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HomeMy WebLinkAbout21562-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22711 Date NOVEMBER 9, 1993 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 150 MASON DRIVE CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 7 Lot 1.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 1993 pursuant to which Building Permit No. 21562-Z dated JULY 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 DECK ADDITION & FINISH 2ND FLOOR AS APPLIED FOR "AS BUILT" The certificate is issued to JANE SWEENEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-291225 - OCTOBER 1, 1993 PLUMBERS CERTIFICATION DATED N/A A ild ng 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 19..9.3 N°_ 21562 Z Permission Is hereby granted to: so....... j. ....7-f. ..............,..Jr..............................: to ..l...,.y................ az........ 4y.... . . at premises located at......... / r . ^ 4.- n.. !f ~76lock ............CounTyTax Map No. 1000 Section ..........................7.... Lct No. ...........,lt..3..... "-9 F pursuant to application dated ~3 19....., and approved by the Building Inspecctor.~ Fee S....~7.~/ j gs%.~~.... . G L / Building I spector Rev. 6/30/80 I 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 submi CtJULh4 BdMing inspector with the following: for new building or new use: Final survey of property with accurate location of all buildiy lines, streets, and unusual natural or topographic features. TOWN OF SOUi'H=CSU, } 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 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 $j15.00, Commercial $15.00 3 _ _ Date New Construction......... Old Or Pre-existing Building.. Location of Property .../.sQ . ew House No. Street Hamlet Onwer or Owners of Property ) County Tax Map No 1000, Section ...l.U ,7...... Block 4.7........ Lot.... 113 Subdivision ....Failed Map.......... .Lot.. Permit No ................Date Of Permit. /../.......Applicant. . 4) Health Dept. Approval ..........................Underwriters Approvaaal......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... fee Submitted: O . V ~RG• 11 Dy~ APPLICANT C 6 ~ 1I " ~o 1cLD . F . ~G 0-,NMEN7f G 1 ,a N m \ 1 . I a In ---I} + H `fi'r F0 UNDATION (1st) n FOUNDATION (2nd) 2. z ~ o r, ROUGH FRAME & PLUMBING ti H ! , 3. m m H INSULATION PER 11. Y. STATE ENERGY CODE r 4. OZI 4-04, FINAL o ADDITIONAL COMMENTS: L ' x \ 'v H 9 O ' S a r~ H Sa O N m H a i 79 i f ''lam Fd ^ rrc_r~ tit Mood I:re A-4 rc V~ 41 I Board of Appeals ? Or Town of Soamold ~ .t~ 1 Ii 1 • C7 = H7ArtC: M~E?'rt it ul + t ) . •'r~;-;. oleo; ',5 ~ ~ i :'u~~!k L'Wrr-ha Tax Mn~n .rerY-F[Art: 1 t-D00, Sc+ !04. e:i_. . Rteccl 4 , ST, i t III /TTAUTxDetm AORATTpi at AOpI10r tr To IM SWO M AYrOSAUMa- RMBrtdeQ Mar ,i'f,i58! i y MMM 7W OT M WW TOR STAVE 2 WMATION TAW. $?ff. C'P. D. P. ri. Cp aNtmm W MDT NAS B. NI-r £/¢v. Z.Sd M TAIL AIAySTOA'k rm Swat _ MCOIiIYI<0 r ~ iO.rJOV~ W. Su eve, ted r O • AIO MM COA. IQ' t',t ,.r!r.. - ODAAAMM AOICATM 06W SMALL OM r . OMST TO MIS ARSON FOR WHOM THE OOY!` 20ce_ ef,_:k. VA"'! i _ YL. P. 0 PWASM NO ON 145 SSWW TO IN TM1S OOWAW, OOVMWAWAS AOW XT • Ifs- 'r• I IAOM banTUUON USTM gLftuK Ar r. TO UK ASS MW OF THE LUZM 641. sual. 1 ?L~ i •~4v .a C-' L.fcer:sed Larva' Surverpr; r o ADD AAfMIM1NAl ODAAMM AYITESmY110AM AM a (!U su5ua' Greerrbar^f - N°,v York i 765-1802 BUILDING DEPT. INSPECTION ( ] FOUNDATION 1ST [ J ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: i DATE INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAG6 I BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date Application No.onfile 050rritlh9: H 741<<5 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 dEfl'';E SdEPOF." NA:n'N DF..`'<'3, Cl1TCHOGUE, N.Y. in thefolfominp location; ? Basement [I Ixt FL X 2nd FT, OUT/ GAF.. r : HED Section Block Lot was examined on " ` F T I- M f E fl y • 9 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPtACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K W. AMT. K W. AMT K.W. My K. W. AMT. H.P DRYERS RJRNACE MOTORS FIXTURE APPLIANCE MINES SPECIAL RECPT TIME CLOCKS EELl UNIT HEATERS MULTI.OUTIET DIMMERS AMT. K. W. On H. P. GAS H. P AMT. W. A. W. G. AMT. AMr. AMT. Mrs. TRANS. AMT. H. P SYSTEMS Anti. WATTS NO. OF FEET SERVICE DISCONNECT MD. OF S E R V 1 C E AMT. AMr. rnE 1 / 7w 1 / JW 7 / Sw S / aW S. OPEMt`COND. OF CCMOHO. HO. W "AEG 410 HO. OF NEM a 'FkUMxL OTHER APPARATUS: - DEFECTS REMOVED AS PER 09-07-93-1 i ` GOODALfi ELECTRIC LIC.i783 7355 MAIN ROAD a GWAL MANMY MATTITUCK, MY, 11952 11 F Pre This certificate mua not be ahered in a mommr; 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. / BOARD OF HEALTH G_, FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY o BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORK SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY .y CALL Examined tIA I L TO Approved ~ , 19vpermit No.. ~ _ _ . Disapproved a/c 2j'JUL ( ilding Spector) APPLICA ION FOR BUILDING PERMIT 1 31993 Date 19.. . INSTRUCTIONS TOWN OF c1CJUi'i.r'.i.:3 a. s app icatron 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 stieets 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 inspections. (Signature of applicant, or name, if a/corporation) Sp jY/~asvya r, Ct~ 17& om........... L"~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (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 . Plumber's License No. Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done.. ~ y~a~a ....!1 . f!oS!!L`° House Number Street Hamlet / L County Tax Map No. 1000 Section ...t`.©.......... Block Lot . Subdivision - Filed Map No. Lot r . (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy v. `~ftfJ b. Intended use and occupancy ~J.. IV ~ { 1r 3 Nature of work (check which applicable): New Building Addition Alteration p moval Demolition Other Work.,,,,,, 4. Estimated Cost .pry (Description) . Fee (to be paid on filing this application) 5. If dwellig, number of If garagennumber of carswelhng units Number of dwelling units on each floor , . , 6. If business, commercial or mixed occupancy, specif~nat ure and extent of.each.tvpe of use . . 7. Dimensions of existing structu es, if an Front ~ • • , • • • • • Height / . y: ........Rear y Depth. . . Number of Stories . . Z.. , With alterations or additions: Front Depth ?V.. , , , , , , , , , , Rear Dimensions of same structure Height . • • • • , , Number of Stories . , . 8 Dimensions of entire new construction: Front W..~... , ; Rear . y', , , , , , , , Depth . z7'. , tuber of Stories 2 . 9. Size of lot: Front /We sue.........:.. Rear ....!Fis . De th ?L~ , . . 106 Date of Purchase / 9p Name of Former Owner 11. Zone or use district in which remises 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 14. Name of Owner of premisesTr:r. -CFSWAAi~ Address o „Cia?yoz.. , /?:r-Phone No. rl.,79. Name of Architect , Address . . Phone No. . Name of Contractor 1Q!. ~?~/r1r+< ~y, Address .5~?~; , , , , , , Phone No. . Ywithin 15. Is this property 300 feet of a tidal wetland? *yes. Y...... No......... *If es' Southoldi,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. s~ey • IMP RA ED AS NOTED - 1'3es;T~~~s~ mP#.~,1/kr&~ lalall~'r 13UI s~ RK: 76r.1802 q AM 1DEI,ARTIy TAT 1°OP_l,OWjIVC INSFE ®4 PM NS: F t R THE . F(AINDATION 7I4113 REOUIREI) 1=431," PoURE6 Cf,)NCRE'TE . ROUCN . FRAN111V(,; S; p 3. PIUStIIATION tLIMBING 1Sf COMPP..ET1- F TRUCTII)N PVII,IST ALL C43NSTRUCTIdO C.O. rliF REOVIREME'NTS OFATMEN'FET STATE CaN sTRUC3`ION ENERU Fl,31FS NOT RFSPpNSIC3LE FOR CSICN OR CONSTRUCTII ERRROOS STATE OF NEW YORRl (.1k_ $.S COUNTY F g y 1 worn, deposes and says that he is the applicant (Name of individual signing contract) . . • • ' ' ' • bein dul s above named. .Slleisthe I'..~?? (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly'i 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 perfnner pct forth in the application filed therewith. Sworn to before m.........`19 otary Public, ounty ty 5~ (Signature of applicant) NOTARY PU~g I. IC~p of N Y, Teim 7E~p~r~s May 31,19 it- 10 %Y ID I~ 10 7, 7L-F-I, J i ~L u~~> Kew-7~ ~ ~ I , i LIN I „~y~[.7 _IociluT l(i Et1 , i I, . q ~ . ~ .r~__ - Iii i i 1 i I i - - _ 7 .I j ~ r..._ . - v I,1 } fr r_ - 'II s- ~ , 4 i i '~i~f ~ f I i I = - i ~ ~ ~ ~ I ~ ~ ~ ~ ~ it ~ ~ ~ ~ ~ _ ~ ~ ~ - _ ~i i ~ illii ~ f i~ I ~ ~ ~ ~ i ~ - =_i ~ I ~ il_i~,~~.~- ~i ~ i, ~ i I I I i ~ 'I ' ~ - i ~ L I i~ I I ~ i i ~ i ~ ~ ~ I iI ~ ~ I~ i ~ ~ ~ ~ it ~ ~ i ~ ~ _C'rrsasss`s'rt'~za'!'r=r'~E. i f __._w._-_- _a -._u___:_:__.__c__.:. ~ ~J ~ 5 `7"- \ _