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Home My WebLink About22798-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24336 Date MAY 6, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 1755 EVERGREEN DRIVE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 102 Block 1 Lot 4.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1995 pursuant to which Building Permit No. 22798-Z dated JUNE. 5, 1995 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE,DECK & OPEN PORTICO AS APPLIED FOR. The certificate is issued to GEORGE & EDITH HOFFMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0045-APRIL 2, 1996 UNDERWRITERS CERTIFICATE NO. N-383564 - APRIL 19, 1996 PLUMBERS CERTIFICATION DATED APRIL 4, 1996-LISO PLUMBING & HEATING it ing Inspector Rev. 1/81 FORM NO.3 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) Date 191St. N2 22798 Z Permission Is hereby granted to: ,~4 4,,/4 /d...'........ .T?......... , . % ...................~-fin e... ~ rV......... at premises located at... ~~?J~ , r 4...... ...........Kl~ County Tax Map No. 1000 Section ........./P......... Block Lot No. " pursuant to application dated 19.. and approved by the Building Inspector. Fee $.0..9/.e.4 Building Inspector Rev. 6/30/80 Form No. 6 Q r. ~'y + TOWN OF DSOUTHOLD EPARTMENT Q ' TOWN NIAY 765-1802 r %OG-O 'OLD -3 Tp 0 TION 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 17 lead. . 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer y_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 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, Commercial $15.00 / Date f ev New Construction....(..... . Old Or Pre-existing Building Location of Property. /'17S ~yaLa~~N va i" c me v . . r....... House No. Street Hamlet Onwer or Owners of Property.. S>7~1N ~Ap f hPAn/ 4 . County Tax Map No 1000, Section.... °......Block Lot. : l° Subdivision.! N:~. u:oyDS- Pvk Gv~ ci.}o G~~ ./....Filed Map.. d.7l2.T.~..Lot. <G..../.L Permit No.Q~°...r...8~:...Date Of Permit. ?~r/~ .....Applicant.(!. .47A~ ~ Health Dept. Approval.. H/"Z / 171A ..............Underwriters Approval `?/~fl.flA............. Planning Board Approval Request for: Temporary Certificate........... Final Certicate. . e e Submitted: a.:° d 'Jr a o APPLICANT r I i i - ; THE NEW YORK BOARD OF FIRE UNDERWRITERS 35x21 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 - _~o RT- '9 •99C ;.v1552895i 95 _d 333564 1 Date Application No. on file THIS CERTIFIES THAT - i only the electrical equipment as described below and introduced by the applicant named on the above application number in the ptemia of - I t GEORGE HOFEM.A?I, EVERGREEN CRLVE, "THE WOODS CUTCHOGGE, N.'. in thefoltowing location; yLl Basement [XI Ist Fl. ? 2nd Fl. GAR/ ATTIC POUT Section Block Lot was examined on APRI' . 16,1996 and found to be in compliance with the National Electrical Code. NXTURE SWITCHES FIXTURES RANGES COOKINGDECKS OVENS DISH WASHERS EXHAUST FANS S INCANDESCENT PIIKMESCENT OTHER MAT. K W. AMT. K.W. ANT. K.W. AMi- K.W. AMT. H.P OUTLET ECEPTAGtES i 34 62 48 31 3 1 71; 1 1.2 3 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALRECPT TIMECLOCKS SELL UNIT HEATERS M LTI-OU$ T DIMMERS SYSTEM AMT. K. W. OIL H. P. GAS H. R AMT. NO. A. W. G. PMT. "P. ANT. AMPS. TRANS. "T. H. P. NO. OF FEET AMT. WATTS 3 F 2 - i 5 6aP I SERVICE DISCONNECT NO.OF S E R V I C E ' METER 1,4 ]W / R ]W ] .R 3W 3 A tW OF CC COND. A W. G. NO OF HIAEG i OP NAL AMT. AMP. MI [QUIP. NO.OF NEUTRALS NEU PER SI' OF CC. COND OF MIiEG 1 200 CB _ X , 4/0 4i0 OTHER APPARATUS: WHIRLPOOL BATH-1 < WELT, P1311L ~ ~ (1 MOTORS:2-F H.P. G.F.C.I:-8 SMOKE DETECTOR:-5 ANY - / 1996 M THREE "C" ELECTRIC ___.'-5327-E RT. BOX 45M GENERAL MANAGER SOUND AV'E'NUE RIVERf-EAD, NF, Per This certificate most not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. INSP$CTORS n„ gtfFllt ~ ~ TM G~1 SCOTT L. HARRIS, Supervisor o Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector Southold, New York 11971 Gary Fish Building Inspector ~Vd Fax (516) 765-1823 Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: Building Permit No. a-;1 `7 r9 g.- owner: Mt7--T4 ",VT-?or.r (please print) Plumber: 1 5o 7i?_t• F- ( L"e. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Plumbers S' na re Sworn to before me this day of /fW/L 19 Notary Public, County Notary Public =AY DOLOR S L. LISO Notary Public, State of New York Suffolk County • No. 46410 Commission Explreo Ad, 31, I BLDG.DEPT TOWN OF SOOT i-D O~~g11FF0~,~C0 o~ Gym N Z. Town Hall, 53095 Main Road "p • Fax (516) 765-1823 P. 0. Box 91971 Telephone (516) 765-1802 Southold, New York 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 30, 1996 Liao Construction Corp. Herricks Lane P.O. Box 439 Jamesport, NY 11947 Re: George Hoffman - SCTM#1000-102-1-4.6 Prem: 1755 Evergreen Drive, Cutchogue To Whom This may concern: We are unable to complete your certificate of Occupancy bec se of the following reasons: xx An application for certificate of Occupancy is not on file. (Enclosed) / xx No Underwriters Certificate on file. xx The check is not on file. $25.00 xx No Health Department Approval on file. No final inspection has been made. / xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22798-2 Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIELD INSPECTION REPORT DATE -COMMENTS I~ I y FOUNDATION O ST) Iltr--ii ~ ~J u o a FOUNDATION (2ND) I~--° Illf- II a w ~ ROUGH FRAME 5 II II 111 ~ PLUMBING 77,11 C4 INSULATION PER N. Y. STATE ENERGY II jj CODE u II - 3 II II II I II ; w ~~--111 II jj 1 FINAL IN---° ADDITIONAL COMMENTS: Q m ~ ro \ H x a , y - ~ n ro H 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING j~/]/FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE _`T/ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ vfINSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ' l INSPECTOR 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: tf7 DATE [ INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. [ ~NDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 9:::- T DATE / d INSPECTOp ` r ~9OARD OF HEAL TH FORM NO. 1 /S3 SETS OF PLANS URVEY TOWN OFSOUTHOLD / t [ > BUILDING DEPARTMENT J SCHECK EPTIC • FORM TOWN HALL r~ SOUTHOLD, N.Y. 11971 ~d TEL.: 765-1802 MOT S FY 9('~ CALL Examined 19.!J MAIL T0: . . Approved 19/4Permit No.~ Z 7`~. 94 - Disapproved a/c _ . it I g nspector) APPLICATION FOR BUILDING PERMIT Date 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 in A) 0 S tj I b t7 : 1 W C C3 Y, (Signature of appli ant, or name, if a corporation) to)--o OkEo QJ. /f~1 k...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~:/l7L (ti ./.1. Name of owner of premises ...."f (as on the tax roll or latest deed) If applicant is rporatio/ny/signatur of duly authori officer. (Name and title of corporate officer) Builders License No. 7</ ri Pl umber's License No. . Electrician's License No . U TOOther Trade's License No . 1. Location of land on which proposed work will be done. . . . ~ House Number Strg Har.ile County Tax Map No. 1000 Section 1. Block ( .....r........ Lot - . Subdivision . 4N D ..U//0q~ 3..i? Filed Map No. )l.?....... Lot L.......... (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 Cat v %F V t 3. Nature of work (check which licable): New Building Addition Alteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost Fee . 5. If dwelling, (to be paid on filing this application) g, number of dwelling units Number of dwelling units on each floor If garage, number of cars .....2 6. If occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front Rear Depth gsht mess commercial or Nu berofStories........ Hei Dimensions of same structure wit h alterations or additions: Front Rear Depth : . Height n Number of Stories . 9. Sze of lotS Fonttire new construction: Front ....S•~ Rear ...5 . Depth . Height / ) Nu.bier of Stories ~ . . . Rear l1 e~ s/s ci l } 9J 10. Date of Purchase ....I.................. Name of Former Owner ...#XAN .t(ti4!,n 11. Zone or use district in which premises are situated 12. Does roposed construction violate any zoning law, ordinance or regulation: ..4).b . 13. Will lots be regraded S ..'i • . • , Wil}-yxcess fi 1 be removed frc?r premises: Yes o 14. Name of Name of OOwne Architect remise .n e t Ed! rt! ~."~Nt" 'Address'Nn"! 1 ! e° 2a (ogoo r.. 'P ione Nam No . 4 Address ~ f'' !"J! Phone N0)Y. 4..... . Name of Contractor PMW 4) . , , , , Address k'.?^ Phone No. 44 . 15. Is this property within 00 feet of a tidal wetland? Yes,,,.,,,. No.i *If yes, Southold Town Trustees Permit may be required. 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 interior or corner lot. APPROVED AS NOTED DATE: _.,_._.._.r_ B-P ft _ F E BY: N(m'IFY BUILDING DEPARTMENT AT 7(z-1802, 9 AM TO 4 PM Foil THE FOLLOWING INSPECTIONS: - TVVtO REQUIRED 1, FOUNDATION FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS t;; y _ i, STATE OF NEW YORK, V#S f b COUNTY OF.. . akZ -I}~fA; • • • • . • • • • • • • ~ ` • • • • • • • • • ` being duly sworn, deposes and says that he is the applicant (Name of individual~l act) above named. r--r--- He is the ...............4 4?... (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 stet forth in the application filed therewith. Sworn to before me this day k 19 Notary Public, .61(e ,4 . County JOYCE M. WILKINS Natant Public, State of New York • No. 4952248, Suffolk Countit Term Expires June 12,1SS (Signature of applicant) K y U ..,4 yo ! O ut ~m rn~ = - m cif C'j cl U3 rm n r) to 19 rn 2V: S TO OUt2VR ANN. ~f l ~50 L) ~ r i o Z SO el) ( ~I < D •(y V 1 tit LR 5.37°4?' 3" E: 294.17 f4 ~ . il 1Q 3 R: B~P\A/IELL (WICANT) A") p~a n~ m z (~'m 1( ,•1 ~ k ~ l ~ ` rn z < N.E a. IC A o Z to tiroZ M ~r a q 0 0 { ®CD m Z: %P 0 M i rig m 0 > 3: C) n MA . ~ n in -i M P Z $O '01n-iZ A A m C D Ni r ~ c~m~~ xtm-4<p m om~ SEE FILED N1R D x O O r- r m D £ O r v O ~C a n p O O 00 D o€r~ ~~~nfitirA , m,.,., F+ n z c. n A b-4 t3 n z m a ~ T-17 b ~n to x O z Q- + 'z f m x r` _ x z D " b D S y o z p` , Y ao O ~ aTF, ptE m "0 n ,f r a u' _ m l or.C) m z D e 1 '0 r o F_ r~ A n -x D f}! 4 O D u0 g' x O 0 ip m O Z D &I z m -f -4 rrl r x "n l p~ O O . fir.. ~Ir n i~r7i b' 00 Ymi m r > r N J F v to > 03 K z~~p O. 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Q O x t,- 0 O LL yr w Y' W LL VL ow: 41 W p, 3 w r N a: ' O } A f y~' - P l CD fit HIS 910 41 v, _ ti u -i ti. 1 - f~ FT7T ~ A I '~`t r eao« 7 ~ _ I C~tAOt u i i i V _ YI L PLUMBER CI PLUMBER CERTIFICATION If Copper tubing IS Used ON LEAD COA iN LEAD CONTENT BEFORE for water distributing CERTIFICATE C RTIFICATE OF OCCUPANCY 4 / system; Diving shall be SOLDER US p~ 1 1 f i d` : Y of typos K or L on SUPPLY SYS SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/14 "XCEED 2/10 OF i%LEAD. OCCUPANCY OR OCCUPAN OCCUPANCY OR USE IS UNLAWFUL USE IS UNI USE IS UNLAWFUL WITHOUT CERTIFICATE WITHOUT CEI IITHOUT CERTIFICATE OF OCCUPANCY OF OCCUPANCY OFOCCUI a.ppRrhm as IInTFn .._.~..ri , DAVE: /0 5 S B.R M X12 for wow dF fof w@W dWWbu My ~ a BY, 3iIMM1Y. Noh doll M Y,;• NOTIFY BUILDING DEPA E IT AT d"Pw & d"pwlzLqdL 785-9802 9 AM TO A PM FOR THE - FOLLOWING INSPECTIONS: b. FOUNDATION - TWO REQUIRED PFFH A 11 FOR POURED CONCRETE _I;f+ t_ _ 2. ROUGH - FRAMING & PLUMBING 3. INSULATION' 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. DD NOT PROCEED WITH WITH ALL CONSTRUCTION SHALL MEET _ _ _ - - --.w--~_~ • FRAMING UNTIL SURVEY THE REQUIREMENT'S OF THE N.Y. URVE~YF STATE CONSTRUCTION ENERGY OF FOUNDATION LOCATION )CATION - - - - CODES. NOT RESPONSIBLE FOR HAS BEEN APPROVED. DESIGN OR CONSTRUCTION ERRORS DYED. r . _ .~T 4LEVATE NEATINC pAOFAiIpe. AOFGI i~pe_ V APPLIANCES Ill- AS NEW MD)~ A. REQUIRED NY PANT. 717.3 (0) (4) OF +e N.V. STATE BUILDING CODE. t J a 23 23 SF~K ~ n l3 rl i ` u CJ LOW I~ I a 77- _ I 1 a% - 1 T o~ -to 71, -141 D~. I,' f 1~" I-to -n&, %L, \Q Ilk - - i Y, !wn R y -Aw ''rr ~ n 1 yyF 1 LJ ~&lh -L4 _ ~ } J i i i M{ _71' I U o E„, 3y, &cc~.~. in 61 ~'~r,,. ~ I ~ ~ i QY i - n~ i 1 , y ty ELEVA~ATE HEATING ~I ICES I ii BY 18" AS ` APPEIAII i : v REQUIRED B PART. Y i a j ) (4) Of 1 717.3(a - - T ' t ; t ? ~I 6 N.Y. STATE BUILDING CODE. ri s ! , ~ ~i t ! _ _ ~u.yiw+M+Yrwa.au~Wnwaer. 4^ ~~..w aw'+w' rvww. ~u.M~mwvNu.4..•rv _ lx~nY~S ~ ly~ui7 I~ V(, t W D t~ ~ _.:If i i !I i 4 I `1F - i ; 1 ~n - , jk~. } s U i ~ ` ~ ~ ~ - Co 3 ~ I _ JI I ~ I i . _ _ i ypOEES i I 'rye. a ?7 q6 -7 y g5 -21 '1~~4 VNm41 - Fi I u PROEwrE%Cr ES APE AS 1 1k tp u , c~/n`~ s cv RQp R to 51 OV5. 714 Of BU1lD MG C DE. --rt - _ ft I - - 1. I 1 ;ti a '1411: J~ 7 1 I y 3100:, C, Aj . Af p~ ~iltf~youb ~D I a = i t 1~hi~k.w. ' ar e I ~i i. ¢i_~~~I_~ a i~ 1 ? 17n+k //I 9 CC I 1 1 . i #i LA ~1nE-lubtl t~oua ~ ~ G~~~kF~i~oti~ j __~-s ~ ~,6'1L ny' 11t+ r~~ _ .d } ~j! k.~Nf[64. 6. i<o~ e ' ' I ~f ~~i ~a ~ lua4e 1C1~Y1 ~L„ FF~• 3 i ' Y tic t~ll~*UU F1 Ij~o°' ~w AL RATED SEPARAZIDN OE c c l f Lq~ u o y COOL r 111 PAiQ.117 IID~ C~a ~,i v' Dn p F u, 1 t r_~ ~ _ 1t I 1 I rv ) s 3' C-4 ' f n , ~z lw) H - OP~~voa.. 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