HomeMy WebLinkAbout13296-z FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. . Z1A454 March 11 19 8
. . . . . . . . . . Date . . . . . . . . .
THIS CERTIFIES that the building . . . . . . .Addi t on
Location of Property 1,2499. . . . . . . . . . . . . . . .New Suffolk Ave. Cutchogue
House No. Street Hamlet
County Tax Map No. 1000 Section . . ,116 . , , .Block . . 06 Lot 012
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Ju1X 16 19 84. pursuant to which Building Permit No. 132962
dated . . . . . . . J41X 26 . 19 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 . . . . . . .
Construct Addition to Existing One Family Dwelling
. . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . . . . . . . . . . . . . . RUSSELL B. CASE
. . . . . . . . . . . . . . . . . . . . . . . .
(owner,1c�ssee�effer�lH
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . N/A
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . Pending
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev. 1/81
FORM Na
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 13296 Z Date ......� / ....� .................... 19.E
Permission is hereby gronowlV
... ........................... .................
. .q. ..............................................
to .. ... ... i3..». ...� � ...� '�R ..�. ......Ge'H t-tht.q.........
�- �. ..�...... ..... ........ I -•....... .....................
of premises located at ..�.. ..4:1.s I . . . ..'...I IVY......
I
................................................................................ ................................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section .......�/..�....... Block .......... ........ Lot No. ....I .), ...
pursuant to application dated ........ ..�..�...................... 19 ., and approved by the
Building Inspector.
Fee $.. 2.:.3D...
Building Inspector
Rev. 6/30/80
FIlfLD INSPECTION DATE ` COMMENTS
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CODE
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NEW YORK STATE DEPARTM11T OF FFft1IROMt!E"JTAL CONSERVATIO°J
Regulatory Affairs Unit
Building 40, SUNY ,
Stony Brook, NY. 11794
Henry G. 4 i 11 i ams
Commissioner
RR NO PER"SIT NECESSARY - TIDAL WETLANDS ACT
�aSes LA�a e..
y.II
Re: O a A CICI i i w" 4-o e vt. a tiS Ga 4 4-a,5 Q-
Dear Mr Cec—�e
A review has been made of your prop�osal to: caa5--ruc,c-- 3O'u �
3J
oLdcLe Jrtoo Ola 4-Le S(�aRwurGx S�cQ i Oi• ci.S OY,06Tra+JS [W 'w320
cc+4,,a9 130 f dw l��+cQwa•a� o� r+1� an�b(nwgT��z. o�
Plecoulc tial.
Location: 6'00,t Ad-
�' =IfSr op M000ee34.Ftn1ts SoJrNSivE 0 -C/l,-ra
SJ} IO�K /7J�
CIA-aa /6crnfai� Sd I"/cp 6 00Jil Cr
SvF�Lic
It has been determined that no permit is necessary under Article 25 ro1
(Tidal 'vJetlands), because 1L a+$eL��1wJ Wr61 be va eA"53 OP 7a`
�r . i-R z A� ( w# -(*,of � 4 4 r4J v— m l}� 4,0 i'a4 -" 16+�� �
However, any additional work or modifications to the project may require
a permit. It is your responsibility to notify this office in writing if such
additional work or modifications are contemplated.
Assuming you have obtained any other applicable permits, you may proceed
with your project.
Very
yours,
c"—r— L�
*0-2.
Daniel J. Larkin
Reginal Permit Administrator
DJL:R?!T:l l
13 a V&
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1001165
+, BUREAU OF ELECTRICITY ,
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date A} ril 9, 1985 Application No.on file 3714575/85 N
THIS CERTIFIES THAT 686474
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
Ross Clare, SIS Now Suffolk Aveilm, E/0 Moores Lune, Cutchogue, N.X.
in the following location; NI Basement R� 1st Ft. n 2nd FL. Section Block Lot
was examined on April 4, 1985 and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
RECEPTACLES SWITCHES mERcaa
T
OUTLETS INCANDESCENT FLUORESCENT vAPOA AMT K W. AMT. I K.W AMS K W I AMT %W. AMT I HP
21 41 32 21 1 1.2 3 r
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS I BELL UNIT HEATERS I MULTI-OUTLET DIMMERS
AMT. K.W OIL HP GAS H.P. AMT NO. A.W.G AMT AMP AMT AMPS.I TRANS.I AMT H p SYSTEM$OF pMT. WATTS
NO. FEET
a,
SERVICE DISCONNECT NO.OF S E R V_ 1 C E
METER NO OF CC COND A W.G. A W.G. A.W G.
- AMT. AMP. TYPE EQUIP. 14W 13W 3 N 3W 3,e"4W PER% OF CC GOND. NO Of HI-LEG OF HI NO OF NEUTRALS OF NEUTRAL
1 100 CP S 1 3 1 5 _
OTHER APPARATUS% '-
Motors; 1-r
_ HoWard Dulls 4t=
BOX 5'74
Laurel, N.Y. 11948 LIC. 156 —
GENERAL MA(rJAG R
t Per 11
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may b identified by their cre entlair.'
COPY FDR BUILDING DEPARTMENT.THIS COPY OF CEATiFICAIMf ST NOT.B ALTEREq IN ANY MANNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
II �yC�
Examined . . P .h ., 19 �.1 Received . . . ., 1 194 .).
Approved . . . . . . . . .a.(v ., 190. Permit No.
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT (�
Date . . . . . . .�.�/6. . . . ., 19 d.X
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 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 building for necessary inspections.
= d
(Signature of applicant, or name, if a corporation)
IJx !fir � . . . . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
w!y. .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . .��.`� 5 5 .. . . i.. S
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . I . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
u r-
�. . .
House Number Street Hamlet
County Tax Map No. 1000 Section 7. Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . `o .°�. ,1:1.. (_02.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . . . Alteration . . . . . . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . .
(Description)
4. Estimated Cost .. . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . . . . .
b
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . .
Ifgarage,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 . . . . .kK l. . . . . Rear. . . .'�..... . . . . . . Depth : (!�. 6. . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . / . . . . . I . . . .
. . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . ./. .. .. . . . . . . . . Rear .3
Depth . . . . • , ?'. . . . . . . . . . .
Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . ,
8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . , . . . . . . . . Depth . . . . . . . . . . . , , . .
Height Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . , .
. . . . . . . . . . . . . . .
. . . . . . . . . ,
9. Size of lot: Front . . . . . f!q: . . . . . . . . . . Rear . . . . . . . . !:Y f.. . . p 3 .-f- 6 0 . . . . . . .
10. Date of Purchase ini al E r I' P7.3 Y • • • • Depth . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . • . • . • . . . .q. . . . . . . . Name of Former Owner . qE'Q. f{.0°;45�; . . . . . . . . . .
11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . .!�4
13. Will lot be regraded
14. Name of Owner of remises . . �/m • " • • • • • • • • Will excess fill be removed from premises: Yes No
p /5 f �'�SE. . . . . . . . Address .C�7 c,rf og uE , , .Phone No. 3.y-.O.S, . .
Name of Architect . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . ,
Name of Contractor . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
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. -
i V i
Sji.
OF NESitOROG
COUNT
Y of . . . . . .F . :�. . . . . . $'S
��(Ne of indi 1 siA " " • • • . • being duly sworn, deposes and says that he is the applicant
am ofi ng contract)
above named.
Heisthe . . . . . . . . . . . . . . . . . . . . . . i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly 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 manner set forth in the application filed therewith.
Sworn to before me this
. . . . . . . J6. . . . . . . . . . . . . .day of. . . . . . . . .. 19 !yT
..
Notary Public �� ..������"lsl�-SCl/�Z . . . . . Go=fr
No: 5C, Stole
�3KI ,
NOTpuallRY f eV io Suffolk
New Yorq. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LINDA P.
1 (Signature of applicant)
.fommisslon Ex County
Aires March 30r 198;(0
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'T "�'ERT'IFICATE
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��e. t � sel dated owned. _ --- - - APPROVED AS NOTED
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�a:- . . .. .. --- --- - ------- - - -___ _____ _ ._ ._____ -_-_ GATE ��
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- :'7 B.P. # 1 ��( .-�
= t, - N - - -- -- ----I=mo- _ _- - _ - -1-1i RFEE: BY • �. . cc
- -- NOTIFY BUILDING EPARTM N T - �- ---_._
T •�-� D E T A
A- ' Vid ,�abs toIlld lxg: •�� - - � 765-1802 9 AM TO 4 PM FOR THE 0
- + f FOLLOWING INSPECTIONS: v
I 11—� bat �s .atim in , all exterior wall s & R-19 batt x - __ � -
- t 4 at con - .
all �'�;���s, CellIn � �s�'ters m � 1. FOUNDATION - TWO REQUIRED
' , 6or ' y
t'e I I i -
.FOR POURED CONCRETE
µ,-Ir - - -s 1. a - ► +rs� vapor-bar�riers� against ,� �; � 2. ROUGH - FRAMING & PLUMBING �-'
--------_.--.--_-_------ ---- -
" ode or' i I Insulation* - - -- 3. INsuLATION .
�r_ 1 0 e� 41, , e�! f'o�' gl a ing requirem . ` 4. FINAL - � 'Q
COI�'STRUCTION MUST
I I i ! BE C" MPLF..TE FOR C. O.
F � �ttate'ria1 se es tions such "as pailint, stain, -- - - '
Ce -mid t e Cabinets s ounter;to a light fixtures I I i �--- _ —— -1i I � ALL C01�aSTRJCTION SHALL MEET - -
s. _ s — I TR
a '81 ae plUm ing �`ixturess to be selected a�xd Approved ( -- �,, 1 � � I THE REn• .Z�IENTS OF THE N. Y.
. �— — — — -- --- = — -- -1 STATE CONSTRUCTION & ENERGY N
L 1 . #,WMe '. -- , ., .
CODES. N'7T RESPONSIBLE FOR
is Panels to be aeleEtes - owner ar insa Isd D I
a csvrd to sa 'aotur,'s reeo> endations,�
ES GN OR CONSTRUCTION ERRORS. �'
1'k I6. S tie Syst shall�be revised, as required, to r
r�o _Orjo- to loam. coid�e req � -n- g_.,. -
ui rements,0 - - _ _
Frc '! t to s ►+d t�oti ra .r s at bias
>.
' ement area. - --- 1: - - -
_.
-- 4 - ---- - - -- - -. -- --- - _..._. _.
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