HomeMy WebLinkAbout24381-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25565 Date: 03/04/98
THIS CERTIFIES that the building ALTERATION
Location of Property: 1000 BRIDGE LA CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 118 Block 1 Lot 18.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 21, 1997 pursuant to which
Building Permit No. 24381-Z dated SEPTEMBER 30, 1997
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 ALTERATION TO EXISTING NON-HABITABLE STORAGE BUILDING AS APPLIED FOR.
The certificate is issued to ALICE S FIFE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N446405 02/24/98
PLUMBERS CERTIFICATION DATED N/A
Buiteing Inspe0or
Rev. 1/61
"UK NO. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N4 24381 Z Date ........ ................................. 19.1..,(
�Permission is hereby9med n� tn:
. . .........................................
,� � .... . ..........���,� �...............
to ...r4:/� .... �� ......, T. . 11 .......5,/.�7?� 6......................................
............ .............. a................ ..................................
..............................................................................................................................
................................................................................ ................................................................................
atpremises located at.........................................................................................................!.. ...
p�...............
County Tax Map No. 1000 Section..../,lf...pp......... Block .....4?1......... Lot No. ..,,14..'.j.........
pursuant to application dated ...!✓ ?��'....... r, ................. 19. � and approved by the
Building Inspector.
Fee S•••✓ `•••
Rev. 6/30/80
-- — Ire: 111 NV 11 nn
T014N OF SOUTHOLD U
BUILDING DEPARTMENT I
TOWN HALL FEB { 9
765-1802
" n BLDG.DERT
APPLICATION FOR CERTIFICATE OF OCdIDAh
A. 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 linea,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewer age-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 architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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. 11
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. '
C. 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, �C±o`m/mercial $15.00
Date . . . � A-). .� 1 .0 . . . . . . . . .. . . . ,
New Construction. . . . . . . . .}. . Old Or Pre-existRg Building. . . . . . . . . . . . . . . . ���� `� u
Location of Property. . 1N� 1R,1 q.L�. :1 1� . . . . . . . . . . . . . .. . . �. . .
House Mo. Street Hamlet
11
Onwer or Owners of Property. �. . I . ... . . . . . .t. . . . . . . . . . . . . . . .L . . . . . . . .. . .. . . . . . .. .
County Tax Map No 1000, Section. . UY. . . . . . . .B1ock. . . . . 1 . . . . . . . . . .Lot. (.�. . .. . . . . . . . . . . . .
Subdivision. . ...I. . . . . . ...7. ..-. . . . .. . . .. . . . . .�� 4IV
.jj. . . .. .Filed Map. . . . . .. . . . . .Lot. . . . . . . . ... ......
.....
Permit No. �. . 1 �J. �. . . Date Of Permit. // . /S 1. . . . .Applicant.AJ �L. .. . .. . . . . .
4 mon- Q[a/:vf3ti
Health Dept. Approval. . .� . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . .... . . . . . . .
Planning Board Approval.).)j. . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certi to . . .
Fee Submitted: $. `1. . . . . . . . . . . . . . . . . . . . . . ..
. . . . . . .. .a
P ICANT
ate. -5
adt TUA l5 IG
JAN 2 8
BLDG.DEPT,
I
Environment East, Inc.
3075 Indian Neck Lane
1 P.O. Box 190
Peconic, New York 11958-0190
516-734-7474
F1Fe (Ze3slOeJcG
NASSAU P7-•
Ot
"V-e- �fZ bz4-u -
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PaGE 1
1001093 BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
Date FEBRUARY 24,1998 Application No. on file 14943797/97 N 446405
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
AICE FIFE, BRIDGE LANE NASSA��UTT POINT, CUTCHOGUE, NY
in the following location- EJBasementL.� Ist Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on F? BRUARY 17,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT I OTHER I AMT. I K.W. AMT. K.W. AMT, K.W. AMT, K.W.
5 b 7 4 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIALREVPT.1 TIME CLOCKS I BELL IUNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT, NO. A.W.G. AMT. I AMP. I AMT. j AMPS. I TRANS, I AMT. I X.P. NO.OF FEET AMT. WATTS
1 1 211 1 1 1 1 2 6001
SERVICE DISCONNECT NO.OF S E R V I C E
METER
AMT, AMP, TYPE E9U P. 1 0 YV✓ 1 0 SW 1 0 3W 10 dW NO.OPER 000ND. OF CL CGO;ND. NO.OF HI-LEG OF N4lEG NO.OF NEUTRALS Oj N UTRAL
I
i
OTHER APPARATUS:
G.F.C.I:-4
TRACK LIGHTING:-16
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DOROSKI ELEC. INC. LIC.#2941-
425 14ONSELL LANE
CUTCHOGUE, NY, 11935 GENERAL MANAGER
11 �
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentials.
COPY FOR BUILDING DEP,4RTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
ILLD ICS"'ECT 1ON DATE CGmm1..NT^
FOUNDATION ( t )
FOUNDATION ( 2nd )
2 . lfJ(Vl.��h P
ROUGH FRAME & �y
PLUMBING �9 v
3 .
s >
INSULATION PER N . Y .
STATE ENERGY
CODE
moo.
4 . --f
FINAL
c
ADDITIONAL COMMENTS :
r
4
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z� f /tPdPII(�Utt� Tete �QJ�
y
Fame
c, Environment East, Inc.
a 3075 Indian Neck Lane
Box 190
New
Peconic,New York 11958-0190
516-734-7474
August 20, 1997
Southold Town Building Department
Town Hall
Main Road
Southold,NY 11971
Dear Sirs,
Please note that there are two sets of surveys-one showing the proximity to other existing structures
seaward of the work we are doing and one showing contours and work we are doing. Important to note all
work is not on new ground,but a rework of existing footprint.
Please call wi questions.
Sincerely,
Peter R
mg
Presiden '
Environment East,Inc.
Encl.
PRS:jm
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH FLOG.
[ ] FOUNDATION 2ND [ ] 1 LATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
7G5-1902
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ry • Q-,PKC . ��
DATE X, INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ 7FNDATION 2ND [ ] INSULATION
MING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: f7�Gci�u�.A
DATE L�S' f% INSPECTOR ��
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] DOUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]/FRAMING [ j FINAL
[ I FIREPLACE A CHIMNEY
REMARKS.
DATE /,02-///,9h/7-INSPECTOR
�ygd
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE S CHIMNEY
REM/ARKS: � �,
DATE INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
FORM NO. t t• -
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL 2 t 1y97
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Fsamined . . . . . . . . .. 19 9� [� q Received . . . . . . . . . . . , 19 .
Approved . . : : - /?C�. . . . ., I Permit No. d!`. a
Disapproved 41/C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
)Idir htspec or
APPLICATION OR BUILDING PERMIT
Date . Jam. . . . . . . . ., 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 stre._
or areas, and giving a detailed description of layout of property must be drawn on the diagram which Is part of this app
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 petit
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 Occupan,
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 ti
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances.
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe,
Tire applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t
admit authorized inspectors on premises and in building for necessary inspections.
E:tJU i.RZM -1E/J-- >r=ASTI NC -
(Signature of applicant,or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
& &-Rfll_. . . . . C0tt 11 . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . A f.--t GC— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
applic, i a M
uized officer.
(Name mid tporate officer)
Builder's License No. . . . . . Jr. �S ro f ( •�
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .
t_(OOb .. . . . . . . . . . . ... . ..... . . �GE ..tr�NE CJTcth�w� . . . . . . . . . . . . . . .
House Number Street T Hamlet
County Tax Afap No. 1000 Section . . . . . .�. �� . . . . . . . . Block . . . . .} . . . . . . . . . . . . Lot . . . .1.��'. 3. . , . . . . .
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 . . J. FA(VM1:�l. . . . J�:
�cvSL1rl�6 t ,'
b. Intended use and occupancy acow - P. . . .
"' .R�f7lt IN�M� M IMI@O
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . V. . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . .
(Description)
1. Estimated Cost . . F. °`' . . . . . . . . . . . . . . . . . . . . . . . . . . Fee
(to be paid on filing this application)
If dwelling, number of dwelling units . . N .". AZ
If garage, number of cars . . . . . . . N. ... . . . . . . . . . . .Num
. ber of dwelling units on each floor . . . .fl),.!l : . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
r
5. If business, commercial or mixed occupancy, specify nature m extent each l d tt of h tyPra o8f se . . . N.`. ir:
A : . .
_ rurt? , . . . .
t. Dimensions of existing structures, if any: Front . . . . .U4.-. . . . . . Rear . . . . (o :�?. . . . Depth . . . . ..�.
.�? . . . .
Height . . .12 -0... . . . . . Number of Stories . . . . . . . .1. . . . . . . . . . . ._ . .i . . . . . . . . . . . . . . . t. . . t,.. . . . . .
Dimensions o same structure with alterations or a ff tions: Front . . ) .q. ... . . . . . . . . Rear . . . .1� . �. . . . . . . .
Depth . . k(O." . . . . . . . . . . . . . . . [[eight . . . . .I.4. ". . . . . . . . . . . . . Number of Stories . . . . .r. . . . . . . . . . .
_ u ,_ p b'-V ... . . . .
3. Dimensions of enure i)ew construction: Front . . . . .3. .0. . . . . . Rear . . . .3. A. . . . . . . Depth . . . . . . . . . . . . . . .
Height . . {D. ,l :Q. . . . . Ni}.�nt,er of torics . . . . . . .1.'. . . . . . . . . . . . . . . . . . . . . .
1c..1 QJ,u b u . .r. . . . . . . . . . . .
9. Size of lot: Front . . . . . .. . . . . . . . . . Rear . . . . 1�. .'. 15. . . . . . . . . . D.e}'th .9 7 3 . . . . . . . . . . . .
3. Date of Purchase . . . . . . . . JU. Av.. . . . . . . . . . . . . . . Name o£Former Owner . .r.. . A.'. . . . . . . . . . . . . . . . . . . . .
1. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Does proposed construction violate any zoning law, ordinance or regulation: . . Q.17� . . . . . . . . . . . . . . . . . . . . . . . . .
i. Will lot be regraded . . . . . . .Ni?. . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes
3. Name of Owner of premise:; Tc t1. . . . .C_ . , , , , Address l000&zto6 , �0N�. , Phone No. .7-3 4.-.�a 6 73 : .
.'-A;chitect . . . . . . . . / CurcrtoGue
. _tJd . �y� . . . !^!�-. . . . .Address . : . . . . . . . . : . . . : . . . . Phone No. . . . . . . . . . . . . . . .
of Contractor .tr SC. Address .PQ. . . .$px.t.�. . . .'Phone 140. i73A,:7,4:7.4-.
' PECONIG N`(ttQ7t
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
operty lines. Give street and )lock number or description according to deed, and show street names and indicate whether
terior or corner lot.
1
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ATE OF NEW YORI 6
S.S
�UNTY-(!P1 'z >��pw ( ?r�4�.� :r'�. .�. . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
ove named.
_. isthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . !. . . . . . . . . . .
(Contractor ent, corporate officer,etc.)
said owner or owners, and is duly authorize o perform or have performed the said work and to make and file this
plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the
irk will be performed in the manner set forth in the application filed therewith.
vorn to before me this
. . . . . . . . . . .�. . �. 7. . . .day of
Cou
rY y
eta Public
�,�ci (Signa ure of applicant)
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