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HomeMy WebLinkAbout19293-z ~ ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20170 Date AUGUST 27, 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 3000 MOORES LANE CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 116 Block 1 Lot 8.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 1, 1990 pursuant to which Building Permit No. 19293-Z dated AUGUST 3 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & DECK AS APPLIED FOR The certificate is issued to CHARLOTTE B. WHEELER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-05-APRIL 26, 1991 UNDERWRITERS CERTIFICATE N0. N-198676 - AUGUST 2 1991 PLUMBERS CERTIFICATION DATED APRIL 22, 1991-HARDY PLUMB.&HEATING INC. Building Inspector Rev. 1/81 I~ roans xo. s TOWN OF SOUTHOLD BUILDING DEPARYMEN7 TOWN HALL SOUYHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED3 N° ~S l 2 y w z Date ~1tisQ.Y....... ~ D9..d.Q Permission is hereby granted to: ' l~.. t0 ..\.,.i~:1r:T.t!.....! fe .G... ~ ~ ~iyl.Y..Y':4:7.d:A....::!,:7R.~S:C:R~4~ at premises located at ...................................4.r.'.:l~C~...~-z............. . County Tax Map No. 1000 Sectio ....I Block Q..~.......... Lot No pursuont to application dated ...M~~.....~ 19.~.~, and approved by the Building Inspector. 1 Fee 5.,1.~.7~4....... CAJI . wilding Inspector Rev. 6/30/80 I JJJ Form No. 6 ~ ~ _ 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT t11JU 2 61981 TOWN HALL 765-1802 g 80._t3G. pEN7. TQWN C;F SC7UT,h'CILp APPLICATION FOR CERTIFICATE OF OCCUPANCY m 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 0£ 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. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1, Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming gaol $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Euilding - $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 $1/5.00, Commercial $15.00 / Date New Construction....!!...... Old Or Pre-existing Building....... / J . J Location of Property...~tJO O......11'.c~J/Zt .4` 1~~............ House No. / / ~ Street yYamlet Onwer or Owners of Property.. ~./(7~~la~r.~iLM~~,~~~~+:~ County Tax Map No 1000, Section...f ~G......,Block.....~..........Lot...4c.~ Subdivision....~.1~d{l,i ......................Filed Map............Lot...................... Permit No.... .Date Of Permit.. ',~..3 ~~:....Applicant. (/.t!/.~~~.~y . ~d1f,~:'!~.`;+!.~w Health Dept. Approval ..........................Underwriters Approval.........//.............U. ~ Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Pee Submitted: $ `I a y~nn~' ,C~ ~.cG~~ C O ~ ~ d ~ ~ V ...........APPLICANT • • ~,..LG.-.i..... . • - TEL.7G=-1802 ~ . OFPICF OL' D,ilIL• DILIG IVSI?£GI;OR u'~ 'd TO\Yi~i I::.LI- y ~ O ~ SOUTHU~D, N.Y. k 19Zfl ' z1 ~ ~ C E 12 T I F I C A T Z O t7 Date APRIL 22, 1991 Building Permit No. Owner WINDS WAY-MOORES LA. (please print) Plumber HARDY PL. & HTG. NORTH, INC. (please print) I certify that the solder used .n the water supply syst~...m contains less than 2!10 of 1~ lead. . " (plumber's signature) Sworn to before me thi~ ~_day of 19 ttotary Pub is Nota•:; i'vh_ic, County (,i,~%ifl~Y~+W1:eE'~".:ti'k~liti:dw'•fS;`>i~ iAiu ~t~j~-' _ _ _ ~ T _ _ ____~A THE NEW MURK. BOARD OF ~1RE W11~i+ v~t;x 7A00:1.2.1. EUREAU OF ELECT~ICTTY 05 JONN STREET, NEW YORK, NEW YORK 1003E AUGOST G7,.v9.1 AppUcationNo.onfiie 7:148~690/~0 [Y 79t;fi7F TNIS CERTIFIES TMAT - Mlr tAt eisctt~l slMipmswt r daeribst! Mlots snd inteodMCed 6y tM ypiicMat nowsd an tks ebsos yiFMe~ttow ttnwMr M the promise ~ ~ .HAR[,OTTE AHEF:I,fR. 4~CNDFIN AVt,NUF(MtXtkP:~ f~ANI•;), C[JTCH+Ji;UI„ N.Y. in tAefel/otriwRWntten' ~ BsEeptent © I.t FI. ? Pnd Ft. G.AH/1*1"1'.fC/6UT ~.,tion 11nck Lot ~ loos eiemined on JUI,~I ~ 7.99 L and ound to 6e in cdm lance with the J d' rorptireweswes~this leoed. taCIR lYtllOri ~ T NGNptettM OTNEn AMT. K. W. AMT. W. NAT, LW. AMT. t. W. AMf. R S E~ RNIYd MOTOK IIITIIr owllMtb 1~lf pNCUtY~t'?T 7Tl/g00If lIOAMEii AMT. t. W. pl N. OAt N. AMT. NO. A. W.6. AMT. AAV. AMi. AMR.. WT.. K e. NAT. WAlit - JiMVIC! OEOYMMCT S E ¦ v ' 1 £ AMT. AAM, ~ Tot +/tw i,?JW a.r tw to nv - No.d Mato NO. ofMpRIW - W.OF C,CdID. p' AC~CW ~t~1 I _ ~ _:f Of :~YI~M _ $ OTMM pt+1lRTYk Y_ i F PAUL, R. [StIttNS i,lc'.$?,A2F, ~r~~,~ °i 275 TORN HARAOR LANk G!~%~ Sf?iTTHOLD, NY, 1t97'1 gMIM?MIIM~ i] i .t„ ' Ptr ~ ' ' matwlsr Mwn ~ of tM ~ t • 11M~ ~ ~ CMyC',k~ NOS` ~E ALT IN A~MAMMI~: s k ~ THE MEW Y~?RI( e~ ~?F Uwf}~RMM~~~"15 r suMewu OF R4SGrtiNCRr sa ~ol~l~ arwer~r. NINr rpMrt, raw rolelc fooss ~ AUGUST ~7?.,1.99] .fpp?(cotionNo.onflb 714t??.690190 N ]9867n '~7'll~ C~RfllptS THAT ~b Hr:iitetrkd gr~wtntt r dweriMd 6donr and IwttotMrced 6y tAe t~NcoJtt wnntni on tM ta6oes a~rgptlrw:wriwMr in eMpromlM~ ~ N C'I'F; WHEELER, i~INl7FN AYENUF,(MOORF:S LANr'~l, i'UTCHCx;IIE, N.K. 4tlrtt~R ~ ].nt ~ IAt FI. ? Z„d GAR/AT'F 7. i./6131 ,q~:ttan Lot wut eartntwtd on ondJaund to Le in cdmttttt»tre kiEA tks rwyatrorntnM q/tldt2M6+rd. RftYif 1 s~ N11tii OTNEA AMT. K. w. t. w. AMi.. KW. K. W. ~ AMT. X. t. M11~ tglplp t/f11M1a RRRR RRt:YT My ItM1 ~ MMMR~i Mt. N. w. 00 N.1. OAl N. AMT. M0. ? W.O. IJAT. A/N. AMT. AAVA 7M114 FMT. N. AAIT. WATTS 5 F 1 30 f ! k V 1 C AMT. Aw. t~ T / tw i w ow f lr tw s/ wv w. W NO. a HHtb Oi ~ :"OA1l111wt ~ w. only tlr?~Rnuu 4KW GRNERATOR-] - ]OQAMP. AUTO TR.SWT7'C'H-1 5TON A!C 11NiT-]. 2rCiN A/C UNST-.1 k"k.AIR HANDLERS-3 MOTORS;2-0.50 H.Y. P P14NELBOARDS:1-1.8 C1:R. 7.00 G. F.C.I:-9 SMOKE DF,TECTOR ; -1. ~"°l rl,: t<~<Cont.inUed an Pape l ~~fRd11RA ~ ~ ~ nM Err ;n , 91Nar of +b. H ~ . _ ,F~. n. ~ _ ' e~? fat f.gw~!t• tws e~nr of ~ ter af~~. ~ ~r ` r . _ .~~,u~. c "r lELD i.:SPCC: iU17 Illln;c ~ CUCfMCNT.. ~ ~ A~ 1`• - - - IN FOUNDATION ^ " ~~St) a N ~tiy . ~ V FOUNDATION (2nd) _ - ~i z 2 . ~ ? K.ey ~ ROUGH FRAME & _ _yr d- .PLUMBING ,p1 C N _ l ~ [*7 r 3. m ~ H IIJSULATION PER N. Y. STATE ENERGY x CODE ~ r 0 4. FI7JAL 0 z c~ ADDiTI011AL COMMENTS: fLw -p xN LJv~. `~r.JU"V`~L~l~-~` xt ~.I _ H .,Q • t7 . O N 2 ~ x ~ • r ~ y w x o v ~ m Q H I 765-1802 l BUILDING DEPT. 6 1 NSPECTION [ ~ FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: G~, DATE INSPECTOR r ~ ~ 765-1802 BUILDING DEPT. 1 NSPECTION [ FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~S~ .H~~~~~ l K DATE fl- ~ INSPECTOR i l ~z~3 ~ 765-1802 BUILDING DEPT. t NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [~SULATION [ ]FRAMING [ J FI~NAnL~--~' REMARKS: ~ 1-~-~'1/~f!~t~"'-~/ DATE ~1~'_~/~. INSPECTORS ~~~y~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL REMARKS: ~~"'~`'-r' °~'~titiz~ L~i-c11~ mac- DATE ~ 4 INSPECTOR l ~ f ' _ B0,1RD OF HEALTH 3 SETS OFiPLANS.~. . /i FORMNO.1 SURVEY / ' { TOWN OF SOUTHOLD ..,.~llect; ~~s BUILDING DEPARTMENT SEPTIC CORM ~ . TOWN HALL 2 • ' • • n $OUT~OLDG5-18021971 NOCALL ~..I~~. ~ • ~:~`:°~`r7...... E%atui ~A~..~+~.., 197. p p MAIL T0: Approv• SdaQ.. 19gQ Permit No. . DisaPProved a/e ~ ~ . . /j J~1JG - 1(9~(j ~ ~ 4 (ding Inspector) l~ BLDG. DEPT. APPLICATION FOR BUILDING PERMIT TpWNOFSOUTH LD Date 15 .rte'. INSTRUCTIONS " a. Tl»s application must be completely filled in by typewriter or in ink and submitted to the $uilding Inspector, with ~ sets of plans, accurate plot plan tUscale. 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 shalt be kept on the premises available for inspection throughout the work. - F. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shatl,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 3uildin> Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tc¢ulations, for the construction of buildings, additions or alterations, or for iemoval or demolition, as herein described. lie applicant agrees to comply with all applicable taws, ordinances, building code, housing code, and regulations, and to .dmit authorized inspectors on premises and in building for necessary inspe~~t ns/~. "~jy~ Signature of a~Q,lie nt or,~inaAme, if eor uon (Mailing address of applicant) /65) ~ Mate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ;ame of owner of premises ..lC..~!r•~ .!!':'q'G~ ..!qv!`/di.J4.~~ . (as on/the tax roll or latest deed) "applicant is r , st~atur d y authorized officer. ' • (Name and title of corporate officer) Builder's Liccnsc No . . Plumber's Liccnsc No. . ••J' ~ Electrician's License No. . ~,~.~~~.t... F<tw!°.'~w Oilier Trade's License No . ' 3oob (vt a~ . Location o(land on which proposed rk will bi: done' _ Jam" Ilousc Number Street. Hamlet / CountyTa%01apNo.1000Spection Bl'ock J,,,•,,,,,,,,, Lot...,,ud~;•„ Subdivision .~'/~DC?... d.k'Q Riled hlap No. Lat . • (Name) State csistin^ use and occupancy of prcmi;e~ Jnd intended use and occupancy of proposed construction: A. Iixisting use and occupancy B. Intended use and occupancy.... •9•• ' ' ~;seS ,•rti:l iPb m~ + ~ ~ r Nature-of wort, check which aPplic ~ Addition Alteration • ( able): New Building . Repair R~movat', . Demolition ,Swimnin; pool........... . Tennis Couch Ace~essory Building....... ~Fenre•.,^,,,. ^ ...Other [fork........... . Y Estimated Cost ~ VT?? ,':'f' Fcc . ?~.7:G~ r.. , , (to be paid on Ctling this application) If dwelling, nutnbcr of dwelling units Number of dwelling units on each floor . . . If garage. number of cars .......2 ICbusincss. commercial or mixed occupancy, specify nature and extent oCeach type of use . . . Dimensions of existing structures, iQ any: Front . Rear Depth . . Hci~ht . Numbecof Stories . . Dimensions of same structure with alterations or additions: Front Rear , . . Depth 1lcight ~ ...q....... Number of Sliorics , ~ . Dimensions of entirefncw canstntction: Front /.G..... Rear ...~Il..C°....... Depth ~ ~ , , , , , , Hei;ht , ry.. Nurnt~erlof Stories ~!Y... r. , , , Size oC lot: Front ~l Resr ~6is.'.~........... Depth . Sr•~°... , rF'°,° , , , , Date of Purchase ....":'r~~: , . Name of Former Owner , Zone or use district in which pabmises arc situated . . Dacs proposed constructionj,tviolatc zany zoning law, ordinance or regulation: will lot be regraded ....~f': , . . , SVi[l excess Fill be removed from premises: Ycs No Name of Owner of prgrpises !i"(w.tit'k?~y• (,~•y.. Address fPt':°. ~C~"~ ~s .~r+P?~!'q'hone No. ~~":47?a::. . . Name of Architect .t+MtG?. , t7+jq q~., , ,Address ,~~yw:?'Lvln,..n,',rh Phone No..1L,f.:4.7f?.Y.... . Name of Contractor . W:wo4.kr!+P~. /.is~!•:in.•~. ej ..Address ./kt.YO.4!~w~'!! : 'Phona No.. Js %J..x~ta':.... ..Is this property loG~te~ within 300 feet of a tidal wetland? *YGS.1~N0.... *If yes, Southold Town T ustees PLOTDIAGRAM a required. -ter Locate clearly and distinctly.all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~perty Hnes. Give street and block number or description according to deed, and show street names and indicate whether crior or comer lot. ' - ~~i C/~ I I~ I, •\TE OF tiEW Y S.S ~j UNTY OF ~.'Gk'~. :.~~:'!~p~'"~'.1........ being duly sworn, deposes and says that he is the applicant •(Namc of individual signing Contract) , we named. (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly au'titorized to perform or have performed the said work and to make and Gle this lication; that all statements contained in this application arc true to the best of his knowledge and belief; and that thr;, k will be pcrl'omtcd in the manner set',forth in the application filed therewith. ` trn to before me thisy~°~_ ~ 1. 61...E of 1~ ary ublict • , . • ~1`+.. County ~/G~/.~iGj? ELVAB A<1jNNEVN,W (Si;nature of applicant) NoYAry Pub11a, $tMtioiNiwlAfMk . Tenn ~~9fE§~REtt~f a1,'1 ' -r SUFFOLK CO. HEALTH DEPT. APPROVAL ' ~ H S NO i ill .i' t t I I it ~ STATEMENT OF INTENT ~ ~ ~ ~ ~ ~ THE WATER SUPPLY AND SEWAGE DISPOSAL v ~ r ~ SYSTEMS FOR THIS RESIDENCE WILL ~r J+.. CON R TO E T ND l ~ ~ - FO DS OF THE SUFFOL F H~ L H SERVICES. 0, a~~`' ~r ~~'J~ N SUFFOLK COUNTY D PT. OF HEALTH ~~7_~%5~~~~~" SERVICES - FOR APPROVAL OF ` ti0 " Y',3A+tiCE 'J 1 ~ ~ " ~ ~ _ - - CONSTRUCTION ONLY `~1~/ VE:>ETA':Jw, TQP 1 ±iJP,Fr i`r ~ _ ~ c~ S DATE' _ ~ c ~ i ^ = - H. S. REF. NO. -`p~~',P';~,4 APPROVED- I 1 Gl ~ II..44 iT ~ J?.~~ ? r 'T7~ \ \ ~<t". \ `~Z 3 L ~ 'k~~~ J ~ 1 V 1 ~ it C~ ~ T. ' T,` ~ 1L ~ f~ ` ~ SUFFOLK CO. TAX MAP DESIGNATION: poP DIST SECT LOC PCL s ~ .5 Jf,~~.' r ~ 2~.;} ~ H ..t ' '+.:i~Fi_ ~ . - OWNERS ADDRESS. k ~ ~ - ~ ~ \ _ - ~ 1•;..;-..40 L ( 1 i~'7 i _9 ~ ~ ! iy 'l ..'r / ~ ` ~,~~~~7 HJI.t ~ , Ji2.Ci'I~~G + v, ¢ 3 a DEED: L.SQ,$O P.49~,,::.EF j ' ' .>J A. W ~ 1 ~ ~ . , \ ~ Z TEST HOLE STAMP PLEASE NOTE . ~ c i". - x;-__ _ \ So,~~ Requires sepiic ta~~c ~ ~ HUMU` - y cover to grade. ..OAM t"'"`.'~'NMbwOro Mtcsa seats n:.-,n~rM ooN YrM nt bs aonaFknat T~f. o _ _ 4" mtoa~rYYf~rooogt. ' M1~t {"i r_ E _ (£uarartleaa Mlieaeed ttwaon tMH n•n ' r `1' ~\'V~ ~ 't ¢r.!'blM peon l.r Whem tlrow iJ , 9 ,,OAM g;!a orMraq.9aormm.ntd a,srtcye IN~"ECTION REQUIRED 1. ra MMM.onl arli. EehaM>o tlsa ` ~ _ 2.5 iaewrlan IiaaaJ Irxaon a:~ " ~ , ?+?PA aeftOnaaa of tM Iwgdiq Inri- ' .Ar:Fln. Guaearrtaas an nal trsne:er i=4NE 9ue~"."~1trlMlppalaarnrEawp fw~ t: k _ i IJUi E'S ~ _ ~ ~EAL . ~ ~ ~7 ' i K bq~,~7 1.~,GT h~ 1.~. Ff r t~ l R F+A,V' r'0s E~`(PJQ.r r. _ _ s ~ ~ - - 9L7G. DEPT ~ t r t; Mj~ ~ t ~r Vv fi7 v . v',~~ ~ TOJ~I.=..-SJJTHQSrI WATtiC. ~ ~n~~ ~ r ~ 1 ~ 4 r .c - - r , J ROf ~I t :ter t s ! E is TU Jti~" ~ `~I, c' -DERICK VAN TUY~. P.C. SACt:~ 1 ~ ~v,r GArs,M "'f~.l*: ;rA LEV..~, ? _ cs`z H`~ LICENSED LAND SURVEYORS 15 J' 6REENPORT NEW YORK n~ton.e rosy ahryr ~ ~ ~m : ~ V 4„ .f ? rt ~ ~ 1 ~ ~ ~ fit ~ ' ~ ~i ~ ~ tV I ~ ~ ~ r ~ ~ c~ ~ A ' ~ ~ 2 if s' ~~'aa ~ S y' u'w' - \ / J{ ~1 _ it ~ rn\ °i• , ;iF ~y ~ o j ~~9 i j r~';n~ ~y' rt~j L7_ f 1 ~ ~ I,a`;C;~..'~ t'~~ J~~- ~ ~~i1~ 3P4~~ 1?,~~ '~e" ~,i t.'Jn~ Fla, ~ ~ o ,~ti ~ .~r~~,..~ ~ P) wr ~~~Cj]~~ f'.';J ) Ri .mil ~j/ ~^?'I r" {ii 1~~q,~ (,-v`(~~.' i rr, 1 ,~t~ (1 i rY l f 7 ~ ~ ~~,~lp" a ~"•r -71.-' t~'s,'~ CSC i i m v ~ , ~.a ~ w ~ • q r J l F"~ y j f j Cr m f% t t^ l "t,re F 26.1'7 y ~m~o~.., IF,c1S.~~ "i41 N~:w ~4i4`~f ~e n°°~~.: fJ 4z~"~,r+ `,~i 253.3. 1` .l ! Tt ~i ~ ~ g 111 i ~ ~t^ `"i'i ~ tw, w 1 - fir.- ~ J i , G1 r ~ 1 ~ ni ~ rn ~ ~ ~ i. c,9 I i t.. t ~ ~ s~°3 O~ d ~~~l.l~_ l'1 11) ~ 1 '~,~~~11i) N ~ ~,+y it 1 i 1 ~"~i O ~ ~ ~ 1 ia1~~ ~~4~ fr,, `p s, 11..E ~1 IC'S~'r' t.t , ~~a ~ ~ 0 4. 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