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Home My WebLink About12918-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12898 Date October 17 .................................................. 19 84 THIS CERTIFIES that the building....0~n.e., f ~. ~ y..d.W~ ~.~.~.n. g ...................... Location of Property ...2. ~..~..~.~. ~. y ? ?.. ~. 9 .~.~.. ~ .d .. .......... ¢ u t c h o g u e House No. Street Hamlet County Tax Map No. 1000 Section . .0.9.~. ....... Bloc]( , .~ ............. Lot ...~.8.; 2. .......... SnbdivisionQ~.e~q~. Y.~?.W..E.~.~.a..~.e.~ ......... Filed Map Bio..~.2.~.~....Lot Bio..~.2. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .K.a?.q h...6 .......... 19 ~ ,4. pursuant to which Building Permit No. q .2.9. ~..8 .Z ............... dated ~I.~. ¢ ~a..6 .................... 19~.~., 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 ......... .... 0n.~. fam. Lly. rt.ue 1 ~t.ng ..................................................... The certificate is issued to .. G~o~g~ D. ~ Martha I Swahn .............. ...................... of the aforesaid building. Suffolk County Department of Health Approval ...~ .~..S. 9..3.2. .............................. UNDERWRITERS CERTIFICATE NO .......... ~)q.6. 5 ~ ~.3fi. .............................. Rev. l/Sl Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12918 Z Permission is hereby granted.to: ~-~ c-~ ~ ........................... ~o..~...~.~.~ ............. ., ............................. ~....~...~~ ............ ,.. ~ . ~ at premises located at .~.~.~.......~;~...~..,..~ ............ .~~ ....................... County Tax Map No. 1000 Section ..... ..~..~....~.. ..... Block ......... ~ ......... Lot No....I...~...'..?....; ...... pursuant to application dated ......... ..~.~...~. ......................, 19.'~..L~.., and approved by the Building Inspector. Fee ~..~ ..................... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in Wpewriter OR ink, and submitte~.!icat~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 Apr!l 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: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. CopV of certificate of occupancy $1 .DO use --Pre-Existing C.O. $15.00 Vacant land C,O. $ 5.00 Date ...........~)¢7~e~....:~ ...... ~g~ New Building .... ~ Old or Pre-existing Building .~././~. Vacant Land /.~/~. Location of Property .~. ~'~ ..... /.. House No. Street Ham/et Owner or Owners of ProperW ~ ~' ~ ~ '~' County Tax Map No. 1000 Section . .~.~Block ..... ~ ........ Lot.. Subdivision ..... ¢~., .~ J .Filed Map No. .Lot No. Permit No./~ ~/~ ~ Date of Permit ~t(:.~ff .Applicant ~... ~' . ~ . Health Dept Approval /~O ~ Labor Dept Approval ~/~ .... Unde~riters Approval .................... Planning Board Approval .................. Reque~ for Temporaw Certificate ..... ~ ............ Final Certificate .. . Fee Submitted $ ........ ~ .................... Construction on above described building and permit m~/ets all applicable cpdes~and regulations. A licant 7 c.a. FIELD INSPECTION --~ ~ FOUNDATION (1st) FOUNDATION (2nd) ROU6N FRAME & PLUMBING INSULATION PER N, Y. STATE ENERGY OBE FINAL ADDITIONAL COMMENTS: o ll~O~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIE~ o~y the electrica[ e~ulpmertt ~ described below and introduc~ by the applicant named on the above application nu tuber [~ the premlse3 of ~rg~ O~hn, Silver Colt I~., ~n View ~t~t~, ~t~ue, m~s e~amined on ~A~t ~ ~ l~ and ~ound to be in compliance with the cequlrements o~ this Board. FIXTURE ,~ERCURy OUTLETS SWITCHEE FLUORESCENT DRYERS FUTURE APPLIANCE FEEDERS ~IMECLOCKS ,UNITHEATERS MULTI-OUTLET DIMMERS FIXTURES RANGES OVENS EXHAUST FANS SERVICE DISCONNECT OTHER APPARATUE: R V I C E 2/0 ~. ~/o Detectors Francis B. ~c Caffer~y Bridge I~e 4010, P.O.~ox 245 Catoho~z, N.Y. 119~5 LiC. l145 E This certif[cc~te must not be altered in any manner; return to the office of the t~oard if incorrect, GENeRAl. MANAGER /', 11 Per~ may be identified by their credentials. COPY FOR B~IILDING DEPARTMENT. THIS COPY OF I ANY MANNER. Env ronmentai Engineers & S~ientist~ HOLZMACHER McLENDON and MuRREL~, P~:. · 575 BROAD HOLLOW ROAD, MELVILLE, NE~ ~A~ER R~SOU~p~S ; ~TER SUPPLY & TREATMENT SEWERAGE & QU~TIC ~DEL ~Y~DI~S *{P~LOT PLANT STU~{ES · WAT~R~ASTE ~IENT'S NAME AND A~DRESS - HARR~ GOL, L~MAN WAI'E:R ANALYSIS OTHER (SPECIFY) I I REC. CODE ] DATE ~ ChlorideS (mg/I) Total HardneSs (mg/I as CaC03)~ ' Alkalinity (mg/I as CaCO~) pH - ; ' Total ' Specific Detergents (mg/I ~$ MOAS}: Oxygen ,(mg/I) Hexaval~nt ' H~rdness (mg/(a~ ~aCO~) Temp, ~ T;ITLE ?: LAB. NO, FIELD NO. ARINE E~O~.OGY TIME ; COL. ~' RE~;EIVED ANALYS'IS ~SWAH~, 8 Z LVE::b: SPECIAL C~MPLAINT [~ 95~ OTHER (3) LAB, I.D 03 TEST r RESULT (Ing/I P) (mg~l) Result IEPORTEQ ~ ~ Environmental Engineers & Scientist~ HOLZMACHER, McLENDON and MURRELC, P}",C '~ ~, ~[ FIELD NO. ~ 575 B~OAD H~LLOW ~OAD, MELVILLE, ~fi... YO~K ~74~ (5~$~:$~-}' ~0 ~A%ER RESOURCES · ~ATER SUPPLY & TREATMENT · SEWERAGE I ~RE~ME~T · CQUATC ,~& A~INE E~OLOGY~ TIME MODEL STUDrES ,~P LOT PLANT STUD ES · WATER~ASTE WATER LABORATORY ~AND~ ANALYT CAL SERV CES COL GY OLIENT'8 NAME ~ND ADDRES~~ DATES: 'CO~LLE~TED RE]CEIVED ANALYSIS ' ~' ROuT}NE ~ RETSAMP ~PECIAL COMPLAINT 'D~STRIBUT~ON OTHER (SPECIFY) 'PO)NT O~ , , ~ ~ REC. CODE DATE O~?F~ '; ~ELE ~ LAB- WELL NO. ~ O~EY __ (3) ID. 03 B~cteda ~ ~ : Nitrates (mg/I N) CaGe3) B~*a } Chemical Oxygen ' (~gA P) ~ Total ~ MISCELLANEOUS Oetergehts (mg~l as MBAS) % 8 GNATURE /~J~ , HOLZMACHER, McLENDON and MURRELL P.C. · CONSULTING ENGINEERS, ENVIRONMENTAL SCIENTISTS and PLANNERS 575 BROAD HOLLOW ROAD, MELVILLE, N.Y. 11747 · 516-694-3040 c~,'~l~,,T~ ~ ~ ADDRESS Harry Goldman Water Analysis Main Road Mattituck, NY 11922 Lab No. 459024 Date Collected 6/26/84 Additional Sample Info. See Lab Report ~ 410045 vinyl chloride .......................................... methylene chloride ........ ~, 1 dichloroethane .............................. chloroform ...................................... 1,1,1 trichloroethane ........................... 1,2 dichloropropane ............................. trichloroethylene . tetrachloroethylene ............................. benzene .... toluene ...... p-xylene ................... m-xylene....... ............................... . chlorobenzene . o-xylene o o-dichlorobenzene - temik < 1, ......... <1 ......... <1 ......... <1 ......... <1 ......... <1 ......... 10 ......... <1 ......... <1 Date R~port~ 7/5/84 S.C. Mc~_ndon, P.E. Lab Director 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~, [ ] ROUGH PLBG. FOUNDATION /ND []INSULATION FRAMING FINAL g ,~ DA,, ~/ ? INSPECTOR MOSHIER BACKHOE SERVICE 101 SOUND AVENUE RIVERHEAD, N.Y. 11901 ~,.gffOLK COUNTY DEPARTMENT OF ~Fr~L"fH 5ERVICI~ FOP /PPqOVAL OF CONSTRUCTION ONLY SINGLE, FAMILY DWELLIN~,~NLY SURVEY FOR GEORGE D. S~IAHN ~ MAt?THA I. S~/AHA LOT NO. 2, "O£EGOIV VIEW ESTATES" AT CUTCHOGUE TOWN OF SOU~OtD SUFFOLK COUNTY, NEW YORK GUARANTEED Examined..~.ct~..~...~... Approved . . · .~/]. ~.~.~. · · .[o.. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 ., 19~.. Permit No..].~..~.]. ~ .~-.. Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspec~Sns. ,~ j / ....... :..x. .... 'd;'; 'a'tio'n' .... (Signature of applicant, or name, if a o p r ' ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0~' tV'~t'~ ................................................................. 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 ......................... Electrician's License No .... /./. ~d.~.-.~ ............ Other Trade's License No ...................... Location of land on which proposed work will be done ................................ , . .............. . . . . . . e. .... :'T; ..... ?4...,. ......... ............................... House Number Street Hamlet County Tax Map No, 1000 Section ...... .O..c~ .~.~'· ..... Block ..... ~. ........... Lot... } ?. 7..2~.., ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of pre}nises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .V..'~. ~.,~..r5)..77'. ............ · ....................................... b. Intended use and occupancy ....... i ............................................ ..... property lines. Give street and block interior or corner lot. 3. Nature of work (check which applicable): New Building .......... Addition ........ Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work ............... (Description) 4 Estimated Cost /t[~f°v° ' Fee .~. ~ ~- .o: ! (to be paid on filing this application) 5. If dwelling, number of dwelling unil;s ............... Number of dwelling units on each floor...,P"~.'? ........ 6. ~ ~gn;'ssn,;~x~)r~ci~r mix'e'd ~c'u'pan~: spec'[~ ~;iure and extent of each'type of 7. Dimensions ofexistin stmcture~,' ' ' ' g ~,'ifam Fr/~/~y: ont .... t .......... Rear .............. Depth ............... Height ............... Numlber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ...,q/t] ........... Rear .................. Depth Height Number of Stories .... ~/~..,~ ...... Rear ....~6' .......... Depth . .~4'~ ........... 8. Dimensions of entire new construction: Front ~ ' ' Height .. ,1.~.' ......... ~Num~ber of Stones ...... [ ~- . . . 9. Size of lot: Front..../~;.3. .... : .......... Rear. i. i .~.-~?i i iiii iii ii ii 10. Date of Purchase ........... ; .................. Name of Former Owner ............................. ' hpr~ ' 't ted 1 1. Zone or use district in wh~c mlses are si ua ..................................................... 1 2. Does proposed constructmn violate any zoning law, ordinance or regulation: .............. ............... 13. Will lot be regraded .... ~/.~:~.. ........ Will excess fill b.e removed from premises: _~,! No 14. Name of Owner of premises ~.~.~.~i i .~?v]~.'t~i .... Address .~..t~t44e?.;..&/:~. ...... Phone No..~.~?..-. ~-.~.-. ........ Name of Architect ........................... Address .. ~ .............. Phone No ............... Name of Contractor. C/.~.~.e.,v.c.t .. ~ .d4/q./.e.~. ....... Address ~.,.o.e.~t~.. ~f~.. .......i Phon; Nol .~.~.~.~. ?.Y..2./. ..... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate ~1 set-l~ack dimen~ions from ~umber or description according to deed, and show streef names and indicate whether i~o STATE OF NEW COUNTY ....... :S.S ' ......... .~...e.o.,~j~.e .... D.:.. ~?.,4..~ ................ 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.) of said owner or owners, and is duiy authorized to perform or have l~erformed 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 mann6r set forth in the application filed therewith. Sworn to before me this d / ........................ day of ............ , Notaw Public ...... ~..~ ./~.% J.~..~:. ~'/ae~L. Couny ~ .~...~ ~0[ARY PUBI. tC, State t}{ Nmw Y0fk ........................ N0 4'797878. ,qMf01k C0untv_ (Signature of applicant) Term EXi)~res Malch 30, ' sui~vEY FOR S/dFFOLK COUNTY DEPARYMENT OF HEALTH SERVICl~ FOP ~PPROVAL OF CONSTRUCTION ONLY / ~ SINGLE FAMILY DWELLING ONLY HEALTH DEPARTMENT-DATA F~ APPRO~L TO C~STRUCT NO?~ ~ I ~ MONUM~N~ ~ ~ S~AK~ SUBDLVIS~N M~P FI~D IN ~HK OFPIG~ OF ~ ~NK OP ~F~K GOUN?Y ON APNI~ ~197~ AS FILE' NO 6~1, GEOt~GE D. SWAHN lOT NO. 3, ' OREGON AT CUTCHOGUE YOWN OF SOUTI~OLO SUFFOLK COUNTY, NEW YORK ~ MAt~THA /. SWAHIV VIEW ESTATES" DATE: FE'B. 18, 1984 SCALE: I "-' ,E,O ' NO. 84 - /~r N UNAUTHORIZED ALTERATION OR AODITION TO THIS SURVEY I$ A VIOLATION O~SECTION 7209 OF THE NEW YOR~K STATE EDUCATION LAW ~COPIES OP THIS SURVEY NOT KANING THE LANO SURVEYOR'S IRKED SEAL ~R EMBO$SEO SEAL SHALL NOT IE CONBIOERED TO G~ A VAL/O TRUE COPY RGUARANTEES INDIC&TED ~EREON SMALL RUN (~¢LY TO THE laERSOH~ FOR WHOM THeE SURVEY IS PREPARED AND ~N HIS BEHALF TO THE TITLE COMPANY~ GOVS~N- MENTAL AGENCY AND LENI~JNG INSTITUTION LISTED HEREON, ANO TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE HOT TRANSFERABLE TO AOOITIONAL INSTITUTI(~NS OR SUBSEQUENT OWNERS NOISTANCES SHOWN HEREON FROM PROPERTY LINES TOEXISYING STRUCTURES ARE FOR A SPECIFIC PURPOSE ANO ARE NOT TO BE USED TO ESTARLIGH PROPERTY LINES OR FOR THE ERECTION OF FENCES JGUARANTEEDTO: SE.C//.,~IF'Y T'/7'LE. 8 GUARANTY CO. li lll1 YOUNG , YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND ~.AND SURVEYOR N,Y.S. UCENSE NO. I;~845 HOWARD W. YOUNG~ LAND SURVEYOR N.Y.S~ LICENSE N0.45895 RIVERHEAD~ NEW YORK BRANDIG & SONS INC. 1046 ' ~- :'SURVEY FOR GEORGE D. SWAHIV ~ MARTHA I. SWAHIV dmva ia, 19a,~ &Or NO. 2, ' OREGON VIEW ESrATES' ~. AT CUTCHOGU~ DATE: SUFFOLK COUNT~, NEW ~RK' NO. .~U~H~IZEO A~rEel~lO, OeAOOmON ~ m~S GUARANTEED TO. su~E~ · ~ w~a~O, ~ ~ SECT O~ 720~ ~ THE ~R/TK TI~&E 8 ~UARANr~ CO. NE~ YORK STATE E~CAT ~ LAW NOT B[CO~.$10[~D'TO~AVALI~ TRUE COPY HE~ DEPARTMeNT-DATA F~ APPR~ TO C~STRUCT AND ~: HIS BEHALF ~ YHE ~TLE C~Y, '" YpUNG S YOUNG ~ER'AVE~E , : ',~ , , RIVER~AO~ NEW YORK '~UE~/V/~N M~P F/~D /N THE OFF/C~ OF ~ ~ OF AN~.~ND SURVEYOR N.Y.S, UCENSE NO. 12845 ~LK ~OUN~Y ON ~P~I& ~,19~ A~ ~IL~ N~ 6~1. HOWARD W. YQUNG~ LAND SURVEYOR ~ ~ L~ ~ ~c(w),~lc TANK(~)a CE~/(~)~ ~RE~ N.Y.S. LICENSE N0.45893 ME ~ Fl~ ~TI~S ~ OR DATA OITN~O F~ OTHERS · I SU~Y:F~ ''{GEORGE J ' A P R R ~E: '~ R'WHO~ T WIL~ c~O~TO THE: {TAM~I OF TH~ $U~K CO~TY DEP~RTMENT ~J ~TO~A '~j ~N~$Y~U~RE~ :ARE FOR :~SPECIFIC ~ ~NDER AVE~E RIVER~AD, NEW YORK ' ' : "" aUD ~W,~OUN~ P"OFESSIONAL ENGINEER ~ND'SURyEYOR N.Y.S UCENSE NO.