HomeMy WebLinkAbout16021-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17414 Date OCTOBER 14r 1988
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Propert~ 985 CARRINGTON ROAD CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 11 Lot 1.2
Subdivision Filed Map No. Lot No.
conforms substantIally to the Applicatlon for Building Permit heretofore
filed in this office dated MAY 5r 1987 pursuant to which
Building Permit No. 16021Z dated MAY 28, 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 DWT~,LING, ATTACHED GARAGEr REAR DECK.
The certificate is ~ssued to
JOHN F. & EILEEN EICH
(owner,
of the aforesaId building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-42
UNDERWRITERS CERTIFICATE NO. N008792 4/6/88
PLUMBERS CERTIFICATION DATED
1o/s/88
PERFECTION PLUMBING & HEATING 10/14/88
- / / Bu~l~ing Inspector
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~_ 16021 Z
Permission is hereby granted to:
,ic '
...~.z...~..~.....~..., ......................
' ao. U.L.!. IIg',~ I .
o~ ~,~,o~o~ o~...~..~.~.~~,.~.~.~.~ ........ .~-.~.~ ............
County Tax Mop No. 1000 Section ...... .]../../. ........ Block
Building Inspector.
......... , 19~..~.., and approved by the
Rev. 6/30/80
TOWN OF SOUTHOLD OCT t 1 t98
Budding DepartmentTown Hall ~.~_ ~
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. Thru application must be filled ~n typewmter OR mk, and submitted ~, ~ to the Building Inspec-
tor with the foJlowmg; for new bullrings or new use'
1. Fmal survey of property w~th accurate Iocauon of all buddmgs, property hnes, streets, and unusual
natural or topographic features.
2.Fmal approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3.Approval of electrical installation from Board of F~re Underwmters.
4 Commercial buildings, Industrial buddmgs, Multiple Remdences and simdar buddings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responmble for the buildmg.
5.Submit Plannmg Board approval of completed site plan requirements where applicable.
B For existing buddmgs (proof to April 1957), Non-conforming uses, or buddmgs and "pre~existing"
land uses:
1. Accurate survey of p~operty showing all property hnes, streets, budd,ngs and unusual natural or
topographic features.
2Sworn statement of owner or previous owner as to use, occupancy and condition of buddmgs.
3 Date of any housmg code or safety mspect~on of buddings or premmes, or other pertment ~nforma-
uon required to prepare a cert~hcate.
C. Fees' Additions $25 00 POOLS $25.00 ALTERATION $25.00
1. Certffieateofoccupancv New Dwelling $25.00, Accessory ,$]0.00 Buszness $50.00
2. Certd~cate of occupancy on pre-exmtmg dwelhng $ I00.00
3 Copy of certfffcate of occupancy $ 5.00, over 5 years $ ]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date .........................
NewC°nstvuctzon ...... Old or Pre-existing Buddmg ........... Vacant Land .............
Location of Property .... I . ~.. : ........................... .,.
House No Street Ham/et
Owner or Owners of Property ...~t~[ . .~. ~J.C.H. 3..E.~.L.%.F..~..~./.~..~ .............................
County Tax Map No. 1000 Section 11 ~ Block . II ....... Lot J[',~ ....
Subd~vlmon ............................ Fded Map No .......... Lot No .............
Perm,t No. I ~..1~[ ~-._,Date of Perm,t .5~. ~i 77.,~, .Apphcent . . . .~...q~ . .~...'.....~. ........
Underwriters Approval .5.O. .............. Planmng Board Approval .....................
Request for Temporary Certificate .................. Final Certificate ......................
Fee Submitted $ .........................
Construction on above described buddmg and p~/~t meets allc~?cabie codes and regulations
Rev 10 10 78
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No.
(please print)
P]umber ~~3 //~//;~/%~/~2~
(please print)J
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(p~umber's signature)
Sworn to before me this
; G day of d~-
Notary Public,
County
Notary Public
Fax gove eet
Gary F~%h
boutholdTowe BuddmglL)epartment
Mam Road, gauthold, NY
765-1523
Dear Mr Ft~h,
As per our conversation of diis af~moon, I have scat thc memo ofzale from the property m
question. A~ I mentionS, i ~ mtelested m getting ~c ~rtificale of occupancy m addition to getting a
copy of~lte most recent ~urvcy t l possible I he SuffoJk Coun~ ~ m~ number ~ I O00-11 I- 11 - 1.2. Thank
you For your t~mc and help
,.,AN 0
~JanI29-97 04:22P Russ L'Ho,,.,,eDleu PT P.02
SELLER,
REPUBLIC BANK
Nome, FORECLOSURE
Addte-a~Dne Hanson Place
Brooklyn, NY
Phone N~...[~718-488-4477
Fax NO. Z-7~8-488r4570
BUYER~
Name, ~US$ & ~DNNZ~R
Address, 45125 Main Road
Southold, NY 11951
REALTY
CUTCHOGUE, N Y. 11935-1343
($16) '.'3~-5657
FAX(SlS]?~-7~S DA l[. Januar}, 7
3[ [,L[II5 ' A I' TORNEY ~
REPUBLIC BANK
Name: FORECLOSURE D~T.
Add[ess, One ~anmon Place
1997
Brooklyn, NY 11243
Pl,~r~ No~-718-488-4477
Fax No. 1-718-488-4570
BUYER~' ATTORNEYx
Nome: WILLIAM D. MOORE, ESQ.
Address~ 315 Westphalia Ro~d
....... Mmt~ituck, NY 11952
MARION K1NG
LJc ReaJ Estate Bmk~
Phone No. 765-9389
Fax No. 765-9369
LOCA;ION OF PROPERTYt 9~5
Phone No. 516-29B-9~7~
Fax No. 515-298-5664
Carri~g~9~ Road, Cutcho~ue~.N¥ 11935
SFLL[NG PRICL~ $225,000
UA~E OF CUNIRAETtTo Be Decided
RFMARKS,
5.C,H. No. 1000-111-11-1.2
AMOIJNI 0~' BINDER~ -
OATE QF C[0SINC-: To Be Decided
Barr~NovicK
HAR [[JN R.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[~FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
FINAL
DATE /~/~//~ ~*/~'
INSPECTOR~~
765-1802
BUILDING DEPT.
INSPECTION
[~FOUNDATION 1ST [ ]
ROUGH PLBG.
2ND [ ] INSULATION
[ ] FINAL
I' ] FOUNDATION
[ ] FRAMING
REMARKS: ~**~-~~ O/~*"~-~~
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [v]~NSULATION
[ ] FRAMING
FINAL
DATE /F/~///,~ 7
INSPECTOR .~/ ~
765-/.802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ]ROUGH PLBG.
FOUNDATION 2ND [']INSULATION
FRAMING [ ]FINAL
DATE~/Z~/~/~?
INSPECTOR~
76S-1802
BUILDING DEPT.
INSPECTION
OUNDATIO:;
OUNDATION
(2nd)
OUGH
FRAME &
PLUMBING
:ISULATION PER N.
STATE ENERGY
CODE
FIL~A~
ADDITIONAL COMMENTS:
-~/~ 31£/ ~/~c~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION ZST [ ] ROUGH PLBG.
FOUNDATION /ND [ ] I~iSULATION
/
FRAMING E/J/FINAL
REMARKS:
DATE
INSPECTOR .~'~,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
/
FRAMING [~/FINAL
DATE
-~t,:...,L L ,
;
DEPT. OF,.
HF. ALTH SEltVtCE~
Examined
Approved .
Disapproved a/c
BOARD OF HEALTH ...
S TS
TOWN OF SOUTHOLD CHECK . -~-~-'/~- - -
BUILDING DEPARTMENT SEPTIC FORM ..O.'J~. .
TOWN HALL
NOTIFY
MAIL TO:
APPLICATION FOR BUILDING PERMIT
Date ?4/....vT..
INSTRUCTIONS
a. Tbas application must be completely filled m by typewriter or m ink and submitted to the Budding Inspector, wit
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 adjommg premises or pubhc sir.
or areas, and giving a detaled descnptlon of layout of property must be drawn on the diagram which is part of this ap
cation
c. The work covered by ttus application may not be commenced before issuance of Budding Permit.
d. Upon approval of this apphcation, the Building Inspector will issued a Bmldmg Permit to the apphcant. Such pet,
shall be kept on the premises avadable for inspection throughout the work.
e No bmldmg shall be occupied or used in whole or m part for any purpose whatever untd a Certificate of Occupm
shall have been granted by the Bmldmg Inspector
APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmldlng Permit pursuant to,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulatmns, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto descnb.
The apphcant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and
admit authorized mspectors on premises and m bulldmg for necessary lys~% ~..
(Sen~ure of applicant, or name, if a corporation)
(Mailing address of applicant) //~'¢/
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bmld~
..... O.q.O. .................................
Name of owner of prem,ses dO -~ F~') K ~/C-/'f ......
(as on the tax roll or latest deed)
If apphcant ~s a corporation, signature of duly authorized officer
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No .....
Plumber's License No ..
Electnclan's License No
Other Trade's License No ..
Location of land on which proposed work wdl be done,
lIouse Nulnber
County Tax Map No 1000 Section //~ . Block
Subd:vmlon
(Name)
Filed Map No
Hamlet
Lot
Lot
State existing use and occupancy of premmes and intended use and occupancy of proposed construction
a. Existing use and occupancy k'/~'~'#':/? , ........
b Intended use and occupancy P~./c~6t.7~. qS./"UGZ.''~. /~"~'/gy -ePtq-Z~..ZZ('~.Fe- ............
6
7.
9.
10.
----11
12
~--13
14
Nature of work (check which applicable) New Building ~
Repmr . Removal .. Demolition
Estimated Cost ...~.,.~/ ~..~ O .......
If dwelling, number of dwelling units .. / ......
Addition .... Alteration ..
....... Other Work ...........
(Descnphon)
(to be paid on filing this application)
Number of dwelling units on each floor . ..
If garage, number of cars ...... ~ ..................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use ~,4
Dimensions of existing structures, if any Front ,,q/dC-. .. Rear ........... Depth ..........
Height ....... Number of Stones ..
D~mensions of same structure with alterations or additions Front ..... Rear .............
Depth . .: ..... Height..
Dimensions of entire new construction' Front
Height gl. ~. t.... Number of Stones
Size of lot Front /~O ~ . .
Date of Purchase
· . ~,. . . Number of Stones. I .u..
· 7. 2' P'2- '' Rear· 7~' ....... De';t{t' i~.~.~. ~'..
Rear i'~..~iO.? .:; :' il.'be~th'.=~'~../, i ']i.'iii'i
Name of Former Owner ~7~ ~/-/~.(- ./[J, . wq' d.~ ~'.~
Zone or use district in which premises are situated
Does proposed constructior~ vlolate any zoning law, ordlnanc;'orregUlatlon'''--- . ''ii.i' .i.ii i. .'' ''"'".J7~.~
WdI lot be regraded ,,~'.~--~ ...... . Will excess fill be removed from premises' ~ N~
Name of Owner of premises .~/. oFn,). ?7..~'(c,~.. . Address,~¢7. d~TH4m .Mo.~,o.. Phone No.5-/~
Name of Architect ...................... Address ............... Phone No ............
Name of Contractor ,5 ~..t_.~/ .... Address ........... Phone No
15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ...~..
*If yes, Southold Town Trustees Permit maybe required.
PLOT DIAGRAM
Locate clearly and distinctly all bu,ldmgs, whether existing or proposed, and indicate all set-back d~rnenmons fro~
property hnes Give street and block number or description accordmg to deed, and show street names and indicate whethe
lntenororcornerlot ~"a°~'l'~-Z~..lq,~t~/g~a~ ,r~. f? l'*~'t~~E' ~,~o..t~a.'ro~l
STATE OF NEW YORK,
COUNTY OF..
SSL
(Name of individual mgnlng contract)
above named
·. being duly sworn, deposes and sa
that he is the apphcan
He is the ....................
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
application, that all statements contained m this application are true to the best oflus knowledge and belief, and that th
work will be performed in the manner set forth in the application filed therewith
Sworn to before me this
.. fi'-- . .. day of ..... ~..o~ ...... 19U
N otaryPubhc, ~.t~' .~...,~..~.~. County5 ¢~_~ ~. ~.~.,
~ ~IISU~. St~..~.~. ( Signature of apphcan
~ 4~787~ ~
C~NiGU£d5 ie[:FL~.,.'~g ML~14 C, LA
-75 ~ I~T.
HEALTH
hlAP OF !--~4(%-EFH'Y
/
PLEASE NOTE
L]' h'i 0 f-J,-~ ,'Vl L:
It is the apph,cant's responslbihty to
maintain adequate sanitary distance
between all water supply and sew(-.ge
disposal facdittes.
i~l · -- i iii izI
RODERICK VAN TUYL, P.C
,~. v'..-,._ -r"-~<
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
H S NO
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS for THiS RESIDENCE W,LL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CC~DE~T OF .~AL~'H SERVICES
SUFFOLK COUNTY DEPT Of HEALTH
SERVICES - FOR APPROVAL Of
CONSTRUCTION ONLY
DATE , '~-~-~6 /', ,
H S REt NO
APPROVED
SUFFOLKCO TAX MAP DESIGNATION
DIST SECT BLUE ~L
OWNERS ADDRESS _
DEED L
TEST HOLE
,I
id
STAMP
SEAL
- dTR
.Z;kitQ~i~.ff, ~:'LFL~ ~rD i~l:.AN OLA LE~L:L.
,/
Iii, MQf',~UM [ I-,IT
T'ITLP2 NO,
STATEMENT OF INTENT
THE WATER SUPffl..Y AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO DEPT OF HEALTH SERVICES
APPLICANT
SUFFOLK COUNTY DEPT OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE , ,~,
, s REF. NO
^~'.OVED .... -
SUFFOLK CO TAX MAP DESIGNATION
DIST. SECT BLOCK PCL
{,~Z:)O ! I i I I 1,2
OWNERs ADDR[SS
DEED L. P.
I~l~l~ I~lC~I ., Ii .......,
~ANP~
G F~A,VE: L