HomeMy WebLinkAbout20516-z
L FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22216 Date MARCH 26, 1993
THIS CERTIFIES that the building ADDITION
Location of Property 535 BIRCH LANE CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 83 Block I Lot 27
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25, 1992 pursuant to which
Building Permit No. 20516-Z dated MARCH 31, 1992
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 TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WILLIAM & BERTHA DAVIS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-26222 - JANUARY 7 1993
PLUMBERS CERTIFICATION DATED JAN. 20, 1993 - MATTITUCK PLUMB. & HEAT.
Building Inspector
Rev. 1/81
f'
FORM NO. s
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)
N°-N°• 2051OZ Date ...0/1-2 / 19.22
Permission is hereby ranted to,
o . . r
W14.
at premises located at
.
County Tax Map No. 1000 Section Cl..3....... Block /...........yLot No....... r.22.......
pursuant to application dated ~26............................ 19J..V and approved by the
;cBuilding Inspector.
om
7L~fpL Fee ;...Lfj~.~la......
l Bui ng for
Rev. 6/30/80
F
t
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 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.
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 $pp15.00, Commercial $15.00
Date jvk{ . j s.,.. M.3 . .
lew Construction...` Old Or Pre-existing Building .
/I I
,ocation of Property 3s............ 1 m-d-,. >
s ~.~e
House No. Street Hamlet
)nwer or Owners of Property.... ft.-a YT. ;~~cc v:$,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
:ounty Tax Map No 1000, Section... 7........
.Block....I. .......Lot....?.?
ubdivision
......................Filed Map..........pp..Lot..................
ermit No.~.0,5.1k.Z,.... Date Of Permit...... Applicant. it,QlY4e.
ealth Dept, Approval....Underwriters Approval..?b'bi Q Z/5?.........
lanning Board Approval..,-
equest for: Temporary Certificate............ Final Certicate..
ee Submitted; `
C-0 2- a~~~~
APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS VAGE 1
F BUREAU OF ELECTRICITY
I 85 JOHN STREET. NEW YORK, NEW YORK 10038
Date dANwy 07,7993 Application No. onfile 78521692!92 N 262222
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
V;T.CUM-1.. 5 t1RFl IA DAV181, FORCH IMF, CUYCW)GOF, N,S.,
in thefollowing location, Y Basement ® 1st Fl. ? 2nd Ft. Section Block Lot
was examined on DECK. ffll fi'd 29 r 1X1'12 and found to be in compliance with the requirements of this Board.
H%TURE ECEPTACtES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS t7RE ORESCENT OTHER AMT. % W. AMT. K.W. AMi K.W. AMT. K. W, AMT. H P
DRYERS FURNACE MOTORS APPLIANCE FEEDERS SPEUAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K. W. Olt H. P. GAS H. P. AMT NO. A W. G AMT AMP AMT. AMPS. TRANS. AMT H. P. NO. OF FEET AMT. WAlT3
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMt. AMP, METER
TYPE I,e 2W 1 ,a 3W 3 s 3W 3,9 4W NO. OF cc. COND. A. W G ry0 OF HIAEG A W G NO OF NEUTRAI3 A W G.
EQUIP. PER .0 OF CC.COND. OF HbtEG OF NEUTRAL
OTHER APPARATUS:
Yi.F..C.1:t°1
G & $ CON'PRA.CTOR CTC. 578
BOX 2Pi
OU4'HOLD, NY, 11971 GENERAL MANAGER
11
Per
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.
• HER. ~
SUFF. CO. HEALTH DEPT. APPROVAL H. S. NO?
OWNER:
13 E P,TH_A DAVf 6
AfA lam ,
~-tevY York . !JC?2>
AREA: ,ti{•~i;_ :.>•~_'i
DEED: ,,N % tl
~ r r
'1r dM ~ ~ is %
LOT -1; '
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n J
6 ow,
Q SCALE: =U'°
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A6, A''+
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O
• •7, !Sn:;• rixc: t*M ar^oroa'wn of nd3ninn
p
J i xP to t~'s su'+, is a of inn of
seauon 7i'^nt YtSe i¢eW Vork .StRt$
nifJCkt1AR I.R.W.
! C Canios of this srsrosru map not baaring
* the t3ad ;nrvaYm a inKal ^.oai a
~a - orebo,;W, seal shslf not be considered
to be 3 VEhd truo onpy.
rr. t: Hr:•' ! i~v, i r , ~~_?~t / v~ Guarantees lrn r.tt'A hm"n aball run
/tME v:. J ? F{QC1`is '-'y only m emon for nhcrn ihr sawn
r, vu, MAY 25, S9bB, v a.. s
_ P Is txcvassvJ. zed an his bt'r:IIif to tae
title P.mi^,my, governmental 2,.e cy rad
ten',rn', in,3nwa wn 11.'z n`hr:con card
TITLE CERTIF. to she -no;}ues of the fandin, lmii.
tucton. L-u_;„ntoea oro not v nn:.e: ahie
to P.Cdtlorm; insile"tions er sub9goqueni
n ^ owners. VAMP
Guavavv~cej
•`~/~rti~C'd -.fi riC_i A,T CJ7'0HC(U:-• ca t^ rri G'C
r 4~t. •Ti#'ic~ Gu cc• C~ h o fin'( ~ F
AT .a o-fA`' Q
RODER`I G~K VAN TUYL. P. C. ~ Zo m4W, ryro
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_ 1AND
LIC• LAND SURVEYORS-GREENPORT. N. Y.
TEL. 765-1802
TOWN OF SOUTF.3OLD
OFFICE OF BUILDING INSPECTOR
u°, ` t 3~~ rn P.O. BOX 728
e?? i TOWN HALL
SOUTHOLD, N.Y. 11971
C E R T I F -I C A T I O N
Date O J
Building Permit No.7 OS. It
Owner ,M r_ _ !l_ ASS I~ iJ1
(please print)
Plumber Lv k L%Lll
P
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
(plumber's siy
Sworn to befor,2 me this
rL(1^0.1:~_day of je/-AJL1,4k yI
19 93 ~LNota y lic
Votary Public, County
EDITH F, JACKSON
W 4M758
*jaw b &&& County
TMm B*m Feb. 18,199
I ~ iit`1l`f L N i.^
v /9
rOU (1st)
OUNDATION (2nd)
a
o
UGH FRAME & y
PLUMBING 01)
m
LATIOPJ PER N. Y,
H
STATE ENERGY
CODE
_Jl 11
H
FINAL
ADDITIONAL COMMENTS: m
. 'v
N \
9
O ~e\'
W
m
A
y
v
cr?
v
765-1802
BUILDING DEPT.
INSPECTION
OUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
jRARKSo:m_e/t-"-e
4
DATE c3 9 v INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ) FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO DATION 2ND [ ] INSULATION
[ FRAMING [ ] FINA,L/
~
REMARKS:
DATE y INSPECTOR
ppp~
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
[ - ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
i
r
DATE INSPECTOR -Z~17
r
l~ -
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] IN ULATION
[ ] FRAMING [ FINAL
REMARKS-.. ZaA~~-
Z DATE lZ' INSPECTOR
s
BO,%RD OF REALTII
FORMNO.1 •
3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT curer; _
TOWN HALL SEUTIC FOR:t _
SOUTHOLD, N, Y. 77077
/ TEL.: 765.1802
E:camincd . .3?..... CAI. L'
19%
'%Pproved s30 Hn t t To
1Permit No.G~,
Disapproved a/c
(B dine Inspector)
APPLICATION FOR BUILDING PERMIT
Date . r/ltsra~ . ;Z'5: 19 l Z
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
tsbf 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
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
.tion.
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 per:-nit
all 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
all 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
iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
mit authorized inspectors on premises and in building for necessary n inspections.
(Signature of applicant, or name, if a corporation)
i-.>~ ...(I(I...SOL-JLJ& ~1(a-'
...1!97.1...
(Mailing address of applicant)
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
4l) ?K g cov 1~w~,~
me of owner. of premises U.\S
.
(as on the tax roll or latest deed)
pplicant is a corporation, signature of duly authorized officer.
tires:...........
(Name and title of corporate officer)
Builder's License No. j 3 4 .H .T
Plumber's License No .
Electrician's License No . . .
Other Trade's License No . . . . . . •
'.ocation of land on which proposed work will be done. j c.vuP
53.5 Qvrf 1 GL .o
louse Number Street " " " "
Hamlet
'ounty Tax Map No. 1000 Section ........S , , , , , , • Block , , )
Lot... ~7
ubdivision Filed Map No. .
(Name) Lot
ate existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy ....QA,Q
Intended use and occupancy ..jonR.Tbhr~....lPstt~z p
Pure of work (check which "oplival . .cable): New Building Addition ~ \Iteration
c
• Demolition Other Work
Estimated Cost
(Dcscnption)
Fee.....................................
S. If dwelling, number of dwelling u (to be paid on filing this application)
jots , , , , , , • ' ""'Number of dwelling units on each floor .
Ifgaragc, number of cars
6. If business, commercial or mixed 'occupancy, specify nature and extent of each type of use , • • • • . • , .
7. Dimensions cf exi sting structures; if any: Front ...4 3
Height Number of Stories z, Rear Depth .
Dimensions of samefstnicturc
8 will't alterations or additions: Front , .
Depth . • Rear ..~2~ '
ql..... Height ....?0. Numberot'Stories.....fix of
. Dimensions of entire new
construction: Front ,
Height , J,G, : Rear J~.:....... Depth .
6 um bar of Stories I
9. Size of lot: Frant :1
, , l 6 , S'
10. Date of Purchase 5k us{ Rear E " . ' . ' . ' ' • • .
; Name of Fonner Owner Depth JQ . .
It. Zone or use district in which premises are situated , , , , , ,
12, Does proposed construction violatC any zoning law, ordinance or regulation: . N.O, , , , , , • , , , • , • • , , ,
13, Wi11 lot be regraded N 0 ,
14. Name of Owner of remises Will excess t7i1 be removed front premises: Yes No
premises ~er , . Address S3is ;
ame of Architect , •r :....Phone No. 7 3 Y sra
N-
Name of Contractor u,iae. ' ' ' • • • Address Phone No.... .
w.a.,? V . S
5. Is this propert within 30 • Address wetland? !IJI, , $yyxi r l~ , , , Phone No..76•>; ; ZG ?1 r.
*If y Q feet of a tidal wetland? *Yes
yes, Southold Town Trustees Permit may be required. * No•?C"
PLOT DIAGRAM p
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
+roperty lines. Give street and block number or description according to deed, and show street names and indicate whether
nterior or corner lot.
410.0
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%TE OF NEW YORK
UNTYOF..i?~,{(p~~t...... S ~go,Gq
(Na
me of divRiduai signing co'I... • ' " " being duly sworn, deposes aiid says that he is the applicant
;'c named. ntract)
s the J,'q !ice .
(Contractor, agent, corporate officer, etc.)
lid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
cation; that all statements contained lit this application are true to the best of his knowledge and belief; and that the
will be performed in the manner set forth in the application filed therewith.
m to before the this
fv d .day of t LUw'r l) 199.-4ry Public, • , County
Notary 0. ROMEO
v Public, State of New York `
Qualified in Suffolk Coun k (Signature of applicant)
Commission Expires _71,Y1 i a,
1 +
t
a ' + UNDERWRITERS CERTIFICATE
REQUIRED
!
UCCUPA[cy OR
w~
USE IS UPS 9VF
F b~~6TH ~ OUT CERT9EJCAT , G°,' ,.hl HIP ,EN AT
1 OCCU°pg~~AA~ !'~i~Li?V.RIVG llUg•~~~: - FOR TFIE pry`y' FfPUIVG. Gmg hFlGIRvi~
o Vld 1 r(1i5 i'OliHEp (,ONCRETE LOIIIREO
2. ikOUGH _ EFi,a 147iA!G & PLUMBING 3. I VSUL TI()N
h. 69AL4: . CONSTRU
BE L'OMWLET- F CTION MUST
ALL CONSTRUCTION
THE HEQUIREMENTS SHRLL MEET STATE CONSTRUCTION F THE N.Y
CODES. NOT & ENERGY
DESIGN pR CONSTRUCiIpry RROFRS
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r' 9CAl APPROVED BY OPAWN BY
BAiE REV49EO.
-:DAviS
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