The URL can be used to link to this page

Home My WebLink About14553-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20584 Date MARCH 10~ 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 2515 PINE TREE ROAD CUTCHOGUE~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantiaily to the Application for Building Permit heretofore filed in this office dated JANUARY 15, 1986 pursuant to which Building Permit No. 14553-Z dated FEBRUARY 24, 1986 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 & ALTEi~ATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building, EUGENE & ANN BURGER (owners) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-225513 - FEBRUARY 21~ 1992 PLUMBERS CERTIFICATION DATED JUNE 4~ 1991 - K&K PLUMBING & HEATING Rev. 1/81 FOEM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTFtORIZED) N.o 14~3 Z Permission is hereb/granted to: _ . ............ ~....~ ............ ,o ...... ~.....~.,~.....~......~..~~....z,::~..'...~.~ ...... ~~.t,.....~z.~.. ~..~..., ............. ..! ..................... : .................... ! ...... at premises located at .....~..~../..~........~..~..~....~. ............... .0~.~.~.. Coun,¥ Tax Map No. 1000 Section ..... J...~....~. ......... Block ..... ..~....~ .......Lot No ...... .~. ................ pursuant to application doted ..~~...~.~ ............. , 19.~..~., and approv~ by the Building Inspector. Building Inspector Rev. 6/30/80 tOWN OF SOUTHO.~L..? ............. j APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted m I~amea~a 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 disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial bulldings, 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 property 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Businese $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $50.00 Date ...... .~./~. ~.//~. ~ ........... // NewCons truction ...... O d or Pre-existing Buildioq ....... z2.~.. Vacant L~ "and ............. t. ocatlon of Property..~.?'~l .~. J~?(.~...~... ~.~, ..... ~'.~...~...~..~ .............. Owner or Owners of Property ...~...~ ~...~.. :'....~./..~..~....~.. ~./~..~.-.~..~. ~ .............. CountyTaxM pNo. lOOOSecton~.~l: ~.0~.. . Block .~.. . ~ In, /~L Subdivision .V..~' .~....~...~....[./~.~..~. .... Filed Map No.. [ .'..~ .~1..Lot No .... [..~ ....... Perm it N o./~J-.J-.3~ .z~.-. Date o f Permit .~/~.~/~./(..~...App ,,cant. . .-/:.qq~ .cd<..%.. ~.~,f.~ .f~..c..~--.. ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tempora[y Certificate ..................... Final Certificate ....... ~ ............... Fee Submitted $ ............................ Construction on above described building/~/~ ~ermit meets/a~ap.plicable codes and regulations. ~ ~L~ Apphcant ~.~.....~... ~_ l · .J.'~. ~ ......................... / R~, 10-10-78 5%1 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N,Y, 11971 TEL. 765-1802 ,CERTIFICATION Building Permit NO._% q~ (please print) (please print) I certify that the solder used COntains less than 2/10 of 1% lead. in the water supply system (plumber's signature) ~ Swor,n~to befor/J me t~,is __ ///day of F~ ,. Notary Public ERIC G KOCH Notary Public, State of New York No, 62-216210O Gue~ed In 6uflo~ Coumv TOWN OF $OUTIIOLD OI:IqCE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 April 4, 1991 TEL. 765-1 ~02 Eugene & Ann Burger 2515 Pine Tree Road Cutchogue, N.Y. 11935 To Whom This May Concern, Ple are unable to complete your Certificate of Occupancy because ,of the following reasons. /_--/ An application for Certificate of Occupancy //is not on file. / blo Underwriters Certificate on file. /~/ The check i:;(outdate(t/not on file.) /_-/ No Health Dept. Approval on file. /-~/ No final insi'~ection has{been made. Please contact Thank you for your cooperation. ()ur office on this matter. lhLilding PcrmJ. t I~ I 4 5 5 3 Z I 4 5 5 4-Z Building Dept. (NEEDS lrNDERWRITERS ONLY) Plumber :~older Certificate on ~ile. all permits involving plumbing being issued after April 1,1984 TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN IIALL SOUTIIOLD, N,Y. 11971 April 4, 1991 TEL. 765.1802 Eugene & Ann Burger 2515 Pine Tree Road Cutehogue, N.Y. 11935 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_-/ An application for Certificate of Occupancy is not on file. /_ No Underwriters Certificate on file. /~/ The check [:;(outdated/not on file.) /'_-/ No Health Dept. Approval on file. /-'/ No final insf~ection has(been . - made Please contact ()ur office on Thank you for your cooperation. l;uilding PermJ. t: f! I 4 5 5 3 Z this matter. I 4 5 5 4 - Z (NEEDS UNDERWRITERS ONLY) Building Dept. ***/~/' H<) Plumber Solder Certificate on file. ( all permits in~olv].ng plumbing being issued after April 1,1984 F1ELD I~SIECTION tiDATE II C OMf.fE:~'£S FOUNDATION (1st) FOUNDATION .(2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS F15%LD ISISUECT.ION 1. FOO__NDA_TI.O_N ( 1 s t ) FOUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Ye ADDITIONAL COMMENTS: '! 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION ZND FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE ~/~ INSPECTOR INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING r ] FINAL INSPECTOR 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,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 schedhle. 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 ~ 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 a~ees 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 i tions. ~a~ ~ ~ ~o ~ (Signature of applicant, or name, if a corporation) (Mailing address of applied t) , ~ Tv'~ ~ ................. r~ / ~q3 J State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .0. ........................................................ Name of owner of premises ....~..[~J..~..(7~.~.. 60 ~k..~ .......................... (as 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 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 .................................................. · ................. ........ .... ........ C.c . .C¥ ..... House Number Street Hamlet County Tax Map No. 1000 Section \ O~ Block (~ ~ - · OO t~ Subdivision...~->.c~...~¢:4'~.... '~..~qC. · ·~. .~.~) ........ Filed Map No...~.[.Q .~ ....... 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 ..... .~..~..~.(. 0..~..~...Q~.~.....~-.~. .... .~.~. 4.( ........................ 3. Nature of work (check which applicable): New Building ' Addiiion Alteration ....... ... Repair .............. Removal .............. Demolition .......... i.. Other Work ............... ' (Description) 4 EtimatedCost ~'0t OO.O ar.> F (to be paid on filing this application) 5. If dwelling, number,ofdwellingunits.,.......,..... Number of dwelling unit~ on each floor ......... ....,.. If garage, number of cars ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each typ6 of use ..................... 7. Dnuensmns of e~x~st~ng structures, if any: Front ..... B.~. ....... Rear ...I.~'..: ...... Depth .../nt.~ .......... Height ~.~ Number of Stories Dimensions of same structure with alterations or additions: Front ............. i .... Rear ............. i .... Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .... ~ .qr. ...... . ]gear .~D..i ...... Depth ...~.S.-- ......... Height . ...~.-..'J'~. .......Number of Stories ..... [ ......'c'..'~t~Jr~ ~.~' . . ~(~¢,~t5:1~i ........ ~ ............... 9. Size of lot: Front ...... ~..~,, ~., ~;, ...... Rear ..... {~ ,'71 ............... D,ep t_h 10. Date of Purchase .... [~'1.2,0. I~.~. ............. ~Na.m~ of Former Owner .~.9~-¢0.~. 1 1. Zone or use district in which premises are situated.. [.(_C ~ I D ~ ~1~.~ ~,, . .i ........................... 1 2. Does proposed construction violate any zonin~ law, ordinance or reaulatinn. 13. Will lot be regraded ..... .[~. .................... Will excess fiilbe removed! from premises: ~ No 14. Nmne of Owner of premises ~... l'~.~.k?-.&. ~..l~. ...... Address'2,.q.I.X;. p. lhl .T(Lr, C,.. Phone Name of Architect .... .~f~.ltB, > ............ Address .................. Phone No ................ Name of Contractor ... ~.,~. fk~. I~ ............ Address .................. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& ind,icate all set-back dimensions from property lines. Give street and block number or description according to deed, and showl street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .............................................................. 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 Notary Public, ........ . FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 E×amined ! .*..., 19 k Approved (~1.~....0~.. ........ ! .~..., 19~& ........... Permit No..)..~"~'~ *~ Received ........... ,19... (Building inspector) APPLICATION FOR BUILDING PERMIT Date . INsTRucTIONS jt~{~~ ,' ~ 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 ig 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. (mailing address of applzcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, ptumbei or~ 4 Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Nmne and title of corporate officer) Builder's License No ................. ' ......... ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · .......... ....... .... . .......... ...................... ltouse Number Street Hamlet County Tax Map No. 1000 Section .. t.O. .~.{ ........... Block ..... .~. ........... Lot .... .~ ............. Subdivision .............................. ....... Filed Map No ............... Lot ............... (Name) 2. State exist~ng use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy . .' v ?.' ............... b Iht nded nd pan . , e use a occu o; ........................................................ ,:, ...... 7 2 ~. Nature of work (check which applicable): New Building .......... Addition .. Repair .............. Removal .............. Demolition ...... ~.... 4. Estimated Cost ............................ Fee .......... (to be ....... Alteration .......... .. Other Work ............... (Description) mid on filing this application) ;. If dwelling, number of dwelling units. ·.........! ... Number of dwelling unit~ on each rom'. .......... ..... If garage, number of cars ........ ~. ~ .............. , ............. , ............................ ;. If business, commercial or mixed occupa.n.ey, specify nature and extent of each tyEe of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... ~ ....... Depth ............... Height ............... Number of Stories ............................ ! ............................ Dimensions of same structure with alterations ' ' Fron ' Rear or addlhons t ...... ; ..... i ....................... Depth ...................... Height ...................... Number of ,Stories ...................... Dimensions of entire new construction: Front Rear ' Depth Height ............... Number of Stories ............................ ! ............................ ~. Size of lot: Front . .~../ ................ ,Rear ...................... Depth ..................... I Zone or use district in which premises are situated ~ ~ Does proposed construction violate any zoning law ordinance or regulation: ~ ~. Will lot be regraded ............... ~, ............ Will excess fill be remove~ from premises: Yes No Name of Architect t~ t*3 Address ~ Phone No Name of Contractor t ~ I .t Address ' Phone No 5. Is thi~ property located within li00 feet of a tidal wetland? * Yea ..... No ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from · operty lines. Give street and block number or description according to deed,.and sho~ street names and indicate whether terior or corner lot. ~ATE OF NEW YORK, S.S )UNTY OF ................. ............................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) eve named. is the ........................................ (Contractor, agent, corporate officer, etc.)~ said owner or owners, and is duly authorized to perform or have performed the shid work and to make and file this ')lication; that all statements contained in this application are true to the best ofhi~i knowledge and belief; and that the ,rk will be performed in the manner set forth in the application filed therewith. 'orn to before me this ...................... day o£ ...................... 19 ,tary Public, ................................. County (Signature of applicant) WITH 0 UTCERTI. FI CATE ~OE OCCUPANCYr r soLDE. ~...'T-~AIICANN~T ~ If ~opper, . ,NOTIFY ;DEPARTMENT ,AT 765-1802 9~AM TO',4PM FOR ;OLLOW~NG INSPEC~ONs: 1 FOUNDA~ON ~O'REQUIRED FOR POURED CON~ETE E RO~GN FRAMING & ~OMB ~'FINAb CONSTRUCTION MUST BE COM~L~O~C 0., ~LL CONSTRUc~N ~LL MEET: ~ ' ' ' ~OUTH~PTOH LUMBER -Ii ..~ r