HomeMy WebLinkAbout20967-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24047
Date NOVEMBER 28, 1995
THIS CERTIFIES that the buildin~ ADDITION
Location of Propert~ 470 NEW SUFFOLK LANE CUTCHO~%~E, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 6 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 15, 1992 pursuant to which
Building Permit No. 20967-Z dated SEPTEMBER 22, 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 DECK ADDITION TO EXISTING ONE FANILY DWELLING AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
LOU JEAN DIu~RSON RON~LD D. GP~%ESSER & S~E~EE GP~ESER
N/A
N/A
N/A
Rev. 1/81
il~ng Inspector
FO~' 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)
N°_N.° 2095TZ
at pre//mise, located at .....;~"/'.Z~.....~,~,~"~ _,~_ .Tf~'/~ .~::~'.~...~.(. ..........................
County Tax Map No. 1000 Section ...... ~.~ ...... Bilk ......... ~ ......... Lot No. ~
pu~uont to application dat~ ...~ .................................... , l~and approv~ by the
Building Inspector.
Fee ~...~..
Rev. 6/30/80
Form No. 6
TOWN OF $OUTHOLD
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 plumbar certifying that the solder used in system contains
less than 2/10 of t% 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.
~. 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.
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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........... Old Or Pre-existing Building .....................
Location of Property. ~Z~70 .. ~g4~.~~d .~, C~t--~.~ .~.O..~..L~..,_~.~ f~:.l/.~.~--~
House NO. ' ' ' '/Z~get
Onwer or O~ers of ~roperty~...~...~'.~-~-'.~..~..~...~c~ .........................
County T~x Map No i000, Section/~.~. ........ Block ..... ~f ......... Lot..~ ..................
Subdivision .................................... Filed Map ............ Lot ......................
Permi~ N ................. Date Of Pemit. ..Applicant ......
Realth Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $' '~'~'~: ..................... ........ ~.~.
AIIFLICANT
L 30q ?1
C0eR 7
THE NEW YORK BOARD OF FIRE UNDERWRITERS
8057834 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
-- DECF, HBER 1.3,199~ 107P~395/95 ~t 04a126
Date /Jpplication No. on file
THIS CERTIFIES THAT
oo~y the electrical equipment as described below and introduced by the apl~icant named on the above application number in the premJses of
ROIgALD & SR]~REE GRAESER, 470 NEW SUFFOLK ROAD, CUTCHOGU~,,
· , DECEMBER 06,1995 and found to be in compliance with the National Elect~¢al Code.
FIXTURE FIXTURES RANGES OVENS EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT OTHER
2 2
DRYERS
SYSTEMS
NO. OF FEET
E
)THER APPARATUS=
E R V I C
NO. Oi~RC~COND
OF CC, COND
NO. O~ HI-LEG
A, W. G* NO OF NEUTRALS A W G*
O~ HI-%~G OF NEUTRAI`
P. O. BOX 542
CUTCHOGUF,, ~, 11935 GENERAL MANAGER
11
rhis 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 MUS~ NOT BE ALTERED IN ANY MANNER.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 22, 1995
Lou Jean Dickerson
470 New Suffolk Road
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx 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 # 20967 Z
Thank you for
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
Main Road
11944
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ].~.~JLATION
[ r./J~ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS
DATE
N.Y.S.T.T.¥
DISTRICT
1000
SECTION
109.00
BLOCK
06.0O
LOT
003.000
CONSULT YOUR LAWYER EEFORE SIGNING THIS INSTRUMENT · THIS INSTRUMENT SHOULD air USED IT LAWYERS ONLy
THIS INDEN~I]~ made the ~ $~ day of July , ni,~l~, hundred and ninety
BE~EEN LOU JEAN DICKERSON, residing a% New,Suffolk Lane,
Cutchogue, New York 11935 and GE~6 DICKERSON,
residin~ at 565 F~.~, Bx 542,m~Suffolk, New[~k,
paHyofth~rs~par~,a~d LOU JE~ DICKERSON, residing at New Suffolks. Lane,
Cutchogue, New York as to a fifty (50%) percent
interest and RONALD .DL G~SER ~nd S~E , G~SER,
husband ~d' wife, bbth residing at.34 Bluebird Place
Riverhead, New York, ~s to a fifty (50%) percent
interest, ~s -tenants in co~on / -.with -LOU~.~E~,
DICKERSON,
party o~ ~e second pa~,
WITNESSETH, that th~ party o~ th~ ~rst par~, {n co.s~dera6on o~ t~, 4ellars and oth=r valuable co.s~derat~on
pa{d by the par{y of the second part, do~s hureby ~mnt and r~[~as~ u.to the ~y oflhe~ucond ~rt, ~e he, rs
or successors and ass{~s o{ ~he party o~ th~ s~cond part Jorever,
ALL that c=rmJ, plot, p[ece or parcel o~ ]and, with the bu~ld{n~s and }mF~wm~nts ther~n e~cted s{t~te,
lyin~a.dbe{n~ at Cutchogue, Town of Southold, County of Suffokk,
and State of New York, described as follows:
BEGINNING on the westerly side of New Suffolk Roa~ 441.18
feet south of the corner foxed by the itnersection of the
southerly side of Main Road with the westerly side of New
Suffolk Road;
RUNNING THENCE along the westerly side of New Suffolk Road,
South 9 degrees 53 minutes 20 seconds East, 50.75 feet to
land of Beebe Holding Corp.;
THENCE South 80 degrees 6 minutes 40 seconds West, 202.25
feet to land of the Sacred Heart Church;
THENCE North 9 degrees 53 minutes ~0 seconds We~t, 50 f
THENCE parly along the southerly side of land of
Church and partly along the southerly side of land of R.
Williams, North 79 degrees, 53 minutes, 50 seconds East~
202.25 feet to the point of BEGI~ING.
Said premises co--only known as Suffolk Lane, Cutchogue, New York.
Said premises are not encu~ered by a credit line mortgage~
BEING AND INTENDED TO BE the s~e premises conveyed to the
party of the first part by deed ,dated August 25, 1972 and
entered in the Suffolk County Clerk's Office on August 31
1972 in Liber 7231 Page 561. '
TOGETHER with all right, title and interest if any of the party of he first part n and to any streets and
roads abuttiug he above descr b~d prem ses to the center lines thereof; TOGETHER with the appur'ienances
and all the estate and rights of the party of the first part in and ta said premlsesi TO HAVE AND TO
HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of
the party of the second part forever.
AND the party of the first part covenants that the party of the first part has not done or suffered anything
whereby the said premises have been encumbered in any way whatever, except as aforesaid.
AND the party of the first part, in compliance w th Section 13 of the Lien Law, cov{'nants that-the..p:~rt~,~ef
the first part will receive the consldera on for this conveyance and will hold the right to recelve,s~c[~ consid-
eration as a trust fund to be app ed first for the purpose of paying the cost of the lmprovemeni~&~,lt app y
the same first to the payment of the cost of the improvement before using any part of. h~ o a '.~ [~ h~e for
any other purpose.
~ v~rty sna. oe construe~ as ~ ~t reaa part,es whenever the sense of this indenlpre,o requires.
IH WITHE$$ WHEREOF~ the party of the first part ms dui} executed this deed th~ day and year first above
l/ J TRANSFER Tn~ / .... "..-:.
e.~.gll ,' '~'".. ~ ,, I SUffOLK--- /
.... /COLINF~
" SEP 16 199Z
~.~ , :,' i, TOWN HALL
" ' ' . ..... ~OUTHOLD, N.Y. 11971
TEL.: 765-1802
.?. ....... ,19
'pproved...~...~. ....... , 19~..~. Permit No....~..~', .7.~
)isapproved a/c .....................................
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
ClIECK
SEpTic' ;;i", ...............
APPLICATION FOR BUILDING PERMIT
ubdivision ......... ·
............................ Filed Map No.
(Name) .............. Lot ...............
talc existing use and occupancy of premises and intended use and occupancy of proposed construction:
Ems~mg use and occupancy . '/'/~ ......... c .................
INSTRUCTIONS
a. Tl~s appIicatinn must be c~mpIetely ~ed in by typewriter ~r in Ink and submitted t~ the Bui~ding Inspect~r~ with ~
t~ of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot pi:tn 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-
¢. The work covered by this application may no~ be commenced before issuance gf Building Permit.
d. ;Upon approval of this application, the Building Inspector will iSSued a Building Permit to the applicant. Such permit
e kept on the premises available for inspection throughout the w~rk.
e. - No building shall be occupied or. used in whole or in art for any purpose whatever until a Certificate of Occupancy
nil h~ve been granted by the Building Inspector. P
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
filding 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 wi,th ail applicable laws, ordinances, building code, hoe ' g code, and regulations, and to
mit author/zed inspect0~hr~premi§~s'and in building for necessary insp~:tj~ns.
' (Mailing address of applicant)
ate whether applicant is ~ lessee, ag}hi~,' architect engineer, general contractor, electrician, plumber or builder.
~me of owner 0 se
~pphcant ~s a co[p.~r,.q(i(~n~.~)tj~ce:ofdttly auth6nzed officer.
t~ame and t~tle of corporate officer).
Builder's License No..42'~_~.~ ............
Plumber's License No .........................
Electrician's License Nb .......................
Other Trade's License No ......................
oca.onoflandon wbichpropo ed work.iii be'done. ..¥/a. ??
louse Number / '% .. ·
Street ....................
Hamlet
......... Block .. .
............. ~ot ...................
.3. Nature of work (check which a pllcable): New Building
Repair ..... ' ...... Addition . Alteration .........
......... Rcm'oval ..... Demolition
i ......... · ............. Other Work ..............
4 E ti d Co ese n
· s mate st ......... ~ ........................ Fee ...
5 . , (to be paid on filing this application)
· lfdwelling, number of dwellinglunits ............... Number ofdwc~lling units on each floor. '
If garage, number of cars
If business, Commercial or m;-~ ^-
,.,,:; uucupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing stmctur s, if'any: Front ............ ' · ·. Rear ...... i ... Depth ...............
Height Number-of Stories .......
Dimensions of same structure with alterations or additions: Front ........................................
Depth ' Height .............. Rear ...............
8 .................. I. · · ..................... Number of Stories
· Dimensions of entire new construction: Front Rear ............. ~'"' ......
.............................. Depth ...............
Height . Nu 'qbe of Stori
.......... r;J t r es ..........
9. Size oflo ...... ............................... '
I0 D fP h .... I ........... Rear ...~ .... D pth ...........
· ate o urc ase ~ . · .......... e .....................
' Name of Former Owner
I 1 Zone or use district in which pr~'mises are situated ' ' '
12 Does proposed construction violate dny zoning law ................................. i
· ordinance or regulation: .................
13. Will lot be regraded ......... ?'ij~jj j"~ ........ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ... .......... Address ........... Phone No ...........
Name of Architect ...... i. ' ........ ' .....
.................... Address Phone No .........
Name of Contractor... ~ ................... · ......
...... : ............. ' ....Address ................... Phone No ................
15. Is this property within 3i00 feet of a tidal wetland? *Yes ........ No...
· If yes, Southold T;own Trustees Permit may be required, ' .....
..-. I PLOT DIAGRAM
Locate clearly and distinctly aIl'~uildings, whether existing or proposed, and, indicate all - '
property lines. Give Street and block ,,umber or de~-' ........... set back dnnensions from
interio, r or comer lot. i] ~,4~puon acuornmg rD aeea, anD snow street names and indicate whe!her
" ,. AP ROtIi D AS NOTED
FEE: ~SY:' ~
NOTIFY S01LOI~-O DEPAR'~'NI' AT
76~-1802 9 AM TO 4'PM FOR THE
FOLLOWING INSPECTIONS;
1. FOUNDATION - TVVO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR
ALL CONSTRUCllON ~U. MEET
STATE CONSTRUCTION ~) ENERGY
CODES. NOT n sPO ,ma), FOB
,. DESIGN OR CON~I'RUi:~tlON ERRORS
TATE OF' NEW YORK,
' ' ' ~ ...................... + ................. being duly SWorn, deposes and says that he is the applicant
(Name of i~/v'idual signing ~contract)
)Ore na~c~.
' is the
' ' (Conffactor agent Corporate officer ere )
s~id owner or owners, ~d is duJy a~thorlzed to perform or have performed the said work hnd to m~. and file this
phcation; that all statements contained ~ this application are true to thc best of his knowledge and belief, and that the'
~rk will be perfomed in the anner set, forth in the application filed therewith.
'Om to before me this
a~ Pubhc ....
· . · ~ ............ .County
Term ~1~ ~r 81, 1~ (Signature of applicant)