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HomeMy WebLinkAbout11885-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...... .o.np.Z~a..m.i.i.y...d.w.e.?:..5.~.~. ................... Location of Property 4¢993 R.o.w. o££ Oregon Road Uu~chogue [Y[~sk ~]d ........................................................ Streot Hamlet County Tax Map No. 1000 Section ...0.?.2 ...... Block O~ .Lot p/o 00~ Minor Subdivision ......... B.~..x~. ?~ ............... Filed Map No...~.7~...Lot No ...... 3. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ff.u. }7..2.~. ....... , 19 82 pursuant to which Building Permit No .... 'J ~ ¢3.~5Z ........... dated ..... ~aptamher. fl .......... 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..Qne.-£.amily .dxaeZling ............................................... The certificate is issued to ........... JOI-I3I Vg2~. ]3013~GONI)TEq~ ..... (owner, Jee~ee'~m~ ..... of the aforesaid building. Suffolk County Department of Health Approval . J ~'n~O.-~.~.....~..~Oz/.~.~. ................... UNDERWRITERS CERTIFICATE NO ......... p.e~di~lg ................................ Building Inspector Rev. 1/81 Permission is hereby granted - TOWN :OF ~OUTH0~D BUILDING D~PARTM~N~ TOWN HALL SOUTHOLD, :N; ¥. BUILDING p]ERMi'I~ (THIS PERMIT MUST BE KEPT ON TffE PRE~IS~S COMPL~ION OF THE WORK AuTHoRiZED) Date to at premise ...//©. Couhty Tax Map No. 1000 Section~;~../~... ...... BI ....~.r./,..; ....... , Lot No.; ..... ~/ pursuant to application dated ....... ~..~....~.-..~ .......... ??...~. ...... 19 and approv~ by the ~ ,,~, ~u"~n~,,,~ .~ec+or. - , ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted 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 topographic featu res. 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and c'~ndition 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 dwelling land use ¢ / 5,00 3. Copy of certificate of occupancy $1.00 Date .... .~/j.~/..~. ~.' .......... New Building I/ Old or Pre-existing Building Vacant Land Looat,on of Pro art . P Y ....7 ........ r,~. J-¢ .~/ ........ ~ ....................... ~ ........... House No. ~ Stree.t, ! Ham/et Owner orOwnersofProperty .~..1~.~.,~, ~...1~. ~.d.,'il.~.~'' ~ ' ............ ... ............................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. jl./.0~/... Date of Permit .~/~./~.~.Applicant .~//~../,4,,/~.. 'l(~,~/~,~., .~ .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate .................... Final Certificate . Construction on above described building and p~j,t~eets ~ r ~ HENRY E, RAYNOR~ Jr., Chairman JAMES WALL BENNETT ORLOWSK[, Jr. GEORGE RITCHIE LATHAM, Jr. WILLIAM F. MULLEN, Jr. Southold, N.Y. 1 1971 TELEPHONE 765-1938 July 13, 1983 Mr. Robert W. Wendell Winds Way Building Corp. 1020 Glenn Road Southold, New York 11971 Re: Baxter Properties Access Road Dear Mr. Wendell: The following action was taken by the Southold Town Planning Board, Monday, July 11, 1983. RESOLVED that the Southold Town Planning Board accept Inspector John W. Davis' report #303 regarding satisfactory construction of the access road to lot #3 within the subdiv- ision of Baxter Properties, Inc., located at Mattituck and said access road to be maintained at or above its present state. A copy has been enclosed for your review. cc: Building Department Very truly yours, HENRY E. RAYNOR, JR. , CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Susan E. Long, Secretary Southold, N.Y. 11971 HENRY E. RAYNOR, Jr., Chairman JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RITCHIE LATHAM, Jr. WILLIAM F. MULLEN, Jr. TELEPHONE 765-1938 August 31, 1982 Mr. Victor Lessard Building Administrator $outhold Town Hall Southotd, New York 11971 Re: Baxter Properties Dear Mr. Lessard: The following action was taken by the Southold Town Planning Board, Monday, August 30, 1982: RESOLVED that the Southold Town Planning Board Approve the access to lot number three on the subdivision map of Baxter Properties, located at Mattituck, for the issuance of a Building Permit, subject to the applicant complying with the recommendations stated in Inspector Davis' report #215 regarding improvements on the right-of-way before the issuance of a permanant CO. If you have any questions concerning the above, please do not hesitate to contact this office. cc: Robert Wendell Very truly yours, HENRY E. RAYNOR, JR. , CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Susan E. Long, Secretary FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No .................. ~ .......... ,... Date . . .~.~ ~..~7~. . ..... .... .., 19 .... dC>2/. · ·...-~.~zT~../..c(/.../¢..~.~. .......... PLEASE TArE NOTICE that your application dated .... /TJ.~...?..~ .......... 19 .~. ~.z~. for permit to construct . , ~.~ .~._~./."?.~,~... -, ~ at House No. . /. Street /Hamlet County Tax Map No. 1000 Section .. ~).7.~. Subdivision .~. ~:.. ........ Filed Map No...."~./[.~.~. ...... Lot No.. *~-..: ........... ----, is returned herewi,h and disapproved,on the foilowin~ ~rounds. RV 1/80 HENRY E. RAYNOR, Jr., Chairman JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RITCHIE LATHAM. Jr. WILLIAM F. MULLEN, Jr. Southold, N.Y. 11971 TELEY'HONE 765-1938 July 22, 1982 Mr. George H. Fisher Senior Building Inspector Southold Town Hall Southold, New York 11971 Re: Baxter Properties, Inc Access to lot #4 Dear Mr. Fisher: The following action was taken by the Southold Town Planning Board, Monday, July 19, 1982: RESOLVED that the S~uthold Town Planning Board ~prove the access to lot number four located within the subdivision known as Baxter ~ropertiest Inc. situated at Mattituck, based on John Davis' report #231 and said access to maintained at or above its present state. I have enclosed a copy of said report for your review. Very truly.yours, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Susan E. Long, Secretary Enc. cc: Robert Wendell Henry E. Ra~nor, Jr.~ Ch~irm~m Repor't. Naa 231 Soul, old q~m~n ]Rm~ing qoard John W. ])avis D~e: July 9~ 1982 RE: BAX"~ PROPt~q']'}'~,~ INCo~ l,~_nor Subdivision at Cutchogue tns?ect3, on of R.O.~J. and Access TM I made an inspection of +ho R.0.W. m~d access r(md today as requested by l~r. Wendell who advised that 'kh¢ road work and driveway entra3]ce into the property was now templet, ed. ~he access road from Oregon Road t,o the west side of Lot No. ~ (new house on this lot) is sa~isfsc+,ory, kdditional gravel was ~dded brosght in £irs~. ~te R.O.W. for the remaining lengSh is only part~a]ly cleaFed and there is no road im?~rovement in front of Lo~ s Nos. ~he lower branches of three la~'ge m~q~le ~rees in front of ~ he Bokina house bare been ~r~mmed for c].earance, qbe maple ~ree in *he Oregon Road R.O.W. at ~he access entmance does not appe;rr to be too much of ~m obs~',r,m+ion mhd could re~in. ~l~e driveway in+o Lot No. h and p~n'king area Lhere R-s 2"~ of crushed bl,mstone on a bankr~n base. ~his area is l~,rge enough ~o per~,,iL e~mrgency vehicles exit by making T ~rns. SEE S](E'~]{ q~f~f. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S SOUTHOLD, N. ¥. Exam,ned ....... ................ , ^pp,co,on .......... roved.~, ~ r ~.~, //c~:;~"~' ......................... ....... .......................... APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS o. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate 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 pubJic streets oF areas, and giving o detailed description of layout ofproperty must be drown on the diagram which is port of this application. 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 issue o 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 port for any purpose whatever until o 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 buildings for necessary inspections. ·" 'g ............ ~,~,'" .... , '~;: T,~,'~'g/ :,~,~ ~'g;~'g;g,:~i'~;~'i ........ ...... ' (Address of applicant) State whether opplic~j~ is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ,,,,~,,~..~.,.~.,.~../~_/~,,..~....~,,C~,...~=,.~,,~.~ ................................................................................... If opplicon~corpomt~si~ot~ of duly outh~officer. "~ ........ [d;k~-;~tle~ .... ~ com'""-';~te o~i~"-'"'"'"'"T ...... Builders Lic~se No ................................ .... E*,ct,~,~ ~,~ ~o...~ ....................... Other Trade s L~cense No ............................................... 1. Location of land on which proposea work will ~e ~one. ~ No,; ,./~ ............... Lot ~o..~..,.,~ / v ~ , ~unicip~ 2, State existing use on~ occupancy o{ premises aha intended use ~o~nc~ of proposea construction: a. Exisiting use ad ~cupancy ~~ '~~ 3. Nature of work (check which~applicable): New Building'. ................. Addition .................. Alteration ................ C~'~ ...... , (Descnphon) (to be paid on filing this application) 5. If dwelling, number of dwellihg ,,unitsz/,/,~ ~ ........ .~..~./. ............. Number of dwelling units on each floor ............................ 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 ................................ Height, ....................... :....Number0tof Stories ................................ , 8. Dimensions of entire new construction: Front ........ ~. ......................... Rear ..... . .~..~, ................. Depth ,.'.~..~.. ............... 11. Zone or use district in which/premises are situated ........ ~ .................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ..~,~///,)~/./~..~.Z..~... Will excess fill be removed from p,~emises: ( ) Yes ( ~f~o 14. Narne or ~wner aT premises ...~,:K~. ....... .~.....:¢.Y..'~.J. ..................... ^aaress ...................... x...z..., mane r~o ....................... Name of Architect ......... '...~... ............................................... Address ................................ Phone No ....................... PLOT DIAGRA~ Locate clearly and distinctly aH buildings, whether existing or proposed¢ and indicate all set-back dimensions from property lines. Give street and block number or description accord!~g to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~q,,~ORI~/ /~ c c COUNTYi G¢ _ ..-X~...~ ......... '~"~ , . , ............................ ~).~)..b.,~.~..~..~..~.~.,.I ....... being duly sworn, deposes and says that he is the applicant , (Name o( individual signing contracO above named. He is the ...................................... e.~.........~~ ~ ...................................... ~[ ................................................................... ~gent, corporate officer, c.) of said owner or owners, and is dbly authorized to perform or have performed the said work and to make and file this application; that all statemen~ts contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in ~he manner set fo~h in the application filed therewith. Sworn to Eefore me this .... o, ............... - - /' ............... otary ' · ..... ~y .............................................. ~ .... ~I~H ANN nEVIL~ ~ ~BOC, State of N~W Y~k , --/ SUFFOLK CO. HEALTH DEPT. APPROVAL · DISMAL SYSTEMS FOR THIS RESiDEN~E WILL coNF~M TO THE STANDARDS ~. TH~ ~~O~ SUFFOLK CO. D~T. OF ~ALTH O~ ~ ~LT~ D~¢~ ' A~LICA~ SUFFOLK CO~TY DEPT. OF SERVICES -- FOR APPROVAL OF CONSTRUCT ION ONLY ' bawe beea DATE: for t~is~ ~ n~l°cati°n~ ~~ "0' .... Chief Services ~ -~ , , . ~N~ ~.Y~K SUFFOLK CO. HEALTH DEPT. APPROVAL Hi S* NO, ~ 'STATEMENT OF INTENT -'~ ,~- ' ~ ~ THE WATER SUPPLY AND S~AGE DI~SAL SYSTEMS FOR TH1S RESIDENCE WILL CONFO T THE · ~ , SErVICeS -- FOR CONSTRUCT ION ONL~_Z DAT~: APPROVED: T~T ~LE ~/ ~ ~OUCATION LAW. ouM ~ note - that ~[nc~ this ~u,~:,~,,~;~ he possibili~ exists that the t~m ~.,,~< water supply may contain trace amounts of pesticides.and/or nitrates. ~.d~ t~,' .1.~',~;[ ~ :b -: 5;'-:: '~ ~;'~ SEAL c~'~ ~t~1~ t~ gue~<e llCCUPII'NCYOR ............. USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ....... -,., 4., ',\ ...... APb'II,VIeD AS 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ?. FOUNDATION - TWO REQUIRED FOP, POURED CONCRETE ~ ROUGH - FRAMING & pLUMBING ~. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C. O. ~LL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~J'ATE CONSTRUCTION & ENERGY CONES. N~]T RESPONSIBLE FOR t q ¸-7 ,?