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HomeMy WebLinkAbout17372-z3 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18293 Date AUGUST 16 1989 THIS CERTIFIES that the building ADDITION Location of Property 955 ROSEWOOD DR. MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18 ~ 1988 pursuant to which Building Permit No. 17372-Z dated AUGUST 30 1988 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LEROY & ADELE ERICSON (owners) Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A NO. N-085606 - AUGUST 7 1989 PLUMBERS CERTIFICATION DATED uil ing Inspector Rev. 1/81 F08M NO. D 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) ti~ oi73~r2 Z Date .....~.1..`~ O .................. 19~~ Permission~isyJhe~reby grante to: i~ ~ ~ ~- at premises located at .............~.......9.~•+~••••••••• ~F~~'~i~~ ~~~'1 aa' g....... - .............. .................... County Tox .................................................//............. ... Map No. 1000 Section .......,/.~ L3 .................................................. Lot No. . Block .........r~,.......... ............................ ......SO .............. pursuant to application dated ........... / p ..~•~.~••~•• •••••••••••••••••••••••••, GG 19~.Gf., and approved by the Building Inspector. oU Fee $~~w<~. ........ ,~Xt~ ~'!~.....s ... .......... .. ........... ~Bfiildin or Rev. 6/30/80 • ~v~~-Q' ,~~o TOHN O ~ D t5 (If( t2 (1 v 15 n F BUL SOUTDOLD . I ~1! LDINC DEPART:(C17T AUG ~ 6 19~ U TONtf QALL SOUTIIOLD, NEA YORK 11871 'rowro of sourHO( n 765 - 1802 • APPLICATION FOR CERTIFICATE OF OCCDPAtiCY ' NEH CO:;S DATE ~G/~_ /~1 /`~ ~~ ' TRUCTION ..,,.••OLD OR PRE-E •- - %ISTZtfG BUILDING, ~_ _pACAtfT LAt;D.... 'Location of Pr Gy~+-~ r .... opcrty• / /~ .~~Gwbad ,~/" ,X~G/.Bc~ ~t/i-p _.t.! DOUSE P;O. • .................. .... ~~~/iIGLtG,L STREET DAMLET •~ Ovncr or Ovncrs of Property. ~~~~ ~''~~%/ ....Y... ... e.~f':OGSo.> County Taz Map No. 1000 Section .1~,~__ Block '•_•--•-- -••••••••••- ~- • - - . Lot' f. 5~ Subdivision...... '---.. ................. Filed Map ..., , • ..Lot. Pcr~it :fo. -~~-""- " -•----..Date of Permit -......-'-Applicant Ucalth Dept. Approval .._... •.•••..•_....... .. ••._•••.•••• Undcrvritcrs APProval._._-__-_ Planning Board Approval ,-___-,..-•_•-•• - Request For Temporary Certificate --•••. Final Certificate _ FCC Subnittecl: $--•• ................ ••....... ... ~°' 10/!4/88 ~o ~ i~~q3 Q~e•~86 iy FOIUd N0. TOWN OF SOUTIIOLD BUILDING DEPARTPfENT s ,, , ,: ~ i ~; TOWN HALL '-'-~ ~~ ~ ~ i 765 - 1802 ~ ; a~ APPLICATION FOR',CERTIFZCATE OF OCCUPANCY INSTRUCTIONS A.'This application must be filed in t e Inspector with the followin YP writer OR ink and submitted to the Building g; for ^ew buildings or new use: 1• Final survey o£ property with accurate location of all buildings, property lines, streets, and unusual natural or topographic fcatures_ 2, Final approval oF.IIealth Dept. of water supply and sewcrare-disposal(S-9 form), 3. Approval of electrical installation from Board of Pirc Underwriters. 4- Sworn statement from plumber certifying that solder used in system contains less than 2/10 of 1Z lead_ 5. Commercial buildingsi, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible For the building. 6• Suhmit Planning Board Approval of completed site plan requirements. II• For existing buildings (Prior to April 9, 1957, non-conforming uses, or buildings and "pre-existing" land',, uses: 1. Accurate survey of p=operty showing all property lines, streets, buildings and unusual aatural or topographic features. 2. A properly completedjapplication, a consent to inspect signed by the applicant and a certified absC~act 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 Qecvpancy is denied, the Building Inspector shall state the reasons therefor in writing to Che applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informations required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1- An application for vacant land Certificate of Occupancy shall be submitted, ' and a certified abstract of title issued by a tiCle company showing single and separate ownership ofi,the 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. 0. FEES: 1• CERTIFICATE OP OCI~UPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swi®ing Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy an pre-existing dwellioS - $100.00. 3• COPY of CertificatC of Occupancy - $5.00 - over 5 years - $10.00 4• Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 ' 6. Temporary Certificiate of Occupancy - $/S.Op Residential ~+ $50.00 Commercial ' Te'• 10/14/S8 N ~ ~ ; s) ~ ~ h N W ~ ;w '~ C W ~ H '7 ! i ~" V W d a,' y " I ~ ~ O ~ ~ ~ < V a v s ~ l0 ~ b ., W x ; ~ ~ W ~EIY ~ z .~ o ~ ~m ~ s~ 4 Y QN"p o ~ v /~/ a / Y~ ~ C ~ `. 3 '.N O W H `~ W .. C m ~ ~ f W ~ g M ~ p ~ .0 ~ ~ y i ~~ N Y ; j < ~ 4 ~ ~ N " u i v ¢ ~ r T Z ~ E ~' ° `r O ~ . o w O rn 2 °° z ~ ~~ x ; - e - s ~ ~~ ~ '~ x ~ Y ~ ~ Z v N 0 ~ - ~ E [ W ~ N ~ F x 8 ;, g a ; ~ E+ •y ~ ~ oo .« V W t0 .+ RC r ;". ~ Z gCg ~ E ~ h' ; s ~ ~ ee a~ W ~ a w . p r L3. W a W rc o m O H O C ~ r-1 d = ~ ~ ~ W} 0 ~` xk u .a{ a i ~ , W p ~ -« ~ LL p " t" S ~ N u O ~ ~w 2 S' a~ n ~ u ~p H . ~' ] Z 0 p C `~ ~ 3 o' , w r1 0 a ~ w ~ w < a O ~ N o rcw _ ~ ~ ~ m mz $ > Z = ~ 4 o « _ N ~ ~ ~' ~ N w '3 ~ ~ ~ C 2 Q v ~ °~ ~ < ~ ~ N/~/ ~ 1~1 = Q O ~ © H ~ W ~ ~ i ~ ~ S u a ~ e >- ~ ~ ~ ~ o6io m O ~ ~., ', . ~ ~ r C ~ d , ~ -~ c A W W ~ ~ N ~ 2 N ~~ aF a" c r • ui Z O ~ Ol N 0 u ~~i A~ c U ~ Z v H W '~' E ^ W s ~ g ~ g ~~ d a m Z H r y F W vi ~ o _ N . ~ H .~ y gyp' ~ ~ N ~ z '. '~ W a H '0 n E' ~ a ~+ 6 c `a'H ,a m , w W '3 W ~ C r ~ Z .-~ x r ~ IL • [ ° ~j ~ O iii 1 to ao 3 E C . • d S + ~ q O ~ u v] ' r ~ < H p a W d ~' C E , 3 P ~ i U ~ ~..o~-. O u ~' ~ v W y ~ ~ ~ •t Ol ~ tb k O ~ ~ ` ~1 ~ N h ~ K K W K ~ .. ~ ~ L F o C ~ S~ N C ~ ~ sd .n L O . ~ 1 - ~IIIIIHIIU1uI1111N~111Wbi~ ~uiIIIIIIIVIIIJ7111111111111111111111 )})IIUII;UIHlUIlIIIIIIIIIII4fil11 IIIIIIUIIIIIIIIIIIIIIIIIIIIilllllllli ~~~FOi.,~r'~' p5 r'~~~,",y ~C~ T0~'N Oi~ SOUTIIOI.~9 a? f6ii: ~~ `, +y~< OPI'ICL' OF EiUILDING INSPECT02 u '"~ ~,~~~;~~ ~ ['.O. UO!C ] 179 ~;~ ~ r,'j ~ TOWN IIALL ~ ,y~~ ~~~~, SOt7TItOLD, N.Y. 1 1971 j7-Q-c. ~ yrl9g$ TEL. 7C,5-18(?~ ~~ aays 'i'o P7hom This May Concern, ,; We arc unable r.o complete your Certificate of occupancy because of the following reasons. /_"/ An application for Certificate of Occupancy is not nn fil.c. f'j1„r~ea-ccQ_, /~// Flo Underwriters Certificate on file. / 't'he chccF: .i:; r^,-}<a;;;~,~=<l/nut on file.) -9~S•o-U /_/ D:o fical.th Dept. Approval on file. /_/ P:o final insl~,ect:ion has been made. Pleasr.. contact: our o-ffice on this matter. Thank you for your cooperation. 1htildinrJ permit. 1! 1 .~ ~ _~ ~ Z IIuildiny Dept. ~'`"/t// Ito I'lurnbnr ;;older Certificate on file. l ( al.l pnrtniCS involv.i.ng plumbing being '(/ i:sucd after ~1pri.1 1,1989 ) Cam- ~ Gl. (~ rl::LD I~:S:`E~':lUti ~ jJ;,iF '~~ ~UaKM6NIS-~ - ~ 1 F (j - _ "° U C'7 ~ ~ . i ~ - -- r f+ FOUNDATION (1.~) ~- -- C FOUNDATIOW (2nd) - - ~ 2 0 3 ` ~ . z ~ ° G ROUGH FRAME & V PLUMBING ~ V ~- H N ~ 3. ~ ca INSULATIOAI PER N. y STATE ENERGY ~ ~ CODE .? ~ .~ ~ .-.~ O C/ ~ 4 . . _ p- L I. V 3 _ ....L?- H ~y ~ ~ ~~ 'Y ®' FIidAL ~ ~ C ~ ~ ADDITIOPlAL COMMENTS: x ~' ~ ~ ~~ ~\ ' ro x ro~ H~ y 04 z 1 ~~ x ro a~ r _ ~ H ~ b ~ c•] ro H 17.E 7 ~ rss-isoZ BUILDING DEPT. INSPE~°TIC~N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ~INAL REMARKS: ~~ ~Z. DATE 1 ~ ~ + ~ INSPECTOR 1'~ ~. (~37v T65-1802 BUILDING DEPT. fi:Tj~~JiiG7`I [ ]FOUNDATION i5T ( ] ROUGH PLBG,Q [ ]FOUNDATION 2ND [ INSULATION /~x--- [ ]FRAMING [ ]FINAL DATE D ~ 0 INSPECTOR ~i~~'/1 173 ~Z- 765-1802 BUILDING DEPT. !N!SPECTI~N [.~j FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [~RAMING [ ] RINAL 4 DATE ~~ INSPECTOR ,~ ;~ ..~ ~~.. t rn ~p 11326- ,N ~ J- '~,_ O ~, ' , ' I DIE, * a' ,.. ,~ 4~.a'~~' ~ n \ ' 0331 ," 4` !~" -' m .3 "• i, A, b ~~ ~ ' ~~ 1 15 r~ „ v. / J~~~f,. O_ n 3 '. 7L , ~""~ N-~ 11y 33 m o = o wa,~ `Sx ~~ 0 3 "` w ~- a µl. sc 3°3 s>, Ip 3 'o ~ o, \ 033 I ~,` '~ ~ - $61 apt d ~. __ gU7;~Y,g~ 9 974HEALTH DEPARTME,N~Tr DATE A K H. D. REF. $b~~ ~~ The sewage disposal and water supply faailitios for this location havo been inspected by this d ent d found 'n to be satisfactory.~~ti,~~ ~ '7/~ Chief of General Engineering ((// Services REVISIONS FEB.7, 1974 A PR.19,1974 APR.23,1974 UNAUTHORRED ALTERATION OR ADDITION TO TN19 SURVEY IS A YIOLATION OF SECTION , T209 OF THE NEW YORK STATE FOUCATION LAW - , I;,. COPIES OF,TN19 SURVEY NAP NOT BEARING THE LAND'BURVEYOR~B INKED 9EAL OP EM8098ED' 9CAL BNALL NOT EE CONSIDERED ' TO NE A VALID TRUE. COPY EUARANTEF9 INDICATED HEREON 9NALL RUN WLY TO TNE`pER80N fOR WNOM TVE SUPVEY'19~PREPARED, AND ON NIS BEHALF TO THE .TITLE COMPANY, OOVERNMENUL AGENCY AND Ll NDIND INSTITUTION LI9TE0 nEREDN~AND TO iNE A8910NEE8 OF THE 4CNDINO IN9TITVTIDN. DDARAN TEES PHL N07 'fMNBfERABLF TO AODITIVNAL IxsTlI UTIONS OR SU88EOUENT OWNf.R9. , 0` a~g O0~ ~, ~0 4 ~~, 4 ~ ~ ~~ P,~~~ e II`1E M1~o,S ~~ ,._' r .~ cc~ -" rv .- i I~- ., x ` ~ NOTE f 1 •=MONUMENT SUBD/ V/S/ON MAP f/LED !N THE OFF/CE OF THE CL ERK OFSUfFOL K COUNT Y ON /4 N. P4, /969 AS F/L E NO. 5240. ~- THE LOCATION OF WELLS AND CESSPOOLS, AND%VOR FROM DATA OBTAINED FROM OTHEASNS~ YOUNG & YOUNG 400 OSTRANDER gVENUE, RIVERHEAD, NEW YORK "`^~ ALDEN W. YOUNG H ARD W.YOUNG PROFleeiONAL [NOINHHR AND AA~~ YOR LAND BURV HYOR. N.Y.B. LIO. NO, 12048 FZfN. .B:L NC 48088 SURVEY FOR: ,P~tO w, r ~~ JAMES P CONNOLLY & CLAIRE F Q ~~ LOT N0.15," ROSEWOOD ESTA 1 g . 1 ATI v ..c ,T •,eF 0.78 AueeB. :.... , ... n MATTITUCK ~~'~ 'i'~f''s~ ~~~~~- JJ OF SOUTIiOLD ~ ~ANDSU~rE,.J" SUFFOLK CO., N. Y. ev /~~~~~ , ~~~_; I II 80• DATEI NOV. 16, 1~9H73 N6' 73 ` 13 124 ~r,..~., .e°.. "' ,' "._ FORM NO. 1 I r d~ TOWN OF SOUTHOLD }l~ k'~w BUILDING DEPARTMENT ~,l\! TOWN HALL BLDG, DE SOUTHOLD, N.Y. 11971 TOWN OF &OU7t10LD G ~ TEL.: 765.1802 Examined .~>~~........, 19~/U Approved ...~''3... r~lJ ~ ~ 3 ~ ~"` ~ ......, 19 ... Permit No............ /// Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS '~ SURVEY ....... .:~....... .~ . CHECK ...................... SEPTIC FORM NOTIFY CALL ..................... MAIL T0: ...................................... .. J" ~`f!C ...... . ~(B ing Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ........ ~: ~~~...., 19 r16~ a. This 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. (Signat~r of applicant, or name, if a corporation) • (Mailing address of applicant) /!9 8 ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. ^:~;2q q`" i °GYt;L~ ~t"/C~`to!;'+,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, CJ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name an title of orporate officer) `~ Builder's License No. .,. ~a.1.7~N-~ ................. ~ Plumber's License No . ....................... . ~ Electrician's License No . ..................... . Other Trade's License No . .................... . 1. Locatiohn of land on w{iich proposed Iwork will be done . ................................................ . House Number Street Hamlet f County Tax Map No. 1000 Section ....1~:'~'~......... Block ~, , ... Lot .~.t°.......... Subdivision~V.Ss/ ~.c?U.....~.... f .: Filed Map No. ,_.~.d, , , . , .. , , , Lot .. J ......... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy)of proposed construction: a. Existing use and occupancy .....~~~ ~~m' ) G~~e1 `~~ ......... .... 4 !~. ~f~, .......................... . b. Intended use and occupancy .... `:~°.t ~ F/. • • G~.S • • .:c~.~,J.Q ~~t .................................. . 3, Nature of work (check which a ~~ licable :New Buildin .....~. ~ eration ddition ....... ~1 F}p ) g .. ...... , .. ; .. Alt ........,. . p ........... pval........ ... ... Rem ~ Re air ...... Demolition , .... Ofl~e; Wp~k.,. j ~I~etion) 4. Estimated Cost .. ~~.r.~...Q"'D . ....................... Fee ............. ~ ........_... gin.. r+;f, ~ .... t=a a.~ .e`:=.i ~. .. (to be paid fi1~14~stggpll~at~yxg~ ....~ ...~,..~...<,.,.~rn,,..« ~ 5. If dwelling, number of dwellingl,units ............ . .. Number of dwelling units on each floor ............... . If garage, number of cars ... . 6. If business, commercial or mixe 7, Dimensions of existing structure Height ...............Nun Dunensions of same structure w Depth .................... ~'8. Dimensions of entire new const: Height ............ Nun 9. Size of lot: Front .... t"~.`. ~. , 10. Date of Purchase .......... . 11. Zone or use district in which pri 12. Does proposed construction vio: - 13. Will lot be regraded .. . 14. Name of Owner of pre ises /. Name of Architect ~ ~° ..~Li Name of Contractor--l~~~f1.~~.1.'~ 15.Is this property loca *If yes, Southold Towr ................................................................... l occupancy, specify nature and extent of each type of use .................... . s, if any: Front ...............•Rear .....,........ Depth.............,. berofStorics ........................................................ th alterations or additions: Front ................. Rear ................. . ..Height ... .......... Number of Stories ....... . action: Front 1. ~ .r4..~~ .. ~ ~O ~~ ~ ~ ~ ...... Rear ..7.. , .........Depth .,1~.......... . ber of Stories . , .~ .... .................... .. .. ............. . ........... Rear ...././~. ~ ............. Depth ..~7.3:............... ..................NameofFormer Owner ............................. mises are situated ............ . ....................................... . tte any zoning law, ordinance or regulation: . /v U ................ . . . ........ . ..Will excess ,t,11~?e removed from premises: q Yes No p(q G`jY1G.SP:n ....Address Q?~'l~l~,~$N?4acQ-I~, rPhone No.~/~:',-~ (v SS /. >~r, icxS frn, ... Addres~s~,5.5 c~C~k~Pp ~,~'~: Phone No.o7,9. ~ : ~ ~~ . . l ~f ..GottS~~..... Address~:4.,PwX ~?~~15.~QYEQ>y~one No. 7a;? ;SS/:.. . =ed within 300 feet of a tidal wetland? *YES....NO.... ' Trustees Permit may be required, PLOT DIAGRAM Locate cleazly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~~tumber or description according to deed, and show street names and indicate whether interior or corner lot. 7a.y9~ ~~~r~-l G7.rar 1~~~ ~~ i~6~ '.I w r '^~ 1 rw •~. io'~ u.7" 3 ~ar~u STATE OF NE\y,YO~jC, ~ S COUNTY OF . 4!. j~--U.Z.K ... . ,~,f"~, V~ ~g~ Z Cf g ~'- , , , , , , , , , being duly sworn, deposes and says that he is the applicant (Name of individua si ntng contract) above named. He is the ... , ..... S-r P.~? ~Y'q,G.t~p Y' ............................................................. . (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 this application; that all statements conta}ned in this application are true to the best of ltis knowledge and belief; and that the work will be performed in the manneri set forth in the application filed therewith. Sworn to befor~~ejjme this .,...,...~4.~........dayof; ••L~~~ Notary Publi~ ~~-e:'!^.`~:`~ , f!!! :.4!. SRO A.'1`1.D '4A. 0 IfIJS~A t10~r^~ `;' P1lI~?a1C, Stato at' Nom Rork O,~tn].ii':i.orl :in Sttfi'o1.I~ COtztlty Cou~lssiort l%~rpi~ os - ~~ ;~/ .1~9~