HomeMy WebLinkAbout11344-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z~3946 Date .. October 22 ~.5.
THIS CERTIFIES that the building new dwellir~g.
Location of Property 4550 Wum~eweta Rd. Cutchogue
House NO. Street Hamlet
County Tax Map No. 1000 Section qqq .Block q4 . .Lot 32-33
Subdivision .N.a.s.s..a.~..~.t. :..G.l.u.:o..l~.r..o..p.. ...... Filed Map No...~.5..6...Lot No .... .2.2.3.7.2.2.6..
conforms substantially to the Application for Building Permit heretofore filed in this office dated
·...J.u.l.y... 29 ,19.8.q. pursuant to which Building Permit No. d ~1344Z
dated ....A.u.~.u.s..t..2.0. .............. 19.8.~. ,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 .........
...~?.~.v..<,.e..o.n. ?.-~..m.~.z~..~??.~.~. $.~.~... ............................................
The certificate is issued to EDWARD N. CARTNICK & WIFE
..... . ................ ?o¥,,'o~ .....................
of the aforesaid building.
Suffolk County Department of Health Approval ................. ? .q.-.S. 0. ?~. ...............
UNDERWRITERS CERTIFICATE NO .......................... .N.5.8.~..8.0.8. ...............
Building Inspector
Rev. 1/81
BUILDIHG P,ER~I'I
(THIS PERMIT MUST BE KE?T ON TH,E P~EgI~ES UNTIL
cOMPLETION OF THE WORK AuTHoRIZED) 1
Permission is hereby granted to:
:ULL
tO
at premises located at
~.~ ~.. .~., ..~,~...Z~: .~ ~ ~.~..~ ..........
County Tox Mop No. log0 Sectton ..... ~.~ ..........Bilk {~...~ ......... Lot No. ~.....~
pursuant to oppiicotion dated .. . ~_. .., 19~., and approved by the
Building Inspector. , ~ ~
Fe~ ~.~.~.~...~.~. ~, ~
!nmector
Rev. :6/30/,80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
BLDG, OEPr.
TOWN OF SOUTHOLD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted iall~ 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~Coperty 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 .... /.l~,. ,~, Jr..~..~,~- .....
New Building ...... ~ ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .... .~ .~.~.Q. ljt/p/'l, tl ~ ~ .e.t.e,. ]2~1 ....... J~[8, $ s~.u. ~;,..Uu t Dh o ~ e .............
House No. Street Ham/et
Edward N. Cartni~k
Owner or Owners of Property ....... ,
County Tax Map No. ,1000 Section .~[.~.. Block .... ~..~. ........ Lot... ~-~.~...~...~.'.~.
Subdivision ................................. Filed Map No. l..~.~ .... Lot No ..............
Permit No. ~-~, ,~, ,q.~,:~,. Date of Permit ~\ ,~, ,~,~ .... Applicant ..................................
\\ ~.~1~ _ CJ .~. App
Health Dept Approval '- .Labor Dept royal
UnderwritersApprova, .......... P ann,ng oard Approval ......................
Request for Temporary Certificate ..................... Final Certificate ..... ~ ...............
Fee Submitted $. ~'~.' .~.~.): .¥/':~
Construction on above described building and permit meets all applicable codes and regulations.
~,C),--j~Z~_~ ]~C~q (~ Appli'cant .~~(~),..'~.'.
" ' ..................
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICIT~f
~- ~0~'2~[ ~, ~:~ 8~ ,JOHN STREEt, NEW YORK, NEW YORK 10038
o~ly the el~trical equip~ent as ~scrlbed below and introduced by the applicant named on the above application number in the premises of
in tke fotlmvlng location; j~ Basement [~] 1st FI. [~ 2nd ri. OL;~i~k~ Section Block Lot
was cxa,nl,ed on Aksfi! [[8, ],983 audfottnd to be irt compliance with the requirements of this Board.
OUTLETS
DRYERS
IIECEPTACLES SWITCHES
RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
OTHER APPARATUS.
E R V I C
NO OF CC COHO A ~N G NO OF HI LEG A W O A W O
PER ,~ OF CC COND OF HI LEG OF NEUTRAL
E
11935
#2941
This certihcate must not be qltered in an), manner; return to the
COPY FOR BUILDII~
Inspectors may be by their credentials
;E ALTERi IER
10o1o93 THE NEW YORK BOARD OF FiRE UNDERWRITERS
~ BUREAU OF ELECTRICITy
~O~'~-'~ .'~0, [~ 85 JOHN STREET, NEW YORK, NEW ~ORK 10038
the~ollowlng location; ~ Basement ~ 1st FL ~ 2nd FI. Section Block Lot
~ ~m~.od o, ~v~er ~, ~982 and ~o,nd to Ye in compliance witk the req,~rements of tkis Board.
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
86 72
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS-
~o~ors: 1-13~ Yf. F.
2-G.F.C.I.
2 -$~oke Detectors
2-15,0 K.W. Heat ~s
1-4.5 K.W. ~t Water
2-Post Lites
Gary Doroski
42 D Monsell l~a~e
L~chog~., N.Y., 11935
S E R V I C
OF CC COND ,
AWG
OF HI-LEG
NO OF NEUTRALS
2
AWG
OF NEUTRAL
2/0
I~Lc~ #29~1-E
GENERAL MX~AGIER
5~ Th~s certificate must not be altered in any manner, return to the office of the Board if inco?rect. Inspectors may be ident,fied by thmr credentials
COPY ?07 BUIL~DING DEPA.T/VtENT. THIS COPY :OF CE~E~!FI~A!~E,~U$i NOT BE ~[TI:aI:D !N ANY MANNER.
FOUNDATION ( 1 st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y. ~----- --
STATE ENERGY
q,ODE
4. ~.~ u~C
FINAL
ADDITIONAL COMMENTS:
1~%7 YO}IX S~--ATE D~JPA-rU~L?~2!~£ O~ ~l~F~g~ ~S~TIOlq
R~a~ B ffa~s
Bldg. 40~ S~ - R~m 219
Stony Br~k, l~{ York 11794
(516) 751-7900
PDBF~RTFo FLACKE
Co~missioner
As a r~mult of your in~_i~5 concerning the above referenced Darcel~ this
Depar~dnent h~s conducted an on-site inspection° ${e have found the ~ or
-- 'l:~ererore~ pursuant to Fart ~61~ Offlc!al Compilation of Codes~ 7~les
and P~lations of the State of ~,]~ York~ Section 661o4(b) ~ no pem~t under
Article 25 (Tidal ~tlands) of t/~e Envi~tal Conservation Law is re~rech
Ve ,rf.~ truly
DANIEL Jo I~P~KIN
Reqion~l Permit ~anlnistrator
DJL/cr
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
PLEASE TAKE NOTICE t:t your :plic:: dated~. ~(X'. ~.:~ .: ~. ........ ,19~.
for permit to construct...4~../t~..~.,..~..~.~../~/. .... ~ ..... ;~Z~ ((.. % ................. at
Location of Property ........... '~Z~t~.C~ ~ ~..~ ......... ~Z~
House No. Street / .... ~ ' ' ~[e~ /
County Tax Map No. 1000 Section ...//~ ....... Block .... 4~. ...... Lot ~.:
Subdivisio~f~. ~ .... Filed Map No.. ~ ......... Lot No. ~. ¢.~ ............
is returned herewith and disapproved on the following grounds ~/f~ .d~f.~/~..
e ~A ¢c-: 3 z' /'~; ....... ~": .............
~..~..:~ .................... - ..... ...C.. .......... ....../ .................
/ B~ilding Inspector
RV 1/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
for permit to construct..0/'~.,./.~.~?./f-d./(-.~/.. ~)~.~--r.['./,//~..~. ........................ at
Location o f Property ............ ~(Y/d~.(~ ~. . 1~ ~ ...... ~ ~ f /~C R~. ~'-' ~ '/ '
House No. Street /Hamlot /
County Tax Map No. 1000 Section .... ddd ....... Block ... [.~ ....... Lot~'~ ~.. --
Subdivision g~(~. ~.. Filed Map No.. ~ ~ ......... Lot No.~O.~ ~(~ .~..
is returned herewith and disapproved on the following grounds .~.. ~.. ~.G .~ ......
.~vz4c...d .... ~(¢~r¢ (¢ ..... ~U~~5.. ~".
..... ~. ~?~¢.~5~.. ~ ~... L.~ ~,~4~(~.. c ..................
Building Inspector
RV 1/80
,Application Received
Disapproval Issued ' Permit
19
FORM NO. 10
APPLICATION FOR DEVELOPMENT PERMIT
In the Town of Southold
Type of Development Proposed:
Addition and/or Alterationl--t
Other (specify)
New Structure (including storage tanks~
Flood Proof Below Base Flood Elevation~
Elevation Daba in relation to above mean sea level ~f:
(a) Lowest floor elevation, including basement ~ feet
(b) In a V Zone, bottom of lowest structural me~ber ..
inches
feet inches
FIRM--Flood Insurance Rate Map, Zone designations .......
Location of Property:
Co~ty Tax Map No., District, lO00, Sectzon ///_ Block ~_ Lot(s)__
Subdivision ...... Filed Map ~ -- Lot(s)
Approval from othe2(s) before Permit is issued:
DEC
SEaVIC Il 7
HEALTH ~ " ~ ~
BUILDING PERMIT
WETLANDS (Town Board) ......
ZBA
PLANNING BOARD
I- (~¢-arq~ ~ ~-¢~ , the applicant, am the Owner~,
O~n~¢ 0~-r~_~-~g~'Co---ntractl~_~, Lesseel I, Agentl--l, Con-
tracto'r~, and agree-to comply with all applicable sections---o~ the. Code
of the TeEm of Southo]d; County, and State ~d to a~it authormzed
specters to premises authorized to perform or have performed the said
work and to make and file this application, that all statements contain-
ed in this application are true to the best of my knowledge and belief
and that the work will be perfo~ed in the mannerset forth in the
application filed therewith.
COUNT~ OF
SWORN TO THIS o?~ ~ DAY
JUDITH T, TERRY
Nota~ Pubhc, State of New Yo~
No. 52-0344963 Suffolk Coun~,~ ......
address and phone ~
if not given above:
4/80
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined ........ 19~.~.
Disapproved a/c .....................................
................ ( / /
APPLICATION FOR BUILDING PERMIT
Application No. //'ffc'/(e(
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 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 w.ith all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and ~n buildings for necessary i spections.
(Signature oFappliqant, or name, if a corporation)
· [;_ ....
(Mailing ~ldress of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electric[an, plumber or builder.
Name of owner of premises . ,~ff. d..c?..o~N,. ~'¢~r~r' [~_~.
d ............ .... ......................................
(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 ......... ~ ?.'/ ............
Plumber's License No.. ~'.'.~..;/, ,~rI.~ ] )J ......
Electrician's License No...~,C.{. !~. 1.,..~ .......
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
............... 7.;,,,.. ...... ..........
House Num her Hamlet ~
County Tax Map No. 1000 Section ..... I. Ii. ......... Block ..... ].Zgt..._. ~,Z.... Lot g .-¢,'5:~.~..~ ./¢. ......
Subdivision .................................... Filed Map No. ~./..~..2./.~.~..~... Lot ...............
(Name)
2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... 0.[).'.4g...~. 2. d .{}-la~. ~'.'.O~.2... ..........................................
b. Intended use and occupancy .... E' '~¢" a .'. d..q~:".~ T. ~-.~.~. .......................................
Nature of work (check which applicable): New Building .....~..... Addition ....
..... Alteration ..........
Repair .............. Removal,' .............. Demolition ............. Other Work ...............
(Description)
4. EsfimatedCost ..... ,. ,a..~./.0..'r..-r .................... Fee ...l.: ...............................
(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 c~s ....... . .................................................................
6. If business, commercial or mixed occupancy, spec~y nature and extent of each type of use .~ ....................
7. D~ensions ofexisfingstrnctures, ffany: Front ............... Rear .............. Depth ...............
Height ............... Number of Sto~es ........................................................
D~ensionsofsamestmcturewith:~terationsoradditions: Front ................. Rear ..................
Depth ..................... ' HeiSt ........... , ........... Number of Stofiej ............. ~ .~ .......
8. D~mansmns of enhre new construction: Front... 6 ~''' '~' · ' · Rear.. ~ fl~. ¢ .... Depth .~ t..q ........
Height ....... 1 ~...~ Number of Stones ...... ~ ~. ....... ~ ......................... , ............
9. S~ze of lot: Front .... 1~ ...... ......... Rear ..... ~ ~.~ ........... Depth ..~.~ .............
m. of ........ I. *' ............. Nav o? Poi -- .....
11. Zone or Use dlsmct ~n which premises are s~tuated ..... ~.~ $. ~...~ .............................
12. Does proposed co~straction violat~ any zoning law, ordinance or regulation: .... ~. ~.... ...............
13. Wfl[ lot be regraded ..... ~. & ~ ................. Will excess fill be remove~from premises: Yes
14. Nmne of Owner of p[em~ses ~.~*~.. ~h/~ddress ~ ~b ',*~ .... Phone No. ~J~., .~
Name of Architect .~ * ~.. ~.~ h .., ...... Address ............ '. ...... Phone No. ~.>~., ~.
Nmne of.Contractor ~ ~.~.~ .[d~ ~l.~. · · · Address ................... Phone No.¢ ~, ~].2.~.
PLOT DIAGRAM
Locate clearly and distinctly all b~uildings, whether existing or proposed, and~ indicate all set-back dimensions from
property lines. Give street and block n~tmber or description according to deed, and show street names and indicate whether
interior or corner lot.
?
COUNTY QF~
............................ i .................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the. ~ .......................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dqly authorized to perform or have performed the said work and to make and file this
application~; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will ?e performed in the mannier set forth in the application filed therewith.
Sworn to l~efore me this
Notary Public, . unty
Notary Publio, State of New York
NO, 52.034496:5 i'$uffolk Count~'~..~ (Signatur? of applicant)
Commission Expire~ March 30,
~a'~;~a CER'B:IC/~TE
N~' 'CH Jr~ i4 EY
I
'Jl
AX AX
L
!t
_WW'r ( F.
AT 'E -t_,'
RODERICK VAN TUYL,
NEW YORK
¥
SUFFOLK CO. HEALTH DEP'i'. APPROVAL,
HS, NO.
STATEMENT OF INTEN~ ' ' ,
THE WATER SDPF'LY AND,SEWAGE DtSPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES,
At~PLI'CANT
SUFFOLK COUNTY DJ[PT, ~F HEALTH
~,ERVICEs -- FOR
CONSTRUCTION ONLY
DA'rE. ,
H. S. REF. NO..
APPROVED'
APPR,QVAL OF
'SUFFOI
DIST. SECT. BLOCK ' I~L.
OWNERS ADDREI~S: '
DEED:
S~ST[~ FOR THIS EESlDEN~ WILL
CONFORM TO' THE ~TANDARD5 OF THE
DATE:
T~"H~L~" ,, , "" ~," ,,"