HomeMy WebLinkAbout13367-zFORM NO. 4
TOWN OF 5OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z13304 Date April 2 ., 198..5
THIS CERTIFIES that the building ..... N.e..w..D.w..e .1.1.i.n. ~ .............................
Location of Property .4.7. Q .................. .R...O. :.iq:. RE..f..~.q9 .r.e.s..L. 9.n.~' ...C.u?.c.h. 9.g.u.?'
House No. Street Hamlet
County Tax Map No. 1000 Section . .1.0.9. ....... Block ...0.3. .......... Lot .. ?./.O...0.0.2.: .5 ....
Subdivision ....... X ...Filed Map No. .Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
July 25 19.84. pnrsuant to which Building Permit No. 13367Z
dated ..... .Apg.: ..... 2.3. ........... 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 .........
New Private One Family Dwelling
The certificate is issued to .............. .R. QB..E.R.T..~.,..&..A..N.N.E...i~..R.I.~..V.A.N...I~..T?.R. ......
(o wrier, la~oe-o~ ~
of the aforesaid building.
Suffolk Co ty D tm t of Health Approv 1 14-SO-156
un epar ell a ..........................................
N677576
UNDERWRITERS CERTIFICATE NO ..................................................
Building Inspector
Rev. 1/81
* NO access Lo Rt. 25 ( Main Rd.
FOB,H ~1'0. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CC~PLETION OF THE WORK AUTHORIZED)
N? 13367 Z
Dote
Permission is hereby granted t9:~ .~ ~, . ~ _
..~?¢...~/~....~:.:.,.~.,~../~ ~-
..... '~.~,~.~%...~.. ./..:.. ......... ~ ~
,o ........ ~~.~.....~....~.~.~ ..~~.~ ..................
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co~.~ r= ~, ~o. ,ooo s.~,o. .... ZO..~ ........ ~,~k .0~ ............ to, .o. .
Building Inspector.
Rev. 6/30/80
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~ex~st~ng
land uses:
1. Accurate survev of p~operty showing all propertv 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
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.0(]
$15.o0
New Building .~ ........... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ......... ~ ................. Hamlet
House No, Street
Owner or Owners of Property . ..~. ~. ?,q~...~. ,~,. i ?_. ,0.~,~-?,,, .~/~.. ~F~c.~?,~ ...............
County Tax Map No. 1000 Section . ~\..0.~ ......... Block .. ,0,~-.~ ......... Lot .~'tO. ,~; ,~,, .....
Subdivision... ~..O.T~..-I. r.-[..~. .................. Filed Map No..~?~. '~..~. · · Lot No..J ............
Permit No..~.~.~,G.'7. ~ Date of Permit . .~.~0.%.~.~~. .Applicant...~--D?.%~'.~'. · .~..A~ .~ ~-j~,~ ........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval .~..~,~.~. 9. ·~.. .~. .[-~. ........Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .~.. · ...................
Fee Submitted $, .~. ;0.o. .......................
Construction on above described building and permit meets all applicable codes and regulations.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date
Building Permit No./ ~
Owner~
Aplease print)
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(p~umber' s signature)
Sworn to before me this
~,~ day of ~~
19 ~%9~ ·
Notary Public, ~
/~ Notary Public
County ~N~ D. MATT~W~
NOTA!(Y PLJ~L ',C, Stuta of New Yor~
No, 52-4636665, Suf~aP4 CounW~x
Con~mrcr~lol~ Exp~es Morch 30, 19.~
T(
Southo]d, N.Y. 11971
April 3, 1985
Ann-Marie Van Mater
P.O. Box 521
Cutchogue~ NY 11935
Re: Access road within
Lot # 32 Country Club Estates
Dear Mrs. Van Mater:
The following action was taken by the Southold Town Planning
Board, Monday~ April 1~ 1985.
RESOLVED that the Southold Town Planning Board accepts the
final access road report No. 433 for the access road within the
minor subdivision of Country Club Estates~ Lot No. 32 located
at Cutchogueo The Planning Board~ als~ accepts the 11 foot
road width.
Enclosed lsa copy of the report for your.review.
c/cC..'~ullding Department
Very truly yours~
B~NN~TT ORLOWSKI, JR. CHAI'RMAN
SOUTHOLD TOWN PLANNING BOARD
Diane M ~chultze~ Secretary
By
RE:
~ennett Orlo~ki~ Jr.~ Chaperon
Southold Town Planning Board
John W. Davis
COUNTRY CLUB KST~TES, LOT NO. 32 (NOW MINOR SUBDIVISION WI~{ LOTS # 1 and # 2)
ACCESS ~O LOT NOo I
Insoection of the above access as follows:
The roadway is h[~2 ft. J~' in lengfh and stops ?~ ft. from the house attached garage.
"here is a s~fl}le (sond and gravel,) area here in front of the garage.
~he roadway width i,'3 11 ft. instead of thc reco~m~ended width of Ih ft.
No surface chips were ~sed (not important)°
The roadway ~s profiled at the entrance so that no runoff goes into Moore's Lane.
~e present road as constructed has a smoo'th surface~ no irregularities arid is usable.
7he graded area in front of the garage can be used for turning emergency vehicles.
~his ins tallation was done some time ago with no inspection on ~ part~ as I was not
notified when the work would be started.
~he follo~¢ing ~nfor~a';zon from the lot owner, who I happened to meet on ~e site:
~fil topsoil was re~mved~ sand and gravel brought in for the base cm~rse, and that
the road contractor had been paid for a l~" depth of asphalt paving. Also~ that the
area in front of the garage weuld be paved with asphalt, and that he did not ~ow
about the change in road
I contacted P. Corazz~i on the asphalt ~onnage placed. Ne said he used 87 tons
(was in his records) for a ~" depth on ~he bank~un course. Theoretical tonnage
for the width and length at 2~" in thickness for this r~d as built would be 7~
tons. A ~" depth would re~zire 1~3 tons. ~e owner was misinformed as to the ~"
depth of asphalt.
Provided thc ll ft. width is acceptable to the Superintendent of Highways and the
Planning Bosrd~ I would approw the road work.
NOTE: I went over the above with Mr. Dean, He will acceot the llft. road width°
RAYMOND C. DEAN
SUPERINTENDENT
TEL. 765-3140
August 21, 1984
Victor Lessard
Executive Administrator
Southold Town Building Dept.
Main Road
Southold, New York 11971
Dear Mr. Lessard:
As per our conversation this morning, you requested
me to inspect the access into Mr. Babcock's minor sub-
division located in Cutchogue, N.Y. This afternoon, I
personally inspected the subdivision and rode through
and found it to be sound and safe for vehicles and/or
emergency vehicles.
~. truly yours,
/ ~/~ RAYMOb. D C. DEAN
~J /~ Sup't of Highways
cc: Mr. Phillip Babcock
Southold, N.Y. 11971
(516) 765-1938
August 22, 1984
Victor Lessard
Executive Administrator
Building Department
Southold Town Hall
Southold, NY 11971
Re: Country Club Estates
Lot No. 32
Dear Mr. Lessard:
Please let this confirm the action of the Planning Board
on Monday, August 20, 1984.
RESOLVED that the Southold Town Planning Board recommend
to grant approval of a building permit within the subdivision
of Country Club Estates, Lot No. 32 subject to a 280-a
approval for the access road. This is conditional upon
no certification of occupancy being issued until completion
of the road as per the requirements of ~hn W. Davis'
report and a review by the Superintendent of
Highways and the Planning Board.
Very truly yours,
BENNETT ORLOWSKI, JR. , CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
mane M. Scnultze, ~ecre~ary
cc: Mr. Gary Olsen, esq.
John W. Davis, field inspector
Ray Dean, Superintendent of Highways
THE NEW YORK BOARD OF FIRE UNDERWRITERS
i00037~
BUREAU OF ELECTRICITY
~1~ 8,~ JOHN STREET, NEW YORK, NEW YORK 100:~8
Date Febzsaary 6~ 1985 AppllcationNo. onfle 301186/8~
T.,S CERT,..Es'r.^T N 677575
in the following locatlon; ~ Basement ~ 1st Fl.
was examined oa J~q.I~.U,~,Z~ 28, 1985
FIXTURE
OUTLETS
28
[] 2nd FI. Section Block Lot
and found to be in compliance with tke requirements of this Board.
EECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST
INCANDESCENT FLUORESCENT
DRYERS
OTHER APPARATUS:
~-G.tLC. I. ].~rr~e Deteo'tor.
E R
NO O~C~COND. A,W O
OF CC, COND
V I C E
NO, OF HI-LEG A, W. G
OF HI-LEG
C~]ar].es M. I~1 Electric
760 Long Cz'eek Drive
8outhold, N. T 11971
Lie. 657
FIELD %NS?ECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
7LS4802
BUILDING DEPT.
INSPECTIONi
FOUNDATION XST [ ~RoUGH ~PLBG'
FOUNDATION 2ND [ ] INSULATION
[~]/FRAMING [ ] FINAL
REMARKS: ~//~
///~/~
DATE INSPECTOR
BUILDING DEPT.
INSPECTION
FOUNDATION XST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:_
[ ] FINAL
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[//~'FOUNDATION ~,ST [ ] ROUGH ~LI
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
R£MARKs: ~/~
INsPE~I'OR
$
SUN'~VEY FOR *
ROBERT VAN MATER ~
PART OF LOT NO,~, *'COUNTRY CLUB [STATES"
AT CUTCHOGUE D,~*r~ OUI.Y
~N ~ sOLrFHOLD sc~[,[~ I" ~ 5
SUFFO~ COUNTY, NEW ~RK ~o. 8~- ~
FORM NO, 1
TOWN OF SOUTHOLD
,- BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
E×amined,- .. ....
Disapproved a/c ................ ~. :~-.'. · ..,~ ........
(Building ~J~;
APPLICATION FOR BUILDING PERMIT
Date....'J.{ .'..~. · ........ 19~..~.
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter 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 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~gnature of applicant, or name, ~f a corporahon)
.- .'-~c>.t~.o.'/,..~..xTkck~.~,,~.,,.. D..q..~...~'....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder.
Name of owner of premises .... '-'~ -- 7...~2'~Z~.~.~..'.'~ .~5-_~.~..k~~~ .......................
(as on the tax roll or latest deed)
a corporation, signature o f d~uly authorized officer.
Builder's License No ..........................
Plumber's License No....~..d...~::~... ,.~~)
· Electrician's License No .......................
Other Trade's License No ......................
1 Locatio f~d on which proposed work will be done ~,<2~)..k~...~,~t,D~ .~.~ .....
............................
House Num~;r/~ Street Hamlet W~
County Tax Map No. 1000 Section ..... ~... a ....... Block .................. Lot ......... . ..........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and ~ccupancy ~f premises and intended use and ~~cupancy ~f pr~p~sed c~nstru~ti~n:
a. Existing use and occupancy .........................
b. ...... ......................................
3. Nature of work (check which applicable): New Building . ~' Addition Alteration
Repair .............. Rem6val .............. Demolition .............. Other Work ...............
Estimated Cost '
q. (to be paid on filing this application)
5.' If dwelling number of dwellinglunits Number of dweliing units on each floor
If garage number of cars
6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth: ................... [.. Height ...................... Number of Stories ......................
8. Dimensions of entire new consti'uction: Front ............... Rear ............... Depth ...............
~ Height ............... Number of Stories ........................................................
9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ......................
Date of Purchase Name of Former Owner
Zone or use district in which premises are situated .....................................................
Does Proposed construction violate any zoning law, ordinance or regulation: ................................
Will lot be regrade~l ........ [ ............. ~ ...... Will excess fill be romo~d from premises: Yes No
Name of Owner of premisesXlC~r~{~S,..~O...~.. Address.~ , ~-- .~;O44.O,..'~...~. .... Phone No.-]i~.~':.'~.[.~'2-.. ·
Name of Architect . .~.~.~...~....~..... Address .... ~:::~... Phone No..e-Mq'B.~ffT. II ....
Name of Contractor ~ Address Phone No
10.
11.
12.
13.
14.
PLOT DIAGRAM
Locate .clearly and distinctly al1 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, S.S '.-'
COUNT ................
· '" (Name of indivi~ng contract) being duly sworn, deposes and says that he is the applicant
above named, i
He is the ~
i (Contractor, agent, corporate officer, etc..)
of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this
application; that all statements cont'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 I
........... ./.t~. .... .~ .... day of... ~ ...... 19,~.
~la~¥ ~0g[IC. Sta~e 0f ~lew r0r~ '~ig!l~'t~ure of applicant)
la*m E×p~res March 30, 10fi.~
/
.,. CO~ DEP~UENT OF H~[~ $~tCES ~T ~F LOT NO~i !'~UNTRY CLUB ESTATES"
~N~ ~UTHOED
fami_ ~es~d NE~ ~RK
SURVE~ R~ INKE~ ~k O~ EMBOSSED SEAL SHALL
NOT Ig ~ ~IIOE~D TO K A VA~ID,-TRUE COPY
, , NGUARAI ~E~ ~DL~TED H [PEON ~L RUN~LY ~
HEAL~ DEPARTMENT-DATA F~ A~R~ ~ C~sTRUcT ~ ~R! ~ ~m W~OM.' TH [ SU~EY ms PREPARED
~ NEAREST W~ IAli~il, ~ t SOURC; ~ WATil, ~Ia~E __~IC __ MENTAL ~NCY *~ C~NOI ~6 IN&T)TUTIOH LIS~D
,H ~F CO, T~MAP ~T I000 SECTION IQ9 ~CK O~ LOT ~m2-~ H~E~ ~HD'TO ~E ~I~N~S OF THE LENDI~6 '
~E~ A~ ~ ~ELLI~I WITHIN I00 FE~ OF T~S PROPERTY INStitOT ~. GUARAHTEI$ ARE ~T T~SFERABLE
OTHER THAN THOSE SHOWN HEREON. TOAd1 ~Ak*~iMSTIT~TI~I OR SUBSEQUENT
, N D STA~ ~[t S~N HEREDN FROM PR~[RTY L NES
WILL C~FORM ~ THE STAN~ OF THE S~K CO~ DEPARTMENT ~ EXI~TiH6 ~$TRUg~ ~ ARE FOR A ~PECIFIC
OF HbLTH I~lC[S. pUkPOS~ AND ARE NQ~'T~ BE USED ~ ESTABLISH
AVE~E
,, - , , RIVER~AD; NEW,:~RK
mUNTY ON OCT, 11~1178 AS, FILE NO.67S6. ~: . A~O ~NO suRvEYOR N.Y.S. UCENSE NO. 12845
.~ "OOUflTRY OLUB ESTATES" ,
YOUNG,
LAND
SURVEYOR
M ~ L~ ~ ~L(W),~IC TANK(~ I C[~O~(~),WN ~e~ '1) I N~Y. S.~.LICENS E N0.45893~'
SRANDIS & SONS INO. 1046
~ Lr .
SU~ FOR ,
R~EI IT VAN MATER '
~RT ( F LOT NO.~ '~UNTRY ~EUB ESTATES"
AT GU' 'CHOGUE
~WN ~ ~UTHOLD . SCALE= I' = ~0'
suFFO~COUNTY~ NEW ~RK NO,
NEW ~ ITATE E~CATI~ L~W
ffCOPIEi ~ ~11 ~V~Y NOT KA~G THE LAND
YOUNG & YOUNG
RIVERHEAD, NEW YORK
ALDEN W. YOUNG, PRoFESSIONaL ENGINEER
AND LAND SURVEYOR N.Y.S. UCENSE NO. 1~845 ;
HOWARD W, YOUNG, LAND SURVEYOR
N,Y.S. LICENSE N0,45893 L '
,~ :. I TITLE NO. T-12L84745
ROBERT VAN ~MATER aAN. 28, i985,
MAR 2 0 1 )85 a. ~. ~,. ~~~ ~RT OF LOT N9. St, "mUNTRY CEUB ESTATES" NOV. ~3j ,984
AT CUTCHOGUE
~aeillties for ~i~ 3.<~,~otioa ~e beea ~WN ~ ~UT~HOLD SCA~E: I"
~ospeot~ by tht'~s ~ep~t~en% ~d fo~ SUFFOLK co~TY, NEW ~RK NO. 84
~ ~ ~ ~ ?~ ' GUARANTEED'~
~-- ' 77~: , THE TITLE ~UARANT~ C~PANY
SOUTHOLD
NOT .E CONSIOE~DTr B, A VAL,O TRUE COPY ROBERT ~~~~
OEPAR~MENT, )~TA F~ APPRO~ TO C~STRUCT ~[ ~R~ ~ WHO~ THE SU~EY ~S
C,FO~. ~ TH..T~ --O. TH ESU,,K CO~*YDE,aRT..., TO EXISTING . TRUC~ . ~E,O~ A,PECIFIC ~~ '
'" YOUNG YOUNG
IUBDIVIIION UAP FILED II '~ ~IOE OF THE OLERK OF 8~FOLK AL~EN W ~UNG, PROFESS ONAL ENGINEER
ON ~T, I/il~l a~.:FILE NO.eTa6, ANO~LANO suRvEYOR N,Y.S, UCENSE NO. 12845
PAROEL NO. , MINO~' 8 i~le~fl PCAfl .PREPARED ~R
"OOUNT ~ ~LUB
L~T~ ~ ~Wl,~t ~¢~TAKII~I CE~OLI(~) ~H ~RI~ N.Y.S. LICENSE NO. 4589 3 -
FIE~ ~T ~ ~ OR ~at40IT~O F~ OTHERS I