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Home My WebLink About22405-z Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23427 Date DECEMBER 29, 1994 THIS CERTIFIES that the building ACCESSORY 750 SOUTHERN CROSS ROAD & Location of Property 840 PINEWOOD ROAD CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 5 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 5, 1994 pursuant to which Building Permit No. 22405-Z dated OCTOBER 25, 1994 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 AN ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to CLAIRE CHAMBRUN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N336225 DECEMBER 13, 1994 PLUMBERS CERTIFICATION DATED N/A Bui ding 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) 9 Date 19.F . N® 22405 Z I Permission is hereby granted to, i .t . lzcr........... :fie t to...... ,c. •L tiG~G ~.........e.6ede.S'S.'G7eey....C ...~~r ~2....- F k .........................~....YV. f at premises located at r~ V Q ................................1 I I............... Vic- ?..........n!.~.`~..-..................... County Tax Map No. 1000 Section ....../10....... Block Lot No. . pursuant to applicatlon dated ...............t 'Se 19..9T....., and approved by the { Building Inspector. j ~ -21 ...'s...... i Fee $ Building I ector f Rev. 6/30/80 Form No. 6 S~2~ooeQ r bn. TOWN OF SOUTHOLD ~at ~1C~~cP BUILDING DEPARTMENT n~C 14 I~ 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 dwellin Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building ng $25 $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 ~~$115.00, Commercial $15.00 Date ...tAt.., l99 Jew Construction... Old Or Pre-existing Building ,ocation of Property... g4c . ~.J' 4 fQ?07.." .............GK . . 0. House No. Street Hamle inwer or Owners of Property. l~~frl:.'~...~(Ql'/tE~' Qtf*.............................. ounty Tax Map No 1000, Section Block. Lot.?Z:S ubdivision...V:~^E.. U .................Filed Map........... Lot ermit No. Z.2-.44 d.5z..... Date Of Permit. ~4 .as: Y.. Applicant.4.!xi~ ealth Dept. Approval..../)/,/ ................Underwriters Approval...... Lanning Board Approval.... 1114 quest for: Temporary Certificate.........., Final Certicate..?,,,..... ae Submitted: , a $y vv tiricT I No "is i:OHMENT° ' awo 7DATIOYr MATT Ot7 ' f2nd1 ti o ~H FRAME ~ - LATI011 PER N. Y. II n y STATE ENERGY II CODE I ~l = rx2 F ADDITIONAL COMMENTS: Ul m • x ' H •-7 O V O m ~V Y M-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~a DATE-1/Ac INSPECTOR, t-f - - 2a `10 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 10850'77 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 x Date DECEMBER 13,1994 ~1galiPRraD" r 06711294/94 N 336225 THIS CERTIFIES THATPERMIT NO. 224052 only the electrical equipment as described below o n TPrdQaT~d"Ey'TTse b~ scant named on the above application number in the premises of (3QLLY~ WILLAM & CLARE CHAMf3U , 840 PINEWOOD ROAD, POLE#LIL 2, CUTCHOGUE, N.Y. in thefollowing location; ? Basement ? Ist Fl. ? 2nd Fl. GAR/OUT Section Block Lot was exd.nined on DECEMBER 03,1994 and found to he in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K W MAT K.W AMT. K.W AMT. H P. 2 5 3 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS $PECIALREC'PT TIMECLOCKS EELS UNITHEATER$ MULTI-OUTLET DIMMERS SYSTEMS AMT. K. W. OIL H. P. GAS H P. AMT NO. A. W. G AMT. AMP AMT. AMPS. TRANS. AMT. H. P. NO. OF FEET "T. WATTS SERVICE DISCONNECT 140. OF S E R V I C E AMT. AMP, TYPE METER 1 qTN 1,e' 3W 9 3W 3~0' KW NO, OF CC COND. A. W O. NO. OF HI -LEG A W. G. NO. OF NEUTRALS A. W TR EQUIP. a PER0 OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: r G.F.C.Ie'1 MICHAEL J. HURLEY LTC44221-E 9905 NASSAU PT. ROAD CUTCHOGUE, NY, 11935 GENERAL MANAGER z.1 1 Per f 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 DEPARTMENT. THIS COPY OF CERTIFICATE M-LIST NOT BE ALTERED IN ANY MANNER. i FORM NO. 1 TOWN OF SOUTHOLD OCT -5 1994 BUILDING DEPARTMENT J TOWN HALL 3 0-r-0 I(~ " BLDG. UK. SOUTHOLD, N.Y. 11971 TOWN or- SOUrNOLD TEL.: 765-1802 R Examined 19 Z.. eceived........... , 19.. Approved 19 ermit No0• V....7~ Disapproved a/c (Building Inspector) P ICATION FOR BUILDING PERMIT Date . 5 199 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 ec ons. nn / ' (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. Name of owner of premises W.M. 0; &AJAJ . C (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License Np• • • . (.Q.!5 • • A• ( • • • • • • • • Plumber's License No. JVA Electrician's License No. ..42 :g.i.. i~ . Other Trade's License No . 1. Location of land on which proposed work will be done . ~~t o ...........~f nEoo~.. House Number Street Hamlet County Tax Map No. 1000 Section ....J.1 O-. Block Lot Subdivision ..CG k• • • • 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 b. Intended use and occupancy GZ 0451-••••••••••••• 3. Nature of work (check which applicable :New Building X. ~ . y Addition . Alteration . . . Repair Rernoval Demolition Other Work (Description) ~i•.~° 4. Estimated Cost . q Fee...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars ...:....l 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front y7......... Rear ? Depth .?-A Height 4 Number of Stories ...1......... . Dimensions of same structure with alterations or additions: Front S r~ Rear ;-7777777 Depth . . Height . Number of Stories . 8. Dimensions of entire new construction: Front 1%~.0..`.... Rear 6 $'.Q Depth .f.S~IaY....... . Height a`.........Number ofStories ...I 9. Size of lot: Front / . 14Q!............ Rear 1.q4) Depth ..I.O.Q.•.1. 10. Date of Purchase Xame of Former Owner 11. Zone or use district in which premises are situated ~S.IP 12. Does proposed construction violate any zoning law, ordinance or regulation: t . P . 13. Will lot be regraded ........I~.C7 Will excess fill be remove from premises: Yes ~ 14. Name of Owner premises w . M4%uY.......... Address $ (t!ne u (n R Phone No.7.'~1.`g-. 7.1.9 b Name of Architect . f P Address tz? Phone No. v0 ~r z 5 ~~ul qq S..3, . Name of Contractor .w Address .1.S,a.$67JuldD !Yt. , , , Phone No. 7(0. PLOT DIAGRAM Locate clearly and distinctly ail 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. i e,~/ STATE OF NEW YORK, S.S COUNTY OF . . .......~.w:.,. Lt~ ~l%lttDtS................... . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He isthe...... E) Ui c1.`!~ _ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du~y 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 set forth in the application filed therewith. Sworn to before me Phis day ofi. , i9 ~ev Notary Public;"Z. . unty HELENE No: 49 .51364 HORNE !6A . C • • Notary Public, State of New York (Signature of applicant) Qualif Commission Expires spay 22, 1. i Z, acct5(we I8 -D DO NOT PROCEED sl YpAG - UNTIL 2nd SURVEY OF - i _ FOUNDATION LOCATION HAS BEEN APPROVED ! N IQ „ i J ~ rSX ~ 1~ it ~ ~ I C } III ~GK Co R~K - I V DATE: B.P. 2 _ril g I AS NOTED -,erk, v r,C 4 x~ 42JAP o ~jG 1~"0~I FEE: BY. \k'I 1 i NOTIFY BIJELAM DE E t p \y ~j; 765-1902 9 AM TO 4 OR_TH FOLLOWING INSPECTIONS: o~ ~ p S{J' T v 1 FOUNDATION - TWO REQUIRED I ~ ~V F0R POUR M CONCREM I ~.~I K/ III b Ins, q j`~)~ I, l~ \ \Vli .14.. 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