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Home My WebLink About21552-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22594 Date SEPTEMBER 16~ 1993 THIS CERTIFIES that the building ALTERATIONS Location of Property 370 FISHERMANS BRACH RD. CUTCHOGUE~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 1 Lot 13.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 1~ 1993 pursuant to which Building Permit No. 21552-Z dated JULY 23~ 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 ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MARIAN J. PRAUS (owner) of the aforesaid building, SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOBM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ $OUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...... .~/~'~. ~. .......................................... ~9.~... 21552 Z Permission Is hereby granted to: __ ,,~ ~~~~.,...~.......~...~~ ~..,..~.../..~.. ....................................... i ....... ~... . . .~~...,.~ ....... ,o..~~~/.~ ...... ~...~~ ...... ~..~.~,~ CounlyTax Map No. 1000 Section ......,~_~//../. ........... ~' ...~....~..~'./ ......... Block ...~ ...................... Lot No. pursuant fo application dated .....?...~../._. ........................................... Building Inspector. ~-~ Fee $.. Z~.,~...~.~.,.. 19...?...'-~... ....... and approved by the ~/Building Inspector Rev. 6/30/80 ~ ~ " TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 YOWN OF SOu~*~O~ D ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must b~ 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. ~ith accurate.,!oca~io~f:;~iq'~Ui~d~fi~,,'p~pert~!ii%n~S, ~,~ ~ ~', st~eetsF:and Unusual ~ural~ri~to~gr'aphi~f'~aturesi~ ? ,'2'i ,~i~l'ApProval from,Health Dept. oftw~er ~upp%y and sewerage-disposal(Si9 fo~m). ~" 3.'J'Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than ~/10 6f 1% lead. 5, Commercial building, industrial building, multiple residences and similar buiidings 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, buiiding and . , unusual natural or topographic features. 2.. A properly completed application and a consent to inspect signed by the applican,t. ' If a Certificate of Occupanc~ is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. C~rtificate 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 $1~.OQ, Commercial $15.00 Date .... ff. ........................... New Construction .......... t Old Or Pre-existing Building..~ .............. Location of Property .... ,,, . ............... . ..... House/No. , Street Hamlet Fropert Onwer Owners of " County T= No O00/ eetion..lZ! ........ ..... .Lot .... 3./ ........ Subdivision .................................... Filed Map ............ Lot.. . Permit No.~.~.~..~..~.....Date Of PeTmit.. ~.~/~../~..Applicant~,~.~ ~o~O~'~ .......... Health Dept Approval ~ ~ .......................... Underwriters Approval...· ...................... Planning Board Approval .... Request for: Temporary Certificate...'.f ...... Fee Submitted: $..~ ....................... APPLICANT 'OU~DATIO|~ (~nd) ~OUGH FRAME & ·PLUMBING ~tSU LATIO~'~ PER N. Y. STATE EHERGY CODE Ill FI:;AL ADDITIO~;A'L CO~4E~$TS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ~L/GH PLBG. FOUNDATION 2ND [~]~ INSULATION [~FRAMING REMARKS: FINAL DATE ~ INSPECTOR.~ · THE NEW YORK BOARD OF FIRE UNDERWRITERS [~(~012 [ BUREAU OF ELECTRICITY .~T ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date THIS CE;IFIES THAT o~y the el~trical ~uipme~t ~ ~scrib~ ~w a~ int~uc~ by t~ applicant ~med on the a~ve application numar in the prem~es of in the followlng location; ~ Bm, ement ~ Ist Fl. ~ 2,d FI. GAR seoao, BIlk Lo~ . FEBRUARY 28,1994 ~s exam nea on and found to be in compli~ce wHh the N~onal Elect~cal Co~. FIXTURE OUTLETS DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER APPARATUS: 200 A~.P DOOSL~ THRO~' S E R No. O~,~C#CONV. AWG OF CC. COND I C E NO OF HI-LEG A, W.G. NO OF NEUTRALS OF HI-LEG OF NEUTRAL PAU5 R. BURNS 275 TOWN HARBOR LANE SOU~HOLD, NY, 11971 LIC,#282-R GENERAL MANAGER 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. ...... ,w.,~.rma~.,~ ..... ~.r~,,~a~, ........ ~y their ,ccreden~als.. C~LDING DEPARTMENt. THiS COPY OF CERTIF CATE MU~?T NOT BE ALTERED IN ANY MANNER. !~\' JUL - 91993 Exan, incdT/. . .......... ......... Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 766-1802 · INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORt'! ............ HAIL TO: ~ a. This application must be completely filled in by Wpewriter 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 ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...~ B.~.,..~..~.~. ~..,~....~..~.. ~.~...~.v. .......... -- £Signature.~f applicant, or name, if a corporation) c~/:~ ,~a -,A ~/o _ ...~...~.o.~ :~. . . . ~ .'?. /. (?. .$'J ................. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... o.,..*.,/... .......................................... Name of owner of premises .,,).e...,9..~.. .l"'~¢ ~ ....................................................... (as on the tax roll or latest deed) If ~ ~9/~ga-~o~at~on ~ signature of duly authorized officer. / ' '-'~' '/(~~...~ "fl%me and title of cor~r'ai~ ~t~)~'''~ .... Builder's License No. ,,~-~...~"~'..~.."~. ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be'done .................................................. · 3..'Z.o.. F,,~ ~_..~...~.. ~, ~d ~ ....................................................... .C.~ ..... 9~...~..... House Number Street Hainlet Co ,ntyTax ,apNo. 1000Sect,on ....... Ii/./ ....... B,ock ..... .......... ........... Subdivision ..................................... 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 ...QI ~ .~. ~.. I:¥F~..t J .~O.G[ ~ Intended use and occupancy ...(~J'-~..?t<~rrt .~ .l~...'~....~. 1 l%....gQ.)..Y~..... ~ qx)....~. ~. ,~..~..o-,x.-.. ~.. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . .. Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost.·--~..~'~.(~)s.7 .......................... Fee ...................................... (to be paid on l-fling this application) 5. If dwelling, number of dwelling units .... ] ........... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, spe.c~f~, nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ~ff..~..D:. ......... Rear .............. Depth ............... Height . .--/~- ~ l'~C' ....... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ....... ~ .1..~.. .......... Height ..... . ................. Number of Stories ...................... 8. Dimensions of entire new construction: Front..~). *.~w.. ...... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..~..',~..~ .............. Rear ...................... Depth ...................... 10. Date of Purchase ....'~). 3 ..r~. .......... . ......... Name of Former Owner ............................. 11. Zoneoruse&stnct~nx~h:chprem~sesaremtuated ~r. 3 'c,~.....vt~.]. ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..S~.e,). .......................... 13. Will lot be regraded 14 O .. Will excess fill be removed from.pt~emises: .Y~es 14. Name of Owner of premises Name of Architect ............. ~ ............. Address_~. ........ . ........ Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Y~es.../v~. 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 corner lot. 765-'~802 9 AM 'PO 4t PM FOR THE FOLLOWING ~NSPECTiONS' 1. FOi )NDATIOr, J 'D.,~/O REQU~R ED g~ POURED CONCRETE 2 RO~JGH - FRAMING ~ PLUMglNG If>. F',D:t','_ f'Ot~SI'~uCTJON ~JST BF CG~FLET~ FOA ALL CONGTRUCTR}N SHALL NtEET TN5 REOUiREMENTS OF THE N.Y. ~TATE COt,~TR[JC~ION & ENERGY CC.[~ES. NOT RESPONSIBLE FOR DF~!GN OR CONSTRUCTION ERRORS STATE OF NEW RK~ ~ ~ ·. ~.o~.t .az/.~..~.~...~-~..~'e'. ~'.~...'77 ........ being duly (Name of individual signing contract) above named. sworn, deposes and says that he is the applicant agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the '~vork will be performed in the manner set forth in the application flied therewith. ~worn to before me this $~u. ~-~ Z$8~0, guHolk Count ~erm ~res Oeto~r 31, 18~ ,