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Home My WebLink About14927-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z15861 Date June 18, 1987 THIS CERTIFIES that the building F o o 1 Location of Property . 12370 OREGON ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 083 .Block 03 . .Lot 7 . 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated M a y I 5, 1986 pursuant to which Building Permit No. 1/4927 Z dated June 3, 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 ......... Inground pool and fence as applied for. The certificate is issued to THOMAS J. & KAREN M. UHLINGER. (owner, ~Y~ ~ ff~Y~ X of the aforesaid building. Suffolk County Department of Health Approval N / a UNDERWRITERS CERTIFICATE NO .... N 76154 1 PLUMBERS CERTIFICATION BATEB: N/k Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWt~ HALL SOUTHOLD, N. Y. 6UILDIHG PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14927 Z Permission is hereb/granted to: ....~....o..~c.... L.~..~.~.~.. ....................................... ..... ~~.,~....~.:.~.,.....L~.~.~.~... -~ ,o at premises located at ../....~.....~...'~.....~. .................... ~.~ (~: .................... ~C,~~ ........ County Tax Map No. lO00 Section .... ..C~.....~.....~.. ...... Block ....... ;.~...~.~ ..... Lot No, .....~..*..J. ............ pursuant to application dated ..... ~~..J..~, .................. , 10.~....~., and approved by the Building Inspector. 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 OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 -- BUSINESS $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 $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C OhS truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. 12.37o Location of Property ................................................................... House No. Street Hamlet Owner or Owners of Property .~14 ~ ~¢r ~ County Tax Map No. 1000 Section Subdivision ................................. Filed Map No ........... Lot No .............. Perm,t =ate of Permit ...... ~..Applicant .... ,¢?..~,,, ??. :,L),, ,~, (7: ?, .~, .6..r~,,, Health Dept. Approval ........................ Labor Dept. Approval .................... Underwriters Approval .. ~. .- ................ Planning Board Approval ...................... R f T yC tiff Fi lC rtific ' equest or emporar er cate ..................... na e ate ....................... Fee Submitted $ ~. ':-~' Construction on above described building and permit meets all applicable codes and regulations. Apphcant~ ........................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~[~250~3 BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 Jury 3o. 986 N 761541 THIS CERTIFIES THAT o~ly the electr~eaJ equipment ~ ~scrlbed below and int~duc~ by the ap~icant ~med on the a~ve appHcatlon number in the prem~es of Uhl~er, s/s Or~on Argue, e/o ~x Lane, Cutch~ue,~y in the follo~'ing toca~io.; ~ flase,nent ~ let FI, ~ 2nd fT. OUtSide .%etlon Bilk Lo~ ~s exam~ued on ~ A~ 24 t 1986 and found to be in eo.~pllarlce with the requirements 9f this Board. FIXTURE OUTLETS SWITCHES I 2 DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 1 SYSTEMS NO. OF FEET E ITHER APPARATUS: - -:L-G.F .C. I. E R V I C NO, OF CC, COND, A, W. O, NO. OF HI-LEG A W, G NO OF NEUTRALS A.W.O. PER ~' OF CC, CONO OF HI.LEG OF NEUTRAL ~Swi~ing Pool) This certificate cSvere compliance at the date of inspection only o BeCause of unusual ~%vironmente it is advisable to have frequent test .and/or repairs made by a qualified person. Henr~ Bohn 121 Sheep P~stu~e Road ~tauket,N.¥. 11733 Lic$2675EP~ [his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOuR B~ILDING DEPARTMENT. THIS COPY, OF CERTIFICATE;: , ~US~ i ~ N~T BE ALTERED,..~_ IN. ANY MANHER. 765-'~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I/NSULATION / FRAMING [~4 FINAL REMARKS: DATE ~//~a/0vT INSPECTOR -~ ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: FIELD INS~ECTION FOUNDATION (1st) COMMENTS FOUNDATION 2nd) R~UGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: Examined . .~.~,~ . . Approved . .~:~h . ~... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., ., 19~...~. Permit No. ~ .9.cJ..~'.?..~. Disapproved a/c ..................................... BLDG. DEPT. TOWN OF SOUTHOLD Received ........... , 1 9 (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, relationshiv to~!oining premises or public streets and giving a detailed description of layout of property must b~~gram which is part of this or areas, appli- cation. .__ ,,_ c. The work covered by this application~ ,ot.l~l~rnnl~[F~ d. Upon approval of this applicatim ~h~ ~d~4~'~v~rl~t~s~d~a~lB"flt~h~ l~g~rlit"t*o"the applicant. Such permit shall be kept on the premises available i ~p~ ~l~kr~-the work. e. No building shall be occut i,~ ~e~ ~_[l~'%p'~art for any purpose whatever until a Certificate of Occupancy shall have been granted by the B~t~ ~it~ ~ APPLICATION IS HE_P~ [A~ ~ *'~n_i~artment for the issuance of a Building Permit pursuant to the Building Zone Ordinance ~l~iI}-_~ *.wi~ ~d~ [I,~1~[ County, New York, and other applicable Laws, Ordinances or Regulations, for the consti~t~ [~io [~ ~ or alterations, or for removal or demolition, as herein described. The applicant agrees to comll~7~ ~tll~ ~li [l~t~vs, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on ~r¢ ~ ~[~ ~l~ing for necessary inspections. ~" J,--~~P/ 9/] ' (Signature of applicant, or name, if a corporation) ... ..................... .... (ma~ing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... (~. ~/A'. ~'~,-e. .................................................. , ........................ /. · ~ .......... : ' ~ ~ A~NOT~D (as on the tax roll or latest deed)' If applicant is a corporation, signature of duly authorized officer. D ~,r .............................................. (Name and title of corporate officer) NOT~F~ 765-1802 ¢ ~ rO ~t PM ¢0[1 'THE .uilder's License ..... .... Plmnber's License No ......................... 2 ~'tOU{iI~ O[tA?~tNG & pt. GMBING Electrician's License No ....................... BE CO~LECE ~-OFt C.O~ Other Trade's License No ...................... ALL CONS ;I[jCTtON Sf-~ALL MEET 1 Location onand on which proposed work wiil be done .................... · /"-% . .../d,,,~'" ~ ./c,'"" .................... k,/a. ~.9. · ·..~. ) ? .............. t~'~t'~.~o~. ~.W .................. House Number ~reet County Tax Map No. 1000 Section ....... .~..~. ....... Block .... .~ ............ Lot....7:/'. ........... Subdivision ........... .:.7:.'. ...................... Filed Map No ....... ~ ..... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... / ~"'~ ; ~/Z~,~ }/.,~,..zS:-.....~. ......................................... b. Intended use and occupancy .... .'%.. 7.. 3. ~ Nature of work (check which applicable): New Building .......... Addition 'i ......... Alterat~9~ ~ ....... Repair .............. Removai ............... Demolition .......... i. . Other Work .~a~,~-~ ...... ~ ~(". (to b~ paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling ufiits 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 ............... Rear ...... i ........ Depth ............... Height ............... Number of Stories ........................... ! ............................. Dimensions of same structure with alterations or additions: Front ........... ! ...... Rear ........ i ......... Depth ...................... Height ....... ~ .............. Number ~f Stories ........... i ......... 8. Dimensions of entire new construction: Front . .,~.L.. ~l,?t.0.~,.. Rear ....... ! ........ Depth'. ~.: .~.ft .~~. [.. Height .. Number of Stories ........ I . 1 1. Zone or use district in which premises are situated ' ,c - ~ ~ ~ ~._l ' 12. Does proposed constrgction violate any zoning~aw ordinance'O'~r~e~ul~t'~,n. 1,4/~ ' . ' Nmne of Architect ......... ~... Address ............ , .....Phone Name of Contractor .......................... Address .............. ~ .....Phone No .... ...,,~ ........ 15. Is this property located withinti00 feet of a tidal wetland~ ~ Yes ... No .f~.. * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether e~isting or proposed, and~ihdicate all 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. . ~ ~.~ ~ __~. !DIATELY'o application; thaI all statements contained in this application are true to the best of his knowledge work will be performed in the manner set forth in the application filed therewith. Sworn to befor~me this ........ dayof. .... ......... Notary Public, .[...~_~...~.,...~..~..~.:/7 .... Count~ (Signature of applicant) STATE OF NE~ YORK, S.S COUNTYjOF. 4 ............ -~,',~ - / .... · X~Z~..~.... C~. ..... ~'..~.~. f/~../~. ~ ......... being duly sworn, deposes and says that he is the applicant (N~me of individual signing contract) above named. ! I (Contracto}~'~;~t',~rporate officer, etc.i) . of said owner 6r owners, and is duly authorized to pe~ave performed the ~aid work and to make and file this and belief; and that the