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HomeMy WebLinkAbout22008-z s FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23276 Date OCTOBER 11, 1994 THIS CERTIFIES that the building ALTERATION Location of Property 2445 PINE TREE ROAD CUTCHOGUE, NY House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 3 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1994 pursuant to which Building Permit No. 22008-Z dated APRIL 12, 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RAYMOND T. GOODWIN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N311953 APRIL 28, 1994 PLUMBERS CERTIFICATION DATED N/A B it Vg 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 le2 , 19. N° 22008 Z Permission Is hereby grante o; eel g''w')....... W/ ? f3......rd................................... ~~r-......... 3 ra.....~.CT l........./....... x.S~r^......:.......... G 1s ,f~ I4";, d.... . r...I . . at premises located at T P. ? f~e~1 County Tax Map No. 1000 Section/.... r.~ Block .....F~ Lot No. ...,0................. 19....., and approved by the pursuant to application dated Building Inspector. Fee Building Inspector Rev. 6/30/80 Form No. 6 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT f ? b~i~' TOWN HALL 1 l 1 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and i "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. z 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. 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date 0/ 1. ~1 J ew Construction........... Old Or Pre-existing Building., i/_ ocation of Property...~~~ Al rZJ E U T C 6 G V I House No. Street Hamlet ~ I nwer or Owners of Property.... PC 1 N r~l<u - d.~?. x .'1. . . . . . . . ounty Tax Map No// 1000, Section ....CC .7..... Block .........Lot... 3 ubdivision....Pl,Q'$s/?!~.. f~/}ln.~?..........Filed Map 1 r1(.....Lot.....~.L ermit No. Op 8„Z.Date Of Permit Applicant..... Ay P J7~ T °Y71J/A) 2alth Dept. Approval.......... . ..............Underwriters Approval......................... lanning Board Approval....................... / equest for: Temporary Certificate........... Final Certicate., ee Submitted: c~e5 X73 APPLICANT 4ge'Ylr-1. N ..m +Y i i - n .n_ n i a ue. c. .v,... . n k 3. _ e._ - Mu' m-sK?.+YN 6V>FPYr'1' 4. ~d00 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGES 1 1135185 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date APRIL 28,1994 Application No. on file 05802594/94 N 311553 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 RAYMOND GsOODWIN, 2445 PINE TREE ROAD, CUTCHOGUE, N.Y. inlhefollowinglocation• ? Basement Ist FL ? 2nd Fl. Section Block Lot was examined on APRIL 25 ,1'994 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER 11 AMT. K W AMT. K. W. AMT. KW AMT K. W. AMT. H. P. 4 8 4 1 8.6 1 1.4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIMECLOCKS BELL UNITHEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS HP AMT NO. A. W. G. AMT. AMP AMT. MAPS. TRANS. MAT. H. P SYSTEMS NO. OF FEET AMT. WATTS 1 600 SERVICE DISCONNECT NO. OF S E R V I C E MIT. AMP, TOPE METER 1 ]r 2W T A 3W 3 e 3W 3 AT 4W NO OF CC, COND. A. W. G. NO OF NI-LEG A' W' G. NO. OF NEUTRALS A W G. EQUIP. PER .e OF CC. COND. OF MI-LEG OF NEUTRAL OTHER APPARATUS: MOTORS" 11--F H.P. C.F.C.It-2 I~ I MODERN ELECTRIC EAaT,INC. LIC.#4253 E 10470 ROUTE 25 MATTITUCK, NY, 11952 GENERAL MANAGER 11 Per 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 MUST NOT BE ALTERED IN ANY MANNER. l= Ly .;U:J 3 CONMENT~ FOUNDATION - - - y (1st) 0 FOU14DATIOII (2nd) 2." ROUGH FRAME ° PLUMBING 3. CA y INSULATION PER N. Y. m y STATE ENERGY CODE / l© 4. Z ~ rrl Jr H FINAL ADDITIOJlAL COMMENTS • m x•~ y • 9 \ H O m ~e • r • a m ~ .ti H Town Hall, 53095 Main Road C2 Ca Fax (516) 765-1823 P. 0. Box 1179 1-5 Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 5, 1994 Mr. Raymond T. Goodwin 163 Weyford Terrace Garden City, NY 11530 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22008-z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. M 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING NAL REMARKS: a i i I DATE ® INSPECTOR K M-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [GH PLBG. UNDATION 2ND [ INSULATION '/AM [ ING [ ] FINAL REMARKS: a j DAT~ ~0 INSPE ~fJ -g BOARD OF HEALTH l 0, ,A FORM NO.1 s3 SETS OF PLANS ..V TOWN OFSOUTHOLD SURVEY TOWN HALL ....f! fi BUILDING DEPARTMENT /CIIrCK FORM SOUTHOLD, N.Y. 11971 Examined TOWN Et11H~OLD TEL.: 765-1802 NOT I FY , r l CALL 5l~ 7-394-7 ......7.1y 19 ?lL y MAIL TO: 9? Permit No.~! Approved / , 1 Disapproved a/c (uiYding Inspector) APPLICATION FOR BUILDING PERMIT Date 199Y 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 o,r 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 i ections. (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. Q w nr E- Name of owner of premises ~f'~ Ft.7 Nla D , T', , lScro u! t (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 No. S 3 ! . 5 Plumber's License No . Electrician's License No. Other Trade's License No . 1. Location of land on which proposed work will be done . i a!li~ , kr- 2, D.......... ~ v TC FF G ~ u G~..l. House Number Street Hamlet County Tax Map No. 1000 Section f.~..7 Block Lot .70 . Subdivision Filed Map No. .1.1.7.1 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 " " 3. Nature of work (check which pplicable): New Building Addition Jotrition' . Repair • Removal Demolition Other Work ij(j:(Description) 4. Estimated Cost . .j.... Fee................. . . . . . 5. If dwelling, number of dwellin (to be paid oh } application) gi units 1.......... Number of dwelling units on each' If garage, 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 Rear Depth • . . Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear Depth . . . . f ..Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth , . Height Number of Stories . 9. Size of lot: Front . 6?: W, , , , , , , Rear ......4A !?.9 , Depth Q 5~ % • . 10. Date of Purchase ; Name of Former Owner s?s r r S, Lr+~2GLi jijF 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 ! Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . Address Phone No................ Name of Architect Address Phone No.......... . Ufc'Go Name of Contractor 'Tll"T`' YAddress lav. 2 cAV,, Ny. 10.0.1. , Phone No. s('4 r.7•a? -.V7.~ 3 15. Is this property within 00 feet of a tidal wetland? *Yes..V~... No......... *If yes, Southold own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alll 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. ! rz 6 A-T r Fs-e hi D S v 2 ?1~ I~ I STATE STATE OF NEWK $ S OF. . ^c. • U W 1 f~- , being duly sworn, deposes and says that he is the applicant (Na e of individual's* . . . igning contract) above named. He is the Q tJ.~ (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 contailned in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me th' / .day of G~ ) . l 19 l Notary Public,. County CLAIRE L OLEW Notary Publio, Stars of Now York No. 48796061 ture of applicant) Qualified In Suffolk ¢eurr(Signa Commission Expires December Sly, 192 FLOOD ZONE B FLOOD ZONE A-4 LO T 15 Posy 251.00' --,277.55'MAP ~C M 0.35 S PIPE N. 87°0/'20"E u.s YON. J 255' FND. 4 W 160.06' 4' SPLIT RAIL FENCE Z p 3 FE per' PL9'/ o V ! r 0.4,5 + u_se RCH a Y I tN 0.4'E - o !yj V • _ f1O b a t~o.z m Q /8./' c o 9 E Z m 10.1 Kt0' o 40 O to m O w_ i i..o r !STORY ° LOT 14A .5' Z R L~u O il - FRAME w HOUSE 12.7 3 x 1. ~Q,/P.3 m K 2 I 50.3' C I ( J 01 /29.8!' + s.so ~ \s V 27 % YTA KE 170' 4'5 IT RAIL FENCE N (e m FENCE 10.6 029N241.00' 263.00'MAP I 0.35N ` o.L.E S. 87'0120 "d! LOT /4 [ 8 APR - 7 199A 9 DEPT. MEADOW LANE. ewe TOWN F SOUTHOLD., (NOT OPEN) '~OF NE?NYO L 0 T 14A _ 1. NO MA P OF CERTIFIED To: ~.9~ NASSAU FARMS WILLIAM T. HOLGAN COMMONWEALTH LAND AND TITLE TOPAZ ABSTRACT CORP. NO. 17248 3 Z * LIC. LAND SURVEYOR APPLE BANK FOR SAVINGS * AT PECONIIC 40 E.- 13TH-.ST. RAYMOND T. GOODWIN 4 FitEOA/A11+2B,/5t35.79 _ TOWN OF SOUTHO HUNTINGTON-STA.,N.Y. I-D SUFFOLKCO.,N.Y. 51G-GON-ST5 NOV. 18.1993 Job N! 9376 QEYAT/ON9;; REFER. 77 N.S.V. .aQT7AM OF . 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