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HomeMy WebLinkAbout18405-Z _ _ _ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector • Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219193 Date JULY 9, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 195 PRIVATE ROAD #32 SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 09 Lot 10.5 MINOR SUB Subdivision COMM DEV AGENCY Filed Map No. Lot No. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1989 pursuant to which Building Permit No. 184052 dated AUG. 25, 1989 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 WOOD DECK & STEPS The certificate is issued to TOWN OF SOUTHOLD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-38 JUNE 8, 1990 UNDERWRITERS CERTIFICATE N0. N132808 JUNE 4, 1990 PLUMBERS CERTIFICATION DATED HARDY PLUMBING & HEATING MAY 24, 1990 r/ Bui~n~spector Rev. 1/81 rosti 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 18 4 0 5 Z Date ...~.....a.'~.:1.~ 19...J~... ~ Permission is hereby granted to: ~ ..,D.... ~ , to .......QL....... . at premises located of .........~...:rl . .....~}.J ....1..~....~.~ County Tax Map No. 1000 Section .dl.........../Block ..f/....~....... Lot No....1~...:.~- pursuant to application doted ...L~~r~1..4- ...........<....y 19.~~ond approved by the Building Inspector. Fee 5.1• A~11.`J!~!2~fl.:I„~ ..................'.....9~/.... ,~r~... Building In ct~ Rev. 6/30/80 1 THE NEW YORK BOAR© O~''~~1~~~: UN;QERWRITEitS#'' PASE 1 _ B3 JOHN STREET."NE1NF'Y~ ~IMKt'1h008H - JUNE 11, 149U 650p4hA4/A4 N IA;2t308 Dote Application No. on fRe THI9'CERTIFIES THAT only the slectrled equipment as described 6abro and Introduced by the eppiicent nomad on the oAooe eppltation number 1n the premLee of i iW0 BEARS f1l1Tl.DERS, PRIVATE Rrr--Oyy~~Ap LOTIt4, 66%.0!S S/0 SUUNDVIEW AVf'„ SOUTHQD, N. Y. ` in thefolloainplocatlonT ®Besement LJ /stFl. LJ Ynd Fl. OUT Sertion59 Block09 Lot i'10 .lil uNRS examined un MAY i h , 199 ii end found to 6e in compliance with the reyuiremenp of thia.Boord. R%TYRE RXTNRRS RANOlS COOKMID DICKS OVlNf MSR w T FANS OUTIlTS ACIES SWITCMK INCANpESCENT PIUOIIESCENT GTHER AMT. R. W. AMT. R. W. AMT. R.W. AMT. t: W. AMT. N. P. 8 25 l2 R i 1.2 1 F DRYBRS RJRNAC! MOTORS RITUR! AMl1ANCE IRRDRRS SHOAL RRC?T TIMl CIOCKS a1DT IIRATMf MtlN40Yi1RT DIh1A1fiRS AIAi. ~ .Jl. W, dl N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMH, iRANf. AMT. N. P, ~f ~ ~T AMT. wAtTs :S F 1 it) 1 SRRVICB DISODNNBCi teO.OE S E R V - t C - AMT. AAM. TYPE ~ 1 / tw I F ]W ] / TN 1 / IW NO.OP CC. COND. A. W. ~ NO. q N4lEG A. W. NO. p N[uMA~lS `ti W'p~ PER O W CC. C OF NP NFUIRAL 1 1011 C, B 1. K .l !i 1 4 OTNRR AIIMATUS: ' MoTURS:1-3/a H.F. SMOKE QETECTt1R:-'L e WTI.t-IAM T.STOCk IIC.BH84f 125U SMTTNTOWN AVENUE BOHEMIA, NY, 11716 A ORIMIN MARA~OF 1 1 Ptr E~/ This ~~rtificab must not be oltered in a~ryr rmtnmr; return to tM offiw of the Board if:intorreN..lntp~eton may be ideMjfied by thsMr cndsrMak. a` COPY FOR BUI .THIS OF IFIGTE AMlST BCC ALTS=Ri AlIY AMIMER. - TL•L.7G:-1802 ~Gl~fCa;~ r r ` -0~~ TO:•~!•N OAT' S.(3J:T~~~:ll: ~ ~ ,c OFFICE 0!' B~[:JILDI~J~ IVSPfiG-T;OR ~ • 0~0, 1 ~~0~ SOU'FHU"D, , I.Y. 1:1.971 ^c C E R T I F I C A T Z O. 17: Date MAY 24, 1990 Building Permit No. 18405 Owner TWO BEARS (please print) Plu7sb~2 HARDY PL. & HTG. NORTH, INC. (please print) I certify that the solder used _a the water supply system contains less than 2!10 of 1$ lead. " (plumber's signature) Sworn to before me this - day of n 19 ~ D - ~P.~tt~D~ Rota y Public Nota_° Po~_ic, SUIGFOL,~ County . Nf&NMI@ K gfl~NAr NvNry Pu~,19~OQ/12Nrw YMic ~oa.°°o;'~9~ I =IELD IGS:'°C7iU;J ~~UniE OOMMENTS ~ 1. ~ ~0 _ - - yw FOUIJDATION (1st) 9 FOUNDATIOIJ (2nd) _ _ _ m 2 . ~ „ t.LLO z o ~ P,OUGH FRAME & PLUMBING 9 H 3. , x m~ m IIJSULATION PER N. Y. + STATE ENERGY CODE r ~~h, ~ r 4 , y FIIJAL v ADDITIOPIA COMM NTS: ~m~9 ~a~.~~_~ ~'dt Q~2c. fFS~ - "ga. N\ a~ a yyy,\ w~~^\ x~ L _ H- T l b~ m '9C .i •l ' 80AKD OpF HEALTH Y........... 3 SETS r/ PLANS FORM NO.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORPI TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL James. C:. f1>=flahPn.... . Examined. ~."tl..,19~/ MAIL T0: / u Town Hall, Main Road .\pprovcd ..cr~':~. 19~~PermitNo..(~~...7~~~ Southold, New York 11971 Disapproveda c o ~an~ .Artl 2 21996 D (Building Inspector) APPLICATION FOR BUILDING PERMIT etoG c • Ar. ~ TOWN OF SC~~ i7~!tii r t Date 15 . INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted [o 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 Petmit 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 Reculations, 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. • Town of Southold - Community Develop. (Signature of applicant, or name, if a corporatton) Town Hall, Southold, NY 11971 • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en;ineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises ,TOWN. OF SOUTHOLD (as on the tax roll or latest deed) 1f applicant is a corporation, signature of duly authorized offices James C• McMahon, Administrator, C.D• ...................r (Name and title of corporate officer) Builder's License No . . Plumber's License No. ~g~~~ T........ . Electrician's License No. D, g 9 . Outer Trade's License No . . 1. Location of land on which proposed work will be done. . P. ~ lV Chi. ~ . ~ ~ , , , , , , Clouse Number Street. Hamlet County Tax Map No. 1000 Section .....59 • . • • • Block Q.9, , , , • • , , , , . Lo[ l0 : , . Subdivision F.iIcJ ~Iap No. Lot . ..(Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy VACANT b, intended use andAta:upancy Single-Family Residence /}TKI,vSel~- cAp~ 3. Nature ofwork (check which applicable): New F3uiidinS • • •X.•..... Addition rUteration Repair Removal Demolition . , ,Other 1Vork . • ~ . p~~,~-~y • (Description d. EstimatcdCost~ip.~tlt./,Y,,,,,,,,,,,,,,,,,,,,,,,,, pea , W,~}yed„-•Town Pro,~ect (to be paid on filing this application) 5. if dwelling, number of dwelling units , , , , , ,L , , , . Number of dwelling units on each floor NSA , , , , , , , ICgara^_e,numbcrofcars :NlA;,,;,,,,,,,,,;,,,,,,,, 6. Tf business, commercial or mixed occupancy, specify nature and extent of each type of use . N?.A . 7. btmensions of existing structures, if any: prom N./.A Rear . (vlA.....:.... Depth . !y/A, , , . Hclght „IJ/A..:,,,::::Numberof5torics,;NiA blmensitlns of same struct ~t •.+th altcrattons or additions: ptont . N!A ~ Rear .MIA bepth . ~ ; {`Icight N/A , , , , Number of 5tohes N/A . tl: btmensions of entire new ctlrtstLh~ on: prom ~c~' ~ • Rear a3v?' bcpth P?`J~ . Helgltt ! 8f,Et , , . Numbe , of 5toHes 5: Slie of Intl t= ; i : ~ ~ ~ Rear.../.?,~ Depth ./.~ZJ.. 10: batetlfpurchase Na a of porrncr Owner 11: zone tlr use district in which premises~are situated ' ' ' fSld f~tl~~...r9~'ic. u.~ ll~iei.4L. . 12. hoes proposed construction violate any zoning law, ordinance or regulation: 13: Wtl11ot be regraded ..Nil) excess fill be removed from premises: Yes T 14. Name of Ownertlfpremisesl':oWC1:Af,;$p}(tiho~d,;AddressMajh;Rd, SoutholdPhoncNo,7b5-1892 Name of Architect ::N%A:.:.:... Address N!A . . , • ptl~~~Nt„ N/p. , Name ofConttactor:TWP;:~~a!'.~;9uildei-s+. frA~idress P.o.,Qpx, 211,7 ,Amagp o.329n403P 15:Ig this property ltlrated vithin30tl feet tlf a tidal vetlaud? ~YES:.::NOJ(::. *if yem, titluthtlld TtlVif Trustees permit may be required: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. SEE ATTACHED SURVEY V? ` , :S`it~A't~0'F\~1Ar'1rCf'iQK, S.S CbCIN~TY OR . ,James C • McMahon being duly sworn, deposes and says that he is the applican (Name of individual signing contract) above named. Ilcisthe„C,ommunity Development Administrator (Contractor, agent, corporate officer, etc.) ~ • of said owner or owners, and is duly autharized to perform or have performed the said work and to make and fife thi: annlicatlon; that nil statcmcnts contained in this npphcxtlon are truo to the best of his knowledge and bcllcC; and that the tvtlrk will be pcrforntcd in the manner set fottit In the application filed therewith. Sworn to before me this .::.::::.::::~i::::..::daydr:... ih~Y. Ndtarypublic, .,,:suffnik::~-:~~ (1~. County HELEN K DE VOE • +~\~,.9..X-1,~: NOTARY PUBLIC, SIMe eF Neu Ybk Na 4707878, Suffolk pwngr (S igna to rc o f a ppl ican'. ) Term Expires hkrch 30,19~~ A s TEST HOLE G~ 990y~ eROwNISN _ `V • -aaQ A OREV SANOY v F CLAY WITH I~ 10% eRAVEI 3' / L PALE eROwN `TjQ JO.Qj. COARSE fAMD 9' V\ ~ 33 • ~~O eRONN CLAYEY F n 9AMD wITN ~ LAYERS OF CLIY O R v 2S.O0~ 'PQ Q 13' O.\~ L.39.27' ~ ~QO exowN coAReE VV J SANG y ry 15.8' ~ ~ y°~ ,~6 wnTER iNeeowN or' coAREE SAND jd. , ,O zz' - P~ Q`~ a 5~ aP. rtia Q NSb 5(4Oa~\ O~ S QO ~ ~ ppO ~ a Q`O b~ !B . bD ~ Q a0• F `O~. ~ e RO 90 . ` i ° 55 Ry p O~ ? ptcP;~c~ b f~ti o; ~ Sci° ~o . n i. 0 ° 0 5 " ~sE ~~s PO' . = oP• ' 39. ari `"o . D 's "a0 • t/ ~ 0 ~ b a • ti ` • FTFe Qt~~ll 00 F 6~D B• ~ ~p h~ ~ /CROP COQ F r~F SePG~ p`,o. tisE egv~r~ ASF,~ o s ~ I /s, grad fa~k ° 5 AREA = 30,214 SQ.FT. O~ ~~/pA ! ~b Q~ t:. F~j~~y A ~ . .,ti, a Quo ~xpr~~s rev ~F ~~g`~'~~-~' c~~~r - 11, FPp~,pf0 O Y~a~s ~ ~~~~"1~' ~ SURVEY OF PROPERTY ~Ui`+~ D,yrE c~)~- Abp OPAL THE LOCATIONS OF WELLS AND CESSPOOLS SHOWN HEREOIIJHE FOR FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. ~~~~t~Q~~1~IUNITY DEVELOPMENT AGENCY SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~ ' FOR AP 0 OF CONSTRUCT ION ONLY 'l ;~~x-/ A T S O U T H O L D DATE ~ S EF ~ SO FEB a 1999 TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y. APPROVED 0 Dom. 1000 - 59 - 09 - P/O to HEN.'!N S€IlVIC6S SCALE I" = 30 3• ~l~,f,¢:~. NOV. 22 , 1988 ~ ~a iAN SL's /I~ IAMES C. MCMAHOrv 1NC 9~• y cwuwuNm DevEtoPA~ENr Oaf~cE F~c~~ TOWN HALL ~ pn~~ in accordance with the minimum J _ ~ M~1ITMOLD. ~~QI[ 1 tf>11 atandorda for title aurveya as established by ' 11 THE WATER SUPPLY AND SEWAGE DISPOSAL 1M 41.A.L5. and approved and adopted ~ ~ ~I ~S• LIC. N0. 49668 TOSTHE STANDARDS OF THE SUFFOLKCCOf~OTM for such ua by The New York State Land r 9 Title AsaociaNon. i.- DEPARTMENT OF HEALTH. P~CONI M S P.C. (y516) 76 5 0 0. BOX 909 MAIN ROAD ELEVATIONS ARE REFERENCED LOT NUMBERS REFER TO "MINOR SUBDIVISION " TO AN ASSUMED DATUM. SOUTHOLD , N.Y. 11971 MADE FOR COMMUNITY DEVELOPMENT AGENCY. D 88 ~ 143 (5 s •~~o 'b• PJ~ ,o J~~ ~3a ~ F q R . zs.oo' ~o~'o L:as.z~' ~ 40 J g? ~ ,ti , '6. _ \ e~'' Q ~s~'pa~\ ob ~F o~ ~,©e ~ ~ LOT Q /i p. . i ~ d / / . ~ r~ t• ~ \ , ' ~ ~ ~ " / _ ' ~ Lor b o 4~ Q r.~ PGA 5Q ~ s ~ ~ ~ ~o ab ~ y. • OrEN >/P'A!~ ~ SURVEY OF PROPERTY FO R COIYIMUNlTY DEVELORMtNT 14t~Ef~CY AREA= ~nz,4lt AT S4UTHOL D TOWN OF SOUTHOID SUFFOLK COUNTY , N.Y. 1000 - 59 - 08 - P/O 10 ' SCALE I" = 30 NOY. 22 , l988 y~01.ANDgG Sspt x lAI1(fOYd bG.1 ~Qd H~FZ,L~ ' C L ~ O O 9 . • e Q Y. S. LIC. NL1. 41N9 P~CO r'SN~~ ORS , P. Q. ~16) T65 5020 Q. BOX 9O9 ELEVATIONi AiIE II~EIIEIICBO M#tN ROAD lQT YUi1~R1 NEfE11 TO ~ "M4NOR Sil(OIYISION " TO AN ApUMED DATUM. SOUTNOIG , N.Y. 11971 ~tAOE •at c+9nw~t~tr1'r ~VELEIDMEMT ADEMCY. „per, _ A,~ A 88 - t~3 (~1 _ _ _ s'~ ~ ~ ° . it P ~ ~ 'O~ ~ P 33 ~~O\ J~~ J3o '4~ ~ F`~ , k :25.00' 9~ ~ :38.27' k ~r~ yo oa _ ~6• r~ O w~ _ OP ~o~~ P s~ ~4r~o~~ ph s, O QQ`O ~ LOT 5 / ~ . \ moo/ / / R~ ~ Rbe ~ / aT ~ / a R .16~ ~ ~ " er~ , ~,i ~ ~ dF i i p • / LOT 4 N J I 1 ~y I ~,o~ v~ I Q~G tp O Pr-,..red i.. accordance with the minimua. S I ~ !V~ cQ' <;ydc fu title surveys as establi:;h~d by ~ L~ ° u.:; L. A. L. 5. and approved and adopted ~ for such use by The New York State Land - ~ ` ~ Title Association. ~ ~ ~ k F 9~ OPEN SPADE SURVEY OF PROPERTY FO R rr.s ~ e_so-9s COMMUNITY DEVELOPiNENT AGENCY AaE~ ~ AT SOUTHOL D TOWN OF SOUTHOLO SUFFOLK COUNTY , N.Y. CERTIFIED TO: SOUTHOLD SAVINGS ~4 100 - 59 - 09 - P/0 10 RUSSELL GREGG SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES TAAk1IY GREGG SINGLE FAMILY DWEl11NG ONLY SC ALf I" = 30 DATC~UN 0 ~]990H.S. REF. No ~9-~-3~' NOM. 22 , 1988 The sewage disposal and water supply facilities for this Sit. 1, 1888 (fOtAd. /OC. location have been inspected by this Department andi or Fes, 18, 19~ ~f~~ NO other enci s and fgundsati~~ory. 5 " A. y SG ~--t-~ t;,~'~0~ eN N~FG9~ Chia of Bureau of Wastewa er Manat gsrnent ~ - yo 0 E ~ . S. LI C . NO. ~li6S P.( q.SUR ~ P. C. '~16 a ~49e ~ ~Q• BO W were te,Iv. eue.r,.,, wt p~R Soll,,.c (a.,,.1-. B oK MAIN ROAD ~ ELEVATIONS ARE REfEREMCED lOT NUMBERS REfER TO : ° MINOR SUBDIVISION " TO AN ASSUMED DATUM. SOUTMOLD , N.Y. 11971 MARE fOR COMMIIMITY DE YELO?MENT AGENCY. N,~~ _ p tt 8i7