HomeMy WebLinkAbout17258-z fz.rr:,aar�
OfFBLTown of Southold 12/22/2020
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 18276 Date: 8/14/1989
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 175 First Street, Laurel
SCTM#: 473889 Sec/Block/Lot: 126.-10-9.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/14/1988 pursuant to which Building Permit No. 17258 dated 7/21/1988
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:
one family dwelling with attached garage as applied for.
12/22/2020 Corrected for Suffolk County Tax Map number only.
The certificate is issued to Williams Jr.,Jeffery
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-61 7/31/1989
ELECTRICAL CERTIFICATE NO. N-089991 9/1/1989
PLUMBERS CERTIFICATION DATED 6/13/1989 n K KK Pl mg&Hffting
Aut ature
s
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 2-18276 Date AUGUST 14, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 175 FIRST STREET LAUREL N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 26 Block 10 Lot 009
Subdivision M/o Ppty G.Tuthill Filed Map No. 861 Lot No. 97 & 98
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 14, 1988 pursuant to which
Building Permit No. 17258-Z dated JULY 21, 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 ONE FAMILY DWELLING WITB ATTACHED GARAGE AS APPLIED FOR.
The certificate is issued to THOMAS & JOANNE KRAEBEL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-6I-JULY 31, 1989
UNDERWRITERS CERTIFICATE NO. PENDING - AUGUST 14, 1989
PLUMBERS CERTIFICATION DATED JUNE 13, 1989-K & K PLUMBING & HEATING
Building Inspector
Rev. 1/81
Foeas xo. a
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 4 ~ 7 2 IJ ~ Z Date 19. ~G!
Permission is
he`~anted to: E ~
l
. .............~o.....................
to .t%~C1s'~;~'r(+:~...GZ.........,. .'.-(...u~-.....1e2~~?%':~~~t~....~lu~j•••••.-~
Gtd • G U
. .
.
of premises located ot ......1.~i„l............C!l~7y.......4.
............................................~C.~...........................................................................................
County Tox Map No. 1000 Section ~v~.t..~ry.... Block Lot No........../...!./........
pursuant to application doted 19.01.
~ and approved by the
Building Inspector.
Fee $...~t!..`~.
~~:~7j But~Inspector
Rev. 6/30/80
.
TOWN OF SOUTHOLD n ~ ja Fi' n r"~'~'"`-~--~(
U v L5 '1 Ip~ ~ ~ I
BUILDING DEPART?tENT ~
TOWN HALL d'yOy r
SOUTIIOLD, NEW YORK 11971 ~"`"~1
765 - 1802 TOW~LDO'DEP7;
OFSOUTHOLD
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
/ DATE... ~/~.~~g.....
NEW CONSTRUCTION ._.~.//.-.7OLD OR P~R;E-E%ISTING BUILDING......VACANT LAND..._._..
Location of Property. ~.J.t7^..,!,'r-`%'~„~~+`~~-~~~__._...._L.C1Vr.-~~,.
HOUSE NyO'y.) STREET HAMLET
Owner or Owners of Propertyl:7'Ir.°~./.7'?~s „ ~~7(13`~R~..~~i Lo
//n- l~ q
County Taa Map No. 1000 Section ~Y:.. Block Lot L>.Q!Q,Q~
Subdivision....2~.-'-''-y,,,,,,,,,,,,,,, Filed Map ........Lot.~.7
. r
Permit No./l.a~~~'...Date of Permit 7~~~/~?p,,,Applicant :-J~yl~;~~~~°°
Health Dept. Approval .~J~~/`;/,,,,,,,,,, Underwriters Approval
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted:
APPLICANT f.- . = : = : ~~1C~Q.~Q~
J
re°• 0/14/88
CO ~ ig~ ~(v
~~~~0~ C TEL. 765-1802
O O _
To~~rr or so~r~~oa,~
; OFFICE OF BUILDII4G INSPECTOR D -„I ~
m P.O. BOX 728 ~ ~ ~
`r,,. ~ :E~ ~r TONN HALL .~J~ Z 3 I~~!;
~r~i~9 ,~~j~- SOUTHOLD, N.Y. 11971 3
towfk~ caH c>R;
C E R T I F I C A T I O N
Date ~l ~ ~ b~ ~
Building Permit N\o,~. o L
Owner O.-e `.~2~
(please print)
Plumber ~ ~ ~~vm~~ Q~~ ,p
(please print) "~S~_ e
I certify that the solder used in the water supply system
contains less than 2/10 of 1B lead.
- (plumber's signature) ,
Swo r~, to befor me this
p~day of~7~ T
19 ~J ~ ~ ~ L
N taLy Public
Notary Public, County
In~BuK
~t~1D~~~
'Mm F~N?MJrm. 81,1Aj0
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THE NEW YORK BOARD OF FIRE UNDERWRITERS ,-.,'':,`;v: ,f
9't1D!7J('Fi I~~-1(~~ ~ ' BUREAU OF ELECTRIGTY
B5 JOHN STREET, NEW YORK, NEW YORK 10038
°K;t"C~;~P~(it%R u1,1,~t~L3 r~776#SS91R~3 IJ ~iS9?~~7.
Date Applicatian No. on file
THIS CERTIFIES THAT
only the electrical equipment oa deacrihed 6ebte and introduced 6y the applicant Homed on the shove application numher in the premises of
'r~a:>l~s rtRarsHna+. ~la~x ~.vk,l'fzr~, r r~fL'r':# rAS°T~~"['[ft.df, rf.x~
h r,~T 3A~
in thefo[lowing Inca i as Rt4g~t LJ let Fl. ~ 2nd Fl, .Section Block Lot
~,~~ir5'f~'~,
u~as examined on oadfound to 6e in conrplionre with the regnirenrenta of thin Roard.
FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXXAUST FANS
~ryUTLETS INCANt1E5CENi fIUORESCENi OTHER AMT. K. W. AMT K. W PMr N W. ApMi +.K W ~9AMi. H P.
1.7",> I~G ~L) .f ~9 S L«G R
DRYERS FURNACE MOTORS FUTURE APPIIANCR FEEDERS SPECIAL REC'PT TIME CLOCKS gEtl UNIT HEATERS MULTWUTLET DIMMERS
AMi. K. W. Oll H. P GAS H. P AMT. NO. A. W. G. AMi AMP. AMT. AMPS. TRANS. qMT H P SYSTEMS AMi WAILS
NO.OF FEET
t4 p 1 2,ts 1 fit)0
SERVICE DISCONNECT NO. of S E R Y I C E
AMi AMP 1YPE METER I ~ YW 1 ,6' 3W 7.e 3W S,R' dW NO. OF CC COND A. W G NO, Of HbIEG A' W G' NO OF NEUTRALS A W G
EQUIP. PER9 OF/CC.CONe. OF HbLEG /OF NEUTRAL
Z~Q ~fl ~ ~ ~ 4f/~ ~ ti3 ~f
OTHER APPARATUS:
JAC:SJ227 Li/20AP9F f7Y~ C i:Et'E' '$Ri{~R.-'1
tgt7P022S:'i-:f' H.FT.
r,.~'.t°.x.-~
SAtIVA't't)id~; C. '!>R~'('CJ hIC,#~1t749•-F,
fu7f~+~R'f"R:1 LAAJ~
R. R . BO% `I,C)cv+ GENERAL MAN~AOER
CSREFi,TVP~R`!", NY, 1'Jtf'-j~} 5. ~;r
Per_ '?w„
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. TNIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
7651802
BUILDING DEPT.
f NSPECTION
[ ]FOUNDATION 1ST ~ ] ROUGIi PLBG.
[ ]FOUNDATION 2ND [~`IFfSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
/ (\V /
/%i
~,r-' j' . '
y,~. /
DATE ~~_INSPECTOR ~ i ~
5
765-1802
BUILDING DEPT.
INSPECTION
[ )FOUNDATION 1ST [ ~ ROUGH PLBG.
[ ]FOUNDATION 2ND IN CATION
[)FRAMING [ FINAL
REMARKS:
DATE INSPECTOR
I
4
i ~
765-1802
BUILDING DEPT.
INSPECTIAN
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
-
L~~
~ l.~l
_(~-2
DATE ~ ~ INSPECTOR
a
765-1802
BUILDING DEPT.
1 NSPECTI®N
[ ]FOUNDATION 15T f IROUG6~1 PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[G]'~RAMING [ ]FINAL
REMARKS: 716~~~2~~~ ~c ~
--e-~i~
c~i~-C G~y~~
d ~
DATEI ~ U INSPECTOR
rsS-lso2
Bl11LDING DEPT.
tNSPECT101V
[ ] FAUNDATION 1ST ( ] ROUGH PLBG.
( OUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ ]FINAL
REMARKS: ~
DATE S -Z`~ INSPECTOR ~r "
c 2~~
765-1802
BUILDING DEPT.
1 NSPE~TION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
i
REMARKS: _~_.~~"~-'~'`u",~-,
I ~i
r
f
ii
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DATE °~-3 / INSPECTOR
7f5-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION i5T [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND SULATION
[ ]FRAMING [ ]FINAL
REMARKS:
~
-G~r~_~ s
' ~
DATE ~INSPECTO
~ ~:~a ~ - a-7~
Standard N.Y.D.T.U. Form 8001.1-84-5M-Dareain and Bale Deed, without Covenant agaivsp Grantor's Acte-Individual or Corporation (ainglo ah ~ t)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY.
,~f~395 PG52~
INDENTURE, made the ~r=A day of ~~0,~,^~= ,nineteen hundred and eighty-S2Veri
BETWEEN
DERRICK S. DOUBRAVA and DORA KATE DOUBRAVA, tenants in common,
residing at 1455 Ole Jule Lane, Mattituck, NY
tf+~JB
i
~ party of the first part, and
2 1 JOANNE SIDOR, residing at no#~ Peconic Bay Boulevard, Mattituck,
NY
party of the second part,
WlTNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consideration
paid by the party of the second part, does hereby grant and release tmto the party of the second part, the hdrs
or successors and assigns of the party of the second part forever,
ALL that certain pgl~o~~~t, iece or parcel of land with the~uildittgts antj idntprovements the fgot~ eredj situate,
tying and being in4h~e aft Mattituck, tPown o Sou ho , ounty o u o k,
State of New York known and designated as lots numbered g7 and 98
on a certain map entitled, "Subdivision Map Section One of Property
of George I. Tuthill and others" filed in the Office of the Clerk
of the County of Suffolk on the 15th day of January, 1929 as Map
no. 861.
TOGETHER with the privilege in common with others to use aright-of-
way leading from the Boulevard, so called, to Peconic Bay, which
said privilege is contained and recited in deed to George I. Tuthill,
et al. from Frank Bray, et al., dated April 12, 1928 in Suffolk
County Clerkts Office in Liber 1368 of deeds, page 24.
dt por"1",or. c~
BEING AND INTENDED TO BE~the same premises conveyed to the party
of the first part by deed made by Louise Ellen Fox, dated December
23, 1986 and recorded in the Suffolk County Clerk's Office on
January 12, 1987 in Liber 10217 cp. 533. ;ZEiS~
RECEiV D
$ '
REAL ESTATE
6UG 1R 1987
f~shi~+.SfER TAX
gl;~ t (1tK
t n:~I~rY
TAX MAP
DESIGNATION
D~tt. 10 0 0
See. 126.0 TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and
roads abutting the above described premises to the center lines thereof ;TOGETHER with the appurtenances
10.00 and all the estate and rights o[ the party of the first part in and to said premises; TO HAVE AND TO
EII• HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of
the party of the second part forever.
let(,>: Gog.o ~
AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of
the first part wtll receive the consideration for this conveyance and will hold the right to receive such consid-
'y'7/, eration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply
.A~~ ~ the Same'first to the payment of the cost of the improvement before using any part of the total of the same for
, any other purpose:. . ;a
The wofd "party"• shall be construed as if it read "parties" whenever the sense of this indenture so requires.
±~'"~.'i.3 IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above
.
" written.
assn.: ' ~
` '1~ ~ IN PRESENCa OF: Y ~=A
!!ll~.,.1 DERRI C"llKl~M'S4~~D`\~,OUBRAVA
~i, x ~ ~z~~~~
DORA KATE DOUBRAVA
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BOARD OF HEALTH
3 SETS OF/PLANS
FORM N0. 1 SURVEY .ll .
TOWN OF SOUTHOLD CHECK ~t.~If'7.. .
BUILDING DEPARTMENT SEPTIC FORM
• TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY p ~y®by~
TEL.: 765.1802 CALL . 8.-. • .
MAIL T0:
Examined ~ ~ 19Q?.~
• 19 Permit No. ~
Approved ~/~jt
D ~.a
Disapproved a/c
JUL 151988
~r t3i_DC. orr~r"".
(Bu' ing Inspector) YOVVN OF ~OUTFICSt.0
.APPLICATION FOR BUILDING PERMIT
Date , 19~~
INSTRUCTIONS
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.
( nature of applicant, or name, if a corporarion)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of ownerofpremises . `r`.`.'.c`!~?N?y•• ~~Q•~~:••••~Y:0.e-~~'L"••••••••••••••••••••.....•..
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate office}r-)~ `7'~
Builder's License No. ~.I.P {
Plumber's License No,r-~.-~. >f..~p~•~• • • • • •
Electrician's License No.'~:1-. ~ • • ~Dy 9'~ N
Other Trade's License No . .
n G-~t
1. Location of land on which proposed work will be done. .C7.~.u.. r ~ rccz~-r-r-r-,~,.~~.......... .
House Number Street Hamlet
County Tax Mnap No. 1000 Section ~°?~a......... Block ......~.Qp./~. , Lot . n.p.p.~/.... .
Subdivision . ~~.D, r'I''~-. • ,Z, ; !l l ~.~..S.ec.. ~ Filed Map No. Q Su, Lot . 1 O..... .
(Name) .
2. State existing use and occupancypof premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .V Q,rC~Q^ ~ ..L~~ i i?is.a '~•'a47?~ :,S .
b. Intended use and occupancy RC':?. (%/~C~, .............:PtnY, a»s4~. ,:,s,~ ,g.d•.r.:..ps~~ .
}i,
i~ tj
3. Nature of work (check which applicable): New Building , Addition Alteration ......a... .
Repair Removal Demolition ..............Other Work .
I (Description)
4. Estimated Cost . Da Z7 . Fee .
(to be paid on filing this application)
g, ~ units .....I......... Number of dwelling units on each floor .
5. If garagennumber of adwellin.0
g d occupancy, specify nature and extent of each type of use .
7. Dimensions of existin structures, if any: Front . . . Rear Depth , .
H 'ghtness, commercial or mixe ber of Stories . .
...............Num
Dimensions of same structure with alterations or additions: Front Rear .
Depth , ...3~ ..Height Nu ber of Stories
~
8. Dimensions ofgntire new construction: Front ..:(D~......... Rear Depth .`r~.......... .
Height Number of Stories 7~.-...
~ ' /07, ~ y... 1
9. Size of lot: Front a?r~. ~ / Rear , . g. 7 , Depth o~o'?`J.•.lr(••..:.::::: ; ;
10. Date of Purchase X1.3?.8.~ Name of Fgrmer Owner.Deh-!c/5 S• ;1~,gri(?~'rvq w, ~D!^R,
11. done or use district in which premises are situated f5'~Sfde~-t7-iG.~-, , , . , , , , , , ;Doyh;-q~c„
12. Does proposed construction violate any zoning law, ordinance or regulation: CVA `
13. Will lot be regraded y2.5 ' ~ ~ ~ ~ • ~ ~ ~ ~ •
' • • ..........Will excess fill be removed from premises: No
14. Name of Owner of gremises . ......Address Phone No.......... .
Name of Architect . y~`gf'r:.~ari~!c~oN. , , , , Address~~^e; Tree, i2o~ ,C',v,~hone No. ?31•J~-. ~ ~ ,
Name of ContractorQ.~~~a: ~~!~.~-wc~;~a,~, , ,Address ...................Phone No.
PLOT DIAGRAM
Locate clearly and distinctly all, buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether
interior or corner lot.
iPofCltitlES; IAPPfi~,VA~I,
?d 13~PiAOVE EXCESS FIL.1.
Ff~CJM ASOVF !'REMISES
GRADINp 407
git1VEWAV CONS7'tltUCf70N
Gk&SfAOOL CONSTFiUCTiON ,r,.,,,,,,,~„„,,,,•,,,_•
Ck~LLAf1 GONSTRUCTKSN -....~~yl'-__
tx'f?iGA
STAT~
~ ~~~R S
COUNTY OF ,rti OY
• be ~
• • • W • • • • • • • ~ • • • . • • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ~ d ~ ~ r................ .
(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 manned set forth in the application filed therewith.
Sworn to before me this
~ day of'.. G(, .L~......, 19
Notary Public, .~•......L County Q~ p
CLAINE ~ 04EW ~J~C~ ~ ~2~
NoUry f+ubNo, M of Nsw York p .
No.4B~9606 (Signature of a plicant)
Qualifkid in Suffolk County
Commission Expires becembar 8,1
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