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Home My WebLink About21424-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23214 Date SEPTEMBER 14, 1994 THIS CERTIFIES that the building Location of Property 25 MOOSE TRAIL House No. County Tax Map No. 1000 Section 103 subdivision ADDITION Block 4 Filed Map No. CUTCHOGUE, NEW YORK Street Hamlet Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1993 pursuant to which Building Permit No. 21424-Z dated MAY 20, 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 ABOVE GROUND SWIPING POOL ATTAuhu~D TO EXISTING ONE FAMILY The certificate is issued to DWELLING AS APPLIED FOR BURRIS T. & VIVIAN JESTER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A H-042145 -- AUGUST 10, 1994 N/A ulldln~ Inspec~ · 0~ NO. ~ 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) Permission is hereby granted to: ...£.~...~.,,~........~../.~ ................. ..,~~,,..~..~..././.~ ~o .... ~~....~. ...... ~~~...~.~ ................... ...... ~/....z,.....f,:::~......~~'~ ..................... otpr,,m~ses~oted ot ....... ~.~ ........ ~~~.~ ........................ County Tax Mop No. 1000 Section .... L..~.....~. ...... Block ....~......~... ...... Lot No......~.-....3. ......... p~,~,,~., ,o o~p,,~o,,o. ~o,~ ......... ~.~ ....... ~....~ ......... ,,~.~ o~ o~p,o~ ~, Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF 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 lihes, 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and · pre-exlstzng 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 Buildin~ - $100.00 3.. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ' ~b~V~ ~Ot~ Date .'~'~..~... f.~.,.l ~ ~.~. .... New Construction ~OO Old Or Pre-existing Building ................. Location of Property..~..5..~. ~.~.~. ].~..~.~.'ll C~TC ...... .. .. House No. Street Hamlet Onwer or Owners of Property. .. ! ~ ~ County Tax Map No 1000, Section. /O'~ .Block...O.~ ...Lot. C ................ ....... .Filed Map ...... Lot ..... ?ermit No Rtqaq-L .Date Of Permit..~,~O/ ~ .~, .Applicant.~.{~C~%'~...~.~. :[ealth Dept. Approval ............... ........... Underwriters Approval ...................... 'lanning Board Approval .................... (equest for: Temporary Certificate ...... Final Certicate ....... "ee Submitted: $ ....... ~ 00. . ..................... ,z- ............. · "' ' ....... · ...... ~ --,~ ...... ' APPLICANT~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 2 8049249 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT BU~IS JES~'ER, 25 H~SE ~AIL, CUTCH~U~, N.Y~ in the folmwlng location; ~ B~sement ~ Ist Fl. ~ 2nd ~. O~ Section Bl~k Lot ~s exmnined on ~U~U~T 08: i994 and found to be in compl~nce with the N~onal Elect~cal Code. FtX1URE OUTLETS ECEPTACLES SWITCHES OTHER RANGES, R SERVICE DISCONNECT )THER APPARATUS: ~QUIP. 1~2W 1~3W 393W 3~4W NO'O~ERCC~COND' TIME CLOCKSt SELL UNIT HEATERS MULTI-OUTLET SYSTEMS mT. A~I'S. TRANS. NO. OF FEET V I C A W G NO. OF HI-LEG A.W.G. OF CC COND. OF HI-LEG EXHAUST FANS H P. DIMMERS AMT. WA~T$ NO. OF NEUTRALS A.W.G. OF NEUTRAL BURNS JESTER P. O. BOX 619 CUTCHOGUE, NY, 11935 ~NFa~L M~AGER 1.% Per-~ ; This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by ~fl~'~e'~t]a~J's. COPY FOR BglLDtNG DEPAfiTiVlF.~T. THIS COPY OF CErTiFICATE ~ILJST NOT BE ALTEF~ED IN A~Y J~A~JNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAOE l 80~92~9 BUREAU OF ELECTRICITY ~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date ~GUST 10,1994 ~pplicationNo. onfile 85312694/94 H ~42145 THIS CE~IFIES THAT B~RIS JES~R, 25 MOOSM T~IL, CUTCH~UM, N.Y. in the followlng locatio.; ~ B~sement ~ Ist Ft. ~ 2~ FI. OUT Section ~1~ Lot u~ examined on ~UGU~ 08,1994 and found to be im compl~ce w~h the Na~on~ Electrical Code. fiXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES OTHER DRYERS FURNACE MOTORS [ FUTURE APPLIANCE FEEDERS AMT. K.W. OIL H.P. GAS H.P.I AMT. NO. A, W, G. SERVlC~ DISCONNECT 1 ~O. OF I S OTHER APPARATUS: SWIMMING POOL- 1 G.F.C.I-1 G.F.C.I~-I *(SWIMMING POOL) This certificate covers compliance at the date of inspection only. Because of unusual ~nvironments it is advisable to have frequent test/and or repairs made by a qualified person. RANGES )ECIAL REC'PT R <<< Continued on Page 2 ~>> COOKING DECKS OVENS DISH WASHERS ,:';:s. u.,T..,., V I C E OF fo. NO OF HI-LEG EXHAUST FANS AMT. H P DIMMERS GENE~AL MANAGER COPY FOR BUILDING DEPArTMEnT. THiS COPY OF CERTiFiCATE MUST NOT BE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 10, 1994 Nr. & Mrs. Burris Jester P.O. Box 619 Cutchogue, NY 11935 To Whom This May Concern: We are unable to complete your Certificate of because of the following reasons: xx Occupancy 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 # 21424-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st FOUNDATION 2. (2nd ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION ]FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INACTION ] FRAMING [~/FINAL BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INS~TION FRAMING 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ _] ~/J~TION [ ] FRAMING /~ [~2/'FINAL REMARKS:''~//~ ~ M, I Examined ..- .............. , 19 ... Approved ' .~.A.q., 19 ~F~' Permit No .~./.~1.~....~r ' Disapproved. a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1803 (Building Inspector) APPLICATION FOR BUILDING PERMIT gO,(RD OF~ H~-~t, rl~ ......... SURV.E.Y ......... CIIECK .......... SEPTIC ' FO Ri'I .... ~TO: . ' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ,~ets 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 br areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- bation. c. The work c6vered 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, g,nd re~lations, and to admit authorized inspectors on premises and in building, for necessary inspections./,.~ x~ ~,~.~' ~ [/ .~LL . · .... .... ...... -- (Signature of applicant, or nanny, if a corporation) . . . .(Mailing address of. applicantt~f / [ ~] ~5~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~...~.~'..~. !..-q... !....~. .... I. ?..I. ~ .I.~... >)..~. ?..( .(.l'~ ....................... (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. Electnc~an s L~cense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................. ; ................ .o. .e. . . .T. r.¢,: . · Itouse Number Street Hamlet County TaxMap No. 1000 Section ... :~.Q.~. ........ Block ..~..~.... ' Lot....~.."~ ........... Subdivision...~..~..~..?.~..~....(?..... (Name) 2: State existing use and occupancy of premises arid intended use and occupancy of proposed construction: a. Existing use and occupancy ~q, O b. Intended use and occupancy 6( c) ',J .~.. (' 0 ti 14 Q ~ :": 1' "" ' ' i >'~ ......... · 3.Nature of W'ork (check which ~pPlicable): New Building . ~ ........ Addition .......... Alteration .. ;.. ;.. ~.. , Repair .............. Removai .............. Demolition .... ; .......... Other Work/~t l~[l~J .1~ . .. · ~.~, I ..... ' , ~OOzO~ [220oL (Description) 4. Estimated Cost .~ ~.IQ iD ' ,,,j L.._, 2. , ...... i : ....................... Fee ...... .... ... i · (to be pa~d on fihng this application) 5 If dwelling number of dwellin~ units ' Number of dwelling units on each floor 'If garage number of cars ? ................ ' ............... 6 If business commercial or mix6d occupancy specify nature and extent of each type of use ' '" .... 7' Dbnension[ of existing struct~ies if any: ' ' ' .................... Front ' Rear Depth Height Number of Stories .................. Dimensions of shme structure with alterations or additions: Front Rear Depth ' ~ Height ' i ................................... ................... i ............. ' ........ ... Number of Stories ' Dimensions of entire new construction: Front ..................... ............... Rear Depth Height Number of Stories .......................... Size of lot: Front ........... i .......... :.. Rear .............. ; .... Dept.h ... ~ .................. Date of Purchase .... o~,/. ~ i~ ........ . ......... ~q'ame of Former O~wner .... (--2ct.~C cJ ....... ~Zone or use district in which pr~mises are situated.· ..~< .~.~.,:.e].¢.vl .~l.*.t ..... iii.. i.. i. i. ii. i. i'." ii ooes proposed constructio~vioilate any zoning law, ordinance or regulation' .~, O ........... ' i. Willl0t be regraded ,~.a ,. - ........... i . ' . .... ' ' '~ i .... , ....... ~z. · · wi.i excess fill be removed from premises: Yes No · Name of Owner of premises D~.~..P.(~...,~. e.~..~.~j~ddress .~._~7/ff..o..o.~.~· .Tf~ .~¥1~)~. Phone No..~.'~.t/.T.7.o3: ~... Name of Architect ......... ~ ............ Address ................... Phone No ................ Name of Contractor ........ ' ·; ............. Address ............ . ...... Phone/bio ................ 15.' Is this property with±n g00 'fee't of a tidal wetland? ~Yes ........ No.. ~ ..... · If yes, Southold ~.own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly MIi buildings, Whether existing or proposed, and. indicate all set-back dknensions from property lines. Give street and block inumber or description according to deed, and show street names and indicate whether interior or corner lot. 9. 10. 11. 12. ]3· 14. STATE OF NEW Y~P~ .... · .~-~ ~. t~. L~.. ~ .... ~/~-~./~'./~. ............. being duly sworn, deposes and says that he is tlie applicant (Name of.individual signing contract) above named. , (Contractor agent cori~orate officer ete ) of said owner or owners, and is duly !authorized to perform or liave 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 performed in the, c~manner ~et forth in the application ill'ed therewith. ' 5worn to before me this ~/~/ /) i otary Pu!hc ................ i County . , Term Expires May 31,19 ~.'~--