The URL can be used to link to this page

Home My WebLink About15575-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ZI6081 Date August 20, 1987 THIS CERTIFIES that the building ... 9.n.e. . .f .aD.J-. 1. ~-..d.w. e, .1.1 .i.n. g: ..................... Location of Property .6.9.0...O.L.D..8..A.D.D.L.E...L.A.~E.:...C.V..~.C.I?.G..V.g .......................... House No. Street Hamlet County Tax Map No. 1000 Section 095 .Block ...0.4 ........... Lot .18.8 Subdivision..O.r.e.g.o..n.y.i.e..w. E s t at e s .Filed Map No. 624 1 .Lot No. 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated . '...Npy.....1.9 .... !.9.8.6 .... ptlrsuant to which Btlilding Permit No. 15575Z dated D e c. 16, 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..~..~.~.m..~.t.y., a..~.R~.! ~ .~.g.,..2...~.~/...g.~.r.a.g..e..~.~. q..s2.~.. ? ?.c.~.: ................... The certificate is issued to FRANK & BARBARA SOKOLSKI (owner, ~e~ave~fdt~g of the aforesaid building. Suffolk County Department of Health Approval 86-S0-241 Aug, 13, 1987 UNDERWRITERS CERTIFICATE NO. N825748 Aug . 7 , I 98'7 PLUMBERS CERTIFICATION DATED: Stephen O'Connor 8/18/87 Building Inspector Rev. 1/81 FOR~ NO. I~ TOWN OF SOUTHOLD BUILDING DEPARTN~ENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15575, Z Permission is hereby granted to: .......................................................................... Counw Tax map No. 1000 Section ..... ~.~.~ ..... BIlL ....... ~ ........ Lot No...~.~..:...:~. pursuant to application dated .... ~.~..~ ...... ~..~. ............ , 19~.~., and approv~ by the Building Inspector. Fee $. 2.?..~..~....~ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF 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 natura~ 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 p~"operty showing all property lines, streets, buildings and unusua~ natural or topographic featu res. 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: Additions $25.00 1. Certificate of occupancv New Dwelling $25.(10, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copyofcertificateofoccupancy~,.Vacant T.a,d C.O. $ 20.00 $ 5.00, over 5 years $10..O0.~.~.fl~....?. 5.Updated C.O. $ 50.00 Date ............. NewCons truc tion ...... Old or Pre~existing Building ............ Vacant Land ............. Location of PropertyHouse .............................................. No. Street ~ Owner or Owners of Property~1~ .... ~ ~.. ~.~0 County Tax Map No. 1000 Section......~ .~.... Block .,...~<~'. Lot. .....J~".. ~ Subdivision .... .~.~.Lf<~....~..~...Filed Map No..~ :.~ ..... LotNo .... ~ Permit No. /.~:~.~--~Date of Permit .{~.~Applicant.. ~ .~ .~ ~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and p~s all app~icab,[e c d.~es and regulations. - Applican . . .C. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ AUgust 7 > ].9~7 8S JOHN STREET, NEW YORK, NEW YORK JOO38 Date /IpplicationNo. on file 461197/87 N 825748 THIS CERTIFIES THAT only the electrical equipment as d~scrtbed below and ~ntroduced by the applicant named on the above appllcation number in the premises of Wind,way Building (.,Orpr Old Saddle Lane, Silver Spur Road~ Cutchogue~ FIXTURE OUTLETS 32 DRYERS I OTHER APPARATUS: IECEPTACLES 39 I FIXTURES 23 32 [] 2nd FL Section Block and found to be in compliance with the req.irements of this Board. RANGES JCO~KING DECKS OVENS DISH WAiHERS I ~.2 ·: ,,~--_. I. , 2 SPECIAL REC'P , ~ ~ ..... E CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS 1 30 j 1 I C E NO O~,.C~SCONO A w o FURNACE MOTORS FUTURE APPLIANCE FEEDERS GAS H, P A~T NO A W. G Jo. OF j S ~ETER 1 Lot DIMMERS NO OF NEUTRALS I A W O. · 2/0 Cmodale Electrieml Cont~ Inc. 7355 Main Road Mattituck~ N,Y, 11952 Ltc. 783E, This certificate must not be altered in any manner; return to the office of the Boa~d if incorrect. Inspectors may be COPY FOR BUILDING DEPARTMENT. their credentials. /vlANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR. P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 CERTIFICATION Building Permit No.--////~fi,~D~ '~''' print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this / day of ~ , Notary Public,~ County Notary Public OUNDATION ~1 s t) OUNDATION } OUGH FRAME & PLUMBING ]NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION [ ] FOUNDATION :~ST [/'ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [/J/FRAMING [ ] FINAL DATE. _~/~/~ ? // ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL DATE 7GS-1802 BUILDING DEPT. INSPECTION [~FOUNDATION '1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS. DATE ,//~-'~/~, INSPECTO~ ; 76S.'t 802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [~OUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE .,INSPECTO 7r~.ts~z BUILDING DEPTo INSPECTION FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION :)ND [~NSULATION ..... INSPECTOR FORM NO. 1 ~ ~'~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... Received ........... ,19... O.~ .t.F (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 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 dexnolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, hous, ing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~e~ions. I /7 , ~ .... .Z~.,~.~../~.~.:~,,,,,'j. ~ ...... (Signature of .applicar~, or name, if a~orp~gation) /o ,~/,~ .. .................. .. ~-~.,rf~./.o ~....../.,'~2/, ....... .... v (mailing adaWres~ pf app,lic,ant) State whether applicant is~owner, lessee, agent, architect, engineer, general contractor, electrician, pmmoer or builder. ..................~ /d'"'t,:. . ,' '/.~'z,,~/.. . . ................................................................ of owe, er pre,nises.. . .............................. (as on the tax roll or latest deed) If applican~p~tion,~ign~j,re o~ uiy author.ized 9~'ficer. ....~. ..... ~..~ :....&~..~.,~.. ~../.~., (Name and title of corporate officer) Builder's License No .......................... /7 Plumber's License No ................. Electrician's License No.. ~.~l~.~.. ~/~.'-~/_~ Other Trade's License No ...................... ~ 4~p~2~ .~./~..~.~.~ ' ~ 1. Location of land on which proposed work will be done ............................................. ......................................................... ................. House Num bar Street ...... County Tax Map 1000 Sectiot~ .~. ~.~. ..... Block....~..~. ........... Lot. ff.~.'. ?.~..~ ......... Subdivision ...P.~..~fff~~. .~/.~'.~. i ~2~r.~ ..... Filed Map No. ~'1.~[ Lot ~ ....... · "/ .... (~'a~e) ..................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ................................................................. 3. Nature 6f work (check which applicable): New Building .....~..... Addition .. Repair .............. Removal .............. Demolition ........... 4. Estimated Cost ...... /.~.). f(,t.~...t/...."L~. ................ Fee .......... ....... Alteration .. ........ ·. Other Work ............... (Description) // (to be,~aid on filing this application) 5. If dwelling, number of dwelling units ....... . ........ Number of dwelling unit ~ on each floor ................ If garage number of cars ~ ' 6. If business, commercial or mixed occupancy, specify nature and extent of each typle of use ..................... 7 Dimensio s of e isting structures if any Front Rear Depth Height ............... Number of Stories ............................ t ........................... dditi Dimensions of same structure with alterations or a ons: Front ........... . ...... Rear .................. Depth ...................... Height ...................... Number of ~tories ........... ~ .......... 8. Dimensions of entire new construction: Front .... .-).~ ....... Rear ...~ ;.; ...... Depth . ~.~. .......... Height .... l[q.' ..... ..._.,iNumber of Stories ........ ¢.~..O~'.. ....... ...... ~ ........................... 9. Size oflot: Front ................ ./.,]~. ' Rear ..... ~.~./~,&.l~ ....... t Depth .../.~'~.ff.q ........... 10. Date of Purchase .............................. Name of Former Owner .; ........................... 11. Zone or use district in which premises are situated ............. .;,~ ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation' .~ 9 ..... 13. Will lot be regraded ....... ~,~.~J~,q[ ................t~,~j}l excess fill be req:~ove4 frae,p/e/hight, Yes 14. Name of Owner of premises . (i~Wr~I.dS~t~ .'1.~.~. ,//~ress .~..~.t~ ~..~ .~. ~.4'1 .~.~.~c~e No. ~2,.l-r..~.i.?! ..... Name of Architect , .... ; ..... Address . ' Name of Contractor' i ~. ~.dlt ~ ~ .~.' ~* i~ ~..~'i .~.''. Addt~s~ i~ i~J~' .~. ~'~;1~''' ............. PhonePh°ne Ne.N° ................ .~. $~.-./.~.,~...-'.. 15. Is this property located w hin[100 feet of a tidal wetland? ~ Yes ..... No .~.... * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to.deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW Y~)R~t, S S ' ~ COUNTY OF .............. '~''~/ '~ t~' ';~ / ' l ............. j~. ,~.t~. '. ~.: .~. ~[ ,~. ~...~..~. ...... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above earned. ....~.: ~ 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 this application; that all statements contained in this application are true to the best of his iknowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............/-'.q~. ........ day of .............. , 19... Notary Public, ''"~'~''"~"'"/~Q'/~"~'"g~"Y~I~O[ C°unti~ 80. 4707878, Suffolk County,)', Term Expires ~rch 30,19~ , (Signature of applicant) NOTE: · = MONUMENT SUSDIVI$1ON Mt~P FI~O IN ~IE OF THE CLERK OFSUPFOLK COUN7~ ON APR~ ~ 19Y~ ~SPI~ NO, ~41 SUEFOL~ COUNTY T~X M~P OIS~ I000 ~ 0~5 BL~ ~ LOT THE LOCATION OF*WELLS AND CESSPOOLS SHOWN HEREOI~ ARE FROM F~ELD OBSERVATIONS AND OR FROM DATA OBTAINEO F~OM OTHERS APPLICANT:_ ADDRESS TEl SUFFOLK COUNTY SI~IGLE ONLY .$ THE SEWAGE DISPOSAL AND WATEr{ SUPPLY FACILITIES FOR THIS LOCATION HAVE BEEN INSPECTEO 6Y THIS DEPARTMEW(' AND FOUND TO BE SATISFACTORY, ,"" ~ief Of ,.'~tewa{~r Mana~ement~t_ Sectt~-~_~----_.._.JSectton ' '~ REVI$1ONE~ dAN. I~ ~1957 dUNE 25~1987 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YOR~( ALDEN W. YOUNG HOWARD W, YOUNG PROFESSIONAL ENGINEER AND LAND ~{JRVEYOR SURVEY FOR: LOT NO. ~. "OREGON VIEW ESTATES" CUTCHOGUE TOWN o~ SOUTHOL~ SUFFOLK CO., N.Y, SCAb. I: / "= 50 ' D~'r~. NOV. ~, 1986 1159 NOTE; m -' MONUIWENY SUBDIVISION MAP PILED IN ~ OPFI~ APRI~ ~ 19~8 ASPI~ NO. G~q/ H~AR~ST PUBliC WA~ M~IN = q MI~ WAT~ ~VIC~ = P~IVATE W~ SUFROLK COUNTY TAX MAP DIS~ lO00 SEC~ 095 8LK~ LOT 18.008 TWO THE LOCATION OF WELLS AN0 CESSPOOLS SHOWN HEREON ARE FROM F~ELD .,~JFFOLK COUNTY DEPARTMENT OF HEALTH SERVICEb FOR '~.PPR~¥AL OF CONSTRUCTION ONLY )VAL YOUNG & YOUNG 400 OSTRAND£R AVENUE,r RIVERHEAD, NEW YORK NOTE: ~ -' MONUMENT SUBDIVISION MAP FI~O IN ~ ~C~ OF YH~ C~RK OF SUPFO~K COUNTY ON APRIL ~ 19~ ~SPI~ NO. 6~41 ~AR~ST PUBUC WA~ M~IN a 4 MI~ ~ WATKR ~RVI6~ = PRIV4T~ SUFFOLK GOUNTY T~K MRP DIS~ I000 $ECK,09~ BL~ LOT 18.008 THE WATER SUPPLY AHD SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS 0¢ THE SUFFOLK COUNTY DEPARTMEN'~ OF HEALTH SERVICES APPLICANT: ...... ADDRESS. TEL UNAUTHORIZED ALTERATION OR AO~ITIOR TO THI:~ SURVEY I$ A VIOLATION OF SECTION 7209 OF THE ~EW YORK STATE EDUCATION LAW REVISIONS JAN. 12 ~ 1987 o~ 9 YOUNG & YOUNG 400 OSTRANDER AVENUE, RI.VERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W, YOUNG .SURVEY FOR: ~t~AIVK C. SOKOLSKI ~ BARBARA TNO 8. ' "OREGON VIEV/ ESTATES AT CUTCHOGUE TOW~ OF SOUTHOL~' SUFFOLK CO., N,Y. TEL ..... 5~IEFOLK FOR APPROVAL OF CONSTRUCTION DATE_. -- APPROVED COUNTY DEPARTMENT OF: HEALTH SERVICE~ % YOUNG & YOUNG 400 OSTRANDER AVEHUE, EIVERHEAD, NEW YORK ALDEN w. YOUNG ,SURVEY FOR: ' LOT NO 8. ~ ~ " OREGON VIEI41 ESTATE~ "~ CUTCHOGUE SOUl.HoLD SUFFOLK CO,, N,Y. ,S~ALE: ! U = 50 ~' DAT,E' NOV, 3, 1986 NO, 86 -1189 SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATEi OF OCCUPANCY ff (x)p~r tubing Is treed for water distributing ly~tem; ~lplng shall be of tybel K or L only CC~