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Home My WebLink About13740-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z. ! .~.~.8.0. .......... Date . .~..r.c.h.. ! .7 ..................... ,19 .8.6. THIS CERTIFIES that the building .. 0 ~.e.. ~' a ra.~ 3. ~/..d.~.~. ~ :L ~.r~g ....................... Location of Property R.O.W. off Stillwate.r Ave. Cutcho~ue County Tax Map No. 1000 Section ...1.Q3. ...... Block ..... 0. ] ........ Lot. P./.q. ! .9 ......... Subdivision.. B.:Lum...Li ¢ ~e.ikZ ............. Filed Map No ......... Lot No ....... 2. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..M~?.c.h. J .......... ,19.8~. pursuant to which Building Permit No.. fi. 3..7.~.0.Z. ............ dated .... ~l~?.c.g. ~ ................ 198..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 ......... ...One..£am&.ly. d.w.e 1 ].ix~g ...................................................... The certificate is issued to ~.T.~.V.E.N..B....& DEBORAH L WICK ....... io¥,,'o;, ..................... of the aforesaid building. Suffolk County Department of Health Approval .. 14:.50-2.3~ ..~.~.~.....6...?..87 .......... UNDERWRITERS CERTIFICATE NO ............ P.q Cg.~rlg ...... .M.a.p... J .7.,.. ~. ~.~.6. ........ Plumbers Certificate 3/~2/86 Building Inspector Rev. 1/81 FON. M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13740 Z Permission is hereby granted~to: ~ ,-- / , ............ ..:...-'.~.~.~ ......................................................... -. .... .b~.~..~....~.:~.:.....!~.~ .~ ~ .... ,o ..... at premises located at ~,.~,:,,o, :,,~,,:,,,,~,~,,, ~.~ ,...,~.,.,,,,,.,,,~,,, ,,~,~, ......... ~ ............ County Tax Map No. 1000 Section ..... [.?....~. .........Block......................J Lot No...../~./~.....l..~. ..... pursuant to application dated ....... .~..q~.C~..Jf ........................... , 19.~.~.'~, and approved by the Building Inspector. ;>:~ ~ ~.~) Fee $ ........................ 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: I. 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 peoperty 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 $5.00 / 2, Certificate of occupancy on pre-existing dwelling land use -- P~e-E×±st,±~g C. 0. $15.00 3. Copy of certificate of occupancy $1.00 / Yaca[~f, land C.O. $ 5.00 Da,e I. F. ........... New Building ...~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~./~./~.'~...~).~..~....~.~.' ,~ ........ YT..~.0.),,, House No. Street Hamlet Owner or Owners of Property.. ~--~. ~.V.~.~...~:;~..¥...._~. ~,~..~[~.~'~..L..,.,, .~.~.~ ........ County Tax Map No. 1000Section ..I.(~.~ ......... Block ...~ ........... Lot...~.~..../.~.... Subdivision. ~-.~-~.~-'~ ]..~.~.~,\ .~... ~ .......... Filed Map No ........... Lot No...~. ......... Permit No. \~:~.~.~..~.. Date of Permit '.~./~.. I.~.~, .Applicant. ~.~.,..~.F~.~"~).~,"~..~/ ............... 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 an~/regulations. C.6. TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.L \'~kO 7--- Owner ko~ ~ C'~'-- , ~('~ ['~ (please prin~ Plumber ~\~ \ ~ ~.~ ~O[%~ (please 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 ~'C~L~, Notary Public,~CQunty TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 May 30,1985 To Whom This May Concern, The building permit issued to Mr. Steve Wick (B.P. # 13740Z) required no D.E.C. approval. The septic, as indicated by the Health Department, is one hundred (100') feet from the wetland. The Topographical map shows the building constructed on the property is approximately fifteen (15') feet above the average high water mark. The un- derstanding the Town has with the D.E.C. is, if the building is more than seventy-five (75') feet from the wetland or the elevation is ten (10') feet or higher, n~--permit is required from D.E.C. Hoping this will be of some assistance to you. VL:dsm Yours Truly, -& Victor Lessard Exec. Admin. Building Dept. 765-18~2 BUILDING DEPT,r INSPECTION [ ] FOUNDATION 2ND [ ]. INSULATI~ [ ] FRAMING ~]'F~INAL 7/~ REMARKS:/, .,..~,.,,,~.,~ ,/~/~/~.~ ~.~ .~ ~ _~ FIELD FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY 0DE FINAL COMMENTS ADDITIONAL FORM NO. 6 TOWN OF SOUTHOLD 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 submitte~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 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. Co Fees: 1. Certificate of Occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling J land use 3. Copy of certificate of occupancy $1.00 / --?re-Existing C.O. $15.00 Vacant land C.O. $ 5.00 .... . Date ................. ,~.. New Building · . . Old ca-,Pre:existing Building ....... Vacant Land ~"0cu ~FF '' Location of Property ......... . . ,~,, ,~,'.L.~ ,~, ,~r~ .~,~,~,... .. ., ,~?'Z'-.. . . . .. ..CZ~'Y-¢'~/~6 ~,~ House No, Street Ham/et Owner or Owners of Property ' ~ z~ ~ bi /~ ~ ;7'~C'-L ~ County Tax Map No. 1000 Section )~ ./( /..~. .... Block ....... Lot. .', Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ................. .... Date of Permit Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Appr6val ........................ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ......................, Fee Submitted $ ............................. Construction on above described building and per~it meets all applLcable, codes and J~0WN OF $OUTHOLD _j FIELD REPORT - POLICE DEPT., TOWN OFSOUTHOLD, NY Central Complaint No. Hamlet of Gcc. ' Sector - Incident Or Crime ' Grid N~ y . ceI Date of qcc. Time of Gcc. D~te of Report Place of Occurrence PDTS 2 - Continuation ReDo~ Atteched~ ~ Yes Form PDT$ POLICE DEPARTMENT, TOWN QF $OUTHOLD, NEVI YORK Short Form Suppl~menr,~/ A~d Contiau,i~on Report [~UPPLEMENTAK~' REPORT D~ of K~l~r~ CONTINUATION REPOkT ~ -b--. ~.~, ,--3 LL o,V /As J. DEMPSEY i!ebruory 25, 1986 Dear' ~q~rt WJt~ re~-~r~ to ~,our reee~ of job o'~ 1- house was flippe~ 2- or,e car' ~,ar~[~e, Not two 3- rest deck ~d~ed 38' x 10' If v'Ou m~ed ~y ~ddit'iona] j~formstion~ ease let me know. Th an ks. Sie c el'el BLDG. DEPT. T?_...~WN OF SOUTHOLD 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1803 :xamined...~¢,4. '~.t..~ .... 19~.~.'~. ,pproved...~}q 0~.."~..., 19~.~. Permit No. ].~.~. I/L.Q .'.-~. )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... , t Date .lyl~.r. ql~. 1 1955. INSTRUCTIONS 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, relatiohship to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ition. 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 ~ail 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 roll 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 dmit authorized inspectors on premises and in building for necessary inspections. .... 4o. b.n..~ ... ~e.m.p.s.e.y. ,..In. ?: ................. (Signature of applicant, or name, if a corporation) ....P.Q..B.o.x...5.,., g.u.~,qh. 9?~qe~,. )( ..y.....] J.9.3.5..., (Mailing address of applicant) ¢tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. general contractor Steven B. ~ ebo a L. qame of owner of premises & D r h Wick (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (,~_.~(Name and-tittemt%orpora~ oflr&er)'~ Builder's License No .......................... Plmnber's License No. Ceorge IV, artinel* O.O. Electric Electrician's License No ....................... Other Trade's License No ...................... '. Location of land on which proposed work ;rill be done....L9.~.*.2.,..B..1..u.m..~.,.~.~.~.e. :'1..~..S..u.b.d.J:.y.5~.~.o..n ......... CutchoF, ue, 1~ .Y. S.CM#1000-103-1 p/o .19 House Number Street Hamlet County Tax Map No. 1000 Section . .1.0.5. ............. Block .q ................. Lot. p/o ~ 9 Subdivision..1~] Crrt .L~[.~.t. el 1 ..................... Filed Map No ............... Lot 2 (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land b. Intended use and occupancy ..... one. ,f. am i,3.3r. ~.el] ir~g. a~a.~,A~ ·.. ~.,t~,.~,id~4tt.,~ ~.,,.~j{,lllL~I.~,.~,~ ............. 3. Nature Of w brk (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... 4. Estimated Cost l'[O0.,.O00... ~ ............. I. 5. If'dwel!ing, number of dwelling units ·. · ~ ~' ~ ~D (Description) ..... Fee ......... : .9 ........................ °°' (to be paid on filing this application) Number of dwelling units on each floor ................ If' garage, number of cars ... 2. !.bu&lt ~-.~.~ ........... ' .......................................... 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 ...................... ' F 4~. 42 ', D pth .4.0. 8. Dimensions of entire new constrpction: rent.. [ ......... Rear .............. e ........... Height . 2/I-. [ .......... Number of Stories . .2 ..................................................... 9. Size of lot: Front .%52.~ ...... i ........... Rear... 26~ ~. .............. Depth 222. ~. 0. Date of Purchase . .2 ./~5. .... i .................. Name of Former Owner .b/.F....~]_um~. 1. Zone or use district in which premises are situated ..... r e.aicl%a ia.l ................................... 2. Does proposed[construction violate any zoning law,ordinance°rregulati°n: ..jn.q ........................... 3. Will lot be regraded ....n.q..! ............... Will excess fill be removed from pre n scs x Yes one 4. N~me of Owner of premises S &.D.. Wick '' '.'~. W.uu~cnopueCreek Ave .~----~T~ 754 5.9 .4.. Nmne of Architect ..... ; ..... Address ................... Phone No ................ N~une of Contractor ......... i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alll bmldmgs, whether existing or proposed, an& indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. Survey attached ;TATE OF NEW YORK, I S.S 7OUNTY OF ................. .......... .J. QIg~. ~,. De~pee,y. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) .bove named. i~ en~aI ao~r. acto~ lc is the ...................................................................... (Contractor, agent, corporate officer, etc.) , smd owner or owners, and ~s duly authorized to perform or have 15erformed the said work and to make and file this pplication; that all statements contained m th~s apphcaUon 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 ...... , 4otary Public S C DEPT. OF HEALTH St~vm- RODERICK VA~UYL, P.C. L'C SED L* D GEEENPORT NEW YORK SUFFOLK CO, HEALTH DEPT. APPROVAL H. S, NO. ~ t.-.:m.,,,' ,:...~ 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, APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOr APPROVAL OF CONSTRUCTION ONLY DATE: H.S. REF NO., APPROVED SUFFOLK CO. TAX MAP DESIGNATION: DIST. .?~C T BLOCK PCL. OWNERS ADDRESS: TEST HOLE STAMP SEAL , ~ ' ~ ~ SYSTE~ EOR T~S ~ESI~NCE WILL [[ I / . , '~e noted ~ ~q~-this ' ~ l~ed i~n a~cul~{c ...................... L~ water supply may contain trace ama nts of pes?cides and/pr ~trotes. ~. ~ ~-.~ ,