HomeMy WebLinkAbout14089-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z1446~/ Date June 2 ., 19.8.6.
THIS CERTIFIES that the building ..... qn. ? ?.f.a.m..i.l.y. dwelling.
Location of Property 470 Haywaters Dr. Cutchogue
County Tax Map No. 1000 Section ..... .~ .0.6 .... Block ...... .5 ........ Lot 21
Subdivision ............. .X ................. Filed Map No. X .Lot No. X
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... .d.u.n.e.. 3.2. ........, 19.8.5. pursuant to which Building Permit No ..... ? 4089Z
dated ..... .~.u.n.e...1.2. .............. 19 .8.5., 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 .........
·..O. rte..-.f.a.m. 5,..ly. dwelling.
The certificate is issued to JOHN R. DEMPSEY
..................... ?o¥ 'ei'f ......................
of the aforesaid building.
Suffolk County Department of Health Approval ................. .8.5.-.S. 0. 7.~.? ................
UNDERWRITERS CERTIFICATE NO. N 74 ? 589
Building Inspector
Rev. 1/81
FO~'r,'4' NO. ~
?OWN OF $OUTHOI.D
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 14089 Z
Permission is hereby granted to: < ....
-~..~......~...~ ~ ~-
...... .~c~..~....~. .....................................................
~. · 1~ ~'~
'
.............................................. .~ ....................................... ~..~.: ...... ~ ............. ~ ...............
~, ~r,m,,,~a,,~ ~,..~. ........ ~.~.~ ................................ ~ ...........................
County Tax Map No. 1000 Section ..... .~..?....~. ........ Block ....... ..~ ........... Lot No .........................
pursuant to application dated ....... .~....'~... ..................... , 19.~..~.., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
,~outhold, N,Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accura;~e 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 peoperty 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 $5.00
2. Certificate of occupancy on pre-existing dwelling[ land use --?ve-:~×isf. ing C. 0. ~ 15.00
3. Copy of certificate of occupancy $1.00 Vacant. :~and C.O. $ 5.00
~ Date.. ~r~. ) .t~ .'~/. · .?0..-72 · / .~..~ ....
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
k/ '7 ................ < ...............
Location of Property..L-J.~.L~...
House No. Street Ham/et
Owner or Owners of Property ,-~.0.' .~1~ .~ .... ~ '.., .~ ~./?~¢~,~ [. ~. ............................
County Tax Map NO. 1000 Section .. I.q .q. ...... --:.Block .... ........ Lot.. ·
Subdivision ................................. Filed Map No ........... Lot No.
Permit No. ~..~O~... Date ofPermit 7./.'.1.~?...Applicant ..-~...~. .....~:~Fd~.~ ?-.y ......
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ...... ~ ............
FeeSubmitted$..~.....~.(~ .~....~. ....
~o,nt~uction on above described building and permit meets all applicable codes and regulations.
~. .A~ .... ~ Appica t..~.~.~ .... ¢ ...... ~"~'~1 ..................
Rev. 10-10.78 ~
THE NEW YORK BOARD OF FIRE UNDERWRITERS
10001111
BUREAU OF ELECTRICITY
. uly e5 STREET..EW
THIS CERTIFIES THAT
John De~psey, V~u~ston Eoad, W~eweta & ~laywaters, Nassau Poi~ Cutchogue~¥
July 28, 19~6
PIXTURE
OUTLETS ~ECEPTACLES SWITCHES
27 44 28
DRYERS
FIXTURES RANGES OVENS
27
SYSTEMS
NO. OF FEET
Lot
EXHAUST FANS
OTHER APPARATUS:
~o~ore ~ 1-1h~
2 -$~oke DeteC~or
Track LightiRg 16'-0"~ 8 lites
E R V I C
NO OF CC COND A W G, NO OF HI.LEG A W G HO OF NEUTRALS A, W, O
1 ~/o ~ 2/o
27~ TOWn [-Zarbor Lane
$outhold,N.Y 11971 Lic~282E /G~N~RAL MANAGER
This certificate must notbe altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COpY FOR BuiLDING DEPARTMENT, TNIS COPY OF CERTIFICATE MUST HOT BE ~LTERED INANY MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
83 JOHN STREET, HEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application ~tumber in the premises of
in the follo~ving location; [] Basement [] 1st FI, [] 2nd Fl. Section Block Lot
was examined on ~'~'~ ~ ~ '~ and found to be in compliance with the requirements of this Board.
FIXTURE
OUTLETS
EECEPTACLES SWITCHES
DRYERS FURNACE
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
INCANDESCENT FLUORESCENT
OTHER APPARATUS:
E R
NO i. 2/0
OF CC COND, A W, G,
PER ~ OF CC COND.
V I C
NO OF HI-LEG
A. w.G. NO, OF NEUTRAl
OF HI-LEG
1
AW, G
OF NEUTRAL
1/o
Pa~l
275 Town ~rtx~r Lone
SoHtD~old., N,!f. 1].~Cffl
L:Lc. 28,V,E
GENEI~AI~ANAGER
Per
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.
COPYFO BUILDING DEPARTMENT. THISCOPYOFCERTIFICATE USTNOTBEALTEREDINANYMANNER
FIELD INSPECTION
;'OUNDATION (2nd)
?.
tOUGH FRAME &
PLUMBING
COMMENTS
o/c t~e
INSULATION PER N.
STATE ENERGY
CODE
Ye
FINAL
ADDITIONAL COMMENTS:
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
PERMIT
~ PERMIT NO.
10-85-0210
UNDER THE ENVIRONMENTAL CONSERVATION LAW
PERMIT ISSUED TO
John Damp soy
ADDRESS OF PERMI]~-EE
P.O. Box 5, Cutchgoue, NY 11935
LOCATION OF PROJI~CT (Section of stream, tidal wet[and, dam, huildieg)
Mud Creek, Haywaters Drive, Cutchogue, Town of Southold, Suffolk
DESCR~PI[ONOPPRO)£CT Construct a one family dwelling, driveway, deck,sanitary system, 180' X 4'
fixed elevated catwalk 3.5' above grade, 16' X 4' hinged ramp and a 16' X 6' float secured by
two (2) 8" diameter X 20' pilings. The southwest corner of the house shall be setback a minimu~
of 67' landward from the landward boundary of the tidal wetlands, while the northwestern corner
of the house shall be setback a minimum of 71' from the aforementioned wetland boundary which
was established by this Department on April 2, 1985.
COMMUNITY NAME (City, Town, Village) TOWN
Cutchogue Southold
COUNTY
Suffolk
1. The permittee shall file in the office of the appropriate Regional
Permit Administrator, a notice of intention to commence work at least 48
hours in advance of the time of commencement and shall also notify him
promptly In writing of the completion of the work.
2. The permitted work shall be snbject to inspection by an authorized
representative of the Department of Environmental Conservation who may
order the work suspended if the public interest so requires.
3. As a condition of the issuance of this permit, the applicant has ac-
cepted expressly, b'y the execution of the application, the full legal respon-
sibility for all damages, direct or indirect, of whatever nature, and by whom-
ever suffered, arising out of the project described herein and has agreed to
indemnify and save harmless the State from suits, actions, damages and
costs of every name and description resulting from the said project.
4. Any material dredged in the p~osec~ion of the work herein permitted
shall be removed evenly, without leaving large refuse piles, ridges across the
bed of the waterway or flood plain or deep holes that may have a tendency to
cause injury to navigable channels or to the banks of the waterway.
5. Any material to be deposited or dumped under this permit, either in
the waterway or on shore above high-water mark, shall be deposited or dumped
at the locality shown on the drawing hereto attached, and, if so prescribed
thpreon, within or behind a good and substantial bulkhead or bulkheads, such
as will prevent escape of the material into the waterway.
6. There shall be no unreasonable interference with navigation by the
work herein authorized.
7. That if future operations by the State of New York require an alteration
in the position of the structure or work herein authorized, or if, in the opinion
of the Department of Environmental Conservation it shall cause, unreasonable
obstruction to the free navigation of said waters or flood flows .or endaoger
the health, safety or welfare of the people of the State, or loss or destruction
of the natural resources of the State, the owner may be ordered by the Depart-
ment to remove or alter the structural work, obstructions, or hazards caused
thereby without expense to the State; and if, upon the expiration or revocation
of this permit, the structure, fill, excavation, or other modification of the
watercourse hereby authorized shall not be completed, the owners shall,
without expense to the State, and to such extent and in such time and manner
as the Department of Environmental Conservation may require, remove all or
any portion of the uncompleted structure or fill and restore to its former
condition the navigable and flood capacity of the watercourse. No claim shall
be made against the State of New York on account of any such removal or
alteration.
95-~O-4 (9/7S) (SEE REVERSE SLOE)
FIA COMMUNITY NO. J DAM NO. PERMIT EXPIRATION DATE
I
December 31, 1986
GENERAL CONDITIONS
8. That the State of New York shall in no case be liable for any dama§e
or injury to the structure or work herein authorized which may be caused by or
result from future operationa undertaken by the State for the conservation ar
improvement of navigation, or for other purposes, and no claim or right to
compensation shall accrue from any such damage.
9. That if the display of lights and signals on any work hereby authorized
is not otherwise provided for by taw, such lights and signals as may be pre-
scribed by the United states Coast Guard shall be installed and maintained
by and at the expense of the owner.
10. All work carried out under this permit shall be performed in accor-
dance with established engineering practice and in a workmanlike manner.
lt. If granted under Articles 24 or 25, the Department reserves the right
to reconsid~[ this approval at any time and after due notice and hearing to
continu~, rescind or modify this permit in such a manner as may be found to
be just and equitable. If upon the expiration or revocation of this permit, the
modification of the wetland hereby authorized has not been completed, the
applicant shall, without expense to the State, and to such extent and in such
time and manner as the Department of Environmental Conservation may require,
remove all or any portion of the uncompleted structure or fill and restore the
site to its former condition. No claim shall be made against the State of New
York on account of any such removal or alteration.
12. This permit shall not be construed as conveying to the applicant any
right to trespass upon the lands or interfere with the riparian rights of others
to perform the permitted work or as authorizing the impairment of any rights,
title or interest in real or personal property held or vested in a person not a
party to the permit.
13. The permittee is responsible for obtaining any other permits, ap-
provals, lands, easements and rights-of-way which may be required for this
project.
14. If granted under Article 35, this permit is granted solely on the basis
of the requirements of Article 36 of the Environmental Conservation Law and
Part SOO of 6 NYCRK (Construction in Flood Plain Areas having Special Flood
Hazards - Building Permits) and in no way signifies that the project will be
free from flooding.
15. gy acceptance of this permit the permittee agrees that the permit
is contingent upon strict compliance with the special conditions on the
reverse side.
SPECIAL CONDITIONS
16.
In order to protect the values of the affected wetland a permanent vegetated buffer zone
shall, be preserved. There shall be no disturbance to the existing natural vegetation or
topography within an area extending 50' landward of the wetland boundary established
April 2, 1985.
SEE ATTACHED CONDITIONS A - J
PERMIT ISSUE DATE
April 17, 1985
Alter~ate ~ j
I PER~IT ^O~N~STRAro~L)~ ~.-, iL,... ~t__ I ^oo~ESs
lCharl~s T. Hamilto'-~''-~'' I,~--'~..".~-..,J
Bldg. 40, SUNY-=Room 219
Stony Brook, NY 11794
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
765-180Z
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION XST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
REMARKS:
~ FINAL
DATE' "'~ ~/(~ INSPECTOR
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
DATE,.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1803
Permit No."),q.. S
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BI.DO.
TOWN OF SOUl'l~Oi. L
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
:ts 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
r areas, and gNing a detailed description of layout of property must be drawn on the diagram which is part of this appli-
]tion.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this applicatiou, the Building Inspector will issued a Building Permit to the applicant. Such permit
~all 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
~all 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
uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
_egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
flmit authorized inspectors on premises and in building for necessary insp~ections. ~ /
. ........ , ....
(S'tgq~re of appncant, or name, ~t' a corporation)
....P.O..l~o..x..5.,..O.u.~. 9.h.qgu..e.,...1J...Y..... 3.1.9. ~ ....
(Mailing address of applicant)
¢tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
qame of owner of premises John R. Dempse3r
(as on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
Builder's License No ..........................
Plumber's License No .... Oe O;r..g e. JVia]TgiI1 ok-...
Electrician's License No.. ~gt~a.].. B!~..iq$ .........
Other Trade's License No ......................
Location of land on which proposed work will be done .............. · ................ ....................
_ .. ~ywaters Drive,..C.u.t..c.hp. gu..e.,. N.Y.
House Number Street Hamlet
County Tax Map No. 1000 Section . . .1..0.4 ............ Block 5 Lot .... 21
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
vacant land
a. Existing use and occupancy .....................................................................
b Intend duseand ccupancy one famS]y dwellit~', ,}
3. Nature of work (check which applicable): New Building . ...X.X. .... Addition .......... Alteration ..........
Repair ....... - ... Re,no*al .... Demolition ............ Other Work ...............
· ~,.., ~ c ~ t,, ~ ........ (Description)
4. Estimated Cost $100,000 i Fee. ...............................
' " (to be paid on filing this application)
5. If dwelling, number of dwelling tinits ...... 1 . Number of dwelling units on each floor ................
If garage number of cars ' ' '
6. If business, commercial or mixedi occupancy, specify nature and extent °f each tYPe °f use ....................
pth
7. Dimensions of existing structure~, if any: Front ............... Rear .............. De ..............
Dimensions of same structure wi{h alterations or additions: Front ................. Rear .................
' · . ....Number of Stories .....................
Depth ............. ,. Height ....... ~6"] ......
8. Dimensions of entire new construction: Front ........... Rear ...6.0.' .......... Depth .. 39.'.
Height ...287 ......... Number of Stories.. 2 .....................................................
9. Size of lot: Front .. iA.O: .... ! ........... Rear..q2.1 .................. Depth . .289/.2.52 ............
0. Date of Purchase ...1 .... ; ....... Name of Former Owner J3:[z~.da. S.tewa~g .............
1. Zone or use district in which pre scs are situated.., re~q~,d erst zaZ ....................................
' 2. Does proposed construction violate any zoning law, ordinance or regulation:n.c~ ..............................
3. Will lot be regraded · ~O ..... i ................... Will excess fill be removed from premises: x Yes No
4. Name of Owner of premises .~.: i..D.e.m.p..s 9Y. ....... Address .~.Q..Bg.x.. ~ ~..qu..t.e.h~l~§ffe No..'7. 5.4..6. Q5 ~3 .....
Name of Architect ' Address Phone No
Name of Contractor i Address Phone No
PLOT DIAGRAM
Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions front
,roperty lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
lterior or corner lot.
survey attached
;TATE OF NEW Y4ffRK. ,~'
~OUNTY OF~ ....
.l~er0p8.e.yi .................. being duly sworn,,deposes and says that he is the applicant
John.
(Name of individual signing~ contract)
.bore named, i
te is the ....................... owrmr ...........................................................
(Contractor, agent, corporate officer, etc.)
4' said owner or owners, and is drily authorized to perform or have 15erformed the said work and to make and file this
pplicatioff; that all statements contained in this application are true to the best of his knowledge and belief; and that the
york will be performed in the manner set forth in the application filed therewith.
;worn to before me this
............ ,./.~/_~....day ,of.. ~ ......... , 1~,~. .
/
/ #0f*lW ~ ~ ~ ~,t~ k, 'N ..... ~ (Signat't~re bf applicant)
0