HomeMy WebLinkAbout10721-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z 10 451 Date .A pr%.l. 10.,. 1981
THIS CERTIFIES that the building ...............................................
Location of Pro eft 1240 Gold Spur Lane, Cutchogue, ~!ew York
House No. Street Hamlet
County Tax Map No. 1000 Section . .095 ....... Block .... O .6 ......... Lot .... 0.1 B... 1 ~ ......
Subdivision..0~e. gg~a.v.J,~W..~ t;o.t.e.~ ........ Filed Map No..6.~/~ .1...Lot No...1.1 ..........
conforms substantially to the Application for Building Permit heretofore fried in this office dated
....d.u.n.e...3 ........... ,19 .~.0. pursuant to which Building Permit No .... .1.0.7.2. .1..g ..........
dated ........ ~..u .n.c.. 1. 9 ............19..~.0, 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 .........
.......... o.n.e. ?, .a.mAz. y.' .....................................
Stall er Associates .........................
The cerhflcate is issued to ..................... [o~,n.e),.~.s.s_e.e_or_~_e~t,2_ ,
of the aforesaid building.
Suffolk County Department of Health Approval ...1.0 · gO.-42..1.2/12./.80 · R~>.berg..A...V.~I la
UNDERWRITERS CERTIFICATE NO. . . N.4.~ 757.6. ......................................
Building Inspector
Rev. 1/81
FOII,M. NO. 2
?OW~ O~ $OOTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH*OLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N? ]07~1 Z
Permission is hereby granted to:
....//.z..Z-o ...... .z'.~..-~ /,,,,~.,~. z ~ O ....
........ /...~..7..... ~.~..Z,~.~
........ ,v..,...7',...
~o ....C~z~..~..~...~ ~.~.........c~. z~,~.......~.,~./~.zz~ .~...,j,~4.,~.//.xx~ ...................
............ .~zr- ....... .~..-T:.-~/./.~z~-....~J.:z-~..~..c;~/~..¢ ..................... /... ........................
at premises located at .~.4,~.~.~--~ .......
~z~9o.~..~,.z.~--~....~ ~ r,~ z~-~'.... ~ ~ .,Z.~. ................ '.~...~...l .................
pursuant to application dated .,~...~.- ........................ , ]g~.~., and approved by the
Building Inspector.
Fee ~.....~.~.....
in Inspector
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 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 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. Certihcate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
~"~ Date... ~., .'~...~. · .'~'~. , ~..( .......
New Building .v ...... Old or Pre existing Building Vacant Land
L°cati°n°fPr:~e;t~'~iu'~e~'~i .... '~''"~JJ'if~''~'~'~'~Street I~' i'~'/IO''~'"~--~'"~'~
Owner or Owners of Propert~- ~/.r~..4~jl.'l...v.l.~...~.-~.~.,.,.~.-.....~/.-~.~-~.
County Tax Map No. 1000 Section . 0 .~.~.~'. ....... Block . .0..~. .......... Lot, ,~...~../.~: ././,.
Subdivisio.~/'~. ~...~.lF.~... ,~.¢.~.. .......... F,led Map No. ~7..~,L~.(....Lot No .... Il .........
Permit No./0.7~,, (~ Date of Permit ~.~.~.'T..~...Applicant .~z{'~.6 .~...7-~....g~-~ ~.G .. ........
Heaith Dept. Approval . 10. S.O. ,~. ,*'~. ......... Labor Dept. Approval ........................
U nderwriters Approval . .~,~.? ,~. t~.5 ......... Planning Board Approval ......................
R eques, for Temporary Certificate ..................... Final Certificate .... ~ ~.~ \~'
.........
.............................
Construction on above described building an.d ~ me~ all applicable codes and regulations.
.....................
Rev 10-10-78
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRIC!TY,
E5 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT -~ ~ ' ~" ~ ~
only the electrical equipment as described belo~ and int~duc~d by the applicant ~med on the above application number in the premises of
S~e~ll~ ~oc. I~., (~ Sp~~ S~., ~n Vi~ Eel.s, ~e~
in the following Iocatm~t; ~Bas4~t ~'%s, FI. ~ gna FI. Section Block Lot
. OC~OD~ ]-~ J.~O~[) and found to be in compliance with the requ~rements of this Board.
FIXTURE
OUTLETS
17
FIXTURES
SWITCHES
NCANOESC~NT FLUORESCENT
1.7 1.7
DRYERS MOTORS
RANGES OVENS DISH WASHERS EXHAUST FANS
HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
E R V I C
NO OF CC COND A W O NO OF HI LEG A W O
PER ~ OF CC COND OF HI LEG OF NEUTRAL
210
OTHER APPARATUS
~o~or/~ ~
G.O. Ele¢.
6 Poplar
z-~ad3:or~, N.Y, 11763
'[,,'Lc. 2677 E
GENERAL MANAGER
This cerhf~cate must not be altered in any manner, return to the office of the Board ~f mco~ect. Inspectors may be ~denhhed by thmr credentials
COPY FOR BUILDING DEPARTMENT. THIS ¢OP~ OF ~EKTIFIC~T~E~t[~S~ NOT-BE[ALTEEED IN ANY mANNER.
FIELD INSPECTI(
FOUNDATION
(1st)
COMMENTS
FOUNDATION
2.
ROUGH FRAME
PLUMBING
(an~)
INSULATION PER N.Y.
STATE ENERGY
copg
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-180:3
Examined .~. Z~-/~::~. ~.(~...., 19~
Approved ~.D¢~.~ ../O .... , 1 Permit No. ~.~. ~.~t( .'(.~ /
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Application No../(~.Td/('. .......
Date.
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 t6 schddule.
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 dia~am 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
(SignaJ;~e of applict~nt, ~'r na~^q/if, a co[~or,ati~n)
N eofownerofpremises h Z.O..C.t.err 7. .......................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ...........................
Plumber's License No. ~.,. ~.~.[M~. ~...2/~1. C.
Electrician's License No. ~,. ~.~g~.~..2~ Q,
Other Trade's License No ...................... Nk~.~ G..~ ~,~)[Qr~ ~
1. Location of land on which proposed work will be done ..............................................
..... .0~ ~. ~ ~.~ .... ~. ! , F.~C. . . ~S .~. . .'r~. . s. ................................... C..,.,.'~ c,,/.~
House Number Street Hamlet
County Tax ~, No. 1000 Sec,on ................. Block.. :.6. ,~ .......... ~ot...~/. ~./. ! ........
Subdivision(~.~ .~.2//~.~).~'~7f27~7... Filed Map No..~.>.~..~./ ..... Lot~--..// ...........
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... V~.. J4.%. 'm ................................................
b. Intended use and occupancy .. J..~.~.. ~ .... .~.Y(~.~.~.~.~. .... ff .~..~. ~.~. ...............
3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration ..........
Repair .............. RemOval .............. Demolition .............. Other Work ...............
. (D ripti
4. Estimated Cos ...... : ............... Fee ...........................
(to be paid on filing this application)
5. If dwelling, number of dwelling units_ ............... Number of dwelling units on each floor ................
If garage, number of cars .... 0~1~'. ............................
6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structurds, if any: Front ............... Rear .............. Depth ...............
Height.. .............. Number of Stories ........................................................
Dimensions of same structure wtth alterations or additions: Front ................. Rear ..................
Depth .................... i.. Height ....... ~ ............. Number,of Stories'. ........... , .........
8. Dimension,s. pi entire new construction: Front..,.~ .o ......... Rear....~.g. ......... Depth .2 ~ ..........
[[eight . .I.~F .......... Number of Stories ...... I ........ i ..................... ~....,~ t ...............
9. Size of lot: Front . ./..~.. ..... i ........... Rear...~'~.~'. ............. Depth .'~'../?. ................
10. [)ate of Purchase T ............................. Name of Former Owner ...--. .........................
1 1J Zone or use district in which premises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: . .~0 ..........................
13. Will lot be regraded .~[~ .... ! ................... Will excess fill be removed from premises: Yes
14. Name of Owner of premises ...' ................. Address ................... Phone No ................
Name of Architect .~ ........ ~.. ·
.g/X:. F Address .............. PhoneNo .............
Address/~7. S~.~.~::.. ~(}~ .Phone No. ~t.~....
Nam e o f Contract or ~i~l~.~,~.
PLOT DIAGRAM
Locate clearly and distinctly all! 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.
STATE OF NEW YORK, . . j ~, ,,
couN1;Y.
.... . ...............
(Name of individual signing contract)
above named. ,
being duly sworn, deposes and says that he is the applicant
~~..,
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this
application; that all statements con{ained 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
...... .~...'~..:...: ....... day o:f .... ~ ........ , 19~..
Notary Public, ~.~.~.~..~.~..~.... kO~..: ...
LINDA F KOWALSKI ,
~o, 52'45247~1 !
QuaJJhed m Suffolk Coun~
/
X~? ,'
VlTO RANDAZZO
· ' DEC 5, 1980
AT QU~CHOGUE DATE JUNE 3, 1980
_ ~bS SgW,32;~ ~t2pOS~! ~N]] 1~V~,Or ~tlppl}l ~WN OF SOUTHOLD SCALE [":40'
...... ,.,~-,.. r~,,~t~z~ vn~l toun~ SUFFOLK COUNTY~ NEW YORK NO, 80-283
C~Of OV OO~OP~L ~J~O0~ ~COPIES~ THIS SURVEY NOT BEAR~G THE LAND
HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUCT AND ~ HI~ ~EHALF ~ THE TITLE COMPLY, GOV~N-
OTHER~THE~THANARE~THOSEDWELLI~SsHOWN HEREONWITHIN ldO FEET OF THIS PROPERTY OWNERsTOINSTIT~TI~' ~UARANT~E~ ARE AODITIO~A L. INSTITUT,~S OR NOT TR~SFERA BLEsuBsEQUENT ~ .~ ~5~ / ~ [..~'~-~-- -- --' ~ ,
WILL (~FOB~ ~o T~ ST~N~D~ OF TM~ SUFF~K COUNTY OEP~MT~N/ TO EZlSTINt~ ~T~UCTU~ ~ FO~ A ~P~ClFIC ~%~%% /
OFH~LTH S~VICE$ PURPOSE 4NO ARE NOT TO BE USED TO ESTAeLISH
~ ~ OS~ANDER AVENUE
~ RIVERHEAD~ NEW YORK
Q: STAKE - ALDEN W YOUNG, PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THEOFFICE OFTHE CLERK OF SUFFOLK COUN~ AND LAND SURVEYOR N Y.S UCENSE NO 12845
ON APRIL 4, le15 AS FILE NO, 6a41, HOWARD W YOUNG, LAND SURVEYOR
( ~ L~T~ ~ W~L(W),SEPTIC TANK(S~e CESS~OLS(CP) SH~N HERE~ N Y S LICENSE NO 45893
~.~ ,, ~q~ , ,
SUR~ ~OR
VITO RANDAZZO
SUFFO~ COUN~ DEP~T~70P H~TH S~V~CES ~OT I I,'MAP OF ORE~ON VIE~ ESTATES"
AT CUTCHOGUE D~TE .JUNE 3, 1980
FOR APPROVAL OF ~ONSTRUCTION ONLY ~ O~ ~OU~OL~ SCALE 1"=40'
~/~__~ SUFFOLK COUNTY, NEW YORK NO. 80-28~
APPROVED ~~* W COP ES ~ THIS S~VEY NOT ~AR~G THE L~NO
~U~l ~T[[~ iNOIC~TEO ~[~EON ~LL RUN ~LY ~
~EALTH ~EPARTMENT-DATA FOR ~'PPROVAL TO C~STRUC T ?~E ~.?~ FOR WH~M THE SU~EY ms PREPARED
..... "' +~ ~ ~ - [ S YOUNG ~ OSTRANDER AVENUE
YOUNG .,v~..~AO..~w ~o.~
~, STA~E.~ ~ ~ . ALDEN W YOUNG, PROFESSIONAL ENGINE ER
ON ae~lL 4, 1975 AS FILE NO. ~41. i HOWARD ~ YOUNG~ LAND SURVEYOR
ARE ~ FIELD OB~ATIONS ~D OR DATA OeT~l~O F~ OT~,~RS .... '