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Home My WebLink About10778-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Eall Southold, N.Y. GERTIFICATE OF OCCUPANCY No Z-25054 Date JUNE 2, 1997 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 1725 NASSAU POINT ROAD House No. Street County Tax Map No. 1000 Section 104 Block 13 Subdivision Filed Map No. CUTCUO($UE, N.Y. Hamlet Lot 2.4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 14, 1980 ~ursuant to which Building Permit No. 10778-Z dated JULy 14, 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 BATHROOM ADDITION TO EXISTINC ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. BArBArA M. BALDWIN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/~ UNDERWRITERS CERTIFICATE NO. 1997 PLUMBERS CERTIFICATION DATED N/A H-055452 - MAY 29, Rev. 1/81 FOR~ NO. 2 TOWN OF $0UTHOLD BUILDING D~AI~T~NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10778 Z Permission is hereby granted to: ......... 7 ~._ . r.)x.,~. . . .. .~. .~ x.z. ,r. /-. .~ . . .~/. ,/. z,~.~. . .'. ............................................................................... i ! / ._., at premises located at ...~...../.Z~;~ -~........~..~.~...'. ...... ~....:~.....~...~./.~-~(~/~../O ~, Building Inspector. ~ee *../....~....~... ....... ~,',, / Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS 8~66171 BUREAU OF= ELECTRICITY 35 JOHN STREET, NEW YORK, NY 10038 Oot~ MAY 29,1997 /~pplication/Vo. o./ll, 13954497/97 H 055452 THIS (:EI~'IFIE$ THAT o~/y th~ 4/4ctr/~d equipment as d4~Hb~d ~ and h~trodiw4,d by tim B~ B~WIN, 1725 NASSAU ~I~ RO~, C~CH~, ~ex.mi~o. ~Y 22,1997 ~NrmC~ RXTUIIES OTI~R AI~ARATUS: Co04aNG DICKS ] OVENS [DISH WASHERS EXHAUST FANS mMM~IIS BATHROOM ADDITION-1 *NO VISUAL D~'~CTS: "~J~ electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. BARBARA BALDWIN BOX 1~46 CUTCHOGUE, ~', 11935 P,r 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BU~LDING DEPARTMENT. THXS COPY OF CERTXi=XCATE MUST NOT BE ALTERED IN ANY HANNER. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-i802 APPLICATION FOR CERTIFICATE OF 0CCHPANCY This application must be filled in by typewriter 0R ink and submitted to the building znspector 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 I% 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 si~e plan requirements. 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, 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 Occupanoy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. 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-~xistin~ 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 Date ................................ New Construction ........... ~Old Or Pr~-existing Bn~ldi,~..~.~~. Location of Property..Housef ~'~' ~No. ..... LV~. 5~U.. ~. Street '~' ............................ ~amlet'~' ~' ' '~' ' Onwer or Owners of Property..:.k..~.~.~4~!.(A ............................... .. . .... . -- · county T~ ~p ~o ~ooo, Section.. Z~ ~{ ~'-~ ~ ........ Block ............... Lot ..... .~.~ ............ /~/~-- ' ~:~.~ot. f..L ................ Subdivision .................................... Filed Map.~w.~.~ .. Permit No../~'i~..~. ...... Date Of Permit....~./(.~./~...Applicant. ~.'.~.. ~---~- - ..... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ...... Request for: Temporary Certificate ........... Final Certicate...~. ...... Fee Submitted: $ ~.J)., ............. Co ~P~oSq APPLICANT 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY REMARKS: ,., ROUGH PLBG. INSULATION ~]/FINAL DATE COMMENTS FIELD INSPECTION .~ ~-~ ~ FOUNDATION FOUNDATION 2. ROUGH FRAME& pLUMBING (aha) INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~FINAL DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 i, APPLICATION FOR BUILDING PERMIT Date .~.~-..(-'..~..l .~... INSTRUCTIONS a. This application must be completely filled in by typewriter or 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 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 commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the promises 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 regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~.~1}.~.~... ~... ~..~. ~--~-,~.~,~'. ~,'~' ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate office, r.~,/~ Builder's License No... ~..~. Plumber's License No.. Electrician's License No.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section . ./.d)../~.. ......... Block . ./.,~. ............ Lot .... ~, .~..7..~... Subdivision ,~"~J'~.~..~.. ~. ¢.~.~. · ~.~O.../~. ~... Filed Map No./~. g,V. ~.~J~ · · · Lot . ..~./ .......... (Name) State exishng use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~,~ b. Intended use and occupancy ~'.-~..~t*'* ~ .~A.. ~.~tg', ~'. · .~. ¢ .~ ~ .... ~ .~.~"~..~..'~. .... ~--..~..'~. ?.g~... 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...~...~..g '¢.~. (,'... If garage number of cars i 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 .~E.~.~. ........ Depth . .~.~..¢. ....... Height ./. 6. ~l.~. ( ..... Number of Stories .... /. .................................................. Dimensions of same structure with alterations or additions: Front .. ~. ~.~. .......... Rear .. ¢~.~.~. .......... Depth ... ;~ ,t ............ !. Height ../~ s-..t.~../ .......... Number of Stories .... ./ ................. 8. Dimensions of entire new constrqction: Front .... /~, .( ....... Rear ... ~ .¢. ....... Depth .. ~,../ .... i .... Height ...'~..t ......... Number of Stories ..... g, ~ ............................................. 9. Size of lot: Front ... tt.~.*. 3,~° ......... Rear ...tl~..( ............. Depth . .~.~.~../. ............ 10. Date of Purchase ...~ ~. ~... ilq.7.$ ........... Name of Former Owner .. ~'.4' ~ .~'~' ~ ,~'. ~- ....... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~K.~. .......................... 13. Will lot be regraded .. ,~'./~"i..,~?.~. .... · ..... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~,~. ~'4'~ ~,~t~'~'~,~'.. Address .,~$.~4. ~' ........ Phone No. ~..~..- .~',~. ~.. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor . ,iT. ~./~.. ~ ~ ~ ~.~. ......... Address . ~'~.~ ~. a- ~ ~.~ ~... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all ~buildings, whether existing or 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 corner lot. STATE OF NEW YORK COUNTY OF. ,,~(&~. ~J~'g-..~. .... S.S : ~2~/? .~. D16' / l'U being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. 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 manne? set forth in the application filed therewith. Sworn to before me this .......... ./?....~: ...... day of..i~ ~.~..~ ~f~ ............ 19 ~. No 52.zt524771 Qualified la ¢l~.~olk County Commission £xptres ~areh 30, 191~ (Signature of applicant) z~ lyFrw I~I[PT OF N!ALTH ISEI{V POll APPItOV~t.;, OP' CQN!TllUCTION ONLY I;IATI: ~ELEDYNE POST 18AE,10E--12X18