HomeMy WebLinkAbout23184-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32790 Date: 12/18/07
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 1000
(HOUSE NO.)
COunty Tax Map No. 473889 Section 111
OLD MENHADEN RD
(STREET)
Block -L-
MATTITUCK
(HAMLET)
Lot 17
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in tbis office dated
DECEMBER 7, 1995 pursuant to which
Building Permit No. 23184-Z
dated
DECEMBER 15, 1995
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 SINGLE FAMILY DWELLING WITH ATTACHED WOOD DECK & GARAGE UNDER
AS APPLIED FOR.
The certificate is issued to ROBERT & MARY J HAMMER
(OWNER)
of the aforesaid building.
SUFFOLK COUlllTY DEPARTMBIIIT OF HEALTH APPROVAL R10-07-0097
12/06/07
ELECTRICAL CERTIFICATE Il1O.
N-329497
10/07/94
PLUMIIBRS CERTIFICATI01II DATED
11/21/97 MATTITUCK PLUMB.&HEATING
ignature
Rev. 1/81
Form No.6
0JL (,.,1 i .1'195
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.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
.'
.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
I. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
r!pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
,
C. . 'Fees
.1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-~xisting Buildine - $100.00
3. Copy of Certificate of Occupancy - " .25~,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy Residential $15.00, Commercial $15.00
-Z.3 ..:7A""/?-"C- /.9.98'
Date........................................ .
New Construction...~...... Old Or Pre-existing Building.................
1&')00 ~o /II'NNA.D~,A/ ~",o C'crr~t'lt;;1,!;ve
Location of Property.........................................................................
House No. Street Hamlet
Onwer or Owners of Property... ~"':'~.. .~:... .~-:';"..... ?:~~~.. .~'.. .~~.':"!'~... H....... .
~I ~ '7
County Tax Map No 1000, Section. ....... .... ..Block............... .Lot......................
'-'-' --------
Subdivision............. ...............-.-;'";'...... .....Filed Map........... .Lot......................
:z 3//$4 -t . lz-frS/9 ~ . IC'''SI.rr- <V. #A__Ed:...
Permit No............... .Date Of Perm~t............... .Appl~cant. . . ........ .. .... .. ..........
~
Health Dept. ApprovaL....................... ..Und.erwriters ApprovaL..........................
Planning Board ApprovaL.......................
Request for:
. ,/'
Temporary Certificate........... Final Certicate.... .......
Fee Submitted:
$... ~;C....................
~" tu., r:!- ..<A ~.~.. '<--
................... ................... ..........
~ 7'35)/
co~3,nT()
APPLICANT
FORM NO.3
TOWN OF SOUTHOID
BUIlDING DEPARTMENI
TOWN HAll
SOUTHOID, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ....'O'~\;~{1)ber...l.5................................... 1935........
N~ 23184 Z
Permission Is hereby granted to:
... .RQR~r.:t.. w.... .~.i\Q!Q!~r.... ............. .....................................
... .~? ..~~r.~.~.~.~X. .~~~~....... ............... ...............................
Manhasset, N.Y. 11030-3015
..........................................................................................
to .... .CONSIRUCI..A. .ONE.. F.AMlL Y.. .DWELLING.. .Itll IH. . GARAGE ..&. .DECK.. AS.. AP.P.LLED..F.OR..................
............................................................................................................................,.....................................
......................................................................................................,...........................................................
..................................................................................................................................................................
..................................................................................................................................................................
at premises located at......... ).QQQ..~.~.~.~.Ao.~N..RQ~P.... ................. ~.~.T.C.I:\Q~U~~ ..N...y...............................
..... .{R~P.I.A~~.S.. .~p.. .it~.1 S!}.O.l.}................. ................ .............................................................,......... ....
County Tax Map No. 1000 Secfton ...J.U.............. Block .....0.4.................. Lot No. ......1.7...................
pursuant to appllcafton dated ......'O'~C.F.M~~R.l,............................. 19~,!i............ and approved by the
Building Inspector.
Fee $......6!l9...0.0.......
'~J'4'~m
Rev. 6/30/80
- .........--- --
THE NEW YORK",BOARO OF FIRE UNDERWRITERS
PAGE 1
!IUREAU OF ELECTRICITY
85 J<;)I1NSftlEET, NEW YORK. .I'IJII;\I\/ 'fORK 10038
Da.. OC'l'OBER 07,1994 Application 1'10. onfl/. 839&2594/94 N 329497
THIS CERTIFIES THAT. .,
only 'M _.rlcal..,uip....n. .. "-'ribed".,."......, l,~uc'" by 'M ."p1Ican' _~ on 'M ._ ."p1le.,ion nu"""'r In ..."......... .}
1001093
I
ROBERT HAMHElR, 1000 OLD MIilNHADEN 'ROAD ,POLE'4, CllTCtIlGUE, N, Y .
in'M}""olClnll'oca.lon, [jj I/u<!.....n. [j 10. Ii, 'iii 2nd 1'/. . GAR/ATTIC/OUT _lion Block Lo.
'ic.. ..amlnrd.... OC'l'OBER 03,1994 _found to"" In compliance with the NatiolUll Electrical.code,'
, AXTun
OUTUTS
F1XTUIIS
AaIS SWdCHIS ~DESCENT f1LUOIIfSC!MY OTHER
aANGIS CtlQlllNG DICKS OVlNS 'IXlIAUST FANS
T. K W. AMY. Ie. w. AMY. K,W. AMy. K. iN;' AMt: H. P.
22
59
37
22
1
F
DRYERS
FUtlNACI MOTORS
OIL H. P; GA$ H.P.
Mun APPU~ _ SPIClALnCH TIMlCLOCXS
AMT.' NO! A, W, G.AMY. AMP. ANiT; AM.h.
IIU UNIT HlATQS ,...n.ouT~
-~S ,':JY$TIM$,
......... "AMY. H.P,'NOiOliIrllT'0
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AMY. K.W.
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SlRVI~ ~NRCT
AMY. NU. T'tPI
NO. ell' 5 E R Y
MlTH
IQUIP. lJ11Vi1.'IW 3#1W 3"-,,!, NO.Oi'i'.tC D, . Of1:c~'8No. NO. Of HI.l!G
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A.W.G.
Of HJ.LIO .
E
NO. ~ NeUTRALS
A.. W.O.
Of NfUTRAL
1
200 CB ,
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2/0
1
2/0
OTHlR _AM
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G.F.C.I.-7
SMJKE DE'l'EC'I.'OR.-3
DOROSKI ELEC. INC.
425 K>NSELL Ll\NE
CllTCtIlGUE, NY, 11935
LIC.#2941-E
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This certific~ muttnot.be-a~ in any manner;returnJo th.,OHk, of the Boardlf incorrect. Inspector.s
, cttdential,.
GUARAN TEES INDICA TED HERE ON SHAU RUN
ONL Y TO THE PERSON FOR WHOM mE SURVEY
IS PRePARED, AND ON HIS BEHALF TO THE
Tl1l.E C04IPANY, GOVE:RNMENTAL AGeNCY,
LENDING INSmUTlON, IF LISTED HEREON. AND
TO THE ASSIGNEES OF THE LENDfNG INSTITUTION.
GUARANTEES ARE NOT TRANSFERABLE TO
ADDITIONAL INSTITUTIONS OR SUBSEOUENT OWNERS.
UNAUTHORIZED AL TERA TlON OR ADOITlON TO THIS
SUR~Y IS A VIOLA TlON OF SECTION 7209 OF
THE NEW YORK STA TE EDUCA TlON LA W.
SURVEY OF
~. ... . LOT 348
- . ..
IN
MAP OF SECTION "0"
NASSAU POINT CLUB PROPERTIES, INC.
oS s <0,> SITUATE
0"~ -t... CUTCHOGUE, TOWN OF SOUTHOLO
.g-
Oo... SUFFOLK COUNTY, N.Y.
~
COPIES OF THfS SURVE:Y MAP NOT BEARING
THE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALlO TF?UE
COPY.
SURVEYED FOR: ROBERT HAMMER
MARY J. HAMMER
K
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FM# 806
DATE FILED MAY 7. 1926
TM# 1000-111-04-017
GUARANTEED TO:
ROBERT HAMMER
MARY J. HAMMER
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NOTE: CESSPOOL &: WEll LOCATED BY SURVEYOR, SEPTIC TANK LOCATED BY OTHERS.
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OEe 0 G 2007 H.8. R(' f~Q.~ - 0"7-0c"l'l
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the WW3ge d:spesal and wahH S:"~l:)\ Y:'.'~::'i:::.., ~;( 'this !ocannn have been
in::;o:Y:::t'Jc gno'lc.lt :Jc;rf::cd t>' ~'-iis C'~~;, ',t,:;~ ?0:,nJ;.ies ar:.d found to
'i.
SURVEYED: 12 JULY 2007
SCALE 1 "= 40"
N
OLD
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79.3800<8'7v 60
MENHADEN
ROAD
SURVEYED BY
STANLEY J. ISAKSEN, JR.
P.O. BOX 294
NEW SUFF. LK. N.Y.
631-734 5835
07R1604
1. 21 NOV 07 SHOW BlOCK UN[[) PLWrfR IN DRM;WAY MfA
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I'IAP 06 '95 16: 21 TOI-JII OF' SC'UTHl)LD
P.2/2
Town Hall, 53095 Main Aoad
P,O, Box t119
SOUlhold, New Vorlt 119'71
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Fax (518) 765.1823
Telephone (516) 785.1802
OFFICE OF THE BUILDING INSJ:lECTOR
TOWN OF SOUTHOLD
CERTIFICATION
DATE, 17:;.117
Bul1dinq PerJlli t No. ~ '3/ S of! ~
Owner: K06<!'--.-- w. HAMME'c...
(p18llse print)
Plumber:
I c.~tlfy that the solder used in the water supply system
contains l~$s than 2/~O of l' lead.
Sworn to before me this
~/
day of
19f1
County
d-S f ?'j02-
785-1882
BUILDING DEPT.
I NSPECTI,ON
[ ] FOUNDAnON 1ST [] ROUG LBG.
[ ] FOUNDAnON 2ND [ ] IN ~TION
[ ] FRAMING
REMARKS:
DATE
INSPECTOR
d-~{f~
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INS~ION
[ ] FRAMING [ ~AL
[ ] FIREPLACE & CHIMNEY
DATEY!)-7 11' 7 INSPECTOR
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7&5-1802
BUILDING DEPI'.
INSPECTION
[ ] FOUNDAnON 1ST r~UGH PLBG.
[ J ?UNDATION 2ND [ ] INSULATION
[ / FRAMING [ ] FINAL
R~KS. ~ if .
~~.-..6 r- / ~ &C
DATE
t;/J-/1f
{ {
INSPECTOR
.",
d--I 5'10 ~
765-1802
BUILDING DEPT.
INSPECTION
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[ ] FOUNDATION 1ST <<ROUGH PLBG.~
[ J FOUNDATION 2ND [ ]_ULATION
- ~
[ ] FRAMING [ ] FINAL
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[~UNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
REMARKS. Ph ~ ( /,/1:;...4d~....,
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7&5-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDAnON 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [~TION
[ ] FRAMING [ ] FINAL
REMARKS: fe - ~A-- j7t2~.r;-
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(J)J( 6, ~
DATE 7
;)-L (~
765-1802
BUILDING DEPt'.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO H PLBG.
[ J FOUNDATION 2ND
[ ] FRAMING
[ ] FINAL
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DATE
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FOUlIDA TIOll
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(1 st)
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FOUNDATIOn
(2nd)
2.
ROUGH FRAME &
PLUMBING
3.
IlISULATION PER N. Y.
STATE ENERGY
CODE
4.
FI;JAL
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ADDITIONAL COMMENTS:
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N.Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ~
,/'........... ..
J SETS OF PL~~S ..........
SURV~Y .....'rf............
cueCK :f(.J?Y!(Jo...~........
sePTIC FOR.l k":...........
BLDG. DEPT.
TOWN OF SOUTHOLD
E~amilied . . . ./k. ./7. ..,199.31 f) 3/ ffLj"i:-
A~proved . . . /.J./;j}-(s' ., Iyl-l Permit No. ~.
Disapproved alc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NOTIFY:
CA L L ....................................
HAIL TO:
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
APPLICATION FOR BUILDING PERMIT
Date. ./ /.1.1 ;;)..)."0....,19...
INSTRUC'TIONS
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 Butlding 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 necessary inspections.
.. EtJ. Y.I~. m4:T~~~:!i. .~.c;..,.........
(Signature of 1cilicant, or name, if a corporation)
... &'t::f.l~~.. .N.'i.t.q~:..............
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
... .G~~A-.~... .C'.~~~...........................................................
Name of owner ofpremises~. ~ . . ~.I'~':I)).'(X\.~ . . . . . . . . . . . . . . .. . . . ... .. ..... . . . . . . .
. (as on the tax roll or latest deed)
If a e of duly aut~orized officer.
.. ..:.....~;~
orporate officer)
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.% .~.:>.~Jo.......:....
.-:-._-~ .:;.~ -~- ~::_::--~=-~~-:;:~~~-;-~::;-:.~~.
Builder's License No.
Plumber's License No.
.... ...... .... ..........
Electri~ian's License No. .......................
Other Trade's License No. .....................
I. Location of land on which proposed work will be' done.
. ...\~~.~.................;... ..Dln.~ J?~h~.~~.IJ9!....... .Cw~~:<............
House Number Street' Hamlet
County Tax Map No. 1000 Section ... \\\. . . . . . . . . . . .. Block ...~............. Lot... r:;. . . . . . . . . . . . .
Subdivision N.~~~.,..f.I. .0~~ ., . . . . .. . . .Filed Map No. ... ~~. . . .. .. Lot . ~yt.. . . .. . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing Use and occupancy .... .\l~C\-~ . ~. . . . . . . . . . . . . . . . . .
b.lntended use and occupancy... .\.r. ~~ .t.l.\ .D~/i~... .):~~<];,;;~<,::~):;.' :';.;:j>;>:;:::::::::::'
3. Nat~re of work (check which applicable): New BU~ding . ./.... Addition.......... Alteration ..........
Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . .
<# -" .. &cription)
--R '2"O?j 00 O. U<..J
4. Estimated Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
S. If dwelling, number of dwelling units. . . . \ . . . . . . . .. 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. Dimensions of existing structures, if any:. Front. . . . .-:-:: . . . . . . . Rear ..................... Depth .-:'. . . . . . . . . . . .
Height ....~........ Number of Stories. . . . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . .~. . . . . . . . . .. Rear.. .~. . . . . . . . . . . .
Depth. . ..... . . . . .........-r. . '" . Height.. . .. . . .~.. . . . . . . . . Number of Stories.. . . ... . '" . . ...~ . . . .. . .
8. Dimensions of ,ntire ~ew construction: Front. . . b-~ . . . . . . .. Rear.... :(;;2....,-. .. .. . Depth '.~.""""'"
Height . .1.4.~ ~5. . . . . Number of Stories. . . . . .I. :".1,.. . . . . . . . . . . . . . . .. . . . . . .. . . .. . .. . .. . . . . ...... . . . .
9. Sizeoflot: Front.... .1.b':). ..p.k......... Rear......... .(p.t......... Depth 33!l\..<(. /.!?~/../~.:....
10. Date of Purchase .............................. Name of Former Owner .............................
11. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . '.' . . . . . . . . . . . . . . . . . . . . . . . . . .
12. D?es proposed construction violate any zoning law, ordina~ce or regulation: ............................ 'n;~
13. WIll lot be regraded ............................ WIll e)~,ci~IJl!!I'..~ov~m premIses: Yes ~
14. Name of Owner ofpremises~~W:I'~. . .. .. Address m,o;r~~. . . Phone No. ...............
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
Name of Contractor e~Il>>?CI'! .'P.t~~... Address ~:[;:. /v'f./66Y.... Phone No. ;:;J~.'f.-;J.<(7y'....
15. Is this property within 300 feet of a tidal wetland? *yes........ No....~.
*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 from
property lines. Give street and block number or description according to deed, and show street names and indicate whetl.er
interior or corner lot.
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STATE OF NEW YORK, SS
~y OF e"~' "1''' .... ~ ~
.. .jeJt-f!y.', ... 0f'?:'7. ~~:":"'~' . . . . . .. . .. . . . . .... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
lbove named.
:Ie is the............................. ......................... " .........................
. (Contractor, ent, corporate officer, etc.)
)f said owner or owners, and is duly aut onze 0 perform or have performed the said work .and to make and file this
lpplicalion; that all statements contained in this application are true to the best of his knowledge and belief; and that the
.york will be performed in the manner set forth in the application filed therewith.
;worn 10 before me this Al
.........C.~h........day.Of.~~........; 19fJ
'otary Public. .... ...... .b:................ Cou ty
,
OOYCE M. WILKINS
. N4llary Publlo. State of New Yorfc
No. 4952248, SuffoIIc ~l\Ir
Term Expl....June 12.1a..z.;S-
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SURVEY OF
LOT 348
MAP OF SECTION "0"
NASSAU POINT CLUB PROPERTES,/NC.
FUD AlA Y 7, .. FIE NO.f!(J6
A T NASSAU POINT
TOWN OF SOUTHOLD
SUFFOLK COUNTY. N r:
1000 - 111 - 04 - 17
Scale: 1" = 40'
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Tille Association.
j
N. Y,S. LlC. NO. 49618
PECONlc. URVEYORS, P.C.
(516) 765 - 5020
P. O. BOX 909
MAIN ROAD
SOUTHOLD, N. Y. 1/971
93 - 310
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SURVEY OF
LOT 348
MAP OF SECTION "0"
NASSAU POINT CLUB PROPERTE5, NC.
FI.ED AM Y 7, .. FIE NO. IIOB
A T NASSAU POINT
TOWN OF SOUTHOLD
SUFFOLK COUNTY. N r
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N. Y.S. LlC. NO. 49618
PECONlC URVEYORS, P.C.
(516) 765 - 5020
P. O. BOX 909
MAIN ROAD
SOUTHOLD, N. Y. 1/971
93 - 310
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