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HomeMy WebLinkAbout10640-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25201 Date AUGUST 14, 1997 THIS CERTIFIES that the building ADDITION Location of Property 7525 NASSAU POINT ROAD CUTCHOGUE. N. Y . House No. Street Hamlet County Tax Map No. 1000 section 118 Block 4 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 1980 pursuant to which Building Permit No. 10640-Z dated APRIL 24, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN J. & FERN M. TOBIN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. l/Bl j I " , " FORIII NO. 2 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORiZED) N? 10640 Z Date .4/~.~........?.(,!................, lJh.. Permission is hereby granted to: ,.........) ~ fv.. ' tf;;G ~ ~- hit ' L~ It' ,~ ......~;;...<J.?:.?i.R.T...c...:.. .. ..1'V1.e,(:/.Irt}T.Q~/ ouvy\l---1 ...,(.,O'Y....Z.~s::.........,......... ... ........... ,....... , ....5Cl..uThtl.t:LJ.,:-:::..N.,:7.......... ,..,..... .... ' to ..,.w.UST./Zf.l.Cr:...,.t.1I2I?.I..I.t.Q.~(.I..:7Q....z:.>.:,.I.sr:I.I."'!"7"'~.I/U:-:<j . JrAvt /&-/...01...... ....................................,...........:.:........,.................. ."......'.....2..~...:.:.:...:.:.;:............................................. at premises located ad. .7:5. .d.$:.......&::J..:i5 a t;(../. Pl.&/.....J:j;,.,............ .....................,. , C . - '+ ..................................:.~....ri..........d........ ............,......... ..QTC~7~f:).....N..:. ..:,. /.LU;:::;.;I;&.!...tb.I.N.L...../k.!i..... ..If::~.. ....?7f./.;:[b"/............. cf7....P.f/.....s:.7...... pursuant to application dated .~//(I..(,.,......./::i:. ,..........., 1~, and approved by the Building Inspector. Fee $...I.~.~... .... , ~j ::; , TOWN OF SOVTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewr~ter OR ~nk and submitted to the bu~lding inspector with the following: far new building or new use: 1- F~nal 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-d~sposal(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. 11. Far existing buildings (prior to April 9, 1957) non-conforming uses, or buildlngs and "pre-existing" land uses: 1- Accurate survey of property showing all property lines, streets, bu~lding and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certif~cate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. 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-existin~ Building - $100.00 3. Copy of Certificate of Occupancy - . .2~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commerc~al $15.00 'll- 1:2 ~ r 7 Date........................................ . New Construction........... Old Or Pre-existing Building................. Location of Property. :I~.2:?... .!l!{~.. .P.!:.t./J.<f...;............C ?+7.<;-.f!.o.f}.'-!-.r::......... House No. Street Hamlet Onwer or Owners of Property.. ~ :':'~ . . .:;( . . :. . . .tC:of!l-!. . . . . 0.'. . ': . .I. f?4/1". . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. ~ /./.D.... .Black~.. 4........ .La~.. 3................ Subdivis~on................................... . Filed Map........... .Lat...................... Permit No............... .Date Of Permit............... .Applicant. .. . . .. . . .. . . .. .. . . . . . . .. .. .. Heal th Dep t. Approval. . . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval............... . . . . . . . . . . Plann~ng Board Approval........................ ~ Request for: Temporary Certif~cate. .......... Final Cert~cate........... Fee Submltted: :2.~ - $ . . . . . . . .. .. .. .. . .. . . .. . .. . . .. ......~...mf3~................. 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[ ] FOUNDATION 2ND [ ] INSU ION [ ] FRAMING [ ] FIREPLACE & CHIMNEY "\ L REMARKS: ~ -~~ -~~~~ -- . - /---- DATE j d_ k hi. ~dii ,:1i ,. , . , r~ latj6 ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] JNSULATION [ ] FRAMING vf FINAL [ ] FIREPLACE & CHIMNEY /11 ~ REMARKS. . OM"" J. K IfilS: y ~ t/VL- - - DATE / i ..i.! j, .H v , " : ~ ~ ',;.',1 , ~~I J1 - ~ "'., ;. >,l-~ '" ~-" ""~~----_.-C?- -- '0 . 1~J'.~ r'" ,~ , " 1\\"",1 . . , , 1 "'::' , ) ~" Io;~ ' , , '. , .$. " ,j,!' '; (JIfO~ I 'IN IOd t n'Vsst/N ':"~ " (" -' ,,""<~ _1 ... I '~;, ~ ' " I ~- -"'~",'t'f:\),l r -.~ \~ r,?,- '. . l ~ \ ~- '-.1 · ._" - _.....!f1J...__. : l' " ,e ;,.Jofl\ _..-flr I ~:09'OOr - ';i.o<f,6-;"';i N _( \ ___i 'I" ;": " " ')>f~ '.- .-' 30" '" I, . ilf" ~/J. . \ . . Z I'D ., , N \ .~ 0 , \ " ," f\) " ., ( . . o (j 0 . f () o . :, \ . t ~ C , . 0 , , .. ~ I f'I " \ , [" I XI \ I I \ ~ 0 ):> CJ \ ~ t " . \ ,. ." .. \ l , \ . II . ! , . 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J. :hJ~ s.lJ{V"" mol' 1'\01 booting tho land SUl'Voyor.s Inked ,t",\sed $0:01 shall nol bQ .:onsid()rad to be 0 vahd copy, , or (t'I(hfJ~OI;~in inchCQlUd horeon .hall 'un pnly to tha ~f,i)'TI Ih. sut./('y IS pr1)paftolJ, and on his. b~holf to the Iny, gQv~rnm~la' oaoncy and lendIng in5t11~tion liitod i ' 'f' J 10 th,;, anjgn'01 of IhB I...ndin() inslitutlon. poJOra~ t+.. '-...: -':--" \ ,:,.:JIM Of& f\Gt \fQn\fO)(QbtlJ to addiUooQI I~Ut\l:tml GI' AU disto-!\(',,, ta we1lt G'1d (:.$51'0<11; orG .Ht) ~'~''''.... ~~ , OWf\<9ts. by lo,otion from hOU$~ owners and fiald i ob,.,rvat+Guu.' 1;."':8 mO$' won, and cess- , po~l$ ore nol vl$ibla thos!) dlm~,",ton) " \>J -----._- -- cannol b9 certlf,~d, - I \1)' . VE.')" FOR REFERI':Ncl!' " , riLES M'JEL~ER ,AlO SECT/OifEl NASSAUPOINTc!.ua' PRO?i!:RT/:iS,' me. \) I'lL EO OCT. 4,1r.)/!)-F/I.~ flO. 74:3, . , \ ' '!,SSAU PO/NT AMENDED MAPA (IF secT. D N,1SS.AUPOI,'TCL":J i>.1D?- ?,\ :J ('F SO'JTH()LD ERT/IIS, /tiC, f/L'IZO OCT. 1:1, w:zo- I'll. ~ "II). }' JJ. CUAI/AIITEItD TO' '\ 1 ~'J. !) L/( COUNTY, N, Y 'hi:' ", ~ ;:',?~ III~ 50' .. \ "I_ \~~~t' .. \ ' ,;iF~~ ''a /0,/97'3 ' -; ~., ~.J'a.~,~ ." ?4,1913 , " " :5,1913 I " , \ I'~ "2 I! !.ANt). aUitVEYOIf ' ~ .. ~W :, 1 . No'!!'. I.IC.~O. ~1J7'" ',\'.' 't.t ,., , fI,/;.i.l' 1':\ 1 ,.)~ I'.'('! - RIV!RHIE40 II Y." .",' , ,.~ ~ ;";,' " ~ 'f'; i,.~ .,,,,Jll\&~L:_~.~"...&..L.JL' - ," .~. ,. \:,::1':. 4 <-..~ ~i~;~''"~....,__~t~A.J;.~(..1L J.c-.J.d _ ,.!:..~, ...... '.~~.it,~ . . --;;.-- .- , FORM NO.1 .... # \. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 """""'1:d- ,J. r, 19 to Application NO/()!),@. . . . , . . . Approve "'flt/,?.. <?? r, , IJb. Permit No. ./eJt. sl.Q-2, Disapproved al c , , , . . . . . . . . . -:-:. ' , . , , . . . , . , , ".. . ................. . ~ APPLICATION FOR BUILDING PERMIT -- -, -- ---- -- ~/~ L/ - I.s-/ .Po . Cm: Do" ...............19 INSTRUCTIONS a. This application must be completely filled in by typewnter r in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accotng to schedule. b. Plot plan showing location of lot and of buildings on premi es, relationship t<y'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 co.vered by thIs application may not be commenced before iss ance of Building Permit. d. Upon approval of this applicatIOn, the Building Inspector will is e uilding Permit to the applicant. Such permit shall be kept on the premIses available for inspection throughout the wo e. No building shall be occupIed or used In whole or in part for any pu pose whatever until a Certificate of Occupancy shall -have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building epartment for the issuance of a BUIlding Permit pursuant to the Building Zone Ordmance 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 a,grees to comply with all applicable laws, ordinances, buildmg code, housing code, and regulations, and to a~mit authorized mspectors on premises and in buildings for nec~s.s~~~~... ~~ . . . , . . . . . . . . . , (Signature ~a e, if a corporation) Ik4: .~.~,C . . . . .. .. . . . . ",,0.,.:a... / /. ~.I.j... (Mailing address of applic t) State whether applicant IS owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......,., .~.A...J'.^-. .................... -.................................,............. Name of owner of premises ~l(k!.~. , t. . ~ ' y.~Mf. .7Q ~/~ . . . . . . , , . . . , . , . . . . . . . . , . , , . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .. . . ,. .., . ........ . . . ............... . (Name and title of corporate officer) Builder's License No. . ~~3...,....,..,..., Plumber's License No, .... ............... . ElectricIan's License No. . .13-'1-' .~'.'-(E!'~.~ -# 75'Z 5- Other Trade's License No. ....,.,..,...,....,.. I. LocatIOn of land on which proposed work wIll be done. /?~:<-.~.. ~ ~ . ..... t . . . . . . . . . . . . . . . . . ... ./ /-! . , . d;r~:t ' .................. . ............................ '" House Number Hamlet , -~#f!~/!F. 6'u-~'t? ~ OCJS County Tax Map No. I 000 s~on . f :. ,. ".,..... Blotk .... ' . , , .. ,...,.. Lot.. .. ..,....,..,.. SubdivIsion , f;~?S.4?! /: .. .C1t..vE. ,lJ?dpP. . : . Filed Map No. ,/56...,... Lot, . , . :F7. . . . . . (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. EXIsting use and occupancy . ~. ~. . . , . . . . . . . . . , , . . . . . . . . . . , . . . . . . . . . . ... ...., 00 r -- ~ -." b. Intended use and occupancy.. ~...W . ./p'I;JRf/I.Od-l./.a.. .?::'~ (~?>:':j'I' .<.(jj~4..,.... , " !, j ~ jj: "' - I , ". ."',. * ~ . 3." Nature of work (eheck which applicable): New Building. . . . . . . . . . Addition. . . k: . " Alter~tion ;-:-: . . . . . . . Repair .............. RemQval . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . '#! /-T! o::n;j (Descrjptjon) 4. Estimated Cost. . '~J..,j-:o:-P.. .!. .. . .. . .. . .. .. . .. .. . .. . . . Fee. .( :T.~. . . . . .. .. . . . . .. . . .. . .. .. . . . .. , (to be pajd on filing this application) 5. If dwe1ling, number of dwelling ~nits . . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . . . If garage, number of cars .....,................................................................... 6. If busjness, commercial or mixe~ occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front. . . . . . . . . . . . . . . Rear .............. Depth . . . . . . . . . . . . . . . Height ,../.12 (. . . . . . . . . NU11jber of Stories. ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure wjth alterations or additions: Front ................. Rear . . . . . . . . . . . . . . . . . . Depth. . . . . . . . . . . . . . . . . . . .1. . Height. . . . . . . . . . . . . . . . . . . . . . Number of Stories. . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new constvuction: Front. . . . . . . . . . . . . .. Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height ............... NUn)ber of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front. . . . . . . . . . .:. . . . . . . . . .. Rear...................... Depth ...................... 10. Date of Purchase ...........'.................. Name of Fonner Owner ............................. I J. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . /1,C? . . . . . . . . . . . . . . . . . . . . . . . . . . 13. wm lot be regraded .........1................... wm excess fm be removed from premises: Yes No 14. Name of Owner of premises ~ltfN.. .7]>.6/1).... AddresslJ~f'TM.. ~Phone No. ............... Name of Architect . R . . i.;L......i.. :'. .;..:,' ., . ',' . . . . . . . . . . . . . . Address .. . . . J ; . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . .'f-..r..~. . . . . . . . . . Address ~/I;{.,. 1 ~ . Phone No. 76..(".-.1.3.6 ~-:-:. . . 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. ! , , , , 5C:c. f/,OtJ fl ~/C..I/( oy'1ff:/Ce:WtTH . , i , 1 , STATE OF NEW YORK, .L 'S.S I COUNTY OF ...:s~.. . .. " / . . . . . . . . ,fo~I;:~~r.. . . f. . . )JIl@.;I:-!I.If.(f;7().I1/. . . . .. being duly sworn, deposes and says that he is the applicant , (Name of individual signing contract) . above named.! I He is the . . . . . . . . . . . . . . . . . . . . . .1 . . . . . . . . . . . . . . . . . . . . . . . . . . . .' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , (Contractor, agent, corporate officer, etc.) ! I , of said oWl1er or owners, and is duly authorized to perform or have perfonned the said work and to make and file this application;1 that all statements contajned in this application are true to the best of his knowledge and belief; and that the work will b~ perfonned in the manne'r set forth in the application filed therewith. Sworn to before me this i ... ..~...' . ~rf~..... .dayo~.. Nfl," /l.~':-:........., 19 J?1; a.,:f'--f(~~' Notary 1) lC, .................!......... \. . . . .. County /J . /, l . T . 1 NOTA~~~~~l~. ~~t~ttL~:: Yorl! . [~(." .~. . . . . : . . . . . . . . . No, b2.4524771 \ (Signature of applicant) QualifIed In Sull"li: :County COmmIssIOn ExpIres MaH,:h 30 19" n I,'"~ i ,~