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Home My WebLink About13525-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date May 21, 1987 THIS CERTIFIES that the building one-family dwelling w/sliding door b&ocked h'6£' kb' 'lb& b'~S&hb~.' ........................... Location of Property ~3~sb Hi .4.0 ........... .Cp.u.n..t.ry. Club Drive Cutchogue "S't/e~ i ....................... h ~ ~ i e i County Tax Map No. 1000 Section ....1.0.9. ..... Block 03 .Lot 2.10 Subdivision..Cg.u~.t.r.y..C.l.u..b..E.s.t..a.t.e.s. ..... Filed Map No. 6736. .Lot No. 25 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..o.c~ob. er. 9.,..%98Y.. .. pursuant to which Building Permit No. 13525Z dated ..... hlo.vB~ber..8. ~..19.8. 7. ...... 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 ......... .... ~ri.v. ate..oner f,amily..Owe}.~i..hq..w./s._ .1.i.d.i.n.g..d.o.Q .r..b.l~ o..c.k.e.d...n.o.t...t.o..b.e...o.p, ened. The certificate is issued to .................... JOANNE ROBERTS (ow * er, I~sXeXq~ XOX,~ of the aforesaid building. Suffolk County Department of Health Approval ............ 14-SO- 193 N711902 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: 8/27/85 /Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13525 Z Permission is hereby gronted to: ~ ........ .~.l~~...~.~..~ ............ ...... ~...~...~~...~.....~. .......... ................................. ..,~ ........................ ~ ................ ~ ............................................ :~.~.~%...Zo~ .~. ~TZ... ........ / County Tox Mop No lO00 Sect on . Block · · ,~,m_. ................ Building Inspector. Fee $,A~..~.~..~.~ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted i~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final su~¥ey 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. For existing buildings (prior to April 1957), Non-confo'rming uses, o~ buildings and "pre-existing" land uses: I. Accurate survey of p~perty showing ail 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory,S]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5. updated C.O. $ 50. 0 0 Date . .~:).r.~ ;'. ,~.'~,~, ............ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .'~..~. ~...~.-~ r2~.~s.%% .~ .~.%~....~..~N-~.~. '..~'~.. ~.. C.k.~.~.c~.' .~..~?~:~ .~L~.. House No. Street Hamlet Owner or Owners of Property ...'-;~..~'~ ,(~...%~-~.K~ .,r~__... ,~ .'.C4~'.~:~ .... -~ ~ .~ .................. CountyTax Map No. 1000 Section . .~..~.~. ........ Block ...~)~.'.'... Lot...~-~...~..~ ...... Subdivision..~:~'~..~:.~F.~..C~¢%?~..~...~, ,'~,, .~, .....Filed Map No ........... Lot No..~:~ ..~-~ ...... Permit No.¥:~3 .~'~,~.'.~. Date of Permit .~.~:.~. :.~.~Applicant ~.~C~q~..~'~.c~ .x~T~..~~,:~. '..~.... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...¢~. .... ~:t~/~'2,0 Construction on above described building and permit meets all a~p,~licable codes and regulations. .\ .. ~-1~O. ~0~.~ __ Appdcant . ~~-.~.,. ~. ~~~ ................. Rev, 10-10-78 --' ~ TOWN OF SOUTHOLD OFPICE OF BUILDING INsPEcToR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /~ff An application for Certificate of Occupancy is not on file. (~-'~Z/~-~J No Underwriters Certificate on file. The check is(o~w~a-~d/not on file.~.~-~ No Health Dept. Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. -~uilding Permit # _/ ~__ ~ .__~ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY Octob¢~Zr 08~ 19U5 85 JOHN STREET, NEW YORK, NEW YORK 1OO3'8 $25933/85 THiS CEETIFIE~ THAT only the electrical equipment as described below and introduced by the applicant na~ed on the abQ~e ~p/ication ~u~ber in the premlses of Ooa~ Robe~ta~ H/$ Co~tr~ Club D~'o, 600'W/O ~oraa L~e, Cutchogue~ ~ in the following location; ~ Basement ~ 'st Fl. ~ 2nd ~l. Section Block ~t was examined on OCtObers' O[~ ~85 andfoundtob~incompliancewiththerequirementsofthisBoard. FIXTURE FIXTURES RANGES OVENS OUTLETS RECEPTACLE~ SWITCHES FLUORESCENT EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME ~LOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R NO PER,~' OF CC. COND. OF CC COND A, W. G. 1/o V I C E OF NEUTRAL P.O. ~ox 143 GENEI~AL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the 8oard if ii~co~ect. Inspector:,s may be by their credentials. THIS TOWN OF $OUTtlOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit Owner J, (please print) (please p~int) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. -~(pf~mber'V's s~'~nat6re) ' Sworn to befo~ me thai~ ~7 day of {~{{'~Jd.'9'~ , Notary Public, ~_ County t~o. 52.2419~50, Su[fo{k Coun~ Notary Public~ COMMENTS ROUGH FRANE QODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 May 9, 1986 Joanne Roberts BOX 1080 Cutchogue~ N.Y. 11935 Dear Ms. Roberts: Your request for an extension of Building Permit #13525Z is extended to November 8, 1986. Beyond that date a new permit will be required. Yours truly, Victor Lessard VGL:hdv Exec. Admin. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH pLBG. FOUNDATION 2ND [ ] INSULATION ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined./f~.~ · .~. · .... 1~. ' Received ........... ,19... Approved .~.~. · .~. ...... Disapproved a/c . · ·: ...................... / APPLICATION FOR BUILDING PERMIT Date .... .~k2 ........ 19~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 issued 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 pumuant to the B ........... ~"~-.~-~-~e we,"- ,,r ~ _ut~hol~ ~ ~roJk Couu)z¢ Neam~0rk~nd other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions ot alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (L:~"-~'ig}~ature of applicant, or name, if a corporation) (Mailing address of applicant) XN,NN/ N\c~:~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............ '.. :. · ~ ..... Plumber's License No../.~. · .~. · ~~ Electrician's License No. Other Trade's License No ...................... 1. Locajjon of land on which proposed work will be done .................................................. '1 q o .............. ...................... ltouse Number Sti~t Hamlet County Tax Map No. 1000 Section .... ~..C,~. .......... Block .... (~ · .'~.. ......... Lot....~.~.~.. )..C? ....... .... i' Lot 5uomv stun ................ : ........ Filed Map No ......................... 4,~.'-r:: .q~ (Name) State existing use and 9,cc~angy of premises and intended use and occupancy of proposed construction: a. · .... b. Intended use and occupancy,/.: ............... RePmr · ~ ..... ,..-. ~!~v~l .............. Demolition .............. Other Work .............. [ ~~ j ~' rte be paid on filing tMs application) 5. I~d*ehing, number of dwellin~u~its ............... Number of dwelling units on each floor ............. If garage, number of cars ...... ! ................................................................ 6. If business, commercial ' or m~xed 0eeupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing st~ctures~ if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of same st~cture with alterations or additions: Front ................. Rear ................ Dep~ : : HeiSt Number of Stories 8. Dimensions of entire new const~etion: Front ............... Rear ............... Depth ............. Height ............... Number of Stories ...................................................... 9 Size of lot: Front Rear Depth 10 Date of Purchase ' Name of Fo~er Owner 11 Zone or use district in . which premises are muated ................................................... 12. Does proposed cons~uction violate any zoning law, ordinance or regulation: ................................ 13. W~I lot be regraded ......... 4 ................... Will ~xcess ~l be removed from premises: _ ~Yes t No 14. N~e of Owner of premises ~.~.. Address ................... Phone ~) Name of Architect .......... ~ ................ Address ................... Phone No ................ N~e of Contractor ......... ~ ................ Address ................... Phone No ................ PLOT DIAG~ Locate cle~ly ~d dis~ctly fll ~bu~d~gs, whether existing or proposed, ~d, indicate fll set-back d~ensions from property fines. Give street ~d block number or desc~ption accord~g to deed, ~d show street n~es ~d indicate whether interior or comer lot. i i STATE OF NL~'~Y~, .Z- S S (_.~,/ame of individual sigfiing~ contract) above named. . being duly sworn, deposes and says that he is the appJicant ~~ontra;t~r, agent, corpo;ate officer, . of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; tt~at all statements conIa~ned m thxs apphcat~on are true to the best of 4~s..~k~owlcdge and behef, and that the work will be performed ~n the manner set forth m the apphcat~on filed therewith. . Swqm to before me this ·.'..~, .~.~. dayqf' ~..~ 19~././ : " . County ~, . Notaj~ Public, . ..... ~ ...... _:~...~...:.~ . .-..~ ~ 5O LOt forr~erly or Muzinic r~oW VlostO ~arin Lot .f. .40, 9fi5 s Area ' Lot 51 Lot ~6 ,/ IFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAl. OF CONSTRUCTION OF Single Family Residence Only LTH DEPIRTId£NI-DATA FOR APPROVAL TO CON$1'RUC¥ SURVEY FOR JOANNE ROBERTS LOT NO, 25, "cOUNTRY CLUB ESTATES" AT CUTCHOGUE DATE, TOWN OF SOUTHOLD SCALE~ SUFFOLK COUNTY, NEW YORK NO, GUARANTEED TO' THE TI TLE fo .- i or Muzinic , now VlOSt° Morin I 0 .... ' 740 ~ SU~Y FOR ~0 JOANNE ROBERTS LOT NO. ~5,"OOUNTRY CLUB ESTATES" SUFFOL~ COUNTY DEPARTMENT OF HEALTH SERVICES AT ~UTGHOGUE O~TE, SEPT. ~N ~ SOUTHOLD SCALE= I"= ~0' FoR APPROVAl. OF CONSTRUCTION OF SUFFO~ COUNTY, NEW ~RK NO. e4 -. ~OZ Single Family Residence Only ,~umm~z[.~LTE~TIONORAOmTION~ miS' GUARANTEED TO: DATE HSREF. NO. ~ O~ [~ HZ~YO~,~*TZE~C*T,~L*W THE TITLE GUARANTEE CO. HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STR~CT me ~'FOR WHOM THE $U~EY-IS PREP&REO ~,~'~ .... ~0,'(' '""'" , ~xxx~ ~ : YOUNG S YOUNG ~~0~"AVE~E NOTE = ~ ~ MONUM.EN~ ~ = STA~E ~DEN W. YOUNG~PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND~ND SURMEYORN.Y.S. UCENSE H0.1~845 ' HOWARD W. YOUNG, LAND SURVEYOR =i SUFFOLK COUNTY HEALTH DEPARTMENT SINGLE FAMILY DWELLING ONLY H.D. REF. NO../~"~'~D~=J: - ....... i ~^TE~L.' THE SEWAGE DI~AL AND W ~TER SUP~DV FAC LITIES FOR THt~ ~ ~, FOu~LOCATION~TO~E '~EEN INSPE~,TED 8~ ~HIS DEPARTMENT AN . . o ~ , ~, ~, , o r i~ ~~ , o ~as[ewat~ t ~anagem~ Section Lot ,/ / '%;' 5U~Y ~0~ AUG, 5 ~ 1~5 LOT ~0. ~,"COU~TRY CLUB EST~TE~" ~T CUTCHOGUE ~N ~ ~OUTHO~D SCALE, ~ "= 50' SUffOLK COUNTY, NEW ~RK NO. ~U~lZ[~ ~L~ION O~D~I~ION ~ ~lS r GUAranTEED TO OTHER THAH THOSE SHOWN HKR[OH. OWHERS YOUNG a YOUNG .,vE.~.NE~o.~ NOTE, I' MONU~N~ G, ST~E ALDEN W. YOUNG, PROFESSIONAL ENGINEER sua~VlSlON MAP FILED IN THE OFFICE OF THE CLERK OF AND ~ND SURVEYOR N.Y.S. UCENSE N0.12845 HOWARD W. YOUNG~ LAND SURVEYOR ~ L~ ~ ~L(~),~IC T~(I~}I C[~OL~(~} I~ ~ N.~S. LICENSE N0.45893 BRANDIS & EONS INO, 1.046