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HomeMy WebLinkAbout28092-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-29103 Date: 12/05/02 THIS CERTIFIES that the building HEATING SYSTEM Location of Property: 1275 NEW SUFFOLK RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 7 Lot 6.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 19, 2002 pursuant to which Building Permit No_ 28092-Z dated FEBRUARY 19, 2002 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 INSTALLATION OF NEW HEATING SYSTEM IN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ELIZABETH MCGRATH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 58446 12/11/01 PLUMBERS CERTIFICATION DATED 11/10/02 TIM HORTON uth ized S ' nature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 28092 Z Date FEBRUARY 19, 2002 Permission is hereby granted to : WALTER TERESKO PO BOX 963 CUTCHOGUE,NY 11935 for AN "AS BUILT" INSTALLATION OF A HOME HEATING SYSTEM AS APPLIED FOR at premises located at 1275 NEW SUFFOLK RD CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0007 Lot No. 006,;4. pursuant to application dated FEBRUARY 19, 2002 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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, at sR iflg�n unusual natural or topographic features. 2. A properly completed application and a consent to inspect ed by the app If a Certificate of Occupancy is denied, the Building Insp r s1 A1-9z 1& t reasons therefor in writing to the applicant. BLDG. OC-PT. C. Fees TOWN OF SO THO p 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25V: 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ,November 6: ,2001 . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. .X, To A%7o .story, frame dwelling and 1275 New Suffolk Ro k. detached frame garage Cutchogue Location of Property. . . p4�,. . . . .V. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. Elizabeth McGrath County Tax Map No 1000, Section. . 109:00, , , , , ,B1ock. .07;00 . . . . . . . . .Lot. .P./,o 006,;000, , , , , , , , , . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.).�Q Z. . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . .4bA. Ce-ticate. . X . . . . . . . Vis. req Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . CO Zz oC l I CO APPLICANT Wickham, Agent ��gUFFO[,�c f/J Town Hall,53095 Main Road Fax(631) 765-1823 P.O.Box 1179 �i Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING, DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Building Permit No. illO Y LZ� Owner: lILV324X �7 /\ CIBC VI (please print) Plumber: (please print) �14x J.A•AP � I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this day of 2002 AUM M.SHAUGHNEMY ' Notan/Public.Sett e4 Hwv Yltk No.62.4528119 Notary Public, Countyid ma 6 Ca!^� .' Sam i4ow1 bw"!° r7�, 3Y Electrical Inspection Certificate Date Electrical Inspection Service, Inc. Application# 12/11/01 375 Dunton Avenue 58446 East Patchogue, New York 11772 (631)286.6642 Issued to: Elizabeth Prentiss Street: 1275 New Suffolk Rd Village: Cutchogue Zip:11935 Town:Southold Section: Block: Lot: Introduced by: M& D Associates L1c.# 3392-E was exam/xd and found to be/n compliance with the National Electrical Code ❑ Commercial ❑NV Defects ❑ Pool ❑1st Floor Dlndoor ❑Basement ❑ Hot Tub © Residential ❑ Det. Garage ❑Attic ❑2nd Floor ❑Outdoor ❑ Addition ❑Survey Switches Receptacles Fixtures GFI Heaters A/C Fans Dishwasher Washer/Amp DryerlAmp Oven Range/Amp Garbage Disposal Furnace Oil Gas Circulator Smoke Detector Bell Transformer Meter Amps Phase UG/OH Telephone Television Carbon Monoxide 1 200 1 ❑/ r❑ Other Equipment. Building Permit# r Hu o S. Sur-di President Rough Inspection: Inspector: Quentin Reynolds Final Inspection: 12/11/01 Inspector: Quentin Reynolds A This certificate must not be altered in any manner.Inspectors may be identifed by their credentials T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: 765-1802 /�` Survey PERMIT NO. 0y tCheck Septic Form N.Y.S.D.E.C. Trustees Examined 1 Y '20 0 7 Contact: Approved (Yi,20 0 L Mail to: Disapproved a/c Phone: I 7e A Building Inspector FEB 19 4 4 APPLICATION FOR BUILDING PERMIT t T11i "-` '^l�') Date "cZ , 20 Q2— INSTRUCTIONS LINSTRUCTIONS 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupancy is issued 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 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 code,housing code,and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a orporatioa) G U 1A(�, � 1 " �Ia (Mailing address of applicant) OF 0CpUpA#1%V State whether applicant is ownetILssee, agent, architect, engineer,general contractor, electrician,plumber or builder APPROAb AS NOTED z a.�� Name of owner of premises ( � Z 2:�'� � r / o 0PZ— (as on the tax rojI*T1IweBUJMG DEPARTMENT PT 765.1802 9 AAA TC 4 PH Fr-F. If applicant is a corporation, signature of duly authorized officer F0LL0%gNG INQPEc-nrw 1. FOUND , (Name and title of corporate officer) P. FoW,pGH - r ';"LLk" S INSULATl Builders License No. 4 FINAL - Crr­I!FT"RUf." Plumbers License No. ALL CONS n, THE 17 C1 , Electricians License No. er,XT CWf-, , w+►, r, t Other Trade's License No. "d`` r7!II1�"�' ► _• . 1. Location of land on which proposed work w'll be done: l �, Neev c,k CU o House Number Street Hamlet County Tax Map No. 1000 Section 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 b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 6. 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 r Rebr t Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owners 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be re-graded Will excess fill be removed from premises: YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO X • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) " ...-...-.�.—�—... ( ' r lbeing duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)al ogre 4 F .t (S)He is the 0Luyka, / , (Contractor,Agent,Corporate Officer, etc.) of said owner or owners, and is duly authorized to perf4m or have performed 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 befgre me thi f day of h ' J Notary Public - ature of Applicant NE NOWY Public, State ofNow York No.4951364 qualified in ounty Commission Expires May 2Z C ae3