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HomeMy WebLinkAbout14631-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy ' No....Z J .5.q. 5..0 ........ Date .... I7..e .c.e.m.b..e .v. fi. ~ ................ 19..86. THIS CERTIFIES that the building Addition and deck addition to existing one family dwelling - Location of Property . 20~5. Ws.at. Cr.ae k. ~.. 1255..~id.w. Qod. f~Qad .... C~.t. qhog.~', .'~.. Y. House No. Street ' Ham/et County Tax Map No. 1000 Section .... 1.1.0. ..... Block ..... 0.2. ........ Lot ...... 0.7... ~-'.. '~ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated F~.b.p. u ar.y.. 2 6, ......., 108 6. pursuant to which Building Permit No .... 1.z~ 63.1 .~ ........... dated . .M.a.p.c..h..8., .................. 19 .S..6, 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 and deck addition to existin~ one family dwelling. The certificate is issued to BARBARA CHRISTENSEN ..................... ek .................... of the aforesaid building. Suffolk County Department of Health Approval .. N / A UNDERWRITERS CERTIFICATE NO. N 77 7786. Rev. 1/81 l~OR~ NO. ~ TChVN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJvtlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) Permission is hereb/granted to: , ...~......~.~....C~.~.~.:. ....... ~~.....~..~...~~ .......... ~...~.~.....~..:~.,...;....L!.~..~..~... ........... ~ ~ ~......~ ....... ~:....~.~.....~ ................ ~ ............ ~ ..................... : .......... ~.~... at premises Iocated~at .~..?..?...~.....'.L~.....~?~...~....~...~....!...`~...~.~..%..~....~..~.~....~....:.....~ ~ County Tax Map No, 1000 Section ....... I..!...~. ......... Block ..... ,?....~/. ........ Eot No ..... ~.~.....~. ............ pursuant to application dated ...~~......-~...,~. ................ , 19...~....~, and approved by the Building Inspector. Fee $.....~....:.~.,. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPAI~CY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposai-(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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusgal 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 or land use [/~1 C,~ <~t. ('~,,, ~ ~ C) ~ J;-. 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building ... ~ ....... Vacant Land ............. Location of Property .;~05~.... ~.e.:~ 1~..Cr.e.~ k./~v.(~/~5;. ~:L c~p.o, cl. ~.c1..... g.~ gbPgg,~ ........ House No. Street Ham/et Owner or Owners of Property ...~.....C .h.r.~. 8..~.e.qs.e. g, ......................................... Caunty Tax Map No. 1000 Section ...~.l.q ......... Block . .2. ............ Lot .... .7. .......... Subdivision..~]/. ~ ............................ Filed Map No ........... Lot No .............. Permit No. ,1,~6~33, .[. Date of Permit3/.~/. ~6....ApplicantE.~¥.~'p, .mp.ep.t..~{~fl.t~,, ~.qq ,. ~.o.~..~.. Health Dept. Approval .... ~./..A ................. Labor Dept. Approval ..... ~/~.A. ............... Un~Jen~riters Approval ........................ Planning Board Approval .... .~/.A.. ...... : ....... Christen. Request for Temporary Certificate ..................... Final Certificate ....... ~. ............... Fee Submitted $. ~.,,00 .................... Con,ruction on above described building/e~d p~~ codes and ragu lat ions. R(I~. THE 1001093 THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN ~'~,~T, NEW YORK, NEW YORK 10038 November 6, .... 420545/86 ~ppllcutlon NO. on fite N 777786 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Robert Christensen, Car. West Creek 2nd Wood, Cutchogue, N.Y. inthefollowinglocation~ [] Basement ~ IstF1. ~ 2nd FI. Section Block Lot t~s examined on October 30,198 ~ and found to be in co.ipllonce u'ith the re~t,~irements qf this Board FIXTURE OUTLETS 2 12 f FIXTURES J j FUTURE APPLIANCE FEEDERS FU RNACE MOTORS SERVICE DISCONNECT OTHER APPARATUS: I~.F.I, Track Lighting-16~O' 4 RANGES ~FECIAL REC'PT TIME CLOCKS BELLIUNITHEATERSUNIT HEATERS MULTI.OUTLET AM, T, AMPS. TRANS. ~ SYSTEMS NO. OF FEET ~10. OF S V I C E lites EXHAUST FANS DIMMERS OF NEUTRAL 425 Honsell Lane Cutcbugue, N.Y., 11935 .,~ Pe . This certificate must not,be ollered in any manner; return fo the office of the Board if incorrect. Mspecfors ,may be identified by their credentials. 7GS-~.802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL ,, / / ]65-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL 76S-:!.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~UGH PLBG. FOUNDATION 2ND [ ] INSULATION [~MING [] FINAL DATE: ~INSPECTOR ,,/~,,,~.~ ~ BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FINAL DATE ~/'~ ~ , INSPEG'q'OR BUILDING DEPT. INSPECTION [~] F/~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL F1ELD %NSUECT~ON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... (Builatl~ Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .~ .nT.~?..~.mp.n)..~.%s). ~..~.n.q .....r.q~.. ?:4n.e. r ...... (Signature of applicant, or name, if a corporation) .:~.~.~ 3.2o. 75..~.n.a. ~_.~n., (Mailing address of applicant) 119J8 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor ........................................ Name of owner of premises ..~.. (%. t ~v. a~- w-- ~ ~Z~V' ~ ~-c~ ~, (as on the tax roll or latest deed) If~js a~co~/6~ture of duly authorized officer. · ) ........ :., ....... (N~me and title o~rporate officer) Builder's License No..~gff..~4~~. :[[~. 5~.!~6- ..... Plumber's License No ........ ~//L ............. Electrician's License No ...... [~/g. ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~I.e ;~.~...Crp.e.~..Ay~.. ~/.o. ).~i.dF. qgql. ~qaO ............ 5-5- . ..... ~ ......................... W..a~. ~.ue.e.k. kv.a ................ g~.~.e.h~g~p ............... House Number Street Hamlet --r - County Tax Map No, 1000 Section ..... /. [...O. ........ Block ....... ~.. ........ Lot ..... .7 ............ 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 . b. Intended use and occupancy ~.~.qe.,l¢..~a~J.~y .~¢.s.~O~pee . ;~ ~'~ ~'r~~r ........ '3. Nature of work (check which a. plicable): New Building ..... ' ..... Addition..2; ....... Alteration ....... : .... Repair .............. Removai .............. Demolition ............ Other Work ..... : ......... ~<. '~ ,: ~Z~] (Description) 4, Estimated Cost,, ,~,~,,0, r,O,0,:~:i,0~ ....................... Fee ....... (to be paid on filing this application) k~5: "If dwelling;'fiu'rnbe~ of dwelling units ...... o..n9 ...... Number of dwelling units on each floor ................ If garage, number of cars .... ~ .................................................................... 6. If business commercial or mixed occupancy spec/fy natu. m and extent of each type of use ..................... ' .2,~ 7. Dimensions of existing structures, if any: Front .... '. ..... '. Rear ... De .......... Height ....2./4:. ~. ........ Number of Stories ...~. ................................................... Dimensions of same structure With alterations or additions: Front .. } .2.'.6.. '~ ......... Rear . .. 3 ¢..6. .......... Depth .~9 ' ...... Height . ?!47. i .. Number of Stories ...~'. .... ~ 7'6" .... i' " ~6 ....... , .......... Dimensions of entire new construction: Front ...... ......... Rear .... ~ .......... Depth .. 3.9. .......... Height ..... I9'./.9 .......Nu~nber of Stories .... 9. Size of lot Front .......... :i ............ Rear ..... : .... ............ Depth ............... 10.. Date of Purchase .......... : ................... Name of Former Owner ............................. 11. Zone or use district in which piemises are situated..R.e. ~..d.~ ¢.~;[.a~[ ...................................... 12. Does proposed construction vi01ate any zoning law, ordinance o/e regulation: ...~q'. ......................... 13. Will lot be regraded ... I~9...: .... :..,. ............ Will ex~ess fill be removed from premier: . Y~s _ . No 14. Name of Owner of premises ~. C ./XC'.s.~ .q-.~.%~. ¥.~, Address .Y .0. Q . .D .o y. qo.,..U.~ppl~;m~).gl.l;~. ?.~.~..-.5.~.~.1... Name of Architect E ........ i .......~ ........... Address ~ ................. Phone No ...... - .......... ...... nv2~ro~ent ~ast, 'rnC.Addr~s~Q75 In~t,l~k. La..phrmaNo .~3~ 7474 marne o~ con~ractor ............................ ~>~'dfli~;' 'rTZ' ' 'XI95'23' .................... 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 accordin: to deed, and show street names and indicate whether interior or coruer lot. Atltached STA'rE OF NEW YORK, I S.S COUNTY OF ................ ................................................. bein duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named. , He is the ..................... i .......................... ' .......................................... ! (Cent;actor, agent, COlt orate officer, etc.) of said owner or owners, and is dgly authorized to perform or hax'e performed the said work and to make and fii~'~this- application; that all statements cofftained in this application are tru ~ to the best of his knowledge and belief; and that the work will be performed in the man~er set forth in the application file d therewith. Sworn to before me this ] ............ · ~.~ ..... . .... day ~f ....... .~....F~-.. ........19 ....... co ................. ~1~. ~7 ~ x--4Signature of applicant) OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOTIFY 'BL~ LD NC, DEPARTMENT AT 765-1802 .9 ,AM 'ro 4 PM FOR THE FOUNDATION ~0 REQUIRED FOR ~OU~D CONCRETE 2 ROUGH F~AMiNG & PLUMBING 3 INSULA rlOr~ 4. ;INA~. CO~JSTRUCT~ON MUST 8; COMmiE FOR C.O, AL~ CONSTRUCTION SHALL MEET FHE ~EQUIr~SMENTS OF ~E N.Y S~ATE CONS rRUC~ION & ENERGY CODES, NOT RES~NSIBLE FOR ~IGN OR cONSTRUCTION ERRORS, J .!