HomeMy WebLinkAbout14441-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No... Z14746 Date... August 1. 86
............................................. 19...
THIS CERTIFIES that the building one-family dwelling
770 . Hi. ghl.a, nd .R.o. ad Cutchogue
Location of Property House No. Street Hamlet
County Tax Map No. I000 Section ..... .1.0.2....Block ...... 8 . .Lot . 3 4
Subdivision X ..... Filed Map No. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore fried in this office dated
November 1 19 8.~ursuant to which Building Permit No... 14zt41Z
dated ....... D..e.cember..,............,..2 19 ,.,85 , 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 .........
PrivaLe one-family dwelling.
The certificate is issued to ......... THOMAS & THERESA REI.L. LY
............ ....................
of the aforesaid building.
Suffolk County Department of Health Approval 85-S0-149
PENDING
UNDERWRITERS CERTIFICATE NO ..................................................
Rev. 1/81
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPL~"'ION OF THE WORK AUTHORIZED)
14441 Z
Permission is hereby granted to~) ~ ~ ~.~ .
.... zu.:..~:~,<.~.¢.J..~...~,....~.~.,...
.......r~. ......... ~¢ .........................................
.... ........
,o ........ ~o~.z,,z~.~...,~,~.~....~.,,~.~...r.~,.~.rz~..,.~......~.~...=
............ ~z'.~t~..~...~t:....~./. ~z~ ........ ZC.~z..4..4...9..~ ................. .z.. ........................
ot premises located at ..... Z.'Z.~....,.~.~.~.~}...~,~....~.. ........ ~..~. ........................ : ..........
..................................................................................................... .,.~.~~..~.....~. ....
c~n~ To, Mop No. lO00 ~c,,o..~./.~.~.. ....... ~,~ ..~ ......... ~, ~. ~ ..........
Building Inspector.
~.. ,.Z~/....?.
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
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.
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.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancv $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00
$15.00
New C on s t r'UC t i on.. ~. Old or Pre-existing Building ............ Vacant Land ............
Location of ProperW ..............
House No, Street Hamlet
Owner or Owners of Property .... '~'"'{~.~.~/''/--'~:"~1o~ .....
County Tax Map No. 1000 Section ....................... Lot ..... ,-~, ... .....
Subdivision ............. ~,~ ................. Filed Map No, .......... Lot No ..............
Permit No./..~y. ~//..~--.. Date of Permit ./~] .~].~.?..Applicant...~.: ~...~./..~.~.~.. .~,......,....... _J~/~3 ,/M/(-_
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval....~/~./~.~. .......... Planning Board Approval ......................
/ !
Request for Temporarv Certificate ..................... Final Certificate .... .~.. ................
......
nstruction on above described building and permit meets all applicable codes and regulations.
TOWN OF $OUTHOLD
OFFIC~ OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No. /~ ¢
Owner ~, /~ [ L~y
(please p~int)
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
Notary Public,
County
(plumber' s signatu~
]bio. 4839960
Qualifled in g~ffolk County
Commission Expires M~ch 30,
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom This May C~ncern,
We are unable~to complete your Certificate
of Occupancy because,of the following reasons.
cation for Certificate of Occupancy
n file. . .
~w~,ters Certificate on file. ~
/_~/~he check is (~l/not on ~ile. )
/~/ No Health Dept. Approval on file.
/5/ No fina]~ inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit # 3- ! ~ t L Z
umber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [/] INSU~.,ATION~
FRAMING [/*~]- FINAL
REMARKS:
FIELD INSFECT]~ON % DATE COMMENTS ......
FOUNDATION (2nd) ~~~-~ ~~
INSULATION PER N. Y. , ~
STATE ENERGY ~ ~' .
ADDITIONAL COMMENTS:
76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND.~INSULATION
FRAMING [ ] FINAL
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
/
DATE ,./~/~ INSPECTOR ~//~/~/'~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
~ FOUNDATION :)ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS:
DATE
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
June 24, 1986
TEL. 765-i
802
VGL:h~v
C.Co
DER Cont.
A. Reilly & Sons, Inc.
P.O. Box 434 ,
Mattituck, N.Y. 11952
SUBJECT: B.P. #1444tZ
Thomas Reilly
770 Highland Road, Cutcho
Dear Norm:
Our inspection of the above premises shows
that the slab has a large crack in it. In order
for a Certificate of Occupancy to be issued for
this house this will have to be corrected. We
cannot accept it as it is. Please contact the
mason regarding this matter.
trul¢
Victor hessard
Executive Admin.
Inc.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1803
DEFT
. .- OLD
Received ........... ,19...
Disapproved a/c~.~~ ......... 7'/ ........
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date ................/¢/. , 19~.~-'
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 this applica[ion 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 g 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 necessari, inspections?~/
.~..,...~r. ?.z. ..... .~,. ~...../..~..c.: ..........
(Signature of applicant, or name, if a corporation)
~?.. ~..4 .Y... ~.. ~m. ~f~.,.../.z ~. ~ .~..
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....................... ~.~/~.~.¢ .~.. ........................................................
Name of owner of premises ' .~.~..~..'~..~..~.~ .~'-~..~..~..~?.~. .... ~..~.~. ?-'..~'~' · ............................
(as on the. tax roll or la{est deed)
If applicant is a corporation, signature of duly authorized officer.
'~'~2; and tit~e officer) Builder's License No.. ~5 ....................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done. r. ~, --. .... t, .--.-------- ...... '. .................
..... 7.7.0. ................... 2/. /. ~/.~.~. .~ ~. . .--.~. ,o ............... .c. .~, .r-. .c. .~. . p .~. . ~.e. .,. . ./t/.~
House Number Street Hamlet
County Tax Map No. 1000 Section [ C> ~ Block ~ Lot .~...t~
Subdivision../fTt./..~t.~..Z..~.~'. ,/).... ~..~..~.~.~..e.~. :.,. Filed Map No. ~.~..~.././.O.. 7... Lot..3.
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
.,q.c. .,q. . .x4.'?. ...
a. Existing use and occupancy . ~ · ....---- .............................
b. Intended use and occupancy ....... ' ·. ................ i i'.''~ ......
~1 ~ ,3. NaShua.of. work (check which applicable):
'~'~ ....... Rem6val .............
4. Estimated Cost .......... ¢~). ./. ~. p.o..: .o. 9...
New Building .......... Addition .......... Alteration ..........
Demolition .............. Other Work ...............
....... ..................
(to be paid on filing this application)
5. If dwelling, number of dwelling ~nits .............. 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 wlth alterations or additions: Front ................. Rear ..................
Depth ................... ;.. Height ......... _~ .......... Number of Stories ......................
8. Dimensions of entire new construction: Front ......... ~.. . Rear .. ~¢~-. t~.. ........ Depth . .~---~. ..........
t?ight ............... Number of Stories ..... /(. ......... ; ........................................
9. Size of lot: Front .'...~..~.~.~, ~. l .'~. ...... Rear .... ~..~.~.. ~.~. ....... Depth . ?r..°..~.,.~..~-% .........
10. Date of Purchase .......... i .................. Name of Former Owner .............................
1 1. Zone or use district in which pr~mises are situated../~... ...............................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...41~..O., .......................
13. Will lot be regraded ...... .~, O.. ........... ~ ..... Will excess fill be removed from premises: Yes _ ~
14. Name of Owner of premises ~..~../.~..Z:.~... Address//.~...~:,~,~*s~,,qq~hone No. ~.7.~.~-. J~.~.F:'. ~
Name of Architect ......... ; .................. Address ................... Phone No.
Name Contractor ./}.: ¢i ¢ .'V.Z/ ddress -/7, hone
pLOT DIAGRAM
Locate dearly and distinctly al! 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.
STATE OF NEW YORK, S.S
COUNTY OF .................
(Name of individual signing contract)
above named.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is doly authorized to perform or have performed the said work and to make and file this
application; that all statements cogtained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manaer set forth in the application filed therewith.
Sworn to before me this
~ T/',~ie NO. 8308- 05466
MAP FILED IIV TH£ OFPICH OY THE C~EIPK
COUNTY ON APf~ 26~ 1977 AS PILE NO. 6557.
SINGLE FAMILY DWELLING ONI. Y
UNTY DEPARTMENT OF HEALTH SERVICES
,~PROVAL OF CONSTRUCTION ONLY
EUT- DATA Fd'R APP.O~L ~o construct
SURVEY FOR
THOMAS D. REILLY ~ THEPES.4 J. REI£LY
LOT 37 "HIGHLAND ESTATES"
~ ~ CUTCHOGUE
TOWN OF SOUTHOID
SUFFOLK COUNTY, NEW YORK
DATE
SCALE' /'~ dO'
NO. :
AND ON MIS .EHALF TO THE TITLE CO~IPANY, GOVERN-
~.[~.~.~ .~.~E_N_CY_~.~D [~ENDING INSTI'I~VrION LISTED
GUARAfl~
~ TH/e
SU~DIVISIO~ MAP FI~ED IN ~HE OFFICE OF ~HE C~ERK
OF SUFFOLK COUNTY ON APR 26~1977 AS FILE N0.653~ ,
SURVEY FOR
' LOT ~7 "fllGHLA~D ESTATES" ~u~r ~,~
~, ~ AT CUTCHOGUE DATE : DEC 6,19~
' SUFFOLK COUNTY, NEW York NO
~UNAUTHOR~ZED ALTERATION OR ADDITION TO TH~S ~N~ TOt
SURVEY IS A VIOLATION OF SECTION 7209 OFTHE
NEW YORK STATE EDUCATION LAW CHICAGO
SURVEYOR'S ~NKED SEAL OR EMBOSSED SEAL SHALL
NOT 8E CONSIOERED TO BE A VALID TR~E COPY
~GUARANT[ES INDICATED HEREON SHALL RUN ONLYTO
~ ~H[ P[~SO~ FO~ w~o~ ~H[ SU~V[~ *S
H~LTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT A~ O~ H~S a[HA~ ~0 ~H[ ~L[ CO~Y,~V[~-
.NEARESTWATERMAIN__M,.! .SOURS~OFWATER'PR/V. TE PUBLIC ME.TAL .GENCYAND LENDIN. INSTITUT,O~ L,STED
~SUFF. CO. TAX MAP DIgT. SECTION BLOCK LOT-- -- HEREON.AND TO THE ASSIGNEES OF THE LENDING
~ THERE ARE NO DWELLiNG,'WiTHiN lO0 FEET OF THi~ PROPERTY~ *INSTITUTION GUARANTEES ARE NOT TRANSFERABLEDiSTANCES SHOWN HEREON FROM PROPERTY LINES
OTHER THAN THOSE ~HOWN HEREON. TO ADOITIONAL INSTITUTIONS OR SUBSEQUENT
~THE WATER ~UPPLY AND SEWAGE DISPO3AL SYSTEM FORTHIS RESIDENCE OWNERS
OF HEALTH SERVICES. PURPOSE AND ARE NOT TO 6E USED TO ESTABLISH
YOUNG YOUNG
-- ~ ~ ALDEN W. YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.~S. LICENSE NO ~2845
~ HOWARD W. yOUNG, LAND SURVEYOR
~THELOCAT[ON~WELL(W),~ICTANK(ST}aC~SP~LS(CP)SHOWNHEREON N.Y.S. LICENSE NO 45093
NO~'E
· ~ ~ONUM~NT
SUEfllVl$10N M~P FILED IN ?HK OFFIC~ OF ?HE GLEHK
OF SUFFOLK OOUNTYON APH 26~197Y AS Pl~E N0.653~
SINGLE FAMILY DWELLING ONly
T/tie AIo, 8508-05466
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
FO]/PPROVAL OF CONSTRUCTIONONLY
.s NO. 0
HEALTH DEPARTMENT-DATA FO"'R APPROVAL ~0 CONSTRUCT
~ NEANEST WATER MAIN__MI?- ii'BOURSE OF WATER~ PRIVATE__PUBLIC
· )(' $ LIFT. C O. TAX kiAJa DIET. SECTION BLOCK LOT
j'X'THERE ARE NO DWELLINGS WITHIN lO0 FEET OF THIS PROPERTY
OTHER THAN THOSE sHOWN HEREON,
/??~'tC~/ 1~7 II~';~ TE~.,
SURVEY FOR
THOMAS D. RE'ILLK ~ THERESA J. HE/LAY
LOT $? "HIGHLAND ESTATES" Ju~ z9,/9~5
AT CUTCHOGUE DAT~ : DEC. 6,198,~
TOWN OF SOUTHOLD SC~L[= /"--40'
SUFFOLK COUNTY, NEW YORK ~o. : ~'.~'-//0.9
~UNAUTHORIZED ALTERATION OR ADDITION TO THIS I ~UA.~/V~'~"~
CO.
~ COPIES OF THiS SURVEY NOT BEARING THE LAND I THOM/J$ D/8~S~N~IY
m )V~l I~1~ ~ V~HM~ 400 OSTRANDER AVENUE
m /UUIM ~ /UUI ~ RIVERHEAD, NEW YORKrm
, m J HOWARD W. YOUNG, LAND SURVEYOR
, ) m) N.~S. LICENSE NO. 45893
" /
SUBDIVISION MAP FliED IN ~HE O~ICE OP THE C~ERK
OF SUFFOLK OOUNTY ON AP~ 26~ 1977 AS PI~E N~ 6~3~ ~ , ~ ~ ~ ~ --
TOWN OF SOUTHOL~ SCALE: 40'
SUFFOLK COUNTY, NEW YORK NO. : ~-//~
~UNAUTHORIZED ALTERATION OR ADDfTION TO TH~S
SURVEY tS A VIOLATION OF SECTION 7209 OFTHE
NEW YORK STATE EDUCATION LAW
~ COPIES OF THIS SURVEY NOT BEARING THE LAND
SURVEYOR'S ~NKED SEAL OR EMBOSSEO SEAL SHALL
NOT BE CONSIDERED TO BEA VALID TRUE COPY
~ ~GUARANTEES INOICATEO HEREON SHALL RUN ONLYTO
~ THE PERSON FOR WHOM THE SURVEY ~S PREPARED,
H~LTH DEPARTME T-DATA FOR APPROVAL TO CONSTRUCT A~o ON HIS ~EHALF TO THE T~TLE COMPANY, GOVERN-
~SUFF. CO. TAXMAP DIST. SECTION BLOCK LOT~ HEREON,AND TO THE ASSIGNEES OF THE LENDING
~THERE ARE NO DWElLInGS'WITHIN I00 FEET ~F~ PROPERYY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
RIVERHEAD, NEW YORK
ALDEN ~ YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N~,~ICENSE NO 12845
HOWARD W. YOUNG, LA~D SURVEYOR
'~E L~ATION ~WELL(W),gE~IC T~K(ST)~C~SP~LS(CP)SHO~ HE~EON ~.~S. LICENSE NO.
'9
- '-,l- - 4 i"~-~~- ~ul'~ ~/u'ccaw ~t ~,uf.4~¥ ye
AF~OV~'D AS NO~'ED ' '
NOTIFY ~UILDfNG DEPARTM~A~
1 FOUNmAm ON - TWO RE~U(~ED
BE C~MPLETE FO~
ALL CONSTRUCTION SH~LL
f
II t
PLUMBER CERT[FICATI'ON
ON LEAD CONTENT BEFORE
C.E. RTIFICATE OF OCCUPANCY
SOLDE2 US.~D IN WATEI~
SUPPLY SYSTEM CANNOT
EXCEED 2/10 of 1% LEAD.
{or water distributing
~y~.em; piping shall be
o~ types K or L_on~_y