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HomeMy WebLinkAbout11435-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildir~ Impector Town Hall Southold, N.Y, Certificate Of Occupancy No...zl~79.~t ........ Date ..... August 1.3 19 .86. D~rmer addition THIS CERTIFIES that the building ................................................ Location of Prope~ty ~0.~ O.l.e. Pasture R.d [ Cutchogue, N.Y. Hou~ No. ~met Hamlet County Tax Map No. lO00 Section ... ] ~ ...... Block ..... .0.1.3. ...... Lot ...0.0.1. ........... .............................. Fried Map No ......... Lot No .............. Subdivision . conforms substantially t° the Application for Buildin~ Permit her~tofor~ filed' hi this office dated 11435z .0 p.t.o.b.e..r..1 ~., .......,19 .~. ~. pursuant to which Buildin~ Permit No .................. dated ...O.~.t.~.e?. 2.7~. · 19.81 wasissued, and conforms to all of the t~luirements of the applicable proviu'ons of the law. The occupancy for which ~ certificate is issued is ......... Dormer a~d£tion to existing one family dwelling The certificate ~ issued to ....... ~r. Sp..~ .$~,i~il Bress ler · .................... of tho aforesaid building. N/A Suffolk County l~l~'tmmt of Health Approval .......................................... N477369 UNDERWRITERS CERTIFICATE NO .................................................. ~a Inspector ' Town OFi BUILDING TOWN HA~L SOUTHOLD, llUILDIhlGi P'ERMiT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL dULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: pU~s~ont ~o application datod .... ~ L...~2....:?....., } ond by 8uil~ln0 n,p~ctor. Fee $ , FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPA Instructions This application must be filled in typewriter OR ink, and submitted m~ 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, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~'operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 / / 4.Vacant Land C.O. $5.00 5.Updated C.O. ~ $15.00 Date ................ NewConst~'uction ...... ~'"'~ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .................... ' .~,',',)..t.:&>....~.~ .~..~.~.~. .... . .~...~.....~.....,Cq¢~r*~ .C~.~.... House No, Street Hamlet Owner or Owners of Property .i~.~.~ .~..'.~,.. C.~, .,~..¥~,.....~.~...~...~r~ ~._.~..~ .~..... ........... County Tax Map No, 1000 Section ............... Block ............... Lot ................ Subdivision ............. Filed Map No ........... Lot No .............. Permit No. t i .Apphcant . Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate,. i ................... Final Certificate ....................... Fee Submitted $...~'. :?...~.. ~..~. ~% ..... THE NEW YORK BOARD OF FIRE UNDERWRITERS p~'t BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 "ate Mas 7, 1980 ~pplicatlonNo. onfile 046614 only the electdcal equipment as described below a~td introduced bf the aoolicant named on the able a~pllcatlon number in tko premises of ~Eric Brestez, Old ~a~ture ~(d., ~ezt Creek Ave. ~ Pequash, /' C%ttchogua ~ in the foHowing location; ~[Basement ~[ Ist Ft. ~ 2nd FI. Section Block Lot FIXTURE OUTLETS DRYERS SWITCHES FIXTURES RANGES · OVENS EXHAUST FANS SYSTEMS OTHER APPARATUS: 1-4.SKW Ho~ Wa~er t~eater ]-6'-0" 5 Lites Track L~.~h~inE S E R NO. OF NEUTRALS A, W. g. OF NEUTRAL · Goodale Elec. Contr. l~{ 1, ~ox 1Sa, Main Rd. MatCituck~ N~Y. 11952 Lic. 783 E This certificate must not be altered in any manner; return to the office of,the Board if incorrect. Inspector~ may be identified by their credentlals~ ~ PT I~OR B I~LDING DEPARTMENT. THIS COPY O~ C:ERTI~ICATE MU NOT BE[A~LTERED IN ANY MANNER. TO~N OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 August 6, 1986 TEL. 765-1802 Re: Eric Bressler & Abigail Wic, kham 11435z - Addition Dormer 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. /Z/ The check is outdated. /~/~/No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. FIELD INSP~CTY~N FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMMENTS ~kINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Disapproved a/c ....... ' .............................. ' (BuiVling Inspector) ~ APPLICATION FOR BUILDING PERMIT Application No./d.~'..57 .~.- ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the dia~anz which is part of this apl: cation. c, The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc':al of this application, the Building Inspector will issue a Building Permit to the applicant. Such peru shall be kept on the premises available for inspection throughout the work. e. No buihlJng shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of a Building Pemdt pursuant to t Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, honsing code, and regulations, and adnfit 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 o~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) uilder's Uce e No. Plumber's License No .......... ~....t ........... Electrician's License No.~.O.~.. Other Trade s L ceuse No ...................... I Location of land on which proposed work will be done. Itouse Number ~20D~- Streettgk. b '(D/¥?.-~ ~'Tz-cOt~-- ~ Hamlet OMA/--I'~ ~O~-Fc.O-r,~_-- County Tax Mnp No. I000 Section ...ff.O..~='~.- ........ Block . /~' Lot &")~?,~ Subdivision ..................................... Filed Map No ............... Lot .............. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . i.. '..~-~..r'c~. ~-x. ~: ................................ Nature of worx (check whict, ap licable): New Building .......... Addir!on ...... Alteration Repair' Removal Demolition Other Work I ~ ! .~..: ~ (Description) : ?. Estimated Cost . ~ ..................... Fee ................ ¢ ........... i (to be paid on filing this application) If' dwelling, number of dwelling Cnits ~ Number of dwglling units on each floor.. Ifgarage, number of cars .....~ ................................................... . .. ....... ..... lf' busir[ess, commercial or mixed occupancy, specify hature and extent of each type of use .................... Dimensions of existing structures, if any: Front.. i~..¢¢. ........ Rear . ~.~ ......... Depth ....~2~..'~. .... Height ............... Nt tuber of Stories ... [ './..~w. ............................................... Dimensions of same structure w~th alterations or addtt~ons: Front .~.'~ ....... Rear .~ ...... Depth i Height Number of Stories Dimensions of entire new constrt~ction: Front Rear Depth Height Nu nber of Stories Size of lot: Front..~..: .~5~. ~ 6.. .......... Rear ...................... Depth .................... Date 6f Purchase ' Name of Former Owner Zone or use district in which prqmises are situated .................................................. Does proposed construction viollate any zoning law ordinance or regulation: Will lot be regraded ......... .' .................. Will excess fill be removed from premises: Yes No Nmne of Owner of premises ~ . Address ................... Phone No ................ Name of Architect , Address Phone No Name of Contractor , Address Phone No PLOT DIAGRAM Locate Clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lin'es. Give street and block mmber or description according to deed, and show ~ and indicate whether :terior or corner lot. rATE OF NFcW BJ , .... ~x,L~t~~:,,~,,,~.[.~ ~'· ' ......... being duly sworn, deposes and says that he is the applicant (Nan4e of indh idual sigr ing c6ntract) rove named. e is the ..................... ~ ............................................................... /-~..~(Uontractor, age, t, corporate officer, etc.) f said owner or owners, a~d is du}~authorized to perform or have performed the said work and to make and file this ~plication; that all statements confained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the mm~n~r set forth hi the application filed therewith. worn to before me this ~ ' ND/'A~Y PUBLIC, $~af8 of New Yo~ ' g'" ' ~ (Signatnre of applicant) i No. 52-8125850, Suffolk Count ~ ~ ?/, .\ 27~5.0 ?