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HomeMy WebLinkAbout12454-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy ADDITION THIS CERTIFIES that the building ................................................ Location of Property 50 BROADWATERS DRIVE & ,7000 S.KUNK LA. CUTCHOGUE House No. Street Ham/et County Tax Map No. 1000 Section 104 ...Block 5 ..... Lot 10 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~i~y..:1,~. . , 198..3. pursuant to which Building Permit No. 12454Z dated . 3.ulY. g.9. .................. 19.8..3, was issued, and conforms to all of the requirements of the applicable provisions of the law. ~te occupancy ~r w~ch this certificate is issued is ......... ..Eor. addit~ons.~.Q.a~..~gg.~.~$~Y. ~welli~ The certificate is issued to .. GOI~.EMA. N · &, E,I,EANO, RE · · ~¥~E]LL ..... . ...................... Iowner, te~eo Or tet~anr! of the aforesaid building. ~/A Suffolk County Department of Health Approval .......................................... N618991 UNDERWRITERS CERTIFICATE NO ................................................ Building Inspector Rev. 1/81 FOEM ~0. 2 TOWN OF $OUTHOLD III[JILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERJvIIT (THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE. WORK AUTHORIZED) N? 13454 Permission is hereby granted to: · -~.c..~.~.~.T~.c..~....5..s.~.O'.~.L~Z"~'.~..~ ~ - i~/ ~ ~-~ A~E ~du~~ ~ /~ 77~ ..................... ~ .................. t. ............................ ~ ~0 ...~.b.~....~....~....Z..~ .......... ~....E.~.i ...... i~.~,.....~ .......................................................... Te ~1~ ~E~CH~-~. ~E .................... .~.....~ ....... ~ ........................................................................................................ a~ p~mi~ l~a~ a~ ............................................................................................................................ CU~C HOGU~ County Tax Map No. 1000 Section /~).~.. Block ~ Lot No. /0 pursuant to application dated /c//~,~ /,j~ 19..~...~... and approved by the Building Inspector. Fee Rev. 6130/80 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 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, 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 propertv 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 safetv inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of o,c, cupancy ~, $5.00 ) / 2, Certificate of occupancv on p-'~e.~i,ti~ dwelling landuse--P~e-Existlng C,0. $15,00 3. Copy of certificate of occupancy $1.00/ Vacant land C.O. $ 5.00 ' :" , , Da'te. Building Old or Pre existing Building ×× Vacant Land of P operty SK.UNK LANE , Location r .............................................................. House No. Street Ham/et Owner or Owners of Property .C©I~A~..~ ELEANORE SWIVEL County Tax Map No. 1000 Section ... [~)~ ......... Block 5 Lot Subdivision .... ~ ........................... Filed Map No ........... Lot No .............. 7/29/8.3~ ICON-TECH ASSOCIAte., INC. Permit No.l.~.4. ,.5.4~.... Date of Permit ......... ':,~pplicant .................................. Health Dept. Approval ..... ~.~ ................. Labor Dept. Approval ........................ ,N, 618991 - NA Underwriters Approval ....................... P(anning Board Approval ...................... XX Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ,5 00.. Construction on above described building and permit meets all applicable co,c~and regulate, ~, Applicant ']~]:'Y'A~ P ' HO~UN'C' ¥ ' P ~: '~?'? ' '~' tk.... ~ ICON-TECH AS~bb'fA~'E~ i~'.'':' ' ' Rev. t0-10-78 ~ lO95OO4 THE NEW YORK BOARD OF FIRE UNDERWRITERS 'D~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW ~ORK 1OO3~ Oate October 6, 1983 ~.."~-"--~-.-.,f~ ~9547-83 N61899~ THIS CERTIFIES THAT only the electrical equipment as ~scrlbed belo~ and introduced by the applicant named on the above application nu tuber in the premises of ~le~ & El~re S~0'ell, C/O ~k ~./B~a~a~$ ~, ~tc~, N.Y~ in the followlng locatlon; ~ Basement ~ 1st FI. ~ 2nd FI. ~ Section Block Lot ~ .~..,~..d o,~ Septet 29, 1983 and found to be irt compliance with th~ {equirements of this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST fLUORESCENT 16 33 22 16 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK UNIT HEATERS DIMMERS SYSTEMS NO. OF FEET SERVICE OlS(~ONNECT OTHER APPARATUS: Panelboards:l-16ciro 125anps. 4-G.F.I. 2-SmokeDetectors 1-4 ton A. Co Umit S E R V NO. ECE%COND OF CC. COND, 2 NO OF HI-LEG AWG. OF HI-LEG Icon-Tach Asaoc., Inc. 144 N. Ocean Ave. Patcho~, N.Y., 11772 This certificate must not be altered in y manner; return to the office of the Board if i~ C0F Y FOR BUILDII IG THI~ MANNER. ~FIE~D INSPECTION FOUNDATION FOUNDATION 2. ROUGH FRAME & INSULATION PER N. STATE (1 PLUMBING ENERGY C,ODE FINAL DATE ~ .COMMENTS ~.~-~ ~J~. ~f,~d~ ADDITIONAL COMMENTS: ._ ICON-TECH ASSOCIATES, INC. DESIGNERS/BUILDERS 144 N. OCEAN AVENUE PATCHOGUE, NEW YORK 11772 (516) 654-2600 NOVE~ER 14, 1983 TOWN OF SOUTHHOLD BUILDING DEPARTMENT MAIN ROAD, SOUTHHOLD N.Y. RE: FINAL INSPECTION BLDG. PERMIT # 12454z ATT: MR GEORGE FISHER DEAR SIR, THIS IS TO NOTIFY YOU THAT ALL CORRECTIONS HAVE BEEN HADE PERTAINING TO THE FOREMENTIONED PROJECT, AS YOU INDICATED TO US DURING YOUR LAST PHYSICAL PROJECT INS- PECTION. I AM ALSO SENDING A COPY OF THE FINAL UNDERWRITERS CERT- IFICATE WHICH WAS ISSUED FOR THE PROJECT. COULD YOU PLEASE ~AKE FINAL INSPECTIONS AS SOON AS POSS- IBLE AND SEND US THE CERTIFICATE OF OCCUPANCY SO WE MAY CLOSE THE PROJECT. IF ANY ADDITIONAL INFORMATION IS REQUIRED, PLEASE CON- TACT US I~B~DIATLEY. SINCERELY, .o9soo4 THE NEW YORK BOARD OF FIRE UNDERWRITERS,. , BUREAU OF ELECTRICITY -- ~ 85 JOHN STREET. NEW yORK NEW yORK 10038 16 ~ '22 16 DRYERS, FURNAC, E MOTOES APPLIANCE SERVICE DISCONNEC1 panelboazds:l-16cir. 4~G,.F.I. 2~lDkeDetectors 144 N. 0cern Ave. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [/~_ ROUGH [ ] FOUNDATION 2ND [ ] INSULATION /~ F~MING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION ['] FOUNDATION 1ST [ ] ROUGH P~BG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING REMARKS: [ ] FINAL iNSPE~OR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~ISULATION . ' FRAMING [4/ FINAL ,~~/~/- ~/-* '~ DATE INSPECTOR FILE NO, ~B¥/ MAP OF PROPERTY COL. EMAI",I J. & C. ~LEA]NOR SURVEYED FOR 5EWELL LOCATED AT P~o~//c SUFFOLK COUNTY, N. Y. LOT ~ ~/~ ~ ~vE~ MaP OF ~/~ SCALE 3~ FEET TO I INCH ~ = STAKE O = IRON PIPE · ~ MONUMENT · = SPIKE ~l~. GUA~ AE ~ ~ SURVEYED ~ /~- 19~3 JAY C. RO~LI~SON, succzssoR TO THOMAS C. MERRIC~ AND ROBERT J. BARTLEY ASS~IATES ~ND SURV~ING N. Y. STATE: L~CENSE NO. 42516 AVENU~ TOWN OF SOUTHOLD . BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL: 765-1803 · .............. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter 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 cmnmanced 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 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 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 regulation~ and to admit authorized inspectors on premises and in building for necessary inspections. .......... I. 99.n.-:T .e.c.h..A..s.sp.q .i .a.t.e.s.,..I.n.q ~ ..... (Signature of applicant, or name, if a corporation) .~.4.4...N....Qq .e.a.n..A.y.eB.q¢,..PAt. 9.h.o. gu..e., .N...¥, .... (Mailing address of applicant) 11772 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... ~pp.% ~ c .a.n.t./..E .n~i. n..e .e?. ............................. Name of owner of premises . ...B.rp.r...ET.i.k.s. 9.n ......................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duty agthArized officer. ........ Builder s License No..Unkn.o.wn. ~t.t. PT~.eA~ rw ~, ~ Plumber's License No. UnknD.wn. ~t.t..t?r~Ars$... Electrician's License No.Unki%own. ~t .Pr.e. sen2.. Other Trade's License No. ~l~k2OWr~ .ltl;. p.r.e..s.e.n.t i. Location of land on which proposed ~ork will be done. Sou.t. hwes.t~, cor~er, o$..~~. { ~Rq~¢. hg ~ ) . ?. .......... ~ House Number none Street Skunk lan~' HamletOutchogue (Pe~onic) County Tax Map No. 1000 Section ~.04 .............. Block ...... ~ ........... Lot..' .... ~9. ' Subdivision ...... ~.~q~} ............ 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 ~. ~rY. WO.Q~. ~F,~9. X~ ~O~qq?. ~. ~ .~. 9~E .g~.~g~ ............ b. Intended use and occu~anc,~2 Story wood frame residence with a 1.car garage 'knd a' ~bk'~ ' ~bb'd ' g~'~8 ' k'ddx~ ~b'~ ' &V 'fS~' ' 3. Nature of work (cheek which applicable): New Building .......... Addi :^_Add±~:±on ..%..'. t .............. Alteration ..... Repair .............. Removal .......... Demolition .............. Other Work ............... ! ~ (Description) 4. Estimated Cost ...... .$..4.0., .0.0.0. ................... Fee ......... ~..~t .7.. · .~,. ................. (to be paid on filing this application) 5. If dwelling, number of dwelling units . .4..B.e..d.rp. qm..s. Number of dwelling units on each floor .1.s.t.=. 1...B.~. ...... If garage numberofcars EXi$~.i~g 1 ~a~ .G.~gg.e. .2n.d.=3. BR 6. If business, commercial or mixed ioccupancy, specify nature and extent of each type of use ......... 7. Dimensions of existing structures; if any: Front..3..2: .2..f..t ..... Rear . .3.2...2~..f.t .....D;~I~ i..2.4.: .2..f.t.' i i i i 1 story Height · .10· ~.t ......... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front . .3.2...2.. f.t. Rear 39.. 2 ft Depth...39.2 ............... Height ....3.2...g .t ............. Number of Stories.. 2 .s.t.o.r .y 8. Dimensions of entire new construction: Front ................ Rear Depth (aght ............... Number of Stones ................. . ................................. 19'0'Size of lot: Front .... ,1.QQ, .0.0.: .f..t. Rear 100 ..00. £t De,,*}, 150.00 ~c '" Date of Purchase July 1, ~-9'5'~ ..... ~a~i ~f~o'r~r'~v~;'W. i.~.ei~a~' i~~)h'~li~ti~''~ '~Ik~'c;n 1 I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construetion violate any zoning law, ordinance or regulation: .... No .......................... 13. Will lot be regraded ...... ~. ~q ..... ~. .... ~.~ ......Will e~cffss~fill be remo~e41 from premises: Yes No 14. Name ofOwnerofpremises ~o.teman ~eweJ.± --~ ,t tzrescen~;~ ..... 88° ""68 ~ .................... '~uareSSpor t' 'Wa~h','N :Y','' · rhone No...q7t., ..... Name of Architect $ 9P,tl-r~f g.c.h.' .A..s.s.qq .i .a.t.e.s. ~..IAkfdress +44. t~ .. · Ocean. A~e Phone No.6.5.4. 7.2.6.0.0. ...... Name of Contractor [Jial~nown 'at .P. re.sent A~ .... ................. uure~paz c~ogae.,..N~ ¥... · Phone No ................ : PLOT DIAGRAM .' Locate clearly and distinctly all buildings, whether existing 6r 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 comer lot. PLEASE REFER TO ATTACHED SURVEY/SITE PLAN 'OF EXISTING CONDITIONS AND PROPOSED CONSTRUCTION STATE OF NEW YORK, COUM'Y OF .SufJ?.olk ..... ... S.S .................... BRYAN. P....HORN. UNG .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. .O. WNERS AqENT 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 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 mannerlset forth in the application filed therewith. Sworn to before me this 18th MAY 83 ........................ day of ..................... ,19... No~, lic - · 3' :..IaELLE.T.I.'~R.,..S~FFI~LK.. County __ i Iluallfiedl~n Suffolk County gf?.,~.~. [ f__/' . (Sign~ure~f a~plii~n't) Commission [Ipires March $0, tg.~.~'~ * ~ Pp~+ifiPate filed in OnondaEa Coun~ , J ( T USE IS UtlLJ~flJL WITHOUT ERTiflCJ~T[ 01: OCCU?J~HC¥ If copper tubing is used [Cor water distributing system; p|pJng shall be of types~ or L ~n~ 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ,i. FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH - F~MING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CON.RUCTION SHALL ME~ THE REQUlREME~S OF T~ N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FO~ DESIGN OR CONSTRUCTION ERRO~ ii i II P I I I I '1 ,,J --