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HomeMy WebLinkAbout13082-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy THIS CERTIFIES that the building...0.~.. FAMI. ~.~.Y..B.~..~.~J~.I.~ 9 ....................... Location of Property .410..8;tJ~v. 5.R .CO. 5? R. q4p CUTCHOGUE House tVo. Street Hamlet County Tax Map No. 1000 Section 095 .Block 04 ..... Lot 18.37 Subdivision OREGON VIEW ESTATES .Filed Map No. 624J .... LotNo, 37 conforms substantially to the Application for Building Permit heretofore Fried in this office dated 4 / 20 / 84 pursuant to which Building Permit No. I 3082 Z dated 5 / 2 / 84 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 HENRY M. BOGARDUS III & SUSAN A. BOGARDUS (owner, I~OXo~ J~KfY~I~ X of the aforesaid building. Suffolk County Department of Health Approval 14 - S O- 73 I / 15 / 87 UNDERWRITERS CERTIFICATE NO ..... N 725955 I 2 / 1 I / 85 PLUMBERS CERTIFICATION DATED: I 1/20/86 .... Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BI: KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 13082 Z Permission is hereby granted to: B~ ~o- R R,b ~ ....... ~.~..~..~......~..,~,~.'~.~.~.: .............. ,o ...... ~~~*.. ~...~ ........ ~.~ ................. at premises I~ated at ..[.~ ....... ~/~.....~[~[~.~.~,-.....~~~' ~ ..~~~..~.....~~ .................. ~ ............................. ~. ...... Building Inspector. Building Irtsl~ctor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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 of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 ~ecember 19 1986 Date .......... .. ' .......... ... New Building ..X ........... Old or Pre-existing Building ............ Vacant Land ............. Location of Property 410 .Silver C. ql.t..Ilo'ad, .(~qt.(lhqgge;, .i~gw .Y,q];l~ .].],9.3.5.. House No, Street Ham/et Owner or Owners of Property..~e.q~.X .~....,B°gardus...,....... ,III & S.u.s. An. .4...3.qga,~c[u,s, ................. Map N 1000 S cfi 095 Block 0,4, Lot 1,8 ,3.7 ....... County Tax o. e on ................................ · · · Oregon View Estates p N 6241. 37 ~ Subdivision .............................. ,, .Filed Ma o ...... ... . Lot No ............ , . Permit No. 1..30.8. 2. g. .... Date of Permit .......... Applicant ?,e.q~ .~...]~o,~.~.~d.~s..%~. ,&, .S,~.s~D. ~,., ~Bogardus Health Dept Approval To follow. Labor Dept Approval N%7.25955 Planning Board Approval Underwriters Approval ............................................ Request for Temporary Certificate ..................... Final Certificate ...A ................... Fee Submitted $ .5. :0.0. .... {.~.~'.2 ~5 ............ Construction on above described building and permit meets all applicable codes and regulations. ...................... Applicant . ']~(~G III Rev. lO-lo.7a ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ O[ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 /)ate Dec~'~m'L~er ll~ 1985 32107~/~5 THIS CERTIFIES THAT in O, e follo~i.~ Ioc.tion; ~Base.nent ~ 1st FI. ~ ~nd Fh Section Block Lot w~examlnedon [~C~: 5, 1985 and found to be in compliance with the requirements of this Board. J'CH~S iNCANDESCENT ~ ~I~5 AMT K.W. ~T. K W. ~T. K. W DEYEES FURNACE MOTORS FUTURE APPLIANCE FEEUERS ;PECIAL REC'PT TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS S R V I C OTHER APPARATUS: r~ ~ou~lr~ld. N 5~ [197[ LJc 578 ~ ~j~ . ' ,,~ u, ,.~ ouara IT mcogrecf, Inspectors mo be ident'f'ed b the r r ~*~~~~~~ , Y y ' c edentJals, ~'~J ~~ARTMENT. THI~ COPY OF CEH~ ~IOA~E ~, i~T ~'OT"" ~LT .... ~ ....... "'"" ~ ..... . ~ ~ ~=~ D~MANNER, HENRY J, SMITH & SON, PLUMBING. HEATING & FUEL OIL. MAIN ROAD SOUTHOLD, N.Y. 11971 (516) 765-36~0 Inc. CERTIFICATION D a t e _N o~nmber_20~_lR~ 6 ~uilding Permit No.__i~2Z' Owner Henr~_~2~. Plumber Henri J. Smith ~ Sonz Inc. I certify that the system contains less than solder used in the water supply 2/10 of 1~ lead. /~Henry P. SmiCh Sworn to before me this _[2!hday of NovembeE__, Notary Public, Suffolk County J, J0TARY PUBLIC. State ol New Yolk ] Residing m SulJotk County _ ~-/ Commission Expires March 30, l~-J[,;~- FIELD I~SPECTION COMMENTS , FOU~NDA_~TI__ON ~ (_1 ~_~ )__ FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~DE ADDITIONAL COMMENTS ---'" ' "~' ' '" d~ / '// .__2i 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST FOUNDATION FRAMING [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL REMARKS: (~~ 78S'X80Z ~ BUILDING DEPT. ,L '~, . ~ INSPECTION FOUNDATION Z,$T [ ] ROUGH pLBG~i ~/FOUNDATION 2ND [ ]INSULATIoN [ ]FINAL FRAMING RKMARKS: .... r OAT", INSP£CTOR /~/~ 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION '~ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING REMARKS: DATE INSPECTOR FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File Nc> ................................ PLEASE TAKE NOTICE that your application dated ........ 4/.c. a r,,.. ,d,'~),. ,, 19 0./~. for permit to construct , . . ~.~[.c~.~.,.. i~,~.~. ~../'. ( ~ .q )'/~...;~)X~,Z~ J. ~, J.~ )~,~ ............. at Location of Property . .'./. ( ~ ....... ~ /. ~,,, , b4::,, ~'~ ..... :,.,~,. House No. Street Comity Tax Map No. 1000 Section . 5'~?~'7~: ' ..... ~%<~'... ~) ..... Block ..... Lot ~ ~. ~. ~ .~. ...... / I ~ J~2:'~ .:: :%~: :-- ~ ~ .... , -./- _. ~:"' ' ' ~t r'~ / " /~.// . Building [aspector RV 1180 Examined . .~/~. ,.~. iii FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Received. Disapproved a/c . .'.-~'.~7-.777. i'..TT ............. ~ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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 regulation?, and to admit authorized inspectors on premises and in building for necessary i~nspections. ~ tx .. 37:'. ........ (Signaturk/of applicant,'dr name, if a corporation) .s,..~.q...c.,.c..~..~... s.¥~. .... "~.~.,:-.e,..~.7.: .... (Mailing address of applicant) I~ ? lo State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plmnber or builder. .............. ©:.~..~.n .c....-..~:~:,~.4~. ~ ~: ......................................................... Name of owner of premises .. ~.r~..-e~'~"~..tPF...c~.... V?.~:?.<c~.~ ........................................ (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.d.. ~....~7..~ Electrician's License No. ~" z, ~' Other Trade's License No ...................... House Number Street Hamlet County Tax Map No. I000 Section . .(-.?).~7 .......... Block .... .~. ............ Lot..~.).] .~?p .C?~ ?. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .... .('.c7~%J.~3 c~JQ.Q Y, ..... .(~ .L'h4 ~k-.. :]~----. ~?'¢~ t (~..~, ........................ Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition .............. Other Work ............... '"~S +,, c"~:) ~ ,~ / o~. (Description) 4. Estimated Cost ........... Fee · .7.~. ........................... (to be paid on filing this application) 5. If dwelbng, number of dwelhng~um ............. Number of dwelling units on each floor ............... If garage, number of cars .... 4 /~ .......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each ty. peofuse ....... ,... 7. D~mensmns of ex½st~ng structures, if any: Front...~l~.. ........ Rear . .~ ....... Depth . .~? ......... tteight ...~ ........ Number of Stories .... .'~7 ................................................. Dimensions of same structure w~ith alterations or additions: Front ................. Rear .................. Depth ................. i. Height .......... Number. of Stories · . . ~ . . t '' ,,5 I .............. 8. D]menstons of enttre new construction: Front .... ¢.C. ........ Rear .... ~ ....... Depth ...~?. .......... Height ... { .L.~ .......... ~umber of Stories ... ! ..... . ......... , ........................ , ............... 9. Size of lot: Front . .(fit. ?... ?.q.l ........... Rear . {..&..3~.,. '?.q. ........... Depth ~ Bt> 10. Date of Purchase . t. ~: .")...-.8.'.31 .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are sitnated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .to{ .C~. ........................ 13. Will lot be regraded ........ . ................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premisesl.'t.'~..'~.' 9hr*r..~.~.-t. .... Address ?~.~.~ .fl .r~,,~j~ve~... Phone No..7~l:.~.C:.~ ..... Name of Architect ......... i ................. Address <,,~,,no~, . Phone No. Name of Contractor ........ i ................. Address ................... Phone No ................ · ' I PLO~I DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ,iS.S COUNTY OF ................. ...... ~.' 'CftC''' .~.~ 9'-Y~ .°~. ~..'".~....'... being duly sworn, deposes and says that he is the applicant (Name of individual signing'contract) abgve,named. (Contractor, agent, corporate officer, etc.) of smd 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 contained 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 : ~ ...... [UI~UC, St,~te of Nm~ "ors ............. l'l,). 47028'7S, 7quf.to~k O0u,]ty (Signature of applicant) ' Te(I,I .xprres March 30, The water supply end sewage disposal aystems ~'C. ~ ~ ~ '~ for this Residence will conform to the standards ~ ~0~ of the Suffolk County Department of Health TITLE SURVEY OF PROPERTY AT ~* - ':.k~ ~~ CERTIFIED COPIES RE ON FILE WITH AND GUARANTE::;O: A~T~AT,ONO, THrS ERTIFI UNAUTHORIZED ~he New ~ork ~anh ~.rve~ ~n. (p. r.) SU~¢OL~ COUm~ ~w YOaK aTV Fils No ~0 (LINOENHURSTI (WILdAMSBURG) 275E. SUNRISE HWY. 11757 30 CONSEYL~A STREET ~21~ Date ..... AND ADOPTED BY THE NEW YORK STATE LAND TITLE ASSOCIATION ON JUNE 7. 1977, SINGLE FAMILY H.D, REF. NO. DATE DEPARTMENT HAVE BY 3rillS, FOR THIS NT AND -, Ch water Management Section "MAP OF OREGON VIEW ESTATES FILED APR. 4, 1975 FILE NOi624J A'T CUTCHOGUE CERT~F~EO TO' TOWN OF SOUTHOLD COMMONWEALTH' LAND TITLE SUFFOLK COUNTY, N.Y. INSURANCE COMPANY TITLE NO. 12940 S 84 I000 095 ' - 04 18. 37 TOWN AND CO~/NTRY ABSTRACT SCALE I" = 50' SOUTHOLD SAVINGS BANK__ NOV. 13 1986 HENRY M. BOGARDUS I1..~.1 ' ,SUSAN, ,A, BoGARDUS /~ ~ A *.~ . , .. .. TEST HOLE NO.4 4.0' 4.0' ( 516 ) 765 - 5020 Prepared in ~ccordanfe with ,[he mm,l~.,~ R O. BOX 909 standards for'~i~le surWy; as esbbli;hed by ~e/I MAIN RO AD the LLA. L.S, and approved and adopted , _-___t SOUTHOLD, N.Y. 1197 ~or ~uch use by The New York State Land ; 14.0