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HomeMy WebLinkAbout16765-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... z.-; ! 6.8.6.! ...... Date . .Y,l.a.y.. !.6, 1988 THIS CERTIFIES that tbe building ALTERATION Location o f Property .... 5.3.0.q.g.a.i.n...~ .a y.v.i. .e .w..R.o..a .cl... S. ? .uy.h.o..1 .d.,..N.: .Y.. .............. House No. Street Hamlet County Tax Map No. 1000 Section . .7.8. ........ Block .. ? ............ Lot ...3. ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .F.e..b.r.u.a..r.y..l. 8..,..I.9.8.8. pursuant to which Building eermit No. 16765 z dated . .~.a.r.c.h../4. · i . 1.9. .8 .8 ........... 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 ......... CLOSE 1'I~ EXISTING PORCH AS APPLIED FOR The certificate is issued to THOMAS & BEATRICE MAC DONALD ..................... ?o;3,'o;,'/~gg4~;~x .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. I'I85430/4 - February' 24, 1988 N/A PLIJHBERS CERTIFICATION DATED: Rev. 1/81 · OB~ NO. 0 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) No- 16765 z Da,e ..... ~ ~i ........................................ , Permission is hereby granted to;,, ~ .~ ...-~....~.,....~.i~.~4.. ........... ..~.e...o.......~'.....~..../.~.....~4 ....... .. o, premises located o, ...~.~..~.~.....~..~......~.....~.. -/~-~..~.... ......................................... ................................... ~..~.~..~-..~-.-.-.-.-.-.-.-.-.~q._.~,..././..~.,[. ................................................................ County Tax Map No. I000 Section ........... .~...O~..... Block ........... ..~... ..... Lot No .......... ~ .......... pursuon, ,o opplicotion doted ....... ..~.../../.~.. .................................. , 19.~...~., ond opproved by the Building Inspector. .ee *...~..~ Rev. 6/30/80 BL[~G. DEPT, TOWN OF $OUTNOLD FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of 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 installa- 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 pzOperty 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling, $25.O0, Accessory'iS]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 year~)/~l~O.~O 4, Vacant Land C.O. $ 20.00 ~./ L 5.Updated C.O. $ 50.00 Date~./.~.~f...~;'f<~...~' ..... NewCons truc tion ...... Old or Pre-existing BuiJding ............ Vacant Land ............. Location of Property .H~¥f fof. . . ..~. .~.~. .~'/. ~. .~ . . 2~S.tr.e~t. . . ~t~ : ~. . .~. L~. . . . IL .~. .~a//~/e.t Owner or Owners o f Pro perty ~. ~J//~. J'~/. ~. ucC.. ~..~...~./..~..~.. i~.;~/,~.~.~ ~/i ......... County Tax Map No. 1000 Section...Z .~. ........ Block .... ..~. ........ Lot... ~ .......... Subdivision .~.~.~,. .~/~.~,. ~/~-. ~..~.~ .~.~.~....Filed Map ~~"i .Lot No.../. ......... Permit N0/,( Date of Permit .......... Applicant ~(./~'..~.d~..~.'..~,~'..~.~.~E.~./~. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval . .~ ................ Planning Board Approval ...................... Request for Temporary C~rtificate ..................... Final Certificate .................... Fee Submitted $ .~ .~,. ~,Q ..................... ?g a,~r s a~l a~o~llcab e ?o,~~ lations. Construction on above described buildi mit meet I and r,~u AppJicanS~/~.~~.-'z./.../..//./~..w/..~L . .~..~. ~..~ ............ Rev. 10-10-78 FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: THOMAS MAC DONALD AND BEATRICE MAC DONALD, HIS WIFE The estate or interest insured by this policy is vested in the insured by means of D E g D recorded 9/25/81 Poli~yNo. 81--52--36305 Amount of fnsurance $58,000°00 Dateoflssue 9/16/81 Schedule A The premises in which the ~nsured has the estate or interest covered by this policy is described on the description sheet annexed. Schedule B The foNowmg estates, interests, defects, objection to title, liens and incumbrances and other matters are excepted from the coverages of this policy: 1. Defects and incumbrances arising or becoming a lien after the date of this policy, except as herein prowded, 2. Consequences of the exercise and enforcement or attempted enforcement of any governmental war or poJice powers over the premises. 3. Any laws, regulations or ordinances (including, but not limited to zoning, building, a~)d environmental protection) as to the use, occupancy, subdivision or improvement of the premises adopted or imposed by any governmental body, or the effect of any noncompliance with any violation thereof. 4~ Judgments against the insured or estates, interests, defects, objections, liens or incumbrances created, suffered, assumed or ag reed to, by or with the privRy of the insured. 5. Tit~et~anypr~pertYbey~ndtheiines~ftheprem~ses~rtit~et~areaswithin~rrights~reasementsinanyabuttingstreets~r~ads~venues~anes~ways~rwaterways~ or the right to maintain therein vaults, tunnels, ramps or any other structure or improvement, unless thru policy specifically prowdes that such titles, dghts, or easements are insured. Notwithstanding any provisions in this paragraph to the contrary, this policy unless otherwise excepted, insures the ordinary rights of access and egress belonging to abutting owners. 6. Title to any personal property, whether the same be attached to or used in connection wdh said premises or otherwise. SURVEY by Van Tuyl & Son, dated 12/28/70 shows aone story house and garage; no encroachments or variations° Inspection made 6/12/81 finds; addition of roofed and screened porch at southeast corner of residence~ Company excepts any state of facts a survey or inspection of the premises made since 6/12/81 might show. AGREEMENT in Lo 4965 cp 354. DECLARATION OF COVENANTS AND RESTRICTIONS in Lo 6216 cp 256. RIGHTS of tenants or persons in possession, if any° POSSIBLE unpaid water charges° TITLE INSURANCE Company of New York Policy of Title Insurance IN CONSIDERATION OF the payment of its charge~ for the examination of title and its premium for insurance, insures the with/n named in~ured against all loss or damage not exceeding the amount of insurance~stated herein'and in addition the costs and expenses of defending the title, estate or interest insured, Which the insured shall sustain by reason of any defect or defects of title affecting the premises described in Schedule A or affecting the interest of the insured therein as herein set forth, or by reason of un- marketability of the title of the insured to or in thel premises, or by reason of liens or incumbrances affectin~ title at the date hereof, or by !eason of any statutory lien for labor or material furnished prior to the date hereof which has now gained or which may hereafter gain priority over the interest insured hereby, or by reason of lack of access to and from the premises, excepting all loss and damage by reason of the estates, interests, defects, objections, liens, incumbrances and other matters set forth in Schedule B, or by th e conditions of this policy hereby incorporated into this contract, th e koss and the amount to be ascertained in the manner provided in said conditions and to be payable upon compliance by the insured with the stipulations of said conditions, and not otherwise. IN WITNESS WHEREOF, USLIFE TITLE Insurance Company of New York has caused this policy to be signed and sealed on its date of issue set forth herein. Pres/dent Attar: Validating Officer or Agent 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I/I~SULATION ~ ~.~[ ] FRAMING_ [//]/FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH*PLBG:: FOUNDATION 2ND [ ] INSULATION FRAMING [~j,. FI NAL THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100~ THIS CERTIFIES THAT otzly the electrical equipment as deserlbed below and introduced by the applicant named on the above application nl~ rr~ber in the premises of Thomas McDonaLd, 4'~00 Main Bayview Road, $outhold, in the followlng locatlon; [] Basement ~lst FI. [] 2nd FL ,Section Block Lot ~s examined on February 18 ¢ ~988 and found to be in compliance u'ith the requirements o.f this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT 2 DRYERS E R C NO, OF CC. COND A W, G. NO OF HI-LEG A W G, NO OF NEUTRALS A W, G, OTHER APPARATUE: Thomas McDonald 4300 Main Bayview Road $outhold, N.Y. GENERAL MANASER 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. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED N ANY MANNER. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~ ........... 19 .~.~ Approved...~/.. ~. ......... , 19~..~. Permit No.&~.~...~'..z. Disapproved a/c ..................................... (Building Inspector) BOARD OF HEALTH ...... 3 SETS OF~PLANS ....... SURVEY .......... ~', CHECK ~- J~.~'i~ SEPTIC FORM ............. : NOTIFY MAIL TO: BLDG. DEPT, TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT . Date ................... 19... INSTRUCTIONS a. This application must be completely tilled in by Wpewriter 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. .~ e. 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 necessa/~g~spections:~4 . .¥/ :. .......... (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................... Name of owner of premises . . ~.. ~.~.. ...... ~...' .................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ..... ~ ................ 1. Location of land on which proposed work will be done ................................................... House Number ~ Hamlet County Tax Map No. 1000 Section .... ~ ......... Block ...... ~ ......... Lot .... ~. ............ Subdivision &~ ~.~fi.~ffZff~iled Map No. ~ ....... Lot../ ........... (Name) ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .............. ~ ............ ~ .... . .......,... ,~ ........... .,. ;, ............ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration . ~ ..... Repmr .............. Remoyal .............. Demolition .............. Other Work ............... 4. Estimated Cost ................... Fee .................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ..... ~ ........ Number of dwelling units on each floor .... ~ ........... If garage, number of cars ..... ~ .................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ 7. D~mens~ons.o~.~ttng~tmcture~, ~f an~: Front.. ~ ~ ......... Rear . .~ ........ Depth. ~ ~ .......... Height , ~ ~&~..~{~;.i.~: .'Number of Stories ..... / ................. Of same structure with or additions: Front ~ ...... Rear ... Depth . .( .~ , ,~.~. HeiSt ...................... Nu~er of Stories A ......... Height /~ ' ~ ........ ~um~gr of Stories .... ~ ...... ~ .......... 10. ~ateofPurc)ase ~'~p~;(~, (~/. ....... ~ameafFoanerO. wner~t~r~:~J~g~}J~ 11. ~one or use district in which premises are situated.. es/ e.q /gZ .... :.. :...C:. ..... 12. Does proposed construcJ~n violate any zoning law ordinance or regulation: . .~a'. .................. 13. Will lot be regraded ./~.~.~ .......... ~...~x...z~.Willexcps~fil~removed~mpremises: _. _Yes -- No 14. Nme of Owner of premises'/~d~.~/g~ UD2~ddress ~QO.~V/~m~ Phone No. ~Z~- .... Nme of Architect .......... ~ ................ Address ................... Phone No ................ Nme of Contractor ......... J ................ Address .... ; .............. Phone No....~ ........... 15; Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No .~.. *If yes, Southold To~ TruStees Permit maybe required. ~ ~ PLO-T DIAG~M Locate cle~ly ~d distinctly ~1 bufld~gs, whether existing or proposed, and, indicate ~1 set-back d~ensions from property ~nes. Give street and block ~umber or description accordmg to deed, and show street nmes and indicate whether interior or corner lot. ~ j ~ ~ ~ APPROVED A8 NOTED, FOLLO~NG , FOUNDATION ~O REQUIRED WITHOUT CERTIRCA/E FOR POU.ED CO.~ETE ROUGH FRAMIN~ ~ PLUMBING ~, INSU~TION 0F 0CCUPgNcy 4.BEFINALcoM~ETECONSTRUCTIONFoR C.O ~ ALL CONSTRUCTION SHALL STATE OF NEW~Z~/ :o THE REQUIREMENTS OF I'HE ~.v STATE CONSTRUCTION ~ (Name of individual signing contract) above named. He is the ................... i .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly~ authorized to perform or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work wi/1 be performed in the manner Sworn to before me this. .............. .day Notary Public, '~iL~ Commission Explrel~ I~mber 8, 1 ~9..~-~ set forth in the application filed therewith. (Signature of applicant)