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Home My WebLink About10943-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.'l.0. ~ .9 ~ .......... Date ...... Na.7. THIS CERTIFIES that the building ................................................ Location of Property . . ' I.'IQ. )I.~a~.~l:~.r.,.ql. ~.oj%d., ...... .~.t~.q~:~gg;q9 ~. fi.~¥..~1.q~13 ....... House No. Street Ham/et County Tax Map No. 1000 Section .. 102 ....... Block . .08,. .......... Lot ... 0 ~2 ........... Subdivision..H.~,~h~.e,~d. ~.s.~ ~,.e.r~ .......... Filed Map No6537 ..... ~Lot No. 35 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... 0cgo.h*~'. 2A .... ,19 P,0 pursuant to which Building Permit No... ~0.5t4~. Z .......... dated .O¢~;.o.ll(~'. 2.4. ............... 1¢10.., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... P~'Iva%~ Ono Fam$]y D~mll:in The certificate is issued to .... g A~:h % ~,i~.{. I~ o B.~I. ¢ (own~,te~ f~r.d:tltlotlt2_ of the aforesaid building. Suffolk County Department of Health Approval ..... UNDERWRITERS CERTIFICATE NO ..... iq 5 ~ .5.9. ~ 4 ..................................... Rev. 1/81 FOI~M I~07 2 TOWN OF' S~OUTHOLp TOWN HALL SOuTHOLD, N. Y. BUILDING (TH S PERMIT MUST BE KEPT ON THEPP, E/~ISES UNTIL ULL COMPLETION OF TH~- WORK AuTHORtZEDi , N? 10943Z Date ,..~dZ~.ZX~.,...~..~ ...... , Permission is hereby granted to: ....... ........ ~.....z~e~..~.~.,.... ........ ~.:~., ...~.,~ ...... ~o ..~.6o.;~.~r~..c.~....~.~...~.~z ~.~..~m~4~ ........................ ...... :....~.~ ....... ~~....~.....~.~....;.~ ............... ~ ............. ................. ~ ....... ~....~ , ~ ".. '~ ........ ~t uo..~.~ ......... Cmn~v T~x Mop Uo. 1000 Se,~ion ..Z~.~ ......... e~k~ purguant ia application dated ~;~.....ZZ .;. 2....:, 19 ., and 'approved by the Building Inspector. : 'BUlldin~:ln~ect0r : 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 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 3. Copy of certificate of occupancy $1.00 $5.00 Date ......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~o.u~; ~o/,. ,?~..... ~-~/~./~..~.'~..~..... ~-4'~.; ...... . .~..~..~..' ....... ~l~n[e't Owner or Owners of p roperty~.~;~.~.~.. ,~.~?.~.?.' .... ~..-~. ;_¢.~ . , .~..,~4_./,~ .~ ............... County Tax Map No. 1000 Section ... ?..///~,~. ..... Block .... .~-J. ~ ...... Lo" t..~--).~..~, ........ Subdivis,o~...~. ~//~..~?, ,~..d'~.~¢.~¢~.). ..... Filed Map No. ~..~. :~?.~..Lot No. p~..~. ....... Permit No. .//~.~,~. :? .~. Date of Permit ~.~.'2.~.Applicant .................................. ,ea,th ,ept. A, prova,../ ept. Approva, ........................ Underwriters Approval .... ./~,'~.'~ ,/~.~..~/. ~.. ...... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ,~'~ .......................... Construction on above described bu,ld,ng and~~/l~c%~d~s and regular,ohs. Applicant. ~¢~2 .%~4~./'~;4~.. ~..~%~/.~. ~ .................. ,..,. ,o.,o-,a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8D JOHN STREET, NEW YORK, NEW YORK 1~f38 THIS CERTIFIES THAT in the/ollowing location; ~ Basement ~ 1st FI. ~ ~.d Fl. S~tion102 BIo~ ~ was examirted on ~r~ 6, 1981 ..a /o..a to be it~ compliance with the requirements 4 this Board. OUTLETS SWITCHES NCANDESC[NT FLUORESCENT 22 19 22 DRYERS FEEDERS SYETEMS NO. OF FEET OTHER APPARATUS: i~G.t. I. E R V I C 1 1/0 1 UO Parmnount Llecgric Coo, 2041 Sholley PI,, ~ E~t ~ad~, N.Y. 11554 1ic,533-E , ~N~At ~NAG~. This certificate must not be altered in any manner; return fo the office of the Board f incorrect Inspectors may be identified by their credentials, ¢O~ fOR B?!tmNG D=~A~M~NT. ~mS, COP~ q~ ~E~Tff~q~M~ST[NOT ~ A[~=~ IN ANY MANN~m FIELD J~NSPE~TION COi¥~ENTS ~ ~ · FOUNDATION (~si) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSUIJITION PER N.Y. STATE ENERGY COpE FINAL FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 .------' ~ TEL.: 765-180:3 Examined.G'-./.,.~¢. ...... l~.~ ApprovedO..~ .~. ...... l~.. Permit No./.~. ~..~ Disapproved a/c .............. -..., .~ ................. ~ ' ................................ : ....... Date ..... , Application No..Z/(?~..~.."~.~] ....... 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 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 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~s. .... (Signature of applicant ,~o,r name~rlfpjc~pc ' ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...dPt, ,~,,, ~, .~3.o. ~ 1 ~).E. ~ .......................................................... N~e o~o~, o~,~,,,~ .... ~.y.Z~. . .~ ~ .... C. ~.e.¢ ................................... (as on the tax roll or latest deed) If ~~io~f duly authorized officer. ' '~tie~~ of c~pbrat:~, ......... Builder's License No .......................... Plumber,s License No.. }.g .~t .5. 1~. U.¢., .~.C~ ~u~ 1 ~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................... //Zo. ........ b~.~,3. '~ .L./,.~ House Number Street Hamlet County Tax Map No. 1000 Section .. / Subdivision ~ .~//2/Z/~..~.~.. 2/j~.,..~ ~¢~r. Filed Map No. ~ ~.~ ..... Lot.. ~ ~ ........ /' (Name) .- ~ .... 2. State existing use and occupancy of premises and intended use and occupancy ofproposed construction: a. Existing use and occupancy ........ ~ ... ~ ................ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ ,~ ~:>~,'-o~ (Description) 4. Estimated Cost ...... .~..o. ....................... Fee f~.../..O.. >.'t ........................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ! ........ Number of dwelling units on each floor .... J ........... , & If garage number of cars ' 6. Ifbusiness, commercial or mixed loccupancy, specffynatureandextentofeachtypeofuse ..~)~.g.t.~.':~L'~;.q~ ..... 7. Dimensions of existing structuresi if any: Front ............... Rear .............. Depth ............... He;ight ............... Number of Stories ....... '~ ................. ~ ................... v ......... Dimensxons of same structure with alterations or additions: Front .. ~.. ~ ....... Rear. ~ .Q .-.8. .......... Depth..~,~r. ~. ............ ;. Height .. ,~.~ ...... ~ ......... Number of, Stories .............. .,, ...... 8. Dimensions of entire new constrUction: Front .. ~ 3,. ¢.' ...... Rear . .(~ .,'z ~. ~ ........ Depth ~.~., ~ ........ Height . ,.~. ~ .0 ........ NumCer of Stories ..... ~ ......... , ....................................... 10. Date of Purchase ........... ~ ................. Name of Former Owner ............................. 1 1. Zone or use &strict in which prermses are situated ....... .~ .,~tJ I ll~t~./.. I./~ ~... v4-F~/~, .~q...~..t2..~. (~ ........... 12. Does proposed construction ¥iolate any zoning law, ordinance or regulation: ...~.O ........................... 13. Will lot be regraded .... [,f. ~2 .~ .................. Will excess fill be removed from premises: Y. es ~1~ 14. Name of Owner of pl~omis~s]~JOJl~/~J~P..~p..~0~Address ~r~ .~/,J~0 0 J~t//~ Phone No. (~, [~, [.. O. ~. 1.. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. ~ ! , STATE OF' NEW YORK covey OF ...... ......... ~k~ ................ ~O~t~ ..................... being duly sworn, deposes and says that he is the appl}c~t (Name of ln&wdual s~gmng contract) above named. He is the .......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly authored to perform or'have perfo~ed the said work and to m~e ~d file this applicatioff; that all statements contained ~ this application am tree t6, the best of his knowledge and be~ef; and that the work will be perfomed in the m~n~r set forth ~ the application filed therewith. Sworn to before me this ...................... :~ ~ ~ ~ ~allfled ~ Comml,sston ~r~ Ma~h 30, 1982 ~ONUMENT STAKE SURVEY FOR MOHRING 'ENTERPRISES LOF NO. ~5 , "HIGHLAND ESTATES" ~. TEL. ~~ ~ ~'~E R AVENUE SUBD/V/SIONMAPF/~D INTM~IC~OFT~ C~BK ~ ALDEN W. YOUNG, PROFESSIONAL ENGINEER SUFFOI~ COUN~ONAPff.~,Ig~ASFI~ENO. 65~ AND LAND SURVEYOR N.Y_S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR L~I~ ~ W~L(W), SEPTIC TAaK(ST)a C/SS~OLS(CP) SN~N HE~E~ N Y.S. LICENSE NO. 45893 ~he water supply and sewage disposal system for this residence will con- form to the standard of the Suffolk County Department of Health Service. SUFFOLK COUNTY DI'~ARTMENT OF HEALTH SL~VICES FOR APPROVAL OF CONSTRUCTION ONLY .AT. /'v/-/? .s R.F. NO. 'HEALTH OEPARTMENT-D~TA FOR APPROVAL TO C~STRUC T ADDRESS TEL NOTE: SUBDIVISION M4P,ClL~'D IN THEOFF/DE OF SUFFO£.~ COUN~ ~ APR. ~G,/9~AS FILE NO. ~ 7 ff ~ L~T~ ~ W~L(W}, ~PTIC TANK(ST)& CESS~OLS(CP) ARE FR~ FIELD OBSE~ATI~S ~D OR DATA OBTAINE~ FRO~ O~HERS SURVEY FOR MOHt~IAIG ENTERPRISES £OT NO. ,~5 , . HIGH£AAID ESTATES . AT CUTCHOGUE TOWN OF SOUTHOID SUFFOLK'COUNTY, NEW YORK DATE- SCALE: NO. OCT. I~ , 19BO I -- 80- 5~0 YOUNG a YOUNG RIVERHEAD, NEW YORK ALDEN W. YOUNG, PROFESSIONAL ENGINEER ANO LANO SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W, YOUNG, LAND SURVEYOR , N.Y,S. LICENSE N0.45893