HomeMy WebLinkAbout17279-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17725 Date JANUARY 31, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 645 SILVER COLT ROAD CUTCHOGUE, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 95 Block 4 Lot 18.4
Subdivision OREGON VIEW ESTS. Filed Map No. 6241 Lot No. 4
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 18, 1988 pursuant to which
Building Permit No. 17279-Z dated JULY 29, 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 WITH ATTACHED GARAGE & DECK AS APPLIED FOR
The certificate is issued to FAITH M. TIMER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-104-Jan. 26, 1989
UNDERWRITERS CERTIFICATE N0. PENDING - Jan. 30. 1989
PLUMBERS CERTIFICATION DATED Mar. 3, 1987-O'Connor Plumbing & Heating
---\i'~°~
uilding Inspector
Rev. 1/81
roan: xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~ 9
NO ~1727~ Z Date 7 19~$.
Permission is hereby granted t
.r..Q.
~ :,.....y~.~..
to l:sw2iGi~...lt:...~l.Z~....~Z .........!~y.~.........rGG°~.~....~*f'
~.~~....//~...'D ~
ct premises located at ...rR.~~r........~Y~~!Z~~+~~:~.fi•.••....~.y~
Caunty Tox Map No. 1000 Section Block T......... Lot No...?...~!..~.
p
pursuant to application dated ...............~1,1./..p............................., )9.~~ and approved by the
Building,, //Inspector.
Fee $...7.OG7
.s..'
1.....r~~
G ing Inspector
Rev. 6/30/80
FORM NO. 6 { I ^E~~ ~`~%'.,~\V~ ~~I
TOWN OF SOUTHOLD l/ ~ 3 Q~
Building Department
Town Hall
Southold, N.Y. 11971 f3LDC,. DEPT.
765 - 1802 TOWN OF SUUTHOLD
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
1. Certificate of occupancy New Dwellino,$25.00, Accessory x$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy ofcertiticateofoccupancy $ 5.00, over 5 years $10.00
4. Vacant Land C.O. $ 20.00
S.Undated C.O. $ 50.00 Date.....~,,36f~~
NewConstruction,,,,,,OldorPre-existing Building Vacan~d
Location of Property ` 7~ !~s-C,,,~ .
House No. Street Nam/et
Owner or Owners of Property :b?~'~n!!.!..?.!?'7~ . .
County Tax Map No. 1000 Section Block ~ /.Vr Y"..... .
Lot....
Subdivision vi~~~D.7~.>..(/4~1~ . ~~'......F~jiled Map No. ~./~~?/~-.~~.../Lo/t No. 7
Permit No. b~~J47~. Date of Permit .7~f~l~QApplicant...l/.'!~~..~:.r!':~,~~~...~r~
Health Dept. Approval ........................Labor Dept. Approval , , , - , . , . .
Underwriters Approval ........................Planning Board Approval
Request for Temporary Certificate .....................Final Certificate , .
Fee Submitted $
Construction on above described building and permit '/ts lI~~pplica co a nd regulations
Rev. 1010-76 /,/(,~y
co~~11aS
TEL. 765-1802
~Oc~VEFOC/(~~G TOWN OF SOUTHOLD
y~ OFFICE OF BUILDING INSPECTOR
~ z P.O. BOX 728
c°n ~ TOWN HALL
"O~y`O~ ~ SOUTHOLD, N.Y. 11971
''~l C E R T I F I C A T I O N
Date
Building Permit No. ~~~Z7Cj
Owner ~~-f~~ 7.'!~6-~
(,Qp/l~ease print)
Plumber U ~ur.~- A ~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
(plumber's signature)
Sworn to before me this
day of ~li/Z-c~~ ,
191 Lis ~-rsa~~~
No1U ry Pu is
Notary Public, County
LINDA J. COOPER
Notary Public, State of NewYork~
No. 8822563, Suffolk County
Term Expires t~cember 31,19._.._
r1ELD II:S:'EC:iU.J ~~UATE ~ i:OC4MENTS
,~7 _ -o
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FOUIJDATTON (1S°t)
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FOUNDATTOtJ ( 2nd ) _ _ - m
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ROUGH FRAME & (C'
PLUMBINCf' _ `
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IIdSULATTOII PER N . ~ '
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STATE ENERGY
CODE
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FTi4AL ~
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ADDITIONAL COMMENTS:
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i1~ ~9 ~~-1802
BUILDING DEPT.
[ ] F NDATION 1ST [ ]ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: it
DATE ~ / v INSPECTOR
l7_~ ~ ~ 765.i80Z
BUILDING DEPT.
INSPECTIQN
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND INSULATION
[ ]FRAMING ~ ~ [ ]FINAL /
REMARKS: `~~-~^~X a~.~r~ c~ -
~a~-•~
DATE / ~ INSPECTOR `
765.1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ROUGH PLBG.
[ ] UNDATION 2ND [ ]INSULATION
[ FRAMING FINAL
~~f REMARKS:
! ~.eh
4
f
DATE ~ 3 ~ ~ INSPECTOR
f
s
2'2~ ~
765-1802
BUILDING DEPT.
INSPECTIQN
[!~I FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:Q r l~ .
f
DATE ~~~lINSPECTOR r~t~~~-c.~'
t
fs tD¢F4~~~s,t;,`° I11411i 11 IMP II IC,A1,'1'11
a.
}d:',''y:F, o:. -?ffis§F.°';a 91;'f~ O1' P1,~NS
=t6a-,`PFOft'N1.NO:x7 SURVEY
TOWN OFSOUTHOLD cnccR
BUILDING DEPARTMENT SEPTiC FORM
TOWN HALL NOTrFY
SOUTHOLD, N.Y. 11971 CALL
TEL.: 765.1802
G MAIL TO~:y ~~1-
Examined .7/~~.........., 19d .~a q 0f~ X~'
Approved • • • • 19~U. Permit No~.~'~7{.~ mi'c/~e~2~~~7^-
/l/~t/~ U
Disapproved a/c ~7/~
(I3tiiildin~ nspector)
APPLICATION FOR BUILDING PERMIT yy y
Date ...........7.
f !P..., 19 ~O.
INSTRUCTIONS
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.
a 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 pazt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Depaztment 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
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building cod housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspectio
(Signature of pplicant, name, if a corporation)
Jv~ (Mail~g ad~ess of applicant) ~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ...T~?<'~~.. f1?., .tl.!~~!t~ .
(as on the tax roll or latest deed)
If applican a c ion, sign ure f my authorize/d offi r.
.te. -
.........................~.Cc.......
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No . .
Plumber's License No. L!..~lr//iffrt~/~ q.. ~ . ,(its/~~~~ '''7
Electrician's License No. . pwT...~N""'?'!!~•" .
Other Trade's License No . ~ ;l ?
1. Location of land on which proposed work will be done.J/..fr~... ~/.r!~.
House Number Street ~ Hamlet
i /L
County Tax Map N/o~1000 Se/c/tion .....Q~:a.......... Block ft `l Lot ...`I'`.''7//`........ , .
Subdivision .....(//.~W'. Y.IG?..Gq/!!r:'~!! Filed Map No. . ~~-.wf....... Lot `Z......... .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b.lntended use and occupancy
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SURVEY FOR
LEANDER B.~LOVER JR.B FAITH M.TINER
i \ LOT N0.4, "OREGON VIEW ESTATES~1
l'`~ `~V AUG. 19 , 1986
/ ~ r% / ~ ~ TOWN OFH
OUTHOLD SCALE AU--C~50 ~ 1996
SUFFOLK COUNTY, NEW YORK No. as-aoa
R UIMUTNORIZEO ALTERATION OR AO DITION ro rHls GUARANTE
SURVEY R A VIOLATION OF SECTION 7209 OF THE TICD diL.~~ EE
NEW YORK STATE EDUCATION LAW
N COPIES dF TNIS SURVEY NOT fEARWG THE LAND S~ `p
NOT f[YCONS OERED TOLfE A VA eOD TRUE COPY MALL ~P{dD IV `O ~'f
k GUARANTEE! INDICATED HEREON SHALL RUN ONLY TO a~ G
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WNOM THE SUMEY 15 PREPARED ~ A
AND pi XIS' fENALF TO THE 7171E COMPANY, GOVf/IN-
N NEAREST WATER WAIN MI.~ NSOURCE Of WATERS PRIMITE _PUlIIC_ MENTAL AGENCr ANO LENDING INSTITUTION LASTED
N fUFf CO. TAK MA? dfT~T~QQ SEC TION 095 MACK ~'L LOT 18.Q HEREON, AND TO THE ASSION EES OF THE LE NOING ~
' NTNLRE ARE NO DWELLINGS WITNIN 100 FEET OF THIS ?ROPERTY dST1TUTId1. GUARANTEES ARE NOT TRAHSFERA BLE
OTNER TNAN TNOSE SNOWN NEREON. TO ADDITIONAL INS TITUTId15 OR SUGSEOUENT _ /
N TML WAi[R SUMIY AND SEWAGE DISfOfAL SYSTEM !011 THIS R[f IDENCE OWNERS RJ
WILL CONFORM TO TN[ STAMDAROf OF TNC SUffOIK COUNTY DEPARTMENT N DISTANCES SNOWN NEREON FROM PROPERTY ONES 45x9
TOE%13TING STRUCNRES ARE FOR A SPECIfIC 'P,~.
- OF NULTN fONICCl. pUR POSE ANO ARE NOT TO SE USED TO ESTafLISN A(AND SDL~E'(
' ARLICAMT' PROPERTY LINES OR FOR THE ERECTION OF fENCES
AODIIESE
nL. YOUNG & YOUNG R~RHEADNNEW YORKE
NOTE• O=PIPE p=STAKE ¦=MONUMENT ALDEN W.YOUMG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
SUFFOLK CO. ON APRIL 4,1975 AS FILE NO. 6241. AND LAND SURVEYOR N.V,S.UCENSE N0.12845
HOWARD W. YOUNG, LAND SURVEYOR
x TILE LOCArgN Of WELL(w), lEpTit TANK(Sils CESSPOOLS(C/) !MOWN NEI1Ep1 N.Y.S. LICENSE N0.45893
ARE fRQM fIELD 0/fERWTIgIS AND OR DATA O~TAIM[D !ROM OTNERf
GRANOIS & SONS INC. 1046
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SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FAITH M. 'DINER
LOT NO. 4, OREGON VIEW ESTATES~~
SINGLE FAMILY DWELLfNG ONLY DEC. 14 ,198
DATE'fAN ~ F fOA®,S.REF.NO. Sc (U~{ AT CUTCHOGUE DATE SEPT. 22 ,1988
The sewage disposal and water supply facilities for this 7~WN ~ SOUTHOLb SCALE I" = 50'
location have been msperied by this Department andJor SUFFOLK COUNTY, NEW YORK No. ea-1244
other ag ICI2S(~ nd fou 1 l0 C atlsf' Or : NuNAUTN0111ZE0 ALTERATION OR ADDITION TD THIS GUARANTEED TO
l6.sy SURVEY q A VIOLATION OF SECTION 7209 OF THE FAITH M. TIN
NEW YORK STATE EWCATI ON LAW NORTH BDlIdIA/ ST COMPANY
Chief o Oureau of Wastewater Management' w corlES aF THIS sDRVEY NDT fEARwG THE LAND @
SURVEYOR'S INKED SEAL OR EMfOSSED SEAL SHALL TICO ~~g ,
NOT CON 3IDERED 70 fE A VALID TRUE COPY F'~ W `
RGUARANTEES INDICATED HEREON SHALL RUN d9LY Ta P~ o~
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT TME PERSON foR w11oM THE SUINEY IS PREPARED rO~ G
AMO pl HIS' FEMALE TO THE TITLE COMPANY, 60VEIIN-
N NEAREST WATE11 WAIN MI. ~ NSOURCE Of WATERS PRIMTE _PUfLIC_ MENTAL AGENCY ANO LENDING INSTITUTION LISTED 7g
R Wf CO. TAX MA?"OIfiT.4QQ, SEC TIOM 096 HACK LOT 18.4 HEREON, AND TO THE ASS ION EES OF THE LENDING ~o++
R THERE ARE NO OWFLLIINI• WITHIN 100 FEET OF THif ?ROPERTY INSTITUTIdI. GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SNOWM HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
K THE WATER SUPRY ANO fEWAGE DIfFOfAI SYSTEM fdr TNIf RRIDENCE OWN EPS ~J -
WILLCONFORM i0 TH[ fTANOARDf Of iNE SUFFOLK COUNTY D[PARTM[NT NDI STANCES SHOWN HEREON FPOM PROPERTY LIMES w, I~/"~
OF N[ALTH f[RVICEf. TO EXISTING STRUG TUREf ARE FOR A SPECIFIC !y, 'O, 4g~'~
?UR?OSf AND ARE NOT TO 0E USED TO ESGDLISH `R"
AMLICANT' PROPERTY LINES OP fOR THE ERECTION aF FlNCES N~6 t4Rp SUS~~
ADDIIESf
TEL. YOUNG YOUNG R,VERH
AdNNEWAOR~KE
NOTE+ O=PIPE ~=STAKE •=MONUMENT ALOEN W. YOUNG, PROFESSIONAL ENGINEER
8UBDIVISION MAP FILED IN THE OFFICE OF THE ~.L,ERK OF AND LAND SURVEYOR N.Y.S.IJCENSE NO.12945
SUFFOLK CO. ON APRIL 4,1975 AS FILE NO. 6241.
HOWARq W. YOUNG, LANG SURVEYOR
N711E LOCATgNOf W0.L(WI,SEPTItTANKIfTI•CEEfFOOLS(N NEIIEOM ,gN.Y.S. LICENSE ND.45893
ARE FROM FIEtA OpERW1T10N3 AMD OR DATA OfTA1MED F O ERS
- GRANDIS & SONS INC. 1046 .R `
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SiyffpL;( COUaJTY DEPARTMEN ' ` SURVEY FOR
fGR RPPROVAL Of CONSi:ti'C''~G" GF ~ LEANDER B. GLOVER JR. 8 FAITH M. TIMER
LOT N0.4, "OREGON VIEW ESTATES'
Single Faajlly ftesl~ierjt`: v~r ~~u ~ AT CUTCHOGUE DATE Auc.s , Isss
HS REF. N0. ;~~P/~~-
~C~..., ?t7WN OF SOUTHOLD scALE I" = so'
DATE SUFFOLK COUNTY, NEW YORK No. es-eoe
1. >"f'sDVED KuNAU rNOnn [D RETENTION OR ADDITION TC1 THIS GUARANTEED TO
RS FROM iG~1TF OF JlPP1tDVPi SURVEY O A VIOLATION OF 3E CTIOM 7209 OF THE TICOR TITLE GUA
NEW YORK l7ATE EWCA 710N LAw
E;,j'1RES TN1D -YEA N COPT ES OF MI! SURVEY NOT GEARWG THE lANO ,APSE OF ryFw
SUR VEYOR~S INKED SEAL OR EMBOSSED SEAL SNA LI S
NOT SL CONSIDERED TO SE A VALI D TRUE COPY D r® ~
K GUARANTEES INDICATED HEREON SHALL RUN ONLY 10 ,yy PR I't:
HEALTH DEPARTMENT-OATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SUMEY IS PREPARED O 't
AND ON HIS' DENAIf TO THE TITLE [OM PANY~ GOVERN- 'T
K NEAREST W~T[R MAIN.`ML 2 NSOURCE OF WATER: PIIIWTE _PUGLIC_ NEN TAL AGENCY AND LENDING INSTITUTION LISTED
R SUFf CO. TAX MAP DI3T 100~,lEC TION 945_ /IDCK _b'L LOT JB.,1 ""HEREON, AND TO THE ASSIGNEES OF THE LENDING
NMERE ARE ND OWELLIIKIf WITHIN IDO FEET OF THIS ?ROPERTY INSTITUTIpI GUARANTEES ARE NOT TRAM SfERA BLE
OTHER THAN TNOlE SHOWN HEREON. TO AOOt TIONAI INSTITUTIp/5 OR SUBSEQUENT I/ _
M TN[ WATER SUPM.Y AMO SEWAGE DI3P0lAL SvSTEM FU11 THIS R[SIDEMCE OWNERS QJ
N DISTANCES SHOWN HEREON FROM PROPERTY LINES
WILL CONfORM TO TN[ STANDARDS OF TNL SUfFOIK COUNTY DEPARTM[NT ~j 0
OF HEALTH f ICL3. TO EXISTING STRUCNWES ARE FOR A lPEClflt 893
AfPLICANT~ ~ ~ ?IIOPEMYALI NE SRORNFOR TTONEEERECTION OiTFERCE3 y~0 a
iUbt n`l ~i/b(i~%JG (AND SURVEVO
ADDRESS ~FAI h, fD4%
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TCL ~~,=~3a~. YOUNG & YOUOVG R~IVOERHEAONNEW YORKE
NOTE: O=PIPE p=STAKE ¦=MONUMENT
SUBDIVISION MAP FILED IN THE OFFICE OF 7HE CLERK OF ALDEN W.YOUNG, PROFESSIONAL ENGINEER
SUFFOLK CO. ON APRIL 4, 1975 AS FILE NO. 6241 . ANO LAND SURVEYOR N VS. UCENSE N0. 12845
HOWARD W YOUNG, LAND SURVEYOR
MM LOCATIOII Of WELL(Wj,SEPTIC TAMKISTIBCE3lPOOU(C?) SNOWM 11[11lON N.Y.S. LICENSE N0.45893
ARE FIIQM FIELD OgEIhWTI0N3 AMD OR DATA OGTAIMLD fROM OTHER!
BRANDIS & SONS INC. 1046