HomeMy WebLinkAbout23130-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-24739 Date NOVEMBER 15, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Property 1320 NEW SUFFOLK RD. CUTCEOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 6 Lot 11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 24, 1995 pursuant to which
Building Permit No. 23130-Z dated NOVEMBER 24, 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 ACCESSORY INGROUND SWIF~HING POOL WITH FENCE ENCLOSURE
AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
WI~IAM LUKERT
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTION CERT. %11451 MAY 26, 1996
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
- ~~lding Inspector
FOBM
ToWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HAU.
$OUTHOLD, N.Y.
N£
BUILDING PERMIT
COMPLETION OF THE WORK ^UTHO~IZ~OI
~ate...~..~Z ~ .......................................... ,~ ........... ~
23~30 Z
'~'~"'"~"~'2.'~ ........... ~':"~ ......... ::". ........ :
.......... ~,~.x...~~..~.~....-~*~ ....... ~....~
...... .......... .....................................................
Count/Tax Map No. 1000 Seotlor~ ...., ./...~...,',~,, ........ Block ...... ~. ............... Lot No ......... ~ ...............
pursuant to application dated..../.:..~..././.¢~. ..................................... 19..~ .....
Building Inspector.
Fee $.., ./...~..~..~.
and approved by the
Building inspector
Rev. 6~30~80
Form No, 6
TOWN OF SOUTHOLD
BUILDING DE?ARTMENT
TOWN HALL
765-1502
/EPPLICAT[ON FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or haw use:
1. F~nal survey o~ property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
Final Approval from ~Iaslth Dept. of water supply and sewerage-disposal(S=9 form).
3. Approval o~ electrical installation from Board of Fire Underwriters.
4. Sworn statement f~om plumber oer~ifying that thm solder ussd in ayatem contains
less :han 2/10 of 1% lead.
5, Co~er¢ial buildiqg, lmdustrial building, multiple residences and similar buildings
and installatione, a certificate of Code Comp~ianne f~om a~chitect or emgineer
responsible for the buildin~.
6. Submit ?lasnh~g Board Approval of complsted site plan requirements.
For ex,Sting buildings (prior to April 9, [957) non-conforming uses~ or buildings and
'!pre-existing" land usam:
1. Accurate survey of property showing all propert~ linem, streets, building and
unasnal natural or ~epogrephic features.
2. A prope~l~ completed application and a conse~t to inspect signed by the applicant,
If s Certificate of Occupancy is denied, the Building Inspector shall state the
ransoms therefor in writing to the applicant.
Certificate of 0c~npancy - New dwelling $25,00, Additions to dwelling $25,00,
Alterations ~o dwellin~ $25,00~ Swimming pool $25.00, Accessory building $25.00~
Additions ~o accessory bui~.ding $25.00, Businesses $50.00.
Certificate of Occupancy on Pre-existin~ Buildin~ ~ $~00,00
Copy of Certificate of Occupancy - ~ .25¢.
Updated Certificate of Occupancy - $50.00
Temporary C~rtiflcate of Oc¢npancy - Residen~ial $15.00, Commeroial $15.00 '
Constructlon...,¥/.,,.... Old Or Pre-existing Building .................
~ou~e No. 8treee Hamlet
ooo, ..... kO. .... .... 0 .......... ....... 11 .............
;ubdivision .................................... Filed Map ............ Lot ......................
[eslth Dept, Approval ........................, , Undelwrltsri Appeoval .........................
'lanning Board Approval ................ ........
[etluest for: Temporary Certificate .... . ...... Final Certicate ...........
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ] ~.ATION
[ ~'I=INAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS= ~ /,.~/~,~-~' ~'~
DATE
INSPECTO~~_ ,~~_
DATE: _:1126/96
ELECTRICAL INSPECTION SERViCE
375 DUNTONAVENUE
EAST PATCHOGUE, NEW YORK i 1772
(.516) 286-6642
11451
APPLICATION No. ON FILE
nU, aOE: CUTCttOGUE
SOUTIIOLD
ADDRESS: Ni~W SIUFFOLK RDA 1)
ISSUED TO BILL LUCKERT
INTRODUCED BI': HANK'S ELECTRIC INC. ,, ,~ LIC No: ~75~E
was examined on 3-26-96 and found to be m compliance with the NaaonaI Electrwal Code
LOCATION: Base,. XX l~t 2nd 3rd Atlio
Hot Tub Pool 32f
Der. Garage ........
SWITCHES ....... RECEPTACLES ....... FFXTUREk'"' HEA'TEPJ " ' FmVS ....... G,t~L ~IR. COND.
2 I 1 I
,msswAsss~ ..... m~n ..... C~OTNES'WA'SS." o~. rds~. , ~as' ,, 0~ s~b~ ~sv~ron ....
~ACE OIL GAS CIR, MOTO~ B~ T~ SER~CE DISCO~ECT
BUILDING pERMIT No.
BLUE ORIGINAL YELLOW COPY
PINK coPY oFFICE
HUGO S. SURDI
pp~SiDF~'
FIELD INqPECTION REPORT DATE COMMENTS
FOUNDATION ( l ST ) I~ r~
FOUNDATION ( 2ND ) ,_ ~ ~ ~ ~
ROUG~ FRAI~E &
PLUM~ING
INSULATION PER N. Y.
STATE ENERGY
CODE
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE-EXISTING
CERTIFICATE OF OCCUPANCY
No Z-17808 Date MARCH 1, 1989
THIS CERTIFIES that the buildingsONE FAMILY DWELLING & ACCESSORY
County Tax Map No.
Subdivision
Location of Property 1320 NEW SUFFOLK ROAD
House No. Street
1000 Section 109 Block 6 Lot 11
Filed Map No. Lot Nor
conforms substantially to the requirements for a private one-family
dwelling built prior to:
APRIL 9~ 1957
CUTCHOGUEr N.Y.
Hamlet
pursuant to which
CERT.OF OCCUPANCY #Z-17808 dated MARCH 1r 1989
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 ACCESSORY GARAGE
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ALFRED & BERTHA M. CAIN
~/A
Rev. 1/81
Building Inspector
L,
II
A
OCT. I m5
BLDG, DE~'L
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
BOARD OF
3 SETS
SURVEY
CHECK
SEPTIC
Ex am in e~l~]7..~.. R/~. ~ .... 19...
Approved.//./.c~..~. ....... 197~.~ .%e rm it No~.J/c~..d?. ~
Disapproved a/c .....................................
~ , (Bu~ing lh~pector)
APPLICATION FOR BUILDING PERMIT
NOTIFY
CALL
MAIL TO:
HEALTH ............
OF PLANS ............
FORM ................
"v ~';'t~, ..... Jb~TRUCTIONS
a. T~s apphcatlon must be comple,tel~'it~a ~J~,~dter or in ink and submitted to thc Buildin~ Inspector, with 3
plans, accurate plot plan to scale. Fee acco~mg ~ schedule.
Plot pl~ showing location of lot and of buildings on premises, relationship to adjoining premises or pubUc streets
or areas, and giv~g a deified description of l~yout of properW must be drawn on the diagram which is pa~ of t~s appQ-
cation.
c. The work covered by t~s application may not be commenced before issuance of Bufld~g Pemit.
d. Upon approval of this application, the Building Inspector will issued a Bulldog Pe~it to the app~c~t. Such
shaE be kept on the premises available for ~sp~[~t~ou~out the work.
e. No bulldog shall be occupied or used,,i.~ in part for any purpose whatever until a Ceaificate of Occup~cy
shall have been granted by the Bulldog Inspe¢/6~3F
APPLICATION IS HEREBY MAD~ to the 9mlam~¢~ep~ment for the issuance of a B~ldin~ Pe~it pursuant to the
Buildin8 Zone Ordnance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or
~e~ulations, for the construction of buQd~s, a~ditions or alterations, or for ~emoval or demolition, as here~ described.
The applicant a~rees to comply with all applicable laws, ordinances, bufld~ code, housin~ code, and regulations, and to
admit authored ~specto~ on premises and ~ bulldog rot necassa~ inspections.
g¢t)~i$lll.~LkB}~'~ll~ ( ',nat ~ ot applicant, or name, if a corporanon) '
... sat. .... .......
~. - · (Mailing address ofap~lic~t) ~ (QQ ~ ,
State whether applicant is owner, lessee, agent, ~chitect, en~neer, general contractor, electrician, plumber or builder.
(as on the tax roll or latest deed)
If appl~c¥is a J:orpor~tion//signature of duly authorized officer.
'" ~i' 'ir3 .........
Builder's~icense No .... .~.. J.4. [..c~..~-~ ...... '"
Plumber's License No .........................
Electrician's License No..qff-.. (1~'.~.. ~ .......
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 ..... 1.0.0~ ....... Block ..... ~ .......... Lot. l.( ................
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and iht?haled use au,d occupancy of proposed construction:
a. Existing use and occupancy..~).~&.-,-~. ~ i.~..[~.'.~/[ t. [ .V'~.. c~'~./9 0~ ..(_..~./
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