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HomeMy WebLinkAbout13560-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15106 Date November 17 86 ....................................... ,19 ... THIS CERTIFIES that the building ...O.n.e...f.a.m.~.~..y..0?.e. }.l.~n.g.. ?).~.h...a.~.~.~..c.h.e.d...g.a?.a. ge Location of Property 2110 Country Club br. & 1980 Moores Lane Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section 1 0 9 .Block 03 .... Lot 0 02.2 1 Subdivision .N/.o..C. 9.u.n.t:c y..C.l.u..b..E.s. ~..a.t.e.s...Filed Map No. 6.7.3.~ .... Lot No .... j.4. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .q q .~.o.b.e. ~,'. ~.1., ......... 19 .8.4. pursuant to which Building Permit No...1.3. ~.~.0.Z. ............ dated . .~9.v....2.9, ................. 19.8.4., 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 attached garage The certificate is issued to SCHADWICK HOMES (owner, Ye~bYoZ Ye)~,~X X X of the aforesaid building. Suffolk County Department of Health Approval ... 14 -S0-210 N7279.80 UNDERWRITERS CERTIFICATE NO ................................................. Plumbers Certificate dated 1/27/86 THIS CERTIFICATE OF OCCUPANCY UPDATES CERTIFICATE OF/~CUPANCY #Zt432~ dated April 1, 1986. · .~..~ ~..~..~. Building Inspector Rev. 1/81 ~'O~m ~0. 11 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) 13560 Z Permission is hereby granted to: ........ .~./Z.~..~.~.;~.....~..~ ................ ..... ~.~.....~.~.~..~,..~ ............ ....... Z/.f.~.'~ ...... .............................. ot prem,$es located at ....&~.~....~x2~f__.~/~.~../~....~......8~/(.~'....~; ........ .~ ...................... Z .... ~.'~.~.~:,~....,~-~,z-~ ................ ~z'.. ~ ............. .~z.....,.~ ....... ../. ............. cou,w 'r,,,, M,,~, No. ~000 Sec,on .... Z.~...¢... ...... ~,~k ....~..~...i. ..... L,~t No. ~'~/ pursuant to application dated ..~.~"~.. ........ ~ ............. , ' .~....~., and approved by the Building Inspector. Fee $.0~ .~....~.........?~.~ Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD 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 .~ ~ 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 p~operty 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 6f occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date .......................... New Building ....~ ......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. ~..O.L)....~T~. y... ~.Q~., ,'~.~.t .U.~., ........ ~.Q'F'.~.I~ .o,~-..~. ,1~.. House No. Street Ham/et Owner or Owners of Property ...5~ .~./~, .'~..~..t.C-¢,~... J-~,O. ~..~.. ~ ........ : ...................... County Tax Map No. 1000 Section .... ~:b.~ ...... Block .... ~ ........ Lot .~.'.~,-..~ ...... Subdivision. ~.~...Filed Map No.~.!..~...~...Lot No...I .~. ......... Permit No. j.'~..(o.~..'~.. Date of Permit .......... Applicant . ~.~. }~/~.'j~(~. [C~l~...[?1¢.0..~0..~' S ........ Health Dept, Approval. !fi ,~. ,~.. ,~..A.~.~. ..... Labor Dept. Approval ........................ Underwriters Approval .~..~..~.9..~.~.0. .......... Planning Board Approval ...................... Request for Temporary Cectificate ..................... Final Certificate ....................... Fee Submitted $ .... .~.....0.~ ................... Construction on above described building and permit meets all applicable codes and regulations. e. z ) y:3 ? FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certi[icate O[ Occupancy No. · .Z. 1.6..3.2.7 ......... Date ...... A. p.rj..1.. ] ................... 19.8..6 THIS CERTIFIES that the building ..... .0 .n.c.. f.. a..m.~.l.y...dEe. 3:..1.i.n.g. .................... LocationofProperty2110 Country Club Dr. a 1980 Moores Lane Cutchogue County Tax Map No. 1000 Section .... .1.0.9 .... Block ....... 0.3. ......Lot 0 02.21 Subdivision..C0UN.T.~¥..C.L.U. 13..~.S.T.A..T.~.S. .....Filed Map No. 6.7.3..6 .... Lot No. 1 6 conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 0. 3 .~....3. ! ......... 19.8. 4. pursuant to which Building Permit No. 1 3 5 6 0 Z dated . N p.c.... 29 ................... 198fi.., 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..~'am,t. 3, y. dm. el 1 ±r~ .................................................... The certificate is issued to SCHgJ).W~K. HOMES ........... io¥,,'e'r,~3~'grZ'~ ~Y~ X X ................... of the aforesaid building. Suffolk County Department of Health Approval 1 6 -S 0-2 1 0 UNDERWRITERS CERTIFICATE NO ............. ~ T .2.7.9.¢. 0. ............................. Plumbers certificate 1/27/86 Building Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLtCATION 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 arid 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: 3. 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 Date .November 13, 1986 New Building ~ Old or Pre-existing Building Vacant Land 2110 Country Club Dr. & 1980 Moores L.a,ne .~Qgu~.. Location of Property .............. House No. Street Hamlet Schadwick Home~ Owner or Owners of Property.. ......................................................... . County Tax Map No. 1000 Section .... ?.9. ........ Block 03 . Lot. 0.0.2.21 Country Club Estates p N ,673,6 Subdivision ................................. Filed Ma o ......... Lot No. 14 13560.Z ~.1/.2.0,/84 Appli Schadwick Homes ~ Permit No .......... Date of Permit ....... cant .................................. Heelth Dept Approval Labor Dept Approval ....... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate Final Certificate ~/Z. 1432.7 Fee Submitted $.1~.,00..v.P.%~a~ .~o~. ~ .th~. C.O. that the garage is included. ~hank you! WICKHAM, WICKHAM & BRESSL1 P. O. Box 1424 Mattituck, New York 11952 (516) 298-8353 Building Department To: Town of Southold Town Hall - Main Road Southold, N.Y. 11971 The accompanying papers pertain to this account: ....... Mortgage Bond ....... Mortgage ...... Building Loan Agreement ....... Deed ....... Extension Agreement ...... Our Bill ...... Termite lnspectiun ....... Water Test Results Date: November 13, 1986 Re: Schadwick Homes to Jermusyk 1000-109-03-02.21 ....... Fire Insurance Policy ...... Title Insurance Pohcy ....... Release ....... Satisfaction .. X ...Surveycopy ....... Tax Bill or Receipt ....... Closing Statement ....... Description of Premises · . ~...Certificate of Occupancy applicatiort to inelncle...Copy of Title Report ...Assignment garage, & our cheek ...... Amortization Schedule ....... Escrow Statement for $15.00. . ...... Title Company Receipted Bill ...... Escrow Check ....... Other We are sorry for the inconvenience caused by this request, but we are finding that an increasing number of lending institutions are insisting that garages and decks be specifically itemized in the Certificate of Occupancy. FIELD ~fNSP~CCTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE uNDERWRITERS 100037~ BUREAU OF ELECTRICITY [~ O~. 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 THIS CERTIFIES THAT was exa,nined on D~I~ ~ ~ e J.~[J5 and found to be irt compliance with the rqquirements of this Board. Lot FIXTURE FIXTURES RANGES : OVENS OUTLETS NCANDESCENT I:LUOEESCENT DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER APPARATUS: E R V t C NO, OF CC COND, A W. G, A W G NO OF NEUTRALS A, W. G. P~R ,~' 0F CC. COND OF HI,LEG OF NEUTRAL ~ ~/o 1 ~/o 657 ~ GENEI~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY FOR Bt :) IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. (please print) Plumber G ~D~(~ ~ {please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. -- (plumber' s s/gnature) Sworn to before me this ;2~ d~y of~ -,-rU~ ___, Notary Public, ....... CoGntv ......... PUP, tIC, St,,t~ ,,,~ N~ York No. 4695650 O~,ahfcd m Suf Nk Comity ~ 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~ FINAL REMARKS: 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved. ~.fO77/...~..o' ..... 1~.'. Permit No./..~...~..~..~...~.' Disapproved a/c . . . ~ · · ·/~ ............ ~. ..... i '~ APP.,C*T,ONFO. BU,Lr',N PE"' 'T Received ........... ,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 foe 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 building for necessary inspections. ....... S.c.h a.d.w.i.c.k .H. ojn. e.s. ........................ (Signature of applicant, or name, if a corporation) .Ne.,*'..S.u.r.C:.oA.k .Av.e..,..~l~t. ki.ku.d<..%1.9.5.Z ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner ............................. Schadwick Homes Name of owner of premises .......................................................................... (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...~7./~.'. '. 6.~. ,~'f--~ Electrician's License No..(/ ..... r./ .........(./ ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. c.o. rZte. r..o.f...Lj_o.d.e~. Av.e.., ~..£.o.~l~.t:r.y. E2'lJb. DrJ-.ve.,. Housi ~q;~ir ............... Street ..... Hamlet County Tax Map o. 1000 Secti(~nl (.../.~/.' .~.~.~ ....... Block . .'~: .'~. ............ Lot. ............... Subdivision,..'P.~..~.?.~'...--~...~. C.~iO~ (~....~..~.. 6736 :1~ ........... Filed Map No ............... Lot .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .ua6awt;. to~: ........................................................... b. Intended use and occupancy .. epp~.~rucJcion, o.f. dwelling... ¢~../'4.~.../L...~..~t-4. ¢~¢i'...c¢/.~..~/ ........... · Alt 3. Nature of work (check which applicable): New Building .X ........ Addition ..... ~ ..... . oration ~ .... [.. :. Repair Removal Demolition Other Work i~ (Description) 4. Estimated Cost ..... ~l.3.q,.~.qq ......................... Fee ~.d~'. .... ............ ; ........ (to be ipaid on filing this application) 5. If dwelling, number of dwelling units...1 ............ Number o f dwelling unils on each floor ............. -... If garage number of cars 2.' 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..... 7. Dimensions of existing structures, if any: Front ............... Reai ....... : ....... Depth ...... : ........ Height Number of Stories I ' Dime ion of stru with It rations dditions: Fr t ' Rear ns s same cture .a e or a on ............ .. .............. .. ,...... Depth Height Number ofI Stories 8. Dimensions of entire new construction: Front .... 7.(P ......... Rear . .7.[1'.: ;.: ....... Depth . .t~Ct'. Z~ .ZOd ..... Height Number of Stories i . 9. Size of lot: Front . .%a%..%5' ..... Rear...18.5.'.. ...... iDepth 240'. 10. Date of Purchase ......................... Name of Former Owner .;. .................. 11. Zone or use district in which premises are situated ......................... i '" .................... . ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: . , ......... bio ...... ' ....... 13. Will lot be regraded ..... .N9 ..................... Wil'l excess fill be remove:d from premises: Yes No X 14. Name of Owner of premises Scbad~ich~. ~omes ..... Addr~s~qe~. Suffoll~. Ave.l .... Phone No.'298-,93~ 4 ~. .... Name of Architect. Larry. :Jut:hill ............. Addross . Greenporfc,. r~ ,~ .. ~. Phone No ............. Name of Contractor 5cbadwic¢ ~ome~ Address ' Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existin property lines. Give~ S "ETAT " .... /c ObF OF~ NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the · .' ........ (Contractor, agent, corporate officer, etc.i of said owner or owners, and is duly authorized to perform 'or have performed the s'aid work and to make and file this application; that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the work will be performed ~n the manner set forth in the application filed therewith. Sworn to before me this ................... day of 19 · TeJnl lap,res k}areh 30, 19~ DRIVE VACA r MON t~NO 181 1,5' · ~ II NORTH FORK couNTRY CLUB, INC. VA CA NT MAP OF LOT 14 MAP OF COUNTRY ClUB FIL ff O.' O¢~. l~ lS?~ F/LEN~ AT CUTCHO~UE TOWIV OF SOl S UPFOL K CO, IV. Y. NO TE,' EL EVATION$ A RE REFERENCED TO ASSUMED DA rUM '[he water supply and sewage d~sposal systems for th~s residence w~ll conlorm to the standards gl the Sulfolk Coua~ Dept. of aealt~ Serwcas. , SUFFOLK COUN~ DEPARTMEMT OF HEALTH SERVICES FOR AP?~OV,~-L OF CONSTRUCT ON ONLY APPROVED ~ SIN.G~~LLING ONLY THE TITLE ~HANTE~ COMPANY TITLENt TI38~-~3G NORVH~OHK BANK8 TRUST CO. NAN ~' SCHAD~ sealand surveying a engineering pc. 40 west main sfreet .ri~rhead, new york 11901 '(5~6)$69H717 : Sept. 27,1984 :1000- 109-03-02,~21 JobNS84-66~ Scale: 1~'40' COUNT'R y ~UB DRIVe' 0 1½ STY FR. DW~/GAt~ SINGLE F.~ILY DWELLING SUff~OLK DOUN~Y HEALTH DEPAR~N~ faellitiom for thl~ ~o~atiou ~ve been ~nsected by this de~e~%men~ ~d found Chief of ~e~l Ak'F NORTH FORK COUNTRY CLUB, INC. MAP OF 'LOT 14 MAP Of COUNTRY ClUB ES TA TES F/ L E D.' OC E I Z, 19 F8 FIL ff N~ G F S G AT ~UTEHOGU6 TOWN OF SOUrHOLD S UFFOL K C~ N. ~ ~ow~ o~ so~ ELEVA?~ONS IN ASSUMED DATUM. CERTIFIED TO THE TI TL E GUA RAN TEE COMPA NY TITLE N~- TI284-3856 NORTI'IFORK BANK~ TRUST CO ROBIN P WICKHAM 8 NAN E. SCHADE seolond surveying s engineering pc. 40 west moin street riy~rheod, new york 11901 '(5i6) 369-1717 Sept. 27,1984 1000-109.03- 02.21 JobNS84-664 Scale: 1'1-40' DATE: EI !~2 B.P ~~ m FX F~ EV F~E:¢~SS ~Y. ~ - NOTIFY B~ IILDING DEP~RT~ENT AT 755 7R02 9 A~ TO 4 PM FOR THE - FOLLOWING INSPECTIONS FOR PqURED CONCRETE ~¢~ ~ / ~-~ 3. INSULATION / 4, FINAL _ CONSTRUCTION MUST BE C~F4PI ETE FOR C O. '~LL CONSTRUCTION SHALL MEET ~HE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. PLUMBEI~ CEBTIFICATIO~V ON LEAD CONTENT BEFORE' CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. If copper tubing is used for water distributing ~ys em; piping shall be of types K or L only "4 ,,FAV I .L_~f t Phone 477:0400 G~!:r~l~¢)t,t l',. N Y. 11944 r ,I 5., ::." + %..