HomeMy WebLinkAbout14688-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z-15261 Date February 9, 1987
Tl4TR(~PTT~T~q~h~++h~h.;1A;~ One Family dwelling with attached roofed
breezeway, garage & frame buz2d~ng
...... 275 Private Road # 9 (Anderson Rd ) Southold, N Y
Location olYroper[y ....... · · ·
House NO. ' ..... 'S't/e~i ........... Ifljr~/el
County Tax Map No. 1000 Section 50 ...Block I .Lot 18.7
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
March 20, 1986 14688 Z
..................... , .~. pursuant to which Building Permit No ......................
dated March 2 I 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 .........
ONE FAMILY DWELLING WITH ATTACHED ROOFED BREEZEWAY, GARAGE & FRAME BUILDING
The certificate is issued to DONALD L. CURRIE & DANIEL GLADSTONE
..................... 'liY.4 k k' X .................
of the aforesaid building.
Suffolk County Department of Health Approval 86 - S O- I 2
UNDERWRITERS CERTIFICATE NO... N 787232
PLUMBERS CERTIFICATION DATED:
January 29, 1987
Rev. 1/81
FOEM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
14688 Z
Permission is herebt granted to:
- ...........
.~.2.~....~.~.t......~...4...~.: .........................
· .~.;~...~.:.....~....~.~.....~..~.~..~. _
ot premises I~ted ~t ~.~...~;....9. .... ~ ....... ~ ........
County Tax Map No. 1000 Section ....... ,0...'~... ....... Block ...... .(~...[ ......... Lot No ..... l..~..:...~ ..........
pursuant to application dated .....~.~..~...~ ..................... , 19.~..(R.., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
WiCKHAM, WICKHAM ~ BRESSLER, p.c.
MAIN ROAD. P.O, BOX 14~4
MATTITUCK LONG ISLAND
NEW YORK 11952
51~-298-8353
February i9, 1987
TOWN OF SOUTHO[D
Angelo Accardo, Building Inspector
Town of Southold
Main Road
Southold, NY 11971
Re: Certificate of Occupancy #Z-15261
Donald L. Currie and Daniel Gladstone
Dear Mr. Accardo:
In accordance with our conversation, we are enclosing original certificate
of occupancy #Z-1526I and would appreciate your issuing the certificate
of occupancy to specify that it includes th~ attached roofed breezeway,
garage, and frame building as shown on the survey. We enclose a copy of
the final survey for your convenience.
I am sorry to trouble you with this clarification, but we are finding that
an increasing number of mortgage lenders require a specific listing of the
structures exactly as they are shown on the survey, even though they are
attached to the main residence.
For your convenience in forwarding the revised certificate to us, we also
enclose herewith a self-addressed, stamped envelope. Thank you for your
prompt reply.
AAW:jnm
Eric.
Very truly yours,
( '
Abigail A. Wickham
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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.
Bo
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 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:
1. Certificate of occupancy New Dwelling $25.Q0, 'Accessory ;$10.00 Business $50.00
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 ..........................
NewC OhS truction ...... OJd or Pre-existing Building ............ Vacant Land .............
Owner or Owners of Property ~..~.~.~...~...~..~...
CountyTax Map No. 1000 Section ..... ~..P ....... Block ....J ........... Lot .... /~*.: .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ......... Date of Permit .......... Applicant ..........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $...~..~..,~.[.~..~. ..............
Construction on above described building and permit meets all applicable codes and regulations.
.
Rev. 10-10-78
FIELD INSPECTION COMMENTS
FouNDATION ( 1st}
FOUNDATION
ROUGH FRAME &
FLUMBING
INSULATION FER N. Y.
STATE ENERGY
CODE
,q-f.; ~r,o
FINAL
DDITIONAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS
100]~07] BUREAU OF ELECTRICITY
~1 85 JOHN STREET. NEW YORK. NEW YORK 10038
THI~ CERTIFIES THAT
D~nald Cuttle, Hyatt Rd.
the followlng Iocat~on; ~ Basement ~ Ist ~7. ~ 2nd ~. S~ction Bilk Lot
examined on December 2 2 ~ ]. 9 ~ ~ attdfound to be in compl ance u' th the req~tiret~tents qf this Board.
DRYERS ~ mRN~TORS ~ FUTURE APPLIANCE FEEDERS
RANGES
ECIAL REC'PT
COOKING DECKS ~OVENS- DISH WASHERS
K W. A~T K W ~T K W
TIME CLOCKS BELL UNIT HEATERS MULTI~OEt~i[LRT
SERVICE DISCONNECT [ NO. OF I S
I C E
EXHAUST FANS
DIMMERS
NO OF HI-LEG
OF HI-LEG OF NEUTRAL
3moke Detector-?
E].ec. Water
G & S Electric !ic,~678,-E~~/~
Bo~ 215 GENERAL MANAGER
Southol~ N,Y., 11971
cer~k~. ~ust not be oJtered in a,y man.er; returo ,o the off,ce of the ,oard ,f iocorrec,. Iospectors may b~d b~e,t,~s.
COPY FOR 5U}LDtHG DEPAET~EHT. THiS CO~ OF CERTIFICATE MUST HOT BE/ALTERED iH ANY ~HHER.
TOWBI OF SOUTHOLD
OFFICE OF BUILDING IN,SPECTeR
P.O. BOX 728
TOWN HALL '
SOUTHOLD, N.Y. ! 1971
~C E R T I F I C A:T'T O N
TEL.'765-1802
Building Permit, NO.
:Owner ' '
(plea e prink):: ,
Plu~er ~ ~ ~ {
I certify tha~ :the, so[der, usaa in the water supply system
contains less than 2~10 of "l% :,leadl
,-':" .: : '(plumber's signature)
Sworn to before ,
~ ~-/ day of
'
7GS-J,8Q2
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS ._~Z~_~ '~/~/~ __
AT , ~ ,INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [/] FINAL
REMARKS: ~/
765-1802
BUILDING DEPT.
INSPECTION
~// []
/~OUNDATION ~,ST ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] I~INAL
REMARKS.-~
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] I~OUGH PLBG,
[ ] FOUNDATION 2ND [ ]INSULATION
[ ] FRAMING [ ] FINAL
REMARKS, ~-~/~/~~//~-~
DATE
INSPECTOR
765-X802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
~SPECTOR ~
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
8OUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
a. Tiffs 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 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 shatl 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 auth°rized inspect°rs °n premises and in building f°r necesi~ .w.i~~ ~.~ ............
(Signature of applicant, or name, if a corporation)
t.oe .....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ...~..O~....J~J~.....~.'..~. ~.~.~./.~. ....'~... I~.A~.. I..g~....~..6.~.IQ~. ...................
(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 ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location o~land on which proposed work will be done ..... ~.. T. 0.~).t.~.. ?.~...~T'.I. .~...g~.~ ..~.g .......
s o.. o..vi
ttouse Num bet Street Hamlet
County Tax Map No. 1000 Section ... ~.O.~ .O.O. ........ Block .... [,.O..O. ........ Lot...O. ! .~.*..O.O. I .......
Subdivision ..................................... 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 . .~J~/. ~{~" ..........................................................
b. Intended use and occupancy . .~.~..Ult..~..P~.[ .~...[~.. , .~..I..1~.. ....................................
3. Nature of work (check which applicable): New Building . .~)~.' ..... Addition ..: ........ Alteration
Repair . ............. Removal ........ : ..... Demolition ........... ... Other Work ....... i ........
(Description)
4 Estimated Cost * [[0~ 0.O.¢. :
.............................. Fee .......... ; ............................
~ (to be paid on filing this application)
5. If dwelling, number of dwelling units .... I ........... 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 ............... Rear ....... : ....... Depth ...............
Height ............... Number of Stories ...........................
Dimensions of same structure with alterations or additions: Front .................. Rear ..................
" Depth ...................... Height ...... Number of :Stories .....
8. Dimensions of nfire new construction' Front .~O''~O~ Re O'-2~" ...... ~o'o'-~d ......
,~, Cn , ............... ar ...'} .... ~ ....... Depth ...............
Height .. ~"t :'7.O. ..... ¢ Number of Stories .... .~. ...... , ........ ........................
9. Size oflot Front .. ].~.O~.O~.I ......... Rear I~,~-0" h~,,,h .~ ~oit
10. Date of Purchase I ~.rl~.l., o Name of Former Owna~ ROSilY' ~ [Oiot~O-~qOD~O
1 I. Zone or use dist~ctin which premises are situated .............. ...........i ....... ............ : .... ;.
12. Does proposed construction violate any zoning law, ordinance or regulation: ...[4P. ..........................
13. Will lot be regraded ... Nfl. ...................... Will excess fill be removed from premises: Yes
14. Name of Owner of premises DO~JI~..1< .~.~tt}&~ .... Address 6~')~..~(~..~q.~../~.0b/¥.c,. Phone No .%.1.~. ~.6,,1:. ~.O.~1~
Name of Architect .P~....b.. ~...t,U.~..~.1.~ .... Address/t?q .q~..~.' i~.~ 'Phone Nol ."/4.~. $.0,.~..pq~.6...
Name of Contractor .......................... Address ............ i Phone No ................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
~TATE OF NEW YORK, S S ' ,'
'
.... ~...~..f~......~.,.I..~.~..~.!~. ..................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
p.
He is the ..............................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge art~t belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
......... , . .......
/' ' NO. S1,2403425 .................
Quallf ed in New YorR Cou,lt'~' ~
Co. mission ~:xplres March ~ 1~9 ~-/ (Signature of app
:.2
STATEMENT OF
THE WATER suPPLY AND SEWAGt
SYSTEMS FOR THIS' RESIDE~
EO~FORM TO THE S]~ANDARD:
SUFFOLK Cgtq DEpt.
% ~-~s~'PL'~^~T ~ fi /',~'~
SUFFOLK COUNTY DEPT.
CO~ST~UC~ ~ON ONLY
DATE: ~
APPROVED:
JSIN~-LE FA~Ly DW~L.~d.~
~UFFOLK CO. TAX: MAP DESIG~I
DIST. SECT. BLOCK
DDrESS-
DEED.
TEST HOLE
A;2 L'A- S ,'T ~_?4 'Z F
DONALD L CLJ~:2[~! ~
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SUFFOLK COUNTY DEPT OF HEALTH
S[R¥ICE$ -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE
APPROVED:
AVE.
STAMP
_ Dc~T ~F' ~ Y
*~ : hEALTH
RIVER4~/ L ~,¥. 1] 901
7,
SUFFOLK COUNTY HEALTH DEPARTMENT
SINGLE FAMILY DWELLING ONLY
DATE, JAN ~.
THE SEWAGE DISt"')$AL AND WATER SUPPLY FACILITIES FOR THIS
LOCAT,ON HAVE "EEr'
FOUN TO
Chip of Wastewater Management Section
RODERICK VAN ~UYL, P.C.
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
SUFFOLK CO HEALTH DEPT APPROVAL
H S NO 8~ ~/ 12
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
coNFoRM TO THE STANDARDS Of THE
SUFFOLK CO DEPT OF HEALTH SERVICES.
(Si
APPLICANT
SUFFOLK COUNTY OEPT OF HEALTH
SERVICES FOR APPROVAL OF
CONSTRUCTION ONLY
DATE
H. S. REF. NO ~,"~0-I~
APPROVED:
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT BLOCK PCL.
OWNERS ADDRESS:
DEED:
TEST HOLE
7;;',N L 'r
P. ii.~ ( ',~t: ~ /
STAMP
50'
I I SUFFOLK CO. HEALTH DEPT. APPROVAL
..... '~---. / t T.E WATE. su~.LV A.O S~WA~ o,..O~AL
~,' '"'""-' I I c~M ~ THE STA~RDS ~ THE
APPLICANT
SUFFOLK CouNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY
DATE: ~
H. S. RF.F. NO.:
AP~ROVEI
~1NQ~..E FAMI
~JFFO4.K CO. TAX MAP
DI~T. SI~CT. llLOCK I~CI..
~OO 50 -] r~, I
~NT~UF~$ ~-m~0
~ ICl( YAN~YL, P.C.
~REENPORT N~W YORK
;I~AL
SUFFOLK COUNTY HEALTH DEPARTMENT
SINGLE FAMILY DWELLING ONLY
HD~ REF~ NO,_
DATE _
THE SEWAGE DISPOSAL AND b/ATER SUPPLY ~
~-OUN~ TO 8~ T~ · ·
na~eme~'t S~c~on
¢ ~'0
PLAIN ~ I
USE IS UNLAWRJL
WITHOUT CERTIFICATE
OF OCCUPANCY
APPROVED A81 NOTED
noti~-~ulumn~ DEPaR~EnT at
765-1~2 9 AM TO 4 PM ~b ~E
FOLLOWING iNS~CTIONS:
1 FOUNDATION ~0 REQUIRED
FOR POURED CON~ETE
2 ROUGH FRAMING & PLUMBING
3, INSULATION
4, FINAL CONSTRUCTION M~T
r, B; COMPLETE ~RrC.O. -
A~ CONSTRUCTION SHA~ ME~
TH; REQUIREMENTS OF THE N.Y
STATE CONST~CTION & ENER~
~ODEs, NOT RE~NSIBLE ~R
~"'ESIGN OR CONSTRUCT ON ERROR~,
+--- ~ I II.UMBER ClRTIRCATION
-~ ~' '¢~ j ON LEAD CONTENT ~EFORE
~ _., I CERTIFICATE OF OCCUPANCY
FOUNDATION ~PL AN
WALL' SECTION
$OI.D~I USED IN WATER
SUPPLYSY$TEMCANNO~ GS, LOCATION
EXCEED 2/~0 of I~ LEAD I"=
SITE
_.~,-~ CO TAGE AT HORION'S POINT
~~ ', DONALD LOUIS CURRIE AIA 1
NORTH ELEVATION
!'
6,
SOUTH:
IELEV,~ON
po
WEST ELEVATION
EAST
ELEVATION
ii
;I
II
SECTION
SECTION I
SECTION
SECTION
1 I
SECTION'S' ~1 ' I
COT IAGE' AT HORTON'S POINT
DONALD LOUIS CURRIE AIA 2
~,7~;~ '~/¢0'1'~C~ AV~iqLi{'. ~q~vJ l'~t:-F~ ,l'q¥ i~;~,,~2~ ),1'~ 5(,,~ ~t:./..~,,
FtNISH SCHEDULE,
II
II
II
II
#
ii
IL
II
II
d
Ii
It
'SPECIFICATIONS'
1, general Cor~itio~s~Pt~ amd ~pec~fic~tions a~e cooperative, All labor and mate~l to
earcy out fully the ~ntent~ems of the plans a~l spee~fi~t~ms'~re part of the eont~aot,
MAIN HOUSE'
WALL: SECTION/:
WALL SE,OTION / SCREEN PORCH',/' SHED:
' :.. i , i} %: ~ fi ~ ~'~," ~( INII~ ]. Distribution: Circuit b~ ~ ~ D ~ ap~ ,~ml, ~II ~i~. ~ ~
~ .I-. : ~:~:~' -. ~ e- ff '~~
l'~j[:.;i DONALD LOUIS CURRiEl AiA ~
irI '
"WALL;'~CTI'ON~ / GARAGE' :! BEDROOM
r
FH ELEVATION"
,E IpLAN' '4%11-~,''
EAST` ELEVATION
14% I~'~'~
EAST ELEVATION