HomeMy WebLinkAbout18406-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219194 Date JULY 9, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 195 PRIVATE ROAD #32 SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 9 Lot 10.5
MINOR SUB.
Subdivision COMM DEV. AGENCY Filed Map No. 4162 Lot No. 5
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 22, 1989 pursuant to which
Building Permit No. 18406-Z dated AUGUST 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 DECR & STEPS
The certificate is issued to TOWN OF SOUTHOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-39-JUNE 8, 1990
UNDERWRITERS CERTIFICATE N0. N132800 - JUNE 12, 1990
PLUMBERS CERTIFICATION DATED HARDY PLUMBING & HEATING MAY 24, 1990
--Ja~~-+LBuilding Inspector
Rev. 1/81
rose: xo. s
TOWN OF SOUTHOLD
lUILDING DEPARTMENT
TOWN HALL
• SOUTHOLD, N. Y.
lUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 18 4 0 6 Z Date ........~::5 . 9..~i... ~
Permission is hereby pronted to•
`
ro .......a1.......~7.~...
at premises located at ~......../..:...'.~~..1.!~............~r~.
County Tox Map No. 1000 Section Block ...0..l~........ Lot No....f.~.:':...47....
pursuant to application dated ....G~2 .............I...~............, 19Q.~ond approved by the
Buildfny Inspector.
Fee i.•!.teatl.`Tktrl~
Buildinp~ lnspseto~~edr-
Rev. 6/30/80
r
THE NEW YORK t3'I~ARD .~F FIRL UNDERWRITERS PAG7: ]
j,1000965
BUREAU OF ECECTRtCITY
85 JOHN BTRE,E'T,~. ts1EW YOft1LSyc;?~EW.YO)RK.40038
Date `TUNE' 12"1990 APPlicotionNo.onfile 650095$9/$9 N 13"I.ff00
THIS CERTIFIES THAT -
onlythe electrical equipment a described below end introduced by the applkant nerved on the above epplicetion number in the premtses of
TNO BEARS BUILDERS, PRIVATE ROAD LOT15, 530.33 S/O SCIUNDYIEW AVE., SOURNOLD, ~tNn~.Y. ~
in thefollowinglocotion; ®Baeement ® IatFf. ®2nd Fl. AT7'TC/OUT Sertion59 Bioc/Y9 Lot P70 10
woa exomined un MAY 14 , 1990 and found to be in complionre with the reyuiremenra of thia Buord.
r-
RXTURE RXTlIRES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OLITItTS ACLK SWITCHES INCANOESCFM -nVORESCENi OTNEP AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. H. P.
11 9 13 11 7 1.2 1 F
- DRYERS RIRNACE MOTORS WTURF APPLIANCE FEMERS SP[CIALRK'Pi TIME CLOCKS BELL UNIT HEATERS MteLTt-OUiIIT plFµfERS
SYSTEMS
AMT. K. W. dl N. P. GA$ N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. M. P. !W ~ ~T AMT. WATTS
3 F 30 1
SlRVICE DKCONPNCT NO.OF 5 E R V 1 C E
AMT. AAV. TYPE EGLKP. 1 S ]'M i A JW ] d ]W 3 / AW NO. aER /COND. OF CC. COND. NO.Of NI-LEG N '~G NO. OP NEUTRALS Or NEUTRAL
1 ao9 cB 1 7C 1 z/o ] a./o
OTNlR APPARATUS:
MOTORS:].-3/d H.P.
G. F.C.I:-3
SMOKE DEYECTOR:-1 -
i
ti'
n~
RTJ=
WILLIAM T. STOCK LIC..pR89E CO~~ iv-
1250 SMITMTONN AVEN77E J
BOREMTA, NY, ].177.6 GREERAAt MANAGER
17
Per
This certificate must not be altered in any manner; return to the office of the Board if incorcact. Inspectors may be identified by their credslltials. -
. A IN ANY E .
-;.iC
. TL•L.7G=-1802
~
~ 5: ~c 06FICE qd= II:UIL• Di~~G INSP£L-T;OR
o ~ P.O. 13.0; : ;~28.
y ~ ~ SOU'FH~OLD, .
f.Y. l: k97 i
O/'~0. 2s '~Yj~
C E R T I F I C B T I. 0. N:
Date MAY 24, 1990
Building Permit No. 18406
Owner Two BEARS
(please print)
Pluxrb2r HARDY PL. & HTG. NORTH, INC.
(please print)
I certify that the solder used .n the water supply system
contains less than 2!10 of 18 lead.
'Y/Y«a-o
(plumber's signatur
Sworn to before~ m,^e this
°~52 day of ~L'L~ y-
Rotary P blic
Nota_•~ Pv~_ic,~(/~F'OLlC- County
MIU~NIE Y. BiIONM
H„~y Vic, ~ YPMwYak
a~su~~~ I
Canmlulon EtrpkM Oq.19, 9~
_ _ _
c 1c:LD 1;: •`',:-~-:U;: Ill niE I_ i;v^4M ENT C~?~
1~9 ~
FOUIJDATION (1st)
FOUNDATIOtJ (2nd)
2.
z
P,OUGH FRAME & _
PLUMBING
~ f
3. ~ ~ r
IIJSULATZOAJ PER N. Y. ~
~r
STATE ENERGY ~ ~y
CODE ~ ~
/f
a . ~ ~
H
FZ;JAL
ADDITIOIJAL COMMENTS:
a
1_
• r u
H
m
v~
m~((~
~Y`V
} ~ BOARD OF HE \LTH .
J SETS OFi PLdNS
FORM N0.1 SURVEY
, TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORPI
' TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
• ~ TEL.: 765.1802 CALL James. Cr. fps=f~ahpn.....
Examined>r~(v-~...~.~.,19~~ MAIL T0:
.,19Q9PertnitNo..~.Q._`QP ~ Southold1,New1Yorka11971
Approved RR M l~
Disapproved c LS ~ V LS
0
.~:~~~sr~, ~ 2 21989
(Building Inspector) BLDG. DEPT.
APPLICATION FOR BUILDING PERMI TOWN OFSOUTHOLD
Date .May, 8, , 1989• • • , 15 .
INSTRUCTIONS
a. Tltis 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 t)tis 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
-hall 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
wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
_gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
to applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
mit authorized inspectors on premises and in building for necessary inspections.
Town of Southold - Community Develop.
(Signature of applicant, or name, if a corporauon)
Town Hall, Southold, NY 11971
• (Mailing address of applicant)
whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWNER
oCotivneroCpremises ,TOWN OF SOUTHOLD
(as on the tax roll or latest deed)
'cant is a corporation, signature of duly authorized officer.
James C• McMahon, Administrator, C.D.
........................................r
(Name and title of corporate officer)
Ider's License No . .
~S,
9.~.T.......... .
•iber's License No. p- p-q
7ician's License No. ...0.4..! .
Trade's License No .
n of land on which proposed work will be done. - , ..1 . (Z,1.4 }4l~. , • 1~~! • • • , ~•p~ ,
_ ,k~:........~3occTyOC
umber gqStreet Hamlet
ax Map No. 1000 Section .....fir. 1. , Block •O• q , • • • , , • • • • Lot ~ ,
,fo.....
n . Filed flap No. Lot . r.... .
(Name)
n; use and occupancy of premises and intended use and occupancy of proposed constnutibn:
,se and occupancy VACAN,T
!se andocCUpancy Single-Family Residence
3. Nature of work (check which applicable): New I;uilding , X,', , . , , Addition Alteration .
Repair Removal Demolition Other 1Votk .
~ (Description
4. EstimatcdCost~?~S~!J/ Fee . W,~;yed„-• Town Project
Qo be paid on filing this application)
5. If dwelling, number of dwelling units ..........1 Number of dwelling units on each floor . , pl,/ A , • •
If garage, number of cars .NlA . " • "
6. If business, commercial or mixed occupancy, specify nature.and extent of each type of use . N./,A .
7. Dimensions oC existing structures, if any: Front , , N?•A , Rcar , N(A.......... Depth . Jyf A, , . • .
Height ..N/A...... .°.~~j fStories.•N/A_,•.•
Dimensions of same structree ~i;< fi}tcrations or additions: Front . N.i A Rear . NlA........... ,
Depth ..NlA ~ fight . N f A , , , , , , , Number of Stories . N/A
.
8. imensions of en,t~~'re nav ~istructio~r: Front ....~'y ~ Rear , ,3:5!~ , , , , , , , , .Depth , s?`/, : ,
' Height ~~.a?J,rf„~" NumberiafStories : ,,`1 ,
9. Size of lot: Front .....f$.3 Rear ...ly+~t•
~ Depth .lS.~?~ a?3~.~ .
10. Date oC Purchase .........P . . .Name of Former Owner ~ •
one or use estrict in which remises are situated ,/~./.Q~/jjc~!(//~~, ,~RK((4 jj/~Qtq,~,
12. Does proposed construction violate any zoning law, ordinance or regulation:.N 0
13. Hill lot be regraded ' ' ' • ' ' ' •
• • • • • • • • • ..........Will excess fill be removed from premises: Yes Z
14. Name of Owner ofprcmisesT.own.~.tf,,$pxtho~d,AddressMd}n';Rd, SoutholdPhoneNo.?fey-1892
Name ofArchitcct..NSA Address..Al~Q. /A
. P N...........
Name of Contractor.TWp•,@ears,Builders,•.~rArddress P.O,Qpx„2117„Amagp~~~~•329,-,gg3P..:.
15.Is this property located with in 300 feet of a tidal wetland? *YES....NOJL..
*If yes, Southold Town 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 fines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or corner lot.
SEE ATTACHED SURVEY
f<
aT
Star
Nam:
!f aPP.
g4
Piu,
STATE OF \E1V YORf:,
COUNTY OF S.S Ficc
„ • J ame s C • McMahon , , , , , , , , , , being duly sworn, deposes and says that he i Oti a
(Name of individual signing contract) t
above named. 1
LOCati,
![c is the „Community Development Administrator '
(Contractor, agent, corporate officer, etc.) ffo~sr•p
of said owner or owners, and is duly authorized to perform or have performed the said work and to
application; that all statements contained in this application arc true to the best oChis knowledge and COOnty
work will be performed in the manner set forth in the application f•Icd therewith.
Swom to before me this Sohdivisi,
g i
~t'.........day of 19 8/. State ctis.
NataryPublic, ,,,,Suffolk.• Pte1~v~,9~; .{lJt
• County , ~rrsti°
`\n 8
~.~t It oe voe \~.y„~r b J~rend
e
Te~~06 ~ d
TEST MOLE Jv • I
P `
s
eEONNI EN ~ yyO WELL
MEY BANDY
CLAY WITN _ y~,
10 eNAVEL V
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PALE MONM ~ l~
COMEE fA MO v
9~ ~O JJ
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AREA 30,000 SO. FT. F,
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i
THE LOCATIONS OF WELLS AND CESSPOOLS SHOWN REON ARE x
FROM FIELD OBSERVATIONS AND OR DATA OBTAINED~ROM OTHERS C9~~~ ~ ~r.p{~I] `J ('~~~Sfi--_`q„ls~1M•^.`~ ~,,~';~I '
EXPIRES TWO YE,~t-~5 F+-sl;ivY ~r~ AF{~f~OVA~
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR
rAP OV L OF CONSTRUC ION ONLY SURVEY OF PROPERTY
X S ~ 3 FOR
DATE V l REF. N0.
APPROVED C~IMUNITY DEVELOPMENT AGENCY
AT SOUTHOL D
THE A SUPPLY AND SEWAGE DISPOSAL ~ TOWN O F SOUTHOL D
S EMS R THIS RESIDENCE WILL CONFORM
THE ST ARDS OF THE SUFFOLK COUNTY / ,
DEPARTMENT F HEALTH SERVICES. FEB S ~ SUFFOLK COUNTY, N.Y.
i0 1000 - S9 - 09 - P/0 10
~,~q~i,~lF.9 VICES SCALE I°= 30~
~G~~~O~~f2 NOV. 23 , 1988
~d ~ C D!VlLOPAAlNT OFFICE
d d/)j TOWN MALL ~A Pr°porsd in aecordonn with tl» minimum
Or 'T SCNIi D, NEW YCJItK 11971 J• NandordE for tiNs EurwyE of u}oylish®d u
. ley L ~ (o S the L.I. A. L 5. and approved antl odo to
V F for Eaph aw h p
p p Y S I C. N 0. 4 9 66 8 Y The New York Stare Land
liNe AewciaNon.
N V S , P. C.
( '~fAlbsez 2 0 D
P. O:'84'X 909 ELEVATIONS ARE REFERENCED
MAIN ROAD LOT NUMBERS REFER TO ' "MINOR SUBDIVISION TO AN ASSUMED DATUM.
SOUTHOLD , N.Y. 11971 MADE FOR COMMUNITY DEVELOPMENT AGENCY.
D.K. 88 ~ 143. C6)
PJ~
'~9.
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O
..tiP a = 2s.oo'
r~
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y Lot a
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LOT ~ yQ'
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AREA 30,000 SQ.FT. ds,
d 5
~,r g PO?0
Q
t
SURVEY AF PROPERTY
. FOR
~011>~~tTY t~EVElQP11ll~N T A~~~ICY
AT SOUTHOLD
TOWN OF S~QUTWOL. D
SUFFOLK Ct'3~ITY, N.Y.
1000 - 59 - 09 - P/O 10
SCAi.E I"= 30' .
NOY. 23 ,.1988
Sept. L la0 ! toand ba 1
L NO SG '
. IN~~
p~QL~~
b O~
P~COM ~ ~ S , P. C.
(/i18) ri - 5020
P. 0. 8 4% sQe ~
MAIN RAAO LOT NyM~sRO ~El~R rti ~ "M4110fl lUSD4V13lON ° 0
SOUTNOLO , N.Y. 11871 M1tPE FOfl cOwWp~'tr DLVELaPMENT AAENCY. *,M,~:
• l~a7l
PJ~ t, '
99
O
~~4.
GG ~O ao F
?O
0
JJ .
~ Ft = 25.00'
~ :39.27'
0
4'
~ 12 ~0
OP e ~6 ~ j ~i
Q• a ~ S~ so ,
~
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r~~ - •o, 9Q
ao
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Drti ~ dF{
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Z / LOT S
F
Fe •m
X~ ~ Set
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6~'l
trtu-
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LOT 4 yQP
, or°
AREA 30,000 SQ.FT. s, 5 ~~O
~~1 5 ~ oQ0
SUFFOLK iX<UNTY DEPARTMENT OF HEALTN Q~
_ _ SINGLE FAMII•Y DWELLING ONLY ~
DAT6~~~.Qi.S. REf. N0.
The sewage disposal and water sup acilities for this
H. S. 88-SO-89 location have been inspected by t Department and/or
other age ies id foun to ~ ~t.
Ctlief of ureau of Wastewater anagement SURVEY OF PROPERTY
FOR
CSOU]~NOLD SAVINGS BANYC COMMUNITY DEVELOPMENT AGENCY
PHYLLIS ATK/NSON
AT SOUTHOLD
Propared in aaordance with the minimum TOWN 0 F SOUTHOL D
sxondards for ti,le surveys as establisher) by SUFFOLK COUNTY, N.Y.
the L.I.A. L. 5. and approved and adopted
for such use by The New York Stata Land 1000 - 59 - 09 - P/O 10
Title Assooiation.
SCALE I"= 30~
NOV. 23 , 1988
Sept ti: 1889 (found be.1
~Y_
a Fsb. 19, 18x0 (find)
1,ANp ,
~ SG h~'r' ~4
C F~ < E""'
' ~ 2~ p ~ ~
s~ ~ * LIC. N0. 49668 ®L
~ /
PECON ~ Y~ P. C.
P. 0. BOX 909 ELEVATIONS ARE REFERENCED
MAIN ROAD LOT NUMBERS REFER TO "MINOR SUBDIVISION " TO AN ASSUMED DATUM.
SOJTHOLD , N.Y. 11971 MADE FDR COMMUNITY DEVELOPMENT AGENCY. ~
RA ~ (5)