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Home My WebLink About15853-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate O[ Occupancy No.Z16279 Date October 13, 1987 THIS CERTIFIES that the building ..... Q n..e..f.a.m..i.l.y., d..w.e.l. 1..i .n.g.. .................... 485 East Road Cutchogue Location of Property ............................................................... House No. Street Ham/et County Tax Map No. I000 Section 110 .Block 6 ..... Lot I 1,3 & 1 l ,5 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 2, 1987 pursuant to which Building Permit No. 15853Z dated.......,...........April 4, 1987 ....... .. ~ wasissued, 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, two story, attached garage and deck. The certificate is issued to JOHN STYPE ..................... i o¥.'e;, .................. of the aforesaid building. Suffolk County Department of Health Approval 87 - S O- 16 UNDERWRITERS CERTIFICATE NO ............ P..e .n.d.i.n.g... 1.0../7/.8. 7. ................... PLUMBERS CERTIFICATION DATED: Mc Shane's Plumbing ............ "'~iii~i~g 'i~l}l~ect or ............ Rev. 1/81 I~OF, M NO. 1~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT ~I'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15853 Z Permission is hereby granted to: ...~.~ ~;.i.~i ............................................... ,o ~.~...~....~.~..~..~.~ ............ ~~ .... ~ ,~ ~ .~o~- ~_,l. . ~ ~ ........ of premises located at ........................................................................... i ...................... · c~ ~ o ~l'~'~ II ~ County ~Jax Map No. 1000 ~Sect on ..... ) .............. Block, ...................... Lot N ................ dated ...~..~.~....~r... ................ , 19..~....~., and approved by the pursuant to application Building Inspector. Rev. 6/30/80 FORM NO. $ ' TOWN OF SOUTHOLD Bu [~ding Deparxmen~ Town Hall Southo~d, N.Y. ..... APPLiCATiON FOR CERTIFICATE OF OCCUPANCY instructions A. This apof cation must be filled in typewriter OR ink, and subr~ittad in duplicate to the Building Insoec tar with the following; for new buildings or new use: ' 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusua natural or tooograohic features. 2,Final approval of Health Dept. of water supply and sewerage disposal--iS~9 form or equal). 3.Approva( of dectricaI installation from Board of Fire Underwriters. 4, Commercial buildings, Industrial buildings, Multiple Residences and similar building~ 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 buildines and "pre-existing" land uses: - 1. Accurate survey of peoperty showing all prooerty 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. '/ C. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date New BuRding ............. Old or Pre-existing Buildina(Z) .... ~/Vacant Land Screer Owner or Owners of Property Subdivision ........ ~'~'~ ..................... FiledMap-No...:.. ,' LotNo= HeaJ[~ Dept. Approval ........................ Labor Dept. Approval Undee,vrJ~ers Approval ./~//~.~.. ,, .......... Planning Board Approval Request for Temporary Certificate .... . ................ Final Certificate Construction on above described building Applicant . -... . and~,,~t'meets all app[i.cable_.codes and regulati,qns. ...... ..... TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner ~ (please print) (please prink) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworr~. to before me this day of 19 ~7' Notary Public, _$c.~ff~b~ Notary ~blic County (~4ARLE8 F. $PACEK ._ Omdlfl~l In 8uff~k ~ \ OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL · ADDITIONA'L COMMENTS: 'j .. 76SJ,802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION V~~/~I~/~ ]FRAMING ~FINAL ~)' REMARKS: / DATE ~.~//~///~, INSPECTO~ ~ ~ //~ ~ ~ 76S-1802 BUILDING DEPT. '~' INSPECTION FOUNDATION 1ST ['~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~RAMING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ~'~OUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE_. , '7 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH 'PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING [ ] FINAL INSPECTO~ 765-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION :;ND [ ] INSULATION [ ] FRAMING [ ] FINAL RE:MARKs: TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of tile following reasons. C/ An application for Certificate of Occupancy is not on file. /~/ No Underwriters Certificate on file. ' The check ~s(outdated~h~t on fil ~/ No Dealth Dept. Approval on file~ /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ..,/' ~- ~ '~2 Z Building Dept. ***/X/ No Pluntber Solder Certificate on ~ile. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is '[~nlawful w3[hou[ of Occupancy. CLear up this matter as soon so that legal action does not haw~ to be Thank you for your prompt at tention. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..~...O/ ..... , 19 Approved ~..~. ..... , 19~?. Permit No../.~. ~.~.~..~? Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS FEB 2 - Date ..... , ............. 19o~..~ 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. (Signature of applicant, or nam , ' p ' ) .. ........................... .,¢ /./.. //./: 2 .. ,~,. ............. "..~.'.....~ .... ¢: .... .. ....... (mailing address or appz~cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... .......................................... Name of owner of premises .... · .'~..D. · ./~..<?. · · .~. · ./../·.~. .~.~ ........................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. / (Name and title of corporate officer)t Builder's License No... 2 ~. 'Z_~../~.. ~./..- ...... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ................... ..... House Number Street Hamlet County Tax Map No. 1000 Section .... //..~ ........Block ..... ~:~. .......... Lot.../'/. ,..~..qr. ~.~,. ~.-'7. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~..7~...~../)..~...~.. ....... : ...... , .................................. . I b. mtended use and occupancy .. t' ' ' ............ / ............................. ' ' 3. Nature of work (check which applicable): New Building .......... Addition. Alteration Repair Removal Demolition ~ Other Work 4. Estimated Cost ...-~ ..... /.~ ,DdgO, aa , .O. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars . ' .................. 6. If business, commercial or mixed occupancy, specify nature and extent of each iype 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 construction: Front ..... ~..~. · . . .Rear .... ~"?--- ......... Depth ~ ~i ;ii ...... Height .. ~.~.. ( ...... ~N~umber of Stories .................... , .................... .......... 9. Size of lot: Front.../..~i~f.. ............ R;~. ~/i ~ .~. .......... i. Depth ... :~ .e2.%7..-r./~ ~. .... 10. Date of Purchase ............................. Name of Former Owneri ............................. 11. Zone or use district in which premises are situated ....................... j .............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .. i ............................ 13. Will lot be regraded ..... ~...O. ........ , ......... Will excess-fill be removed from premises: Y~d No 14. Name of Owner of premises ...2~.,.~..77...~..ff..~.. Address ............. : ......Phone No ................ Name of Architect ............................ Address ......... ;...' ...... Phone No .... ~..~f~g~. .... 15. INsamteh~fsC;rnT;eCtr%~ 'l~oJf~d/'~t~n~'l!ff~P~' ;fAdadr~Sd~i~we~t~' '~' Y~' ~??~ N°'. ' . No' "'~' ' ' ~' ' ' ' ' '~'J~' ' ' ~ If yes, Southold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly ~Jl buildings, whether existing or proposed, and~iindicate M1 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 COUNTY OF .................. '( ' '~l'signing contract) . . being duly sworn, d~poses and says that he is the applicant above named. He is the (Contractor, agent, corporate officer, etC.) of said owner or owners, and is duly authorized to perform or have performed th~ 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 ............ ~ .......... day o!...~0~(i~..~.... ............... , 19.~/. Notary Public,... ~....~., ......... County No. 4707878, Suffolk Collnty ~;~ i t ~to 'Signatur- ~ f applicant) P~EASE NOTE mamlaln a~e-,u' :- '~?pOnmbility to ' ~, N a~e sanitary distance ~We~t~.water supply a~d sewage disposal ~dities. { , LICENSED LAND ~V~ORS GREE~RT ~W YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H, S. NO. STATEMENT OF INTENT ' THE WATER SUPPLY AND sEWAGE DISPOSAL SYSTEMS FOR THiS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK_CO. [~E~T. ~OF I--f_EALT~ SERVICES. A~PLICANT t~ . SUFFOLK COUNTY DEPT, OF HEALTH SERVICES -- FOR A~PRO~AL OF O.ST.UC ,O. o. Y A~OVED: , '~ ~FFOLK CO~ TAX M~ ~SIGNATION: DmT. SECT, SLiK OWNERS ~O~f o~ COAiT5~ /// LICENSED LAND SU'RVE~ORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF' INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK .~O. D~PT,./~)~HEPp3~TH S~-fl~VlCES. (s) //L /d__~<~-.~Y-, Ja-~.v / ~ ~ · - PL~CANT ~"' ' '~ SUFFOLK ~OUNTY DEPT. OF/ HEALTH SERVICES ~ FOR APPROVAL OF CONSTRUCTION ONLY DATE: H, S. REF. NO,. APPROVED: , , ' ' SUFFOLK CO. TAX MAP DESIGNATION: DiST· SECT. BLOCK PCL, OWNERS ADDRESS: ~.~0× C:~ , ST,AMP SEAL ,:~ ....... (3' ~,., ,..: ,, / , , / L,~ / __//I = ~ - ", ~' 11 I ~ ~- ' ~ ~ I t ,,.~ ~ I ~ .... , ' ~. I ~ ~ ~ ~-.~~ ' - - ':'~ ~-_~ ~ ~ / ~ f K ' ~ ..... ,~c.A,D i ....................................... ~ . 4':- . ...................... : ...................... Et-z_~ ? 49.5' ~ , ~ . - ',, '...) ~., r-U .,~,~ ~ ~. GR,E~N~RT NEW YORK suFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STAT'E:MENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. {si APPLICANT SUFFOLK COUNTY SERVICES -- F. OR CONST R UCT ION ONLY DATE: H. S. REF. NO.= APPROVED: , DEPT. OF HEALTH APPROVAL OF SUFFOLK CO. TAX MAP D£StGNATIdN: " SILT. BLOCK PCL. t · SEAL AO L EAST ~,.LOAD ,,' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ' SINGLE FAM)L~/DWELLING 0NL¥ DATE OOT 0 7 l~.S. REF. NO. ~ The ~wa~e msposal a:~d ~ater supply ~aml~ties Io~ this location have been inspected by this Depadment and/or other a[enc~e[and found to be satisf~. C~e~ Bureau of Wastewat~ Management SUFFOLK CO. HEALTH DEPT. APPROVAL H S NO 87-$O-': STATEMENT OF INTI~NT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESID[NC[ WILL CONFORM TO THE STANDARD~ OF THE SUFFOLK CO DEPT OF HEALTH ,',~RVlCES. APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE ..... H.S, REF.NO.. ,~-'. q'~:, G APPROVED SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. IC.30:.) , ~C OWNERS ADDRESS: DEED: L,' ~4 TEST HOL£ ~3A t-I M~'~ '.';% 4?I P. 2,_,4, ,.:~. ~..) STAMP SEAL i TO FLEET'5 I,,IECI/_ I~D,'~ / - / , / SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. 8'7-SO-.= STATENI~[NT ~ INTI~NT THE WATER SUPPLY AND SEWAGE DIS~AL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH ~ERVlCES {si APPLICANT / / SUFPOLK COUNTY DEPARTMENT OF HEALTH SERVICES ' SINGLE FAMILY DWELLING ONLY D~TE OCT 0 7 lg87H.S. ,~. NO. ~ The sewage disposal and water supply facilities for this location have been inspected by this D~partment and/or other a,~ncie%and iound to be satisfac~ry. C~e~-~ Bureau of Wastewat~ Management SUFFOLK COUNTY DEPT· OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOC:K PCL OWNERS ADDRE~: TE~ HOLE STA~ GREENPORT ~ YORK OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY SOLDER USED,IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY If copper tubing is used for water distributing System; piping ahall be of typea K or L o,nFf APPROVED AS NOTED NOTIFY B~JILD)NG D~PAR~M~T AT 7~5 1~2 9,~ TO .~ PM ~R THE FOLI,OW~N~ FOUNDA'~tON ~0 ~QUIRED FOR POUR~ CO~CRE 3 INSULA FIO~ ~- ?,¢,