HomeMy WebLinkAbout18411-Z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
• Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219114 Date JUNE 6, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 709 HLAWATHA'S PATH SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 78 Block 03 Lot 51.2
MINOR
Subdivision APPROVED 4/9/90 Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 22, 1989 pursuant to which
Building Permit No. 184112 dated AUGUST 28, 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-34 MAY 9, 1990
UNDERWRITERS CERTIFICATE N0. N127612 MAY 9, 1990
PLUMBERS CERTIFICATION DATED HARDY PLUMBING MAY 24, 1990
Building Inspector
Rev. 1/81
ros~c xa e
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 18 411 Z Date 19>~~..9~
Permission is hereby pwntad to:
..~,~~.....o....:~....S...CI..~G.T~.4..,~.D
~ ..fl...
. . .
to ........,r,~......
.....t
at premises locoted at „n~,7~'l~/, .
. .
........................................................~,.~r.2~..
ye...........................................................
County Tox Map No. 1000 Section .0.,7E Lot No, S I •
Bl/ock ..G.. 1~....~.
pursuant to application doted ......~.~1 ...........L...~ 19.~~and approved by the
Building Inspecto'r._
Fee S•~Zl%7!~~W`~`
~.~iti2~- ~c••••••••"~........~~.
Building Inspector
Rev. 6/30/80
r
TWE NEW YORK B~Oa~D OR ~ .UNDERWRITERS
uluu')6x ~q~ _
es JOHN srRa~,-N~k'v~~!100sa -
MAY U9,199U Gtil'19UOhy 8tD N 1'1!61?
Date Application No. on Jtle
THIS CffFTi1F1E3 THAT
only the abutrkd equipment v described 6eloro and Introduosd by the eppltcarat notnsd on the abuse eppBation numberlw the promise of
IWO HF.AK:i BUTLD['N`:, N/S iIIAWA(HA'S f'Aftl 4U9.N1, SOUI'N01..0, N.Y,
A117t:/Oll'1 U%R pJ N/0 NS1
in tkefdloa:inR loutc' nt ~ Ixt Fl. ~ Ynd Ft. Section Black Lot
A~~'1 I . , 1 Y ~ m
ugs exomined on and found to 6e in compliance with the reyuirententx of tb4 Board. -
gXTWE q%IURiS COpII1NORECKL OVlNS UST FANS _
~4 Atxfi SYFITQNf INCN10ttClM . rIUOtEKEM OTHER NAT. t. W. AMt. t. W. AMT. R.W. M1T. c w. AMT. N. r.
a7 Sh ]7 S2 -
DRYERS FURNACE MOTORS IUtUM AtM1lAteq eEEOlRS fMC1Al tMC"rt iItY GOCRf Mt I1/Ri tNttipt ~t11LbOmBlT oYANNRf... -
AMT. t. W. ql N. r. GAS N. I. AMT. NO. A. W.O. AMT. NM. NAT. NM4. TRAtK• AMT. N. r. N0~ AMT. WATn -
3 F ;h - - 1 ~U 1 -
:'~0 DISCONNECT MO.Oe 4 E R V 1 C E
AhT AMr. Trn E~DINF. 1 f tw 1 / tw t i 7W 7 / nv No. ictw. ~ ,kw. . a No. of NFUO of w. o. w. a NEU1RAts a F
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OTIIEE AMARATU4:
MO'ft)NS:l~-. 7;i N.P.
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W[I.LIAM 1.51't)CK I.TC'.l6884-h'
1'15[) SM7~IIIltfWN AVI:NIII:
k40111"MIA, NY, 11716 OM~RI..
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Per
This arNficaN must not be oheTed in anytngarror, Morn M tin offiu d the NordN ' ":mDy 6a Identified tiMir credentials.
COPY ROR BUILDN~ DEPARTA~IT. TENS COP1f OF CERTIPN5ITE ANIiT NOT ~ ALTNN~tM'
_ _ _ ._~W _.1..:
'CGL. 7G5-1802
~l t .
Cpl TQ~~~PI OS' S<l1-T-$~~ll:
~ ~ 08FICE OP B~U3LD13J., IvSP~C-rOR Q G^L
~ ~ P.O. BO , Z$. -
~0~~ ~ SOUTHULD, N.Y. 1:1.971 ~3~~p ; I+ ~j
. O' Zt ~
C E R T I F I C A T I O.N:
Date MAY 24, 1990
Building Permit No. 18411
•~A
Owner TWO BEARS
(please print)
Pleaba= HARDY PL. & HTG. NORTH, INC.
(pleiiSC- Orlnt)
I certify that the solder used .a the water supply system
contains less than 2!10 of 18 lead.
- (plumber's signatu{~)
Sworn to before me this - -
d') day, of ~~I ~
19 ~1 Rota y Public
Nota~° Pv~:.ic, SJ`FUL~C- Coun:.y
' MEWdIE V. BROWN
Naery P~Be, S1a>o of Nav Yak
No. 4908712
Oua00ed to Sulbk ~R'~9c) l
Canmiulon E~irw Oc+
_ _ _ _
lour^- OMMENTS
Ir:LD 1,'S. ~.1Uti `~llnic )I
~v_n
m ~l
_ a
7. 3 ~
H
~
FOUtiDATION (1st)
tit
FOUNDATIOt1 (2nd)
2. ' o
P,OUGH FRAME & ~v
PLUMBING
N t c.
3. 1~ d ~ m `
ra
H
IIiSULATIOTi PER N. Y. ~
STATE ENERGY
CODE _
.J~~
H
4.
FIiJAL ~
.
o~
zO
ADDITIOAIAL COMMENTS:
1 9 ~ ~ ~
M
I
m
H "1
- ~ 0
v~
y`
~
7 BOARD OF HEALTH
' 3 SETS 0~ PL.\NS
FORMN0.1 SURVEY
TOWN OF SOUTHOt_D CFIECK .
BUILDING DEPARTMENT SEPTIC r•oart .
' TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
- TEL.: 7G5.1802 CALL James. C1~C1dhQn.... .
C:camincd~a~-~ ~ • ~ 19r/. MAIL T0: ,
/ ~r .y Town Hall, Main Road
\pprovcd~2~..~.~~...., 19~~Permit No..[ P..,~~.~~ rL~ Southold, New York 11971
Disapproved a/c _
~ ~ l5 ~ ~ L5
(Building Inspector)
3
APPLICATION FOR BUILDING PERMIT ~ r s~uC.
[}e~T j
Date aY... ~ 19 .
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 this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
iitall 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.
APPLIC.\TION IS IiEREBY hi•ADE to the Building Department for the issuance of a Building Permit pursuant to the
Buildin; Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Rc^_ulations, for the construction of btildings, additions or alterations, or for removal or demolition, as herein described.
Tire applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
~dmtt authorized inspectors on premises and in building for necessary inspections.
_ Town of Southold - Community Develop-
~(Signature~oi applicant, or name, if a corporation)
Town Ha11, Southold, NY 11971
' (Mailing address of applicant)
State wltetlter applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWNER
\ameofosvncrofpremises ,TOWN. OF SOUTHOLD -
(as on the tax roll or latest deed)
if applicant is a corporation, signature of duly authorized officer.
James C• McMahon, Administrator, C•D-
(Name and title of corporate officer)
Builder's Liccnsc No .
~
Plumber's Liccnsc No. ..~5.~.7..~,~
Electrician's License No. .t~`.~
Outer Trade's License No . .
I . Location o! land on which proposed work w~~il/Il be dona~tte. ~ .
flousc Number Street. z Ham1M
County TaxNla{r No. 1000$~CIIOn Block Lot...S~-~.,,,,,,,,,.
Subdivision Filed ~fap No. Lot
(Name) .
State existing use and occupancy of prerises and intended use and occupancy of proposed construction:
a. Existing use and occupancy VACANT
b,lntendeduseandoccupancy Single-Family Residence
.Si~RRH - ~R,~~. s~~T-
.
i
3. Nature of work (check which applicable): New Building X '
Addition Alteration .
Repair Removal Demolition Oihcr 1Vork .
~y~ (Description
4. EstimatcdCost...(~~,~.(,..v~......• Fee. W,aiyed,.-,Town.Pro~ect
~
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..........l:.... Ntrmbcr of dwelling units ort each floor . , N/ A , ,
If gara;e, number of cars .NIA .
6. If business, commercial or mixed occupancy, specify nature and e:ctent of each type of use .)V./.A .
7. Dimensions of existing structures, if any: Front , N./.A Rear ,NIA.......... Depth . 1yi9...... .
Hcigttt N /A Number of Stories / A, , , , , , , , , , , ,
Dirensions of same structure with alterations or additions: Front N/A Rear .NIA. , " ~ "
Depth ..NlA Ileight . NSA , , , , , , , , , , , Number oC Stories . N/A ~ ~ ~ ~ ~ ~ ~ ~
• Dimensions of cntir;~new construction: Front . , ; ~y°, , , , , , , , Rear , ,:~y , , , , , , , ,Depth" : aa;' ; ; ; ; ; ; ;
' Height r~~. o?%~, Number of Stories , , , ,
9. Size of lot: Front .....~.3,~.>S~ ~.fas~.. Rear ....~~/-,7a.j......... Depth ~.5!U~,~S?13.~~~.....
10. Date of Purchase Name of Former gqcaner .
I I. Zone or use district in which premises are situated . , A ~j,A~i(.e~, - AC?,~E'IGGIL 1i!!O.A~~; , , , , , , , , , , , , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: ,IV 0, , , , , , , , , , , , , , , , , , , , , , , , , ,
13. 1Vill lot be regraded 1Vi11 excess fill be removed from premises: Yes I
14. Name of Owner ofprcmisesT.own.~cLf,,$puthold.AddressM~in''Rd. SoutholdPhoneNo.?1~5-1892___.
Name of Architect ..N! A. Address N~? , . , p} , H/A , , ,
Name of Contractor .TWA. .g ears ,Bui l,ders;, Ia~ic7ress P.O, ,f3Qx, ,2117, ,Am a9pl~dhe'1Vo. 329-.g03P..: .
15.Is this property located within 300" feet of a tidal wetland? *YES....NO.X...
*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 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
' r
s
sTAT>; or- ;;E~v YORE, s.s
COUNTY OF .
. J ames_ C • McMahon , , , , , , , , , being duly sworn, deposes and says that Ile is the applicant
(Name ofindividual signing contract)
about named.
Ilcistlte„Community Development Administrator
(Contractor, agent, corporate officer, etc.)
oC said owner or owners, and is duly authorized to pcrforrn or have performed the sail work and to make and file this
application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
• .............:.~.~........day of , 19
Notary public, ,,,,Suffolk..~~....R;I!~-County
HELEN K DE VOE . ~
NOTARY PUSlIC. State of New York
' No. 4707878.SuttoVkCo~urdyG~ ~ (Si;nature of applicant)
Term Expires Much 30,19-__~•
f
f
CE~VJ E TE
Ry IWELL B CP. T
LOCATION UNNNOW N) i
N/0/F ST. PAT RICKS CHURCH IN THE TOWN OF SOUTHOLD ,SUFFOLK COUNTY I F..
DWELLING )
N/0/F c Q
I. THOMAS SERI KA n a,
s TAGGART W
S. 6° 411 0011 E. 543.92 So ~ c °s3 -
-P _ - - -
O CONC. POST 9 a WIpE ~ FENCE ]~i i OOd o ^
,y n a e SPLIT RAIL FENN 0 0 Q Y m
2 I
P,op M s a ~ ~
N r.iB'// ~ P~oP. dive woy ` N w 3 z w
y OD Q ~O F o
,S Q N . 6 ° 41 ~ 0011 W. 2 98.00 u' ~ ~ o
-N O ~ I
n Z In Q n
o ~ °
m ro PLOT 1 m
W ? PLOT 2 _ Q
~ F- ~ W
° F' ~ $Q ~
a 2 25'
^ ° 3 N/0/F TOWN OF SOUTHO LD
m Pi°p m
z : "'7~ sep/iC
~ 3 ~ h52 ~ rysrem CP VACANT .r
W 2 O ~ 1^ 3 m
Y
° , o W Co O o
z O _
s.r. O I am familiar with the Starrdards for AA~rovel and
o a ~
r ~ ~ //7 4 ZS' N 01;3rrUCtlCn OS ~UbSiJ r`iaCF3 ~jt~iNi1 e I~IS~G>~ .4y~StP,rT}S I
~ ° T H for Sir=.c~!a i~arT:ily Re~iei=_+nces znd will abide by the o=
0 0 ~ ......._..,.e..._.~._ ZW
u_ O aD ~ cunc.rons s~:1 `crth th~rerl and on the permit to
~ ap
o o vi construct.
W Z Z ~ P
m 2° Y ~
Y 1L ~ ~1.
1 IIB. 861 ° cCM~Vr.;tY
W N . 5 45 1 0011 W 117. 30 1 TOWN HAIL ~T orf c F
N. 9° 05 20 y
o slandardsdfor Ills Wveyc as eclabYsMdn SOUTHCKD, NEW Y0(7`t~1C 11971
N/ 0/ F N/ 0/ F THE 0 D 0 R E S HI M L I C K by the LJ.Al.S. and approved and adopoted 5 -'~b `7~
W for each use by TM NeW York Stafe Land 7lfla
LAND OF SAR KUS AND BRIOG ET SHIMLICK Ascoclal(on. TEST H E
a , DWELLING , _ N A KOMI S ROAD
~ WELD t c. P. 150' ~E~ , ~ MI%ED
~.i a`j~ SAND ND
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES j `C` ~Q~ ~ PpOEN AND
-AREA = 45, 611 SQ.FT. Fo AP OVAL OF CONSTRUCTION ONLY I SURVEY OF PROPE ~,``\`~c~,~,,~ CpeRSE
or 1.0471 gcres j ~ ~ SO 3~ AT /w SAND
T REF o Fer3 s uses SOUTH 0 L Q~~T cr_;. 13.2
WATE P I N
APPROVED ~ TOWN OF SOOT L D PALE
BROWN
'itF~HS~ER~/cES SUFFOLK COUNTY, SANDSE
L AND SG THE WATER SUPPLY AND SEWAGE DISPOSAL I 0 0 0 0 7 8 - 0 3 P/ 0 5 I 17 '
~v~p`/'Nj. MfT~d`9`t"< ~A~LY WITH THE STANDARDS 6/ REOUIREMENETST SCALE X11 = 401 ~
U ~ 9 O OF THE SC/FFOLK COUNTY DEPARTMENT OF HEALTH.
~ SEPT_ 20, 1988 I ~ h~~
~ .S 0. 4 6%8 TAs /oeaHons o/ walla and ceasp°ok shown hereon are lrom }f37d + I
p 1 aDaervo/Mns and or /r°m OoID oblalned /rom olhsrs. 4^ ~ * • i 1 ? I ~ re~ r l ~ t a ~ r~ ~~i 1~ - _
,7 1 Srj. ~l~o. eS618 rJQ' Ir/~F"II'~~. ~ ,s : iS.`, L.~~-i °Y ~i~ .~i v. L~~ I IJOO 7
E 1tr_.__.
~'~~GF ~ PLOT NUMBERS REFER TO "MINOR SUBDIVISION ~ JL rll- 1T~4~~
SO r N.Y. 11971 ELEVAT/OJJS ARE REFERENCED MADE FOR 7UhN OF SOUTH OLD COMMUNITY Pty' ~A
I=-~ 3r~~D
TO AN ASSUMED DATUM. DEVELOPMENT AGENCY"
a
' Dx. 88-142 8 (2)
(CEIMETERY )
(WELL B CP.
LOCATION UNNNOW NI
N/0/F ST. PAT RICKS CHURCH IN THE TOWN OF SOUTHOLD ,SUFFOLK COUNTY I F..
( OWELII NO )
N/0/F o ^
THOMAS &ERI KA ~ VL.
TAGGART W „
S. 6° 41' 00" E. 543.92' ~o ~ c `,`,-3 z
Y
d CONC. POST 0 WIPE FENCE ~ , pOd o
a n-._ n o /i SPLIT RNL FENS O O W Y U•
N Z
° I o s N~ ~ o ° J
o i c 1n 3 J
~ ILL Y • N w _ 0 W
I m Q O ~ °
C N
N. 6 ° 41' 0011 W. 2 98.00' ~ N1 ~ _
1
N i I Z J
o r' wl ~ ~ a
~ PLOT 2 AI ~1 ~ m PLOT 1 ~ °
W Q J
7 I ~ W
O H ~ ~
LL = ~ ti
u ;
N/0/F TOWN OF SOUTHO LD
o _ 24.o n
~ z
~ ; W
w Z O - ti VACANT ~r
r~ l 3 ~
~ ~ O W ~ O O
Z 4 50.1' O v
0 o o o~
J Y. p ~ I V• Z
~ ~ ~ ~
Jj ~ O y N
W Z z I 111 P
m Z O
f
OS ~
s =1`
I
' IIB. 86' N. 5°45' 00'~ W 117. 301
N.9 05 20 W
o~ Pr~daprred in auordmee wIM IM minlmun
J N / 0 / F by fM L.I.A.L.S. a1d sa~owd Rd ado9oMd 1
J N / 0 / f THEODORE 5 HI M L I C K for sueA use by TM PNw York Stats fond TItN
s LAND OF SARKUS AND BRIDGET SHIMLICK Assoddlon. NAKOMIS ROAD
a ( DWE LLINO
U
~1~
13 lam`-
AREA = 45, 611 SQ.FT. SURVEY OF PROPERTY
or 1.0471 gcres AT
S4UTHOLD
TOWN OF SOUTHOL D
SUFFOLK COUNTY, N.Y.
G~~LANOg~ 1000 - 078 - 03 - P/ 0 51
2J MEIN II I
'4 oF9'"io SCALE I = 40
~o SEPT. 20, 1988
* .S. LIC. N0. 496! 8 Sspt. 1, 1989 (/ound. loc. )
C S, P.C.
5196
P. J9
MAI PLOT NUMBERS REFER TO •'M INOR SUBDIVISION
SOUTHOLD, N.Y. 11971 ELEVATlONSAREREFERENCEO MADE FOR TOWN OF SOUTHOLD COMMUNITY
TO AN ASSl~1E0 DATLAK O E V ELOPME N T AGENCY
88 - l42 B (2)
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