HomeMy WebLinkAbout11475-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z19531 Date NOV. 23~ 1990
THIS CERTIFIES that the building
ONE FAMILY DWELLING
Location of Property i490 HIGHI~%ND ROAD CUTCHOGUE
House No. Street Hamlet
102 Block 08 Lot 030
County Tax Map No. 1000 Section
Subdivision HIGHLAND ESTATES Filed Map No. 6537 Lot No. 33
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 25, 1981 pursuant to which
Building Permit No. 11475Z dated NOV. 24, 1981
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 ONE FAMILY DWELLING WITH ROOFED OVER CONCRETE PATIO IN REAR.
The certificate is issued to EDWARD C. BRODERICK
(owner)
of the aforesaid building.
ROBERT A. VILLA, P.E.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL il~SO-Ii0 FEB. 8, 1982
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N548544 JANUARY 20~ 1982
BuJ. ld~.n~ Inspector
Rev. 1/81
No. ~1475 Z
TOWN ;01
I~UILI~iN~
TOW~ $~,,~
SOUTH'OLD, NC Y.
BUILDING~ PE~iT~
(THIS PERMIT MUST BE KEPT C)N THE PRE/~ISES UNTIL
COMPLETION (~F THE WORK AUT~.IOR ZED)
Rev.~ 6/30~80
!
'and approved by the
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEFARTME~
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z10874
Date ............................. , ..
THIS CERTIFIES that the building ............................................... .
t490 Highland Road Cutchogue
Location of Property ...............................................................
House No. Street Haml~
County Tax Map No. 1000 Section ] .0.2 ......... Block 08 Lot..0.3.0.
Subdivision~ .i~.h.l.~..n.d..E.~. ~.a.~.~.@.; ..........Filed Map No.6 .5.3.7. .... Lot No. 33
conforms substantially to the Application for Building Permit heretofore fi. led in this office dated
Oct.ober 25 1~] 11475 Z
.................... , .. pursuant to which Building Permit No ......................
dated November 24 l~ !.., was issued, and conforms to aU of th~ requir~mants
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 75 Highland Road Corp.
of the aforesaid building.
Suffolk County Department of Health Approval ] .~.-.S.O.T.1J.0. t..F.e.b.:..8.,.....................19B2, Robert A. Villa
P.E.
UNDERWRITERS CERTIFICATE N 5 4 8 5 .~ ~ . . .
Building Imp~tor
1/81
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 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. '
Fees:
1, Certificate of occupancy $5,00
2. Certificate of occupancy on pre-existing dwelling or land use
3, Copy of certificate of occupancy $t.00
$5.00
Da~e
New Building ....~'. ....... Old or Pre-existing Building(:~) ;,_ ....... ~/Vacant Land
Location of Property / .~.~.0- ........... .z/~.5~z~.f~'?. ~;..~_~;~..,..; ......... ,%.~'., ~.& .'~. ......
o~.~, or o~..,, o,,~o~,t~ .. 7~. ~/~M.~-~ ................................
County Tax Map No. 1000 Section .. .~ ....... Block .
, ........ ...... .,,.... ........... o ,,o ..............
,.~,, ~o..// ...... ~. o,,~.~,t .~ .~z .~,~,,ca~t .... . ..............................
,eaSt, ~,,t. ~,~o~ /~ //~ .~o~ 9~,~. ~,ow~ ...... : ............... ,..
~.~,.~r~.~o~, ~ ~~ ...... :' --
........................ Planning Board Approval ..................
Request for Temporary Certificate .... Final Certificat~
Fee Submitted $ .... ~.. ~0 ................
Construction on above described bu ildin~~~a~des and regulations.
PELLETREAU & PELLETREAU
ATTORNEYS AND COUNSELLORS At LAW
20 CHURCh STREEt-SOX ilO
PATCHOGUE, NEW YORK II 772
TEL. 516 447-8900
FAX 516 475-5651
"ALSO ACIMITTED ~ixl
November 21,
1990
Town of Southold
Building Department
P.O. Box 1179
Southold, NY 11971
Att: Helen
447-8916
Re: 1490 Highland Road, Cutchogue, NY
Dear Helen:
Attached please find a copy of the Certificate of Occupancy
relative to the above captioned matter.
We also attach a check in the amount of $50.00 which represents
the fee to amend/update the C.O. (Buildin~ Permit #11475Z) to
indicate the following:
1. Owner's Name: Edward C. Broderick
2. Roofed over concrete patio at the rear of
be so stated on C.O.
the house to
We have also enclosed a self-addressed/stamped envelope for
your convenience; we anticipate a closing date within the next
two weeks, therefiore, we would greatly appreciate receiving the
C.O. as quickly as possible.
Thank you for your courtesy and cooperation in this matter.
Very truly yours,
PELLETREAU & PELLETREAU
K A. Seaman
KAS: ef
enc.
01H/75
cc: Edward C. Broderick
10006~1 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITy
~ 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~
~.te Jara~x"y 20, 1982 ~p~¢at~o,, ~o. o,/,~ 151119-81
only the ele~ri~q( eq~oment, as d~cribed ~lo~ ¢D~ i~troduc~ by the aoolle~t n~med o~the above ~plication r~umber in t~ premises of
in thefollowlng location; ~. Basement ~ 1st FI. ~ 2nd Fl. Section Block Lot 33
was examined on~ ~; ~ and found to be in compliance with the requirements of this Board.
OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS EXHAUST FANS
FLUORESCENT
DRYERS
OTHER APPARATUS:
1-G.F.I.
3-Smoke Detectors
S E R V
NO O C~COND~ OF CC COND.
2/0
I C E
A, W, G NO OF NEUTRALS A.W. G
OF HI-LEG
2/0
co., { 5/ t/
2041 ~elley P!~,ce, -- - , --
~~~~ cerTmcate must not be altere~ in any manner; return to the office of the Board if iDcorrect. Jnspecto¢~ ma be identifiec~~b t ' ~ ' .
FIELD INS~ECTY~ON
· FOUNDATION
(1
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
3.
INSULATION PER N.
STATE ENERGY
~ODE
FINAL
DATE COMMENTS
t) ~
~) ., m~l
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined'.TY .. :4..¢....,
D~sappro~ed a/c .....................................
APCLICATION FO~ BUILDIN~ PERMIT
Application No././~'..D.-" .........
Date ... ~ ......... , 1
INSTRUCTIONS
a. This application nmst be completely filled-4n by typewriter or in ink and submitted in triplicate to the Buildi
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 stre~
or areas, and giving a detailed description of layont of property must be drawn on the diagram which is part of this apl:
cation.
c. The work covered by this application may not be comnrenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen~
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 Occupan
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Buildh~g Department for the issuance of a Building Permit pursuant to t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or .for removal or demolition, as herein describ{
The applicant agrees to comply with all applicable laws, ordinances, b. uild'~g ~ hog,sing code, an/c~egulations, and
admit a~th°rized inspect°rs °n premises and in buildings f°r necessap/~.~...~.
"(Signature of applica~4 or n~.e,.if a 'corPoration)
........... i~,I;ill,;g ;ddress of applicant) ~ ?
State whether applicant ~essee, agent, architect, engineer, general contractor, electrician, plumber orO
(as on the tax roll or latest deed)
I f app/~ ~,,~o;poration,Tat u re o f duly authorized officer.
O
Plumber's License No .........................
/r'
Electrician's License No .......................
Other Trade's License No ......... /F. ............
I. Location of land on which proposed work will be done ................................................
..... ...................... ........... e. ..............
House Number
County Tax Map' No..1000 Section .................. Block. ~ .~. Lot .~...(~.
/(.,.2. .............................
. .~".//:~ .//.~.~'.c..~ ~t~/-/~ Filed Map No .~.4.~.. 7.
Subdivisioh .... ']/
'" ~ ...... (~q'a;fi~) ................ ...... Lot . .<~... ~ ........
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and o~cupancy ................................................
b. Intended use and occupancy ..................................................................
3. Nature of work (check which apPlicable):.New Building ....... Addition .......... Alteration ..........
Removal ' ~ Demolition Other Work
. Repair .........................................................
, i (Description)
~. Estimated Cost......r......'i . .... ............... . .. e ... ........... . ~. ..........
~ (to be paid on filing this application)
· ' /. Number of dwelling units On each floor
L If dwelhng, number of dwelling?mrs ......... ! ...................
If garage number of cars .~ ·
· ~ Of US
L If business, commercial or mixed occupancy, specify nature and extent of each type e ...................
7 Dimensions of existing structure~ if any: Front ' Rear Depth
Height Number of Stories
Drrnensmns of same structure w~th alterations or addmons. Front ................. Rear........, ' · ' ' ' · . ...... .
Depth .................... ;. Height ....... i .............. Number of Stories....~4~ ...............
:
3.Height Dimensions...o£e?.~re.~...4(........newconstn, mtion:NumberofStories..·Front...~..~..~.~i..................... Rear ~..~.......~ ....... .....,........... Depth ..~..~ ,.......'"'""..
7. Size ofiot' Front .?~..,~., /6. .. . Rea~. ~O..~... .' .. ~)~;th ./..~'.~'.: ..~. ...... ' ....
Date of~ Purchase .. i : Nmne of Former Owner
I Zone or use district in which premises are situated .........
L Does proposed construction violate any zoning law,.I ordinance or regulation: .~.o. ............................
· . . .
I. Will lot be regrade~d ......_... ' · · i · · · Will excess fill be removed from premises.. Yes
~.. ~t" "i Address .~.~J...~.~ ~,~t~. Phone No..~. ~'.'..~..~.g .....
Name Of Owner o~ predl3~se~ · K' ~'~' ' · '~ ' 'i ~
Nmne of Architect . t~f~.~, t~t~.~.'...i Address .q~. ~--Xe,~,l~..,,.~'~.: .... Phone No...~./.
.,~J~J~t~. :iNmate of Contractor. ~" ' Address ./'/Fe0..(~.~ ~:q ~A~:q'. Phone No..G..'2..~,....~,~.(~:~..
PLOT DIAGRAM
Locate clearly and distinctly all ~buildings, xvhethe~ existing or proposed, and. indicate all set-back dimensions from
:operty lines. Give street and block number or description according to deed, and show street names and indicate whether
~terior or corner lot.
TATE OF NEW Yg-RK,
OUNTY OF 'e~..,,~r .......... .
........ . ..... ~~~ ........... being duly sworn, deposes and says that he is the applicant
(Name of individual sig~ing contract)
bore named. :
(Contra~tor,~agent, corporate officer, etc.)
f said owner or owne~, ~d is duly authorized to perform or have performed th~ s~id work and to m~e and file ~is
~plication; that all statements contained ~ ~his application are true to th~ best of his ~mwledge and belief; ~d that the
'ork wffl be performed in the m~ner set forth in the application filed therewith. ~ ~ ~ ·
~ ~ ' ' · I~ ~n N~u
__
~OT NO. ~ , "HI~AND ESTATES" oc~ /3,/98/
· T CUTCHOGUE
~WN
~. i m ) v~m m~m~ ~ v~m~m~ ~~NOERAVEKE
~UFF~K COUNFYON ~PR.~,/9~F/~,6~37 ~q~ AND LAND SURVEYOR N.Y.S. UCENSE N0.1~845 '
i ~/ HOWAaO W.~OUa;, c~.o SUaVE~Oa
~L~TM~W~L(W),~ICTANK(ST)BCE~OLS(~)WNHE~E~ T mJ N.Y.S. LICENSE N0.45893 *
~E ~M FIE~ ~TI~S ~ Oe DATA OBTNNEO
,.h ,u,,f d,r~I [)l: HEAL.I'J-I
'81 :OCT '16 ~ '!'.1 :, tZ
sUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
~OR APPROYAL O1: CONSTrUCTiON ONLY
~ ~P CO. TAX~iP I~E:['T'4°O SECTION IO~ ~CK o~ &OT ~o
OTHER TH~N THOS~ SHOWN HJREO~.
M THE WATER SUP~Y ~ SE~GE OlS~Ab SYSTEM ~ THIS R~I
WILL C~FORM ~ THE STAN~ OF THE SU~K COUNTY'DEPARTMENT
~ z/, ~ ~' ~ 2 Z-~l
SU~DlVlS~ M~ FIZ~O IN T~ OF~I~ Q~ T~ CZE~
,~E ~ FIELD ~ATI~$ ~0 OR DATA OBT~O F~
SURVEY FOR
MONRING ENTERPRISES,/NC.
LOT NO. 33 , ' HIGHLAND ESTATES '
AT CUTCHOGUE
TOWN O~ SOUTHOLD
SUFFOLK COUNTY, NEW YORK
#UI~UTNORIZEO ALTERATION ON AODITION TO 1HIS
SURVEY I~ A YIOL&TION OF SECTION ?209 D~ THE
YOUNG YOUNG
ALDEN W. YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR~ N.Y.S. UCENSE NO. 1284§
HOWARO W, YOUNG) LANO SURVEYOR
N.Y~S. LICENSE N0.4§895
SCALE: / ' -- 50'
AVENUE
RIVERNEAD, NEW YORK
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