HomeMy WebLinkAbout11002-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
~ERTIFICATE OF OCCUPANCY
No Z-23365
Date NOVEMBER 23, 1994
THIS CERTIFIES that the building ADDITION
Location of Property. 560 LITTLE NECK ROAD
House No. Street
County Tax Map No. 1000 Section 97 Block 7
Subdivision Filed Map No.
CUTCHO~UE, N.Y.
Hamlet
Lot 26.4
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 13, 1980 .pursuant to which
Building Permit No. l1002-Z dated DECEMBER 17, 1980
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 TWO CAR GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to STEVEN & VIRGINIA MARQUARDT
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-043217 - NO~EMBER 2, 1994
PLUMBERS CERTIFICATION DATED N/A
Bui ding Inspector
Rev. l/S1
110O2 Z
Perrhission is hereby granted to:
(THIS PERMIT MUST BE KEPT ON 'FH.E PP-E4is~S UNTIL ~ULL
COMPLETION OF THE WORK AUTHORIZED) ;;
Cou!tY, Tox Mop No. 1000 Se:i. on .0..~...7.. .......... ~lc~ i!.~...~..,...L.. ::Lot No.'(::j.~..,..¢~ ....
pursuant to application dated ~'~.- ....... I..~ .......... : ....... ;..i"...;!~-...., 19~.; and approved by the
Building Inspector. '~
Fee $..~.,~.......'%- .......
Rev 6~30/80
Inspector
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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. Commercia~ buildings, ~ndustrial 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pZ'operty 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.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
$15.00
Date ...... /.~./,4,~/.~/.~. .........
New Building ............. Old or Pre-existing Building ........... Vacant Land .............
Location of Property...~ ,~.~.....~../..)~,, ,~,.. ~ ~ C.~-,... ,~A ........ , .~/; ~.~. · .~-~. · ......
House No. i ~ . Street Hamlet
OountyTe ep o. O00Sect o .... :..,.,. .... ..... ....... Lot .....
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No..]/~,~., Date of Permit ./?.//..~,~..~.Applicant ..................................
Health Dept. Approval ........................ Labor Dept, Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $., .~,5,~,°, ...................
Construction on above described building and p~'mit meets allre, ppJ~cable codes and regulations.
Applicant.. ,, .............
Rev, 10-10-78
co-
Town Hair, 53095 Main Road
P. O. Box 1179
$ou~hold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 17, 1994
Mr. & Mrs. Steven Marquardt
560 Little Neck Road
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
The check is (outdated/not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 11002-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~5'~65'~ BUREAU OF ELECTRIqlTy
~- 85 .JOHN STREET, NEW YORK, NEW YORK 10038
Date ~()V~}~J'}~ ~)',i,~ [~J~4 ~pplication ~o. onf'~ ~6~87794/94 ~ ~2J
THIS CERTIFIES THAT
........ ~, NECK RD~ ~ CUTCHOGUg~ N.Y,
in the followlng location; [] Basement [] Ist Fl. [] 2nd FI. ~'~/0~7 Section Block
n~s examined on Of!~'O~E~I ~¥~ ~ ~ 9~i anJ found to be in compliance ~ith the National Electrical Code.
Lot
RXTURE
OUTLETS
DRYERS
FIXTURES OVENS EXHAUST FANS
OTHER
E V I C
NO OF CC. COND.
PER ~'
A. W G. NO OF NEUTRALS A W. G,
I~O. OF HI*LEG O~ Hb[EG OF NEUTI~AL
OTHER APPARATUS:
sktrv~¥ ha~; b~on mado or. the exposed
premises indicated." "No o))vJ,otia
560 LITTI,E NEC, I~ RO~D
GENERAL ~ANAGER
This certificate must not be altered in any manner; return to the office of the Board if
cow ~o~ sU~m~e a~-.~m~m, mE cow 9~
FIELD INSPECTION
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(~se)
INSULATION PER N.Y.
STATE ENERGY
CO~E
FINAL
DATE COMMBNTS ~
, ADDITIONAL COMMENTS: .__ ~
?~,,/ -- -
TOWN OF SOUTKOLD
OFFICE OF BUILDING INSPECTOR ·
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-I 802
Applicant
rermlt No. i,o__ in ~ ~ ~ . o~ .... . ~ulzazng
. a ?~s ~ has noJ~en aone.
In order to complete this fi!e, it is necessary that
z-~z~u~ of Occupancy be issued. F!ease fill out the
enclosed form(s), return same to the above
check for $5.00 payable to the Town of Southo!d. Flease
indicate to Whom the Certificate of Occupancy is to be mailed,
and arrange with this office for an insoec~ion date.
Thank you for you~ prompt attention.
VL:ec
Enclosures
Very truly yours,
Victor Lessard
Adminis tr~ top
I
I
i
.J
FO~M lqOo l'
TOWN O~ SOUT~OLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined Z~...~ ...../...?.
................ , 19.~..
Disapproved o/c ............ ~...........,...___. .............................. ~ ..........................
(Building Inspector)
Application N o.~ ./.,(?...C?.~?~ ..............
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate 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 end of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving o detailed description of layout ofproperty must be drown 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 o 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 o Certificate of Occupancy
sho~l hove been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described.
The applicant agrees to comply with oil applicable lows, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in~ buildings for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ....... .~./.-~.~U/l~..~........~.....J~.../.,f¢.~ .x//~.~'rf~..:..~.~.....~.4C'/~./d~/~,~..~ ..................................................
If applicant is a corporate, s~nature of/d~y authorized officer.
.......... ........
j(/Nome and title of corporate officer)
Builder's License No ....... .~...~.~.~.....~....~./...~. .........
Plumber's License No .......................... ~-~ .................
Electrician's License No. ~.......~..~.....?....~,./..~.-..c..~..~..
Other Trade's License No ...............................................
1. Location of land on which proposed work will be done. Mop No.: ....~./~..~.../2~....../~....~.~..~...../~(~.~,~. Lot No ..... ~ ..............
Street and Number~......~.. ........ ..~/~......~../.1..~'/mb_..l.,,/~..~..C.'.,J~..../..~., .~..
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ............. ¢~..~..~...../~.,.-~'¢~/,I.~...~......~/.~--,~.~/~.~4~....~
use and occupancy ......... .~..~...E~....,~/~.I~,.),i....~.~-~*/..~.~2¢¢f.~',d~....: ...~.../..J.~.....~..~..J.~.~...~...~..~.,~....~'~
b.
Intended
/
property lines. Give street and block
whether interior or corner lot.
3. Nature of work (check whichI applicable): New Buildin¢,. ................. Addition ....~/,¢¢?.. ....... Alteration .................
Repair .................. Removal,: .................. Demolition .................... Other Work ................................................ , ....
,: i (Description)
4, Estimated Cost ............................................................ Fee ..........................................................................................
i (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 structqres, if any: Front ............................ Rear ................................ Depth ............. ; ......
Height Number of Stories '
Dimensions of same structur~ with alterations or additions: Front ....................................Rear ............................
Deph ................................ Height ............................ Number of Storms .......... ,...A'...: ...........
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 Owner ........................................................
11. Zonb or use district in whichlpremises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........... , ............................................
13. Will lot be regraded' . ............. ! .............. Will excess fill be removed from premises: ( ) Yes ( ) No
14. Name of Owner of premises ....; .......................... ..................... Address ...' ............ '. ....... . ......... Phone No
Name of Architect ..............i ............................................... Address ................................ Phone No .......................
Name of Contractor ............ i ............................................... Address ........ ~m .................... Phone No .......................
PLOT DIAGRAM
Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
number or description according to deed, and show street names and indicate
_'JAr .E. OF NEW or'Rio,/
.............. ~%/.~;,¢4.~ ........... ~~/l ......................... being duly sworn, deposes and soys that he is the applicam
(Na~e of individual signing contrac~
above named.
He is the .................................. ~ ...... ~ .................................................................................................................
( %_ , (ContraS, agent, corporate officer, etc.)
of said owner or owners, and is%d~d to perform or hove performed the said work and to make and file
this appligation; 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 fo~h in the application filed therewith.
Swqrn,to,before me this ~
Not, w ............ Cou, ......... '....:. ....... /: ........................................................................
~-~/ . , ~,;~, ~), ~¢,Z'] /~ ,, ,~ ~ (Signature of apphcanf)
/
Term ~xpires Msr~t~ .........
lITTLE
~R~-A ,¢£~RVEZ2 b-OR 03
TO TOWN OF ~OUTHOdD
FO~ ~OAO WIDENING
°VACANT"
~- ~ THE
sU?'F OLK COUNTY
DEPARTMENT O~ NEALTH
SERVICES FOR APPRC, VAL
OF CONSTRUCTION ONLY
DATE .H$ REF NO
APPROVED
/40. OO '
(,~o.o)
(/~,.o) (/~)
/~. 14 °06 '37 "~V 140.00'
CO./14MONS ,OHD Old'Al S~AC~'~
" V~CANT"
'gW~'~, UNDE'P-,, (~oN,.5'T.
F'IN~L, SURVEY, ~:x:,~lo80FWELL,~ _%,*¢,lrr^e.-/Sy'sg'.Yf~ ,~, PER
THE WATER SUPPLY & SEWAGE
DISPOSAL FOR THIS RESIDENCE
WILL CONFORM TO THE STAND-
ARD$ OF THE SUFFOLK COUNTY
DEPT. OF HEALTH SERVICES
NAME
ADDRESS
TELEPHONE
GUARANTEED O/VIY
$OUT/'/OLD .,gAVIWG,5 ~'AIVIf
U$/_1~-£ 7-/TLE /A/SUA~ANCE COMPANy
HAROLD g. TRANCHON JR. N.Y. LIC. NO. 048992
PENN, LAC NO 21115-
JOE5 NO. 77-6'49 FILE NO.,I..ITT/EN~"CI4"
J PROP~'R
SURVEYED FOR: ST~V~',~,~. V/RGIHI,~ A. MAteOUARDT
LOT NO 4
MAP OF Z/TY/_£ /V£CA' /='A:'0,o,E'A:'7'/~,5
SITUATED AT CU7'C/5/OG"U,E'
TOWN
SCALE
FILED
bOOK
OF ~OUTHOL2P -~UFFO4,.~' COUHT'~
1' = 50' DATE
MAP NO. 6048 DA~ //-BO-~7~
NO PAGE
HAROLD F TRANCHON JR. PC.
LAND SURVEYOR
SUCCESSOR TO WILLIAM G. MEIER
NOF~TH COUNTRY ROAD- WADING RIVER
NEW YORK 11792
(516) g29-4Gg5 ALT, 473- 3626