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HomeMy WebLinkAbout12883-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15300 Date February 2.4, ]987 THIS CERTIFlES that the building Addition to existing one family dwelling . 93 Broadwaters Road Cutchogue, N.Y. Location of Property/t~ds'o ~o~ ....................... '~'*/e~i ....................... ~r~/o~ County Tax Map No. 1000 Section 104 .Block I I .Lot 9 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated F e b r u a r y 9, 1984 pursuant to which Building Permit No. 12 8 8 3 z dated Feb ruary 2 3, I 9 84 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 ** The certJficate Js issued to JEROME H. & LOIS K. PARMET ..................... ?d ,do'r,' d:t'itfx 'ff8 .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N 79 3 72 7 PLUMBERS CERTIFICATION DATED: N/A ~ lMailding Inspector Rev. 1/81 ** Sliding doors & sliding unit without steps with openings blocked in channel. must be barricaded FOR~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PEPa~IT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) 12883 Z Permission is hereby granted to: ~.~.~~....~..~....~..~ ....... :~.~..~...~.~.~.......~...~ ................ .., , ~, , .~.~.~-~ ... ...... ........... .~%.....~.~.,.....~.~.i~..,. ............................................................ o~tt premises located at ....~...~.~.~......~.- ..:.....~.~...~..-~..~. ............................ Count~ Tax Map No. lO00 Section ....... .J....O.....~. ..... Block ......... !..J. ......... Lot No ........ ~ ............. ~u~an, to opp,,cot,o~ dot~ .~~.~......~ .................. , ,,..~.~, and oppro¥.~ b~ ,he Building Inspector. ]~uilding Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: I. 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 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. 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 .. .,. ~..~ .......... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Owner or Owners of Property ...... ~. U ,o. o0o ....... .... I.[ ......... m...q ........... Subdivision .................................. Filed Map No ........... Lot No .............. Permit No. '.Z,.. Date of Permit Applicant . .~..q( .,~.(~../~..~..T. .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Fee Sa bmitted $ ' '~' "~ 'tr~' .............. _~ '" ,~\~'I b ' \ Construction on a ore described building anu'per n_i.t meets ah~ue A Rev, 10-10-78 ~iodes a nd?,~,eg~t ion s. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~101093 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~8 "ate February:~,z9~7 App,,c.,,o.~o...S,e ~S~4~/S~ N 793727 THIS CERTIFIES THAT only t~ electrical equipment ~ ~scribed below and introduced by t~ applicant ~med on the above application nu tuber in the premises of Jerry P~t, 93 Broadwaters Rd. in the foltowing locatlon; ~ Basement ~ 1st FI. ~ 2nd FI. Section Bilk Lot wasexaminedon Decemb~)r 29rl, 986 and found to be in co,,pliance with the ~equirements of thls Board. FIXTURE FIXTURES RANGES :OOKING DECKS OVENS EXHAUST FANS OUTLETS SWITCHES DRYERS 5 8 FURNACE MOTOR FUTURE APPLIANCE FEEDERS [.INIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS= S E R V I NO OF CC~COND A WG - NO.OF HILE~ PER ~ OF CC, COND C AW.G OF A. WG OF NEUTRAL Track Ligh%inG-8~~~~ track~, 1 li~e Gaiety Dorosk± li¢. ~2941E 42 D ~onsell L~ne Cutchogue, N.Y., 11935 This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors THIS FIC GENERAL MANAGER Per 11 ? C. may be; identified by their credentials. FIELD INSPECTION COMMENTS FOUNDATION (lstl FOUNDATION (2nd) 2 o ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined .~.~...~.. ~ .2k..~.., 19~.. Approved~...c~....%.., 19~.~. Permit No [;.h.'~ ~ ~ Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No .................. Date .......... .P-~/~...., 19 .~. a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets o[ 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 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) ',~o 7.,(. :.d'.".r/~/'.a.~. ./?/.~'.~./('. d~': d . .~.~.c:. ~. ./7../. '.~, . .~. ,.y ././.~. ~. . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......... .~.../~../~_?..~..../..~..//./'/2..c~.'. ....................................... (as on the tax roll or latest deed) ................ (Naff[e and title of corpUorate officer) Builder's License No..~..at,"~.t~/'.~. ~..--~...~../.~.'. Plumber's License No...P~. (/~. ........... ' ........ Electrician's License No.../~.~./~ ................. Other Trade's License No ..... : ................ I. Location of land on which proposed work will be done ..../V',~. ~-i'r~,'~' ,.: .'-.-: .-- ?..'-... ./,Z.,. t..'~z .cazio .................. .. ................. ..... ........ }louse Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision. ~.~ ~. ................. Filed Map No. ~ ........... f~ Lot (~ ~ ~ (Name) ~t~ ~ A State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~(~G' ~ ............................................... b. Intended use and occupancy ....... [f ...... .¢1 'a'a~ ~.;~.[tqigiql 3. Nature of work (check which ap~plicable): New Building .......... Addition .......... Alteration ..~4 ....... Repair .............. Removal .............. Demolition .............. Other Work ............... ' ~ ~ i (Description) ~ '~.: ...... ~ ~..~st ! ............................................. i / (to be paid on f'fling this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... ! ................................................................... 6. If business, commercial or mixed occupancy specify n. ature and extent of each type of use ..................... 7. Dimensions of exiatilag structure's if any: Front .... .~-~.G. ~ ...... Rear .... .~.(o.r ...... Depth ....'-~.~..~ ....... Hlght .... ./(..t/. ......Number of Stones ...... ~ ................ ~ ./] .............................. ' ~ Dimensions o~'same structure with alterations or additions: Front . ./~.~...~. Rear .................. Depth .................... i. · Height ...................... Number of ~tgories ............ ~ ....... ... 8. Dimensions .o! entire new construction:, Front....~ ~ ............. .D.e.p, th : .............. Height ............. Number of Stones ................................ 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10. ,D, ate o.f Purchase .... ' '/~' '~' :i .................. Nam,o~f Fgrn~er Owner ............................. 11. Zone or use distriqt in which premises are si!uated ...... '/~ "~e--~'~(" "~O2 L' ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... /<*,~o .... . .................. 13. Will lot be regraded ........ ~,.~ ............. Will excess fill be removed from premises: Yes No 14. Name Of Owner of premises .~. g...~'.~(~.../~..~"...7~.. Address ......~..: . .~,~L~... .... Phone No. 7.~.¥(..Fe..~..d'y... Name of Architect .. ~, ....... ' ................ Address ..... ,,, ............. Phone No ................ Name of Contractor ,~.~..¥/~.a..r?~...~?. ~..~.-:. ?..~..,.. Address ~.7d7..~.q ff.~ ~g. Phone No.~.q~, .q/.":~?.~.... PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEV~7~RK, d~ S,S ........ ~~~.~, ~, ................ berg duly sworn, deposes ~d says that ~ is the appl,can, {~ffe of indivia~fl si~fig~bn~act) ~ ~~ / above name~.] ~ i ' o- - ~ is the ...................... ~ ......~.... ~ ...................... ~ ............................ / ~ ~ntrac~agent, co,orate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e ~d file ~is application; that fll statements contained ~ this application are true to the best of ~owledgo and belief; and that ~e work w~l be perfomed in the m~n6r set forth ~ the application filed therewith. ~ Sworn to before me this [ ~ . ............ - / i ....