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HomeMy WebLinkAbout21858-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23806 Date AUGUST 7, 1995 THIS CERTIFIES that the building ADDITIONS Location of Property 18250 ~OUNTY ROAD ~48 CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 96 Block 4 Lot 1.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 15, 1993 pursuant to which Building Permit No. 21858-Z dated DECF/4BER 28, 1993 ~ 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, DECK ADDITION & CARPORT ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWARD ZUHOSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/~ N-308765 - MARCH 28, 1994 MARCH 21, 1994 - J.S. ZUHOSKI Buildlng/~nspector Rev. 1/81 FORM TOl~ff~l OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN'IlL FULL COMPLETION OF THE WORK AUTHORIZED) ~,te ........ ./.~...r.. ....................................... 19.7~... 21858 Z Permission Is hereby granted to: ................... ~.<~,, ,~./~/~/ ..~.~.0.,,,,~..~,,,,,.~:~.:,,, .............................................. .... ~,.;.,~;,.,.~: ......... /.'..<'~.~; t.. ............................ , to ........~. .~.....~...~ '..~,~ ....... ~...~.....~ ..... OountyTax Map No. 1000 Section..,,,~),~/~'~ .......... BIo/ck .... ..~...~.. ........... LotNo ...... .,L/~..,~' .............. pursuant to application dated ....... .,~..~..(...-......./....~.. ........................... 19,,,,,/0~.~, ....... and approved by the Bul~ng Inspector, ~ee ~.. Z!~, ~. .......... 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 f~om 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 an~ 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.' 3. 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 an~'~ 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 - $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 !ew Construction .... Old Or Pre-eMisting Building ................. Locat{on of Property: .... .~ ......... q~V~. ........ .... House No. Street 'Hamlet · Filed Map Lot ..~ {ealth Dept. Approval .......................... Underwriters Approval .......................... lanning Board Approval ........................ eq~est fdr: Temporary Certificate..~. ...... Final Certicate...~. THE NEW YORK BOARD OF FIRE UNDERWRITERS [~.~[97 BUREAU OF ELECTRICITY ~- ES JOHN STREET, NEW YORK, NEW YORK 10038 Date M~RC}! ~.8,1994 Application No. onfile 83569294/94 N 3~8765 THIS CERTIFIES THAT o~y ~he electrical ~uip~ent ~ ~scrlbed ~low a~ int~uc~ by t~ ap~icant ~m~ on the a~ve ap~i~tion number in the prem~es o~ in thefoltowlng location; [] Basement [] Ist FI. [] 2nd FI. O~J? .Section Block was examined on M ~ [~ C H 2 g ~ ~ 9 9 g and found to be in compliance with the National Electrical Code. Lot FIXTURE FIXTURES RANGES OVENS EXHAUST FAN OUT.TS SWITCHES FLUORESCENT OTHER 4 9 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: ?~EDERfNO.OF CO~D.3/A.W,~#40UT-B-I MOTORS~3-F S~{OK~, E R V I C ldO. OF CC. COND. PER ~' AWG OF CC. COND. E A.W.G. NO OFNEIJTRAI. S A.W G OF HI-LEG ~. OF NEU¥1~AL 50 PAT LAN~ EATTI~UC~, NY, GENERAL MANAGER This certificote 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 BU LD NG DEPARTMENT TH S COPY OF CERT F CATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date ~/~ {/~' ?/ Building Permit No. O'~/O~?~- Owner (please print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this /OAt., day of //~:::1:,~-- ,' q4 Notary Public, .~Ct~if~*Jl~ County (pl ' at're) Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765rl 823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 20, 1994 Mr. Fred Milner 870 Bray Avenue Laurel, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 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 # 21858-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** SHOULD HAVE BEEN NOTIFIED IN LETTER OF 3/21/94 ALONG W/NOTIFICATION OF UNDERWRITERS CERT. FOUNDATION~ (1st) FOUI~DATION (2nd) 2. ROUGH FRAME & .FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITZONA'L COM~ENTS: Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 20, 1994 Mr. Fred Milner 870 Bray Avenue Laurel, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of because of the following reasons: Occupancy An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (outdated/not on file.)$25.O0 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 # 21858-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southo[d, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 21, 1~94 Mr. Fred Milner 870 Bray Avenue Laurel, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XXX No Underwriters Certificate on file. The check is not on file. ($25.00) 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 # __BP# 21858Z Please contact our office on this matter. your cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ~II~TION [ ] FRAMING [~'j FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION ZND FRAMING [ ] FINAL BUILDING DEPT. [ ] FOUNDATION 1ST ~ ROUGH PLBG. 7GS-1802 BUILDING DEPT. .~ ~SPECTION [/~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [~BG. ~ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ]FINAL RE:MARKS: ~/:~__/r.~ ~/~'-~ ~' DAT~ INSPECTOR BUILDING DEPT. ~ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMINQ [ ] FINAL REMARKS: ~ DATE [ ] FOUNDATION 1ST ~j~ROUGH PLBG. -3. Nature of work (check which applicable): New Building .... ' Addition Alteration ..... Re r .............. Removal .............. Demolition ' : ......... Other Work .............. l~. 5.©. ~ .' .... ' (D ipti ) 4. Estimated Cost ~ . (~ . . cscr on ', ~. (to be paid on filing this application'l 5. If dwelling, numberofdwellin, un;*~ 1' -, ' - Ir , , o .................. . ~xUmoer of dwelling units on each fl,,,,~ t "~ ·., garage, numoer oI cars ........ ~ ............ , ..... 6. If business, commercial or mixed o~c'u'na~v' ~'~'~"~ ' ' '~' .... ': .......................................... · , ,, peony nature and extent of each ty e of use 7. Dimensions of existine structures ir ..... n'.-~,~,. ~ r~t , P ..... ~-] ............. u~;o~, }Ct ~g~b~., , ..... ~ ............ t~-e...., .... Rear ... ~0: ...... De,.,h ~ ~.x~, ' --y~s-, .... ~.(. ........ l'~umber of Stories ..... .~.. .5~r~, , . ' · v,- ..... w.,o. ....... D~manmons of same structure with alterations ~- --'-,:.:--- - 'q' ' ' ~d;,5 ................................ Depth ...... ~ . .. ~.h, ~<" · ...t ........... Rear ...7.~ .... 8. Dimensions of entire ne ....... ,..,.,: ......... ' ...... Number of Stones .... .~. ..... · - ,~,~-o,u,~uun. front ..... .L~J .... . Re"- /~* ~ ''-- ......... · · , a~ ..... t.q ........ Depth ..Aa. ...... Hmoht ...... 15 ....... N. umber of Stories ........ ~. ..... ~ ............. ~ ....... , 9. Size of lot: Fro'bt ..... lit. ..... ~ .... ~.. Rear ....... /%"~' · · ' · Depth . /~ .............. 10. DateofPurchase 'lq~..q s . . Name~i "' ,i '" ~,~-,,:'~r''t'~' · . ''. '''. ................. ~orme ow, er ~' '"D .............. 11. Zone or use distnct m which premises are situated . . . i~,~,i~e~!J~.~ ...... 5 ..................... Does proposed construction v~olat? any zoning law, ordinance or regulation' ~,,~c5 .................... 13. Will lot be regraded ................................. ....... ; ' g')'© ............... Will ex c es.~t~ ~.(em ovid. from p remises: Yes~ 14. Name of Owner of premises .L~c~;xf~..¢9.~9s..~,'~ .... Address ...'..' ........ ~ . Phone No. fi ~Y :A, J2~.~ ~. · Name of Architect - " '' '~" 'f,~ ................... Address .. :-: . Phone No.: .... VI \ ............... · ........ Name of Contractor ...v-~ .. ~Wh~7. .......... Address .... - Phone No. ,g.~FJ~[ 15.' Is this property within 300 feet of a tidal wetland? *Yes ........ No.~ ..... · 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 cornerlot, lgl q q" · --¢' :ou rv or .... .3.9. s.s ......... '.'.~.~.-ecJ,...~.~ ~ ..................... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) bore named. is the .. . ,' . ' ontractor, ........ · (C agent, corporate,officer, etc.) ...... said owner or owners:, ~d is duly authorized to pcrfom o~ have perfo~ed the said work and to m~e and file this ~ptication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the ork will be perfomed in the manner set forth in the application filed therewith. ,yom to before me this '.-' . , ...... /.n.-. ...... ~. 4~71~ _ / . · ~ ..... ~ ~ ........................... ~ la ~ ~ ~ C (Signature of applic~t) FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ( B u i~di'ng Inspector) ' APPLICATION FOR BUILDING'PERMIT INSTRUCTIONS' B~,~RD OF HEALTH 3 SETS OF PLA~t$ ........ SURVEY ................. CIIECK .... CALL .............. This application must be co~ apletely filled in by typewriter or in ink and submitted to the Building Inspector, with silts of plans, accurate plot plan to shale. Fee according to schedule. b. Plot plan sliowing location of lot and of buildings on premises, relationship to adjoining premises or public sti'eets or areas, and giving a detailed description of layout of property mufit be drawn on the diagram which is part of this appli- cation. . c. ' The work covered by this ap'plication 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 occupiSd. ~ or used in whole or in pa~t for any purpose whatever until a Certificate of Occupancy shall, have been granted l~y the Budding Inspector. A PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buddzn= Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction o.f 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 issp,ections. . . . (Signatur~ of applicant, or name, if a corporation) .... . (Mailing ~ddress of applicant) State whether applicant is owner, !essee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Nameofownerofpremises . V.:.4 ~/ ..L~ .cq)~.~' (as on the tax roll or latest deed) ...... If applicant is a corporation, signature of duly authorized officer.· . (Name and title of corporlate officer) PI mber's Li N " Electrician's License No ,' Other Trade's License No 1. Location of land on which propoced wor~ will be done. c~ House Number : Street Hamlet C hty M 1000 S ti~iu ' k ' ' ., on Tax ap No. ec ................. Bloc '. Lot .......... ' .... Subdivision ........ . .........: .......... ......... '. Filed Map No .............. Lot (Name) ................ 2: State existing Use and occupancy Of premises and intended use and occupancy of proposed constructiom a. Existin~ use a .... ' ~ 5 v,- b. Intended use and occu ancv Ae, B~.'x O~ -) · 1993 0