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Home My WebLink About16282-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19935 Date MAY 24~ 1991 THIS CERTIFIES that the buildin~ Location of Property 955 PEQUASH AVENUE House No. County Tax Map No. 1000 Section 103 Subdivision ADDITION Street Block 7 Filed Map No. CUTCHOGHE, N.Y. Hamlet Lot 22 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 28, 1987 pursuant to which Building Permit No. 16282-Z dated JULY 28, 1987 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 SECOND STORY ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JEFFREY SCOTT SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N187024 - MAY 13~ 1991 · / ~ilding Inspector Rev. 1/81 · OB.~ NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TIlE WORK AUTHORIZED) NO- 16282 Z Permission is hereby granted to: %..~)_~J_m£~....~ ...~.~~..~.~.~../.../..~?- ,o ~...~~....~~....~...~,..z.~..,2_.,, .................... ....... ~~..~......~...W~......~.....~d-~/-.~....~/~./.~. ,t premises located at .........,t..~:...~4......./.....~~-~..4....et~':~s,.~ ........................................... ...................................... ......................... County ToX Map No. 1000 Section ..... ~....~....~. ...... Block .... ~.....~... ...... Lot No...,:~..~ ...... pursuant ,o application dated .... ~ ............ .~..~........, ,9~..Tand approved by the Building Inspector. Fee $.../..L(~.... ~.~.~' Rev. 6/30/80 TOWN OF SOUTHOLD~ BUILDING DEFARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIU~IT (THIS PEP,/V~IT MUST BE K*EPT ON THE PR£MISES UNTIL FULL COMPLETION OF THE WORK. AUTHORIZED) N? 12195 Z Permission is hereby granted to.L,,~' ~.~ ~ ~ ....... ~ ../...~,...,..-~..../.,:.~~..:. ..... ................ · ........ ~.~.~.~....~ ......... ~ ~ ,o ..... ~~~....~ ~...~.~.~Z~.~.....,~ ......... . ~.~ .~ ... ~/~:~ ................... ................................. ~ ............................ /,. ~.~ ~ -~~ .~ /..-~ . ~~ ,, ~,,,, ,~,,~ ,, ..... .~.>~:~.~...~, ......... ~z~~.,.. County Tax Map No. 1000 Section ..../~..~.. ...... Block ...1~../~... ........ Lot No. ~..Z.~... ........ ~ on a rov b the pursuant to application dated ....~.~.'~.. ......... ~...~.:. ..................... , 19...~ d pp ed y Building Inspector. Rev. 6130/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archiuect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1,. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ~ Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date MAY 23, 199! ~ew Construction ........... Old Or Pre-existing Building ................. ~ . 955 PEQUASH AVg. CUTCHOGUE N.Y ,ocation of t'ropercy ................................. ' ' House No. Street Hamlet ~nwer Owners of Property , JEFFREY SCOTT SI~iTlt '.ounty Tax Map No 1000, Section .... !0.3 .... Block ..... 7. ...... Lot....2.2 ....... ubdivisio~ ~ ............................. Filed Map ........... Lot .................... ermit No. IC~-5--Z MARCH 17, 1983 ealth Dept. Approval .......................... Underwriters Approval ......................... lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate ........... ee Submitted: $ .... .2.5:0.0. .................... .. FIELD INSPE~?~O~ COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY q. ODE FINAL ADDITIONAL COMMENTS: .. M~-~o;l r 1,% - i01 ' 'MAp OF P,P-.OP~2P,.TY JEFFREY 5Ml'r',b' Co,~"C/4 0Gu,z, /v. ' FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ......................... . , 19 ..... File No ..... /... ........................ To ~./.~.~....~.~../.~,~.~ .... :.. "~'~'*"~?~'~'~'~' ~ ...... ;4"" . for pemit to const~ct.. ~~..~0~. ~( ~...../. .......... ~. .... at ~o~,ono~op~, .... ~.~ .............. ~~XS. ~ ..... co~tv ra~ U~ ~o. ~000 S~tio~ ../.a ~ ..... '( mo~k ...~ ....... tot . ~. ~... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the follo;ing grounds . .~..~.../~. ~. ~2/2~.~./..~.?-~' ] spector RVI~O FORM NO. 1 TOWN OF SOUTHOLD BUILDING DI~PARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined..'.'.~.,/~..~. ,'~ ......, 19~.7 Approved . 7/~-. ~ .... Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS f. Date ............ 19 . 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 w~ll 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 a~y 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 ofthe Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances m Regulations, for the construction of buildings, additions or aiterations, 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 j4~pe,~'ons, j / ,~ ~ (~fit~l:e~of applicant, or name, if a corporation) ~ (Ivlailir(g add f appli~a~) -- t2' ~ - ress o State whether- applicant 'is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ofpremise~..~MF~. ~~. · .~.' ~~. · ..................... · ~ ~J/J ~ (as ~'n the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S NUST~B~ ~SUFFOLK COUNTY Builder's License No .... ~. ............... Plumber's License No..~..-~.. ............... Electrician's License No .... /~. ~4/~..~.-. ........... LICENSED Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. County Tax Map No. 1000 Section . .~ .F_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. Z~/'Z'Y~..~.~,~~ .......... ; ....................... b. Intended use and occupancy ~-~. ~.~,~../~. ~. ~-... i _~a~. _~?./. Repair .............. ~' Remloval .............. Demolition .............. Other t¥ork ............... i (to be paid on filing this application) $. If dwelling, number of dwellingl units ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixqd occupancy, specify nature and extent of each~type of use " 7. Dimensions of existing structures, if any: Front; .............. Rear .............. Depth ............... Height Number of Stories Dimensions of same struct re w~th alteratmns or addmons: Front ................. Rear .................. Depth ................... :... Height ...................... Number of Stories ...................... · ~,8.Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number of Stohes ........................................................ 9. Size of lot: Front ~ ~ pth 10. Date of Purchase .......... : ................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vidlate any zoning law, ordinance or regulation: . . .......... 13. Will lot be regraded ........ i ........ Will excess fill be removed from premises: Yes No 14. NameofOwnerofpremises..,~ ................. Address ........,..........PhoneNo ................ Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ........ i Address .... : ............. Phone No ................ 15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trfstees Permit maybe required. ~ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: J. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 9. ROUGH. FRAMING & PLUMBING $. INSULATION 4. FINAL . CON'STRUCTION .- ' BE COMPLETE FOR C.O. " ALL CONSTRucTION SHALL THE REQUIREMENTs OF THE N.Y. j ,cS'FATE CONSTRUCTION & ENERGy ' rCODES. NOT RESPONsII~LE FOR DESIGN OR CONSTRUCTION ERRORS, STATE OF NEW YORK, i S.S , . COUNTY OF ................. ............................ : ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigfiing contract) above named, j He is the ..................... . .................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform 6r 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 ........... d.~ ..... ' .....day of ..... ........ 19 ?..~ ll01ARY PUBtlC, Sta.t? 9~coNeu~b.Y~k ~ (Signature o; applicant) . No.370787.8.. Su.n°J,.k ~nq~ ~f FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~.~.~.../.7.., 197..~. Permit No ........... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Ttzis 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- :ation. 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 i~suance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Couuty, 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. ~ '~ig~t~tur~applicant, or name, if a corporation) ~ (Mailifig address of apl~li~ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. °l/ ~/d ~ (t~s 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 N°' "~ i i i Plumber's License No. Electrician's License No ..... .~./~.'.~..~. .......... Other T~ad~'s'License No ........ : ............. Location of land on which proposed work will be done .................................................. House Number County Tax Map No. 1000 Section (O-~ ... Block .C.)..~. 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 ............................................. b. Intended use and occupancy .................................................................... 3. Natu~eofwork(checkwhichapp,licable): New Building.......... Addition .......... Alteration Repair .............. Removal ............ Demolition .............. Other Work ............... ~ (Description) 4. Estimated Cost .... './,~..~... i Fee .~'. .... , (to be paid on filing this application) 5. If dwelling, number of dwelling uhits ·· .. · ........../ Number of dwelling units on each floor ................ If garage, number of cars ' . ........ 6. If business, commercml or mixed Occupancy, specify ~n~ure and extent of each type of use ............ .... " So' ...... 7. D~mens~ons of ex~stmg structures~ ffany Front ........... Rear ............ Depth .......... Height ............... Number of Stories ......... /. ............................................. Dimensions of, s~me structure with alterations or additions' Front . ,d7,¢7 ~ Rear Depth .... .ff'~. .............. ]. Height ......... .~ ............ Number of Stories .... o~ ................ 8. Dimensions of entire new construgtion Front . .¢~...~ ......... Rear . .d.~f. ......... Depth .d~../ ...... Height .............. Number of Stories ....... .~ ............................................... 9. Size of lot Front , Rear 10. DateofPurchase ...i[~..~../.~..,~ ........ Same of Former Owner ~:~ ................ 11. Zone or use district in which~premYses are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .,~]O ........................... 13. Will lot be regraded .... ~'"?r .:: .... ,,..,..~... ~.. Will excess ~11 be removed from premises: Yes No 14. Name of Owner of premises_~sd~. Address ~.f'~. j~e2~.. Phone No. ~.z?~r0'c?..J~ ...... 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 nhmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE .W~O..RJ~,~.. · ~ 'S act), ~bove named. 'lc is the ............. ~ .............................................................. i (Contractor, agent, corporate officer, etc,) ~f said owner or owners, and is duly !authorized to perform or have performed the said work and to make and file this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner s~et forth in the application filed therewith. ;worn to before me this ............... '..dav'o .. Commmton. ,~,t.. n, are,, a0. 1~ (Signature of applicant) Li35044 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 D,~e May 13,1991 ,~pplie~tlonNo. onfile 26557084/84 THIS CERTIFIES THAT N187024 only the electrical equipment as described below and introduced by t he applicant named on the above application number in Ehe premises of Jeffrey S. Sm±th, Pequash Ave., Pole#8, Cutchoque, 31.¥. in thefollowing location: [] Basement ~ Ist ~*/. ~ 2nd FI. Section Block Lot was examined o~t arEal found to be in contpliance with the require,tents ~f this Board. May 6,1991 FIXTURE OUTLETS DRYERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO, OF FEET OTHER APPARATUS: Elec. Room Heaters-2-1.5K.W., 1-2 K.W. Panetboards; 1-8-CIR-100 G.F.C.I.-1 Smoke Detector-1 E R V I A. WO OF CC COND NO OF HI-LEG OF HI LEG NO OF NEUTRALS O~ NEUTRAL Francis B. McCaffery 4010 Bridge La. -Box 245 Cutchoque, N.Y., 11935 lic: #1145-E GENERAL ~&~NAGER 11 This cert;flcate must not be altered ]r~ uny manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. I coPPer tubing is use~ ~or w°ter c~istribUting el tYPes ~ ~OR POURED CONCRETE