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HomeMy WebLinkAbout17241-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217360 Date SEPT. 28, 1988 THIS CERTIFIES that the building ADDITION Location of Property 900 HOLBROOK LANE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 06 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SLILY 13 1988 pursuant to which Building Permit No. 172412 dated SLILY 20, 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 DECK ADDITION TO AN EXISTING DWELLING. The certificate is issued to GERALD & SUDITH WOOD (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 xoaa>< xa a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUU.DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ O1.72lt~ Z Date 19.g~ Permission is hereby granted to: 1 fir- ..~..~>:Ik:p....~.:y..:...I.,...~%qs:z........ (I nI~!^q ta ...L~.~"'isaUl.".~.~...~~r........Ga.kK.P.~-~'t-an...:.~.....q-!!?....1:~~'~r!'~G)...tll:.!'u?'Gf S ct PremisuesYY located ot ....7.R1~......!`1...°."'Gf'".K!!:°:!5.....Q~~.:!:~,.:.....:1 ~...J. ~"^w`, County Tox Map No. 1000 Section .......1 Block Lot No......~I... pursuant to application dated .........~I.ALA.~:t~...~.~ 19~~.., and approved by the Building~~^^I~~nspector. / Fee $..NJ(J..:.. Building Inspector Rev. 6/30/80 p ~ ~ ~ 7''~ ? FORM NO, 6 ~1 ccci,G~„ f TOWN OF SOUTHOLD Building Department BLDG. DEF'T'. Town Hall TOWN OF SOUTHOID Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted a-~~ to the Building Inspec- torwith the following; for new buildings or new use: 1. Final survey ofi 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- ~ tions, 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 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, or other pertinent informa- tion required to prepare a certificate. C. Fees: dditions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwe ino 25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10.00 4. Vacant Land C.O. $ 20.00 a~ 5. Undated C.O. $ 50.00 Date f~~ NewConstruction,,,,,,01dorPre-existin/g~Building Vacant Land Location of Property ~~a...........~/, G~?~if~Q©. lv~~.~'.........d.~Z/,-;?~:' ~'`.'`.'c~-' House No. Street, p Hamlet Owner or Owners of Property ..~~':~~~-1.~... G~G~ f~!:'7^-....~~Q.Q . County Tax Map No. 1000 Section Block Lot l G~ . Subdivisionl.--.77.../.// .........................Filed Map No. .........cOLot No. . Permit N~ 1../.4? 7.J. Date of Permit ~f~/..Applicant ~4 ~!t!;~(. ,z~-r,.F~.~-; ;~ykq , -e,r . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval . ...Planning Board Approval , , . Request for Temporary Certificate .....................Final Certificate . r Fee Submitted $ . ~ Construction on above described building and permit meets all applicable codesrand re"g~u-l~a-t-icolns.~ , , Applicant..... ~-„~',.,~,-'::-:..lr,~:.1.(4--""'i......... Rev. 10-10-7B 3503 ~ U, Z/ `~36c ~~~FQ~ ~ TEL.7G5-180? , ~~`k`~oG~:~ TO~~N OF SOi3TIIOLD L£:~a~.,k, ~ OI~PICL OP BUILDING INSPECTOR ~ ,rf®, . , ~~s~ z P.O. BOY 728 ~ TONN HALL t' SOUTHOLD, N.Y. 11971 To Whom This May Concern, ' We are unable to complete your Certificate of Occupancy because ,of the following reasons. An application for Certificate of Occupancy in not on file. / / No Underwriters Certificate on file, The check is (outdated of on fi1~1._y No Itealt}i Dept. Approval on file. No final i.nspecCion has been made. Please contact our office on this matter. 't'hank you for your cooperat(i~on. 13uildi.nr} Permit If L ~ ~ ! L Z Uu.ilding Dcpt. No Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after April 1,19II4 1 r-r-~-~.o-o~ .r' : l~a~j ~~Q~a :'Ir:LD it:SPEC;IUIJ ((UAiE ~ SOhiMENT° _ 1 t. ~ ~ H H ~ FOUNDATION ( 1st ) o ~ FOUNDATION (2nd) ~ - z .O o ~;OUGH FRAME & PLUMBING H 3 , xi ~ ~o m y I1ISULATIOAI PER N. Y. STATE ENERGY CODE x 4. FZiJAL ~y~ o 1!b ADDITIOPdAL COMMENTS: x 4b m ' x .ti . H ~.Y ~ ~ H H O z a . ~ r~ A H T S d m v H O ~ ~ 1`- 6' l/air ~'~sr ..r.?? i~..+'~! 'rte i~ ' i ~ ~ ; ~~x ~ ~ , o Y c` N C~ R x ~ d fR G• 1~' ~ n ~ ~ R' 6'~uT ~ ~ ~ ~ n ~~.o~ mW/~~,'~'~~ ;iy ~ ~ ~ C J i ~ 1~ ~ In i fi` o to ~ ~ ~ _ ``-r. _n W ~ 1 ~ ~ i~ i~ b ~ 1 I ~ ~.r 7! Si/I 7 SZ ~ 7~ f~ ~v C> tlf -i ~ ~ca n~ Y+ ~ i+ O ~ . i mb"~*r Ja~O^" D ~ i~ ~ ~mmmr^'~2mp OqN Tim m 1 3~`~ nmopr 2?O~ vx, ~ O O a Z.3 rD X 0 0 2 t 'o Oy~yp t p~~~~~nzT~aai~~1 m ~ I ~s C'S °-1 C C i I C9~~'!! ~ ~ nC ~ ,oD xc a I itl '~~C70 y~'~,~~ 1 p 4 m~i~l- ~ ' Iv kl' r Ibi ~ ~ . 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION [ ]FRAMING. [ FINAL j REMARKS: E f f DATE ~ 7 ~ INSPECTOR i , f . BOARD OF HEALTH 3 SETS OF PLANS ?r FORMN0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORP1 TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY 7EL.:765-1802 CALL Examined ..~.~-~+j. 19 ~.g MA I, Tq,; . ~~q Approved...~~?,-~..,19~g.PennitNo..I.~o?.3.~.~-. ~JI lJ,~~A{t~r~ rjf ~;`~Id DisapprovedaJc °r !1 . ~ 1 UL ! 3138 ! ~r rows ~F ~ Motu ~t (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . ~.1 IS~~z INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, acctirate 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 re lotions, and to admit authorized inspectors on gremises and in budding For necessa ns ections. - igtZattue of applic or name, if a corporation) ' (Mailing ddre of applicant} State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..............................\..t.................,..............,..........,.............,..... Name of owner of premises ,V.(7.L"1~ L h v~ ~ t~ o y (as on the tax roll or latest deed) ill If applicant is a corporation, signature of duly authorized officer. ~I {Name and title of ~~ctlorp``orate/officer) Builder's License No. ~ °~~..7..7 .r0.:: , • Plumber's License No . . . Electrician's License No . . . Other Trade's License No . . . I, Location of land on which proposed work will be done . . . • PUf ~o.~L~' , t Q Np.j brRG ~ ~-a . ...M.Qf~i:t~G~ ~ . House Number ~ Street Hamlet Count Tax )v1a No. 1000 SeCUO? ~ Y p f'.I 3 , . , . Black Lot Subdivision Filed htap No. Lot , . (N;nne) , State existing use and occupancy of premises and intended use and occupancy of proposed construction: a• Existing use and occupancy ~.rl~.~•e-• • • • • • ~9'?'• AL,e; !~~Jkn, ayl.... b.In[endeduseand occupancy / d 3. Napure of worn (check wh1R moval ble): New Building , , • • • Addition .'L(E.G' Alteration Re air , , • Dematition ~ • • • • • • ~ • ' Other 1Vork . 4. Estimated Cost . ~ (Description) .....~~.~D~.;C?.~ Fee 5. If dwellin number of dwelling unit ~t tto be paid on 61ing this application) g' s • • • • • • • 7r Number of dwelling units an each Roor . If garage, number of cars • 6, If business, commercial or mixedoc~~••~•~••••••~••••~••••••""'•""""""" cupancy, specify nature and extent of each type of use , , . • , , , • , • • 7. Dimensions of existing structures, if any: Front , , Rcar Height . Numberjof Stories . ' • • Depth , . nl ~ ~ ~ Di P ensions of a e sttircturc with ~Itcrations or additions: Front , • • ' ' ' • • " Dc th . Icight . Rcar . 8. Dimensions of entire new construction: Front , ] ' ' ' ' ' ' NZny13 ~ogf,~t i~fius+av. , , • , • • • ~3. fl.•~,'... Rear 'L ,!n Height ~ Q," Nurriber,; of Stories lt!~!+3!L~; . •t` n• w~•_+~~.t Dep~~ . . 9. Size of lot: Front .1.dl.~.9.~? ~ Rear yS":... , . 10. Date of Purchase ~ • • • • • • • • • • . Depth 3. . Name of Former Owner r........... 11. Zone or use district in which premises are situated . •~p:1."'TI.T.V4 jC•• • ' ' ' • • • • • 12. Does proposed construction violate any zoning law, ordinance or regulation: • ~ • ~ • • ~ • 13. Hill lot be regiaded . ~0, will excess fill be removed from premises: Ycs o ,Y 14. Name of Owner of premises~u~~~ .u • . ~ yN... ~o°!! Address~~~-',/.S'~, ~,~J9y41{.e,.ePhone No. ~r?•~:^ s?••~;~ Name of Architect ~ / ,Address Name of Contractor ..SaR~tl •$•ho,~r~, e ' • • • • • hone No. , .~v. CJ.. ,Address poLio.Y. J9a!r .~?%~~~b~hone N ~?r?; -.Sr7.F':S'. • 15.Is this property located within~00 feet of a tidal wetland? CS ...NO.... *If yes, Southold Town ~rustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property fines. Give street and block number or description according to deed, and show street names and indicate whether Interior or corner lot. ~ ""f i STATE OF NEw O ~ S ...'nit r • ~ • ~ ~ • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (1\amc of individual sip '~g contract) a ve named. Itcisthe...,.,..~WN•2,/e.. (Contractor, agent, corporate officer, etc.) ~ • • • • • • • • ' ' of said ownor or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements conta}ned in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manners set fordt in the application Glcd therewith. Sworn to before me this ......dayof!. ,19~~ tiotary Public,`1 , ,a~. J~-/.:. . 7Ki1 County KATHLEEN D, KOTZKY UvCI~J r~ NOTARY PUELIC, 51ete of NeW York ' ' (((///~~~~~~~w/// No. IE@181 (Slgna[UIC of applicant) Oudifi~d In SuP}Qlik ~o~oty ~ Cemmlylon /rgllp July="$t~i ltrp}t I HOLBROOK LANF_ ~ f¢nc¢ / ~ fd mon. O.SN~ N. 81'03~OO~E ~ FC 0 0 E 101 90~ 267 73 id R ~ fd mon ~ mon R f¢nc¢ 1 0 2N Il Y. a `~-2 3 E 8.6~W 0 Ic o d t, Ic.., m ~ m Q ~ ~ nnea n ~ ~ [+l T E- ~ Di 3 - ~ IL I ~ I?-1 7E ro i O _ D,~ ~-O.OE ~ FC 03 E ~ ~ a I 0.0IE rou °'(I 4x4 /,~N"~I out hous¢ Q garag¢ ~ 3.6 W' ~ w d] ~ ~ /a,`' 2 7 E w O • J 20., Q w ~ J ' ~ -25 4- „~E~~ ~ " m ~a I ~ - w O N ,V ~,q i m RA ~ ~ ~ _ ]5.0 O ~ ~ l ~~al n i o N 33 w o z ~ ~ z N ?cobosr~ ' , In N ~ ~~,'C.W I a~ Z i In fd PIP¢ ~ ~ fd plp¢ II ti¢ I in¢ S 78 01 ~ 27 W. ~ 8 4. 4 5 aPProxlmat¢ high wat¢r Iln¢ The eri~tence of 1•n~gisf,ow nyare not ~;uaranteedMAT T I TUC K C R E E K of record, If any, c HOWARDS BRANCH ) JOB N0. 88-277 FILE N0. 541-F THE OFFSETS (OR [ IIIFn!SI@!5) GlIA5nN1EES INDICATED HEREON sHOwN HEREON TV.E !I-.u! RVN ONLY 10 THE PERSON SURVEYED FOR JUDITH LYNN WOOD STRUCTURES TO IS• - ';Y THE SURVEY IS PRE. I t'i' 1' +~~P Cry HIS BEMAIF TO iF AND C9C A'•:r 'f. :•^.',y.AN'!, GO`rRNMEN- NOi INTE:.Drq iJ 'i ::Y A::D ICNDING INST4 C11GN Of FNLCf A, i...lr.• ~ Ia:'D ?IkREON, AND TO 'A5, F•'JCTIS, Rf.i05, ~'1::. ;~:i: P:^G OF LFIG (ENDING PAS, ADDIiIGN TO EU!i>RiOS ,il l~~~•Pia. GUARA NTF{5 ARE AWY OTHER CONSYRUCTION. ps.N:f'•FFvF TO ADDIDONAI SITUATED AT MAiTITUCK r~~ 1•'!TIC^:5 OR SUBSEQUENT AUTHORIZED ALTERATION OR U'AMi~s ~InoN To THIS sur[v{Y IE n TOWN OF SOUTHOLD -SUFFOLK COUNTY - N Y [ATION OF SECTION ]309 r{ COP@S OF THIS SURVEY MAP NOT NEW YORK STATE EDUCAi1CN BEARING TIIF LAND SURVEYOR'S SCALE 1" = 40~ DATE 6-7-1988 Y. INKED SEAL OR EMBOSSED SEAL SHALL NOI BE CONSIDERED TO BE :UARANTEED ONLt'"-7'O""~- FILED MAP N0. DATE VUIfH _fNN~`N100D~-~-.._ TAX MAP 1000-113-6-11 DISK 3". ~ 'i iARTFORD ,°UybIF:G c7-fj .HAROLD F. TRANCNON 1R. P.C. I ~ LAND SURVEYOR ^JTRACOAS~Ga~ AFjS~RACi`~CCd -:INC ; - SUCCESSOR TO WILLIAM G METER / - NORTH COUNTRY"ROAD - WADING RIVER ~~~n .,JcK•.f f~`t~2.~~~ X,r~+. ~ NEW YORK 11792 ' fAROLD F. TRANCHON JR, ~ ~ LTC. NO. OA8992 (516) 929.4695 PENN. LTC. NO. 21115-E