HomeMy WebLinkAbout17692-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218181 Date JULY 17, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 1900 NORTH OARWOOD RD. LAUREL
House No. Street Hamlet
County Tax Map No. 1000 Section 127 Block 06 Lot 07
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 12, 1988 pursuant to which
Building Permit No. 176922 dated DEC. 15, 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 2nd FLOOR ADDITION TO AN ERISTING ONE FAMILY DWELLING.
The certificate is issued to MIKE ~ VIRGINIA NEVTT.T.A
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. PENDING SLIP 6/30/89
PLUMBERS CERTIFICATION DATED GEORGE MARTINEIC INC. 7/1/89
V
Building Inspector
Rev. 1/81
FOSM NO. f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
II BUILDING PERMIT
(THIS PE ~ 1T MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
I
N°_ 617692 Z Date ..-J~s~~......1. 19..?3:~
i
Permission is hereby granted to• .
to .~.:~,tu.es.~'...cb,,...,~.a~.~ ..............~2.!=an...Q..n...~ ,5~~.r.-Q~..~.~. ~
1~...
ct premises locoted of ...~.g~.C~......~.k1~4h4~..~.J c}.Y~ ....~.~.......~~.~.s:s.1R~..~..
• ..f 1~.~.n...........
~c ~.,4.c1't~....../1l Q..C.~cII~KR~..... .............t..-...................................... .
Caunty Tax Map No 1000 Section; \.1 c~i 7. Block Q `P..... plat No. .Q~ .
pursuant to apphcaYion dated . I ...~a,?C!'k.Wh....~?r . 19.~fi and approved by the
Buildingg Inspector
Fee l.~ a.:l.`S'....
wilding Inspector
Rev 6/30/80
i
TOWN OF SOUTAOLD
~i BUILDING DEPART2ICNT
TORN HALL
SOUTDOLD, NEW YOE2K 11971
765 - L802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
NEW CONSTRUCTION
...QOLD OAR( PRE-E%IpS,/T/Iy,NG BUILDING.~...VACANT ~LA~N~D........
Location of Propercy...~ L~. _ 1VQ~. _~![C{.,~9d.~.. _..~~~.':'tiS~
.
HOUSE NO. (S~T,REET y, , f ' / UAMLET
Ovaer or Ovners of Property..~~~,,~-:_'l~ ~tFlrl~~..~~CiY.t:
County Taz Map No. 1000 Section Black Lot
. _ Filed Map ........Lot..........
Subdivision~~t.j(./......... ~ ~J
Permit No.1.GlV~~...Date of Permit ...._...._Applicant A.{~{i`t1~,t4:~L?O..'z2~.1~-.R~
Health Dept. Approval Underwriters Approval.:`_~fF~,l]~rC.'_...
Planning Bnatd Approv~,I ~
Request for Tomporary~Certifica[e Final Certificate ..Y
i
Pee Submitted: $
APPLICANT... \,C~IX..~`^'!^:~":`Y1yl~,.~G2
it
37)7
C o 2 / ~1 ~l
rev. IO/I4 /88
it
c1:.LD i•. ,,.t~•_~,~ (Jni I` ~w~tMf.NT~
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FDUt1DATI0N (1st}
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FOU1dDATIO[d ( 2nd ) ~i PC
P.OUGH FRAi•1E ~ ` _ ~ ' ~ o '
PLUMBING ~ '
d, v y
3. m
I17SULATION PER N. Y. y
STATE ENERGY
CODE ~
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3 ~ m
H
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FI;dAL (p
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I ADDITIOPIAL COMMEP7TS: x
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x
ro
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9
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TEL. 765-1802
~oc~vFFQL/~~~`~ TOWN OF SOZTT~Od,n
;Z , 'OFFICE OF BUILDING INSPECTOR
',acT P O. BOX 728
u' TOWN HALL
401 ~ r~~°r SOUTHOLll, N.Y. 11971
C E R T I F I C A T I O N
Date `1V~
it
Bua.lding Permit No t~- Y~-
owner
K~,1-UfRCrfl~6p1' 14F{)lL(..~
(please pryi~n~t)
Plumber (~1Cv'S.( ' 'f/~~F~/~/t''~/
(ple se hint)
I certify that the solder used in the water supply system
contains less thanl2!10 of 1g lead.
I
~
ti-
` i {plumber's signature)
Sworn//~~to before methis
~~day of J /I/F Id~~~c.~~CG~~
19~. ~ cam` Notary Public
Notary Public, -~~~iCO~/~ County
ANM HERBA
' Notary Pub;m, State of Naw York
No 52-E86180C, Suffolk County
i~rm Expuaa March 30, t9
765-1802
BUILDING DEPT.
INSPECTION
I -
[ ] FOUNIDATtON 15T ( ) ROUGH PLBG.
[ ] FOUlHDATION 2ND [ ]INSULATION
[ ] FRAIVIiNG [ FINAL
i
REMARKS:
I
'I
~ I G./~~-~.. _
i
i
DATE ~ ~ 3 INSPECTOR
i
i
l~~
~ ~s~-isoz
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST ROUGH PLBG.
i [l
[ } F LINDA
1710N 2ND ~ }INSULATION
FRAMING [ ]FINAL
REMARKS: ~
_
r--
- ~ _
DATE c~ INSPECTOR
i
7 '7
THE NEW YORK BOARD OF FIRE UNDERWRITERS PA!;E 1
IOOOlLl BUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 70038
Date JULY 21,1989 ApplicatianNo.onjile (0481.'I$9/89 N 082107
THIS CERTIFIES THAT
Doty the alectr4d equipment w deurthed 6ebm and introduced 6y the applicant reamed on the ahoue applicotton numher Jn the premises of
t4ICHAELI NEVILLE, N. OAKWC?OII ROAD, POLEMI.7, LAUREL, N.Y.
rnrn rt~~--~~ ~
in thefollouinq location; L.1 Basement ~ Ixt Fl. L"J Ynd F'I. OiIT .Sertion Block Lot
JUNE .30,1989
uvaa examined on and found to 6e in carnplionee with the reyuirementx of this Berard.
R%TURE ICNTACIES SFt17CNE5 RXTURES RANOES COOKING DECKS OVENS DISH WASNERS EXNAUST FANS
OUTLETS INCANDESCENT~ilD011ESCENi OTNER AMi. K.W. AMT. K.W. MIT. K.W. AMT. K.W. AMT. N.I.
34 40 45 f3 1 1 1.2 6 F
DRYERS illRNACE MOTORS WTURE AMl1ANCl RIDERS SPECIAL REC'IT i1ME CLOCKS !EU UNIT NEATFRS MUlil-OUTIIT plkfMERS
AMT. K. W. Oll N. I. GAS N. P. AMT. NO. A. W. G AMi. AMP. AMT. AMIa. iMNS. AMT. N. P. SYSTYAS AMT. WARS
NO.Of RET
a F z - 4 FoD
fNVKB gSEONNECT NO.OF S E R V 1 C E
AMi. AMP, TYPE plgP 1 / TII i / ]W ] R ]W ] / ~W G~RCACOND. a CC. COND. ~ N4lEG N '~G Na. p NEI1TRAl5 ~ E
TGXAI
1 2ao :.6 1 x 1 2/0 1 110
OTHER APPARATUS:
5 TON A/C UNIT-]
HOTORS:1-1 H.P.
ELEC. WATER HEATERS: :1-4.5 K.W.
G.F.C.I:-5
SNOKE DETECTOR:-4
PAUL R. AURNS t,IC.[~282-E
aryl
275 TOWN HARBOR LANE
SOUTH011G, NY, 11919 ouEHtAE Mduou
11
Per G L
This certificate must not be altered in any manner; return to iM office of the Board if incorrod. Inspectors nlay be identified by [hair credanNals.
COPY FOR BUILDING DEPARTMENT. TNIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
~ BOARD OF HEALTH .
I'i i~""~~ [ 3 SETS OF P~NS .~'.K~....
J FORM NO. t SURVEY
iI11+~ ~ ~ 2~ F TOWN OF SOUTHOLD CHECK .
t ~ BUILDING DEPARTMEIV7 SEPTIC FORM
~1~ ~~.._o._~.,.-,. t
ni'7~ u~FT~ TOWN HALL
TC^° `~~"-t~OtO °OUTHOLD, N.Y 11971 NOTIFY
TEL. 7G5-1802 CALL
p MAIL T0: /d7 ~'"'a~~ kJ
. 5.
tpprovcd . ~m1tu... ~ ~ 19 ~ ~
Pd C[ ~rscytu j~ cf • ~~77
c~-eC>~..W~... ~ . ~ 19~' ~ Permit No. ~.W Ra: ~ V v
D~sapProved a(c .
...............I..
(Bwlding Inspector)
APPLICATION FOR BUILDING PERMiT
Date~.~-, ~..Z:...., 15
INSTRUCTIONS
a. Tlus apphcatton must be completely filled m by typewriter or m ink and submitted to the Building Inspector, wt
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 sty
or areas, and giving a detmled description of layout of property must be drawn on the diagram which Is part of this a
capon.
c. The work covered by ttu$ application may not be commenced before issuance of Building Permit.
d. Upon approval of this apghcahon, the Budding Inspector will issued a Building Perntrt to the apgbcant. Such pe
shall be kept on the premises available for inspection throughout the work.
e. No buildutg shall be occupied or used m whole or m part for any purpose whatever untd a Certificate of Occup:
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmlding Permit pursuant to
Building Zone Ordinance of the. Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance
Regulations, for the construcrign of buildings, additions or alterations, or for removal or demolition, as herein descnl
The agphcant agrees to comply with all applicable laws, ordinances, building co e, housing e, and regulations, any
admit authorized inspectors an premises and in building for necessary inspectians;~
. ~
(Signature of apphcanf, or name, ff a r aeon)
(Mailing address of applicant) 1 1 ~7"Z
State whether applicant is owner, lessee, agent, architect, engineer, eneral contractp~ electrician, plumber or bush
Name of owner of premises . G}1-F~-~ L, , , (.t;~ ,
I~ (as on the tax rotl or latest deed)
If apph a a co or lion. si ature of duly authorized ~ficer.
~
(Name and title of cot orate officer)
Builder's License No(.~.~.p. , 3 a ~ µ :1:
Plumber's License N3.'l :1(~~~~.~~.~-~....:-~-.~G .
Electrician's License No. 1
? U~~, • ~~~,.Lr.~ i
~fL.
I
Other Trade's Luense No . . .
I. Location of land on which pr posed work will be done . .
House Number Street Hamlet
Count Tax \Ia No ]000 Se N
y P ict~on l.~ Black ~ Lot ..L .
I
Subdivision Fled Afap No . Lot
(Name) i
State c~~sUng use and occupancy of premises and intended use and occupancy of proposed construction
a. Eeisung use and occupancy', J. S't0.2,-~ , , , ..~~-`J 1 L1r'_ /.(1 t t~} C--
.Intended use and occu ancy
Re air , t , , - , ~ applicable) New Budding Addition . • • • • • • Alteration .
3. Natpure of wort, chect. rvh1 emoval Demolition 01~'o~lc'........ .
(Dcscnption:
4. Estimated Cost ~~°LQ.~.Q~J . Fee .
(to be paid on filing this apphcauon)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If gara;e, number of cars 0,'I(F- . -
.
6. If business, commercial or edited occupancy, sped y nature and extent of each type of use .
7. Dimensions of ~xistmg structures, if any Front . Rear v......... Depth _3. .
Hcigfit Number of Stones ~ ~,r
Dimenswns of same structute with alterations or additions Front 2 Rear .4/:
Depth .2•. , , , , • . IIeight a. 9.~. , . Number of Stones ~ .
Dimensions of entire new construction. Front Rear Depth .
Hciglit Number of Stones . .
9 Stze of lot Front Rear Depth .
10. Date of Purchase ~ Name of Former Owner .
11. Zone or use district in which premises are situated . .
1?. Does proposed construction,violate any zoning law, ordinance or regulation• ~~(fl .
13. 1Vd1 lot be regraded .will excess fill be removed from premises' Yes
14. Name of Owner of remises ....................Address I one No. .
Name of Architect ~ ~~'~'.~pp~ l~(TAk<'t~ AddressG~ ~i.}IJ4'kE-~ J~~tUt,,t~~ No. ~z~.'.`~`f.~~.. .
Name of Contractor . .a.~r.~. luG.... ,Address l~7. Sc;h}f~(,LK,~Q; ,~°A~C7kt'khone No.I~,~S:-6..~( .
IS.Is this property lgcated within 300 feet of a tidal wetland? *YES....NO....
*If yes, Southold Tgwn Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly' all buildings, whether existing or proposed, and indicate all set-back dunensions fro
property fines. Give street and block number or descnpUon according to deed, and show street names and indicate wheth
mtenor or corner lot. i
it
~ -
I
STATE OF NEN YORK, i S.S
COUNTY OF .
• • • • • • • • - - • - • • • • • • ~ • • • • bang duly sworn, deposes and says that he is the apphca;
(Name of individual si,nmg contract)
above named
Ile istlie
it (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is daily authonzed to perform or have performed the said work and to make and file tP
application, [hat all statements cogtained m this application arc true to the best of his l.nowtedge and belief, and that tl
work will be performed in the manner set forth m tlic apphcauon facd therewith
Swom to before me this ~
/,a. ...day of ...../ti1 f.-C.-.......... , 19 rf. Cp
o~ ~ ,n
Rotary Public, ......fiFC-.~~ • •~!¢'•~•/d'•~• • • • • County
K DE YDE .
HELEN
~N~767878,S~uflolACaun~1~9 ( ature of applicar
Term Ezwres Maich 39,19