HomeMy WebLinkAbout15887-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z-16777 Date April 7, i988
THIS CERTIFIES that the building ONE FAMILY DWELL ING
Location of Property ....6.7.0.. ?.o.l.d.. Spur Cutchogue, New York
IVo , e No. ' ............... ....................... /l ie;
County Tax Map No. 1000 Section 095 ...Block 04 i.-- I 8 I 5
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...A.p.r.t..t..8. :..1.9.8. 7.... pursuant to which Building Permit No. 15887 z
dated April 12,' 1987
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 WOOD DECKS & ATTACHED GARAGE
The certificate is issued to ... BLAIR & LORRAINE DIBBLE
.................. /oV, .....................
of the aforesaid building.
Suffolk County Department of Health Approval 8 7- S 0- 6 6 - 3 / 7 / 8 8
UNDERWRITERS CERTIFICATE NO. N 839085 - l 0 / 2 I / 1987
April 4, 1988 - BIair Dibble (Owner)
PLUMBERS CERTIFICATION DATED:
Building lnsp~c't~; .............
Rev. 1/81
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)
N~ 15887
Z
is hereby granted to:
P...,.,on .~....~..*..~.....~..b..~ ........
' '~.~....~.~ ./.~.....C~......: ......................
................................... ~...~ .......... ..%..1 ......
at premises located at~ ....................... (~. ....... ~ ............... ~~ ...................
County Tax Map No. 11000 Section ..... .q~..~...~./. .... Block ...... ..~.....~.. ...... Lot No. ~.~.:.L..~-- .....
Building Inspector.
Fee $ .............. ; .........
and approved by the
Building Inspector
Rev 6/30/80
OUNDATION /~(1st)
OUNDATION (2nd)
OUGH FRAME &
?LU~BING
NSULATION ?ER N.
STATE ENERGY
CODE
FINA/
£TIONAL COMMENTS:
TOWN OF SOUTttOLD
OFFICE OF BUILDING INSPECTOR
P O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Buzldzng Permmt No, /~-~ ~7
Owner lc ~
(please print )
Plumber ~f
(please prlnt)
I certzfy tha~ the solder used in the water supply system
contains less than 2/10 of 1% lead.
S~to before/~e~
day of ~/L{~C ,
p!umber's signature)
Notary Publlc
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000121
BUREAU OF ELECTRICITY
JOHN STREET..EW YORK, .EW
THIS CE~IFIES THAT
o~ly t~ e~tr~c~l ~ulpment ~ ~cri~ ~w a~ int~uc~ by t~ apphcant ~m~ on the a~e ~plw.t~on number ~ the p~m~s of
Blair J. Dibbi~, G~ld Spur S~ree~:, Lo~ ~5, ~rne~
~as exam~ned on October 5, 1987 and found to be :n comphenee ult h the req~,trenwnt~ of th~s Board
38 42 ] 1
OTHER APPARATUS
!-lO0 Amp Trax~fer ~ttch
4-G.F.C.I~ 2-S;aoke Detector
UNIT HEATERS MULTI-OUT[ET
SYSTEMS
NO OF FEET
DIMMERS
410
NO OF HILEG
C E
AW G ~NN~ OF NEUTRALS
Pane]boards: 1-7cir. lOOamps Sekected Load Panel
Paul t~ -~..s
275 Town Harbor La~e
Southold, N,Y. 11971
Lic 252E
Per~ · ' f +i -
This cerhficate must not be altered {n any manner, return to the off~ce of the Board d mcorred Inspectors may be {denhfied by their 'credenhals
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST OU PLBG.
FOUNDATION 2ND [ ] INSULATION
]'~FRAMING
FINAL
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ,]~FO~ATION 1ST [ ] ROUGH PLBG.
[~"FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
DATE ~/~/'~/ INSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
] F~iDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING £ ] FINAL
REMARKS:
DATE
/' f ·
INSPECTOR~~_
765-1802
BUILDING DEPT.
INSPECTION
[~FOUNDATION 1ST [ ]
FOUNDATION
FRAMING
ROUGH PLBG.
2ND [ ] INSULATION
[ ] FINAL
DATE _ INSPECTO .
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
[ ] FRAMING
REMARKS:
ROUGH PLBG.
IN~SULATION
[~FINAL
DATE
INSPECTOR~._~J/~'/
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND I. ] I~SULATiON
FRAMING [//~'FINAL
- /
7G5-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [/,,,]'/FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION :)ND [ ] INSULATION
I- ] FRAMING [~]' FINAL
REMARKS"-CJg~,~
DATE //z
765-1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST [ ] ROUGH PLBG.
] F~IDAT!ON 2ND [ ] INSULATION
*3~FRAMING [ ] FINAL
REMARKS:
DATE
INSPECTOR
/ / / /
xammed ~
tpproved ~
hsapproved a/c
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY ...~],.[x~..
TOWN DF SOUTHOLD CHECK ..... ~q ].
BUILDING DEPARTMENT SEPTIC FORM . ~.../~:
TOWN HALL NOTIFY
$OUTHOLD, NY 11971
CALL ................
TEL.. 765-1802
MAIL TO:
(Bmlding Inspector)
APPLICATION FOR BUILDING PERMIT
Date . .
INSTRUCTIONS
a Tlus apphcation must be completely filled m by typewriter or m ink and submitted to the Building Inspector, with 3
ts of plans, accurate plot plan to Jcale. Fee according to schedule
b Plot plan showmg location icl lot and of buddmgs on premmes, relatmnsh,p to adjommg premises or public street-
r areas, and g~ving a detailed description of layout of property ~nust be drawn on the dmgram which :s part of this apph
~tlon
c. The work covered by ti'us apphcahon may not be commenced before ~ssuance of Bulldmg Permit
d Upon approval of th~s apphcahon, the Bmldmg Inspector w~il issued a Bmldmg Permit to the apphcant Such permB
tall be kept on the premises available for mspection throughout the work
e No bmlding shall be occupied or used in whole or in part for any purpose whatever untd a Certificate of Occupanc~
~all have been granted by the Bml~mg Inspector.
APPLICATION iS HEREBY MADE to the Building Departmant for the ~ssuance of a Building PermK pursuant to thc
mldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, OrdNances m
egulatmns, for the construction 6f buddmgs, additions or alterattons, or for removal or demohtmn, as herein described
~e apphcant agrees to comply wtth all apphcable laws ordinances, bufldmg code, housing code, and regulations, and to
llnlt authorized respecters on premises and in braiding for necessary lnspe~tl,orrs, -- t ,~o'~///-'9
(S~gn.a'tCre eT apphcant, or name, if a corporahon)
/---
(Malhng address of apphcant)
tare whether apphcant is owner,I lessee, agent, architect, engmeer, general contractor, electric,an, plumber or builder.
~alne of owner of premises . ~.. ~ q Y
(as on the tax roll or latest deed)
I apphcant m a co~oratmn, s~gnatgre of duly authorized officer
(Name and tttle of corporate officer)
ALL CONTRACTOR'S MUS~.i}E_$I~FJ~LK COUNTY LICENSED
Braider's L,cense No ...................
Ptmnber's License No ..................
Electrician's License No ....................
Other Trade's License No ...........
Location of land on which proposed work will be done .....
Ilouse Num her Street
County Tax Map No 1000 Section . (~"~... ... . . Block ....~.5l
Subdlvmion ¢.r'K?o.%..~.l,e.~....... . S.. .. Filed Map No
.(Name)
Hamlet '
.. Lot. ] .............
.. Lot
State existing use and occupancy of premmes and ~ntended use and occnpancy of proposed construct,on
a. Exmtmg use and occupancy ...... ¢ ....
b Intended use and occt,, .. b/ .....................
3 Nature of work (check which apphcable) New Building .
Repmr Removal . .
4 Estmlated Cost dP/ .....
5 If dwclhng, number of dwelling units .......
If garage, nmnber of cars ....
... Addlt~ou .
·., A/teration
· Demolition ........... Other Work .............
(Description)
... Fee ................................
' (to be prod on filing this apphcation)
Number of dwelling units on each floor ..............
6 If business, cominercial or mixcd occupancy, specify nature and extent of each type of use ...........
7 Dimensions of existing structures, if any Front Rear .......... Depth .......
Height .. Nmnber of Stories ........................
Dunensions of same structure with alterations or add~tions Front ......... Rear ........
Depth Ilmght '' ,''c, ''' '
.... Nu mpy,~foSt ones '..'~. ~0.a...
8. Dimensions of entire new construction Front . ~..8~ .0 .... Rear . .,q. ~ .......... Depth
Height .... C./~%mber of Stories ........................ ..~. .....
9. Size of lot Front !-~.~-'>O~ ... Rear . 1 )~-.--q- ....... Depih ,~.6,-~ .... ,- ....
10.11 Date of Purchase.,(,,.l//3/~'~ . . ' : ..ciaNaa~eh°LF°~'er Owner~. . .~t
Zone or use ,~lstrlct m wh,cL ).rcm,scs arc sm,areal . ..... ,., .............
12 Does proposed' construction._ violate any zoning law, ordinance or regulation .. tt7.O. ...........
13. Will lot be regraded .~e...q . · ~ ., . . . Will excess fill.be renloved from premises'
14. Name of Owner of premi~es ~5[at.t ~9,~}~- .Address 7~9. ?~. 5,,yv,C'~../~g~Phone No .'7...~f~.s.O.6ff''~. . .
Name of Arclntect ..-{'~"e~ .~v..]'/,I, }J 4." Address .~ . . ,, ...... Phone No.
Name ofCoutractor..~a~ r. ~,[~;~.~ ~,o, .git% Address 7o~..,%,~.~.C?.. ~7.~hone No.
[5. Is thxs property located w~thin 300 feet of a tidal wetland? *Yes ......
*If yes, Southold Town Trustees Permit maybe required. PLeat DIAG ILAM
Locate clearly and d~stmctly alt' buildings, whether existing or proposed, and ~ndicate all set-back dm~ens~ons from
~roperty lines G~ve street and block .number or description according to deed, and show street names and indicate whether
ntenor or corner tot
)TATE OF NEW YORK,
20UNTY OF
SS
(Name of md~wdual s~gnmg contract)
,bove nanled.
being duly sworn, deposes and says that he is the apphcant
te is the .... , ....................................................
(Contractor, agent, corporate officer, etc.)
ff said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
ppbcation, that all statements contained m this application are true to the best of his knowledge and belief, and that the
york writ be performed in the manner set forth in the application filed therewRh;
~worn to before me this
.... 19[?
(S~gnature of applicant)
;', ]' OF HEALTH SERVICE~
~.1 DATt- OF APPROVAL
SURVEY FOR
BLAIR J DIBBLE 8, LORRAINE R DIBBLE
LOT NO 5,' OREGON VIEW ESTATES"
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE OCT 16, 1984
SCALE I" = 50'
NO 84 - 1004
SUfi:OI.K COUNTY OEPART~E~T OF ~L'f~ $[R'VICE~
FOR APPROVAL OF CONSTRUCTION OF | Single. Faintly
[XPIRES ]WO YEARS FROM DATE OF APPROVal
. suer co r~x~P m~-~oo SECT;O. 9~ ~.ocx
4/,,;
N~ ffi = MONUMENT & = STAKE
SUBDIVIS~ MAP RL/D IN ~E O~ CE OF ~E C~RK OF
SU~COUN~ APR 4~1975AS FILENO 6241
SURVEY FOR
BLAIR J DIBBLE ~ LORRAINE R DIBBLE
LOT NO 15 ,"OREGON VIEW ESTATES
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
DATE OCT 16, 1984-
SCALE I ' = 50'
NO 84 - 1004
usu~ '~"(F ~"~"Y o~ ..Y
YOUNG e, YOUNG
ALOEN W YGUNG~ PROFESSIONAL ENGINEER
AND LAND SURVEYOR N Y.S. UCENSE NO. 12845
HOWARD W YOUNG, I.~ND SURVEYOR -,.
NYS LICENSE NO 45895
400 OSTRANDER AVENUE
RIVERHEAD~ NEW YORK
.., ,,. , SURVEY FOR
SUFFOLKCOtjN'I'YDEP~I~..N.111~ BLAIR J DIBBLE 8~ LORRAINE R DIBBLE
,~INGLEFNVIILYDI/f~LING'ON[~ LOT NO 15 "OREGON VIEW ESTATES" FEB II, 1988
~A~~7 ~ ' dULY ~5, ~987
OAT --- -~HS REF ~ ~ AT CUTCHOGUE DATE OCT 16, 1984
The ~wage d~spasaJ and wa~r supply fa~ ~ ~ ~WN ~ SOUTHOLD SCALE I = 50'
location have been ms~cted by this ~part~nt ~/~ SUFFOLK COUNTY ~ NEW ~RK No 84 - Ioo4
R U~UTH~IZEO ALTE~TION OR ADDtTION ~ ~llS GUA
HEAL~ DEPARTMENT-DATA F~ APPRO~ ~ C~STRUCT aND ~ His ~H&LF ~ THE ~TLE C~Y, GOVt,,-
YOUNG YOUNG
SUBDIVISION MAP RLED IN ~EOFRCEOFTHE C~RK OF AND ~ND SURVEYOR N Y.S UCENSE NO IEB45
SU~ COUN~ ~ APR 4 ,t975 AS FiLE NO 6241
HOWARD W YOUNG~ LAND ~URVEYOR
NYS LICENSE NO 45893 ~AR ~8~
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
~PPROVED AS NOTED
NOTIFY ~II.[~N~ ~JEPARTM~T AT
1802 ~ ~ t(~ ~ PM FOR THE
SOLDER uSED IN wATER
e,~ePI_¥ SYSTEM CANNOT
cERTIF~C~ " ~
PLUMBER "' '
ON LEAD cONTENT BEt rjr,:
CERTIFICATE OF OCCUPANCY
If mlaper tubing Is usad
fei' wat~ dl~tributln~
Watem; Idplng ihlll be
J_ _ LLh