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HomeMy WebLinkAbout13513-zFORM NO. ~. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold~ N.Y. Certificate Of Occupancy No. z-157942k Date May 26, ]987 THIS CERTIFIES that the building . .-5.d.d. ~. t../.o,n., t. 9..q n..e..~a.m..~ .1.y.. d..w ?.1.1. ~..n g .......... Location of Property 8925 Nassau Point Road Cutchogue, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section I 1 9 ...Block 0 2 .Lot 2 0 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 3I, ]984 13513Z ...................... pursuant to which Building Permit No ...................... dated..0ct°be..r ..... 31,..1984....... 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 ONE FAMILY DWELLING AS APPLIED FOR MARIAN F. ALES The certificate is issued to ..................... [o~n'e;','~t$~/~; ..................... of the aforesaid building. Suffolk County Department of Health Approval Iq /A N806080 UNDERWRITERS CERTIFICATE NO ' April 29, 1987 PLUMBERS CERTIFICATION DATED; ./ B~lding Inspector Rev, 1/81 l~OR~ NO. ft TOWN OF SOUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13513 Z Permission is hereby granted to: ...... ':~/~.....~..~.~ .................... ....... .~.--~.z/~.~.~..~ ~.....z.,~.~. ~ .~z...~,~,~ ~ v.~...x2... .............................. ....... ~....= ........................ :C.~'..~. , ...... ~.:~ ................. ...l ,, ,,m,,., ,~o,,~ o, ..... ~. . ~.:. ........... ~. .~ ~. . . : :~-. '.:. ?:~X"~ ................ : ....... ................................. ~....~ ............................. ::: .................................. C/~.~.~~:~.~ ~, .z/.~.~,~...~ ............................ ~.~....~.. .7/... ............................................................ C~n~ Tax Map No. ,000 Sec,o....Z./.~. .......... B,~k ..~ ........ Lo, ,o...~.q.. ............ pursuant ,o application dated ..... 0~/'~... ...... ~. ............................. , 1 .~...~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 B~,~G. DEFT. ~ TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in tvpewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, propertv lines, streets, and unusual natural or topographic features. 2,Final approval of Health Dept, of water supply and s~werage disposa[-(S-9 form or equal). :,:~3. Approva of electr cai insta ation from~oard of.F r.¢ ~. 4. ~~~al buddmgs, Multiple Remdences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the,building, 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, o~ buildings and "pm-existing" land uses: 1. Accurate survey of p~operty showing all propertv lines, streets, buildings and unusual natural or topograph ic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: A~L~i__t ionm___$_2~5 . 1. Certificate of occupancy New Dwelling $25.00, Accessory i$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date NewConsisruction ...... Old or Pre-existing Building ............ Vacant Land ............. LocationofProperty [¢.~),~'~ , ~'4u P~ ,~,,Z ./~.~ ...... C; o,;c/ ~c ~,~- i~ , House No. Street Ham/et Owner or Owners of Property ........................... - ................................. County Tax Map No. 1000 Section ........ Block Lot Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. . ' . . Date of Permit . . .Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .... ~ .2-~ . ~'~' Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ Construction on above described building and permit meets ail applicable codes and regulations. Applicant ........... ~ ........................ Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 1OO:~B Im~ 85 JOHN STREET, NEW YORK, NEW YORK THIS ~E~TIFIE~ TMAT Victor Ales, 8925 Nassa~ Point Road, Cutcho~e, M.Y. Sect/on Bilk Lot FIXTURE FIXTURES RANGES ~KINGDECKS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIAHCE TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I ' C E N0, O~ CC. COND PER ~/ OTHER APPARATUS: I~G,F. C.I. 1-Smoke Detector Electric Room Heaters: 1-1.5kw ~ 1-. 751~ A, W O NO. OF Ht-LEG OF CC, COND A, WG OF HI-LEG NO OF NEUTRALS AWO. OF NEUJ'RAL 8925 Nassau Point Road Cutcho~..uv ~ N.Y,, GENERAL MANAGER i~r~~~ho_r~8~Th * cert f cate must not be a tered in on¥ manner return to the office of tho Board i( incorrect, n*pect~r*~ moy be ..... ~dent bed by the r credonhals ~~.~?DING DEPARTMENT. THIS COPY OF qER~IFI~ATE ~ST[NOT BE A~ERED IN,~NY ~NNER TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner /7~,~/,~~' ff-- ~C~_C (please print) Plumber ff /CTv~ /~ L~3 (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Sworn to before me this Notary Public, ~©l;~ County Notary Public ROSENNN GRIFFITH Notary Public, State of New York No. 4814557 Qualified ~n Suffblk County ~ommisslon Expires ~ FIELD INS?EC'~ION'~ DATE COMMENTS PLUMBING _ INSULATION PER N. Y. STATE ENERGY ~?DE ADDITIONAL COMMENTS: // TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR 1LO. BOX 728 TOWN ItALL $OUTHOLD, N.Y. 11971 TEL, 765-1 This is to advise you that .the job under building permit no. 13513M issued to VlctOr Ales on __~_0~/8~~_ for Addition is completed amd a final inspectio~ hos ( ) has not ( x ) been done. An~nderwriters Certificate is needed In order to complete this file, it is necessary that n Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for ~ $25.00paynb]e to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrnnge with this office for an inspection date Occupancy or n,'~e is unlawful without a Certificate of Occupancy. Pleat~e, help un to clear up thi~ matter ~o that legal action does not have to be taken. Thank you for your prompt attention. ... Very truly y~, Victor Le~sard Executive ~dmlnistrator VL:gnr encl . 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~NAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:~ Examined .~.~.. ~ ...... ,1~.,~ Approved . .(~..C?.....~. ...... 1~., Permit No..~..~.C/?....-'~. Disapproved a/c .......................... .(f..,Z'.....3.. (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 issued 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 fhe 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 building 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 ...... .~/.I ~'TD l~... ~..L.~-.~... i .~...~.~. i~('~ .......................... (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 ........ ~. ?.5.~ ............. 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 ~'x ('N County Tax Map No. 1000 Section ... [. [.~. .......... Block....~...~ ........... Lot ...... Subdivision ..................................... Filed Map No ............... Lot . . .q .[ .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... (9~ .eT... 1~../~J ~ .~.')Z .... ~. ~.~*-.L l tk.~g~ ~ b. Intended use and occupancy ~, I '~'~,~" '~ "~i"'~...~...~.~..~..~.... ...... 3. Nature of work (check which applicable): New Building .......... Addition ... ~Alteration .......... Repair .............. Rem6val .............. Demolltion .............. Other Work ................ 4. Estimated Cost .... t~ l O .j oo O ,o.q.~.~ ~:a~-cl~ (Description) ....... ~ ......................... Fee ~.. .... 7~:. .......................... (to be paid on filing this application) 5. If dwelling, number of dwelling lunits ............... 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 structures, if any: Front ............... Rear .............. Depth ............... rttlf)igh~tfi:' ~ :: ; . ~ ~ . . . Number of Stories . i,<~ ,:.~'¥/!~ ~ . .... . . · ....... ................................................. t~i~i~'~Qflsame structure w3th alterations or addltmns: Front ................. Rear .................. ~I~{l~th .../ ........... '.:.. ~.. Height ....................... Number of Stories ...................... 8. I)iinens~a~of-e~ti~i~lew construction: Front ..... .o.~.~.t ......Rear ........... Depth .. J.Bf ......... ;Height ............... Number of Stories /q~...: ............................................. 9. Si~e oblo~.!.~ro~.~ ..~. / .............. Rear ....... Depth .................... 10. ~)ate o:t.~Pt~ehase: j. ......... ; .................. Name of Former Owner ................ 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ....~..0 .......................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...~.l. c4r7.0 t~ .~.-~.~'... Address ?.tr..a~...~.~q?..~a..~.....~ p.. Phone No. 71 ~ ~t.~ .~ ~/~ ..... Name of Architect .......................... Ad&ess ................... Phone No Name of Contractor . ~C:>.~ .~C)5"..V~,. .......... Address Phone No. ~.-}.'~. I..~...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. STATE OF N,BW",Y~RJQ,.~// ,o o ............... ' ......... being duly sworn, deposes and says that he is the applicant ~IQam~ in~}vldual sig~liffg contract) above named. : He is the ............... .Q.~. ~0?-..'~7~./'~ ................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 mannelr set forth in the application filed therewith. Sworn to before me this ~ ........ f~. ......... day of.. HOIAR¥I No. 52 County (Signature of applicant) ) . ~.,~ I , / ~1'