HomeMy WebLinkAbout19540-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20758 Date MAY 28, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 5535 OREGON ROAD CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 95 Block 1 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 21, 1990 pursuant to which
Building Permit No. 19540-Z dated NOVEMBER 26, 1990
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 INSTALL NEW OIL BURNER REPLACE PIPING & INSULATION
The certificate is issued to A.C.M.T. EQUITIES, INC.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 30, 1992
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
roam NO. s
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)
W 19540 Z Date ... ; ...................................... 19.2v
16 ? , 6/42!�
Permission is hereby granted to:
:--4. .. s� ..�... j�........ .....
to � � � � � .. .
. . ......... . .......
`bt premises located at .. 3-�WZ1 ... . . ..... .....................................................
...................................... . .........................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section .........91.. ... Block .............1.... Lot No. .....Q3..........
pursuant to application dated A. 2........... 19.E8., and approved by the
Building Inspector. ,r ///y
v1aFee .. .
ito ....
7u!id# ... ...............
Rev. 6/30/80
I
FORK po. s
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)
Na 16786 Z Date b..........................................
Permission is hereby granted to: �� ,
...C3�
... ...�1.....�...9.... "'. ......................
s�1..............................................
to /za.............. ........ ... .: : .X . ..y..�. .�$TL.G .........
...... .. . ..
of premises located at .. /?��...:�(. � ...............................................................
..................................................r..... .I.•�(/�................................................................................
................................................................................................................................................................
County Tax Map No. 1000 Section Y�.... Block ........!? ..... Lot No. .......a3.........
pursuant to application doted ............ ............................. 19s�� and approved by the
Building Inspector.
Fee $..S%.`..° ...
................. Pz-...... ..1... � . �`�..........
, uil!�P/Inspector
Rev. 6130180
1''', Form No. 6 PX>/ /V
TOWN of souTlwLD f�te�a 11g6 �
i , MAY 2 z I(�t"9 BUILDING DEPARTMENT
TOWN HALL C �%'" G116
g _ 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form) .
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead,
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
I£ a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
1 , Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . . . . . . . . . . . . . . .
ew Construction. . . . . Old Or Pre-existin B uilding. ,Y//. .
ocation of Property. .�5 � � o/2�G0/o :ad
. r ,
U C'� o E
House No. /Street Hamlet
nwer or Owners of Property. .0 C.Q,?T, . .� c� (JI TI'C.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ounty Tax Map No 1000, Section. . . . . . . . .Block. . . . .C.7./. . . . . . . . .Lot. . . .
U . . . . . . . . . . . . . . . .
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
:rmit No. . / ��t/o ,. . .Date Of Permit, W� �j` / �� / �1�7 �C, U1 7e.$. . . . . .
Applicant. . 1„
,alth Dept, Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
.anning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
quest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
e Submitted:
co t.? APPLICANT
s � •
THE NEW YORK BOARD OF FIRE UNDERWRITERS
WE ARE IN THE PROCESS OF ISSUING A
CERTIFICATE OF COMPLIANCE FOR THE
ELECTRICAL INSTALLATION AS COVERED
IN AN APPLICATIO IQI'ED BELOW.,
APPUCATIONNO G�
IOCATfON VJ }
INSPECIO _DATE
18D(0EY W901
MAC ,a 219q�-
IUN I VL I V V a 111 L.
BULLDING DEPARTN1ENT Cl U
Town Clerk'[ Office
Southold, N. Y.
Certificate Of Occupancy
No. Z5739. . . . . . Date . . . . . . . . . . . . . . . . . . .1 . . . ., 19. 74
THIS CERTIFIES that the building located at . W/.S . Or.egon. RQad. . . . . . . . . Street
Map No. Xx. . . . . . . . Block No. . .XF. . . . ...Lot No. N.Y.. . . . . . . .
requirements for one family dwelling & bousine co
!�{?Rlrlrme-ct hcfar eij':J L�lc. :ti6AAil7idlg�lla[ [.IiIMx
built Certificate Qf Occupancy
dated . .be*ors . Apr_ . ,23 . . 19.57. pursuant to which XCjaW-.b'9T.r 4''o.Z5739-
dated . . . . . . . . .Jan . . 14 • . . . 19.7�., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is Private one family .dwelling . • and three Accessory. Buildings
The certificate is issued to OVTLer./ . . . . . . . . .
(owner, lessee or tenant)
ttf the afuresaid building.
Suffolk County Department of Health Approval . pTOn ATUtlne . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. pre. ..-. .4xix.t1ug . . . . . . . . . . . . . . . . . . . . . . . . . .
11OL'SE'NUMBER . . . . . . 55.75. . . Street . . ,.rvgon JtP&d . . . . . . . ... . . . . . . . . . . . . . . . .
. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
' . . .�
Building Inspector
SCIIEDUL.B B
TICOR TITLE GUARANTEE #T1285-2090
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FOUNDATION ( 1st )
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FOUNDATION ( 2nd )
2 . J
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ROUGH FRAME &
Cu
PLUMBING
3 . �i S
�.
IJJSULATIOfJ PER 11 . Y.
STATE ENERGY
CODE
x
4 . G --i
O' -
FINAL +
o
ADDITIONAL COMMENTS :
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VEL CONSTRUCTION CORP.
1138 William Floyd Parkway
Shirley, New York 11967
(516) 281-2646
November 21 , 1990
Office of Building Inspector L
(j u
Town of Southold
PO Box 1179 , 53095 Main Road
Southold, New York 11971 OLD
RE : Renewal of Building Permit #16786-z
Premises : 5535 Oregon Rd. Cutchogue , NY
Suffolk County Tax Map #1000-95-1-3
Dear Inspector :
As per our conversation , enclosed please find a check for
fifty dollars ($50 . 00) in order to renew the above permit .
The application is exactly the same as it has been originally
applied .
If you have any questions please call . Thank you .
Sincerelz
ACMT Equities , Inc .
Box 149
Shirely , NY 11967
ns/ACMT
enc .
('�Anf., fK\..R,GJ'•.. i* � rkJ - H fD_'��;..i �`,s,� e .}
J � o
INSPECTORS o�OSpFFO(�-c
(516)765-1802
VICTOR LESSARD,Principal OG SCOTT L.HARRIS,Supervisor
CURTIS HORTON,Senior =� Z� Southold Town Hall
VINCENT R.WIECZOREK,Ordinance C P.O.Box 1179,53095 Main Road
ROBERT FISHER,Assistant Fire CA Southold,New York 11971
Building Inspectors Fax(516) 765-1823
THOMAS FISHER ?°��• ��0�� Telephone(516) 765-1800
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 30, 1990
ACMT Equities, Inc.
Box #149
Shirley, N.Y. 11967
RE: Building Permit #16786-Z
Premises: 5535 Oregon Rd. Cutchogue, N.Y.
Suffolk County Tax Map #1000-95-1-3
Gentlemen:
During a review of our files, it was noted that the above
building permit has expired and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold Article
XXVIII 100-281 and 100-284 a building permit is needed for any
alterations or additions to an existing dwelling, and it is
unlawful to occupy said dwelling until the Certificate of
Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Victor Lessard,
Principal Building Inspector
VL:gar
Af
��. /�� � ✓'vim-- ,�'-�-�
APPROVED AS NOTED
OCCUPANCY OR ,n:*7401g B.P # 167f6
USE IS UNLAWFUL NOTIFY DEPARTMENT AT
'765-19 AM TO 4 PM
WITHOUT CERTIFICATE FOLLOWING INSPECTIONS: FOR THE
/ FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
OF OCCUPANCY P ROUGH FRAMING & PLUMBING
S. INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL
M Copper hV IS UNd THE REQS T REMENTTS OF E N.TRUCTION SHALL Y
LU
for STATE CONSTRUCrioN & ENERGY
�bI CODES nt1T RESPONSIBLE FOR
8y8tw: PIPSd shah be �GslrN r'.inuSTRuCTi(?At =RRQRS:
of typ" K os nr a 1°^
BOARD OF HEALTH . . . . . .
3 SETS OF PLANS . . . . . . .
FORM NO. 1 SURVEY .
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . ;
TOWN HALL NOTIFY
;SOUTHOLD, N.Y. 11971
TEL.: 765.1802 CALL • • • • • • • . . ..{. %. .
MAIL TO : ,�
Examined . 29 . . . . . . . . ., 1
Approved . . . . . . . . . .. I Permit No.1474A . .Z 1
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
uildi nspector)
APPLICATION FOR BUILDING PERMIT ��
Date . ` . �� . . . . . . .. 19 l
INSTRUCTIONS
r
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 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 shall 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`-issuariFe,,,of a Building Permit:p nt to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New\r%k,and other applicable Lav7�� ' ances or
2ofapplica?nt,
a l
Regulations, for the construction of buildings, additions or alterations, or 9name,
, as li�� �scribed.
The applicant agrees to comply with all applicable laws, ordinances, builds' - d regulations, and to
admit authorized inspectors on premises and in building for necessary ins pe
.c
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Signant, orif a corporation)
State whether applicant is owner, lessee, agent, architect, engin4f,',i6f eral,cont o;a electrician; plumber or builder.
° t „ i
���c'��/.1�. . . ./. ✓9/� . . . Ju—yl—`�' ?-1. ... . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . !./. . . /. . . . 4
(as on the tax roll of latest deed)
If applic , is a or oration, signatur f duly authorized officer.
CY
- . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED
Builder's Licensll 1
Plumber's L ill . . : . .`.
0
Electrician's License No. . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . f5 S 2,5 r
1. Location of land on which proposed work will be done. �L G`. . . t. . . . /,��
. . . . . . . .
. .. . . . . . . . . . .LC. /. !. . . . . . .C17.TC+ EQ.CaQE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House Number � Street Hamlet
County Tax Map No. 1000 Section . . . . . / .S.. . . . . . Block . . . . ./. . . . . . . . . . Lot . . . .: . . . . . . . . . . .
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 . . ,1—. 7. 3 Y. . . . ® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy�lZ(. . `r'1. . .` 4
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alterafi0
Repair . . . . . . �. . . Removal . . . . . � . . . . Demolition . . . . . . . . . I . . . . Other work w
1 (Description)
4. Estimated Cost . .�/.��7 /�.�*RG. t . . . . . Fee . . ®®
` (to be paid on filing this application)
5. If dwelling, number of dwelling units . . . . .�. . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . .
If garage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
o. 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 entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . NuntbgrofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . f: �.'✓� Rear . . . . . . . . . . . . . . . . . . . . . . pt
10. Date of Purchase f . ��. / ��./'. . . . . . . . . . . . . Name of Former Owner .K � �%`. . . 75 ?? t>
11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . "W�)
13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . Will excess fill be remove from premises: Yes No
14. Name of Owner of premises . .S'. J7 �� �' . Phone No. r i:.'. .': .<-..4i l.�. T . . . :. . `.. Address /. .'-f . .� P . �:-'
Name of Architect . . . . . . . , . Address . . . . . . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . .
Name of Contractor ? ? /j�. . .e-': . , . . . Address 2 :'. e1�iG.'f�`' . : ¢hone No.��.�f
15. Is this property local d withi 300 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 from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
PLUME - .^`RTIFICATION `-J-
LEI. ,);VTENT BEFOR / H r
ON
�..
CEArlFic.: . ;t Of OCCUPA
--- CY OR
ie tNI �VVFUL
WITHOUT CERTIFICATE
$ c SYS USEDlNCA vNOT OCCUPANCY
EXCEE 12110 1% LEAD.
1
BER"1611E AIM
STATE OF NETS' YORK, S.S 0
COUNTY OF . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners. and is duly authorized to perform or have perforned 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 set forth in the application filed therewith.
Sworn to before me this pp
. . . . . . . . . .°Z. . . . . .day of. . .. . 1�.�44. . . . . . . . . . .. 19 p� ,
4otary Public, . . . . . . '• '. Kk .(I/d . . . . County
HELEN K DE VOE . . . . . . . . . . .'' . . . . . . . . . . . . .
NMM�i88,&" tgnature of applicant)
Term Expires IAereh 30.