HomeMy WebLinkAbout9798-zFORM NO. 4
TOWN OF SOUTNOLD
HUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-26118 Date NOVEMBER 19, 1998
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 1865 NASSAU POINT ROAD
House No. Street
County Tax Map No. 1000 Section 104 Block 13
Subdivision Filed Map No.
CUTCHOGUE, N · ¥.
Hamlet
Lot 2.3
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated June 19, 1978 pursuant to which
Building Permit No. 9798-Z dated JUNE 19, 1978
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 ADDITION WITH FRONT & REAR DECK ADDITIONS TOEXISTING ONE
FAMILY DWELLING AS APPLIED FOR*
The certificate is issued to DREW & LOIS ~
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N--434669 -- MAY 21, 1997
PLUMBERS CERTIFICATION DATED N/A
* THIS UPDATES CO Z-9598 DATED 4uL~ 20, 1997.
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No..Z..9.~9.~ .......... Date ...~Tul.y..20 ...................... 19 7.9.
THIS CERTIFIES that the building ................................................
Location of Property ...c~.;~p .........
House No. Street Hamlet
County Tax Map No. 1000 Section .'1.O.~. ........ Block ~.~ ............. Lot . .P.a?.~..9;4.2.~ .2...
Subdivision. ~T~cq. Bgll. P. QSTI~..P.I?Op ........... Filed Map No..15.~. .... Lot No...~t.2 .........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...... .O'.tlr, re ..... .'19. ,., 197.~. pursuant to which Building Permit No. 9.7..9. ~. .Z ...............
dated ...... .~.l~ll~e. ~.~. ............. 19~..8. , 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 .........
...gO~i~ion .onto..~ .l~r.i¥,t.e..r~n~..f.~l%Y..~w.e%].$lag .........................
The certificate is issued to ... J~rtl~.P-.~h. H.,..~ohl~l,e~? ..................................
(owner,~)
of the aforesaid building.
Suffolk County Department of Health Approval .I~/FL .....................................
UNDERWRITERS CERTIFICATE NO..43&.6~9 .........................................
.........
Rev 4/79
FOI~M NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 979~ Z
Date Jtme 26
........................................................ ,
Permission is hereby granted to:
Kenneth H. 3chuZer
to ............ a~.. en.~.-,a.. ~z~.va.¢ e...O~e.. ~.em~.%.¥...~e,].,1 ~g. ....................................................
at premises located at .......'1~8~.~ ....... ~[~,~ISJLI..P~:LI~'I;..RO&~ ...........................................................
.......................................... g..u. ~ .o.~.o.~ .e..:...~.~.. Lo.~ ........................................................................
.....~...~...L~ ~ ...~/.~ ~.e..u....~.~.~.~...~.,.,...~.~p../t....~56. ...................................................................
pursuant to application dated ..~T~il~.....J.~). .................................. , 19..7~., and approved by the
Building Inspector.
Fee $....~ 5,.Cig. .........
Building Inspector
lO00-10/~-13-Parl; of 2.2
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with 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 featu res.
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, a certificate 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 peoperty 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:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwe[[ing or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date .~.?.~.~ ./..f~./../.~./~Z~./~. .......
New Building ............. Old or Pre-existing Building ........... , Vacant Land .............
.... .............
ocat o of Property./ . . .. s2
House No. Street / Hamlet
Owner or Owners of Property /~{~ ~. ~. ~[~. ~. ~~ .........
County Tax Map No. 1000 Section ........... ~.. Block ............... Lot. ,~ ............
Subdivision ................................. ~a~ ~o ............... lot ~o ...............
Permit No..ElZ~--6'.ZDate of Permit ¢~/,~.Applicant j&~)~*. ~: ~55~
Health Dept. Approval .~ .... , ..... : ........ Labor Dept. Approval .. ~ ................
unee~r,ters" ' /5~:~'~' ~~ .¢~2~...Planning Board ApprovalApprova, ......... ~ ............
.... ............
floquost for Temporary Cortificato ..................... Final Cortifica!e .~.~
Fee Submittod $.. ...........................
Construction on above described building and p. er~it meets all applic.~ble c~es and regulations.
Rev. 10-10-78
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 ali 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-existing" land uses:
I. 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.
Fees
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-existinK Buildinm - $i00.00
3. Copy of Certificate of Occupancy - = .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
~P..VI~..gK 3~ 1998
Date . : .........
~ew Construction ........... Old Or Pre-existing Building..UPDATBD. CO .....
~ocation of Property $865 NASSAU POINT RD. CUTCMO~UE, N.Y.
House No. Street Hamlet
i f ty DREW & LOIS I~%mf
nwer or Owners o Proper ..................................................................
................ Lot ...... : ...............
)ounty Tax Map No 1000, Section.. IO4 .Block .... 19 ...... 2 3
~ubdivision · -- · Filed Map Lot ..................
~ermit No ~79~ Date Of Permit JJgg/J~ Applicant
~ealth Dept. Approval.. ........... .... .. ...... . Underwriters Approval .........................
ilanning Board Approval .......
iequest for: Temporary Certificate ........... Final Certicate..F~ .....
~ee Submitted: $ 50.00
..
June 19, 1978
Town of Southold
Office of Building Inspector
Town Clerks Office
Southold, L. I. N. Y. 11971
Attention: Mr. Hlnderman
Building Inspector
Dear Mr. Hinderman:
I appreciate the courtesy and time you gave me via our
telephone conversation last month in regard to the addition I
would like to do on the existing house I recently purchased on
Nassau Point. A lot of time and effort was spent on the design
of same, in order that it be in keeping with the surrounding
homes. As you know Lorraines parents have lived on Nassau P6~nt
for twenty years and her brother Bud Baldwin is doing an out-
standing job on improving his home next to this one. It is our
intention to keep up this Nassau Point high quality standard
appearance, for anyones view entering Nassau Point over the cause-
way. Attached herewith for your approval are three sets of drawings,
applications and fee.
It would be appreciated if you could advise me shortly of
your review as we are quite anxious to start this work and complete
it before the winter sets in. Again thank you very much for your
help and cooperation and we look forward to meeting you in person
during your inspeotions of construction.
Very truly yours,
Kenneth H. Schuler
Town of Southo'Ld
Office of Building Inspector
Town Clerks Office
Southold, b. I., N.Y. 21971
Attention: ~r. Hinderman
, THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~' 85 JOHN STREET, NEW YORK, NEW YORK IOO3E~
Kenneth Schuler, Hassau Point Rd., Bay Ave,-2roadwaters Rd., Cutchogue
N.Y .
location;
~J Ist FI. Le 2nd Ill. .~,.ction Bl,,c~ Lot
on May ~ ~ ~ ~9 79 und Jouttd to he in co.qdiance tvi~h tile req~*irentet~ts qf this II,~rd.
FIXTURES RANGES
2-G,F.I.
1-Smoke Detector
:, Clifford E. Jagger
'P.O. Box 61
Peconlc, N.Y. 11958
Lie.1836-E '
Per_ 11
This certificate must not be ohered in ony manner; return to the office of the Boo, rd if incorrect, inspectors may be /denfifmd by
TOWN OF' ~OLITHOLD
I-'IFFIE~E I-IF I=ILIILDING INSPECTOR
TDWN I'~,LERK'S OFFICE:
SrlUTHI3LD, N. Y. 11g'71
TEl-.
. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, bi. Yo
(Building Inspector)
Application No ..........~'~ .............
APPLICATION FOR BUILDIbiG PERMIT
Date ......... , ..................................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate ~co the Bui~dJhg
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 o~
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application.
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 perrm~
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 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
Building Zone Ordinance of the Town of $outhold, 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
~dmit~ut~rizedinspect~rs~npremises~and~nbui~d~ngsf~rnec~ssary~nspe~i~ns~/~;~`~ ~ ~......~'~d~-
"' appii f t, ........
....... ......
St~ta wheCh~?icant is owner, I~ssee, agent, ~rchit~ct, engineer, Deneroi co~tractor, electrician, pJumbar ~ bui[dor
......... ...............................................................................................................................
J'f applicant is a corporate, signature of duly authorized officer. ~
Builder's kic~se No ..................................................... ~
Plumber's License No ................................................. ~
Electrician's License No ............................................. ~
O~er ~ro~e'~ O~ceo~ ~o ............................................... ~ .~.
Street and Number ~.~.~ ........
2. State existing use and occupancy of premises and intended use ~nd occupancy of proposed construction:
~. E~i~m~ ~ ~ ~p=~w ....~,~ ......... ~ ............ ~.~ ............................... ~' ...................................................
b Intended us~ ~nd o~up=~cy ............................ ~ ........................................................................
3. Nature of work (check which applicable): New Building-, ................. Addition ..... ~. ..... Alteration ................
Repair .................. Removal .................. Demolitior, .................... Other Work .....................................................
(Description)
4. Estimated Cost .... ./,..~./.,/Z~./X. ...................................... Fee .............................................................................
(to be paid on filing this application)
5, ~f 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~ach type of use ............ q ..............
onso, o,,t .~-/~.~.~ ....... Rear ....~ ............. ~epth .~.~.~..~...
' .... ........ ' '" .................. z ........... ........... .......
~uimensions or some structure with alterations or additions: kront ..~.%~..~J~.~ .......... ~5~¢~...~ ..........
Depth ..... ~.~ ................. He,ght .~ ...................... Number of Stones ./¢~ ....................
8. Dimensions of entire new construction: Front ......... ~ ....................... Rear ............................ Depth ........................
Height ....... Z.. ........Number of
~.
I 1. ~one or use d~strict in'which ~remises ore s~tu~ted .....................................................................................................
12. Doos proposed construction violate ong zonin~ Iow~ ordinance or re~u{ation: .... ~ ...........................................
13. Will lot be regraded ...../¢¢ ............... Will excess fill be remove¢_from pre~¢s: ( ) ~s (~ No
Address
Phone
No.
o, ............... ................................ ......................
/ ' ~LOT DIAGRAM
Locate dearly and distinctly ali buildings, whether existing or proposed, and indicate all set-~ck dimensions from
property lines. Give street and block number or descriphon according to deed, and show street names and {ndicate
whether interior or corner Iol.
STATE OF NEW YORK .... ~
COUNTY OF .~.~ ....... f"'~
/..~.f!.~,)?,.Z-.Q~./.~. ....... ./.'.¢,.:..,..Q..~.,~.~.....~....~...~-.~...~.: ........................ being daly sworn, deposes and s~ys that he is the applicam
(Name of individual signing c'ontrace)
above named.
He is the ....~.~.....~,.,,~....-~~ .........................................................................................
(Cont~ctor, dgent, ~porate officer, etc.)
of said owner or owners, and is du~y authorized to perform or have performed the said work and to make and file
this application; ?hat ~1 statements .contained in this application are true to the best of his knowledge and belief; and
thor the work will be performed i~ th4 manner set fo~h in th~ 'applicati6n filed therewith.
.............. 'Z~.,.. d~of~.....~,,..,~,...., ........ , 19Z~.
Notary Public,~..~....~oun~ ...... ~ .............
~.]L'~,~A~ ~ S'~'~PH~N~~ (Signoture of opplicont)
.']JOTAI~Y PUBLIC, State of ,New
No. 41~3336235 '
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