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HomeMy WebLinkAbout17620-zFORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218652 Date DECEMBER 18, 1989 THIS CERTIFIES that the buildinq ONE FAMILY DWELLING Location of Property 850 ORCHARD STREET ORIENT House No. Street Hamlet County Tax Map No. 1000 Section 025 Block 04 Lot 013.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 10, 1988 pursuant to which Building Permit No. 176202 dated NOV. 18, 1988 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, ATTACHED GARAGE, DECK IN REAR. The certificate is issued to MICHAEL BOGDEN, JR. (owner, } of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-114 AUG. 4, 1989 UNDERWRITERS CERTIFICATE NO. N096197 OCTOBER 6, 1989 PLUMBERS CERTIFICATION DATED KING PLUMBING & HEATING DEC. 16, 1989 , Inspector Rev. 1/81 IOBM 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 ~ (J 17 b 2 ~ Z Dote ...~.~.:!'Y.1.4~:~4~:...1..~........., 19.~ ." Permission is hereby granted to ... . `1 W ~`~ cY premises located at ..~~~........1.7-.'.`-~........... R~.l.........~1~'~! ...... ........ County Tax Map No 1000 Sectio . ~~- ?~ . Block ...... .. ...° .............. Lot No ... . ... ..1..'~..: ..... n pursuant to appl~cat~on dated .. ` ,, ~`Q'~^~-~1. + .F. O.. .. ., 14~~ ,and approved by the Buiidmg Inspector. Fee $...+a~r~i ~.e.~ 02. Building Inspector Rev 6/30/80 Ca.P~ sz ~~~ ~ TONN OF SOUTII IIUILDINC DCPART:ICt2T TOl1N HALL SOUTIIOLD, NEN YORK II971 765 IBOZ i APPLICATION FOR CERTIFICATE OF OCCIIPAttCY f ~~~ ~~~~ I 'f• NEN CONSTRUCTION ~~~L~'...OLD OR PRE-E%ISTI2tG IIUILDINC......VACANT LAND........ pp ~ ,-,- Location of Propcrty.C~s°~ ............. ~~~C,~~h-j~v'K~.? ........_~!1~:~:?...._, .,,. UDUSE NC. STRLET UAHLLT Owner or Owners of Property~t~~~9`°~~-~..C.~~n~.~.~Li"...5~~.~ .................... County Taz H~a/p No. 1000 Sectioa~~`~?... Black n~.... Lo[ ~~~ :~~ .... Subdivision!:~ ..................... Filed1 Map _.._....Lot/~._.._..._. PerniC No. `~L1~~.'~.?.Date of PcrmiC r~~Q~L .:~...ApPLicant 1.~~~r~~`~.~~. ~. YS1~~w~% ~~ Hea1Ch DepC. Approval .................. Underwriters Approval._............ PlanninII IIoard Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... APPLICANT~.1~~C;~l~-:_ ~_~.7r)~C)C;7:..~:....._.... ~ ~~ ~G3 ~~~> ~~~y Gv z > ~~ 5'y .„ _~~. lD/Ia~as a- _ ' `M ~....'.n ~~ FORM N0. 6 TONN OF SOUT[IOLD ~~ ~ ~ BIIILDING DEPARTMENT TONN UAL, 765 - 1802 i ' '~ APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTROCTIONS i A. This application must be Filed in typewriter OR ink and submitted to the Huilding Inspector with the following; for nev buildings or nev 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 Dealth 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 solder used in system contains less' than 2/10 of IZ lead. 5. Commercial buildings, industrial buildings, multiple residences and similar buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. Far ezisting buildings (Prior to April 9, 1957 non-conforming uses, or buildings and "pre-ezisting" land uses: 1_ Accurate survey of property shoving all property lines, streets, buildings and unusual natural or topographic Features. 2. A properly completed application, a consent to inspect sigved by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, ]957. If a Certificate of Occupancy is domed, the IIuilding Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required Co prepare a certificate. C. For Vacant Laad Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of~the entire lot prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing Co the applicant. D_ FEES: 1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00_ Accessory building $25.00 Addition to Accessory buildings, $25_00 - Businesses $SO.00_ 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20_00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $IS.00 Residential Commercial r ~v- 10/14/S8 cs-~a.•~.. rn~ ~ra~ --.-. F _ ~~ THE NEW YORK BOARD OF FIRE UNDERWRITERS NAGP; 7 , 11951.12 ^uREwu o~ ELECTRICITY - 83 JOHN STREET. NEW YORK. NEW YORK 10038 pate OCTOHHR p6 ,198'a gpplkerion No. on Ella 61163189)89 N 096197 THIS CERTiF1E8 THAT only tke alaetrlcal aquipwtsnt o deacrthed 6alote end Jntroduced by tAe applicant named on the o6oee eppltca[ton !lTAwaker in the pselniese of NICNAl'sL BOGDEN, ORCRAkO STkkE'7', OR1:$N'I', N.Y. in thefoUouinR laeation; ®Bseement ® /At F(. ®End Fl. GAR/OUT .Section Bloek Lot p uws eratnIned on SSPTBNHER T,5, 1')89 endfoundtu 6e in rnmpliance leith the reyuiremente of thu Board. RANORf 000%INRRRCKf OVRIS T fAtK A%fUM - AGYf STlIiONS t){ITtRS INCANDElClNT IIUOtlSCMIT OTNEa AMT. K. W. AMT. K. W. AMi. K.W. AMT. K. W. AMT. N.I. - 29 4b 29 29 1 1.?. 'I. W' .~ ORY9S 1{IRNAGl MOTORS IIITIIM AMUANd liMf SMOAI RRC-T i1MR ClOCl15 pLL UlRi tilAiRRf IMR,T40YI1lT DIkIMRRS NAT. K. W. OIL XJ. OAS N.I. AMT. NO. A. W.O. NAT. AMI. AMT. AMK. TRANS. AMT. H.I. ~ NAT. WATTS 3 F 1 sRRVtcR olseeotallRRCr No.os s e R Y I c e AMT. AIN. TTI! ApY[TRR- ~ 1 tw 1 R 7w 1 / SVI 9 X Aw NO. p G COND. OF CC ~ OiID. NO.Oi N4aG Oi ~~ NO.OI NNIIIIAa OF '! Eu~N I 200 CH 1 X 1 4/U 1 ?.(U oTNn Ai7ARATeX: G.r•.c.I:-m sNOxF. nsTrcTOR:-2 TRACK LIGHTING:-4 ~ ~o SAGS & LADRKANN iNC. LIC.~3635-E P.O.BOX 1.968 SOUTBOLD, NY, 1.1.977. Tkit artificoM nnnt not be akared in anY manner; rNurn to fAe office of flr Boord if ORiRAI MANANR 11 f',. ~ J Psr l.. y v~l» idmtilisd by tMir cndantiab. ~pc~~14FUL/(Cp0 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR z P O BOX 728 vim'' yc TOWN HALL ~''O,~o~ ~ ~~~~ SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N TEL 765-1802 Date ~~~~/~1 Building Permit No. /7 ~20 Z owner LsricN/~~TG ~oy~c+~ Jr ~' (please p int) Plumber ~.nk, ~~w-- ~i.-, -.- ~wfiv~ L/~c- ( lease rint) I certify that the solder used in the water supply system contains less than 2/10 of 18 lead. 'V ....' ~_V.. ~~ ~ (plumber's si nature) Sworn to before e this , ~.,ti1/ ,, n , ~~day of ~ ~ ~j~_ ~ 19 /J / • Not Public Notary Public, County MARtLYN r, NORKEIYN Notary Putdic, Stata of New York No 52-4f;095;r5 Qualified n Suffolk County C' Co`nmisaion Exovea Merch 30, 19 ~ ,• 1::Ld Li: ;: EC: iU;J (llATa ~I i;OMMJ;NT° v 1. - FOUtdDAT?ON (1st) FOUNDATIOtd (2nd) 2 . b DOUGH FRAME & ~ PLUMBING 3 ~ ~ s~c.cP.le ItdSULATIOPi PER N./Y. • - STATE ENERGY CODE W 4. FI;JAL ~, ` ADDIT DIAL COMMENTS: y f d- ~~~za 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. DATE INSPECTO ~~ r [ ] FOUNDATION 2ND [ ~ INSULATION [ )FRAMING ~ FINAL /~~ ~o 765-1802 BUILDING DEPT. INSPECTI®N [ ]FOUNDATION 1ST [ ) R UGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: ` _'~"'~~l" ~- ,. DATE ~ 3 INSPECTOR ~~~zo 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [~RAMING [ ]FINAL ~ ~-~ REMARKS: ~f , ~ . _..1 q / - DATE 3 ! INSPECTOR -~"~ 1 ~~ ~o 765-1802 BUILDING DEPT. INSPECTION [ OUNDATION 1ST ( ~ ROUGH PLBG. [ ] FOUNDATION 2ND ~ ]INSULATION [ ]FRAMING [ ]FINAL i BOARD O£ HEALTH G' ~'V 3 SETS OF FL NS -~~--fl~• FORM NO 1 SURVEY ~ K ~. ~.~:7 TOWN OFSOUTHOLD CHECK -~--- BUILDING DEPARTMENT SEPTIC Foxr1 ~: K;,....•...; TOWN HALL NOTIFY I 40UTHOLD, N.Y. 11971 CALL • • • • •62`•1•°:'~O~' TEL.. 765-1802 MAIL T0: Pd, °7~ 5 3 Examined . ~ °""'^^~~~• I ~, 19 ~ ~ O iw->+-~ Approved ~ ~-tQi'• ~. ~ ?7 , 19~~. Permtt No ~ ~ (O a v ~ Q ^~ Disapproved a/c 'i'G ~l ~ro ~~. ^ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~~/~ 6/ INSTRUCTIONS .., I~ a. Tlus application must be completely filled in by typewriter or rn ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing locarion of lot and of buildings on premrses, relationship to adjoining premrses or public stre•_ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app ' cation. c. The work covered by tlus application may not be commenced before issuance of Building Permit d. Upon approval of this application, the Building Inspector will issued a Building Permrt to the applicant Such peril shall be kept on the premrses available for inspection throughout the work e. No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Burldmg Permrt pursuant to t Burldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or far removal or demolition, as herein descnbc The applicant agrees to comply with all applicable laws, ordinances, burldmg code, housing code, and regulations, and admit authorized inspectors on premrses and in burldmg for necessary inspections (Sl1ignature of apphc nt, or name, if a corporation) (~arlmg address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or buuu• rJw' rc~ .. - . ..~/1. .II ... .. - .. .. .. ..... . Name of owner of premises (! !~ ~hC).~-` C ~~f~4 n . 'w . . - .... .. . . .. . ... (as on the tax roll or latest deed) If applicant rs a corporation, signature of duly authorized officer .. .. .. . .... . . . (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFO K COUNTY LICENSED Builder's License No (3 ~8t : (~ ,rt.~^/ ,~,_( Plumber's License No .. - Electrician's License No ~^:~. J°Q~' `~~O ~ S E J U Other Trade's License No - I Location of land on whrch proposed work will be done .. - .. ... .. ... .. . r~S~`J .. ~Y G~1aY~~,. S~ .. ~ r it ~ .. . . House Number Street Hamlet County Tax Map No 1000 Section ~w.~a, Block ~`~ Lot ~~ rS rJ . , Subdivision ~ Filed Map No ..... .. Lot .... . (Name) 2 State existing use and occupancy of premrses and intended use and occupancy of proposed construction a Existing use and occupancy ~~~,~~~-- .. .. .... ~_ ~•v~ ., 1M~1'ur~t ++'l! +atii i+t''kt'-Y'r1o~ b. Intended use and occupancy .~-~ ~ i. ~ ~ 1UTi~~~. xn~;M ni+1 .. .. . .. l+. ., w. qa .yyl~iR15f1... . P• r^ s+, ~•^ry 3 Nature of work (check which applicable) New Building Addition .. .. Alteration .... . Repair ... .Removal .... Demolition ... .. Other Work . .. .. . (DescnpYion) 4 Estimated Cost ~ ':'} ~'. vim.... .. .. .. .. .. .. Fee .. . ` (to be paid on Cling this application) 5. If dwelling, number of dwelling units ~' T•C .. Number of dwelling units on each floor • .. ....... If garage, number of cazs ~r-e-. .. ... ...... ....... ...... . . 6 If business, commercial or mixed occupancy, spec>fy nature and extent of each type of use ... 7. Dunensrons of existing structures, if any Front .. .. Rear .. ..... .Depth Height ... .Number of Stones .. . .. .. .. .. .. ..... .... . .. Dunensions of same structure with alterations or additions' Front .. .... .. .. Rear ... .. . . Depth .. .. .. Height `~`' ..... .Number of Stones .. ..... 8. Dunensions of entire new construction Front ~~~ ... :Rear 3T~ .. .. .... Depth 3~' ....... . Height ''16. ~ ... .Number of Stones j~%,-rc. . . 9. Size of lot Front 1~l~ .. .. ... Rear jai .. .... .. .. Depth ~7:~ .. .. .. .. 10 Date of Purchase F. 13,x`-. .. .. .. ..... Name of Former Owner '~UC1s~.~.1.~.^,C~x~Y~ .. ..... 11 Zone or use distract m which premises are situated ~a ' ~t~ u+acrt 4a,1' ~ ~ r,, f y,1} ~r.,~\, ,?,,c r,c,~l • . .. • . • , 12. Does proposed construction violate any zoning law, ordinance or regulation fv ~........ ... ... . ... . 13 Will lot be regraded ...~, ~~. ....... .Will excess fill be removed from premises Yes N 14 Name of Owner of premises '!Y1~.c,Ha~~ ~xoojl•, r, Tr.. Address k..,,a. ~~ ....Phone No 3~a . 3:!'# .. Name of Architect cLF~~~t~i.'F1r1~^l~i`r:?~'. .. Address',l,4~ ~ "'~ ~ X73, i~ n +Cros,•r\ .. ..Phone No. ztiy . 6: Name of Contractor ~~'HS.a,~'Y C~{'~r~-YAddress .'~S.~.Gt=C(/~f-+'u$l~honeNo3?~.:3~~,.?55~ 15. Is this property located within 300 ~fe t~of a tigidal wetland? *Yes ..... No w'.... *If yes, Southold Town Trustees PermitPLO~ DIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions from property fines Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~J ~ C: I ~ ~ l~' (~ ~ ~`f2 w" ~ 7"" t`= " '~{r i ~ "_ _ I _.: l 5 © -- - r So _,~ ? ~ --- l~~ d ___.~ ~ _ STATE OF NEW Y~K~~`` ! }~-S S COLNTY OF , . , . Name of individual signing contract) above named --- 1~~~// ~ J_ I ~ s`-~~ being duly sworn, deposes and says that he is the applican~ He is the ... .. .. ... .. .... ..... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file ttu apphcat~on; that all statements contained in this application are true to the best of his knowledge and belief; and that th. work will be performed m the manner set forth in the application filed therewith. Swom to before me this I t, ~ / ~/ .. ....... ../~~~~/y~~\~pday of ... .. `I.(~ 1~. .. ., 19`:x. Notary Public, ~~'~:.w~,-"-C - .. ... \.. County ,~ ~ Jj~ ~ ~/i/ ~~~ QwRflsd in 8uMoNc Oo~xnlr ?CX Commission Expires oecember 8, t ~ (Signature of applicant t ' - ,, ~ ~ _, ~~r" '~~nrF.~i Ff ~ JUN 2$ i~ 30 b~ ~~~ f y ~ ~- -- ?~ ~ + ; ~ %~ ~' 'C ' s 4„ }ti k ; cif} ~ r! T ~ t~ ~~` r!°~j ~ .~, ~~, ~-t ~~ ~ ;4 r 3 ~~ .. ~~._ ~~ =-~¢---r a --~-- 4 r+`n_. -' '-' Crz~~+c'~~'tvCE') ~~ ___-_,e _.._..- --~----- ~/fati f~-i45T'~f.FJie C vacx~.~r~J b1 ~ s ~~ a r t,, 3f ? 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Q ~ -f~ ~3 { 0 ~ ~..._..._ f _. ~ ; ~ r '~ i .t ~"-L_ _,i »w. > y ~~ ~, i"~ ~ i ... 1. -. ,1 ~~ 4~ ... ~ -_~._ t ,~~ >v . t~ ~ ~ _ __ ~ SUFFQLi(COElA1TY ~" i(:AIiOFH~LTHSFa?VICES `" C?t S1;JfL'c F~Mli1~LVVFLI{i1G UtiLY +~ ~~~N.Tr ~i~ ©4 198~s t?c- pry ~_~ ll4 '~. ~ Ci,~ sc"zpe fir; asst e~~d „z~a. sucP11 facdates fer :4is ~_ ,ocz`,~r. h,le t::,a-~ i^~-cc:.~~ 4y t5.," O~~t:srtment ~%r U+.a.>! ~,' c".uar'du .~ ~4'xcr~:re:er iwan~.swc~k ~_~. .r ~ ~ ,~ p by ~ G1 D i m ~ `~! Z N ~ _ c- C ~ A Tt 'n '~ ,tE ~ ~ ~ GY~ ~ v ~ ~~,urt~ O~m~<O Npr ~~D > ~ m'`~ cn~ ~ U°m `"~ ~ to ~ 3 -~ yr ~ ~' ~ v n m D 3 ~~ ~ N ~ ~' ~`~'rgla ~n~ z i ° n p °~ ~D+ o a ~ ~~~~'rD zoo -=i ~=~r~ :'1 ' -- - -r '' "'} i ~yi.`-,~` ". ,4, pm;`psfa 3~q` ;^ ' CJt ~ '~ri 'A O D R! CA~ ,Cls' 3~ i_~ r, < n',~w~~ ~A,~ oo' ~ ~ G EA Y~:~ ~ W.~s ~ as ~' „~ ~ 'p (yy Al '~f ~ C O S ~ RI f• r ~_~ ~ ~ . , j..., .d 7~ J ?~ ~ ~~ z ~° ~. r; Q `n1 ~ ~ .~~ e~„'a + ~• ' .1- ~~ ~ µ „" Eli ~ ~i