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Home My WebLink About14554-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20585 Date MARCH 10g 1992 THIS CERTIFIES that the building ALTERATION Location of Property 2515 PINE RRREE ROAD CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 3 Lot 4 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 1986 pursuant to which Building Permit No. 14554-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 CHANGE ROOF PITCH & GABLE END ON EXISTING SEASONAL DWELLING AS APPLIED FOR. The certificate is issued to EUGENE & ANN BURGER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-225512 - FEBRUARY 21, PLUMBERS CERTIFICATION DATED N/A 1992 Rev. 1/81 ~ // Building Inspector FOI~M NO. ~ TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is herebt granted to: ~ ~ ~.~.~.....'!...~....~~.....~... ....... ,~. ~!.~..~...~.....~ ............... ..~;.~....~.:~.........~.~.~.~..~... ,o.....c~L~.,.~._..~/, ...... ~.....~.....~..~...~.~......~ ........ ~, ~remi~,~ot~d ot...~C,.~..~....~...~ ........... ~~i'"'""~ .......... '"C~"~' ............... :'~ ................................ i ................... i'i ......................................... County Tax Map No. 1000 Section ...J....O....~. ......... Block ....... ~ ........... Lot No ..... ~ ................ pursuont tO c~ppJicotion doted .....~...~~......~.. ................. , ]9.~..(I~, and approved by tile Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This appllcation must be filled in typewriter OR ink, and submitted .- ~ 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 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 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 occupancv New Dwelling $25.QO, Accessory ,$10.00 Business $50,00 2. Certificate of occupancy on pre-existing dwelling $ 5 0. O0 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 .......................... NewConstruction ...... Old or/Qre-existing Building ............ Vacant L~agd ............. .................................................. ou No. , Owneror Ownersof Property ,~.~.~...~...~.; .... ,. ,A~.~l,,..~, :~../~.; .~.~..~.~.. ......... ...... ; ....................... ed Map No .... .I ......Lot No, , Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..................., .. Request for Temporary Certificate ..................... Final Certificate ............... Fee Submitted $ ............................. Construction on above described building and~/r~it meets all~jc,ablecodes and regulations. Applicant....~.~..~...~_6.//J / ~ ~ ...... ~ ...................... Rev. 10-10-78 THE.NEW,¥ORK BOARD OF FIRE ~00~07~ Date ~BRUARY 21,1992' ~pplicationNo, onfile 7435599X/ o~y t~ electrical equlpme~t ~ ~scri~d be~w a~ int~uc~ by t~ appllc~nt ~m~ °n t~e a~ ~ :, EUGENE BURGER, 25'15 PINE TREE ROAD, dUTCHOGUE~ N.Y. ~, inlhefollowinglocotion: ~ Basement ~ IstFI, ~ 2nd f'l. ~ COT~A~ ~S ~xamined o~ Y~BR~ARY ~8 ~ 1992' ' andfound~ to bein compliance with the~r~tt~remenlz ~v~TS ~tcm~ctes[ sw.c.es [[Nc~Moascmfl~tu~tsctml OTHER I ~. ~ ".W. I ~' I ~.W~ DRYERS [ ~RHACE' MOTORS : ] ~T~RE AKIANCE KE~RS ~pEoAL RECPT TIMe CLOCKS I BI LL~IuHIT flEATE~S MULTI.~TMr , DIMMERS R~WIRg COT~A6~ OHLY'I t ~N~LBOARD~tl'12 CIE, ~ ' G.F.C,I~-3 TRACK LIGHTINGs-2 BOX 215 ~ : '"'~ ,' :~,- ~: ' ~ . : rtr,'~,, ,~ ,~ ~ -- ~ Th s ce~ ficate must not be altered in any manner return to the office of the Board if incorrect. Inspector~ may'~e, ~de~fifi~d by their credentials. ~~~~.~~~,~~ ......... ,~,~~ .... FIELD'INSPECTION 1. FOUNDATION {1st) COMMENTS FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. sTATE ENERGY CODE FINAL ADDITIONA~L COMMENTS: HENRY P. SMITH, President JOHN M. BREDEMEYER, Vice-Pres. PHILLIP J. GOUBEAUD ALBERT KRUPSKL JR. ELLEN M. LARSEN BOARD OF TOWN TRUSTEES TOWN OF SO1JTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE 765-I892 August 29, 1986 Ms. Ann Burger 2515 Pine Tree Road Cutchogue, New York 11935 Dear Ms. Burger: The following action was taken by the Board of Trustees regarding your wetland application. Moved by Trustees Krupski seconded by Trustee Bredemeyer WHEREAS, Ann Burger applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated June 20, 1986 and WHEREAS said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS a public hearing was held by the Town Trustees with respect to said application on August 28, 1986 at which time all interested persons were given an n opportunity to be heard, and WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the NOW, THEREFORE, BE IT RESOLVED that Ann Burger BE AND HEREBY IS GRANTED PERMISSION UNDER THE PROVISIONS OF THE WETLAND ORDINANCE OF THE TOWN OF SOUTHOLD, NEW YORK TO Construct a 10' x 24' deck on property located on Pine Tree Road, Cutchogue. Construction material shall be suitably contained at the work site so as to prevent its eroding, leaching or otherewise entering into adjacent wetlands or waterways. This permit will expire on August 28, 1987 if work has not commenced by said date. There are two inspections required and the Trustees are to be notified upon the completion of the work. Prior to the issuance of said permit by the Clerk, the applicant for a permit shall file with the Clerk a certificate that the applicant has -2- public liability insurance policies insuring against any liability which may arise in !the performance of the 0pera~ions pursuant to such permit in such amount as shall be fixed by the T~ustees, which said policies shall nam~ the Town as a name insured. In considering the declaration, pleas~ take further notice that this determination should not be considered ~ determination made for any other department or agency which may also hav an application pending for the same or similar project. A $5.00 Wetlan~ Inspection fee is now due and payable. Upon remittance your permit will bE forwarded by mail. Very truly yours, Henry P. Smith, President Board of Town Trustees Ilene Pfifferling, Clerk HPS:ip ~ cc: Bldg. Dept. Robert A. Greene, D.E.C., Stony Brook Commissioner Henry G. Williams, D.E.C., Albany Army Corps of! ENgineers Coastal Management Trustees file FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Building Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-180:~ Examined ................ ,19 ... Received ........... ,19... Approved ................. 19... Permit No ............ Disapproved a/c .., w..~-.. . .......... .-. . . / ./. . .?. . .: . .......... " APPLICATION FOR BUILDING PERMIT ~NSTRU~TIONS 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. Fcc'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 dett/iled 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 Ihspector 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 MA~DE 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 inspectom on premises and in building for necessary inspections. (Signature of applica~~porati ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Name of owner of premises..~.. · .~ ....... : {~..~¢.. , .~. ~ ./,.~....wq- .................................... (as on the 1'ax 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 .................................................. · .............. ..... .............. ........... House Number Street Hamlet County Tax Map No. 1000 Section . [.O....~. .......... 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 .. ,~ un ~/ ~7 ~' ff_~ ~ ~,~ t~ b. Intended use and occupancy . .~.. ~,. ~-..,.; .' ............... 3. Nature of work (check which applicable): New Building .......... Addition ........ .~. ~Alteration .......... Repair .............. Remloval .............. Demolition ............ Other Work ............... . i (Description) 4. Estimated Cost ........ .~. ~.., .......................... Fee ..................................... i (to be paid on filing this application) 5. If dwelling number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimehsions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ......... Dimensions of same structure With alterations or addittd~g: Front .., ' '~' '~ ' ' ' Rear .... Depth ' Height Number bY Stories 8. Dimensions of entire new cons ruction: Front ...... ' .......:.. Rear .............. e ............... Height Number of Stories '. 9 Size of lot: Front ' Rear .". Depth f P ~ ..:,D. /ti~ Owne 10. Date o urchase .......... , ....... .. , .' ......Na of Former r ............................. Zone or use district in 11. which premmes are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or .regulation: ................................ 13. Will lot be regraded ........ i ..................... Will excess fillbe removed from premises: Yes No 14. Name of Owner of premises . .~(x~.%~.<. ~t'~q t'7.. Address c).~.).¢. ~9~.~..~.~.g?..~.. Phone No.~.~Q.*~.~d.'~ .... Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ........ i .................. Address ................... Phone No ................ 15. Is this property located withint.O0 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town T~ustees Permit may be required. ' PLOT DIAGRAM l,ocate' 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. STATE OF NEW YORK, S.S COUNTY OF ................ ........................... . ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si ning contract) above named. He is the .................... i ..................................................................... , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file this application;that all statements co~tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,ncr set forth in the application filed therewith. Sworn to before me this 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved .......... : i Pe mit Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... Date ..... [..Q~.. ........ , 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 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 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 i~ec~ti~°ns' ot ,-.,urn-- ~ '/~ ( ~i~'~Tat~r'e"~pl~~ e, 'i~'~ corp o ration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ; ...................................... (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 .................................................. -- ............... .u.d. House Number Street Hamlet County Tax Map No. I000 Section ...... [0.~. ........ Block....~ ............. Lot .q ................ 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 ...... .~..../'~r. .... ;; h' ';; ;t ...................... b. Intended use and occupancy ............. ~ .... ~j .~..~~. ~.~ i..~:, ;~:,~ _7t, ,,f ~" ~ .' lN'ature of work (check which ipplicable): New Building ..... ' .....'Addition .......... Alter~0n ......... Rep,a~)[ ~. ,~.111~ ..... Removal; .............. Demolition .............. Other Work.."f ........... ,, .............. (to be paid on 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number Of cars ....[ ............................................ . , ...................... 6. If business, commercial or mixed occupancy, spec~y nature and extent of each type of usel ..................... 7 D~en ions'of isting structures ifa y: Front Rear Depth Height ' Number of Sto~es D~ensions of same structure ~ith alterations or additions: Front ................. Rear .................. Depth ~ HeiSt Number of Stories 8. D~ensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Stories 9 Size of lot: Front ~ Rear Depth 10. Date of Purchase .......... ; ................... Name of Foyer Owner ............................. 11. Zone or use d~stnct ~n which premises are s~tuated .............................................. 12. Does proposed construction vi~late any zoning law, ordinance or regulation:, ............................. 13. Will lot be regraded ...... ~; .................... Will excess tillage removed from premises: Yes No Nme of Architect ........... ; ................ Address ................... Phone No ................ Nme of Contractor .... [ Address Phone No PLOT DIAG~ Locate cle~ly ~d dist~ctlg ~1 bufld~gs, whe~er exist~g or proposed, ~d, indicate ~1 set-back d~ensions from prope~y lines. Give street and blocg number or desc~ption accord~g to deed, ~d show street nines and indicate whe~er interior or.corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigging contract) above named. He is the ' (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 mannbr set forth in the application filed therewith. Sworn to before me this NO. 4707878}~30ffoik Com!ty~r~ ' e' Prepared ~n =eeordance ;vHh Se .~in~rnum H~e L f. A. L S. ~nd app~ved and a~ r~; ~Jch use by T~e ~'ew Yo~ State P O. BOX gO9 MAIN ROAD SOUTHOLD ~ N. Y. "'"' ~(/VE YORS 5020 MEADOW LANE ( UNIMpRovED ) LIC. NO. 49618 ENGINEERS, P. C. CERTIFIED. TO: MAP FIRST AMERICAN TITLE FILE,D INSURANCE COMPANY OF NEW YORK NORTH FORK BANK AND TRUST ITS SUCCESSORS OR ASSIGNS EU6ENE BURGER ANN BURGER E FLR. EL. HSE'.= 8.10 F FLREL. BUNGALOW = 7. 0 ELEVATIONS 4R~ ~EFERENCEO TO NGVD. SURVEY OF LOT 14 OF NASSAU FARMS MAR. 28~ 1955 FILE NO. 1179 AT PECONIC. TOWN OF SOUTHOLD SUFFOLK COUNTY~ N.Y. lO00 - I0 4 - 0.'3 04 SCALE I"= $0' DEC. 9 , 1985 the I. LA.L$. and cpproved and ~4 A ~.~: ~.'ch use by T~e I~ew York State . ~ , ,, aa O. oo' S 8F"OI 20 W. R O. BOX 909 MAIN ROAD 5OUTHOLD~ N.Y. ~- N.Y.S. D~'~E YORS ~ - 5020 II 9 ?1 MEADOW LANE ( UNINpROVED ) LIC. NO. 49618 ENGINEERS, P.C. CERTIFIED TO: J~AP FIRST AMERICAN TITLE FILE,D INSURANCE COMPANY OF NEW YORK NORTH FORK BANK AND TRUST ITS SUCCESSORS OR ASSIGNS EUGENE BURGER ANN BURGER F: FLR. EL. HSE'. '~ iD.ID F. FLREL, BUNGALOW -.- 7.0 ELEVATIONS ,tiRE ~EFE, RENCED TO NGVD. SURVEY OF LOT 14 OF NASSAU FARMS MAR. 28~ 1935 FILE NO. II?9 AT PECONIC. TOWN OF SOUTHOLD SUFFOLK COUNTY~ N.Y. tO00 - 104 - 05 - 04 SCALE I": 30' DEC. 9 ~ 19S5 APPROVED AS NOTED FEE: &-'~' '-- BY~ ,,, ?, ~*,/--- ,* NOTIFY BUILDING DEPARTMENT AT 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: '1 FOUNDA'*rlON TWO REQUIRED FOR POURED CONCRETE 2 ROUGH FRAMING & R-UMBING 3. INSULATION 4. FINAL C{3~.~$TRUCTiON MUST B[ COMP~T~: FOR C.O. ALL CONSTRUCTION SHALL MEET I THE* REQUIP~MENTS OF THE N.Y ' STATE CONSTRUCTION & ENERGY CODES, NOT RESPON~BLE FOR OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERnRC/ITE OF ~PNJCY