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HomeMy WebLinkAbout15203-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15363 Date March 18, 1987 DECK ADDITION THIS CERTIFIES that the bmldmg .............................................. Locatlon of Property 9475 Nassau Poznt Road Cutchogue, Sew York H~dse 'No ................. 'S'tr~i .................. County Tax Map No 1000 Sechon I 19 .Block 01 .Lot 04 Subd~wslon ........... ·..Filed Map No .... Lot No ........... conforms substantmlly to the Appbcahon for Building Permit heretofore filed in thru office dated August 8, 1986 15203Z ................ pursuant to which Bmldmg Permit No ................ August 28, 1986 dated ................ was ~ssued, and conforms to all of the reqmrements of the applicable provmions of the law. The occupancy for wluch this certificate ~s msued is ..... DECK ADDITION TO EXISTING ONE FAMILY DWELLING A SPERES The certificate ~s ~ssued to ............. [o'wn~', ,'~l~l~Xtlfr~)[~,l~ ........ of the aforesmd building Suffolk County Department of Health Approval Iq /A UNDERWRITERS CERTIFICATE NO .... N/A N/A PLUMBERS CERTIFICATION DATED: Rev 1/81 FORM NO. · TOWN OF SOU'~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJk61T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 15203 Z pursuant ,o opphcotion doted . ..~.4,~.,~....~ .......... , 19'~..~., and approved by the Building inspector Building Inspector Rev 6/30/B0 FORM NO, 6 TOWN OF SOUTHOLD Budding Department Town Hall $outhold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s applicauon must be filled in typewriter OR ink, and submitted m '"--'----' to the Budding 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, Muft~ple Residences and slmdar 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 Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all propertv 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- uon required to prepare a certificate. C. Fees' 1. Certificate of occupancy New Dwell[n~ $25.00, Accessory ,$10.00 Bus[ness $50.00 2. Certificate of occupancy on pre-exmtmg dwelling $ 50.00 3. Copy of cert~ficate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5 .Uodated C.O. $ 50.00 Date . ~arc~ ,1~1987 ......... 6. Alteration' $25.00 New C on s t muct i on..~... Did or Pre-existing Bu,ldmg ............ Vacant Land ............. Location of Property . .~47,~..~5~,%a .g. ~.o. ig;~. 3[g8~ ......... gg~.c.b,~g~j~ ................... House lYe. Street Ham/er Owner or Owners of Property . .~...Eipe rc.s· ................... '. ........................... ' 04 County Ta~rMap No. 1000 SecUon ...1]-9 ......... Block .. {:),7, .......... Lot .............. Subdivision Ar,~nde~l .),~a.~. A. Na~s =u..R.o [Q~..Filed Map No... )-5'.(~ .... Lot No .... .7.~ ....... Permit No..l~?.0.~3.Z... Date of Permit . ;q/.2.~../~,Apphcant..E,n.v..i~?..nm.e..n.~..E. ?.s?.,.I..n?. ?,o..~..4...Spa re Health Dept. Approval ... N/,A ................. Labor Dept. Approval ..... N'./.~ ................ Underwriters Approval ... ~.A ................. Planning Board Approval ...~/.A. ............... Request for Temporary Certificate ..................... Final Certificate .. ,'{ ................... Fee Submitted $'.~0...20.D.Q .............. .. .. Construct,on on above described bu,ld,ng a/~~~le codes and regulat,ons, Apphcant/,~, .F~,~rj/',~/~,,4~ ~ ....... ~.e.~ i ~.q~ ......... ~nviroSmgh~ E~st, Inc. eh7 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ' ~'i ~ __~ Envmronment ,East Inc, '.i ~ - Quality Contracting - ~ PECONIC N Y -', ' 11958 ' Copy of certmflcate of occupancy Date .November'..1.9,198~ ...... New Building ........... Old or Pre-existing Building ...~ ........ Vacant Land ............. Location of Property ...9~,?.(~ ........... llass~.u..l~J, al;..R,Q~.Ct ........,qtzl;cb,as;ue ......... House No. Street Ham/et Owner or Owners of Property .... ~.....,~pp,z"q :~ ............................................. County Tax Map No. 1000 Sectmn ...119 ......... Block .,. '1 .......... Lot... ~ ........... S'ubdivislon.~R~3?.~.~3~Aq.]~;)~r)t~ ...... FdedMapNo. ,.;L~.~... LotNo, ,7~) .......... Permit No...1,~.2. Q~'... Date of Permit . .8~2.8.//~.6.Appticant ~. py.J,~.. 9P~e.t)~. ~.e,~ ~a..!t3¢,..fO~'. A. Spe z'~ Health Dept. Approval ....... i~./..A .............. Labor Dept. Approval ...... ~/.~- ............... Underwriters Approval ....... ~/.A ............. Planning Board Approval ....~/.A ............... Request for Temporary Certificate ..................... Final Certificate .., ~. .................. Fee Submitted $ Construction on above described buildi~nd~/~plCable codes and regulations, Rev 10 10-78 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Haii Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A Th~s apphcat~on must be filled ~n typewriter OR ~nk, and submitted in duphcate to the Budding Inspec- tor with the following; for new buildings or new use. 1. Ftnal survey of property with accurate location of all buddings, propertv lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d~sposal-(S-9 form or equal). 3. Approval of electrical ~nstallat~on from Board of Fire Underwriters. 4 Commercial buddings, Industrial buildings, Multiple Residences and similar buddings 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 ex~sting buildings (prior to April 1957), Non-conforming uses, or buddings and "pre-existing" land uses' 1. Accurate survey of peoperty showing all property lines, streets, buddings and unusual natural or topographic features. 2Sworn statement of owner or previous owner as to use, occupancy and condition of buildings 3 Date of any housing code or safety inspection of buddings or premises, or other perbnent mforma- t~on required to prepare a certificate. C. Fees' f3r~ ~ ~_~ - ~7~ 15- ¢'(D 1. Certificate of occupancy $5.00 2. Certlftcate of occupancy on pre-existing dwelhng or land use ~j~ LL~ -J~c~/~ ~ © - ~- 3 Copy of certificate of occupancy $1.00 Date ~ovem. he~'. /.9,19~.6 ..... New Budding ...... Old or Pre-ex~st~ng Budding . . ~ ........ Vacant Land ........... Location of Property ...9~7.~ .......... NarsAu P i t. F, a6 ......... C=tc o ue ......... House No. Street Ham/et Owner or Owners of Property .... ,a..~ . .~l~e.~e~ ~ ................................ County Tax Map No. 1000 Section . .119 ........ Block 1 ......... Lot ... ~ ........... Subd~wslon .M~a.P~ A. ~ra~.u, .Pg,~r;~ Filed Map No ~.~.6.... Lot No .?~ .... Permlt No. .1,5.2. Q~}. Date of Permit ..8/;~8./.~6. ApplicantE..PY.~,~Qr~e.t?~,.~.e,~,. Health Dept. Approval ...... N'./..A ........ Labor Dept. Approval ...... N./.~ .............. U nderwr~ters Approval ....... /~/.A .............. P lanning Board Approval .... ]~/A .............. Request for Temporary Certificate ................ Final Certificate ... ~ .................. Fee Submitted $.. ~).0. Construct,on on above descr,bed bu,ldl~nd~/~;l/able codes and regulations. Rev 10-10 78 FOUNDATION (1st) FOUNDATION 12nd) ROUGH FRAME & FLUMBI~G INSULATION PER N. STATE ENERGY CODE FINAL / '/ ONAL COMMENTS: Environment East, Inc R R No 3 - 3075 Indian Neck Lane Pecomc, New York 11958 516-734-7474 October 2, 198& Southold Tow~ Building Dept. Town Hall Main Road Southold, ~Y 11971 Re: Pe~mi~ # i5203Z, Nassau Pola~ Road, Owned hy A. Spe~s Dea~ Sir, Attached is a photo copy oF a~ ~e~dme~t to be ~ade o~ ~he subject pe~it. Blue prints a~e ordered a~d will follow w~e~ delive~d. This alteration to ~igi~al is ~ei~g by the owners a~~ y~ approval. ~equested Thank you four cooperatiou. Sincerely, k~ Peter R. Stou~g~ President ~ ~uvir~~ast,~ Iuc. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE_~'~/~ INSPECTOR 7GS-X80Z BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBQ. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~/~INAL DATE INSPECTO~ MAP OF.LOT No. 76 'AMENDED MAP ~ OF NASSAU sz~u,~o ,~ RST AMERICAN TITLE INS. CO~ OIX HILLS. 'Unauthonz~ alterabon or add;h~ tea suzv~ TITLE NO. 6iO-S-103~ N.Y. ~. LIC. Yo~SiattEduc~o~La~'"Onbcopf~from~ SCALE: · =~0' otig~n~ of th~s su~e~ mark~ wtth an ~igi~ o~ ~ lind s~ey~'s em~s~ ~ sh~ ~ co~ ' .: ' ' : Exam~ne~_l~-~lr' ,,% .~ Approvec~[ ~- ~ Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y 11971 TEL,: 765-1802 (Budding Inspector) APPLICATION FOR BUILDING PERMIT . TOWN., OF SOUTH_O_L _D Recezved .......... , 19. · · Date ......... , 19.. IN STRUCTIONS a Tlus apphcatzon must be completely filled in by typewriter or in ink and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showing location of lot and of braidings on premises, relationship to adjoining premises or public stree or areas, and g~vmg a detmled descnptmn of layout of property must be drawn on the dmgram which is part of tins app cation c. The work covered by flus application may not be commenced before issuance of Budding Permit. d Upon approval of this application, the Building Inspector wall issued a Bmldmg Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable/caws, Ordinances, Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto describe, The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and , admit authorized inspectors on premises and m bmldmg for necessary inspections (Signature of applicant, or name, if a corporation) aa'~ Zt~h.q~.A/~c.l( ~qne. ~ I~,*~ -ivY' z/q$ (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or buflde: ......... .... Name of owner ofpremmes J~,'~I~.T/.~E..~ . ~ .~J(~A~f~.. ~FE~X .. (as on the tax roll or Iatest deed) If apphcant ~s a corporation, signature of duly authorized officer (Name and t~tle of co.orate officer) Builder's Lzcense No S e. Z/~ . . ~Z- ~T~4 Plumber's License No Electrician's License No Other Trade's L~cense No .... 1 Location of land on wluch proposed work wdl be done qq35 ~. ~/~.~.?~' ................ House Number Street Hamlet County Tax Map No 1000 Sectmn 1(~ ..... Block / . Lot ~ Subdw,s~on ~edded ~afl,~ ._ A/ogled. ~ Fded Map No /~ Lot 7~ . . (Name) 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Exlstmguseanaoccupancy /' ~//y... /~*(~n('~/ ............ b. Intended use and occupancy 3. Nature of work (check which apphcable) New l~uddmg ......... Addition Repair 1} atf .){Removal 4 Estimated Cost . .~.~O. o .... 5. If dwelling, number of dwelling units ....... Alterat,on . .... Demolition .. . Other Work ff~_Y<;' /~.d~.~7 (Description) (to be paid on fihng this application) ... Number of dwelling units on each floor .......... If garage, number of cars ..................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ........... -~x- 7 Dlmens,ons of ex,sting structures, if any Front . .7..o. .... Rear . 7.0 ...... Depth . .~&. 4. ..... Height ../q;,t.. Number of Stones . / . .. ,v;' 2; ........ DLmenslons of same structure with alteratmns or addlhons Front ~ .c~ . Rear ....... Depth ........... Hmght . __ .~.. . Number of Stones .......... 8 Dimensions of entire new construction -F=:mat .~./o .~" . . Rear ........ Depth ....... Hmght ......... Number of Stones ....... ~.2~-7~.''. .'i'. ii 9 S~zeoflot Front ../.~..~ .. Rea~'. 'i'.i'.~l:r~.i Depth 10 Date of Purchase ................ Name of Former Owner .................... 11 Zone or use district in which premises are situated /~.e~/~/~./'C.fl--r~r/. ................. 12 Does proposed construction violate any zoning law, ordinance or regulation . .~.0 ................... 13 Will lot be regraded ...... .~..~. ........... Wall excess fill be removed from premises. Yes N 14 Name of Owner ofpremmes ~ #.~: S/)~..r-.¢.g . Address . .~*&~.~'~2~"..... Phone No ....... Name of Architect ............ Address ......... Phone No. .. Name of Contractor ................ Address ............ Phone No .......... PLOT DIAGRAM Locate cleazly and distinctly all budding, whether ex,sting or proposed, and indicate all set-back dunensmns fro, property hnes G~ve street and block number or descmption according to deed, and show street names and intimate wheth~ ,ntenor or corner lot. STATE OF NEW/YOR, ,K, ~ ] S S COUNTY OF .24Z,~.. (Name of ~ndw,duai sigmng contract) above named being duly sworn, deposes and says that he is the applican He ~s the _4C~ontracto_~gent, 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 tin apphcat~on, that all statements contained m this application are true to the best of bm knowledge and behef, and that th work will be performed m tire manner set forth m the apphcatmn filed therewith Sworn to before me this ·. day of... , . N,~bb,7~ ~'~''~ '' C°untTf~~ - , / ~ ~J.~ /.~ ~/~/./~'.~ ................. N~ ~b~ ~ ~ N~.c~~ ~/ (S~gnature of apphcan~ No 4822563, S~k ~un~ ~ Term Expires December 31, 1~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIRCATE OF OCCUPANCY /:~a~ROVEO AS Nm--~ D~TE: NOTilrY,. BIJILDtNG DEPARTM~IT ~I~T ?e5-18o2 9 Au TO 4 I~q 'FOFI qJHE FOLLOWING II~iPE~TION~: !:OR ~ COl~m_.nE'rE 2 ROUG~ FRAMING & PLUMBIN(il 3. INSULATION J "-. 4. FINAL CON~'RUCTION MUST " 1 BE COMPLEI:.E FOR C.O. J 1,,. ~ ~/~(.j ALL CONSTRUCTION SHALL MEETt THE REQUIREMENTS O~ TIlE ?"' ~4 W~ ~ I / CODE~, NOT RESIN:)NSI~.E FOR r~aSlC-:d~ OR ¢C~NSTRUCTION ~ ~*- ' .0,,, ?', .-,'~,~ ,b:'c ~' .-. 7,' '*