HomeMy WebLinkAbout18154-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218365 Date SEPT. 12, 1989
THIS CERTIFIES that the building POOL
Location of Property 675 HILL CREST DREVE NORTH ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 13 Block 02 Lot 8.19
SECTION 1
Subdivision HILL CREST ESTATES FILED Map No. 7218 Lot No. 17
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 23, 1989 pursuant to which
Building Permit No. 181542 dated MAY 31 1989
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 INGROUND PQOL WITH FENCE ENCLOSURE.
The certificate is issued toELIZABETH AND PETER MC HUGH
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.~ PENDING SLIP 9/11/89
PLUMBERS CERTIFICATION DATED N/A
C~
Building Inspector
Rev. 1/81
vows xo. 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)
N ° ~ ~ ~ ~ 4 Z Dote ...:~~f 19.9./
Permission is hereb granted to:
to ~ , ~ mac
at premises locoted at ....Gi..rf.~J..../~ ~t~..~.l~r..... ~Y~"'~/
County Tax Map No. 1000 Section Block Z.,,.... Lot Na........Cl..f.~/....
pursuant to application doted ......~~F.:~~ 19.~~, and approved by the
Building Inspector.
~ a
Fee ?.~.r..~J.f...~
.............L~~%r~~~vy .l.
Idin nspector
Rev. 6/30/80
D ~G!_~I'~!ir~ '
.FORM NO. 6 D
TOWN OF $OUTNOLD s~p ' z I`', ~
Building Department
Town Hall
Southold, N.Y. 11971 - gLpQ r"s%¢;s"•-.-..
765 - 1802 TOtAlfp OF SUU;'i t,t.D
APPLICATION FOR CERTIFICATE OF pCCUPANCY - r
Instructions
A. This application must be filled in typewriter OR ink, and submitted to the Building Inspec-
torwith tfie fo{lowing; 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 intarma•
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $100.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 '
4.Vacant Land C.O. $ 20.00 ~~/Z~~~//'
S.Undated C.O. $ 50.00 Date ..0...~~......
NewConstruction„X•,Old rPre-e istingBuilding~~............ Vacant Land
..~7s.H?--~.......:~
Location of Property - -
House No. Street ~~et
Owner or Owners of Property
County Tax Map Nopp 1/'0~0~0 ~S~e-ctiorn~..... Block Lot ~..C .
Subdivision . i. !~?!".'^:"~f~'L: l ...Filed Map No. ~~~4j~.~`.,.~L,~ot No. .
Permit No. .r. Date of Permit ..........Applicant ....~.r!-. .
Health Depi. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certific//a~~te~~
.....................Final Certificate ...,X~................ .
Fee Submitted $ ~ y .tJ..V
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ~~~%~~~~'~i.°:..
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JSULATION PER N. Y. '
STATE ENERGY
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ADDITIOP7AL COMMEP7TS: x~~
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THE NEW YORK BOARD OF FIRE UNDERWRITERS 1'7tur
1 t~fl?. C> l1~ BUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 10038
Dote S~;F'TP:Mt#E~S~ ~~l'1'~~`~ APPlicatian No. on file ~~~~7 ~~~1~~ .41 QUi ~l3~~
THIS CERTIFIES THAT
only the electrical equipment os described below wnd introduced 6y the applicant named on the above application number in the premises of
~)arl`EN T4cF)13GH, kialll,tlRFS°>? 11RT~?h N, r 1kRTki4'I', (~,1`.
in the following location; ? Easement {1179' 1..f ~ i~ <
? lat Fl. ? 2nd F'I. Section Bl«;k' Lot
S(i;l>'l'faDFF3F~R t1 ; i q°S*3
wws examined on and found to be in contplionre with the requireneenta o(thia Roard.
i1XTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT fWORESCENi OTHER AMT. K W. AMT K.W AMl KW AMi K.W. AMi. H.P.
t 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
PMT K. W. OII H. P GAS H. P AMT. NO. A. W G AMi AMP AMT AMPS TRANS. pMi N P, SYSTEMS AMi WAiiS
NO.OF FEET
1 his 1 ~0
' SERVICE DLSCONNECT NO.OF S E R V 4 C E
AMi AMP TYPE METER I YW 1 p 3W T d 3W 3,e' dW NO. Of CG COND A W. G. NO. OF HbLEG A W' G' NO Of NEVYRAIS A M' G'
EQUIP. PER9 Of CC COND OF HbIEG OF NEULflAL
OTHER APPARATUS:
*(sWLNSI'fitNC'. ITCIQTr} T'hir C;?i"tT~,1~'a4"F+
cr,v~rs crt~ni~,:l~ianc~e a9' iihra data rs1'
inGp~tetic,la aTl1y, Bhcan;c.~l a~ Itslttir3a).
an~t9.ronmelTi:~ ~t a=: atlvi,ab1.~= Cn
15a,ve fr~elaent tiet,t rantl/Y.r ~r~:f^~~ir;:
Psall4' by a cgtla7.afiL.,d 7~c:rt,;n1t.
(v & S ta~Pl`('T2C,CS'CgNt Zl1G:a9578°~;
/
P3t7X ?.1 ".s
SpTJ`I'flt)LI), IaY , S. 1.9`7 ~ GENERAL MANAGER
17. ~
Per 1 1
This certificate must not be altered in any manner; return to the office of the Board if in<orre<s. fnspecfors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANPIER,
~ I ~ Tss-1soZ
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( } ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING (~]'1=1NAL P~°~,
REMARKS: -
DATE 7/ ~~~~INSPECTOR uti
I
D ~ ~ ~ p Pl BOARD OF HE~ILTH
3 SETS OF PLr1NS .
~~y s+ FORM NO. 1 SDRVEY
!W i!~ TOWN OF SOUTHOLD CHECK :~F .
BUILDING DEPARTMENT SEPTIC r•oRrl
TOWN HALL
SOUTHOLD,N.Y.11971 NOTIFY ~a~g-!?.~.~
, GG TEL.:765-1802 cnLL
Examined • • 199."~f MAIL T0:
:\Pprovcd `~/~f........, 19~Permit No. l ~~5~~
Disapproved a/c
/ (B141 g Inspector) `..f
APPLICATION FOR BUILDING PERMIT
Date ....s. `2.~........, 15 F
INSTRUCTIONS
` I
a. Tlus 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 leave been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Reculations, for the construction of buildin additions or alterations, or for removal or demolition, as herein described.
The applicant a,rees to it+ll`9i11~`~~~'Ez~cabie laws, ordinances, building code, housin; code, and regulations, and to
admit authorized inspectors on~~~ ises and in bu~ltling for necessary inspections.
.,.,_,.,...k....«..
~,r . ~ (Signature of applicant, or name, if a corporauon)
: ~ ~ ~ . ~~..4n~k~~l...tz,-P.....~a~P~fe~, , ~~5 w;-S .
3 a;tti.o- ~ , kIE~T~{'",~it)fP# ' (Mailing address of applicant) l lU~~i'
z ' ,tl.? Ck~+~t)f3~t ri0~~
State whether applicc,~~tg,~is, ,gwner, ]es ag®##t,fk`AcHitect, engineer, general contractor, electrician, plumber or builder.
ud•;~s rettt:L. • .
Name of owner of plra~rpjces .,:~:'~:Q-:~f~t .~'k-...M~ L~U G E-~ .
r ~ 3~i~ :t,~ ..S~t~A`fl'1P (as on the tax roll or latest deed)
~ ~ , g Q :S 3'T~"-~
IC applicant is a corl~dt~~~r~ na ~ au~hgrized officer.
a,
. f ' s~
L~s.M~+
r
Name and tit]e of co orate officer)
Builder's License No. . ~ SOU't-49t1~,~-~Ptu`9
.LSS.°~.=
Plumbei s License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on which proposed work will be done .
House Number Street. Hamlet aa
County Tax \tap No. 1000 SeCt10? Block . , 2-, , , , , , , , , , , , , Lot ...q.: , .
Subdivision Filed ~1ap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing {-l~,w , ~~Sip~n.;~ttwt....r',\t.ll',1~ '~.n\L~( l~('Sa~t'~
use and occupancy .
b. Intended use and occupancY
A6 l ~ q
• (check whit a
J Re.m plicable): New Build'sng Addition 6':'. , . ry~igp, F.....' "
~ei .
Ret air of work oval Demolition , ; Oftfer l~4..,., ~
P
f'
4. Estimated Cost":'..1S.Id,Q Q . Fee , G.s~,,>ts'F'
Qo be paid on filing this application
S. If dwelling, number of dwelling units . Number of dwelling units on each floor .
If garage,numbcrofcars
6. If business, commercial or mix 'd occupancy, specify nature and extent of each type of use , , , , , , , , , , , , , ,
7. Din any: Front Rear Depth...............
Hei ofStorics
Dim Iterations or additions: Front . Rear , .
Dep ~ Icight . ......Number of Stories ; .
' 8. Dien on: Front Rear Depth ,
Heig b of Stories . . . .
9. Size to . Rear ....~q~1.1 Depth ...L1Sp ~ .
10. Date: Name ofFormcr Owner
11. Zone br use district in which premises are situated . . . . . . . .
12, Does proposed construction vioiate any zoning law, ordinance or regulation : .
13. 1Vill lot be re raded .
14. Name of Owner of remises eft ' ' ' ' ' ' ' ' Wdl excess till be removed from premises: Yes No
p E~ . P14N4+6µ ......Address Std, la€-:~-t da~e~T ~D.'Phone No.'7 :6~~ 3. .
Name of Architect AddressG!'~0.~":' c~«~ ....Phone No..
Name of Contractor .M14tRl'~ COQp ......Address 4~ ,~,fl~ u,,.l}'hone No.:`1`?-~' E;t~,`7„
IS.Is this; property located within X00 feet o a Ida "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.
APPROVED AS NOTED
DATE:._.~..._.~.. B:P. M
NOTIFY ElU1L01NG oEPARTMENT AT
7pi5-1802 8 AM ro a PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED '
FOR POURED CONCRETE
' 2. ROUON - FRAMING b PLUMBING
3, INSULATION
4. FINAL CONSTRUCTION MUST
RE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQtMR~AENTS OF THE N.Y.
STATE CQNS11NI4"l'WN & ERtiM
CODES. NOT ~ON$IliClf FOR
DESIGN OR C9N>bTRUC710N ERRQRB
STATE OF NE1V YORK, S.S
COUNTY OF .
(Name of individual signi~'r ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant
~g contract)
above named.
Ifeisthe
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly ,authorized to perform or !rave performed the said work and to make and file this
application; that all statements contairicd in this application arc true to the best of Itis knowledge and belief; and that the
work will be performed in the manner act forth in the application filed therewith.
Sworn to before me this
\otary Public, r?!..~ . 1^'R: S~!~r...... County
HELEN IC DE VDE
IIOIERY PUDLIC, SUCe ~ ~ Y~ (Signature o f applican t)
Tn~m'ExPirags
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NOTES ELEVATIONS ARE REFERENCE
~ TG~J~~O~'~ TO N G V D (M S L 1929 )
ip ~V`~D\vG / /
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~ _ _ _ - -
.a ~
~o- 0 89.50 EL=s7_--=-._"._____------
t: 85.50
EV8~~ R~640.00' 5.83°35`30"w. NORTH
EL-ag.2 DRIVE
REST
~OPO
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BRAN 0 `
. SO
fig.
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SURVEY FOR
PETER T. MC HUtiH ~ ELIZABETH MC HUGH
suFFOLK couNTY DEPARTMENT OF HEALTH SFRVIr; LOT N0. 17, HILL CREST ESTATES, SECT. I"
AT ORIENT DATE SEP.18, 1987
FOR APPROVAL OF CONSTRUC7IGN r.,la'I TOWN OF $OUTHOLD SCALE 1°= BOI
SUFFOLK COUNTY, r;t:d+ YORK Ne 87-1384
DATE K UIMUTN 011Rtp AI TERA TI ON OR AO 01 i10N TL1 TNIS
HS REF. NO. GUANANT ~
SURVEY b A VIOLATION OF SECitON ]209 OF THE ~ ~
MEW YORK STATE EOVCATION LAW PET f ~
KcoPIES GF rNlx suRVer No- sEARwG rHE LaNO E A }~'{`~DM6H M A
APPR6VE0_ - SURVEYORS INKED SEAL OR ENROxSCD SEAL SNALL P CO 6 AtlSTRA
HOT 0C CONxIOE REq TO 0E A VALID TRUE COPY
_ _ _ MGUARANTEES IHOICA/Eq HEREON xHALI. RUN ONLY TO 'T dl.D QS ~ NK
HEALTH pEPA RT MENT-DATA FOR APPROVAL TO CCNSTRUCi THE PERSON FOR WNON THE SURVFY Is vREPAREq .E
ANO a MIS xENALF TO THE il!LE CON PANY, GOVfRN-
N NEAREST WATER •AIN _NI Y 11 SOURCE Oi wATCR PRIMATE _.-.PUfIIC- MENTAL AGENCY AND IEN DING INS 41fUTION uSTED ~t • ~ ~,"w F
N Slit CO. TAX NAI qfT 1000_SCC710N _Q 'jy` pL,OCK 52,. LOT 819 NERCGW, ANO TO THE AxS IGN EES OF tME Lt NDtNG
NTN[K AR[ NO DW[L LlNif WI7NIN IUD FEET OF TNIS PROPERTY IN5 TITUTION GVAAANTEES ARE NOT TRANSFERABLE y~
OTHlR TNAN THOSE SNOWM NEREON 70 ADOI TigNAL INS TITVYIONS OR SUBSEOUE NT ~ e„`.~J~
N THE WATER SUPPLY AND SEWAGE DIxNOxAL SYSTEM F011 THIS RLSIOCNtY OWNERS ~ ryO~ 458e'' " ~ "y'~
WILL CONFORM TO TH[ STAN OAROS OF TN[ SUFFOLK COtNf TY DCpAR INENT R CI STA LACES SNOWN HEREON FROM PROPERTY LINES ,yy
Of NEALTH S[71V ICC7 0 E%1571X6 STRUC TURLS ARE FOR A ]PECIFIC e
PVR pO3E ANO 4AE MOT 70 DE VSEO TO ES TAf U3M t: l
MD SU
AMUCANT~ PROPERTY LINES OR FOR THE ERECTION OF FENCCS
TtL 1 OUOVG 8i 1 ®~~Cj RI~VERH
ApNNEW Y
RN~IE
NOTES p STAKE
SU9DIVION MAP FILED IN THE OFFICE OF THE CLERK ALDEN W.YOUNG, PROFESSIONAL ENGINEER
OF SUFFOLK COUNTY ON AUG: 15, 1983 A3 FILE X0.7218 I ANp LAND SURVEYOR N YS LICENSE NO 12845
NOWARO W.YOUNG, LAND SURVEYOR
it THE LOCATXNI OF WSlI(WI, SERTI C, TANK(ST)>t CExSPOOL4(CI) SlfOWN IN'JI@ON N Y S. LICENSE NO.45893
ME FROOf FIELD ObSENWlT IONS AMO OR DATA UG TWNED FyON OTHERS j DEF
....~....e,...,e.,..,...., - - -
DRANOIS 6 SONS INC.
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