HomeMy WebLinkAbout19790-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20255 Date OCTOBER 2, 1991
THIS CERTIFIES that the building NEW DWELLING
Location of Property 1150 LAUREL AVENUE SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 56 Block 1 Lot 2.28
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 17, 1991 pursuant to which
Building Permit No. 19790-Z dated APRIL 18, 1991
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 2 CAR GARAGE AS APPLIED FOR
The certificate is issued to MOHRING ENTERPRISES INC.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 9I-SO-03 - AUG. 13, 1991
UNDERWRITERS CERTIFICATE N0. PENDING - SEPT. 26 1991
PLUMBERS CERTIFICATION DATED SEPT. 23 1991 - CHAS. SANDERS PLUMB.&HEAT
- uilding Inspector
Rev. 1/81
r
F08M NO. f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N° 1 ~ / 9Q Z Dote .............4~~Ir*~........(..ft..........., 19.`.3:.
Permission is hereby granted to: ,
~bo ~ e~ a,
of premises located at ....1.1..5.~.........Et,Ast
:4R1...... `~i..k44..........~
t
County Tax Mop No. 1000 Section(.''..~.~_
'.~~(~9...... Block ...Q.\........... Lot No...c~a .:.s~..Q......
pursuant to application dated ......S.dG..........~..~ 19..1..., and approved 6y the
Building Insgqpectppor.
Fee S..w~i.. 9..1.:..1. b.
I ing Irupector
Rev. 6/30/80
J ~ D I /r/'
f~, 0 , FORM NO. 6
f~` 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 ~ to the Building Inspec-
torwith 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, acertificate 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: Additions $25.00 POOLS $25.00
1. Certificate of occupancy Neco L`welling $25.00, 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 $ 1 0.00
4. Vacant Land C.O. $L0.00 ~ ~..3.
S. Undated C.O." $ 50.00 Date .
NewConstruction„-„-Old or Pre-existin Buildin Vacant Land
9 9
Location of Property ~~•r0...~~c,!!e~~... l~C'. t 4-:OT~ 3;5~~.....~d(!.'~>,T7Q~_
•
House No. ,Q,~ Sneer Hamlet
Owner or Owners of Property ..!::/.!).T/.~~~?1l.6.. ~/?TF.s.~l,~/Qitfc~.`2~,i.,.~~I!G,•........ .
County Tax Map No. ,1000 Sertion ~fa..... Block , l Lot . .
Subdivision~gbN~. a~+!~. ~tf.7'.~..ti+'G/~'G~%.:~.Filed Map N/o, g~`J ~ ...~Lo~t'N/o. .
Permit No. ~ /.79Q :z, DCa?te of~P^ermit T ./..Applicant ~~-e~A!Pd ..!747?tQ!!~.C?. , ,
Health Dept. Approval . Q ~~.:~.....Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approva!
Request for Temporary Certificate .....................Final Certificate
Fee Subrnitted $ f . ~L .
Construction on above described building and p it meets all a plicable odes d regulations.
Applicant.
htov. ~o ioaa
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~ ;=Y P.U. 1)UX 728 ,
v',. Atli :a> ~ TOWN H,~LL
~j, Off' SUI)'f(IULU, N.Y. 11971
C~ F2 'L• I F I C AT I U N ,
Date 9-d3-~', I
Building Permit No.~'I'~_
Ownar~~NG .~~T ~/y4 ,
. (plr3ase print)
PlurrWerC'~,QL~ ~,~l1~ S
(please pr'ir:k~
I corkity that the soide>r• used in t;lte water supply system
cnntalns less than 7./10 cif .l~ lead.
(p tuber's signatuz:q)
Sworn to befdr~~ ma this
~3 day oPMR~~
Notary Public
Notary PUblio,~ N~~Q-y{,_ CUUnty MgEE.SABATINO
NOxAflY PUBLIC, State of New Yolk
No. 4840592
UueliNed In Nassau (Mun~~
Conuniesbn Exolres !/o/??~/
r~aL '_`i;:SPEC;iU;J IIUnIE I i;OMMGNT°
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65-1802
DING DEPT'.
NSPECTION ~ ~
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[ ]FOUNDATION i5T [ ] ROUGH PLBG. %
~rc,,,e,
[ ]FOUNDATION 2ND [ NSULATION f i~
[ ]FRAMING [ ]FINAL 1~
~ ~~~r ^
R MARKS:
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DATE fNSPECTOR
i
765-1802
BUILDING DEPT.
INSPECTI®N
[ ]FOUNDATION 1ST [ " ] ROUGH PLBG.
[ ] FO ATION 2ND [ ] INSULATION
FRAMING [ ]FINAL
REM RKS:
~
~I
I ~
~ DATE INSPECTOR
/ ? 765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST OUCH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[RAMING [ ]FINAL
RE ARKS:
- -
w ~ ~
DATE ~ INSPECTOR
T65-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
E
r
DATE ~ ~ INSPECTOR
/~7~v
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[~UNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ] FINnA~L
REMAR S:
' DATE ~ / INSPECTOR
i
i
~ 765-1802
~UILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ) ROUGH PLBG.
[ ) 'FOUNDATION 2ND [)INSULATION
[)FRAMING [ ]FINAL
REMARKS: ~
DATE ~ INSPECTOR
-
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d~lature of work (check which applicable): New Building . Addition Alteration .....•v:
Repair Removal Demolition ..............Other Work ~ .
--1 C~ (Description)
4. Estimated Cost .......~C?~I,,GYJC~ Fee~`.-~.<l .lo. t ~ .
/ (to be paid on filing this application)
g, g
S , If darallennumber of azs ellin units , Number of dwelling units on each floor , , , , , , , , , , ,
g g , 2^
6. If business, commercial or mixed, occupancy, specify nature and extent of each type of use . .
7. Dimgenstons of existing stru Num ' if any: Front Rear ; ; Depth .
Hei ht ter of Stories .
De th . , , . , , , , . th alterations or additions: Front Rear .
. ,.Height........ Numb of Stories......,,,
8. Dimenstons of e t resnew construction: Front ~ 7 Rear . , , .......Depth , , , , , , , . , . ,
Hetght b~SOStories 5,~ >26~/.
9. Size of lot: Front Rear ~ epth . y .
10. Date of Purchase 2~% , , , , , , , , , , , , , , , , ,Name of Former Owner ~q:.vIQ`-" L14-72C: ~?V,, , , , .
1 I. Zone or use district in whic~ re~»ises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: . l1U.........:` .
13. Will lot be regraded . l~es' . , ~ , . , , , , , . .Will excess fill be remov~ef~~f~rom premises: Yes Nom
14. Name of Owner of premtses ~lo~in~w ~*4 ,Address .3~3.~~.~`.<.~:. Phone No. ~ 7 ~-'.G4~~
Name of Architect ,~',qy.~~~, wh%~~, , , , , , , , , ,Address C~~~4h. L!¢''1e:...... Phone No..~-446 . , , • ,
Name of Contractor ,/,/U,~12;lN ~ ~ , , , , .Address 3 23 G%h, Cq~t ~?c'S , ,phone No. Pe.yl-;
15. Is this property withi 3,00 feet of a tidal wetland? *yes........ No.........
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all ,buildings, whether existing or proposed, and, indicate all set-back dimensions frolic
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. I x.
ill ~
~ ~
_
'II
STATE OF NEW YOR~~~ $ S
COUNTY OF .
. y//'
(Na~/of na
vid 1 nl~~~/~ ~ ~ ~ ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant
g Ong corftract)
above named. ' /
He is the .................(J. Gc~%'I,er~~t~4iw' •.e,r~ .
(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 and belief; and that the
work will be performed in the manner'iset forth in the application filed therewith.
Sworn to before me this i
' .C~ 1J
~a; , ..day of .C 19~~.~
c.., /
Notary Public . ~!~?~m-c'::'County
&UJMi E.P.CON/3ERD ~
NOrMY W&K,SIayoP N^W Yggt
N0. 9W618118
Oua111eCMNasw/CouMy ,
~ ~w~,.+~ _ ~ ~ ~ ig ature of applicant)
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~X;~IF~ES WO Y AASL
ROM C}pT~ Oi° ~~I~R~01/~I_
SURVEY FOR
MOWRING ENTERPRISES,INC.
FFOLK COUNTY DEPARTMENT OF HEALTH SERV(CE>a
LOT N0.34,~ILONG POND ESTATES,SECTION TWOII
` DATE. NO V. 29,1990
FOR APPROVAL OF CONSTRUCTION ONLY AT ARSHAMOMAQUE
TOWN OF SOUTHOLD SCALE' I"=50'
ATE ~g._._._~
f EF. NO. ~r SUFFOLK COUNTY, NEW YORK No 90-0953
K UM4UTNORiZCO ALTCRATION OR 4001TION ro TNIs
SVRVEY q A VIOLATION aF fE CTION )209 OF THE
~ NEV YORK STATE EDUCATION LA E/
APPROVED J ~ s ~ RcoPIES OF TNIS sunver Nor BEARWO TNI LAMO ~PSf OF N@h,
O fp p p3 SUR VEYOR'f INKED SEAL OR EMBOSS ED SGL SHAH 9 Y'p
MOT B[ CONSIDERED TO BE A vAIID TRUE COPT D yV .P
KGUARAM TEEf IN0I CA TED HEREON SHALL RVN ONLY ro yAP'~
TILE PERSON FOR WNOM THE SURVEY IS PREPARED Q r
HEALTH DEPARTMENT-DATA FORA TO CONSTRUCT G
ANO OI NIE BE NALF TO THE T17LE COMPANY, GOVERN- r Z
~ MENTAL AGENCY AMD 1EN01NG INSTITUTION LISTED
N NLARf3i IEATLII MA/1IM EMI _ N SOURCE OF WATER PRIMTE -PUBLIC _ QI
N fl/F CO TA%MA? pfT 1000 fEC TIOM FLOCK LOT Dh2.1 HEREON, 4MD TO THE A3310N EES OF iNE LE NOINO
N TNLR[ AI1E NO D~'[ILIMff WITHIN 100 FEET Of TNIf PRO PC RTY INSTITUTION. 6UARANTCES ARE NOT TRANSFERA BIE
07N[R TNAM THOSE SHOWN NERfON TO 4001 TIONAL INSTITUTIONf OR SUBSEQUENT
N 7NC WATER fVMIY AMD fEWAO[ OIfPOS AI SYfT[M FOR THIS RRIDCNC[ OWNERS
N DISTANCES SHOWN NCREOM FROM ?ROPERTT lINL3
WILL CONFORM ro iN[ 1TAM OARDf OF TMC SUFFOLK COUNT'/ DEPIRTNCM7 TO EKIf TINE 7TRVCTV REf ARE FOR A f/EClft< <i a0, `J
W MGLTN fOWIC[! PVR POSE ANO ARE NOT TO BE USED TO ES TABIISN UJf
A!?LICANT' IIN)PERTY LINES OF FOR THE ERECTION OF FENCES ~~D S E,Tpa
ADDREu
,<L YOUNG a YOUNG R'°~~~",°EWAOR~KE
NOTE ALDEN W YOUNG, PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
SUFFOLK COUNTY ON NOV. 29, 1990 AS FILE N0. 9031. ANO LAND SURVEYOR N YS UCENSE NO 12845
HOWARD W YOUNG, LANG SURVEYOR
NM LOCA710M OF WELI(WI,fEPTIC TANKISTI•CE3f1'OOl3(CP) fMOWN N[II[OM N.Y.S. LICENSE N0 45893
ARE FROM FIELD OfllERW TIONf ANO OR DATA OB TAIN[D FROM OTNERf
ZH.
G R,YNDIS A SONS INC.
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SURVEY FOR
SUFFOLK COUNTY OENARTMENT OF HEALTH SERVICES MOHRING ENTERPRISES, INC.
e,' SINGLE FAMILY DW[t.I.ING ONLY LOT N0.34, ~~LONG POND ESTATES,SECTION TWOI~ MAY 16, 1991
B 91,5(9 0 AT ARSHAMOMAOUE DATE NO V. 29,1990
DffIL~'~_~.`~._.'~~._ N.S. RE.F. N0.
The sewane disprsal and water supply facilities fnr ibis TOWN OF SOUTHOLD SCALE I"= 50'
location have Meer, inspected by this Departrnent andior SUFFOLK COUNTY , NEW YORK No 90- 0953
othed fo~(nd tC„~r.afis~ctory.
U. j7~' A WMUiH011R f0 ALiERA 710M OR AO DI TiON TO THIS
„~f SURVEY tf A vI0l AT10N Of SECTION 7109 OF THE
NE• YORK STATf FDUCA 710N LAN
Chief of Bureau of INastewa er Management %coP1ES aF rHls suRV6Y NoT B[ARWG TNC l4ND ZPSE °F NEB
SURVEYOR'S INKED SEAL OR EMBOSSED SGL SN4LL AJ
MOT BC CONSIDERED TO BE A vA 110 TRUE COPY p,(IlD IS'
MGW RAMTCE3 INDIU TEO HEREON SNALI RUN ONLY 7D ~ b 'F
MEALTN DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT TME PERSON FDR WHOM THE su RVEY 15 PREPARED O O
AND CN NIS BEHALF TO THE TITLE COMPANY, GOVERN- ~ ~ Z
%NEAR[ST MAT[II f1A1N.MI %SOUR CE Of WATER PRI ~%TE -.PUBLIC _ NENTAL AGENCY ANO LENDING INS 71f Uil ON LISTED o
%fli? CO. TAK MA? pfT 1000 SECTION 56 BLACK I LOT 02.1 HEREON, AMO TO THE AlSION EES OF THE IE NDING 1,
MTNLR[ 4RE 110 DW[LLIMBf WITHIN 100 FEET Of TMIf MOPI RTY INSTITUTION GUARANT[ES ARE NOT TgAN Sf ER48lE *
OTN[R THAN THOSE SHOWN HEREON r0 A001 TIONAL INS TITUTIp/3 OR Su BSE OUE NT S.'°'
% THE WATER fUPPIY AND 3EWABE OIfROf AL SYf TCM FOR TN I! Rp IDE NC[ OMNERS LS'
% OI lTAMCLS SHOWN HEREON FROM PROPERTY LINES TY
WILL CONFORM TO THE lTANOMDf Of TNf SUFFOLK COUNTY DFPARTM[NT ~ O, ~v~
OF NLALTN f[RY IC[f iO ExIf TING lTRUC NRE3 AR[ FOR A SPECIFIC
PURPOSE AND ARE NOT TO BE USED TO ES TABLISN /~~J
AIiUCAMF PROPERTY LINES OR FOR THE ER EC iION Of FENCES d SAND 5 Elo~' i/ p,
ADDRE35
"+t
YOUNG a YOUNG R°°
E~~"~~w
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NOTE ~ ~ =STAKE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG, PROFESSIONAL ENGINEER _ ,
SUFFOLK COUNTY ON NOV. 29, 1990 AS FILE N0.9031. AND LAND SURVEYOR N YS UCENSE NO 12B4S
~ HOWARD W YOUNG, LAND SURVEYOR
%TNE LOGTIgI Of BIf1L(r), 3EPrlc rAMKlsrls cESlPOOIS(C7) fN0%'N NCI1fOM N YS LICENSE N0 45893
a ARE PROM HELD OpERMTiONS AND OR DATA OBTMN[D FII'OII OTHERS
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B gRND15 6 Sons INC.