HomeMy WebLinkAbout17798-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18262 Date AUGUST 8, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1060 FOXHOLLOW ROAD MATTITUCK N.Y.
House No, Street Hamlet
County Tax Map No. 1000 Section 113 Block 6 Lot 23
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 27, 1989 pursuant to which
Building Permit No. 17798-Z dated FEBRUARY Z 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 UNHEATED ENTRY WAY ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to RICHARD & DONNALEE RELYEA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. PENDING - AUGUST 7, 1989
PLUMBERS CERTIFICATION DATED N/A
w~
Building Inspector
Rev. 1/81
noaas xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMI7 MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ~ 0177 9 8 Z Date ........1.~1...v 19.~J.'
Permission is hereby granted to:
to ..C.'Q.~(~j~4frL'.f ,C~1....GF~ .~1•••• ..:.~..........F~G2.~5~~~,,~,,,~i/, .~Ll.........
ct premises located at ......~a~~...lP ..~iGll.."~....f.1...Y••••.........................................
..................................................../.,t.J...
County Tax Map No. 1000 Section ......,~1..~....... Block .........~J........ GGLot No.......r~...,,~........
pursuant to application doted ...~~7 19.~/.., and approved by the
Building Inspector.
Fee $...~'o..
/ Buildlf~6 I for
Rev. 6/30/80
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TONN OF SOllTIIOLD
BUILDING DEPART2IENT
TOWN UALL
• SOUTHOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY t~~j
DATE ~~C? ~ ,
NEW CONSTRUCTION ._.....OLD OR PRE-E%ISTING BUILDING......VACANT LAND..._....
Location of Property,. ~~~~~,.:~~c,Y~~li~af~.~...4~Ca.fi.~,I~..
HOUSE NO. + ~y"~ ~ p~ STREET ~p~p HAMLET
Owner or Owners of Property.... 1~':~1.~'S°~ „~„~C.l,~.~ R~~~.~
County Tas Map No. 1000 Section ~.t, Block ...1-(~„ Lot
Subdivision Filed Map ........Lot........_.
Permit No. .l.(~.J h !Date of PermiC ~L~~,Applicant
Health Dept. Approval Y.l~c~t.._....... Underwriters Approval...~.~,~ „ _ „
Planning Board Approval
Request for Temporary Certificate .:.....,Final Certificate
Fee Submitted: $
APPLICANT... J1~!.ly.r.IJI~K,~°
rev. 10/14/88
ate.. 3~va ~
TEL. 7G5-1802
~5~FF0(~r~cC T0~'[V OIL SOUTiiOi,i~
F''`~~'',, ~~t
i? bi,Ba~ ' .c OI~ FICG OF IIUILDING iNST'ECTOR
o " ~ 1~~~ ~ P.O. IIOX 723
~ "1'itl ~ TOLVN BALL
Oyy~ ~h~ SOUTiIOLD, N.Y. 1 1971
~.(,e,j~ o ~rmir~Pne. ~2ye~
Q•o. E~o~c 37~ U
t ~ . 119 YS~
'I'o P7hom This May Concern,
47e arc unable r.o complete your Certificate
of~Occupancy because pf the follocviny reasons.
/t/! An application for Certificate oP Occupancy
is not cn fi].c. ~Piu~-~+-~-~Q---)
No Undcr~•~r:itcrs Certificate on file.
'ihc chce:P; .i:;(att{rErterl/nc~t_ on file.) yg~j$'.~
t:o tleal.th Dept. Approval on file.
1_/ P:o final inspection has been made.
Please rontact our office on this matter. -
Thank you for your cooperation.
Ilu.ilcliny Pcrm.i_t-. I! 1_ Z ~ ~ Z
I)uildiny Dept:..
~ tlo Plumber ;;older Certificate on L'ile.
( all pcrmiCS .i.nvolvi.ny plumbiny bciny
i~cucd after .1pri.l 1,1964 )
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BUMLDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
C) FRAMfNG [ ]FINAL
REMARKS: ~ ~C~~ ~ ~
DATE ~ ~ INSPECTOR (~JN'
765-1802
~ BUILDING DEPT.
/y INSPECTION
[ ]FOUNDATION 1ST [ ] RO H PLBG.
FOUNDATION 2ND ( INSULATION
[ ]FRAMING ( ] FINAL
REMARKS: t~~~t-c.~~A,r,,_9~r1
DATE ~ ~ ~ INSPECTOR ~"`'V
i~~9~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ G]'~RAMING [ ]FINAL
REMARKS: ~ck,
DATE ~ ~ 02 INSPECTOR
r
/7~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[~RAMING [ ]FINAL
REMARKS: I~fC-E_. ~ ~
_
DATE ~ ~ ~ INSPECTOR
1 ~ l 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]~~NSULATION
[ 1 FRAMING FINAL
REMARKS:
DATE ~ INSPECTOR
_/fib 765-1802
BUILDING DEPT. 6r
INSPECTIO~~
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION [ INSULATION
ING [ ]FINAL
REMARKS: /~~o~.~
c~~
DATE ~C~J INSPEC~!"~
17 ? ~
765-1802
BUILDING DEPT.
INSPECTION
UNDATION i5T ( ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING [ FINAL
REMARKS: /l. ~„a,
DATEf (P~ INSPECTOR
f ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS F'-">~~
~•~'~li BUREAU OF ELECTRICITY
8Ei JOHN STREET. NEW YORK, NEW YORK 10038
Date AtY~1.fST'j,~S, l t9fi~~ APPfication No. on file F4tl610~9I4~~d ~ d'7$$$, 4
THIS CERTIFIES THAT
only the electrical equipment as deacrihed below and introduced by the applicant named on the ohove application numher in the premiaea of
e
!27CH~)'iA REitrYh",W, 7i)50 L:C?R YlC1LL,C~~z~ryry R!?31D, Pl3~,k~#F12, T4~1'Ti~~`OCK; iV,Y.
in thefo[lorvinq Location= ? Baxern nt L"J /xt FL ? 2nd F'1. C(~~ Section Bt«~k Lot
At3C+iJST t~'},1Sf~'.7
' was examined on and found to 6e in c«nplianre with the requirententc o(this Board.
FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
rOUTIET$ INCANDESCENT FLUORESCENT OTHER pMi K W. AMi K.W AMi K.W AMi K W. AMi H P
l1 ~d
~ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCNS UNIT HEATERS MULTI-OUTLET DIMMERS
BEII SYSTEMS
AMi. K. W. Oll H P. GA$ H. P AMi NO A. W. G AMi. AMP. AMT AMPS TRANS. AMi H. P NO. OF FEET AMi WAT75
SERVICE DISCONNECT NO.OF $ E R Y I C E
MIT. AMP. rypE METER L tW I A 9W 3 %8W 3,6' 4W NO OF CG COND A W G. NO OF HbIEG A W C'' NO.OF NEUTRALS A' W G'
EQUIP. PER % OF CC COND OF HI-LEG Of NEUTRAL
OTHER APPARATUS(
rAIfAG.i~, & FUYRR .~1J)UITT.t:>N:> p1sLTt'-3
G~~~'.~•.~:~-7.
RI=~I,YRA RTC{dt~R1i t%~
/
P.G)< f1C~iS 372
{;AUS:E(a, NY, 'Ia'~4G GENERA MANAGER
:1 ~r
~
Per ~.a~.
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
e (w
~M1~ L~CY~'IL~LI~1f/I °~f ~tj~ BOARD OF HEALTH
_.~.a-~...~._~~,..,x,...,,.m».h'~) ~ k~SURVEY OF PLANS vJ~:.........
, FORM N0. 1
I ~ .JAN 2 ~ ~Q89 ~ TOWN OF SOUTHOLD HECK .
` BUILDING DEPARTMENT SEPTIC FORM
~
,,,~.,.m...,.,....v...,~..,-,_.._ ~ TOWN HALL
.,.a~~01~`r°~'~`:`"u`-~~~~~t»'~~ EOUTHOLD, N.Y. 11971 NOTIFY
TEL.: 765-1802 CALL
Examined~~..........., 19 c~C~ G MAIL T0:
Approved 19 .Q/. Permit No. / .7~~0.~ .
Disapproved a/c
Buil Inspector)
APPLICATION FOR BUILDING PERMIT
November 10,
Date 15
' 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 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.
(Signature of applicant, or na , if a corporation)
Post Office Box 372
Laurel~MalVlenvf Yorks oflag~~~nt)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,,,,,owner,,..builder and electrician
Name of owner of premises Relyea, Richard G. and Donnalee
(as on the tax roll or latest deed) I
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ..4?%~:?~ .
Plumber's License No . .
Electrician's License No. ,2148E
Outer Trade's License No . .
I. Location of land on which proposed work will be done. .
1060 Foxhollow Road Mattituck
House Number Street ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ' ' ' ' "
Hamlet
County Tax Map No. 1000 Section 1.13............ Block 6 Lot ...23............. .
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 ,one, family, ,dwe,l,~j ng, , , , , ,
b. Intended use and occupancy , , ,same W t~h UnYleoteeJ ~"Or1t er1~V" U}p
~.....y
( ~~~applicable): New Building Addition X Alteration
3. Nature of work check which
Repair Removal Demolition ..........~,~1,1•'C~h~tQ~York..............
! (Description)
4. Estimated Cost......... $5000.00 Fee.........
(to be paid on filing this application}
5. If dwelling, number of dwelling units 1........... Number of dwelling units on each floor .
If garage, number of cars . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front ! Rear . ,4~ , , , Depth ~ .
Height I Number of Stories a`~ .
Dimensions of same structureiwith alterations or additions: Front ...`~x3. , , Rear .
p „ , , .Height 1.4'li. !='Ctl.~......... Number of Stories o~ .
' 8. Dimensions of~entire new construction: Front ! Rear !~2......... Depth ~ ~ , , , , , , ,
Height ....I:'a'......... Number of Stories ....l...... . .
9. Size of lot: Front s ~'"Y~~...... Rear Depth , , .
15'7
10. Date of Purchase Name of Fopner Owner Alan Dickerson
11. Zone or use district in which premises are situated , , re s i dent i a 1 ~ ~ ~ ~ . . . . . . . .
'i 12. Does proposed construction v}olate any zoning law, ordinance or regulation : . no , , , , _ .
13. Will lot be regraded , nO .....Will excess fill be removed from premises: y06 N.
14. Name of Owner of premises .>z01Y~a ............Address F • 0. Box 372 . , ,phone No. 298._5041, , ,
Name of Architect ..Address , I'~uY22 , . , , , ,Phone No .
Name of Contractor
p P Y 9 Address ...................Phone No............:.
15.Is Chis ro ert lo'ated within 300 feet of a tidal wetland? *YES.:~.NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frog
property lines. Give street and block number or description according to deed, and show street names and indicate whethe
interior or corner lot.
c~~e svrve;',y
i .
i
I,
I
STATE OF NEW YORK, ~ S.S
COUNTY OF i
being duly sworn, deposes and says that he is the applicar
(Name of individual suing contract)
above named.
He is the
~I (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tlt
application; that all statements cant ained in this application are true to the best of his knowledge and belief; and that tt
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this I
Notary Public, fxG~tr-:..~. .IN:~...4~........ County ~
7Vn:~.~.:Q:e~ .
NEIEN H. DE VOE
NOTIIRYpUBLIC,Statoottde York ~ ( natueofapplican
No. 4107870, Su4Potk Catty
Term Expires Mlarch 30,19
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OCCURANCY" OR
US€ tS UNLAtNt=UL
~_~rF _r
- _ . ~ ~l~tTHOUT CERTA=tCATE
~ -
- OE OCCUPANCY
-
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_
_ At~-Pe VED AS NOTE77
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_ ~ pATE: R.P.# y!~
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4 ~ ~ r--~ ~ - - ~ ~ FEE: BY:
pp NOTIFY BUILDIIIG DEPART TAT
0.- ~_r i 7R5-1802 8 AM TO 4 PM OR THE
- ' - FOLLOWING INSPECTIONS:
p" - ~ - ~ Ii~--~~~ E ~ ~ - 1. fOUNDATpN - TWO REQUIRED
~I ~ . ' ~ I''- ~ I ~ ! ~ FOR POURED CONCRETE
t it
~ki ~ 2. ROUGH • FRAMING & PLUMBING
~ ~ _ 3. INSULATION
!I 4. FINAL - CONSTRUCTION MUST
I j ~ I 8E COMPLETE FOR C.O.
Fx I s'(I MG li ALL CONSTRUCTION SHALL MEET
- E;+c.l s'1"rtaCa THE REQUIR9IAENTS OF THE N.Y.
_ I
, r _ ___..~-_~..,,--.-._,_r_....._.__.___... STATE CON9IRUCTION S ENERGY
/a.0 pESIGN OR CONSTRUCTION ERRORS