HomeMy WebLinkAbout11848-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UP DATED
CERTIFICATE OF OCCUPANCY
No Zl1745 Date JUNE 28, 1983
THIS CERTIFIES that the building-- ONE-FAMILY DWELLING
& GOLD SPUR ST.
Location of Property 12pp~W. CORNER HORSESHOE DR. CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 095 Block 04 Lot 18.31
Subdivision OREGON VIEW ESTATESFiled Map No. 6741 Lot No. 31
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUG. 5, 1982 pursuant to which
Building Permit No. 11848Z dated AUG. 9~ %982
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 ONE-FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE AND DECK
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N590320
PLUMBERS CERTIFICATION DATED
STALLER ASSOCIATEs
12-50-82
spector
Rev. 1/81
BUILDING
SOUTHOI~
BUILDING! PE~IT
(THIS PERMIT MUST BE KEPT
COMPLETION OF THE WOR~ ^L~TH~RI'ZEDi
:N9 ~1848 Z
bate
· P~er~issior
is hereby gra~ted to:
.....j...~..
........... ....
at p~emJses located
~UNTIL FULL
C~oty Tax Map No. 1000 Sechon +..~...~.,...,..,;...~k..'
pUrspant t0 application dated ..~.~,¢~..~i ~..~
Sgtl~ing I~sPector. : : ~, ]
~e~.~~
R~v. 6/30/80 · : ! ,~
~Lot No
and ~3pproved by the
FORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building InspeCtor
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z.q .1.Iq 5 ........ Date ....... .g.~r~ .e..2.8. ................. 19.8.3.
THIS CERTIFIES that the building .. Q ~ ¢.-.f. ~ r~ j_.]..y., qlV.e.& ~ $ ~ .......................
Location of Property . .12.Q5 .... S/W..C.qz?.r~?..l~9;e;s.~.~bp.e' .D.C .8~ .pp.l.d. 5put .S.t . ..C.u.tchogue
House No. Street Ham/et
County Tax Map No. 1000 Section . 09.5 ........ Block ..... 0.~ ........ Lot ...... 1. ~.; .3.1 ......
Subdivision.. Or.e.go=..~,~,ev. ~.~t~.~.e.~ ...... Filed Map No.. 6 .~.~.1...Lot No .... 3. .~ ........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· Au gu ~.~.. 5 .......... ,19. $ Rpursuant to which Building Permit No ..... ~. 1. .B.~.g.Z. ..........
dated ...... g ugu ~ I;..9 ............. 19 .~ ~, 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 .........
...... n.ew. on.e., f a~.±l y. g.~qe * ~[~.r~g..C~.. '~1.1~...~.~..~..e~ ~-.4..~[ .~.e}..~?..~...~ ~¢.1[.
The certificate is issued to STABLER ASSOCIATES
..................... ......................
of the aforesaid building.
Suffolk County Department of Health Approval ~ 2 - 50 - ~ 2
UNDERWRITERS CERTIFICATE NO .... ~590320
Building Inspector
Rev. 1/81
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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 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 Unde[writers.
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.
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 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 build!rigs or premises, or other pertinent informa-
tion required to prepare a certificate.
C, Fees:
1. Certificate of occupancy $5.00 ! /¢/$5.00
2. Certificate of occupancy on pre-existing dwelling ~r land use
3. Copy of certificate of occupancy $1.00
Date .. ~"-'¢~'~' ~'
New Building ............. Old or Pre-existing Building(Z) ......... ~ fVacant Land ...........
Location of ~roperty f~o'~ ~o~-,'~'' '~'(2/~/'~f~"""
Street Hamlet
Owner or Owners of Property ,, ,~,~. ~Z:~,, :.; .~_,~.~_~ ~,?, ,~,/,¢, ,~>..~'. .........................
County Tax Map No, I000 Section , ,O.~.~.',-' ....... Block ..... ,~, ,~, ...... Lot,/,~.',~',,/. ........
Subdivision,. , .~.]..J.{.~/, , ~_~.S ,¢ .....Filed Map No, , ,Lot No. ,3 ..........
Permit No ........... Date of Permit .......... Applicant .V.i.'~'.(?... f.~..~./~.).~.~.~.....~.~.~-~-
Health Dept. Approval. ~/~,..-~.(~..(~. , .~. ........ Labor Dept. Approval ...................... ,..
Underwriters Approval...~..~0.'~..~O. ........... Planning Board Approval .................. ~..~
Request for Temporary Certificate ..................... Final Certificate ........ - .........
Fee Submitted $ .............................
Construction on above described building and~per~it'mee~'~ll apl~l~cable~code~ and regulations.
Apphcant ................................
Rev. 10-10-78
FORM NO. 6
TOWN OF SOUTHOLD
Building Dopartment
Town Hart
$outhold, 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 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.
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 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 inforrna-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00 /
2. Certificate of occupancy on pre-existing dwelling ~r
3. Copy of certificate of occupancy $1.00
land use $/5/$5.00
Date
New Building ........ Old or Pre-existing Building(X) .......... ~ fVacant Land
Owner or Owners of Property ..... ; ...........................
County Tax Map No. 1000 Section . .O~.~. ...... Block ..... ~. ..... Lot../~,~./ ........
Health Dept. Approval . 1~.. ~0 .~.~ ........ Labor Dept. Approval ...................... ,..
Unde~riters Approval .... ~.~0.'~... ' ,Planning Board Approval .................. ~,.~
Request for Temporary Certificate ..................... FinaICertificate . .~ ........... *
Fee Submitted $ .............................
Construction on above described building and,p,~rmit'mee~za~all/~~.~¢. ~aPP~'cable~c°de~ and regulations.
Apphcant ,; ..... ~k~"" - ~/I,~/~ ....................., .....
/7
Rev, 10-10-78
FIELD INSPECTION
FOUNDATION (1st
FOUNDATION (2nd
COMMENTS ~ .~.
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
qODE
o
FINAL
ADDITIONAL COMMENTS:
looo3zl THE NEW YORK BOARD OF FiRE UNDERWRITERS
BUREAU OF ELECYRI¢IT~
~- ss JOHN STREET, NEW YORK, NEW ~OnK ,oo3.
"ate Jmmary 19, 1983 ~.~u~o.~o.o.Y~ 191477~-82
in the following location; ~ Basement [] 1st FI.
~a~ox.,,,i..do,, 3~nuary 13, 1983
FIXTURE
OUTLETS
24
DRYERS
[~ 2nd FI. ;, Section Block
and found to be in compliahce_ with the requirements_ , o~f this Board.
FIXTURES RANGES
FLUORESCENT
Lot
OVENS EXHAUST FANS
OTHER APPARATUS:
E
R t V I
C E
OF Hi-LEG
21o
A~Otor$: 1-F.
1-G.F.L
1-~oke Detector
Trackligh~:8'-0", 4 lites,
G. O. Electric
6 Poplar Avenue
Medford, N.Y., 11763 ~c.#2677 GENERA/. MANAGER j
11 ,,,, / q,; /
This cert f cate must not be altered in any manner; return to the office of ~h'e Board if ~ co'reef In ' jr '' ''' ' ' '~'';' '~ %''/
TOWN HALL
SOUTHOLD, N.Y. 11971
ApproveW .....7..,
Disapproved a/c .~ ....... ~2.2' ' ' ' '~' ' ' '~~
............... ~-. ............... ~~ ~ ! ~11~ilnspector) i ....
APPLICATION FOR BUILDING PERMIT
Application No../~/. v~..~.. .....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted 5._. _k4~!i.__d~ 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 issue 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 Southotd, 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 here_in described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regul,~dons, mzd to
necessary insp,ections. /%
admit authorized inspectors on premises and in buildings for ........ '~J'~'' '1~~ i~c~' '~)-
(Signature of app ' , o , ' 9r4p, )
.... aT. . . . ..- .
(Mailing address of applicant)
whether applicant is owner, lessee~agent) architect, engineer, general contractor, electrician, plumber or builder.
State
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly auttmrized officer.
(Name and title of corporate officer)
Builder's License No
Plumber's License No, ~,.
Electrician's License No..~.7,..0...~,aZ~.. ('T'.~.(~...
Other Trade's License No..:-. .................. .~/.~. ~--~[.~/d~ .~?("//'~ C~, .~./..~f~,
1. Location of land on which proposed work will be done .... ~..~
.c
House Number t ~.O~ Street Hamlet
County Tax Map No. 1000 Section .... O~ ........ Block . .~¢ ............ Lot. J ~ 3 J ...........
Subdivision.~.~/~.~.('. ............ Filed Map No. ~,~[. . Lot .~.] ..........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~C~[~
b. Intended use and occupancy .................. .................................
4. Esnm;rod Cost ........ i ......................... Fee ........... TT, ,' .......................
' (to be paid on filing this application)
5. I f dwelling, number of dwelling pnits ............... 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 ~ He'ght Number of Stories
8. r)imensions, ofentire new construction: Front..grO., .......... Rear.. 6..° .......... Depth ~.~ .........
[.C~. - ~qumber of Stories ]
Height .................................................. ~ ...............
9. Size of lot: Front...I.ci~'.0. ............... Rear ..].~.O. ................ Depth .~..'~.. ...............
10. Date of Purchase ........... .................. Name of Former Owner .............................
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 . .~,~.... ................... Will excess fill be removed, from premises: Yes (No)
14, Name of Owner of premises~(~../~; ...... Address/~C,~.q~?.~O~-~...~., Phone No. ~.~.~.o~'~././....'~.
Name of Architect . .,~ ....... ; .................. Address .. ~t~q~. t~. ~'q~-c '~Poh°ne No ................
Name of Contractor ~flq0~-,),, ,2~,, .]~.~, ,,C~ ..... Address 12?.~LI/,,~;2~',~:, ,~one No./f~,C.~ (,g', ....
PLOT DIAGRAM
Locate clearly and distinctly alii 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 whether
interior or corner lot.
COUNTY 01~~ iS'S
........ · ~..~. · i ~f~/~.'.~ .?ff. · .~.. ............. being duly sworn, deposes and says that he is the applicant
' (Na~ne of individual signing contract)
above named. :
(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
apphcation; that all statements cont$~ned m th~s apphcation 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
...... . . .~....(fi~ ........ d~y,oi... :~19~.:.
--- -fl ................
~ Ne. 92.$125850, Sdlol~ C~/
,. { r~'m iExplre$ Mm'~h 30, 19~2//'""
"It should be noted that since this ~ ,~,.~'~/'~,~'~'"-
property is located.., in an ogricultura " _ ..\.
~aetae, r thseuplP~;slbimli~[ ecX~Snt;ai~hattr~hcee ~ , L. Ot' ~0
amounts of pesticides and/or nitrates. ~
Special analysis'q'-~o/~,l J,/~,,, required.
p;';C., to
~ J suRV~ ~o.
~UFFOLK COUNTY DEPAR'IMENT OF HEALTtt SERVICES
STALL'ER ASSOCIATES
FOR APPR()V^L OF CONSTRUCTION ONLY LO~ 3j, "OREGON VIEW ESTATES"
AT CUTCHOGUE DATE: dULY ~' , 1982
DAT~ ~ -- ,-(~ TOWN OF SOUTHOLD SCALE= 1".40'
~~~'~.C} SUFFOLK COUNTY, NE~ YORK NO. 8.-S?S
NtMAOTN~IZ~'O ALTEIMT ON ON AOOeTION m mid
APPRO¥ ~.D .~.,~.~,r~__~.j.,/, ~..,~.~,.,~. ~ suRvEY I~ A v O(.ATlON Mr SECTION 7209 OF THE
~ NEW ~ONK STAT, EOUCAT,0N LAW
#COP~ES ~F TH S ~VEY NOT BEANING TNE LAND
s..uE., !s ,.KEO BEA~ ON E.'O..ED ...~ '"ALL '
~ ~., ~. w.o. THe .u~[~ ,s p.~...~o /~ /
HEAL~ DEPARTMENT-DATA F~ APPRO~L TO C~STRUCT ~NO~ Nil 'MMLF ~ ~"TL[ eNVY, eOVMN-
.... : YOUNG YOUNG
SUBDIVISIONI. MONUMENTMAp FILEDb I"' STAKETHE O~IGE* Mr ~H~ CLEAr OF SU"~OL, COUaTY . RIVER~AD, NEW ~RK
ON A~R. 4, 1975 AS FILE No.e~41 ~DEN W.Y~NG~ PROFESSIONAL ENGINE ER
~ L~T~ ~ W~L(~,~IC T*NK(ST)e CES~O~(~)~ HE~E~ HoWARoAND ~NDw. SURVEYORyouNG, LANDN'Y'S' UCENSEsuRVEYoRNO' Z845
60!
. ~ Se~ee8
I ~E~ A~k~iNS WITHIN 100 FEET OF T~S PROPE~Y
~ ~R TNA~fiOb~ SHOWN HEREON,
~ ~ WA~E~P~Y ~ SE~OE DI~AL SYST~ ~ THIS
I~C~F~NH ~ THE STAN~ OF THE SU~K C~TY OEPARTME~T
I~LTN ~IC[S
FtN~,L
SU!~/EY
STAI, L[R ASSOCIATES
LOT 31, "OREGON VIEW ESTATES"
AT CUTCHOGUE
TO~N OF SOUTHOLD
DATE: JULY 2 , 1982
SCALE~ l" = 40'
NO.
-SUFFOt~K COUNTY, NEW YORK
/ff'UN~I~TH~RIzED ALTEII~TION OR ADDITION ~
~R~[Y ~,A VI~ATION ~ SECTION ?209 ~ THE
N~'W ~RK STATE E~CAT ~ LAW
~¢OPI~ES ~ ~lS S~VEY NOT KARWG THE LAND
SU~V~R~S ]~K~O ~A~ OR EMSOSSED S~AL SHALL
~ ~ C~$10~ED TO K A VALID TRUE COPY
N~UARAN~ I~Dt~TEO HE~EOM ~L RUN ~LY
~'~ ~ WHOM THE SU~EY IS PREPARED
ANO'~HI~ BE~LF ~ THE TITLE C~P~Y, ~OV~N-
MENTA~ A~Y AND LENDING INSTITUTION LIS~O
H~E~, ~D ~o mE ASSI~N~S OF ~HE LENOIN~
INSOlenTly, GUA~ANT~ AR~ ~T
'~ ~AL INSTITUT ~S O~ SUOSEQUENT
OWNE~ S ' ,
~ISTAN~[S S~N HEREON FROM PR~ERTY
TOEXI~T~6 ITRUCTUR~S ARE FOR A SPECIFIC
PURPOSE ~N~ ARE NOT TO BE USED TO ESTABLISH
P~P~RTY LINES OR FOR THE ERECTION ~ FENCES
/VI. II~I~.] ~ /UUI]O RIVER~AD, NEW YORK
ALOE. W. YOUNG, PROFESSIONAL ENGINEER
4N~ ~N0 5U~VEYO~ N.~.5. HCENSE NO. 1~8~fi
HOWARD W. YOUNG~ LANO SURVEYOR
,.KS. LICENSE N0.4589~
41
FOLLOWING INSPECTIONS:
~., .FOUNDATION - ~O R~IR~
8. INSU~TION
4, FINAL - CON~RU~I~ ~
BE COMPL~ FOR ~ O.
~LL CONSTRU~ION ~ ~
TH~ REOUIR~E~ ~ ~
~ATE CONSTR~I~ & ~
COD~. ~T ~S~ ~
DESIGN OR C~ I ~ ~
t
o;
47