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Home My WebLink About11000-z FO~M ~0~2 TOWN OF S~O~THOL I~UIL01NO D~P,~RTMi TOWN 'HALL SOUTHOLD, N~ Y.: BUILDING ~xERMI'I (THIS PERMIT MUST BE KEPT ON THE PRE/~ COMPLETION OF THE WORK AUTHORIZED) N? :tlO00 Z Permission is hereby granted to: dS~S UNTIL ULL premises ~~~..~2.~,~..=~.,...~:~.~ ~ ....... ,iz~.,~... ................. 'C*b~w TaX Mag No 1000 'Sect on .:d~.;...;-; Bock:~ ,. ':Lot No. ;,~.~ ......... pumgont to opphcotmn d~tod ;.,.,~ ...~ ..... I~ .~, ond ~pprov*~ by the 'BUilding Ihspector. ,~ ~..l.L(......~,~ .... 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 unusuai 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 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, 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 40£/ Date ............ .~-'. .......... New Building ...~,- ........ Old or Pre-existing Building ............ Vacant Land ............. Location of PropertyHouse ...................... No. Owner or Owners of Property ..... . .~-'*~,/.~ ~.//~-..~1..~..../~--~... ~,~..~ ......................... County Tax Map ~o. 1000 Section .~' "~..~.~...~t. ....... Block.. ~ .......... Lot.. ~.~. ......... Subdivision /~'/~-~./'~. ~J~~' Filed Map No (~'37.Lot No..~...~. ........ Health Dept. Approval ...... -. .... .--. ........... Labor Dept. Approval ........................ Underwriters Approval ................ Planning Boar royal ...................... Request for Temporary Certificate ..................... Final Certificate . ,~. .................... Fee Submitted $... ~'*' Construction on above described building and permit m~app,~i~able J, cz,,¢~ ~ /'x~P'"~x/ Applicant ....... ' ............. THE NEW YORK BOARD OF Fl'RE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ~,, '~ J ,~ only the electr~l e~q,u, ,p,,n.,ent as d..escrt~bed belo~ a~td t. nt~ro~duce~d by the a]~I!liciant nao~ed on ~he above application number in the premises of /~ ~n~.ana ~ ~c~ax~, e/~ R~tffarm Rd., ~00' N. of ~ ~:., Cut:c,b~gue, No Y. in the following location; ~ Basement ~ 1st FI. FIXTURE FIXTURES OUTLETS SWITCHES ~] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS 27 .32 2Z 27 DRYERS FURNACE FUTURE APPLIANCE FEEDERS ¥1ME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V NO OF CC COND, A W, O PER ,~' OF CC COND, 1 ~/o C NO OF HI-LEG AWG OF HI-LEG OF~L AW'G NO, NEUTRALS OF NEUTRAL 3/0 P~r~[ Eiec. z041 Shelley Pi, ~a~ ~badow, 1t. Y. llb:~4 Lic, ~533 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be BUILDING DEPARTMENT. THIS COPY OF, BE ALTERED IN ANY MANNE~. FIELD INSPECTIO~ ~ ~ COMMENT~ ~ FOUNDATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING INS~ATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL /~OR~ NO. $ TOWN OF $OUTHOLD BUILDrNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date TO ...Z¢~.(.<.:.,~ ..::.......~..(f:.. ............. ~ .......... (O.wcz,er or a~orized ag~nt of owner) ' ' " (address of owner or authorized ag'ent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ..... '4 ........... Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that ~.~q.....,~..~..../.~.....4~)4~ Z......7. ...... .~.~ ........ ~Z.~ / (state character of violation) z~...7~.~....~c......~.~....~z.~.....~....~...~.~_..~.~.c~z~ ~~..~d&~...~...z~zzc~zX.~.3~~/~ ............................... ~ ~ol~t~o~ of ....... ~z..Z~.z.;~.~...z......~....~.~~....~J. (State section or paragraph of applicable I~w,.~ ordinance: or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned fo~hwith on or before the ....~.~...~Z~.~ ....... day of ...................................................... , 19 ........ · he premises to which this ORDER TO REMEDY VIOLATION refers are situated at ...... ...... ~..,.,f~4~, ....................... y of S.ffo~k, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both./ O/D~-,~,/~_//~_c ~/d~,¢ ~:g~ ~<~ ........ uia,ng inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 · TEL.: 765-180:3 ..... ,19 . Application No. ././. ....... ^pprove, :.. . ,'.C. . ..... ,19 . . . Permit No.::C:.C?.O. . . / Disapproved a/c .... :.......----'-~. ........................ /// ............... ......... (Building B~spector) APPLICATION [:OR BUILDING PERMIT Date ................... 19... 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, pjeces, s~Jry inspections./} · iSign~ture'g~ a~l~i &r n~me] if a cor~&;a~io'n) [/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~..~../~.'..~..J.~ ~.~. .... (as~'~on the .... taxC .0 .~ .~.roll or latest ................................ deed) If applicant isa cor.coration: ~ure of duly au, thm,~ed officer./ ~/ (Name and title of corFo6rate o~ficer) t// Builder's License No .......................... Plumber's License No... ~.d..-~..~.....~....~..~..~...-.~. ~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... ........... House Number Street Hamlet County Tax Map No. 1000 Sec~Orq .... ./.0.,.'5~ ........ Block .... .~ ...... ...... Lot.. ~ ~ ............ Subdivision ~¢::~./~2~.. ~.~...,~..~?...~-:.~; ..... Filed Map mo.5'.~. ~ .7. ...... Lot .-~. ~ ~ / (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: r .li/.. a. Existing use and occupancy .. . .~ ............................................. :./.' b. Intended use and occupancy .. ~ '. d~! ~.. ........................................... 3. Nature of work (check which applicable) New Building t/ Addition Alteration R~pair ' Removal Demolition Other Work : ¥' (DTripti°n)' 4. Estimated Cost . ~.~. ! ~.O~O ~ Do ................................ Fee . .L~. ................................ (to be paid on filing this application) 5. If dwelting, number of dwelling Units ....... ] ........ Number of dwelling units on each floor ................ If garage, number of cars ..... i .....~ .......................................................... 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 with alterations or additions: Front ................. Rear .................. Depth., ................... ! . Height ......... ,.. ),. ........ Number, toff Stories ...... .;,.~, ;j ~ ....... 8. Dimensions of entire new construction: Front..Tg: .~ ...... Rear .~.t~-.,~ ........ Depth .'-¢...Y. ........ Height.. ~- .~ ........ Number of Stories ..... . .~., _.,. ~ ... ...................................... .9. Size of lot: Front ./~. 7.,. 7~.. i .......... ~' ~}'~'"7~' i ........... Rear ......... Depth ~,,~. ,.~. ~ 10. Date of Purchase . ./.~.,F.~.... i ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ....................... - .............................. 12. Does proposed constructio~iol~te any zoning law, ordinance or regulation: . ../~.~ ........................... 13. Will lot,be regraded .... ?'.~. $. i .................. Will excess fill be removed from premises: Yes 14. Name o'f Owner of pre~mises~/~ff~/~...]?~ .,~0~.~Address ~/J~?~.~/~. ~1//~. Phone No. (~ ~*. I, .0. ~./.... Nam e of Architect . .~rg ~..~. ~ ~. t~. ~. ,/~/~.~ .... Address ~.~..~_ ~//~ ~. ..... Phone Not~. 7('.~. .~/. ).g, .... Name of Contractorfi'r~.~/~. ~/~I. ~/L~ r~ ~.~.~ $ .~.~. Address ................... Phone No .O ~./. ~. ~<,e. / ..... 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, COUNTY OF ........ .S.S ............................. ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign!rig contract) above named. ~ He i~ the ...................... ~ .......................................................... , ........ (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 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 manner set forth in the application filed therewith. Sworn to before me this ~ ......... i ........... !dayo . Notary Pubhc, ~-{[~..~. ~ Notary Pubtlo, b~ta O _ ilo. 3046936t' oaal f ed la Nassa~ comrnlsslon Expires M~ H£ALTH DEPARTM£NT-DATA FOR APPROVAL TO CONSTRUC.T W NILAREST WATER iAIR__MI - ~SOURCE OF WATER PRI~TE_._PUBLIC~ Ia=CONCRETE MONUMENT £1 = STAKE SUSDIVI$10R MAP FILED IN THE OFFICE OF TRE CLERK OF SUFFOLK COUNTY ON APRIL 26, I$17 AS FILE SURVEY FOR MOflRING ENTERPRISES LOT 36~ "MAP OF HIGHLAND ESTATES" AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK dUN/Ils 1981 FEB 6, 1981 DATE NOV. 18, 1980 SCALE I ": 50' NO. 80-690 YOUNG YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N YS UCENSE NO 12845 HOWARD ~YOUNG, LAND SURVEYOR N YS LICENSE N0.45893 4000STRANDER AVENUE RIVERHEAD, NEW YORK SURVEY FOR SUFFOLK COUNTY DEPAET~EHT OF HEALTH SE~V,!CES MOHRING ENTERPRISES LOT 56~ "MAP OF HIGHLAND ESTATES" FOR APPROVAL OF COHSTEUCTION ONLY AT CUTCHOGUE D~E= NOV. 18, ~WN OF SOUTHOLD SCALE. ~**=50* DATE ~'HS REF. NO. ,JO, %0 '- I~ SUFFOLK COUNTY, NEW YORK NO. 80-630 APPROVED THE ~RSON FOR WHOM THE 5U~EY IS PREPARED ~ HEALTH DEPARTMENT-D~TA FOR APPROVAL TO C~SIRUCT ~ m .~O S~H~[~ m THE n~c~ C~P~, OOV~- · THE~ AR, ~ OWELLI.S WITHIN '00 FEET OF THiS PROPERTY INST, ,UTI..TO A~ITIONA LGUARANTEESINSTITUTI~sAREoRNOTsu.sEQUENT '.~SFERA BLE /'~<~&~--~O~.--~',/. ~' 0 ~ },0 Y ~ / ~ RIVERHEAD, NEW YORK e=CONCRETE MONUMENT ~= s*~ ALDEN W. YOUNG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF TRE CLERK OF SUFFOLK COUNTY ANO LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W, YOUNG~ LAND SURVEYOR ~ ~ L~T~ ~ W~L(W),SEPTIC TANK(ST)~ CESS~OLS(CP) SH~N HERE~ N.~ S. LICENSE NO. 45893 ARE ~ FI/LO OBSE~ATIONS ~D OR DATA OBTAINED FROM OTHERS SUFFOLK COUNTY FOR APPROVAL OF CONSTRUCTION DATE__ HS REF. NO. APPROVED_ DEPARTMENT OF HEALTH SERVICES ONLY HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ~A NEAREST WATER_MAIN MI, - K SOURCE OF WATER, PRIVATE '/PUBLIC __ NSUFFCO, TAXMAp DtSTTOOO SECTION IO2 BLOCK ~ LOT ~ J~THERE ARE NO DWELLINGS WITHIN I00 FEET OF THIS PROPERTY OTHER THAN THOSE BHOWN HEREON. H THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY OEPARTMENT OF HEALTH SERVICES. APPLIC~NT~ ADDRESS TEL M=CONCRETE MONUMENT ~=STAKE SUBDIVISION MAP FILEDIN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON APRIL E6~ 1977 AB FiLE N~BSS~ ~ TI~ LOCATION OF WELL{W)~ SEPTIC TANKJST)& CE$SPOOLS(CP) SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FffOM OTHERS TDY POST E0494 SUR~EY FOR MOHRING ENTERPRISES LOT 36,"MAP OF HIGHLAND ESTATES" AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE- NOV. 18, 1980 SCALE: I ": 50' NO. 80-6'~0 I YOUNG e, YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR NY.S. UCENSE NO. 1784§ HOWARD W. YOUNG, LAND SURVEYOR N.Y.S, LICENSE N0.45893 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK