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Home My WebLink About14866-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15606 Date April 7, 1987 THIS CERTIFIES that the building ..... 9.n.e...f.a.m.i. 1. ¥. dwe 11 i ny: ...... Location of Property ....5.,5..5. Lupen Drive Cutchogue House lye. Street Ham/et County Tax Map No. 1000 Section .. 9.9.7 ....... Block .... .0.9. ........ Lot 0 18 Subdivision Hickory Acres 8ac. 1 Filed Map No. .3 .3.2 5. LotNo. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated . '..A. p .r.i.1..2..4.,.. [9. .8.6. , ~,, pursuant to which Building Permit No. J .4.8.6.6. .z .............. dated ..............,.............May 8, 1986 . ,. 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 ......... .... Qn. ,e..f.a.m..~.l.y...d~.e.l.l..~ .rig.,.. g.a.r.a.g e...a.~. ~..a.c.h.e.d...a.n.d...d.e.c.k.: ..................... The certificate is issued to ROBERT AND PEGGY DICKERSON ..................... ?o¥.'0;, ..................... of the aforesaid building. Suffolk County Department of Health Approval 86-S0-55 Mar, 31, 1987 UNDERWRITERS CERTIFICATE NO. N78741I Jan. 8, 1987 PLUMBERS CERTIFICATION DATED: Dec. 22, 1986 Building 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) 14866 Z Permission ~s hereb! granted to: ..~..~.~..~........~C~..~.~.......~/..~.~. Z,~, ...~-~.~.~..c.~...z~..:..~ ......... z.~.~-~ ,o ........ ~ ~ ~ .~.~.....~:..~ ~~' ~ .~.~....~. ~ .~.~ .............. ........... ................... ........ ............ ~, ~,~ I~ ~ ....... ~...~.,.~ .......... ~.~.~....~ ......................................... ~ursuo,~t to opp,,cat,on da,ed ....~....~(..~..Z...K... ............. Building Inspector. Fee $ ....... 13uilding Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001O93 BUREAU OF ELECTRICITY ~"~ d~d~'--11~13?y ~ LO~'~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~2941/~ "~'~ ~"~"~" ~' ~" ~"~ N 787411 THIS CERTIFIE$ THAT . ~ t~s. ~er~on~ I~p~ Drive, Bill~ & / Lupen, ~tc~, N.Y. m the following locat en Ist FI. Lot ~s exa~nlned on FIXTURE OUTLETS ~6 E$CEPTAC/ES ~ 2nd FI. Section Block and found to be in cotnpliance tt*ith the reqt~ire.tents qf this Board SWITCHES -- FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS FLUORESCENT ~8 26 VAPOR DRYERS FURNACE FUTURE APPLIANCE FEEDERS ;PECIAL REC'PT TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: ~btors: l-lhp 1-13.9 Amp Vaeum U~it 1-G.F.C,I. 2~S~oke Detector~ 2~ack I~[ghting 24' )" ? I&tes S E R V I C E NO OF NEUTRALS AWG. OF NEUTRAL Gary Doroskl 425 ,~,~om~ell Lane Ck:tchogue4 N.Y, 11935 [~LC,, 2941E /:'~ G~ENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials, TOWN OF $OUTI~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION (please print) (please i print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~'~_ day of ~_~e ~9 ~ Notary Public, ~'~'~'~'~/¢ (plumber ' s signatur~ ~' Notary Public County ~o~ ~. ~so~ FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUP/~NcY~ Instructions A. This application must be filled in typewriter OR ink, and submitted ,,, ~ 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINES~ $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5 Updated C O $ 50 00 Date New C on s t r' u c t i on ...... Old or Pre-existing Building ............ Vacant Land ........... Lu4~ fO P.~ ye Cutchogue toca£ion of Property . ...~5~ ..................................................... House No. Street Hamlet Owner or Owners of Property . .~O~).e.~;. ¢. i~.e. g~7.. ~lickerson County Tax Map No 1000 Sect on 097 Bock 09 /nt 018 Subd vis on H;t ckoz".y Acme. s. Se.c.,. 1 ........ J:J_led MapJ~o ............ Lot-No. ~. ~ .......... Permit No. 1[I~(~6Z. ·. Date of Permit .~/.8.,~.~.5...Applicant .~.q~.~.r..o..~.m.e. ~.~. ~.~.? ~.,..Z. 97.-. ....... Health Dept. Approval . .A.t.~.aC be.d. ............ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . X ............. Fee Submitted $.. $ .2~.O .0 ................. Construction on above described building a~i~r~.e~ty~',~Dli~able codes and regulations. Applicant~~..~.es,. fOP i?.&P. DickersoD h'o'; ........................ Rev, 10-10-78 F~ELD ~INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) OUGH FR~ INSULATION PER N. Y, STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: // Iii: APPRDVAI. 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST []ROUGH PLBG. [ ] FOUNDATION 2ND []INSULATION []FINAL DATE INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: /,...~'~ ~,~...~7//~,.,'~ 7GS-~-SQ2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSUILATION [ ] FRAMING REMARKS: [ ] FINAL INSPECTOR INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: /~, ~~,, 765-1802 BUILDING DEPT. INSPECTION [dFOUNDATION'IST [ ] ROUGH PLBG. /]FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL DATE ,, INSPECTOR /~~~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /Z~ An application for Certificate of Occupancy is not on file.3 /Z~, NO Underwriters Certificate on file. /--~;/The check is(oe~d/not on file.)~-570 D /~/No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. .~uilding Permit # ~ .~_~ 6. ! Z Building Dept. ***/~/~No Plumber Solder Certificate on file.C~Mc~ ( all permits involving plumbing being issued after April 1,1984 ) -- TOWN OF SOUYHOL~ Environment East, Inc. R. R. No. 3 3075 Indian Neck Lane Peconic, New York t 1958 516-734-7474 September ~, 1986 Southold Town Building Dept. Town Hall Main Road Southold, ~V~ 11970 Re: Permit # 14866Z, Dickerson, Lupin Dr., Cutchogue Dear Sir, Enclosed is a copy of the Dickerson plans showing alterations requested by the owners. These cha~ges include the addition of 2' to the dining area, 2' added to both of the second floor bedrooms, and the addition of an exterior entrance to the basement. Also enclosed is a copy of the survey showing the offsets to the property lines. If any further information is needed please con- tact this office. Thank you for your assi~i,~ this matter. Sincerely, PrePeters ideR'nt St°ute nburgh/ Enviroomeut East, I~ Encl. 4s ~ (¢ ~' c~ O° I Z' L LJ ~ DN C..ol Zge.. n rrb:-, nr'z----Jr:.C-.¢"- 'SUFFOLK COlJI~Ty D£PARTMEI~T OF HEALTI-t S~.~~:''''" N/O/F PAUL N. $0712'50"E LOT 4 BARBARA STOUTEN~UI~H 143.4/' cP. o 0 LUPEN DRIVE MAP OF LOT 4 "MAP OF SECTION ONE HICKORY ACRES " FILED API~. 20, 1961 FILE NO. 3525 AT EAST CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N,Y. I000 - 097' 09 - 18 SCALE I" = 50' MAR. 2.0, 1987 SINGLE FAMILY H.D. RGF. NO ..... E~ - ~.~ '~ ..... ~___. ~ ..... . . S .LIC. NO. 49618 PEC~IC-~-~YORS &E~INEERS , P. C, (516~ ~6~ 50aO ~ O. BOX 909 MAIN ROAD 87 - 245 N/O/F PAUL LOT 475'_+ 8 03 0 Z N.80. 12 50 E LOT 4 p~p~ S. 80012 '50"W. STOUTENBURGH BARBARA 143.41 ' 165. O0 ' LUPEN DRIVE MAP OF LOT 4 "MAP OF -SECTION ONE HICKORY ACRES " FILED APR. 20, 1961 FILE NO. 3325 AT EAST CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, I000 097 - 09 SCALE I" = 50' MAR. 20, 1987 N.Y. H O REF NO ..... DATE ~ , ~ 3 ~ ~ : ~ SEWAGE DI~I=OSAL AND WATER SUPPLY FACILITtE~ FOR THIS I.O~ATION HAVE BEEN INS~CTED BY TH~ DEPA~MENT AND ~D TO I~ ~T~A~. , ~. ~. ~_. ~. ...... ' ' ~ ~ W~r ~~t ~tion SUFFOLK'COUNTY HEALTH DEPARTMENT ,**,~* I.Y.S .LIC. NO. 49618 // ~PECONIC 'OR S ( 516, 765 5020 P O. BOX 909 MAIN ROAD ENGINEERS , P. C, SOUTHOLD , N .Y 11971 87 245 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: ~65-1803 Disapproved a/c .......................... ~ .'. ...... (Building Inspector) APPLICATION FOR BUILDING PERNIIT Received .......... ,19... / / / '-r'---* ,7 Date ...... ~.~..~. ........ 19 .~'.G. 'INSTRUCTIONS a. Tins 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 tins 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 tlie 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. ..... ~:y.L~.~. .,o. .~. .~. .~.~-.,y. . T. . ~,?. .~. .~. . /~c. .~,~,,~.?~ (Signature of applicant, or name, if a corporation) ·..~ .~ ~'~ff:¢~..~..<~ .~../.e.a~..,. ~.~:?:~.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises., .~.°.~.eF.~..~..?~.7./ ..... ~./.C/'(/~'*fd~.'Q(.~. ..... (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..5 C:..2./..~....~..Z..:~.'.a~..J'.~... Plumber's License No. /"/ ~ Electrician's License No ..... .P~.. ~. ............. Other Trade's License No ...................... ,5~3~'' 1. Location of land on which proposed work will be done ....... .~fl. ..... ?~:'. I..... .... ~..,~.,.-. ........ ................................................. . .~?~x~. ~. 7.~.. Z~-~a,. ........................ House Number Street Hamlet ~ County Tax Map No. 1000 Section ...... ~[~. ......... Block ........ ~. ......... Lot ..... /.c~... ~' ....... Subdivision .................../-//~Ro .t'~ /~cr-i~qmne)~.~.o¢.~.,./... .~./'~..' ' Filed Map No ............... Lot.....~. ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... .Jf.~-~(c~'.,~d~.... ?..~..~..~. ........................................ b. Intended use and occupancy J'~lYr-l/~/ ~'";')1 ~ .................................... ,~,~._ ~ :~.~.~;:~j: .............. 3. Nature o ork.~ ~~ch applicable): New Building ~ Addition ........ Alteration Repair .............. .Rembval .............. Demolition .............. Other Work ............... ~, ~t (Description) 4. Lst~matedC~ost . .t.'4:2~it~.... ~ ......................... Fee .~ ,. ~ ~ (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 type of use ..................... 7. Dimensions of existing structures, if any: Front..~9~t~:~ .... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i ' ' Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ...~/. ~.'...., ..... Rear ....~,f..~.' ........ Depth . .q~.~. '. ......... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..... /.~.b".I' ........... Rear .... L..~.~.~ ............. Depth .../~,O.'. ............. 10. Date of Purchase ........ i .................. Name of Former Owner ~1.~..r-.bq.r,t. ~/-~.~.' .Pe..~.u.r~.~ ..... 11. Zone or use district in which prbmises are situated ...... /e~..$.t ~/¢,O.././.igt/. .... - ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .fro. ........................ 13, Will lot be regraded ........ i P~o ................ Will excess fill be removed from premises: Yes . No 14. Name of Owner of premises ,5~},..~.7¥- ~.c.~.~.r.~¢O. Address .z./.g.o..~./J.o.~..lq.~.~.... Phone No ................ Name of Architect .......................... Address ............ ? ...... Phone No. Name of Contractor ~..~.v~ffe~t.r~.~.T. ~o.~.4.._F.. ~/.c:.. Address ~.o. ? .~'..Z;~.d. ,.~..e.c~.., ~.~.r~.. Phone No..~(6.~. ~'.~:.7..'f-.7..~.. PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockmumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, 'S.S COUNTY OF ................. ............................ i .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. Itc is ~he (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 this application; that all statements contained in this application are true to the best of his knowledge and belief; at~d that the work will be performed in the mann{r set forth in the application filed therewith. Sworn to before ~ne this .......... ......... dayof ........ .O']..~. ....... , N/O/F PAUL N. 80.° 12'50" E LOT 4 /.u / ~OT 475,+_ S. 80°1Z '50'W. BARBARA STOUTENBURGH 143.41 CP. ,~..,,~>c 52, 61 ' . 165.00' LUPEN DRIVE NIAP OF LOT "MAP OF .SECTION ONE FILED APR. 20, 1961 4 HICKORY ACRES " FILE NO. 3325 AT EAST CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 097 - 09 18 SCALE I" : 50' MAR. 20, 1987 HEALTH DEPARTMENT '" SUFFOLK COUNTY , SINGLE FAMILY ( 516j 765 5020 P O. BOX gO9 MAIN ROAD SOUTHOLD , N .Y. 11971 87 - 245 .T i:1 C. ,~ r-d t I r F DU zV D 'ZT J[~'~RO~.~EQ Ag NOTED NOTI~ BOIl.D~ O~ARTM~NT AT 78E-1~2 R ~ TO 4 PM FOR THE ~ INSULA n~N ~ F~NAt ~ONSTRUCT~N ~UST B,~ CO ~,~PLETE FOR ALL "~ON~'I RUCTION SHALL MELT THF A6~UIREMEN~i'S OF THE C~~ ~b I: ,I ,i t rI ,i C .z,-]: C system~ piping of types ~ PLUMBER ~ERTIFICA~ON CEETIF~CATE 01~ O( .CUPANUr SOLDER USED IN WATER SUPPLY SYSTEM CANNOT~ EXCEED ~[10 of 1% LEAD. f , !/4- Iq"' /5 ' 2q OCI U C¥ OR UgE B.BILA FUL C .aTiEICATE OF OCCUPAN,C¥ NO~ BOILDIN6 D~TME~ 765-1802 9 AM TO 4 PM FOLLOWING INSPECTIONS: ]. FOUNDATION - FOR POURED CONCR~E ~ ROUGH - FRAMING & pLUMBIN~ ~, INSULATION ~, FINAL ~ CONSTRUCTION BE COMPLETE FOR 6, O, ~LL CONSTRUCTION SHALL THE REQUIREMENTS OF THE ~ATE CONSTRUCTION & EN~ CODES. NOT RESPONSIB~ DESIGN OR CONSTRU~ION T ! LI;34 i' F~O/'Z Z7 ~ C