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20945-z
i FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21173 Date NOVEMBER 24, 1992 THIS CERTIFIES that the building ADDITION Location of Property 395 BROADWATERS DR.& 660 OAK DR. CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 6 Lot 12.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9, 1992 pursuant to which Building Permit No. 20945-Z dated SEPTEMBER 9, 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 RAYMOND S. SLAVIN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-256120 - NOVEMBER 6 1992 PLUMBERS CERTIFICATION DATED NOV. 17, 1992-ALAN SEIB uilding Inspector Rev. 1/81 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) N2N04 20945Z Date rl` ::::~s......4........... 19.4... Permission is hereby granted to: . Y..... G....................... `~.x....~ . , . :y.:.....4r..9...a- to ...Ca.^.a....:f..~4?...4 rt....'~0.,.. a..~...P., ~ . at premises located at3~,1../?!"~f~`t*~4~ ran ~~R~.() c?JG /,?Z.: . ..2 County Tax Map No. 1000 Section Q...... Ala.~....... Block ......QL....... Lot No....~ :..3....... pursuant to application dated ......AY~ty I 1991x., and approved by the Building Inspector. Yv Fee f . , k B... ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR,ink and submitted to the inspector with the following: for new building or new use: building 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-° form . 3. Approval of electrical installation from Board of Fire Underwriters. ) 4. Sworn statement from plumber certifying that the solder ysed in system contains less than 2/10 of 17, 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. I• 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 $15.}000, Commercial $15.00 'w Cons / Date ..7Y J.G.....~. true Old 0 re-existing Building, cation of ProPert House No. = d..Z. SD ..~'s? •I• E:... ; ~~:/.1.. ~ K• ~ y' . • • Street Hamlet ucr or Owners of Property.. Z U inty Tax Map No 1000, Section./0.~,,,,„Block..O..,` division......... .Filed Map............ Lot..................... nit No...... ..Date Of Permit. - ~-•Applicant... lth Dept. Approval. ..:?.'f. / S/ y. ..Underwriters Approval..... nning Board Approval........ Zest for: Temporary Certificate..... Final Certicate Submitted: ip Q~c ~(Sf~(a2s. co ~cZ I 1 ~l APPLICANT 2 THE NEW YORK BOARD OF FIRE UNDERWRITERS 11AGP I. ©0>; BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date NOVEIINER 06,1992 Application No. onfile 7900219202 N :?£iG12CA THIS CERTIFIES THAT only the electrical equipment as described below and introduced Gy the applicant named on the above application number in the premises of RAY SLAVLN, 395 bROAUWAVER DRIVE, CU'P010CUE, N,Y, in thefollowing location; Q Basement lst Fl. ? 2nd Fl. OUT Section Block Lot wasexaminedon NOVF;NHER 05,1992 andfound to be in compliance with the requirements of this Board. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W. AMi K. W. AMi K W. AMT. K W AMT. H P. 6 8 G 6 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECPT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K. W OIL M. P. GAS H. P. AMT. NO A. W. G. AMT AMP. AMT. AMPS TRANS. AMT. -HP NO. OF FEET AMT. WATTS ,30 SERVICE DISCONNECT NO.OF S :E R V I C E AMT. AMP. TYPE METER I X 2W 1 ,e 3W 31! 3W 3,e' dW NO. OF CC COND A. W. G. NO. OF HbLEG A W G NO. OF NEUTRALS A W G. EQUIP. PER 9' Of CC. COND. OF HI. EG OF NEUTRAL 1 a50 CP I X OTHER APPARATUS: FLE(!, EOON HEATFRie1-7.5 K,W. PATTISTA ELECTRIC Ll'f.:.$2295-E BOX 28S EIA35A{?hQ11A, NY, 11.758 GENERAL MANAGER Per 11 V 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 CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. c~O~f OCA.C TEL. 7G5-1802 o TORN OF SOtJT.HObD _ a y f " c OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN HALL SOU HOLD, N.Y. 1971 NOV {81992 71- C E R T I F I C A T I O N Date /2 y' Building Permit No. 0 Z Owner (please (print) Plumber (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. (plumber's signature) VOIA SEu NOTARY'PUBLIC, State of New York Sworn to before me this Neffo Qualified fnn Su Suffolk lk County / Cornmissicn expires October D, 19 5;-? day o f ~J~3-v'-m~f 19 Notary Public Notary Public,, County ' TEL. 765-1802 S~ffOt X 4;• ~p~ ` TOWN OF SOUTHOLD ,wt ^a r OFFICE OF BUILDING INSPECTOR ° ;r "ads P.O.°BO\ cn 1179 v- cis V r TOWN HALL SOUTHOLD, N.Y. 11971 J.. & V. General Contracting P, 0.. Box 66 Cutchogue, N. Y. 11935 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. No Underwriters Certificate on file. The check is(outdated/not on file.) No flealLh Dept. Approval on file. No final inspecLion has been made. Please contact our office on this matter. Thank you for your cooperation. Building Kermit It 2 094 5 _ Z Building Dept, No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMAR S: 77 DATE Cv v INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL REMARKS: t DATE f0 T~ INSPECTOR PIPP7 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: r I DATE 42-9X 7/ INSPECTOR HOJA3dSN1 3J.Va :SHvVW3v IVNIJ [ l JNIWVVA [ ] NOI1VlnSNI [ ] ONZ NOIJ.VaNnoi [ ] 0081d HJnOa [ ] IST NOIJ.VaNn i [ ] NOI133dSN1 -Jd3a VNlamn8 ZOST-99L I ~ , lEL7 S. c .1J;i ~~J } I~ C:li•tLNT H a ODUDATION (1st) C 'OUNDATION (2nd) Z z o " ;OUCH FRAME & •PLUMSING 3. m 'IlSULATIDN PER N. Y. STATE ENERGY V CODE I 7{- m tln. I ";d6 ~A FINAL l ° 69 ADDITIONAL COMMENTS x M H • y oe m . ^v H ~.a ( BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS v , TOWN OF SOUTHOLD SURVEY 10 BUILDING DEPARTMENT cIIECI : . _ _ . TOWN HALL SEPTIC C0Ra SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ttoTIFY; !:xamincd . fltiw - CALL 199Z qq ~f MAIL TO: S %pprove + • .l 19 71?: Permit No..IQQ9.Jcctor) -)isapproved a/c _ . (B . APPLICATION FOR BUILDING PERMIT Date 19 , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts 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- uion. c. Tile 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 :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 gilding 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. 1e applicant agrees to comply with all applicable laws, ordinances, bull code, housing,, de, and regulations, and to ~~g !mit authorized inspectors on premises and in building for necessary inspect•Ons: f ( oture of a plicant, or name, if a corporation) ~.1t (Mailing address of applicant) :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . amt of owner of premises h. (as on on the tax roll roll or latest latest deed) applicant is a cor oration, 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. Location of land on which proposed work will be done. J73 I-0-0,d-64 O'a`dm .~.Ie:5.........1C House Number Street Hamlet County Tax Map No. 1000 Section .....1A !;49 Block , , , , , , , , , Lot z. , , , , , , Subdivision Filed Map No. Lot (Narnc) State existing use and occupancy of premises and intended use an occupant of proposed construction: . a. Existing use and occupancy s t G.... , . . ~ ' , , , , b. Intended use and occupancy . r...~:. R 3. Nature of work (check which Ipplicable): New Building . , a • Addition . , ~ Alteration Repair . Rcrri 1 74- oval Demolition Other Work f, (Description)' 4. Estimated Cost Z. , . rv ' • Fee S'~ . a (to be paid on filing this application) S. If dwelling, number of dwellm units Number of dwelling units on each floor If garage, number of cars , 6. If business, commercial or mixo occupancy, specify nature and extent of each type of use . Dimensions of existing structures, if any: Front . ,Rear Depth . Height Nurhber of Stories . Dimensions of same structure with alterations or additions: Front • . . Rear Depth • • • • ..,...Height , Number of Stories . , Dimensions of entire now c Nut'ruction: Front ?:m........ Rear ...............Depth ..4-Pt. • , , • • • , Height rtber of Stories . . • .Rear Depth . 9. Size of lot: Front 10. Date of Purchase , Name of Former owner 11. Zone or use district in which premises are situated • • • • . , 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. i of be regraded • • • • • ~ • • • • • • • • • • • • • • , Will excess fill be removed from premises: Yes No 14, Name of Owner of premises . , f Address Phone No. . Name of Architect . . . Address . . Phone No. . Name of Contractor . Address . . Phone No. 15. Is this property within a0* , 0 feet of a tidal wetland? *Yes No.. " ' " " " *If yes, Southold 'own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ally 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. i 615.1 1 I II i i I , i I I I ~I i STATE OF N YO COUNTY OF,C~.(! SiS f v r • • • • • S Q • . • • • • • being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) ibove named. 'leistile ......................1...... (Contractor, agent, corporate officer, etc.) :f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the York will be performed in the manner set forth in theiapplication filed therewith. ;wom to before ~k ,day of lotary Public, % c5iwi E ....County Notary Public. State of Now York J No.4879508 Qualified in Suffolk County Commission Expires December 8,i19 (Signature of applicant) DRIVE OAK s~ - 31992 100.02' 2. -1 N.IYia> X502' ~no~ c' 1N Pf, 1 'D IV 0 1 l-Cj~ W. ~ Inc/~h N Z 27.9' j+' Pvr O 4J m lsfy N ro Jye6 h3°. 0 x Q 1 r o Qa•3 ' sheer I 4 V J fn~e 4 < yV T .ce °.A' Nnj 7G~ tRpf ra,~ ~ 1g.05o°w, 00" W' o 1 i N/04 AREA=14,910 agft SURREY FOR F RAYMOND J. t o VIN AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y G 1000- 104"x, - Scale. 1" = 30' Aug. 21;1882 i ` 4 . rIC. NO. 49618 s1 JF for lb SIMP esl d o a the UU.s and o* and~Aod rare E~ soli wo # 7b, w tort SYW* Lied P. a M,4W ROA Tih Assod ' swrl f1LD, x K 11977 92-1267 --Q z 11;1 U~ p~~ Otp Di BiLco $ MAT[N E%rsT _..I gar , 2•a'Rlne.€ ( N 3"F'~ 4,'-0 zo. o. k - MATCHING 1~1SiF 6 uc Las / - /VIATGNING c~"FEAFi-µT 2~F=1C''oc 2'.4=1G'aG I ` 0-- L] - 'Lam"-IG'ac. {-30 m c Lo 5 e - N I V THAM IVyFsAaY (5'F / J1 p c f111S~. II co MA-f ul U I' h 4' 9 _ 0 4' f _ _ g sL G 4 `-tr TwnnJO C~_"2.;i~' - 2-_2i/1" N QU O W U 6oFF'T - 2'iCo=ll'ou ~j w-l BRIDG,IR6Gr 0' h` c a u S`~ ~ cv,r O I C CI oRMEV. FJECPSOCY?~ 6 (p ~ ~ -01 ~ W 8'-o CE17AR SFFINC ~,mK 0 4l 4i {.IEW WALL Tl S o'~ ~~h VIER / 1 3 2+8 0 ti' cDx~. ril S/a'c~ 3 UQi4 oL.oN G t NI C ~r REMuVe c s D .z6 J m lV ! (/..INAL~ 6e N i 0 SILL. 5s-Lmg- Q WU It p MEAL_nuI V,, g 2x81" 32r®' QL n llC 01 9 Yi4 AkjH. ]~LjS Q)I 0 Q .QI ~J Iz~(nt. AIL 7~j LZIDGIl.1 Gt -I Q xi Ti KL CT N - a 8"C01uc. g~oc~, r Q oR ~7alRED6" UJ N 41 V <C:' cocoa. Loo PS V TAR j~LoIN69AVE t~"Cotdc- I W :1~ z- to -o„ A AL MOVE M P~°P,f.?MF.'S1 ~#S ";JtF.,•.a - - - - .y A 20 ~j~CTION A-A FEE 'Y-' R" NOTIFY BUI! D!{41f: i)FPF 3UIL Dm,f_ ULPARiMENT AT P GAM TO I NS FOR THE FL OOR FOLLO 0I S TO 4 4 N FOLLOWING l l DAGA INSPECTIONS FOUNDATION ~ TW TIUN ~ TWO REQUIRED - FOR POURED CONCRI OURED CONCRETE - ----T H - FRAMING & PLUMBING q.' OCCUPANCY OR 2. ROUGH - FRAMING 3. INSULATION ATION ftM~ CERTIFICATION USE IS UNLAWFUL we"w M b"m a. FINAL - CONSTRU CONSTRUCTION MUST 'WITHOUT CERTIFICATE fwvmmdmm" BE COMPLETE FOR C MPLETE FOR C.O. QkLEADQONTENl BEFORE - OF OCCUPANCY MMIC~q~r THE ALL CONSTRUCTION S VSTRUCTION SHALL MEET CERTolCATVOFOCCUPANCY REQUIREMENTS C STATE CONSTRUCTION lU1REMENTS OF1 THE N.Y. SOLDER &ND IN WATER ~ AS ONSTRUCTION ?i ENERGY CANNOT "CODES. NOT RESPON NOT RESPONSIBLE FOR ~~'`'M L? Plum DESIGN OR CONSTRUCT )R CONSTRUCTION ERRORS I p(('Fm21100F l% LEAD. Mpt L LAW" ! ~I *MrM1~Mr - I i IIc AJ I I h _ i L ~2. SNDWe¢~ I . j " h~ 16'~ 20' LauvsR\ t~ a L H ?o Misr MAN P~Uh~f3J(NG DIAG2,4.rA ~i~gR zt e~~+Tiou ~~1D Levy r147N LAK 4 T7©fQ) SCALE fIAPPROVED BY: DRAWN BY DATE: REVIBEO- ~AR.4 MFR . RAYMDQD 6LA\JN • ¢ 2(,5 /-\DD~TIOIV DRAWING NUMBER 1t II 3~ MIXRp ON Np. ~pOpX CtE111MIM•