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HomeMy WebLinkAbout11253-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy Z10735 No .................. Date October 20 19.81 THIS CERTIFIES ti ti t; b il li lilt 1 u cng ........................................... ;Loca/ion of Property 2060 Highland Road, Cutchogue, New York House No. :Street Ham/et Cotmty'Tax Map No. 1000 Section 102 .... Block 08 .... Lot 028 Subdivision Highland Estates 6537 31 ........................ ~ ....... Filed Map No ...... :, .Lot No .............. conforms substamially to the Application for Building Permit he/'etofor¢ filed in this office dated May 25 81 1,1253 Z. ..................... , 19 . . . pursuant to which Building Permit No .................... dated ....Jt~l..y..7 ............... 198.1.. , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issaed is ......... Private One-Family Dwelling Richard Mohring The certificate is issued to ................... ; i .................... of the aforesaid building. Suffolk County Departnlent of Health Approval ....................................10/20/81, 11-S0-49, Robert .A,...V. illa. PE UNDERWRITEP, S CERTIFICATE NO. N533869 ~, pector Rev, 1/81 TO~N ~)F ~U~i'H~L! :TOWN ~ALL SOUTH'OLD; N. Y; (THIS PERMIT MUST BE COMPLETION OF THE WORK ^UTHC~RIZED) BUILDING PERMIT KEP~ ON THE PREM'IS~ UNTIL F~ULL Date ..~.,. Ni? 1:L253 Z Perr~ission is hereby granted to.' ~.~. , .Z.: ....... :.: .................. .7..~ at, p~emise~ located at ' pdl's~ant t~ application dat~d BOi!ding Inspector. F~ ~..../..~.....:.~.. 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 UndenNriters. 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 $1.00 /~ ~ate...~..~k .~..~/.~..¢../. ...... New Building ............. Old or Pre-existing Building ....... ..... Vaca. pt Land ............. Location of Property ....................... House No. County Tax Map No. 1000 Section ............... Block .......... Lot .............. .o ........... ..,. o, ,.rm,, .......... . ......... Health Dept. Approval ...................... Labor Dept. Approval ........................ ~equost for Tomporarg Cortificate ..................... Final Cortificat~ .. ~ ......... FeeSubmitted$. ~'~O. Construction on above de~ribed bu,ldin~ and~~~~des 7~d, ro~lati~ns.. .................... ~ooo681 THE NEW ~YORK BOARD OF FIRE UNDERWRITERS Ilg ~ BUREAU OF ELECTRICITY ' · : ' '~ --- 85 JOHN STREET, NEW YORK, NEW'YORK 10038 a,,te September 30, 1981 .~pplica,ion~Vo.o,,fle].2.831 'a~ ,N 537195 THIS CERTIFIES THAT in the following location; ~ n.~*.,*nt ~ t~ rt. ~ z.d rt. S~***o..102~to~ 8 ro~ 31 was examined on Sept. 28, 1981 and found to be in compliance wltb the requlrernents ~f this Board. OUTLETS ~EPTACLES SWITCHES iNCANDESCENi FtUORESCENT ~Ic~Y ~T, K,W ~T [ K.W, ~T. KW ~T, K W ~T H p 4 OTHER APPARATUS: Motor/s: 1-F 1-G.F.I. ] 3-Sraoke Dotectors Paramount Elec. Co. 20/,1 Shelley Place East Meadow, N.Y. 11554 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect· Inspectors may be ~dentified by their credentiah FIELD INSPEC~£ION FOUNDATION (1st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: FORM NO. I '1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 . ,~ TEL,: 765-1802 Examined. .t/" ./, ...... ,19& ,- . V }pprove /rl /ee, nitNo ........ APPLICATION FOR BUILDING PERMIT Application No ....... INSTRUCTIONS a. This application must be completely filled~in 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, relgtionship to adjoining premises or public stree or areas, and giving a detailed description of layout 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 commenced beforedssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern shall be kept ou the premises available for iuspection 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 ithe 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 descfib~ TL~ applicant agrees to comply witl} all applicable laws, ordinances, bullring code, housing code, and regulations, and admit authorized inspectors on premlses and in buildings for necessary ~~.~ . . (S~~~,~l~o.~r n.~at~e_, i!a corporation) __ (Maili.ng addr.e.ss 9,f applicant) State whether applicant i~ssee, agent, architect, engineer, general e~ntract~ctrician,~'~- -..~-~ plumber or build, (as on the tax roll or latest deed) If applican~~f duly authorized officer. ....... ~(Name~~and ti~i¢ f corptffat~ ~h~r') ......... Builder's License No .......................... .... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. .... ...... ..... .................... House Number ~/ Street ~/ltamlet County Ta~,x 1~¢~.~. ~Q~O~ec.tion / ................. Block ................ Lot .... Subdivision ...'~.:~..~ ,ff'~. · ,.-~ .......... Files Map:No...~...~.~.~2 ... Lot...~./ ......... 2. State existing use and occupancy of prelnises and intended use and occupancy of proposed construction: Existing use and occupancy i' '\ y Intended use and occupancy ./...~.~..~.( .'~// . Intended use and occupancy.... .... .~. & .~.( ,~,Z, ~./.~.. .... ....... ' ............................. 3. Nature of work (check which applicable): New Building ....... ~X, Addition .......... Alteration .......... Removal ' Demolition Other Work . Repair ......................................................... ~/..~/6~. F ~ .~,.~'/ ff~/ (Description)_ L Estimated Cost ........................... ee .. '~-'--'-- (to be paid on filing this application) L If dwelling, number of dwelling u.J:tits ...... /. ........ Nmnber o f dwelling units On each floor ................ If garage, number of cars ...................................................................... 5. If business, commercial or mixedioccupancy, specify nature and extent of each type of use ................... ~ Dimensions of existing structures, if any: Front ' Rear Depth Height ............... Number of Stories ...................................................... Dimensions of same structure w~th alterations or addmons: Front ................. Rear ................ Depth .................... ~. Height ........ .,.. ?~, ......... Number~of ~ries...~ ...... g. Dimensions of. entire new constmchon Front .~.~ ......... Rear ..~..'~. ~. ....... Depth L Size of lot: Front ...'.~/~.. .... i,' ......... Rear . .~..! . . ......... Depth _~. ___ , . · ) Date of Purchase ~ Name',of Formez:O~i~cr which premises are situated 1. Zbne or use district in .................................................... L Does proposed construction vioI~te any zoning law, ordinance or regnlation: ~ ........... . ................. I. Will lot be regraded .... ~$.e,.~ ...... ,, ............. Will excess fill be remove~l from premises: ' Yes L Name of Owner of prerr~s ~...~. ,~,,~..~_.o../J~. ~'.~_~.. Address~.~.,.~.]..~,. ~.~.. Phone No...~ ~.~-.Z Name of Architect ...,~/.,'.,'.,'.,'.,'.,'~ ~. ,~../~,~.r4/i~'~r.'f... Address . {J~./.~; .~.~.~--. ..... Phone No.....~?.-. ~,. Name of Contractor . ,~..~..lz. ~..~...~,~ .~ ...... Address . .$'..~'q'..~../~. .~. ...... ehone No..~.2/7'.°.~... o (/ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether'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 iterior or corner lot. rATE OF NEW YORK, $.S OUNTY OF .............. ;.. (Name of individual signing contract) 5ove named. :e is the i a ent corpgrate office; f said owner or owne~, ~d is dul~ authorized to perform or have performed the s~id work and to m~e ~d file ~is 9plication; that all statements conthined ~ this application are true to th~ best of his ~mwledge and belief; and that the ,ork will be performed in the m~n{r set forth in the application filed therewith. worn to before me this , ~~N~Y~ ...~ '. ~.~ ....... day or.. · , ........... , ~m~ ~m, ~reh ~ ..... .ota~ Pubhc, .~_ '~ ................ County SU~Y F~ ~ ~v~ ~ ~ ~[~ AT CUTCHOGUE ~g: MAY I~ 19~1 APPROVE~_ ~ SURVEY ~ ~ VI~ATION ~$ECTION 7209 ~ TH~ SU~VE~n ~ INKED SEAL~OREMIO~SED SIAL ~HALL ~ :il :CO ISIDE~D TO ~ A VALID TRUE COPY HEALTH DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ~ ~ I~ ~ ~n WHOM ~H~ SU~EY S PREPAREO ANO ~ Hi~ ~ ~LF ~ THE TITLE C~Y, GOV~N- N ~F ~, T~MAP ~T Io~© SECTI~ Io~ ~CK ~ , LOT~ H~E~ A~ ~ ~O ~E ASSIGN~S OF THE LENDIND NOTE: SUBDIVISION M~P FI~D IN ~E OFF/CE OF T~E CLERK '~ ALDEN W. YOUNG, PROFESSIONAL ENGINE ER OF SUFFO&K COUN~K ONAP~,~/~XA$ ~ENO.~X AND ~ND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W, YOUNG~ LAND SURVEYOR TITLE NO. 8108- su~Y F~ P~UL ~. SHELBY ~ CONCETTA SHE~Y ~ ~o~ LOT NO. 31, "HIGHLAND ESTA~S " OCT ~T CUFCHOGUE O~T[= SEPE 25,/~81 ~N ~ SOUF~LD sc~[= I" = 50' ~FO~ COUNTY~ NE~ YORK NO. 8/ ~ c~,~ ~ m,s s~v[v NOT ~AN~ TS~ CANO ~rN~ $~VIN~$ ~T~: ~, ~<~;; i~I~ AbD[N W.~NG, PROFESSIOHAL ENGINEER SUBDIVISION MAP FI~D IN ~g OFF/CE OF THE OF SMFFOLK COUNTY ONR~.~, 19~A$ ~L~.~~ AND ~ND S~VEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR v / ~,~.. c~. ., .. "It should be .0'~ ~' ,in~e ,hi~ ~ area, the possibility exists that the ~ water SU~~in trace ~ amounts ~~r nit?t?~ ) Special ~S~ lg~quired. I ODAeT~ O~ a~t~ S~V~C~S.I MOH~I~G ENTERPRI~S. INC SUFF~ COU~ .... . ' . ~ ~OT~O. 31, HIGH~AND # _ ~ ~ ~ ~WN ~ SOUTffO~D SCA~E: I ': 50' / / , -- /~. (~ SURGE ~R ~ INKED SEAL'OR EMBOdiED ~EAL SHALL ( / //~ ~ // /~ ~T~ll ~O~IOEMDTO~AVALI0 TRUE COPY HEALTHDEPARTMENT=DATAF~AP~RO~L~C~STROCT ] ~RWHOM ~HE SU~EY IS PREPAREO N NEAREST W~ IAIN--MI.. NSOURCE ~ WATER, ~I~TE~P~IC i I MENYA,. Al :HcY AND LENDING INST ~UTION LISTED ff~F~.T~MAP~TI°9~ SECTION ~O~ ~K ~ LOT ~ ~ I H~E~,Ai )~6 ~EASS~0N~OF THELENOIN~ OTHER THAN THO~E SHOWN HEREON, I '0~A~II0 AL INS'TITUTI~I OA~UBSEOUENT WLLC~ORMm T~ STANWDSOVTflE SU~K COUNTYD~PARTM[NT I N~STJN~KS S~N HE~EON PROM PR~ERTY LINES OF H~LTH ~1~ . " I T~)~ :TIN~ ~TRUC~RE~ ~E FOR A SPECIPIC ~/OgAL ~{~,,~' ' :' lrii YOUNG YO =-- ~ /1~ ~ ~ / ' Ul~'~ ~VER~AD~ NEW ~RK NOT~: ALDEN W YOUNG~ PROFESSIONAL .i Il, I 'I FOLLOWING iNSPECTIONS:,i/'.4- .r. I-O 1. FOUNDATION - TWO REQUIRED FOR poURED cONCRETE 2. ROUGH - FRAMING & pLUMBING ~, INSULATION MuST 4. FIN'~L ' CONSTRUCTION BE COk~P~ ETE FOR C O. ~4 -~ILo'' ~,EL, gL, 'L. ! / / · %01 zJ~ z-'' +J U,'C Tz×CA'v~TE-D ~'i' Y4"= :-o