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Home My WebLink About21761-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFI~ATE OF O~UPAN~Y No Z-23046 Date JDNE 17, 1994 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 9280 NASSAU POINTROAD C~TCHOGUE, NY House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 6 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 22, 1993 ~ursuant to which Building Permit No. 21761-E dated NOVEMBER 4, 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 TO CONSTRUCT DORMER EXTENSION AND ALTERATION TO AN EXISTING The certificate is issued to ONE FAMILY DWELLING AS APPLIED FOR. JAMES HEFFRON & BARBARA MIu~LSON (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N309163 PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A MARCH 31, 1994 K & K PL~4BING & H~ATING APRIL 26, 1994 Building ~f~spe/r FORM NO.$ ' TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No 21761 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ,..../.~. ............................................. Permission Is hereby granted to: / ~ ~ /~ ,,~ /' . / .. ~ .............................. . ..~~,,~....~...~ ...... ........................ . , -- Counh/TaxMap No. 1000 Section ...... .,~../'~., ....... Block ......... ;~, ............ LotNo ........... ~ ............. pursuant to application dated ..... ,/.~...~..~ ............................... .., 19....-'?..~.. ....... Building Inspector. and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN ~tL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY \. 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 C~pliance from archiuect or e~gineer responsible for the building. 6. Submi~ Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '~re-existing" land uses: I. Accurate survey of property showing all property ~ines, 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. ' Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwellieg $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 Buildfng - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $I0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction .... ./.,,.. Old Or Pre-existing Building ................. oca tion of Property ..... f~¢ ............... ~.~U...~.d<Z~.g~./~4~.~ .... .... llouse No. Street Itamlet )unty Tek Map No 1000, Section ..... ~(.~ .... Block...~ ........... Lot ..... ~ ............... bdzvision ..................................... Filed Map ............ Lot ................... :rmit N ........... Date Of Permit ...... ~Applicant. :alth Dopt. Approval ........ ............. Underwriters Approval. arming Board Approval ........ Temporary -' · ./... quest for: Certzf~cate ........... Final Certicate ...... e Submitted: $ ............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1~1071 BUREAU OF ELECTRICITY --- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date MARCH 31,1994 Appticatio. No. on fire 83170793/93 N 309163 THIS CERTIFIES THAT only the electrical equipment as d~scribed below and introduced by the applicant named on the above application number in the premises of ~EFFERNAN, 9280 NASSAU PT ROAD, CUTCHOGU~, N.Y. in the following location; [] B~sement [] let ri. [] 2nd FI. ATTIC ,Seotio. Block Lot ~s examined on ~RCH 28,1994 a.d found to be in compliance with the Natlonal Electricnl Code. E,XTURE I EP "XTU". T A.OE;w. ~RVl~ DI~ONNECT I ~. OF I S E R METER ,o o~ cc CO,~ ~.w ~. ~T, ~P. ~PE ~UJP, I~2W 1~3W 3~3W 3~4W ' PER~ ' OF CC, COND. I 2~ CB 1 X i 4/0 OTHER APPARATUS: JACUZZI- 1 MOTORS, 1 -F H.P. G.F.C,I:-12 SMOKE DET~CTOR~ - 1 LIC,#578-E G & S CONTRACTOR BOX 215 SOUTHOLD, NY, 11971 ICOOKING DECKS t OVENS I DISH WASHERS TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS ~¥. ~J4p$. TRANS. NO. OF FEET V I C E EXHAUST FANS AMT. H P DIMMERS 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. COPY FOR BUILDING DEPARTMENT. THIS COpY OF CERTJF CA*T~[ MU~T NOT BE ~L~TERED N ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION, FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INaCTIoN FRAMING [/,~]' FINAL DATE 765-1~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ '~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [/]//FRAMING REMARKS: [ ] FINAL DATE: I,,~/~/, ('//~''-~ INSPECTO '"-~4 TOWN OF gOUTIIOLD OFFICE OF BUILDIHG INSPECTOR P.O. BOX 728 ' TOWN HALL SOUTHOLD, N.Y. 11971 TEL, 765-1802 ' ~ E RTI F I CAT I ON contain~ J. essl than 2/10 of 1% lead. {plumber Notary Public HELENE O. HORNE Not8~ Public, State of New York FOUNDATION (1st) FOUNDATION 2. f2nd) ROUGH FRAME & ,FLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , ~ SOUTHOLD, N.Y. 11971 Examined -/Z ~ ....... TEL.: 765-1802 Approved .... Disapproved a/c ..................................... . ~ildi~hfspector) APPLICATION FOR BUILDING'PERMIT BOARD OF llEALTH 3 SETS OF PLA;{S SURVEY .................. CHECK ............... ;,;;fi ............. HAIL : INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 sti'eets 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 tlfis application may not be commenced before issuanco of Building Permit. . d. Upon approval of this application, the Building Inspector will/~sued a Bu//ding Permit to the app/icant. 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 ~y 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 descr/bbd. 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 necessa~y~ctions~ _ · . .... o n. fO. . ..... .. (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 ....... 3... (as on the tax roll or latest deed) If applic, ar~ is a corporation, signature of duly authorized officer.' .... ...... ..... - (Name and title of corPorate officer) Builder s License No.... ~ ........... Plumber's License No.../.~: J't~DA4.~ ......... Electrician's License No ..... ~ .... Other Trade's License No.., .................... h Location of land on which proposed work will be done ' : House Number Street Hamlet ' Cotinty Tax Map No. 10O0 Section ' ' Block '- Lot .... Subdivision · .'. Filed Map No. (Name) ......... Lot State existing use and occupahcy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy · .I ~6C/r~l !.cL .~..~1 ~22 C~: ' W~:~ ~'~ · ~ - ~ . '~ ...... ;¢,~Y ¢~t ¢'~, ~-~¢~ ~.'~ ~ ~f¢4~ ......... · '3. Nature of work (check whic applicable): New Building .......... Addition .......... Alteratio ..; ..... Repair .............. Removal ...... Demolition . · Other Work 4. Estimated Cost.. escr n to be paid on filing this application If =~I~ ~ Numbcr of dwelling units on cach floor . :5. Ing, number of dwelli g units I ' ( ) · g g , number of cars ...; ...... ' ............... · 6. If business, commero;,,___... - ' ................... · ........ ' . ~ ~ " ---, m ,uSeu occupancy, specify nature~ and extent of each type of use .............. i. j. 7. Dimensions of ex}sting structulres, if any' Front ~.. 0 ... " -" -/~ -- ~' . ~Height .... ~ ........ Nffmber ofS}nr ~ ' ' ' ',~'/~:~) · ~ear .. 4o..o ........ Depth .. ~..~'... .. mensmns of same stm ~ ith alterations or,ad ' ' ........................ Dentb ' q,ft' ctur,~ W (~¢~ons Front ~,or~ , / -- ? .......... ,-, "" '. ..... "P'~' .......... · · · He r, ht . =,z. Ogr . ' ................ ~xear . .aa ~, ....... 8. o:mensmns of efltire new cons~ructio .~[ ..... ~ ' 'L ......... :. · Number of Stories ...... ./. ~ n. vront ...... O ....... : Rear .... ... ...... '"' · · Height .c. · · Nu[nber of Stories ..... Depth ~.~../. ........ 9. Size of lot:Front .......... 1 .......... ~.. Rear ...................... Depth ......... . ,0. Oo%;;%; 11. ici 52 ~.~,'.' ,'. ' {' ". ...... :~ ....:...'. ~Nam~e of Former Owner ................ ,- wmcn p?mmes are Snuatea .... ~./~5~...' ................... 12. Does proposed Construction violate any zoning law ordinance or re ula' · 13. Will lot be regraded . .0~..; g tion .................. .. 14. Name of Owner of-r~,~'is~', '~'ri',~ ;~o' '/l,'zS' ', ......... Will excess fill be removed fr0mcremises. ' · , , -' , ' · .~ ... Address ..... !.LqQ...e;c.~.-l~.~oneNo. Name of Arch~tect . ~."ir.q^,~..O..e,~r,C/.v~ ..... -.. !~.'.'...ji_.;-I. . . . Name of Contractor'~.~P[ r-, ~,;~,q', '~" · -. ,q. oaress .. ~. {~ur~ ~.,o. ,..,~. ...... Phone No ........ . I5.' Is chi ........ '''.'.;'f~"j,,',,'', ............. Address .w.Q.%'bho/d,,- ,,~. ,, '=0/,-,;.4,.,. : .... · o F~-upercy wltnln ~oo reft of a t~-;~ ---~, '',,, ~ .............. rnone~';O..4~L-.tl~."~ .... · · If yes, Southold Town Trust~ ~--~ - Y.s ........ No .......... ~o ~=~.:~u may De requmred. · . .... [' P!~OT DIAGRAM . Locate clearly and distinctly all buildin;s ~h~*h2 ...... ' ' ' ' ro err Hn ~' I ~ , -~t.*~ ~xlS[lng or proposed and, lnd P P Y es. L/we street and block-urn'- ........ .. , ' icate all set-back dimensions from interior or corner lot ~, ~, m uescnpuon accoramg to deed, and show street names and indicate whether ;TATE OF NEVi. YOI~K_,,, } ' (Name of individual signing ~ontract) named. ~ being duly SWorn, depose9 and says that he is the applicant is the... ........... ,/- - . or, age t 'porat offi ) ' ' , tcontract n ,cot e cer, etc. , said OWner or owners, and is duly at~thorized to perform or have performed the said work and to make and file this 'plication;.that all statements contained in this'application are true to the best of his knowledge and belief; and that the ork will be performed in the mhnner setlforth in the application filed therewith. '- ,yom to before me this I ................ day or. 4... 19.6/ ~. NotaryPuble,$tateofNeWYo~ ' ,~ ....... NO. 4879505 /-~ ~ ' ' Qu?lifl_ed !n Suffelk cpqn~IJ. - ~ (Signature of applicant) · ~omml~mn =xp~rea December u, ~..,~