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Home My WebLink About23686-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24842 Date JANUARY 10, 1997 THIS CERTIFIES that the building ADDITION Location of Property 26600 COUNTY ROAD #48 CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 84 Block 5 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 29, 1996 pursuant to which Building Permit No. 23686-Z dated SEPTEMBER 19, 1996 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 PHILIP BROWN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-405572 - DECEMBER 11, 1996 PLUMBERS CERTIFICATION DATED N/A In pector Rev. 1/81 FOBX NO. f 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) N° 23686 Z Date ................. .. ... ........................ 19.1.. Permission is hereby granted to: , ��...�.... .�:� ....��.� .... .............: :...... .....-... .... :............................... to ...........1 .............. .... ... i�7 '�:..../ .... ....x... ... ................ . - �. .......�� ...... ... ... .� f.... .��..��; ............... . ..:............... pp atp raises located at .. .... .. .. ............................. ...................... i ............................ .................................................................. ... ................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section ....01 y ............. Block .....�f....... Lot No. .....0 .......... pursuant to application dated ..... .:. �..... /1�....., 19../.. , and approved by the Building Inspector. Fee $........................ ......... ... ..... ...................... ding nspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 .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. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25e,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .1/. fir. . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing B1u�ildiing. . .( . . . . . . . . Location of Property.u.�0c�. . . . . . . . . . . . . . . . .�?t . . . . . . . . . . . . . . . . . . . . . • .CCS . . . . v�. .�J. . . . . House No.. Street Hamlet Onwer or Owners of Property. . �, , , , , , , , , , , , , , , , , , County Tax Map No 1000, Section. . . . . . . . . . .Block. . . . . . .. .. . . . . . .Lot.. .. .. .. .. . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .gFiled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.'—. . 6 6 . . .Date Of Permit.J.e . J .�/.�.� .:Applicant. . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. ... . . . . . Fee Submitted: $. . . . . . f.'fY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . V-5 APPLICANT Co -�- a4S'fa 10P5077 THE NEW YORK BOARD OF FI F— RE UNDERWRITERS BUREAU OF ELECTRICITY FAGE 1 Harp DECEf%ph, 85 JOHN STREET, NEW YORK, NY 1.1 ,1996 10038 THIS CERTIFIES THAT APP/ication No.on file 1284319ii/96 only theelectricdN 405572 equipment os described bet and introduced by the PHILIP y applicant named on the obo"aPPlicatbn number in the A. BROW, 26600 ROUTE 48, LILCO premises of in the following location; ❑ POLE. 447. CUTCHOGUE Basement ER 1-t Fl. El 2nd Fl. N. u�aaexantinedon DECEM$ER ®(;,1yg and found to be in compliance with the National E%ctionlectrical ode.4 Block 5 Lot FIXTURE OUTLETS ECIPTACLES SWITCHES FIXTURES INCANDESCENT.FLUORESCENT RANGES COOKING DECKS OVENS DISH WASHlRS EXHAUST FANS OTHER AMT. K.W. r'J AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS AMT. K.W. OIL P. GAS N. P FUTURE APPLIANCE REDERS SPECIAL REC'PT TIME CLOCKS H. AMT. NO. A.W G AMT BELL UNIT HEATERS MULTI-OUTLET AMP. AMT. AMPS. TRANS. AMT, H,p SYSTEMS DIMMERS NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF AMT. AMP. TYPE METER S E R EQUIP. 10 2W 10 3W 3,s 3W 3.0 IW NO.OF CC.COND. V 1 PER a A.W.G. — E OF CC.GOND. NO.OF HI-LEG A.W.G, OF HI-LEG NO.OF NEUTRALS A.W.G OTHER APPARATUS: OF NEUTRAL MICHAEL J. H[TRLFY A 9905 NASSAU PT. LIC. #4221 Rt�An CUTCHOGUE, NY, 11935 GENERAL MANAGER This certificate must not be altered in any manner; 11 return to the office of the Per Board if incorrect. Inspectors may be identified by their credentials. COPY FOR B�IILDING DEPAitTwvuT _..__ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ j INSU!7AWN [ ] FRAMING [ FIN L [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR �i�. 7fS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FQUNDATION 2ND [ ] INSULATION [Z' FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � �s✓r!l/�lZnr✓ ��t�/1L DATE INSPECTOR �,r� BUILDING oar. INSPECTION [ 1 FO ATION !ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ 7 FRAMING [ J FINAL. REMARKS: f c�G�GJ�u of i DATE CJ l �INSPECTOR ,�' M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: 1� DATEINSPECTOR 27- 765-1 BUILDING DEPT. INSPECTION [ ] FOUNDATION 18T [ ] ROUGH PLBG. [ ] FOUNDATION 2ND "NSUTION [ J FRAMING [ ] FINAL REMARKS: �✓a DATE �� -INSPECTOR jr� l • '* 1. 1 I I.I) [N`;1'Li(,r i Utt Kl;l'UR l' UA'I t: COMMENTS FOUNDATION (2ND) -_ ----- --------------- --- - -- -- --- ----------- ----------------- --- �% -- � HOUGH FRANK s it 4 i P1.11F111 I NG It 1 NS111.A'r I ON PF.R N. Y . I E* 51'A-1-f; IZNI�•RRY I II I� FI NAT, jl nun 1'I I O ---- --N : --- � I-� O • L� �x 966i6G I i � Z, 4, J ' �r /• L D lot lee, r . I 4 f I ,. :.,ZNIC R �RiE MEG YESY 4.. - Mw 4L, f •J is � s ;,�/v ��Q��,� i G '20r V`e '� L�4r.. J `• .� Vo yK • �c X ti ,. lb SLC. I . :wC,.: YJ i f I , r • Nrl, • WII.LMM J.JACOBS BUILDER 550 DEPOT LANE Cutchogue, New York 11935 734-5813 J661 6 ( arc �P'h44d. rY � r- P� 2'z 16 C 4 CDX-orOSB Y ��' A-,t►D NSA 1 �� sh, 10 �. c- -Y 6 cch 4C IF a cr h �� J�fiti a GR �rr� 6 (r r X M C N C . i 0'� �A'f✓� / � `o IA P ROVED AS NOTED DATE B.P.# �.. 3 FEE: f �� OCCUPANCY OR NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 FOLLOWING INSPECTIONS M FOR THE USE IS UNLAWFUL FOR POURED CONC EOE REQUIRED WITHOUT CERTIFICATE 2. ROUGH - FRAMING & PLUMBING OF OCCUPANCY 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY UNDERWRITERS CERTIFICATE CODES. NOT RESPONSIBLE FOR REQUIRED DESIGN OR CONSTRUCTION ERRORS , IVA4 !IP• feloWff � F -tA, " 1 , P, fP r J as BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OFSOUTHOLD CHECK . . . . . . • • • . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . TOWN HALL NOTIFY UOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 MAIL T0 : Examined . . . . . . !./. . . . . ., 19 Approved . . . . . . . . ., 1��Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ?� . . . . .. . . . . . . ./��. . . . . ( ing/Inspector) APPLICATION FOR BUILDING PERMIT Date . . . ., 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insVC4W.".M (Signature of applic , or a 6X_6�11 eif a corporation) �� . v °.T. . . . . . `. . . elk (Mailing address of applicant) /p3 f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /-D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . .�fit ).L.l. . . . . . . ��✓. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR' S Nr�T ,$ 6SUyJOyK COUNTY LICENSED Builders 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* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a� Al.�d�. . . . . . . . . . . . . . . . . . . . . . . f . . . . . . . . . . . . . . . . . . . . . . . . . Cir`� �!�.. . �'. . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . gl . . . . . . . . Block . . . . . . .�. . . . . . . . Lot . . . .�. . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . ... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: F,q.�. i �&-/r, n-e , a. Existing use and occupancy . .�. . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy '.7 .Et./ . . . . . /. . . .4. . °!'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . Ix. . . . . . Alteration . . . . . . . . . . .. Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . ... (Description) 4. Estimated Cost ��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . 3 3 . . . . . . . Rear . . 3 3. . . . . . . . . Depth . . . . . . . . . . . Height . . . . . ./* . . . . . . Number of Stories . . ./7'_26 . . . . . . . . . . . 0... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . ,S. . . . . . . . . . . . Rear . . 3� . . . . . . . . . . . Depth . . . . . �. . . . . . . . . . . . . . Height . . XB .... . . . . . . . . . . . . . . . Number of Stories . . . . . ./y. . . . . . . . . . . . . 8. Dimensions entire new construction: Front . . . . . . . . . . . . Rear . . . ( . . . . . . . . Depth . ,/ . Height . .. . . . . . . . . . . . Number of Stories . . . . . .,1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . ./L/!-t. . . . . . . . . . . Rear . . . ..I 4�. . . . . . . . . . . . . . Depth .�W. f...%. . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: � . 13. Will lot be regraded . . . . .Nd. . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes CNo 14. Name of Owner of premises . P!. X32.0. . . . . . . . . Address . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . / . . . . . . Address . . Phone No. Name of Contractor !��.l!! A-44gs. . . . . . . Address � °! .L . . . . . Phone No.73 ' 15. Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No X . . *If yes, Southold Town Trustees Permit may be required. i 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 according to deed, and show street names and indicate whether _nterior or corner lot. STATE OF NEW YORK, S.S . . —OUNTY OF . . . . . . . . . .. . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of i vidiVsigning contract) Above named. Ieis the . . . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) :)f 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 ,vork will be performed in the manner set forth in the application filed therewith. Sworn to before rpe this . . . . . . . . . . . . day of. , 19 �. Jotary Public, County r CLAIRE L.GLEW . . . . . . . . . . . . . . . . No�ry Public.State of New York u Nli 4879505 (Signature of applicant) Qualified in i es December 8 Commission Exp 19