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HomeMy WebLinkAbout17485-z~ ti FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17664 Date JANUARY 9, 1989 THIS CERTIFIES that the building ADDITION Location of Property 155 WOODCLIFF DRIVE MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 107 Block D7 Lot 27 Subdivision Eiled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 28, 1988 pursuant to which Building Permit No. 17485-Z dated OCTOBER 4, 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 & DECK ADDITION TO EXISTING ONE FAMILY DWELLSNG The certificate is issued to MICHAEL BURKE (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. PENDING 1/6/89 PLUMBERS CERTIFICATION DATED 12/26/88-T.P. McSHANE'S PLUMBING Building In ector Rev. 1/81 rows 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 0 ~ 1~ 4~ SJ Z Date ...~...4".~!..~.^.~?:~ :............7..............., 19.L~ Permission is hereby granted to: ~ // - .~~. ~.~ :T1 ................................................... ~.~~~..... u :.~ :....1.% q~:. 2....... .. .~ ~ of premises located at .. ~.~.~,~........W.~?'W.~:!~A-r~.~......~ ~.~:........!.'•••)..~St,, ....~...~' .:........... .`~...~.,~.~R~.....~~: ............................................................................................ County Tax Map No. 1000 Section ...../ ~..~......... Block ...... ~...~........ Lot No....a.7 ............. pursuant to application dated ....~R~?~kl:t1!~.4,r:..f~..~.........., 19 g. ~., and approved by the Building Inspector. Fee $..~~.-J~.:. /..... Building Inspector Rev. 6130/80 " FORM N0. E TOWN OF SOUTHOLD Building Department , Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- torwith the following; for new buildings 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 of Health Dept, of water supply and sewerage disposal-(S•9 form or equal-. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance Prom the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, ar other pertinent informa• tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy onpre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 .. 4. Vacant Land C.O. $5.00 q 5.Updated C.O. $15.00 Data../.•~~J(.~:.•.•••••..••• NawConstr'uction,,,,,//,OidorPre-existingBuiiding .1°......... acantLand ............. Location of Property .l.~~... ............. W~©D.GF~.FF. p~-........./,1?,rf~/ ;~dC/< House Nu. /~~ ,/~ Street Hamlet Uwner or Owners of Property ... /rJ.~CH~.~f:..~.Ua'.(C ~ ............................ . County Tax Map No. 1000 Section .....~ ~ .~..... Block ..~.~......... Lot ..:~.. [........ , Subdivision .................................Filed Map Nod./ ..........Lot No. ............ . Permit No. ~.~ ~~~,~~Date of Permit ~%~~~.Applicant ./7:: ~~'. ~~L r~.. ~~9!~-~..-1.~4-• Health Dept. Approval .... y~,~ ::............Labor Dept. Approval ........................ Underwriters Approval .... ~G ~~F............Pianniny Board Approval ...... ~ ........... . Request for Temp~ary Certificate .....................Final Certificate .... 1/ ............. . ~~/' ~ , ~ Fee Submitted .f.~~ ................. Construction on above described building and permi meets all applicable c es and regulations. Applicant . .~:..~'.......... .../, ,!a"?:...... . Rev. 90-10.78 ate. ~ra~v~{ Co ~ i 1~~~ :1::LD ~i:5:'EC:IUiJ ~ IUiiTF. ~ i;0a`iMGNT° n ~. , /O r/ ~~- r i 1 ~ . „ H C - _ _ y , _ V (1st) rOUIJDATION o p _ ~~~~ c cOUNDATI0IJ (2nd) - m ~ ~ _ f~ -/ fir/! . 1 z o v ROUGH FRAME & ~ d ~~ PLUMBING ~ ~ (' H 3 . l x' t ca ~ rn IIJSULATIOAI PER N. Y. ~ • y o C STATE ENERGY s O v DE C x . . ~ C 1 3 Sf 7 r!. C m SS 4. ~ H FIidAL ~ • z , ADDITIOPJAL COMMENTS: x ,~ ' x ~v H ^ S ~ 9 ' +. y H d O C z . ~ m ~ • r ~ H ,~ d m v y TEL. 765-1802 4'"00' ' `a 0 O • ` .y.._ .~Q TOWN OF SOUTSOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I'C A T"I O N ~- Date / 2 ~L / d'J' Building Permit No. Owner i11 I C Nl~L'L. /`~ V 2 KF' . (please print) /. _ Plumber ~,~ /''`~ `-S~ra,z-s 4 ~.~, .~ - . :: '(pl'ease grint)... ,_ I certify that the solder used in ,the water supply system contains less than 2/10 of 18 lead. (plumber s signature) Sworn to befor me this r' .L day of , ~ Y ~~:~.,- ~ 19~. Not y blic i Notary Public County WILLIAPf NOTARY PUBLIC k O SUFF04K CNTY.EX~l~~ _, r------- ._~. _ _.... ~ .. ..... . ~ _ _ ....._..__~ _ -__ --- --`l 1 ~ y~~: .i C'.~ ~~}. ~~ " C^ ~ 1 ~. .. ~~, ~ n,~ ~J' ~ i , 1 1-; . , i 1 - ~ ( ~ I ` t C ex + .pk , 1 ~ 't.l ~ ~ S I { . ~ ~ I F ~ i. , i ' i ~'- t ~, I ~ r t~ ~ L ~, ~ ^~ i S di -~ ., 1 N ' `~ ~ ~ T S.~ ~ I+ f t 1 , ``4• 1 •y ~1 i titi i ~ ~ i Iti i i' , __I ~ ;, i t. i _ ~ ,~i .lY~ .. .. h + r-~ i e A~ L__-` I I ~~ . -. ~i ~ 01 { ~` a cc 15l U:CY FI?. HO ~ ~" i \ .' i (' ~ ~ ~ Y-~. _. _ ` {J .-~ ~~i ~~ ~ ~ ~ ~1 ii SJ ~ ~' r_~.~_~ lye ~ I~' n i crt q =~:,. ; :..~ ~ ~ f. h. , r._ _ :; ~., erg ,:~ (1'I~` ~:~ E ' ~ (oa a _ I~ ~. ~ ... . . . . :r 1 v"~ .~'_~~ J `~ l M L n 4 pl J u ~ ~1 I ~ 9 ~> 3. Ne . [~ N p ~' . q N~ ' ~„ $J ~llt. 4 ~ ~/,(~ lJ v v I - / t i- ~ L s V 6 U i i). ~ 4: . ~ . _ p ~Y bs J S .~ n ~ Q ~U N v ,x l .T .~ LL" ro ~~ -~ .~ m i w ' p ~ ~i~~. s'da~ ~',rz7 n Gb ;~ ~N 0 ~!. ~ . ~ .'~0' a ~~ kl yy ^` W I .. v. ' ' l ~ I n..~.~.. ~ ( t f" 'ice /x i iii +? " ~ ~ ~ "` . i T 1 ~ f ~~ ! ?~ ~ r ~ ...= ,.,~ ~ i, i ~ _ _ ~, - ~ ,.; C ~, , ~~ ~ ~. s;_ ~ __ ~ ~ i i ii ~,.o-., ti - ~ a ~ i i /^ ~ ~ 1__ _.. _~ -:~-~ 17~~~ 765-1802 BUILDING DEPT. 1NSPECTIC,N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ )FINAL REMARKS: -~-~"-~~-~ ~ ~ L . DATE ~ ~~ INSPECTOR ~~ K~: rrs-isoa DUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ) ROUGH PLRG. [ ]FOUNDATION 2ND [ ]INSULATION DATE [ ]FRAMING [)FINAL 765-1802 BUILDING DEPT. i47 ~ ~.ti ~r.7; [ ] FOUNDATI 1ST ( ] ROUGH PLBG. [ ] OU ION ZND [ ]INSULATION [ ]FRAMING [ ]FINAL DATE d ~ ~ INSPECTOR /o ~.~.. /7y~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ,[~/~OUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING f [ ]FINAL REMARKS: ~~-~=~~~''d'- ~~-2~ L~~~_ DATE ~~d 0 G INSPECTOR ~~ l7 ~~~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~NAL REMARKS: (~~ 1~ . (L/%~ ~ ~~ ~ , In „ .~ ~ ~ . r`7t"" _ °~.-~ DATE / 3 $'O INSPECTOR ~ ,~ y THE NEW YORK BOARD OF FIRE UNDERWRITERS T~~I~r, ~ I(t{I; ?y) BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 . ~Dace~ ~ILI lilirfli{y l~li.l'7;i`F APPHca[ion No. on file 5'~3 "Iftit$~P/RT) kl !ll'11.i ~ry'J'{ THIS CERTIFIES THAT only the electrical equipment as described 6e/orv and introduced 6y the applicant named on the ofwve opplicotion number in the premises of It'Hil ltil, "T. Yt7t!71i;•;, rrb-ItIK)Ut`I,: P'N' i)ii lTl l`;, AY ~'1°1'4";'tf{'i±, CP, X', in thefalloLCing location; L-'J Basement ~ /at F(. ^ 2nd FL t>111 .Sercion B/ock Lot uns examined on `Ill Lllil'~tC~' 6.`'''14. ~! arzdfoundta 6e in coneplianre with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH W ASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES I NCANDESCENT RUORESCENi OTHER AMT K W. AMT. K. W AMT K W. AMi K W AMT. H P a tT d l I f +s s' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEtL UNIT HEATERS MUITI.OUTLET DIM MERS SYSTEMS AMT. K. W. Oll H. P GAS H. P AMT. NO A. W. G AMi AMP. AMT AMPS TRANS. AMT N P NO.OF FEET pMi. WATTS I i'rf)(f SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP TYPE METER EQUIP. ~ ~, YW ~ % ]W 3 $ ~W 3 %4W NO.OF CC CONO PERb A. W G. NO OF HbLFG OF CC. COND A' W' G OF HbLEG NO OF NEUTRALS A. W r'~ OF NEUTRAL OTHER APPARATUS: JACt-Y,'1, J; 'S 'I iP ~. i'.Oh.l(~:" i °,{ p{ f~ Hi ll f_Q•:In ESP{il~ ~i'(I I S°[ t'~~a(t(}~ VAP.(I?I:fttlf.r u8;i,--'7 <'tk. FYl ,r<'lliv ;mtotld:n t~tl~` r,nn?,< UI±'I#165)< ra<i. ;;3t441 b; This certificate must not be altered in any manner; return to the office of the Boord if incorrect. v !'i be identified liv their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 7 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined ©Sx... y .., 19 Approved .P.~.~'~ . ~ .., 19~'~. Permit No. ~.7.y ~~.:~• Disapproved a/c ..................................... BOARD OF HEALTH :.y::.....,. 3 SETS OF/LANS ~r// ....... SURVEY .. .. .... CHECK :~. 3.1a0.o.~, ; , ~',50o U,C'?.... . SEPTIC FORM ................ NOTIFY MAIL T0: (~yp.~p7ry3tJ ................................:.~t ~ ~...~. R..~ ~ ... . (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~~~ Date .. ~~29......., 19 ~~ 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- cations 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 I5 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 insp ctions. (('' ( ignature of"applicant, or name, if a corporarton) "T'T/TUB-/<.. N~ :.... ..f.3.n.~3.y ./,?~ . (Mailing address of applicant) • State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. U. ~~`~ ~.2 ................................................................ . .................. Name of owner of premises . l.vl.: ~~ U ~/~ ~ ..:.................................................... . (as on the tax roll or latest deed) If applicant is a co~rpor/ati~on, signature of duly authorized officer. [ (Name and title of corporate fficer) .................. Builder's License No. Z~°Z. ~'~' Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . Location of land on which proposed work will be done. W~~'. w ®®D G G /F/' ~ je House Number Spt-r~eet ~-7 Hamlet County Tax Map No. 1000 Section ... 1. Q.'. `• • • . • • .. Block .. / ............... Lot .~ .~ ............ . Subdivision ..................................... Fi]ed blap No. .............. Lot .............. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~9 ~ a. Existing use and occupancy ... ~. q~~•m~~~ • •//•~2l~' ~ /N ~. ` ...` • .. • ... • .. • • ...... • . • . _ . • . b. Intended use and occupancy .... ttl~/1.~% ~4.C1. • • T • • •,///~P ~`'G~y(/~ ' .................................... ( a 3. Natpure of work check whiRB~pplicable): New Building .....~..... Addition ...t!...... Alteration ......... . Re air ...... oval .............. Demolition ..............Other Work .............. . (Description) 4. Estimated Cost ..........7.-~ S? ~ .Q ~.° :................. Fee ..................................... . ', (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor .. , , , , , , , , , , , , , , If garage, number of cars .. .................................................... . 6. If business, commercial or mixed occupancy, specffy nature and extent of each type of use ,,,,,,, , , , , , , , , , , , , , , ~. 7. Dims al'~';i~~%g~~sti'tig structures, if any: Front .............. .Rear .............. Depth ..... , , , , , , , , , . ,...' + = Heig' 1~.w:...........Nu b'erofStories ........................................................ Dime i '~s of sam s re ~it~t alterations or additions: Front ....... Rear .......... . .... . .......... .. Dept ,;.. ~ .~.;...Ileight ......................Number of Stories ..................... . 8. Dime "s of entire new cons ~~}on: Front .:............. Rear ...............Depth . , , , , Heig .. .. t, u t}e~of Stories . ......... ......... ... .......... 9. Size to • ~,o., ........ Rear .... ,~0.~. ~ ........... Depth .. ,~a',1-:... . ........ 10. Date o urchase ......... : . . .......... . . . .... Name of Former Owner ............................ . 12. Does ~ o osed constructhon vi ~emises are situated .. f~ :......................©........... , , , .. , , , , , , , , , P P 'p/late any zoning law, ordinance or regulation: ..,t~ .......................... . 13. Will lot be re raded ..... /.U Q ..................Will excess fill be removed from premises: Yes No S 14. Name of Owner of premises ..,/Yl.•. ~ S! 4~1.~ ~.... Address . /YJ, #~:~; , ,W,,(, , ..Phone No ............... . Name of Architect .... ..Address ... . . . .............Phone No. q Name of Contractor ~.•,/~~,% ~L./S7~f e. N, l A!~ , Address /.S.X .L~~',/.. /~?ft~ ,Phone No.. ~Q ~:: ~~ /,2.. 15.Is this property loc;at~(d.within 300 feet of a tidal wetland? *YES....NO.lrrr-~ *If yes, Southold Torn Trustees Permit may be required. ', PLOT DIAGRAM Locate clearly and distinctly all 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 whether interior or corner lot. ~~..Q.~ ~ ,¢ ~ STATE O ~ ~NORK, e', S.S COUNT ~O (Name •of i~vidu~ig /G ~~ • ~ • ' ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant ~~[~'"// Wing contract) above named. ~..~.~ He is the............ U .ti .~'.~. ............................................................... (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 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 bled therewith. Sworn to before me this ... ... ..........~. ~ ....day of ... .........., 19~~ Notary Public, .... l~fc<~:`:..!l i . f`.':t; .v~ . , ... County ~~ ,/~' NOTARYP BIIC St0eEV0E ~~~k~~~ . , .'~ ;l,' .. ................ . teotNewYork (Signatureofa licant) No. A707878, Suffolk County PP Term Expires PAerch 30,19