P~ rev. 10/IG/88 4f. ~• i FORM N0. 6 i .. ~~ -~0 - I TOWN OF SO[JTEIOLD ~ .~ '~ BIIILDING DEPARTMENT ' TOWN HALL ,'~ 76S - 1802 1 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must b~ filed in typewriter OR ink and submitted to the Building Inspector with the follgwing; for new buildings or new use: 1. Final survey of prop rty with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of He~lth 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 II lead. 5. Commercial buildings,; industrial buildings, multiple residences and similar. buildings and instal7;ations, a certificate of code compliance from the Architect or Eagineer responsilile for the building. 6_ Submit Planning Boar Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-existing" land~i,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 O,ccupancq is denied, the Building Inspector shall state the 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: 1. An application for va'icant land Certificate of Occupancy shall be submitted, aad a certified abstract of title issued by a title company showing single and separate ownership oflthe 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 $25.00, Additions to Dwelling $25.00, A1Ceratian to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory 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 S 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 APPLICATION ON BACK rev. 10/14/S8 .~ ~~J~FOC.~c~ ~yc~ " ~ ~ ~~..+%~ rn ~Y'i" ~ ` y~41 ~3 ~~~~ TEL. 7G5-180 To~rrr or sour~or.u or1-}cl, or ~utLDINC tNSrrcTOa TOWN ISALL SOUT(IOL>1, N.Y. 1197( .Tune 1, 1989 MICHAEL GABRIEL BOX 139A MATTITUCK, NEW YORK 11952 To S•lhcm This, May Concern, ,; Ole are unable r.o complete your Certificate o.f~l'occunancy because ,of the folloc~~iny reasons. /'V/ An application for Certificate of Occupancy ~/~is not on file. (ENCLOSED) /_// No t)nder~•rriters Certificate on file. /_ / 'Che chcc4; .i:; (Fancrtxkxk~xic/not on file.) $25.00 /_/ No }Ical.th Dept. Approval on file. /_/ No final inspection has been made. Please contact our office an this matter. Thank you for your cooperation. ^uildincJ Permi_Y. ~! 1 7 7 5 5 Z Building DepL'. ,~.+ r/_/ tlo Plumber Solder Ccrt.ificntc on file. ( all permits involvi.ny plumbing being issucc] aftn_r 11pri.1 1,1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1Ua0564 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 pate MAY 25>1989 Application No. on file 60674989/89 N D73189 THIS CERTIFIES THAT only the electrical equipment oa deacri6ed 6ebw and introduced by the oppficant nomad on the obooe application number in the premises of 'LIKE GABRIAL, RUTH RD.(iST HOl1SE ON LEFT), MATTITUCK, N.Y. in thefollorcing location: ^ Basement ^ lat Ff. ^ 2nd F'1. GAR/OUT .Section Block hat Leas examined un MAY 08,1989 andfound to br in compliance uif.h the reryuirernenta of this Board. fIXTURf FIXTURES RANGES COOKING DECKS OYENS DISHW ASHERS EXHAUST FANS OUTLETS ECEPTACtES SWITCHES I NCANDESCENT FIUORESCENi OTHER AMi K.W. AMT. K.W. AMi K.W AMi K.w AMi. H.P. 1 +~-_ 1 1 FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS EELL UNIT HEATERS M T DIMMERS DRY ERS SYSTEMS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G AMT. AMP. NAT. AMPS TRANS. AMT. N. P NO. OF FEET AMi. WAiiS SERVICE DISCONNECT No. of - 5 E R V 1 C E AMi. AMP. TYPE METER EOUIP. IA4W 1,a 3W 3B3W 3,a'~W NO. OF CC COND. PER% A. W. G. Of CC. COND. NO OF MPIEG A W' G' OF HbLEG NO. OF NFUiRAlS A W 0. OF NEVTPAt 1 150 CB 1 X 1 ,~ 1 - 1 OTNER APPARATUS: G.F.c.I:-1 ~ ~ ~~ P. D. MARCLEY LIC.#19A8 C/~ 103 OLD BRODWAY SAYVILLE, NY, 11782 GENERAL R it Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by then entialz. ~,~FFOr..~~o~ l~ ~ .i~. a~<~f4 r CP `~ ~~oi, ~n V~ C*y 3~ ~ro~rrl or soor~o~,~ OPFICI: OP LiU1LDING iNSPF.CTOR r.o. uox I I ~ 9 TOIUN IIALL SOIJT'IIOLD, N.Y. 1 1971 June ], 1989 MICHAEL GABRIEL BOX 139A MATTITUCK. NEW YORK 11952 To Plhcm This May Concern, ,,. TL'L. 7G5-180 We arc unable to complete your Certificate o.f,~OCCUnancy because of the follocding reasons. /'V/ An application for Certificate of Occupancy is not on file. (ENCLOSED) / ~'/ *to Unden~rriters Certificate on file. / / 'Che chcclc .i::(~tncatx35zk~dnot nn file.) $25.00 /_/ D:o tlcal.th Dept. Approval on file. /_/ No final inspect:ion has been made. Please contact our office on this matter. Tl~atik you for your cooperation. 1hcilQir;g Permit: 1! 1 7 7 5 5 Z Building Dept. i.k~k/_/ hlo Plumber Solder Certificate on file. ( all permil•s involving plumbing being issued after ~1pri.1 1,1984 ) :l~LD I;:SP~CTiUtJ k ~llkTE ~ COMMLNT° -,~----,. ,- .ti ~ Y . __ __ _ _ y V e0U1dDATION (1st) ~ N FOUNDATIOtJ (2nd) m _ z 6 89 8~ o . z o .. . 1' ROUGH FRAME & ~ PLUMBING ~~ w (/J H ~ 3. ra m IIdSULATI0P1 PER N. Y. Sd~ H STATE ENERGY ~ CODE ` ~.., _ X/~ > ~ -~ _ r m y 4. ~JJ ~' FZidAL G _ o z ADDITIONAL COMMENTS: x r rn x ro• H .: 9 ' .. H H O + z ~ 1 ~• m M a r H \ x b H , ~~n.L ~. v. J'LV JVLP ""! ~', - f ~; ~'- ,l i~`~,.., b t' C F {rt'.,,..,. 1 t` L ~ t ~ I~4'.%,l Y (€ N 0~ ! "' :' .Q (> ; i! ~ °' ,r rr' to Q E~ :; . ~ " " ~ Y'. :- '" j ! ,r ~s . ' ~" ~ ~ ~~ , ~ o ~ ~ ~.:;, : - ~ w .;.: ~i.~'' 4~, S` ., `. O . _~. RUTH 17° I I' 00"E. 104. , i .i ~ i ~ i .~ y ~ p [t MI I , 4~ M, ~ 83/.Sf'Y ao,J. ~ ..3 e ,u,yy ~ ~ ?d!. .'~.. ~ ~ _ e q le.<~ 4.Y ,ae' n3..• y ge.e~e ° I ~. n• w N Z lsix~ N.87° I I' 00'~ W Stanley 5ledzieski 104 . ROAD ~~ N. 87° I I ~ 00 O N M 'p . 9,01 ` ~ ~ ~ O 'x Y ,w QS ~z ~ o T b N ~ r C N o~ 3 ~ U O d O ~ p~ O V' N N ~} ~.~~ ~; "~~~' ` ${ ^ t. ~ , ~~ , w t l i t ni~„~ (~ i;.s < ~ 4;, ~ / ~°i ~ . '~ i J :rR~ `J i>j jr A ~kl i 2 `$ y `,} . "S SURVEY FOR MICHAEL G. GABRIEL NOTE ^ •MONUMENT MATTITUCK ~ ' TOWN OF 50UTHOLD SUFF. CO., N.Y. GUARANTEED T0~ it i RIVERHEAO SAVINGS ®ANK ~ ''" SCALE ~ I = 40 INTER-OOUNTY TITLE GUARANTY . '} MAY 2, 1966 ~ MORTGAGfi CO. NOV.10, 1967 MAY.28,1968 .~ ~ ~' '~~ Pi~S~' L E WEER ANO `j LAND SURVEYOR, N.Y.S.LIC.N0.12845 RIVERNEAO, N.Y, :y .. ~2i ~~~s~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: DATE ~ ~ S INSPECTOR ~~~ ~ _. l) ~~~~ 'ss-iso2 BUILDING DEPT. I N~PECTI4N [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ]FRAMING REMARKS: [ FINAL ccl~ DATE ~ i~ INSPECTOR l77s ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]FINAL REMARKS: .~~ ~°'' DATE ~' INSPECTOR />> ~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. DATA INSPECTOR [ ],FOUNDATION 2ND [ ]INSULATION [ ]/FRAMING [ ]FINAL ~~ 765-1802 BUILDING DEPT. ~i1NSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ )FINAL ~ ~a_._n_ ,. ~•.__ ..~ ~ ~.~~~; .w~ ~ : Nr ~~ 1 ~~ ~~ ~~~ HY E,G~d3c~C'1: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined ...P^^.^.-S ... I,i, ., 19 ~~. Approved ... ....~.~.~.., 19~~. Permit No.) ~~ S'y'~ Disapproved a/c ..................................... ............................... Of~CJV ..... .. BOARD OF HEALTH ........... 3 SETS OF PLANS ........... SURVEY .................... CHECK ..................... SEPTIC FORM ............... NOTIFY CALL .......... ...... MAIL T0: ~U(r ~/39~, ~~ - 6 f~ ,9~Ca~z ?/.c.~- ~/tr/~ ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ..... J ~ I l ~ ......, 15 ~~. a. Tlris 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 street 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 inspe^.tions, _ _ (Signature of applicant, or name, if a corporation) .............................................. (Mailing address of applicant) State wltetlter app]icant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. t;GU I7 +/R ................................................................................................ Name of owner of premises ..~iG~~ ~~~/~~' ................ ............................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............................................. (Name and title of corporate officer) Builder's License No . ........................ . Plumber's License No . ....................... . Electrician's License No . ..................... . Outer Trade's License No . .................... . 1. Location of land on which proposed work will be done -.. ........................ U.~.~....R.a...................i`~,~•~ •i•r7~u•~Y:... ............. House Number Street Hamlet County Tax Map No. 1000 Section .... 1.~. ~ ........ Block ..... ~ , • • • , • , • • , Lot .... ~. Subdivision ............... ............... Filed Map No. .............. Lot .............. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... ..... . ..... . .......................... . b. Intended use and occupancy ........ /i a ~• ~ ~ ~~ • • ••:~...~•77i_' •IZ~f 3. Nature of work (check whioh a licabl pp e). New Building , ,Addition ...... , Alteration ........ ... ........ p .............. Re air lj.emoval ............. . Demolition .............~h~r+l (Description) 4. Estimated Cost ...:~ ~.~:.4,0.®.. ~ ................. Fee .................................... 5. If dwellin number of dwel (to be paid on filing this application) g, (ing units .. ~ ..... , , , , , , Number of dwellin units on each floor .. , ~ , , , , If garage, number of cars .., ... , 6. If business, commercial or rr~ixed occupancy, specify nature and extent of each type of use ... , .. , , He.igftt , , , ~ ~. • • • .. • • ' lures, if any: Front ......~~. ".~ ~ "7 ' ~ ' ' ' ' ' ' ' ...... Rear ....`~.......... Depth ..v~.~. . miensions of xisting stru Number of Stories , .~, , , , , , , , , , , , • ...... .................. .............. Dimensions of same structure with alterations or additions: Front , , ....?0.•. 7 ~ . Rear ...~ ............. Depth ......~.~ ........~i.. , ..Height .........~ ....... .. Number of Stories .....~ ............. . 8. Dimensions of entire new co~istruction: Front ... , (zj; ,(, , Rear ...l ~.•.~ ....... Depth . 3,3, , Height ......~' ; , , , , , , , Number of Stories . . ~ , ~ -' ' ' ' ' ' ' 9. Size of lot: Front . n. ~ ~.......... , Rear , ...~d S~a Depth . ~.~~. ~......... ~. , 10. Date of Purchase ~' .l, ~,6 {, , , , , , • • , , , , , , , , , ,Name of Former Owner ~ (`~. ~! L~~.. 5'.4 t ~;~, ! E S~0 p p ,premises are situated , .. , ~ ~S/,QFM.~ ~1, /,~, ' ' ' ' ' ' ' 1, Zone or use dgisirict in whic} violate any zoning law, ordinance or regulation: ...... . 13. Will lot bee draded truction ~~ Will e cess f 1 be em ved from premise : yes C 14. Name of Owner of premises ff Name of Architect ....... M 1e~~~ ~~~?, ~' Address ~D ~ , ~OX~' ~/,+ Phone N~. •g~:.5/,6 3 l . . ...........:. . ...Address ..lw.4r ,suGrC: nl~~... Phone No.. ...... Name of Contractor .~.•. F~~.bU SnN.. , , , , , , ,Address q.~~ , Nlfr,U s ~ • 1 ~ ~~U ~~~.. Phone No..3 G•~,"• I co `~ D 15.Is this property lonated within 300 feet of a > e and? *YES....N0.1~ *If yes, Southold Tgwn Trustees Permit may be required. (~-LMy2F~ ~91i'!Je'c~ i, PLOT DIAGRAM ~ b 1 ,B rX e 3 <y ~ Locate cleazly and distinctly call buildings, whether existing or proposed, and, indicate all set back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. STATE OF NEW O COUNTY OF ~•S ~. .~:.. (Name of ndivid ~ si I~~~~~Lir ~ ~ ~ ~ ~ ' ' ' • being duly sworn, deposes and says that he is the applicant •'ning contract) s above named. He is the ................... .~44J./UT~f~GrljjG? . ......... . (Contractor, agent, corporate officer, etc.) ~ ~ ~ • of said owner or owners, and is dilly authorized to perform or have 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 set forth in the application filed therewith. Sworn to before me this ~ '. ~ ....... .......~0.? ....day oif Kf.!'GN?~ .... ~~ ...., 19 Notary Public, ~J `' ~` s(AiHLEEN D. KOTZIC ~ ~ ' G~%~ " County // NQTARY AUBUC, State of New York ~vv .~/ ~~ x-i ~~~. ~ No. AS4218/ ,~ • ~.! ........ , Quatlflad In Suffolk County Commialon Sxptrn July 3~, i909 (Signature of applicant)