HomeMy WebLinkAbout24215-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25282 Date SEPTEMBER 24, 1997
THIS CERTIFIES that the building ADDITION
Location of Property 8175 SKUNK LANE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 4 Lot 22.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 4, 1997 pursuant to which
Building Permit No. 24215-Z dated JUNE 24, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RONALD R. CASKRAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-432231 - SEPT. 22, 1997
PLUMBERS CERTIFICATION DATED N/A
Q� 7/V
Building Inspecto
Rev. 1/81
Form NO. 1
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)
O Date ! 198 1/
N. 24215 Z ...........lr? ..�.......
Permission is hereby granted.
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............................................................................. . . ...................................... .......
at premises located at ........
..... 1... 4�.......... ,L�{rrf/flf ... .1. ................ .ly. Tf...:......
County Tax Map No. 1000 Section . ....... Block .. ...... of No. .....
° .: .
pursuant to application doted ................... ... �................., 19.,`,�.. , and approved by the
Building Inspector.
Fee $....��..�........
o�.. .. ................
�. n9..4ector
Rev. 6/30/80
rurm Liu. o
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
i
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-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.
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.
0
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 - .25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . .?� l/c,�7 . . . . . . . . . . . . . . .
New Construction. . . . . . .... . . . Old Or Pre-existing Buil ingg. . . . . . . . . . . . . .
Location of Property. !/. .��5 .. . . . . .... . .. . . . . . . . . ` . . .. . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property.. . ::: .4.. .`r .. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. .' . . . ... .Block. . .� l. . . . . . . . . .Lot. . .e7F: :-�. . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. .Filed
7 Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit Nocl�,7l.�E. . . . . . . .Date Of Permit. .� . 2�1 J. . . .Applicant
. .� v�l`'•`� •
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . .:/ . . . . . . . . . . . . . . . .
Planning Board Approval. . . .. . . . . . . . . . . . . .. . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . .
Fee Submitted: $. . . T'r . . . . . . . . . . . . . . . . . . . . .
C.�.J�_;S 3�3 � . . . . . . . . . . . .APPLICANT . . . . . . . . . . . . . . . . . . . . . . .
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SURVEY FORNR
ROBERT N. MADDAMSx i'
LOTS 4 8 5 "NASSAU FARMS"
AT PECONIC DATE . 6ECS,t§i� rza f+='
TOWN OF SOUTHOLD SCALE I"� 4D
WEI
U'FFOLK COUNTYyAUNAOlkOki U6 ACItbS /+ x q O�i�o ru rnie GUABANY,'t0 T�!'"�;r Y�''.x�' S .«�+/"hi:-n£_ a+�en
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMA KS: ---�
DATE � �� q � INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 LATION
[ ] FRAMING [ FINAL
( ] FIREPLACE & CHIMNEY
REMARKS: _
zl
DATE 1 INSPECTO
i
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: �v� er.J CGCG
DATE 101,7107 INSPECTOR /t.�
M-1802
BUILDING DEPT.
INSPECTI®N
[ F NDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REM A��
DATE INSPECT
THE NEW YORK BOARD OF FIRE UNDERWRITERS ma 1
y0z"Z�' BUREAU OF ELECTRICITY ,
F." 88 JOHN STREET, NEW YORK, NY 10038
Bate SEPTEMER :2 P 199'7 Application No.on file 14518097/97 N 432231
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises Of
RONALD C&SKRAN1 8175 SKUNK LANE, CUTCHOGUE`, NY
in thefollowing location; 11 Basement La Ist Fl. ❑ 2nd Fl. Section Block Lot
waa examined on SEPTEMBER 16r 197 and found to be in compliance with the National Electrical Code,
T
OULETS ECEPTACLES SWITCHES FIXTUR S RANGES COOKING bFCKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT K W. AMT. K W. AMT
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RFC'►T TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
OIL M.r. GAS M.P AMT NO. A.W G AMT AMP AMT AMPS. TRANS. AMT. H P. SYSTEMS AMi. WAIT$
N FEET
SERVICE DISCONNECT 140.OF
METER S E R V I C E
AMI. AMP. TYPE EQUIP, I p TVI I 10 3W 3 A'3W 3,e AW NO OF CC COND. A.W G NO OF HbIEG A.W'G NO OF NEUTRALS A.W G.
PER b FCC.GOND OF HI LEG OF NEUTRAL
OTHER APPARATUS:
PADDL FANS-2
MOTORS:2-F it,P.
1
PAUL R. BURNS LTC.#3847rxw� � � LPO BOX 1061
SOUTHOLTJ, NY, 11971-0932 NERAL MANAGER
1
certificate
,If not be altered in any manner; return to the office of the Board if incorract. Inspectos may be identified by their credenNah.
COPY FOR BUILpIN6, DEPARTMENT. ,THIS COpY OF. CERTIFICATE,MUST"Not BE ALTERED IN 'ANY MANNER.
rip
? w HOARD OF HEALTHi�,�t{ �{ •` �5 �� '� FORM NO. 1 3 SETTS OF PLANS . . . . . . . . . . . . . . .
f� I TOWN OF SOUTIIOLD SURVEY . . . . . . . . .. . . . . . . . . . . . . . .
`-I 4 'JUN - 41997 �� �� BUILDING DFIPARTMI:NT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . ..... .`. . . _ . _ _ . _
!' SOUTHOLD, N.Y. 11971
BLDG. TEL: 765- 1802 NOTIFY: '76tr-?L/y
7t)WfV OF S� SOif�r of ' r�
CALL (�{N, , .kcl . . .
Exanined.....�
to)-r., 19.9/
/ MAIL TO: Pr�DOf?
�Y4.1/.&
Approved..... 19.17 PermNo.
... / j
Disapproved a/c .................................. ..........k4 ! N..........
......................................... ..... .. .
..
e
ct0r)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. 'Iris application must be cargrleLely frilled in by typewriter or in ink and suhnitted to the Ikuilding Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. PIoL plan showing location of lot and of buildings on preud ses, relationship to adjoining pretnises or public
streets or areas, and giving a detailed description of layout of: property must be drawn on the diagram which is part of
alis application.
c. ' Slue work covered Iry this app]ieatiou my not be camrnced before ismmuce of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on 13re premises available for inspection throughout the work.
C. kNa building shall be occupied or used in whole or in part for any purpose whatever until a Certificate or
Occupancy shall have been granted by the Building Inspector.
APPLICA'I'I(IN IS ID-WHY MADE to the Building DelxurUmnt for rhe issuance of: a Building Pennit purmrant to the
Building Zone Ordinance of. the Tomr of Southold, ,euffolk County, New York, and other applicable laws, Ordinances or
Regulations, for Lbe construction of buildings, additions or alterations, or for rommal or demolition, as herein
described. 'The applicant agrees to crngrly with all applicable laws, ordiunnces, Wilding code, housing code, and
rep,ulatiors, aol to admit authorized inspectors on premises and in Wilding for uece sary in.pections.
Signature oC app1icer or n;rrr xrr11ion)
P C,�. e- a4�1.........
( rl ing nldress of applicant)
State wire lhexr adgrlicnnC is owner, lessee, ngenl_, arc•hilecr., engineer, general (,outrnctor, electrician, plmixr or Imilder.
...... .7cL.LAS-.•G.. ..../................................../,..........(/........•..j................................................
Imre of: varier of premises Y.1 o.4.... ..J.I•1.Qt.1 Qpt�` ...1.,11.t,C. ..1........................................
(as our the lax roll or latest deed)
if applicant is a corporation, sip
�nature of drily authorized officer_
.........................................................
(Nano and title of corporateofficer)
T
I(Builders License No. .......
Pludmrs License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
I. Icucalioi of land on which proposed work will be doux...............................................•...............
...................�- kN ..................... ...............
House Nuaber . St//reeC-Le/ n Ikarrlet
County Tax Kip No. 1000 Section J.0 7......... Block ... A�.......... Int .-3 ......
Su]xlivisicn ...................................... Filcvl Map No. ............,.. Lot ...............
(Meme)
2. State existing use and occuparxy of. premisesggand intended use aril occuparxy of proposed construction,
n. Rxi sl.i ng u:,e and occulnuxy ...
Q.......................................................
b. Inl emled Ame aux] ocagnoy ...reLst.G.fe- C-t......................... .............,......._..
"J,
I. Nltwa ol' cxxk (dtxdc lilic•11 Ijlgll ie:able): Mw iklilding ... .. ... . . ftklit inn .. ......'. f
At lull . .. ...
MIwil' Ittalrrval Dowlit.ion ......... ... Other Wnalc ' .. .... ....
p� (Deacripl-ion)
4. Hsi illiteil (A)sI: .���dzf ,i........... fee ..... .... ............ ..................... ....
(it) Ln lurid on filing this application)
:i, 1f thiollinl;, lxuixtr of Aielliry; units . ....,.�... . tknlxr of; chacllinl; Imus ext each floor ... .. ... ..... . . .
Ifgarage, Ixnller of earn .......... ......... .......... .... .. .. .
G. If Ixtaitlesa, cxllanerclal or mixed exavqunx:y, Slx:cily ualure alul exlt:nC of: each t.ylle of use......�./.. ... ...... .. ..
1. Dinx:nsiols of existing slnunhuren, if any:, Irrcml ` - �•.^l. ... Rear 4.,a.1, ,.... DLpI-II !6. ...... .
Ik >lh""'....23. •......... . ... Mnimr of Stories . �i. . .... ......... •�
1 ns of San ...'„ with alteralit ill or exklilions: hronC":,JLr?. hear ^,.t:.t......
Dinieuatols of stm• al`s lure
... wi,411 `"'.1'.d.�........... Uxifwr of Sl'nrien ..�:...........
/ 90 /
Iki . Ill // 9tnu:ficxl: plots- . ...l,Y........ ititar . .IQ,. ........ Depth �?.......... .
(,1 // .............. ... Mulx:r of Sl'orien .. .. ......
13. Uinr�nalemn of enure rxaa ccxl� c,
9. Size of lot.: Frrxll: 4, ...Id ..(lee, Rear . .. Depth .... ....
Sf S
I(1. Ik11'e of Hlrcham: ......... II ......... Ntnx: of l�orllr.r (/alxtr d„D.4Pr+4..'�.. . Ma. d o(?w
...............
It. 7Bxle or use dial.ricC in l.dlicll prcmnises etre niuultett „SG•G 5���"U•G.r-]-_. .•. ... ...... .... .... . ... ..
12. Ikx:s pt'ollosed clxlSCrcx:Liorl vjolare Bary ztxllag lira, ordinance or regulal.iun: tp............ .......
11. will of lie repr 1[Ualaen •.••�y.�..•.. Will excess fill Ix: 170110vrxl (roll preniseat YES tJD"
I'). Will lot. lie re�rark�d v-�-(?.
wr
I (�•JJ11 I 1. Address��' `•1 •. 1'1101x: 140m::40,
Nate, of Arcllilect: �'``��..V.l'.'[`7'
4J . tBlreas (�l - l4 ' ' TI : Ny?66� .....
. .bJ�•^ .Nnxo(' lkxCractor !/ .yWreCvre. I11one MI y
�. . . . .... ..
h. la This prolxerly within 3(M) (eet of a Cidal tenrlaltl? i YIL1 ..t/. .... IQ) ........ ..
Air Yles, S(MfI11D11) •Itxm 'IldwI1KSS PI-Qui-I' my 1113 RI?(XIllam.
ISI PLOT DIAGRAM
IBx:ale clearly next dinhinc,fly all IxtildioLfl, Idlether existing or propostxl, anti ilxlieale all rel.--hack diux:nsions
flcal p oilelty lines. Give screct }11x11)Ifx:k Itrllx:r or deacrihlion accoldinp co deed, and filvm street Mann's ilial Ilxlicate
Idx:iher interior or coiner lot..
SI'Alli IMI Ms
9
. ' ..',V.....1.. .. �5 .. . ... ........ .Ix:iuf; duly stixml, delx)ses aol snyl: that he in the applicant
� e
(Nott: of ilxlivictual sigoing collIxact.)
alxrve lurlrsl,
Ik: is the 'ilgen................ .................. .......... ............ ............ .......
((:outrscU , .Igen(:, conlxsa(e_ officer, etc.)
ul` said canner or exnx:re, a1xl is duly aulporiu)tl to Ix)rfona or have Ix:rPunlx:d the said wr)rk aixl to uudce 10x1 file thin
appl icatiuu; (hal. all sLatunt:nl.n c)ncailwd in Ihis application amm
re Io to IIIe Ixt tit. his klxxaledl;e allel belief; aixl
that. the work will be lierfonlled in, the tmuxxr set Borth in the application filed Lhelewilh.
tkaca❑ to Ix:f nn this ...�ff
. ..... .... /``\.day o 1�J..Ii. . 19...
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PROVIDE OPENINGS FOR n. Inw14MrldubaanWiN4no rnlnwMalneoa.l
EMERGENCY ESCAPE AS a NI"" °r"' a"'il°+ '"'"u' yn" a. aeNhwydMrNu }IwI�MI9wtrmw� YFpYrrwhM�i'+Wynr
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OCCUPANCY OR' a. .rill�ao^Dw^ Iw.ra+a .�uw "� Oo,�pa�iaw4Sra ,wwa
USE IS UNLAWFUL '
in tlMi4'tlr�rlklp�. ' T,' ryyp #iFMNPgI,dto41FSIRIh a1h,4I,IMI�4R41,yiita .
WITHOUT CERTIFICATE T. **I mm.Np Ilbiwo +TS4d4,NNrrp4
OF OCCUPANCY COMM"
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9. INSUUaION _
4 FINAL - CONSTRUCTION MUST -
SE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET "'•
_
TNF REOUIREMENTS OF THE N.Y. " " •
aw
$IgIE CONSTRUCTION & ENERGY - "
CnPFS NOT RESPONSIRLE FOR `Y[
f RL
JN �O NSTRUCTION ER80°'S 'j'! - yl{xa�-p' -ems
,^ REW IS ED
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