HomeMy WebLinkAbout17149-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217772 Date FEB. 17, 1989
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 3950 CAMP MINEOLA RD. MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block OS Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 14, 1988 pursuant to which
Building Permit No. 171492 dated JUNE 24, 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 RENOVATE AND ADD TO AN EXISTING ONE FAMILY DWELLING.
The certificate is issued to DR. & MRS. HERB GROSS
(owner, )
of the aforesaid building.
SOFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. PENDING SLIP 2/6/89
PLUMBERS CERTIFICATION DATED MATTITUCK PLUMBING 2/2/89
Building Inspector
Rev. 1/81
~p~~~ y~y~-/~~
FORM NO. ! " ~ """"`~Q'
TOWN OP SOUTHOLD hElf~-GC.
BUILDING DEPARTMENT 0~ ~.Q~,,~_
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Nfl 017149 Z Date ..........~.~rv!.'1~:......°~.~........., 19.D..~
Permission is hereby grouted to:
C
at premises located at ...~9.~~...1..4~M/p....1.I~.,Ler.~t.~K~..VS-'id...........~.~
County Tox Map No. 1000 Section Block ......Q.~........ Lot No.....~.4
pursuant to application doted ........~t...l~l.........f'.~ 19.~'.~'.., and opproved by the
Building Inspectar. if
i /
Fee $...~..ZJ.:.aS..
~ ~.f~
wilding Inspector
Rev. 6/30/80
FORM N0. 6
TOWN OF SOUTHOLD I ~
Building Department ~ ~ ~EB 3 ~0,~9 I';
Town Hall ~~ly? {r~,t
Southold, N.Y. 11971 !S ° rn~ L~ .uE.r f:
gg ~pd~'`1 iJl~ 5'r;Sl'!'P°9C1LC3
APPLICATION FOR CERTIFICATE OF OCG'l~P~l'dO~"""""""`°"-"°°""""""
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 installs-
, lions, a certificate of Code compliance from 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 peoperty 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, or other pertinent informs-
- lion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date _ . , ,
New Building .............Old orPre-existing Building(X) : _X.__.__-s Vacant Land ,
Location of Pro ert 3950 Camp Miniola. Rd.....:... Mattituckr. N;~X;
p Y .
House No.' Street Hamlet
Owner or Owners of Property , Dr.. & Mrs. 1~erJ~-.Gross
County Tax Map No. 1000 Section ...123........ Block 05 Lot 19 .
Subdivision .................................Filed Map No. ..:.......Lot No. .
Permit No.017149 , , , Date of Permit 624(88. ,Applicant Donald. A,...Denis a A. I, :A. .
Health Dept. Approval . .....................Labor Dept. Approval .
Underwriters Approval . ................Planning Board Approval • .
Request for Temporary Certificate .....................Final Certificate ..X.....-......... -
Fee Submitted $ 1.5.00
Construction on above described building and permiCmeets all appl{cabl~odes and regulations.
Applicant . - StanleYr Fliss Jr.
Rev. 10-70-78 ~ ,((J
` -
~t
~~j 7
TEL. 765-1802
~p~~Ff ~~CpO TOWN OF SOUTHOLD
y~c OFFICE OF BUILDING INSPECTOR
~ P.O. BOX 728
v' ~ TOWN HALL
"O,y~~ ~ ~~0~ SOUTHOLD, N.Y. 11971
''~yll l
C E R T I F I C A T I O N
Date
Building Permit No. /t-t~`LZ-
Owner /Y/r„ ~!'S ~7pV*b ~rOSg
(please print) I
Plumber ~ 'v -',,;„4-}''teo,-~" l..,oc~
(please print)
I
I certify that the solder used in the water supply system
contains less than 2J10 of 1~ lead.
I
_ ~
i°
(plumber's si ature)
Sworn to before me this
~C(9d/-~,,~day ofC_~~~~ ~
- - .~~_~e~~-~.~
19~• Notary, ub 'c
Notary Public, ounty FPiT~ oTi9e,~son/
Notay t'atr3lac,Sl~lfcvr i'orer
Flo. 4920758
QualiViad in $uNolk County
Tarm Expiraa reb.16,1990
FIELD INSPECTION DATE I COMMEN'1'~ !,ti
1. Z~ ~ ~
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_ FOUNDATION (1st) 2
~ _ i dL~..tAtitsacP
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FOUNDATION (2 d) a ~
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ROUGH FRAME ~"'""'i'~'' ~N~~~ ~
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INSULATION PER N. Y. .3
STATE ENERGY
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ADDITIONAL CO ENTS: ~ K
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( J ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING (~INAL
REMARKS: O1~
r.S~. ~
,p~ `S/
DATE d~ U INSPECTOR
17/
rss-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST ( } ROUGH PLBG.
[ }FOUNDATION 2ND [ ]/INSULATION
[ ]FRAMING [?J FINAL
.
REMARKS. ~~ti~ ~
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1.~..( w
Y
DATE ~ a ~ 6 INSPECTOR
III
`~~1~~-~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [vY~NSULATION
[ I FRAMING [)FINAL
REMARKS: ~ i ~ ~
DATE Z INSPECTOR ~
/7/x'9
765-1802
BUILDING DEPT.
[ ]FOUNDATION 15T [ ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[)FRAMING [ ]FINAL
REMARKS:
i
DATE ~ 3~~INSPECTOR
f
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l
765-1802
BUILDING DEPT.
INSPECTI~JN
[)FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[~RAMING [ ]FINAL
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i REMARKS: _ ~
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k DA7`E ~ INSPECTOR
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765-1802
BUILDING DEPT.
INSPECTIAN
[FOUNDATION 1ST [ ] ROUGH PLBG.
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[FOUNDATION 2ND [ ]INSULATION
[ J FRAMING [ ]FINAL
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REMARKSg/!~
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F DATE ~Z G~~INSPECTOR~_
151 81 7 2 23 51 1
TELEPHONE
DONALD A. DENTS A.I.A.. P.C.
ARCHITECT
AOUEBOGUE SOUARE~RTE 25
P.O BOX 565
AOUEBOGUE, N.Y. 7 1931
DONALD A. DENTS, A.I.A.
FREDERICK R. WEBER. R.A.
June 28, 1988
Sirs:
These drawings were sent to our office along with the Building
Permit for the Gross Residence. We ask that you send us the
correct set of drawings for this project; the ones enclosed are
not ours.
Thank you.
D. Denis
June 29, 1988
Dear Mr. Denis:
Enclosed please find the plans for the Gross residence.
We are sorry that the wrong plans were sent to you in error.
Building Department `
DONALD A. DENIS, A.I.A., P.C. °l~i O~ I! QQ~~~~~~Q~
P.O. Box 565
AQUEBOGUE, NEW YORK 11931
June 20, 1888 JOe8 8
(516) 722-3511 ATTENTION
Building Inspector
TO Southold Town Building Department MRenovations to GROSS Residence
Main Road
Southold, New York 11871
_ WE ARE SENDING YOU Attached ? Under separate cover via_ the following items:
? Shop drawings ? Prints ? Plans ? Samples ? Specifications
? Copy of letter ? Change order ?
COPIES DATE NO. DESCRIPTION
3 Construction Drawi s 1 thro
2 Surve s w/House lotted thereon
1 Buildi Permit A lication
'x'~PLEASE ADVISE THE AMOUNT DUE FOR THE BUILDING PERMIT
WE WILL INID'IEDIATELY SEND A CHECK FOR SAID AMOUNT.'x~'
THESE ARE TRANSMITTED as checked below:
? For approval ? Approved as submitted ? Resubmit copies for approval
? For your use ? Approved as noted ? Submit copies for distribution
? As requested ? Returned for corrections ? Return corrected prints
? For review and comment ?
? FOR BIDS DUE 19 ? PRINTS RETURNED AFTER LOAN TO US
REMARKS _
COPY TO
SIGNED:
PPOWCI1103 ®Inc, GMm,Md 01111 If e~losurea are not as noted, kindly noNty ua at once.
Memorandum from .
BUILDING INSPECTOR'S OFFICE
TOWN OF SOUTHOLD
TOWN HALL, $OUTHOLD, N. Y. 11971
765-1802
6/14/88
~ Dear Mr. Denis:
We are returning your paperwork for
Gross. It is incomplete. You need to
fill in the estimated cost and we also
need to know the builder,plumbe~ryy and
electrician's license numbers. 'We need
a survey of the property showing where the
~ house is located and where any changes or
additions are going to be. Finally we
need a blank check payable to "Town of
Southold". Your application will be pro-
cessed upon receipt of your completed
paperwork. Thank you for your cooperation
in this matter.
Bldg. Dept.
'key 'I F' ~-s,
s ~ i 1
L t,:.. E:: tx., i~ sue.
suc~ g s 1988
DONALD A. DENTS, A.I.A.
(5161722-3511
TELEPHONE
DONALD A. DENIS A.I.A., P.C.
ARCHITECT
ApUEBOGUE SpUARE-RTE 25
P,O. BOX 585
AOUEBOGUE. N Y. 1 1931
DONALD A. DENIS, A.I.A.
FREDERICK R. WEBER, R.A.
s0~
September 27, 1988- ~d,
Building Department D ~
~ ~ 11~
Town of Southold ~°N!s- p
Main Road ~ SEp 29 J~
Southold, New York 11971 ~ U
Re: Renovations/Addition to Reside 7oW~j~'o~ ~
of DR. & MRS. HERBERT GROSS Dr•SOUrt~iacD
Building Permit No. 017149
Dear Sirs:
Enclosed please find one set of Drawings on the above
captioned project. The following changes to the same have been
made:
(1) We have doubled up on every other existing floor joist on
both sides of existing house.
(2) The tray ceiling in the Great Room has been deleted due to
framing difficulties with the existing structure. We are
leaving the existing ceiling beams and trussing them to
existing roof structure.
Very truly yours,
DONALD A. DENIS, A.I.A., P.C.
'x~~~'~,C''.
STEFAN KARL
SK/lv
Encls.
cc: Dr. & Mrs. Herbert Gross
(w/set of Drawings)
cc: Stanley Fliss, Jr., Contractor
(w/set of Drawings)
_ ~E~~ EVV YORK BOARD OF FIRE UNDERWRITERS '
i Oi7 `P y b BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
N'i<:Uftilt4kv ;'s'! , t91t4 5K'tA 516~i ftr9/8;t Fd Oti ~h =„It 3
Date Apylication No. on file `
THIS CERTIFIES THAT Er f~,d M11,~~i~ I)1 ~i I4`~
only the electrical equipment as described below and iro[roduced 6y the applicant raomed on the above application number in the premises of
t[r:r23YS;9~ attar.,. It~;,rti;~; nT~r,,. 1`~E:I:+•t~;, F'+.a't"l;l°riil"~_ 1~.~~
in the ollowin location• ~y f51'I~ _
f p v~µ;F)~{tla~/B}xRrrFlent LJ lst F'l. ? 2nd F'l. Section Block Lot
uws examined on and found to be en cornplianee with the requireneents q(this Roard. ~
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DI'aH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER PMT. K.W. AMi K W. AMT. KW AMi K.W. AMi. H P
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT NFATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT K, W Oll H. P. GAS H P AMT. NO, q. W. G. AMi. AMP AMi AMPS. TRANS. AMi H. P NO. OF FEET AMi. WATTS
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SERVICE DISCONNECT NO.OF S E R V I C E
AMi AMP. TYPE METER ~ 1W t % JW 3 S, W 9 dW NO.OF CC COND A. W. G. NO. OF HI~IEG A W G NO OF NEUTRALS A. W G
EQUIP. PFR .e OF CC.COND. OF HI-LEG OF NEUTRAL
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OTHER APPARATUS:
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This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their crede tials.
COPY3FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST,NOT BE ALTERED IN ANY MANPIER.
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-
FORM NO. t
TOWN OF SOUTHOLD•-~'~~-•=-..~
' BUILDING DEPARTMENT D
TOWN HALL YfllV ~ Q ~9~~
SOUTHOLD, N.Y. 11971
~ TEL.: 705-1802 BLDG. DES't'-'"'~
TOWN OF SQ~UiI-fOLb
Examined 19 Receive . , 19.. .
Approved AA.c??.e 19 ~.8 Pennit No. ~ g .
Disapproved a/c
..f'~~..~~...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .April 19, 1988 19
INS"I'[iUCT10NS
a. This application Hurst 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 givhrg a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
a 'lire work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building hrspector 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 oC 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.
DONALD A. DENIS, A.I.A.
(Signature of applicant, or name, if a corporation)
P.O. Box 565, Aquebogue, NY 11931
(Mailing address of applicant)
State whether applicart is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Architect for Owner
Name of owner of premises Ilerbert Gross
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
N/A
(Name and title of corporate officer)
Builder's License No. 12,985HI (Stanley Fliss, Jr. )
Plumber's License No. 2366 (Mattituck Plumbing)
Electrician's License No. ,1227E (Glen Bradleyl
Other Trade's License No. 85 . . (George Taylor, Mason)
1. Location of land on wl»clt proposed work will be done . .
39s"v Camp Mineola Road Mattituck
House Number Street Hamlet
County Tax Map No. 1000 Section ....123........... Block ....5 Lot 19 .
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 anJ occupancy , , , One Family Residence
b. Intended use and occupancy , , ,SAM]; '
3. Nature of work (check wlciclc applicable): New Building Addition X...... Alteration X , .
Repaid Removal . , Demolition Other Work .
(Description)
4. Estimated Cost 35 , 000 , , , , , , Fee .
~ (to be paid on filing this application)
Single Family Residence
S. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage, number of cars 1 ,Car .Detached . . . . . . . . .
6. [f business, cotntnercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front 52.1 (total ,Rear , 52.1, (total Depth 36.2 (total )
Height 1$ . ~ ayg s )....Number of Stories . ON>;„(,1,) .
Dimensions of same stnwture with alterations or additions: Front 52.1 (total , , , , Rear .52.1. (total
Depth .55.53, (total), , , , , , , ,height ~$..(ayg,), , , , , , , , , , , , , Number of Stories . S1D71;. S1).......... .
8. Dimensions of entire new construction: Front . Rear , , .........Depth .
}}eight Number of Stories , g • .
9. Size of lot: Front , .100.', , , , , , Rear 100' (avg , , , , Deptlr 154' ~ (av )
10. Date of Purchase February, 7:981 , , , , , ,Name of Former Owner Ann Phillips
11. Zone or use district in which premises are situated ...".A", Residential, - Agricultural.
12. Does proposed construction violate any zoning law, ordinance or regulation: YES -Front yd., ~ portico addition
13. Will lot be regraded , , YFS (x;eax;), , , , , , , , , , , ,Will excess fill be removed from premises: ]0@F No
14. Name of Owner of premisesllerhert, Gr;gss , , , , , , ,Address Sutton, Pl : ~ NYrNYphone No212-421-6877/516-298
Name of Architect I)ONAID A. I)l~IIS , . , , , , , , ,Address 1'n13, 5ti5t Aquelx>gue phone No,7L2-351 ] 9105
Sl'ANI,L;Y F'f.ISS 565 O)cl Main V~cl. , ,phone No.29$-.890
Name of Contractor ..........................Address , , , , .
MatLiLuck;'t7Y'~~~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, wlcetlcer existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block nwnber or description according to deed, and show street names and indicate whether
interior or corner lot.
TATE OF NEW YSt~~,OLK S.S
'OUNTY OF .
DONALD A. DENIS , , , , being duly-sworn; deposes and says drat he is the applicant
(Name of individual signing contract)
uove named.
'e is the ..................ARC}iITECT...........,................................................
!or (Contractor, agent, corporate officer, etc,)
f said owner or owners, and is duly authorized to perform or have perfornred the said work and to make and file this
~plication; tlcat all statements contained in this application are tnie to the best of his knowledge and belief; and that the
ork will be performed in the manner set forth in the application filed therewith.
worn to before me this
........25th..........day of.....9pri1..........,1988 /
rtary Pyblic, , , , ; , , , , , , ,SUFFOLK , , County
w~~l. t(.~. ~ C~~I(~(•.I ~1~.".~'i i.' 1
LINDA S. 1rOLLMOELLER
Notary Public -State of New York DONALD A. DENIS (Signature of applicant)
Suffolk County - No. 4923702
j Term Expires April 4, 1990