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Home My WebLink About20577-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARtmENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20912 Date AUGUST 5~ 1992 THIS CERTIFIES that the building. Location of Property 4250 LUTHER ROAD House No. County Tax Map No. 1000 Section 106 Subdivision ALTERATION ~{ATTITUCK~ N.Y. Street Hamlet Block 9 Lot 1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 22, t992 pursuant to which Building Permit No. 20577-Z dated APRIL 24~ 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 ALTERATION TO EXISTING COTTAGE #11 AS APPLIED FOR. The certificate is issued to GUSSIE CANNONE (owner) of the aforesaid building. SUFFOLK COUN~ DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H-030065 - JULY 24~ 1992 N/A ~di~g Inspector Rev. 1/81 lvORM NO. o TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-No. 2057TZ Permission is hereby grant~,~o: .... .~: ........... ~~~.~ ..... .......... ,o .~~..~~~ ........ ~:..~~.....~~ .~.....~~~ ....... ~..~ .......................................................... ~ ................. . ............ ,,~re,,,.,,~.,.~,, ...... ~ ....... Z~.....~ ........ ~~.....~.~Z .... ................................................... ~~~ .......................................... ~ ~ ........................... co~.~ T~ ~ No. ~000 s.~.o. ....... Z~.~ ...... ~k .......... ~ ........ Lo~ No....~ ................ Building Inspector. Rev, 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CEKTIFICATE 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 ~ccurate 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 i% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations~ a certificate of Code Compliance from architect or engineer i responaible for the building. ~ 6. Submit Planning Board Approval of completed site plan requirements. 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 i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swi,uning 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 $15.00, Commercial $15.00 Date ... ...................... ew Construction ..... ;",'-3. Old Or Pre-existing Building ....... ~ ....... ocat ion of Property. ~. ~ f..~.~.f~?./.~.~.//. ......... ~.~.~/~. IIouse No. Street Hamlet lwer or Owners of Property ..... ~ .~.~. ~./.~. .~..~../~.~..~../~..~_. lunty Tax Map No 1000, Section../..~.~. ....... Block..~. ............ Lot../ .................. bdi ' ' vlslon .................................... Filed Map ............ Lot ............. ........ rmit No ................ Date Of Permit ..... Applicant . alth Dept Approval '-- · ' ....... Underwriters Approval arming Board Approval ..... ~..~. .............. quest for: Temporary Certificate .... Final Certicate ........... ....... . 2o )2. .... APPLICANT INSPECTORS Victor Lessard Principal 13ailding Inspector Curtis Horton Sen/or Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York ! 1971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD JULY 30, 1992 FRANK tR~SAK, JR. 4400 BREAI~ATER ROAD MATTITDCK, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) ~ No Underwriters Certificate on file. XXX The check is ~x~x~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20577-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: G~SSIE CAN~ONE THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 ~0341,37 BUREAU OF ELECTRICITY V 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~Date J [Ff~¥ ?,4 ~ t992 ApplicationNo. onlite 03326792/92 H THIS CERTIFIES THAT only the electrical equipment ~ ~scribed below and introduced by the applicant ~med on ~he a~ve applicat~n ~umber in the premlses of in thefollowlng k,cation; ~ Basement ~ Ist Fl. ~ 2nd Fl. Section Block ~sexaminedon J'[~,~ attd found to be in co,tpl~ance with the requirements of ti is Board. FIXTURE OUTLETS RECEPTACLES SWITCHES FURNACE SERVICE DISCONNECT FIXTURES RANGES S R OTHER APPARATUS: 0VBNS [DISH WASHERS 'IMECLOCKS BELL UNIT HEATERS M~LyTI-i~UM~sLET A~,T, AMPS TRANS, ~ NO, OF FEET V I C A W, G NO OF HI-LEG J A. w G, FLOOR TO 1S? I!LOOR FLOOR 'fO lY? ~I, OOR Lot ~J~EXHAUST FANS O/: NEUTRAL C~BIN # 11 4258 8R~A[(~A~E[~ RD. GENERAL MANAGER Pert~ 1/{7 This certificote must not be e[fered in ~y monner; return fo }he o}}ice o~ the Board i~ incorrect, inspectors moy be identified by their credenfioJs. FOUNDA~TION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & ·PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI;;AL ADDITIO~A'L COMMENTS: If, Y, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [~AL , TOWN OF ~iO~ T~t.d ~ ; Examined ~ ~ 19~ Approved . . .~ ..... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 ., 19F~· Permit NO..t~...'-~..~..~~ Disapproved a/c ..................................... BOARD OF HEALTH . ~ ....... 3 SETS OF PLANS .., ....... SURVEY ............ ' ....... CIIECK SEPTIC FORH .............. t,O~ ~ FY , CALL ................... ... ..... · '. APPLICATION FOR BUILDING PERMIT Dfite .......... ~ ........ , 19... INSTRUCTIONS a. Tiffs 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 streets ,r areas, and giving a detailed description of layout of property' must be drawn on the diagram which is part of this appli- ation., c. The work covered by this applicatibn may not be cbmmenced bei'ore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit i~ail 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 imll 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 ;uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on pr~mises and in building for necessary iqs_~_ ction.~, . .... .................. (Signature of a~pplicar~t, or n~me, if a corporation) . .... .... ....... ... ·~. (Mailing addresS/of applicant) ;tare whether applicant is owner, lessee, architect, engineer, general contractor, electrician, plumber or builder. ,/amc of owner of premises · (as on the t.a[x roll or latest deed) f appl. icant is a corporation, signatu.re of duly authorized officer.- (Name and title of corporate officer) Builder's License No... ~.,~d.~..-.-.-.-.-.-.-.-.-.~ Plumber's License No. ~ Electrician's License No ....................... Other Trade's License No. ~ Location of land on which proposed work will be done ..... ~:ff~d.~X ~.-.~/..' ..O-,,~. ' . /./. . . .x. . flouse Number Street Hamlet Cotmty Tax Map No. I000 Section ...... 2&.& ..... Block ...... ~ .......... Lot .... ~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (NamE) State existing use and occupancy of premises and intended use and occdpancy of proposed construction: a. Existing use and occupafi~y .... ~ f~ .~. ~ ........ ~7. ~J4~. '....; ............................ b Intended use and occu n .. ~ ' ' :' ' ~ ; ' ' " - pa cy ~ 3. Nature of worli~check which ap[ ilcable): New Building .......... Addition .......... Alteration .; ........ Repair . .~,'ffff... ....... Remm al .......... ;... Demolition ....... Other WQrk~, . .i,: ............ · " 4. Estimated Cost ~ ~ O ~ ._~.? . (Desc tion) .......... i ............... Fee .. .~. ................. 5. Ifdweiling, number of dwelling u~its t~.tY. 'f__,~r. (to be paid on filing this applicition) · ~u.m. berofdwellingunitson each floor..."..':~. ........ · If garage, number of cars ...... i..'7"~.. ........... ii .......... . 6. If business, commercial or mixed ioccupancy, specify n, ature a~nd extent of ca, ch !.ype of use ........... 7. Dimensionsofexistingstructures if any' Front ~/~ ~/ Rear . f.~. ~.?. Depth Ii[,2. '.'"k .... Height .... . ........... Numher of Stories . . .~'~ ~ ...... Dimensio~n,s ~ofsame structure with alterations or addit ons' Front ' /'2,.(. ~. }) ....... ~,' .... ?~ ~ }) ...... ..... ] t:,- ........................ fqunloer oi blorles .... :-; t. ~:... ............. 8. ~mlenslon~ ut enhre new construction Front ...... Rear .. De th Height ......... ~,.... Nt~mbjer of Stories ..... ' ...... . ....... i' ' 'i' P ............... 9. Size of lot' Front ~i'[, t, qa Rear ' ~ i5 4 't ................. :~'~' b; z,'; ............ ,.. ' .............. ,..'~t[,~'. . l~nfh '~ ~ 10. ~ate ofPurch,.as, e. :.. .... .., .... .. ....... . ......... Name o~f Former Owner . .,,~./!:.q~ .... (~.~.~'J~,ac6t~ . 1 1. /~one or use msmct m wmca premises are situated ........ /~. ................ . .................... . ..... 12. Does proposed constructio[tyiola~e any zoning law ordinance or regulation. ~ . , l~. Will lot be regraded .Q/.o. . . , ....... ' ........................ 14. · .... ~..,, ............. wiu excess fill be removed from premises: Yes No Name of Owner of premises'.· ;~., ....... Address~./.°..~c..-~g/4..P.~..~.~gl<Phone No.."/t~T. Name of Architect ........... I ................ Address ................... Phone No ................ Name of Contractor ......... I ............... Address ................... Pho,ne/c,No ................ 5. Is this property within 3010 feet of a tidal wetland? *Yes ........ No..~. ...... ·If yes, Southold To~wn, Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bluildings, whether existing or proposed, and, indicate all set-back dimensions from ~roperty lines, Give street and bl~ock number or descriptio~ according to deed, and show street names and indicate whether nterior or comer lot. 76g:1802 9 AM TO ~ PM FOR THE FOr. LOWiNG tNSPECT OHS: i ..... X--["'-"~ ~ ..... 1. FOUNDAT ON '~OREQUI,ED ' m', FOR POURED CONCRETE , 2, ROUGH - FRAMING & PLUMBING ~. INSULATION 4. FINAL CONSTRUC~iON MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE IN.Y. .... STATE"'CONSTRUCT ON. & ENERGY CODES. NOT RESPONSIB~E'FOR DESIGN OR CONSTRUCTION ERRORS rATE OF NEW YO, J~IC,4--, ,I , ' OUNTY OF ..... '-~.'\5.q\ 4/~-.. S'Si ht lC ................. ~ ......... t ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing [contract) >ove named. ~' is the (Contraator ~ ..... ) , , age'4~ corporate Otlloer, etc. :thorized to perform or have performed the said work and to make and file this in this application are true to the best of his knowledge and belief; and that the forth in the application fiIed therewith. said owner or owners, and is duly m plication; that all statements containe )rk will be performed in the manner se /om to before me this ..' .... ... ,tarv Public .--~7..~~~''~ · )r/'- ~" ItOTARY PUBLIC; ~. ¢725089, · - 1em h~lr~ W ~~' C°unty ~Z/ / ~..~.: ....... ~oW4~ouW,, ' .................. ~1,19-Y.g~ (Signa~re of applicant)