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Home My WebLink About6612-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCcu.L-,ANC"~' No Z-23134 Date AUGUST 2, 1994 THIS CERTIFIES that the buildin~ Location of Property 800 ST~RLING ROAD House No. County Tax Map No. 1000 Section 104 Subdivision DWELLING cuTCHOGUEr N.Y. Street Hamlet Block 4 Filed Map No. Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29, 1973 pursuant to which Building Permit No. 6612-Z dated MAX 29, 1973 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 DW~T.T.ING WITH ATTA~D GARAGE & DECK AS APPLIED FOR* The certificate is issued to C~%RLES & BI~/~u~u~ WATTS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL MAY 8, 1974-R. VILLA UNDERWRITERS CERTIFICATE NO. N-159214 -- MAY 14, 1974 PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS UPDATES CO Z-5901 DATED MAY 13, 1974. '/ ~/ulfding Inspector Rev. 1/81 FO~M NO, 4 TOWN OF SOUTHOLD BI. IH,DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No..Z.~..~0..~ ...... Date .................~....~.~ .... , 19. THIS CERTIFIES that the building located at 8~ 8t~rl~n~ F~ Street Map No. Na..e.~..~....11~.. Block No ........... Lot No. p.t..p..1.o.t..1..1~......C~..t..~. ?.~..~... conforms substantially to the Application for Building permit heretofore filed in thin office dated ...... .l~.l~ .... ~.9 ....... , 19.?~.. pursuant to which Building Permit No.6.6.1..~.... dated .......... ..~.... ~? .... , ~9.?.~., was i.,sued, and confo~ to ~U of the ments of the applicable provisions of the law. The occupancy for which ~.hi~ certificate is issued is..~..~;.,.t.,..~;..f..~1...~?..~?.~.~..~. ~. ....................................... The certificate is issued to .C..hsr.l. qs.. &..B...1~...h..e..~..t..t.s ...... · .~..v~.~..r.s .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..~....~....l..~.....b.l~' .R.; .?.i..l~.. ..... UNDERWRITERS CERTIFICATE No...l~..~1...~. ................................... HOUSE mr~E~. ~ ......... Steer...ap~..~....a..~o~.. ........................ Building Inspector FOR!~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N,~ Y. BUILDING PERJ~iT (THIS PERMIT MUST BE KEPT ON THE PT~EMISES UNTILFULL COMPLETION OF THE WORK AUTHORIZED) N? 6612 Z Permission is hereby granted to: · ..~.;L~.~...~.. ~ ;t ~.~, ~.w...W~ ,$.~ ....................... ............... ~.~e~ling..l~o~d ................................. ......................... C~t~ho~e ...... ~.~.. ................ ~o .~.~..,~....°,~..e...~.~..i.~...~.e...z.~. .................................................................................. at premises located at ....~..~..~,.~.~.~..~....l..~.....~.~.~..~..e,~lt ........................................................ ................................. :\-~/~..~te~.;L~n~ ..2oa4 ........... Cu-t~og~e ....... ~..~.. .............................. pursuant to application dated ......................... ]~. ......... ~ .......... 19.~..~.., and approved by the Building Inspector. Fee $?.~ .e..~..~,. ............ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 TOWN I~OUTHO~ ~' APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must he 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 locatzon 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, zndustrial 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-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-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 ,~ 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 Date July 28, 1994 ildi X New Construction ........... 01d Or Pre-existin§ Bu nE ................. .80. Q sterling Road Cutchoque Location of Property.. ............................................................. .... . .. House No. Street Hamlet 0nwer or Owners of Property Charles & Blanche Watts County Tax Map No 04.00 009.000 1000, Section .... 104..00 Block .............. Lot.. Subdivision....M.alp' of Nassau Farms .Filed Map.#l179 .Lot...P./.q plot. 140 Permit No...~-~ ....... Date Of Permit...5J.2.9../.7.3 ...... Applicant...C.hAr. l..eP..a., .~.l.a.n. qh..e..W.%t..t.s Health Dept. Approval ...... 5.(8.(7.4. ............. Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Updated Cert. X Fee Submitted: $. P.°.:q9 ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS IBW BUREAU OF ELECTRICITY ~-- 85 JOHN STREET. NEW YORK, NEW yORK i0038' THIS CEEIFIES THAT Char~5 ~a~5~ ~er~n~ ~.~ 3rd ~ouse ~5~ B~y Ave., in the/oiling l~ation; ~ B~ement ~ 1st FI. ~ 2nd Fl. OU ~ 8 ~ de ~tion Bilk ~o. ~ay 9, 197~ ~dfoundtobein~mplia~e~iththerequirementsofth~B~. FIXTURE I FIXTURES OUTLETS23 ECEPTACLES3~ SWITCHES~i INCANDE~Kr~3 F!UORESCENT M~Ai~RY RANGES ,MT. K, W, COOKING DE~KS OVENS DISH WASHERS AMT. K.W. J ~T. K.W. ,,,.,. j ,~.w. TIMECLOCKSI BELL UNITHEATERS MULT EXHAUST FANS DIMMERS SERVIC~ DISCONNECT J NO. OF I 200 ,CB METER S 1 R V I C OF CC. COND. 4/0 OF NEUTRAL 2/0 · Furnaces: 1-1/8hp, Motor/s: 1-3/~hp I-GoF.I. 2-1/15bp, t-1/4hp Charles ' ~tts Sterling Rd. Cutcbogue, New York 11935 COPY FOR BUILDING THIS MANNER. SUFFOLK COUNTY DEPARTMENT OF HEALTH H.D. Reference No. _:5'd'~ --~ APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM Address . ~;'F~-//m~ /2~/ , /~,~z*~ . ~ ~F. 6. Section 2. Property,i-o'cat.ton / ~zm~.'/f>~ ~, ,~f~ 7. Lot No. ~.~/' ~ /--z/~e /-~e_ , . .. 8. Private well 2(- ~¢9 Villag~/ ~/~/c.l~,~.- Township ~5~,,//~/J 9. Public water 3. Public Water Company name Distance to main 4. Lot size: Width /~ feet Length /~---feet (Enter on center plot below) 10. Sewage Disposal System: A. 900 gallon septic tank: Precast /E~uivalent Block __ B. Leaching pools: Number 7-~ Precast-,-' Block Special If private well fill in blanks below: Tank cape city.~Gals Pump G.P.M. $ Total well depth Depth to G.W. ~b Amount of water in well ~6~ Test Hole Data Feet 0 2 4 6 8 10 12 14 16 18 The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health's current stand- ards thereto." Date //"/-~% Z7 Signed - Owner or Builder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented~ ~e~ewith,=~t is the opinion of the 'Health Department, that an adequate and satisfactory Sewa~ DisposalDate System~///~ ~-o~ , ~can be installed on this SlgnedPl°~--'~[~%_.~/~ ~ ~~' S-15 ~ew~s~d 4/~/72 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Souehotd, Iq. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This opphcahon must be filled in typewriter OR ~nk, and submitted m DUPLICATE to the Building Inspector w~th the following, for new build,rigs or new use: I Final survey of property w~th accurate location of all buildings, property hnes, streets, aha unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage disposol--(S-9 form or equal) 3. Approval of electrical installation from Board of Fire Underwriters 4. Commercial buddings, Industrial build,rigs, Mulhple Residences and similar buildings and ,nstallat,ons, a cerhficate of Code comphonce from the Architect or Engineer responsible for the building. 5 Submit Planning Board approval of completed s~te plan requirements where applicable B For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" land uses 1 Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or prewous owner os to use, occupancy and condition of buddings 3 Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a cerhficate. C Fees' 1. Certificate of occupancy $5.00 2 Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1 00 Date ,,,..~. ~..~./.0../.y..~., ....................... New Budding ~ Addition Old or Pre-existing Building Vacant Land Location Of Property ... /.~ ........... ..-Z.. ...... ~,~.~...~....~r....~..~_.~..~ ................................ Owner Or Owners Of Property .~..../[..~./.~'.,~.-....~'.~.../.~.~... ................................................................... B,oc ....... '.:.. ,o.se Permit No .~..~./..Z..ZDote Of Pormi .~..~.~.~.< Health Dept Approval ...,..~.......d.,..,~...,.~,., ................... Lobar Dept, Approval .... Underwriters Approval / Planning Board Approval Recluest For Temporary Certificate ' -- Final Certificate ,.,.,.~....,. ............................. Fee Submitted $ ...~.~......,..~... ................... Notary Public ................................... County Construction on above described building and permit meets oil applicable codes and regulations. ' ..... ............................... Sworn to before me this (stamp or seal) TOWN OF SOUTHOLD /-/~,~ ~ BUILDING DEPARTMENT ~' TOW CLERK'S OmCE ' ~ SOUTHOLD, N.Y. ~ 3~¢~ ~ ~/.~ ~ ~ ~ ~ ~' ~provea ........................................ , IV ........ ~ermiT ~o....~ ........ ~ ................... Disapproved a/c ................ ~ ........................... j ...................................... ............................ ~ ............. ~ ................. ~....~ ........... .................. (Building In~ector¥ ............... t ................. APPLICATION FOR BUILDING PERMIT .................. ............ ....... I NSTRU~IONS o. Thi~ ~pplicotion must be completoly fill~ in by ~p*writor o~ in ink ond ~ubmi~d in triplicate to ~h~ In~ctor, with ~ ~ of plan*, ~ccumt~ pl~ plan to ~al*. F~ ~ccordinO to ~chedule. b. Plot plon sh~in~ Iocotion of lot ond of buildin~ on promis~s, relation*hip to od~oinino pmmi*~s or public or~~.~ d~tail~d d~ription o{ layout ofprop~r~ must be drown on the dio~rom which c~~Cowr*d b~ thi~ ~lic*tion m~y not b~ comme~ed b~foro i*~u~nco o{ Buildino ~rmff. ~.~ Hp~n opprowl o{ thi* opplic~tion, th~ Buildino In*p~ctor will i*~ue ~ Buildin~ Permit to th~ ~pplicont. ~uch permit sh~ll b~'k~t on th~ pr~mi*e~ av~ilabl~ {or inspection throughout th~ work. e. No buildin~ ~cupi*d or u~d in whol* or in port {or ~n~ pu~os~ whatever until ~ ~ific~t~ o{ ~cupancy sh~ll hove be~n ~[~h~ Buildin~ n~p~ctor A~klCATIO~ IS H~R[BY ~D[ to th~ 8uildin~ D~p*~ment for the issuance o{ o guildin~ ~rmlt pu~uant to tho Buildino Zone Ordinance o{ th~ Town of Southold, Suffolk Count, ~ew York, ~nd other opplico~l~ ~w*, Ordin~nc~ or Re~ul~ns, {or th~ c~truction o~ buildings, ndditions or .ltorations, or {or removol or The ~pplico~ a~ree, :~ ~ly with ~1~ opplic~bl~ I~w~, ordin~ncos, buildino c~, hou*inO c~, ~e~ r~u ~tion*, ~nd to odmit outh0ri~ i~tor~ on pr~mi~ ~nd i~ buildln~ {or n~esso~ inactions. ............ (Si~notur~ of ~pplicont, or n~m~, i{ ~ corporation) Sterling Road Cutchogue - (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~mer Name of owner of premises ....... .OJP, C,~.~,.~.fi...~...~.~.~..~..q..h..~ .~T~.~..~ ................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ~ Sel~ Electrician's License No..~..o.~...~.. .................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ~.~.8..~..a...~....~...8:....z~..~ ........... Lot No.?..~.......~..1...LI:.O.. ..... Street and Number ..... ~.~...$.t.~,].~LO.g..~.Q~.~ ......... ~J~,'~f~Pg'l,~ ........ ~..t.'~...: ..................................................... Municipality State existing use and occuDancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~nca, nt b. Intended use and occupancy ............ .O.13e...~nmJ/~..~tg'.e.].]~,,~ ...................................................................... 3. Nature of work (check which applicable): New Building ..~ ...... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ...................... 2~.~.Q~I.Q..~ .................. Fee (to be paid on filing this application) 5. 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 ~ame structure w~th alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ....... ~ ........................ 8. Dimensions of entire new construction: Front .~ ..............................Rear ..~.~. ..................... Depth .~,~/.~.~. ........... Height .................... Number of Stories ..... (1~ .............................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated IIA" ~tSt 12. Does proposed constr~ction violate any zoning Iow, ordinance or regulation: .... 33.0. .............................................. ]3. Will lot be regraded ...... ~ ................ Will excess fill be removed from premises: ( ) Yes ( ~ No 14. Name of Owner of premises .....(~La.S...~.~,~8.~...1~.~.~.~A~Tress ..... .~.9~.~. ..... Phone .No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of contractor ...J~.~.~. .............................. i ................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly o bud ngs, whether exicting or.proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according t° deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~c ~ /~/~. '~3 COUNTY OF..,,...~1~£~ ........ ~'~'~ ......................... · ~l. ee..~.~ll...~ ................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing controcf) ~bove named. O~ze~ - b~t:Lcte~ He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform Or have performed the said work and to make and file this application; that all statements contained in this application 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 -- of .: ............... .................... , 19...~..~. (Signature ~f applicant) TERRI LEE ~ ~ PUBLIC, State of New York . No. 52-616829~ ~llgg~ in Suilolk County 19~1~j~ Expires March 30, SUFFOLK COU~' ~-"/~ DEPAR~ The Sewage disposal and watep SUpply facilities £or this location have inspeoted by this departm been %0 be satisfaotor¥. ~~und Chief of General Engineering Services "Altemtlon of this Documenl except by ~ Licensed Profes- sloh~l Engineer, Is illega, l". Section 720~ ,'Sul:idvtSon~ ~. N, Y'; S,tae u~liOp,,J.m~., -:' : - ' , , ~ Q Q L Do~umen! except by a Licensed Pro~es- ~ional Engineer. Is illegal". Se~on 7209, Sub~ivls~on 2~ N. Y~ Steie Education Law,.' "Alteration of this D~um~nl , ~cept by ~ Licensed Profes~ si~al Eng~n~er, ~s iUeg~l", 5~lon 7209, 5ubdivi~lOn N_ Y. State Education ~'^ller~t~on o¢ this Document except by a Licensed Profes- sional Engineer, is lfiegol". : Section 7209,~ SubdivistoR 2, N. Y. Stole ~duc~tion L~W, ,,