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Home My WebLink About12055-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Zl1587 No .................. Date .......... ~.P~'~.~. 6 ............... 19 83. THIS CERTIFIES that the building New Dwelling Location of Property . 22.7.5. ~l:[ghl~d .RO~.d. 0~.t.~hogJxe .... House No. '102 Str~ ................... h3t~iei 008 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision .H.i.g.h~l.a.n. ~t..e.~$o.t.e.8 ........... Filed Map No..65~.7...Lot No...1'1 ......... conforms substantially to the Application for Building Permit heretofore Fled in this office dated ..... N. 9.v.e~'0O~'..'[8..., 19.82pursuant to which Building Permit No....'1~05~7, ........... dated ..... I~ecel~b~r. 3. ........... 19.82, 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 ......... ......... New. Dwelling ........................................................ The certificate is issued to Richard ~ohring (owner, levee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 11-16-82 12-so-136 UNDERWRITERS CERTIFICATE NO. 595506 Building Inspector Rev. 1/81 BUILDING 'DEPARTMENT TOWN ~HALL SOUTHOLD, N. ¥, BUILDIHG Fi~RMIT (THIS PEPu~AIT MUST BE KEPT ON THE pREMISES UNTIL I!ULL COMPLETION OF THE WORK AUTHOR ZED) 12055 Z Oot.. ,. ~ . ............... , ..........................................~,,~.~. ~ ~'~ ~/~_.~' ......... ~,...f ~' ~. ........ · '~;~'"'~'"cT'/-~" .~"~ ...... to ...,,, ......................................... ~ ........................ .................. .,~?~, .... ~ .......... ~&:. ........... z~...-~.~~. ~. ~_~.;'. .......... ~ ................ · ' 7~ ........... ~'~ ~' ......... ................. ................................................................. ' ........ '"":'"'!i ................ i ............. ~'~ .................. ; ........................................................ ~ ......... ,~ .......... ,,..,+ ................ [; ............ t .......................... Coun~ T~ /~op ~o 1000 $,¢tion ...................... . ~ oc .~ .' ..... ~l. ot ................... pursuant tO apphcal~on oared ............................................. ?..~,..., ..... ,., PP y Building I~spector. ee , ........ ~ ............... i Building ~lnSpectof Rev: ~/30/~0 , : · ' PORM NO. G TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11-q71 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and subr~itted in duplicate 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 tooograohic 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 building~ 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 sun/ey of peoperty showing all property Pines, 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. Data of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. · /- C. Fees: Ce ificate of occupancy $5.0.0. 2. Certificate of. occupancy, on pre-exis Jn g dwellin g q/rr land us~ ~/ 5.00 3. Copy of certificate of occupancy 81.00 New Building ............. Old or Pre-existing Building(,~) .......... = /Vacant Land ......... ...Owner or O~vners of Property' .~:~.~(~ t~/ . . County Tax Map No..1000 Section .... ~O.~ ..... Block ,~.~ .......... Lot. ~'~'~ ..... Subdiwsion. ..................... ~pphua,,~ ....... Health Dept. Approval ....................... Labor Dept. Approval ...................... ,.. UnderczritersApproval ...................... Planning Board Approval ............... . .. , ..~ ~ Request for Temporary Certificate ..................... Final Certificate ..... - ......... , THE NEW YORK BOARD OF FIRE UNDERWRITERS [00(~[ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YoRK 10038 THIS CERTIFIES THAT o~ly the electrical equipment ~ described below and int~duc~ ~y the applicant named on the abope application nu ~ber in the premises of i. ~o,~i.~,o~.~io~; ~ ~.~ ~ ~ ~. ~ ~ ~. S~c~on 10~o~ ~ Lo~ 11. was examined on ~ ~ ~ ~9~ and found to be in cotnpliance with the rVquirements of this Board, FIXTURE FIXTURES RANGES COOKINGDECKE OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT DRYERS E R V I C NO.%~%COND.I o~:c~§~,D, l i j 1/0 AWG, OF HI-LEG NO, OF NEUTRALS P',~'~.m~ E~tric Co. // ~ This certificate must not be altered in any manner; return to the off~ce of the Board if incorrect. Mspecto~s may b~n~e ~aenTmea py me~rfheJr ¢reaennals.credentia~s. ~[=-- COPY FOR BUILDING DEPARTMENT TH S COPY OF CERT F CATE MUS~:NOT BE ALTERED N ANY MANNER '~ FIELD INS~mCT~ON COMMENTS FOUNDATION (1st) FOUNDATION 2. {2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ~TS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ................ ~ ....... ~ ...... ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins 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 or Regulations, for the construction of buildings, additions or alterations, or for r~ova~ or dem~)lltion, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buflding/qo~/e, ltb3~ing c~de, and regulations, and to~ admit authorized inspectors on premises and in building for necessary inspe~3q'%t~~. ~/~ ' (sig'~ure of ap~(ic 'ant, ~ name, ifa corporation) ~ (Mailing afl~l.r, esE_of ~tl~pF~)~,~ Q ,Se.,n./hb+/fh f. State whether applicant is essee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant ~, a,~~,, f,~31Y a~/uth°rized °(f~Sc~r~ the tax r°ll 'r latest deed) ........ '(~me and title o~ ~pora~;V~r') ......... Builder's License No .......................... Plumber's License No.. ?.°. b.~-...~. ~?.~.?~.y/.. Electrician's License No. ~ ~.~..,~..~/.e....~-,f~../.... Other Trade's License No ...................... 1. Locat~onoflandon hichoroposedworkv/illbedone /qt~. F/~:'d~t'.~_7.. ~--~0.~.~'~1~ , aou.,a +- .,,. '; '." ".; ' ", ..... ;4"7', ...................... . ......................... . . ...... . . .............. House Number Street g Hamlet County Tax Map No. 1000 Section../..0..~.. .......... Block . .0...~. ............ Lot....(~...~. ........... Subdivision...'--.~. g././~..d(.N.a.~)~. · .'~ ...... Filed Map No...~. ff~..7.... Lot.// ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... ..... , ..- , ................................ b. Intended use and occupancy 3. Nature bfwork (check which applicable): New Building . 'Z ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .............. : ......................... Fee ...................... i / (to be paid on filing this application) $. If dwelling, number of dwelling Un~s ............... Number of dwelling units on each floor ................ If garage, number of cars ..... '...'~7. ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height . .............. Number of Stories ........................................................ ' Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth .................... ;. Height ..... .~ ............... Number of Stories.. [ ................... 8. Dimensions of entire new construction: Front . .tjX,..(-?.~. .... Rear .... .~a.7.. ...... Depth .~2 ........... Height ..... ./.~/: ....... _Number of Stories .. / ................................................... Size of lot: Front . .~...t/.7.. ........... Rear. /.~ 2..2._~ ........... Depth . .~..t~.. ............ Date of Purchase ........... ! .................. Name of Former Owner ............................. Zone or use district in which premises are situated ................................................... Does proposed construction violate any zoning law, ordinance or regulation: .V).~. ......................... Will lot be regraded . .~'~ .c~.... .................. Will excess fill be remove&from premises: Name of Owner of pr~,m~ses/t7t/I ~/~.C{~,ff~,p/I/:>.. Address . .~. ~,/.~./g..go.(.~...~.. Phone No..~. 7./.~.~ .~..~ ..... Name 0f Architect I~¢ax[~2~e ~O49L~' / Add ' ~ o..~.~.- ~7 -3.~.' ..... .......... t ................ tess .:~.~.. ,' .~-~ ...... Phone No ......... Name Of Contractor . ~. V~A~Z.~ . ~.~g.t-! ........... Address . .~./, .O. 94./¢B..t'~/.t~.~).~Phone No. (~ ~}.~tY../~/E~/ ...... ,,5'¢# 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and disfinctly all ;buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block fiumber or descfipfion according to deed, and show street names and indicate whether interior or corner lot. COUNTY 0~.'../~,~'~/ ............(Name' .... of'~'--'indivi '~1' "~f~\' ....... being duly sworn, deposes and says that he is the applicant above named. He is the ...................... ! ............................... ' .................... , ....~ .......... , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul} 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 manne!r set forth in the application filed therewith. Sworn to before me this ......... . .../.F~....da; o! ..... ~'.~.~., 19 ~-2, Nota~ Pub,,ic, . ....... ~ ..... ~~.~q. County ............. ~'/ N 01~, R~ I ~pAU~ ~, A~/t e Ho~ I~e'~w yeT~q ~ ........... / .... ~ignature of applicant) No, 52-8125850, Suffolk CoJ41:k~, SURLY FOR SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES LOttO. //, "HI6flLA~ ES~A~ES" FOR APPROVAL OF CONS~'RUCTION ONLY ~N OF ~O~NOL~ DATE ........ ho R[~:. ~ ' SUFFOLK COUNTY, N[W YORK NEW YORK STATE EDUCATION LAW A~ROVED HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUCT AND ~ HIS BEHALF ~ THE TITLE C~P~Y~ GOV~N- ~ ~F CO. TAXMAP ~IT Iooo SECTION IO~ B~CK o~ LOT OO~ H~E~ AND TO ~E ASSIGNEES OF THE LENDING m IgUl /.~1:~ HOWARD W, YOUNG, LAND SURVEYOR ~ ~ L~T~ ~ W~L(W), SE~IC TANK(ST)~ CES~OLS(Cp) ~N HERE~ ./~ ~ N.Y.S. LICENSE N0.45893 ~E ~ FIELD ~ATION5 ~D OR D~TA OBT~ED F~OM OTHERS should be noted that since this ~rt? is located in an agricultural ~0~ [~0~ : ~ea, the possibility exists that the ~ : w~fer supply ma? contain trace amounts of pesticides and/or nitrates. SURLY FOR ~FFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ~OTNO. //, "HIGH~O ~T~T~S" AT CUTCHOGU~ OATE: NO~ 8, 1982 - [&~%~-- t~ ~N OF SOUTHOLD SC~Lt: / = 50' A~ROVED NEW YORK STATE EDUCATION LAW HEALTH DEPARTMENT-DATA FOR APP C~STRUC T AND ~ HiS ~HA~ ~ THE TITLE CgP~Y ~ ~EAnEST W~ ~AIg~I. 3 ~SOURCE ~ WATER~ ~l~T[ ~PUBL~C ~ ~E~TAL AGENCY AND LENtilS INSTITUTION LISTED [~ RIVER~AD, NEW YORK SUBD/VISIO~ ~AP F/~ED IN T~ OFF/CE O~ THE C~E~K OF SUFFOLK ALDE~.~ COUN~ ON APR. ~ , 1977 AS FILE NO. ~5~Y AND EANDW' YOUNG~SURVEYoRPROFESSIONALN. Y.S. UCENSEENGINENo. 12845ER HOWARD W. YouNG, LAND SURVEYOR inspected bv thin c,'~t~m~t and found " ~h~ef of General Engineerin~ ~ervices HEALTH OEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT SUBDIVISION MAP F/LED IN TH~OFFICF OF THE CAFRK OF SUFFO£K COUNTY ON APR. F6, 197F ~S FIAF NO. 6557 N THE LOC~TION O~ WE).L(W),SEPTIC TANK(ST)& CESSPOOtS(CP) SMOI~N HEREON ARE FRO~ FIELD OB~RVATIONS .aND OR DATA OI~TAINED FR~OM OTHERS SURVEY FOR MOHRING ENTERPRISES, /NC. LOT NO. I I, ' HIGHLAND ESTATES ' AT CUTCHOGUE- TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK OE~. $, 198Z' DATE: IVO~. 8, 1982 SCALE' / "-- 50' NO, 82 - 709 AVENUE YOUNG a YOUNG YORK ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N Y.S. ECENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y S. LICENSE N0.4§~95 ._::,:--'-:£:'::T:T---:7;'-:.'.':T':.:."::-':':-' ." __--':-', :'' L :: OCCUPANCY OR USE IS BNLAWFUL WITHOi~T C[RI'iFICATE OF OCCUPANCY NOTI~r' BUILDING 'D~ENT AT 755-7802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: " ~:_ FOUNDATION _ TWO REQUIRED FOR'POURED CONCRETE '2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPL,~TE FOR C, O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF: THE N. ¥ STATE' CONSTRUCT ON & ENER~ C~DES. NOT RESPONSIBLE FOR DESIGI~ OR CONSTRUCTION ERRORS. ii_ ~)1 '0 Water distributing ~'Sbm; piping shall be °l~iYpes K or L only If COpper tubing is used for water distributing syslem; piping shall be of types K or L only U4 d ,I 0 'E.C..I I o k~