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HomeMy WebLinkAbout16836-zFORM NO. 4 ToWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17084 Date JULY 14~ 1988 THIS CERTIFIES that the buildin~ONE FAMILY DWELLING Location of Property 355 THERESA DRIVE House No. MATTITUCK County Tax Map No. 1000 Section 115 Block 15 Subdivision DEEP HOLE CREEK Filed Map No. 4256 Street Hamlet Lot 03 Lot No. 43 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15, 1988 pursuant to which Building Permit No. 16836Z dated MARCH 18, 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~ ATTACHED GARAGE~ DECK & SCREENED PORCH. The certificate is issued to JOHN WEBER (owner, of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATE NO. 87-SO-141 JUNE 27, 1988 PENDING STEVE O'CONNOR MAY 6~ 1988 Building Inspector Rev. 6/88 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERARIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~16836 Z Date .................................................. , 19 ...... Permission is hereby granted to: ~ ,q ~ / /) .~ ...~..w....q.--_ o'""'"'"""~'"~'Z.,.__~,~/~_. ~,~'>"'";~ ......... ~,.;';"5 ...... ........................................... ..................................................................................... County Tox Map No. 1000 Section ..../../...~..~..'~. ........Block ......... ./...'~.....'~.... Lot No ........ ..~.....~.. ........ pursuant to application dated ........................................................ , 19 ........ , and approved by the Building Inspector. Fee ..................... B~ing nspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted t Immmamam 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 p~roperty 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: I. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwe(ling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. updated C.O. / $15.00 NewCons truction...~.., Old or Pre-existing Building ............ Vacant Land ............. Location of Property q.~.q ' O. 4u House No, Street Ham/et Owner or Owners of Property ..." .~q.~l,~, ...~ ,~.~J~ $~.~ ...................................... $15.00 Date .. ;%. . .~ ........... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. .. '- Permit No.. 3 4 te of Permit 3-~.~.~.Applicant . . . e¢./... ,~o,/~ ~,~,~. ............ Health Dept. Approval .../.~.~ ................. Labor Dept. Approval . '~'--:-: ................. Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate ................... d,'~nal C;r~,~ Fee Submitted $ ..... ~,.~. ................... ~ Construction on above described building and permi~al~p~b~codes~ / and regulations. Applicant ~ .~~ ......... 3 7 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Plumber Building Permit No. /~ ~ Owner ..~'~ ~. ~,~¢~ tp±ease print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~ day of ~ , Notary Public, ~ County 0~ Notary Public H£L£N K. DE V0E NOTARY PUBLIC, State ct i~asw Yo~ ~, 4707878, Suffolk County~A, Term Expires March 30,19....,~ GREENPORT LOCATION and MAIN BUSINESS OFFICE Box 57 Mare Road Greenport, N Y 11944 (516) 477-0400 = ~/~ ltCK LOCATION Box 1440 dh Road, Rte 48 ituck, N,Y. 11952 (516) 298-8559 ( RING CENTER (516) 298-4506 ~ r,,J 5 Fast-installing 2-piece Adjusta-Fit is a uniquely steel frame with a %. lip which allows the frame to be adjusted to fit walls from 4%' to 7%" thick. The door's exclusive 2-piece variable width threshold accommo- dates the varying wall thicknesses. Benchmark provides an extra measure of security with an insulated 24-gauge steel door locked into the rugged 16-gauge steel base frame. The system can be trimmed out with Benchmark's snap- on metal trim or any kind of wood trim, inside and out. Specia~ hinge options include spring loaded or non- removable pin. Fire-Rated Adjustable Steel Fram Available In: 2/6 x 6/8 2/8 x 6/8 3/0 x 6/8 Thermal barrier threshold design has several sizes of adjustable aluminum ex- tenders that slide into vinyl threshold to fit various wall thicknesses. ROUGH OPENINGS ADJUSTA-FIT ADD TO DOOR SIZE WIDTH HEIGHT ADJUSTA-FIT 3/4 ,, 3/. ,. 8/86 R Combine Benchmark entrance doors with the Adjusta-Fit® steel frame system to achieve a 11/2 hr. Fire Rating. Adjusta-Fit covers all conditions of walls from 41/8'' to 71,,~' thick. Ideal for metal stud, wood stud or masonry openings. Fire label options · Fire Label: 1~,~ Hour Affidavit Label standard on non-light model doors · Also available with 1,~ Hr. (B, C, D and E) label from Warnock Hersey Interna- tional, Inc. or 11/2 Hr. Brass Label from Applied Research Laboratories. Fire Endurance and Hose Stream Test under ASTM E-152, NFPA and UL10B and others. Regular Hing_e~ Antique Brass Brushed Chrome Primed New! ~pring Loaded Hie eq~ Antique Brass Brushed Chrome Primed Ball Bearinq Brushed Chrome JAMB SIZE 4-1/8" to 4-5/8" ...... Add to Unit 4-5/8" to 5-1/8" ...... Add to Unit 5-1/8" to 5-5/8" ...... Add to Unit 5-5/8" to 6-1/8" ...... Add to Unit 6-1/8" to 6-5/8". ..... Add to Unit 6-5/8" to 7-1/8" ...... Add to Unit List Price 25.00 22.00 N/C 71.00 65.00 42.00 71.00 LIST PRICE 90.00 90. O0 llO.O0 110.00 130.00 130. O0 Section I Page FOUNDATION ( 1 t~) FOUNDATION (2nd) 2. ROUGH FRAME/ .PLUMBIN~ STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-~L802 BUILDING DEPT. INSPECTION []FOUNDATION XST [ ] ROUGH PLBG. []FOUNDATION 2ND [ ] INSULATION []FRAMING [~NAL REMARKS: / /// DATE INSPECTOR ~~ ~,, 765.t80~' BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ R/~UOUGH PLBG. REMARKS: FOUNDATION ZND [ ] INSULATION / [~FRAMING [ ] FINAL DATE ~-~/~-~/~ INSP£CTOR ~ ~ 7..Z.o2 BUILDING DEPT. INSPECTION [ ,] FOUNDATION 1ST [ ] ROUGH PLBG. i '-:~~OUNDATION 2NDe] INs uLATI~oN FRAMING FINAL BUILDING DEPT. INSPECTION F~~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ~r ] FINAL DATE THE' NEW YORK BOARD OF FIRE UNDERWRITERS ~UREAU OF ECECTRIGITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 9 THIS GERTIPlE$ THAT ~ exami~ on .~ ~ be in ~m~iance with the ~ui~ments o~ th~ ~rd. 32 33 32 SIRVlCII DeSCQNN~T S E R V ! C E 4-TON A/C UNIT-1 G.F.C.I:-2 SMOKE DETECTOR: -1 2/0 ^'w''7 2/~; G & S CONTRACTOR BOX 2~5 SOUTHOI,D, NY, 11971 LICENSE NO. 578-E This ~rtificate must not be altered in any moaner; ~?turn to the office of the ~r_d i~ incorrect. In~r~ ?~y~be icbMifbd I~ theis~ :redw~lk. __ NEW SUFFOLK AVE ' 20'E LOT ~/4 (DYVELL lNG) LOT ~9~ N 87°19 "~O" W S. LIC, NO. 49618 "-~ LOT LOT LOT :SURVEY OF LOT 43 M,4P OF DEEP HOLE CREEK E.,qTA TES FILED ,.L4N 28. 1965 NO. Z1256 A T' MA TTI TUCK TOWN OF $OUTHOLD SUFFOLK COUNTY~ N. Y. 1000-115 -15- 05 SCALE I' --40' MA Y 8~ 1987 SINGLE FAMrLY DWELLINC-. ~;~Pi"RE~ '~O YEAR& FROM DATE OF SUFFOLK COUNTY DEPARTM[NT OF HEALTH SERVICES FOR ~O~'/~. OF CONSTRUCT':NOHLY LOT42 (DWELLINg) CERTIFIED TO: COMMONWEALTH LAND TITLE INSURANCE C,O. JOHN' W.~ WEBER : - EVELYN L~I~EBER ~repored in accordance with the minimurr '"~ The water supply & sewage disposal sys- tems for this reslde~ce will conform to the standards of the Suffolk County Depart- ment of Health Services. standa,rds for title surveys as established ~, i :: ~ r' the [. I. A. L.S. and approved and adoptec~ Title Association. "'_1 ~&~' OBSER¥~TM '"O nRi FRO' DATA OBTAINED FRO)4 OTHeRS NEW SUFFOLK AVE I $2. oo' ~ 18~.00' LOT LOT 44 {D~dELL lNG LOT 4~ I~' N 87019 LOT 42 {DWELLING) LOT LOT SURVEY OF LOT 45 MAP OF DEEP HOLE CREEK ESTATES F/LED JAN 28, 1965 N0.4£56 A T MA T TI TUCK TOWIV OF SOUTHOLD SUFFOLK COUNT Y~ IV. Y. 1000-115 -15- 05 SCALE I" = 40' MA Y 8:, 1987 MARCH 29, 1988 ( foundation location ) CER T/FIED TO: COMMONWEALTH LAND TITLE /NSURANCE CO. JOHN W. WEBER. EVELYN L. FF. EBER F,-c~.~,~d in accordance with the minimu:~ standards for title surveys es established ~ the LI.A. LS. and approved and adopte. for such use by The New York State L~ Title Association. NEW SUFFOLK AVE. SURVEY OF LOT 45 f~,o~' S 87° 19' 20"E 87019 '.~0' Fl LOT 44 (D~ELLING) ,I LOT 43 I LOT4~.. (DWELLING} LOT LOT 182.00' LOT ~5 MAP OF DEEP HOLE CREEK ESTATES FILED E/IN 28, 1~65 NO.~l-P56 AT MATT/TUCK TOWN OF SOUTHOLD SUFFOLK COUNTY~ N. Y. 1000-115 -15- 05 SC.4L E I' = 40' MAY 8, 1987 MARCH 29. 19B8 { foundofion location MAY 31, 1988 FINAL Prepared ih a~ordanee ~ I~e mh~m standards for title su~,/~ m e~tabti~hed by the L.I.A. LS. and appm~KI and adoptea for such use by The New York State La~c~ rdte Associetior~. 87-350 BOARD OF HEALTH 3 SETS OF PLANS f'/~'~''''"~ 'FORM NO. 1 SURVEY . .~.'.~.' ,, TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM · TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 ~ ¢ 5- i ! ~ ,5- TEL.: 765-1803 CALL ............... Examined. Approved .~.//~/.~. ...... 19... Permit NJ~.~.~.~. Disapproved a/c ..................................... (P~iildin*~/nspector) APPLICATION FOR BUILDING PERMIT 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 o~ 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/~de, hou}ing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectiOnS. _~. I ~ (Signature of app,/cant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ............................................................ Name of owner of premises ... ~o ~ ~. .... .~J.. ~.}>.'gS[ .................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ....... ~ JP.~.. (~( ......... Plumber's License No ..... ~..~- .el .~'...~ ......... Electrician's License No....C~.~. .~ .............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done: ................................................. ............. House Number Street Hamlet County Tax Map No. 1000 Section . . .I. ! .~ ........... Block . . [.4~.. ............ Lot....O..~ ........... Subdivision. ]~.e. ep. ! '.~.~.~..~. ~. e.¢ .~...~. 577.".~.~.%.' ....... Filed Map No.. q.~..~.~ ..... Lot ..... .L4/. ~ ...... (Name) 2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~ o. I b. Intended use and occupancy .... ~..~..~...~4'~... ~~-- '~ ~'" .... : ............................. 3. Nature of work (check which applicable): New Building .... Addition .......... Alteration ......... Repair .............. Remloval .............. Demolition .............. Other Work .............. ~$ i (Descrip~;ion) 4 Estimated Cost "----~- [0"0 60 0 ......................... ,. · Fee i ' (to be~d on .filing this application) , /. 5. If dwelling, number of dwelling units ............. Number of dwelling units on each floor. ~ ............ If garage, nmnber of cars . . . ,.~ ................................................................... 6. -I-f-q~siness, commercial or mixgd occupancy, specify nature and extent of each type of use ..................... 7. -Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... ,14eight ............... Nu~Bber of Stories ........................................................ ~5mcnsions of same structure with alterations or additions: Front ................. Rear .................. l~h ~ Height Number of Stories - 8. Dimensions of entire new construction: Front ...... 7. q..' ..... Rear ... ~.o. ......... Depth ....~..2. ........ :Height .... /.< ......... Nuo~ber of Stories ..... /. ................................................ :. 9. Sizeoflot Front ..... ILO.. ........ Rear ..... ~'l.o .............. Depth ../.~..~. ...... 10. Date of Purchase--:-. ......... ~ ................... Name of Former Owner .---: ........................... 1 1. Zone or use district in which premises are situated... R.~.~ .... 12. Does proposed constructxon w01ate any zoning law, ordinance or regulation: ./l~r~a. ........................... '. 13. Will lot be regraded ..... /..o.i.:.~ ...... · ........... Will excess fill be remq_ved from premises: Yes NoL 14. Name of Owner of premise~s . . .O_., ./.~tg. bO?,. ...... Address . ~.7.~..~r..~.~/.e.~. $e..'SPhone No.. t~.g.'aT, f. ?.3742... Name of Architect . . . .~'13pt4 i. ~'. .e{ .J-.e.~ ......... Address . . . .~p.'~. ~.'.l-?y..M. Phone No ~ ?g~ ~.~,~'o Name of Contractor ...~..~'b.~ ek, ............ Address .. ~S.oy..F.I,i~ ....... ehon~ No' '~.2'~-½)g ~: .... 15. Is this property located!within 300 feet of a tidal wetland? *Yes ..... No . .~-.. · If yes, Southold Town Tr'~stees Permit may be required. PLO~ DIAGRA~ buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether Locate clearly and distinctly al property lines. Give street and bloclq interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. .......... gP~.~.. · ~.l~.e U ..................... being duly sworn, deposes and says that he is the applicant <Name of individual signing contract) above named. He is the ........... ~. gte-e~."{Te..t~ ................................................................ , (Contractor, agent, corporate officer, etc.) of said owner or owners, and ;s duly authorized to perform or have performed the said work and to make and file this apphcatmn; that all statements contmned m thru apphcatmn are 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 ............. J .day o? ............ 19 Notm~ Public ................... County ~ .....~,,,', r~ ~ DF rOE ....................... ., 0~ Ne, York (Signature of applicant) ~u'-~" I~'-~" 4~ 4." ~'-~" ~'.~" ~'- 1" ~"~' ~-~" ~,~, ~,o~ ,, ~, ~ .... ,, , ,~ , ,,~, , .... ~~ ., ~--'~ ~ .... ~ ~' ~ ~' ~ ~- , , ~ __~ ..................... ~1 -~ ~ :~ I , ~l I I ~ ~ ~ II I~ ' ,,~ ', ~,~,~ i ~.~7~ ~ I, 1 I , / , ,,, ~~, ' ~] ~ ,,~ :Ill l,:, '~l~J ~ II Ii ~,, ~, O~O~PANOY O~ ~UlRm -~, ~ I for Water distributing If ~er tubing is Used ~Ystem; PiPing shall be OCCUPANCY m,,,,. ,:..%,.r. ::.,,,~,'~.~ ,,.,' ./.,..m,~.~,m [ 4 , , , ..... U,IO~ ,~US"~' ~'-0" flLo" %0" . ~ ~ .... . t ~b 4" eoa~ ii ]1 L~ I ~L~©T LLt',/Z>T o~ I--lO Tl4