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Home My WebLink About10278-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Zl1808 Date July 27 ................................................... 19.83.. THIS CERTIFIES that the building 70 ..... ............................. Location ofPronerty 3760 Main Road Oreenport House No. Street Hamlet County Tax Map No. 1000 Section .... 035.. ..... .Block 06 .Lot 026 Subdivision. ?.qr..d.h.a.m...Ag.r.e.s' ,..S.e.c..~....2....Filed Map No. 4.6.0.5. .... Lot No. ~..8 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated d u n e 8 19 .7.9. pursuant to which Building Permit No. 10278 Z dated June 26 19 .7.9. 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 ......... a private one-family dwelling The certificate is issued to GEORGE O. & RUTH M. THOGERSEN (owner,/~s~e~cet~a~O ..................... of the aforesaid building. Suffolk County Department of Health Approval 9-S0-52, 3/31/80 Robt. A. g±lla UNDERWRITERS CERTIFICATE NO... N 7457746 ........ ~'~.. ~ .... <~t._.Building Inspector Rev, 1/81 FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 1027S Z Permission is hereby granted to: ..... .~,Z;~ ,~@z~... ~. ,...../..~z-.,~ir~,~..~,=-~. ~..2...,Z~z~.~,~. -..../~:~.~ ............ ,,~.~,~Z,~,~.~...z.~,.'.7.. ........... ................................................................. :.H~..~.~.:~. ................................................. : ....... .~. ............ ..................................................................................... ~.~..~o..,...~z~~..... ~.....~ ........... ~oZ...~.L~..... .............. Building Inspector. Fee $.~..~ ' B~din~ In~ector ' FORM NO. § 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. 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 ~' / 2. Certificate of occupancy on pre-existing dwelling ~r land use $ !~'/ $5.00 3, Copy of certificate of occupancy $1.00 Date .. July. 7, 1983 .. New Building ..... X ....... Old or Pre-existing Building(X). ~ ........ ~/Vacant Land Location of Property ...... ~ .............. WJ.E~,~. Ls~e ............ Oz'ee~po~t; ........ House No. Street Hamlet Owner or Owners of Property . . .(}eo~.~;e O..~. [t~3. M..~]3~a~$e~. ...................... County Tax Map No. 1000 Section .... 03~ ........ Block ...... J~ ....... Lot... 2~. .......... Subdivision ..... Foz~ham. A~z.e¢ ............. Filed Map No.~60~ ...... Lot No.. 18 ......... Permit No. 102.78. Z.. Date of Permit .6/2~/.79.Applicant . .Geo.t1.ge. D.~ .Th~ez'ssn ......... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ~57.?~t.~. 11~.21/.7.9. i..Planning Board Approval .................. ~ ,.~ Request for Temporary Certificate ..................... Final Certificate ........ X ........ * Fee Submitted $... ~.,.00 ..................... Construction on above described building and permi~meete all ap~pti,~e~ and regulations. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~r [qove~be~' 2[~, ].~i:)JOHN STREET, NEW YORK, NEW YORK 10038 ~.,. ~...~.,,o.~o.o.~.. 0~00~ N 457746 THIS CE~IFIE5 THAT in the/ollo~ing locetion; ~ Be~ement ~ 1st Fl. [~ ~nd Fl. Section Block Lot wasexaminedon ~O'~ber ~9. ].~7~ andfoundtobeiflcompliancewiththerequlrementsofthisBoard. FIXTURE fiXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES DRYERS FEEDERS TIME CLOCKS UNIT HEATH MULTI-OUT/ET DIMMERS SYSTEMS NO. Of FEET SERVICE DISCONNECT S E R V I C OTHI~ _A~R~TUE= 1-Smoke Dec. outlet 1 3 1 5 1-100amp Discount switch for generator Sal Prato Klac. WiS&ina La. Greenporc,N.Y. Lic.1049 ~ENEE~J. MANAGE~ Per- This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. -~OL~ ~ N FP~AIVNE 5 FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... .Z.9.9.0..9 ........ Date ..... .~p?.&l....2. ................... 19 .8.0. THIS CERTIFIES that the building ................................................ Location of Property ..... ~'.0..l~.t, gg$.~$ .l~.~e. ...................... .~l?..e.O.Zl.~.9 .~.~..~. ~.~., House No. Street Ham/et County Tax Map No. 1000 Section . . . .0.~.~ ..... Block . ...~. .......... Lot ...2.~. ............ Subdivision ..]~01¢.012~. ~17¢1~. ............. Filed Map No.../4.6.0.~...Lot No ...... .'1.~. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... .ff.t~..~...~ ........., 19~..9. pursuant to which Building Permit No ...... ~..O.?_?.~.Z. ......... dated ..... ~TI~.O..~ ............... 19 .~..D, 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 ......... ................... ~.~.~V~.~e. 0~.e..Fo.~kly. ~.ell;[ng ............................ The certificate is issued to ....... ~.e.o~go...0....&.. ~.~.~...h. ~:,2,~l~O.~[.e, .l?.8.e.ll. ................. (owner, I~"~) of the aforesaid building. Suffolk County Department of Health Approval ... UNDERWRITERS CERTIFICATE NO ........... ~.1. ............................. Rev 4/79 Building Inspector FORM NO. 6 TOWN OF SOUTHOLD ~uilding 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 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. 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 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 informa- tion required to prepare a certificate. 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 $1.00 Date ... ¥~.ch. 2/~ · 19/[0 ...... New Building.... :~ ,,..,., Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... ,7.0,.: ............. ~/.~kEE[IQ.~, L$~ ............. G~"~,e~po~',t ...... Hou~ No, Street Hamlet Owner or Owners of Prope~ George 0. & ~b ~. ~ho~e~ee= ....... CounWTax Map No. 1000 Se~ion ..... O~ ...... Block ... ~ .......... Lot .... 26 .......... · Subdivision ..... ~d~ ~c~e.$ ............ Filed Map No. ~60~ ..... Lot No...~ ........ Permit No. ~7~, ~.. Date of Permit 6/Z6/79..Applicant , G~ge..0 .. ~hoge~e= .......... Health Dept. Approval . ........... ........... . Labor Dept, Approval ........................ Unde~riters Approval~57~ · · ~/~/~979. ,Planning Board Approval ......... ~ ............ Requem for Temporary Ce~ificate ..... ~ ........... Final Ce~ificate ....................... Fee ~bmitted $ ...... ~0~. .................. Con,ruction on above de~ribed building and permit meets all applicable codes and regulations. G 'rHODERSEN C/O NORTH.RD ' · ~TU/ SURFACE AREA UNZT BTUH -.8LI~N~.'~O0~, ,BO~LE,'GLA~8 , , . .: 42:, FLOOE~ OVER BASEMENT WItH R-l~ INS 72R 0.03 15~8 :. "'- TOTAL LOSS IN BTIJS ~4~86 SHOU~ HAV~ AN ZNSULATION VALUE OF THIS ~OMPUTER PRINTOUT IS AN ESTIMATE OF H~T L,O~S BASE~I ON PARAMETERS SPECIFIED AND SHOULD NOT BE U,.ED FOR DESIGN PURPOSE, ~_ ............ ...... ~ ~.~ ......... ' AP~I. iCATION CONSUMPTION 'TOTAl_ ~ENTS/CCF ~ " $ IO5 OCA AT 7~0 CENT~/CI.,F . : i>~ QLIALI'f'Y OF CON~T~U[:TION,' . TOWN OF SOUTHOLD OFFICE OF BUILDING INSP]ECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 November 12, 1980 George 0. Thogersen 2 Demarre Lane Bayport, New York 1170~ Dear Sir: This is to notify you that Building Permit No. 10278Z issued June 26~ 1979 to construct o~e famil'~ dwelling will expire on Dece~er ~', If more time is required to complete the Job and obtain a Certificate of Occupancy, you may apply, bY letter, fo~ a six (6) month extension. ' If the work is not completed and the Certificate of Occupancy not issued after the six (6) month extension period, you are than required to apply for a new building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector George O. Thogersen 10 Wiggins Lane Greenport, N.M. November 21, 1980 Town of Southold Office of Building Inspector Town Hall Southold, New York 11971 Dear Sir: In reference to your letter of 12 November 1980 regarding Building Permit No. 10278Z , I hereby apply fop a six (6) month extension. Very truly yours, George O. Thogersen 10 Wiggins Lane Greenport, N.Y. 11944 November 21, 1980 Town of Southold Office of Building Inspector Town Hall Southold, New York 11971 Dear Sir: In reference to ~our letter of 12 November 1980 regarding Building Permit No. 10278Z , I hereby apply for a six (6) month extension. Very truly yours, G~orge O. Thoge~sen Memorandum from.... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD Town H^L~., SOUT~OLO, N. Y. 11971 765-1802 3~y~- TOWN OF $OUTHOLD BUILDING D£PARTMENT ' : TOWN CL~RK'S OFFIG~ SOUTHOLD,' N.Y. ~ Examined ..... ~:~'~ · ..(~.. · .......... , ./... ,., '-~ ......................... ~pPL. ICATiON FOR BUILDINO pFRMIT : pate ...~IZD. e...8,, ............................. , 19...~9 ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plat plan to scale. Fee according to schedule. b. Plot plan showing Iocatior~ of lot and of buildings on premises relationship to adjoining premises or public streets o, arid ivin a deta led description of layout ofproperty must be drawn on the diagram which is part of this application. areas, g g .... 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 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 ,i,ssu. ance .of,a Build~.ng ~ef[n~it Building Zone Ordinance of the Town of Southold, Suffafk Coumy, ~ew Tor~, ann o~ner appncap,~ _uws, x.,rumu,ae~ u~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicabie laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ~ _ _ ' Bayport. Ne.v' Yo~.k. 1.1..7.~.~ · ..a',... LAelge,r/l~'.o ..~n.a .................... r. ............................. · {Address of applicant) State whether applicant is owner, lessee~ agent, architect, engineer, general contractor, electrician, plumber or builder. · George 0, Thoge~en . . . .... Name of owner of prembes ................................................................... If applicant is a corporate, signature of duly authorized officer. Builder's License No ..................................................... Plumber's License No.... ............................. ; ................ Electrician's License No ............................................. · o, be selected Other Trade's License No ............................................... /¢605 1(3 Location of land on which proposed work will be done. Mop No.: ......... ~ ............. .-]].~ ...... Lot No ......................... 7 o W3.~,g~.n....~ L.~,,'/..e ..... ../-.-.¢~----~ ........................................................ Street and Number .................................... ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: None . . : ............................... a. Exbff~ng use and occupancy ................................ One famil;f, prlva.~.e [.v. eeJ. denca ...................................................... b. Intended u~e and occupancy ............................................... 3. Nature ~f work (check which applicable): New Building ........ ~ ....... Addition .................. Alteration ..r~. ............ Repair ................ :.RemovoI Demolition .................... Other Work ...................................................... .................. (Description) .$30, .0.09. .... Fee ...... $.. ~'~2~ ................ :; ........... :-' 4. Estimated Cost ........ . (to be poi Jan f ng ~n s opp,icat on~ .5. If dwelling, number of dweIlin§ units 1 .. .... N~ber of dwelling units on each floor ..... . ............ ~ ......... If garage, number of c~rs ......... 1 . . ..................................... ..................................... 6. If business, commercial or mixed occupancy, specify nature and 'extent of each type of use ............................ 7. DimenSions of existing structures, ff any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ..................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 3~ 37' 8. Dimensions of entire new construction: Front . 4 Rear ......... ~J. ............ Depth ........................ 18 Number of Star es .......... 1.t~ ................................................................. Height .................... ~-3u ' ~ . 1~0~ Rear . .. 1~.0,! ............ Depth ...............f. ........ 9. Size of at: t'ronr ...................................................... ' ....... Alvin of Former Owner ....... 10. Date of Purchase ' Febr~ar2..1..9.~.9 ............ Name · . ,Di~trict lO00 Sec: ~5 Blo~k .~.... ~.C~. ~.6. . I J. Zone or use district in which premises are s~tuoteo ........................................ " ~o 12, Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded Ye~ ..... W excess ,fill be removed from premises: ( ) Yes (X) No · Geoz-~e O, Tho~e~sen Address D.~s~n...Ln..~a~ne No4:/~....l.~.~;~ ...... Howler A. Mer~ ~595-3343 14. Nome of Owner or prem,sesG,A~.-.~.~.~[~"p'~'~'~ .............. Address ................................................................. Name of Architect .............................................................. Owne~ Address Nome of Contractor ......... '''-- , ................................ Phone No ....................... PLOT DIAGRAM Locate c early and distinctly all buildings, whether existing or proposed, and indicate all setq~ock 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. See House Plan #428 Sheet #2 attached hereto STATE ~F NEW YORK, ,, JS S COUNTY OF ..... ~.~-*..o ~.'~ .......... ' Gear, ge O, T.h...o.f~ez, sen .being duly sworn, deposes and soys that he is the applicc- (Nome of individual signing contracf) above named· Owner .............................................................................. He Js the ................................. · (Contractor, agent, corporate off car, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this applicotion; that ell statements contained in t~is application are true to the best of I~is knowledge and belief; thor the work will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this ~ · of .......... ........' ............... ........ .: ........................ Notary Public,c~~'''f''-:-'<' ...... ;.,.~4P,.t.~ ................. '" '~ .... ' " (,,.) 0 (Signatg/re of op.olicant) L~'ONA L. DRISCOLL NO* 30-461.1.~26, ofjqce ~ Ma~ -- FTO.O RO~ERIC~K VAN TUYL, P.C. r~ LICENSED LAND SURVE~;;:~RS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (s} APPLICANT SUFFOLK COUNTY DEPT. Of HEALTH SERVICES - FOR APPROVAl Of CONSTRUCTION ONlY DATE: H. S. REf. NO.: APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L..'W~ P. TEST HOLE STAMP L I SUFFOLK CO. HEALTH DEPt. APPROVAL H.S. NO. ~~~ STATEMENT'~ INTENT THE WATER SU~Y AND ~A~ DI~ ~ ~EMS FOR THIS R~IDE~E WILL TOWN~~4~.D,N.~ SUFFOLK COUNTY ~. OF HEALTH SERVICES -- FOR APPROVAL OF / SUFFOLK CO, TAX MAP DESIGNATION: RODERI~ VAN TUY~ P.C. ~ LICENSED LAND SURVE~RS GREEN~RT NEW YORK APPROVED AS ~IOTED DATEz~ ?'6S.2660 ~),M ~o 4PM FOR REQUIR- ED 1~'4SPECTIONS: 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. Fp. AMING iNSPECTION 3. BEFORE COVERING PIPES OF ANY KIND 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y. STATE CODE AND TOWN HOUSING CODE & ZONING DINING RM, 12°x 96 ,~':- _ ' -~3- o GARAGE KIT, 150 x 96 STUDY BED RM, ENTRY II8 X II° SECOND FLOOR 504 SQ, FT tODD 0~5 4 g,G PLAH MO ~p'- m_o ~T PLOT N'O ~ T ,Cl ,~ 60 ' ' HO - /IVT£~IOM S 5C/~LE ; ~,~'~ /LO" I~LA~ NO C.o "% ~AT ~ r %1 /-/V/,¥;~ ~'/d l F O~.c l,i __: ........... ,-.. 37276