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HomeMy WebLinkAbout21157-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22910 Date MARCH 17, 1994 THIS CERTIFIES that the building ADDITION Location of Property 395 TRACK AVENUE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block 1 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 1992 pursuant to which Building Permit No. 21157-Z dated DECEMBER 18, 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 FAMILY DWELLING The certificate is issued to ANDREW & SUSAN KINSEY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspec r Rev. 1/81 FORM NO. I 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) t N °N° 21167Z Date 19.E Permission is hereby granted to ~ 7 ~....pis' at premises located at ....02 7'""""`~rt............................................................................... County Tax Map No. 1000 Section ......Ar'3..7 Block Lot No......... pursuant to application dated 2 19J...... and approved by the Building Inspector. Fee S.?.~Yf I P..'Lr./-,~-irng ieA.~ Inspector Rev. 6/30/80 i Form No. 6 - TOWN OF SOUTHOLD~"~~ BUILDING DEPARTMENT xa TOWN HALL MAR ~ppp ( V«" 765-1802 r, APPLICATION FOR CERTIFICATE OF OCCUPA 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. 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 Buildine - $100.00 Z Y7 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 Date U~67{.CYO New Construction ....G/..... Old Or Pre-existiR& Building l`...... Location of Property....tj G ..............~CC~ChC,llll~ House No. a e,'r Street H let Onwer or Owners of Property..(.lY.d!4x:`.~.~ County Tax Map No 1000, Section.. 37.. .Block....v~ ......Lot... l..( Subdivision ....................................Filed Map.......... Lot...... Permit No .Z-11 5.7 Date Of Permit 1.7~1t.8 pplicant. O v~....... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate...Y.....,• Fee Submitted: $...5.0 Q q)-sib Z a ~ b AP~ICANT lELO i,. . ~ J:: m ~ ' ry VA FOUNDATION (1st) COUNDATION (2nd) ,BOUGH FRAME & I o W -PLUMBING j. H DISULATION PER N. Y. I y STATE ENERGY CODE T ro FINAL ADDITIONAL COMMENTS: s; m N O yam` r T 2 c, -o H n ~t .C [ 9 ~ Cry, 3~ v v?+ v< ! 4 c m n° © w®.~ G7 d y r _ Y~ ry ~y~ J yyjy{~)~ all 1l Y.: ~ - YA P N l I,nl l V ~gPIJ C_ 'yt^I.{~+4~~ A.S. ~ ~3 b 1 N ~ to IL~/.J4 ~F~. D~~ 54.L~ y£ A6 LU s, ry ; i u' < 101 ~j,.' n I z i W it LL, f w7'y, ~rl-t ' ;xi - 4C I If) a U " Z a S`r~y72.1t~/A9fil~'_ f~'A4i=r'C0 .2b. 6"N` q.. _x CG -o.l ez'p1a ~n u 40 LL 1, w M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ZWINAL REMARKS: DATE 7 INSPECTOR BOARD OF HEALTH FORM NO.1 ,~S% SETS OF PLANS TOWN OF SOUTHOLD v URVEY . . BUILDING DEPARTMENT XIILCK . . TOWN HALL SEPTIC FOVI SOUTHOLD, N.Y. 11971 TEL.: 765-1502 tto ~o~ CALL , , . Examined ~ I9 t1AIL TO: Approved ill. 19 . Permit Disapproved a/c r zI, iI INC'fi 41992 f . ~trsG. taEwr. ildmg Inspe tor) Tam OUTHOLD APPLICATION FOR BUILDING PERMIT nt 1 pp Date . Vi"VmLk. 19 /2 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of layout of property must be, drawn on the diagram which is part of this appli- cation. 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 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, and regulations, and to admit authorized inspectors on premises and in building for necessary in Mch/o~ns. (Signature of applicant, or a e, if a corporation) (Mailing address of appli ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 6W.../ ..................C................. , . Name of owner of premises K"1 w.q . (as on the tax roll or lat st deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ..IS-ZC, V.::.Rf...... . Plumber's License No . Electrician's License No. o..4. k.V-MA-u V Other Trade's License No . . 1. Location of land on which proposed work will be done . 7~p~ _.I.FA~ n .IS.r Au ~i Qmil~~.0........... House Number Street Hamlet County Tax Map No. 1000 Section ......1.37 Block Lot 1.9 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy • • C. QA~i 4~ 3. Nature of work (check which applicable,). New Building . . Addition Alteration ..V . , . Repair Removal , Demolition Other Work . 22 c~ (Description) 4, Estimated Cost . . Fee (to be paid on filing this application) S. If dwelling, number of dwelling units Number of dwelling units on each floor.., If garage, number of cars g " " " " " " t 6. If business, commercial or mixed] occupancy, specify nafjure rd extent of each type of use , '~1 , , , M , , , , , 7. Dimensions of existing strgctims, if any: Front i I. ,I.0 , , , Rear 12 Depth , . ~ 5, , .10 Height _ - I.Q...... hidml?er of Stories .....I......... • Dimensions of alne structure with alterations or additions: Front 1 0 Il• • . , • . • • • • • • • . ' ii' ' ' ' ' ' ' , ' ' ' . (Q Rear 1:7r. . Depth . , ..eb.ii, Height tiJQA1,l;". f Stories ..AIOtiIF. . N 1 8. Dimensions of entire new construction: Front 1a r......... Rear Z 2fl........ Depth _ .i.3 • , , , , , , Height . . ..l.C2P.ym'& N Ots~ ber of Stories 9, Size of lot: Front . ! Rear l7d : .1.. , Deppthl gQ l............... . 10. Date of Purchase • Narq of Fo r Owner . /kIY1A ~ ~ ,~f b&Y f`>O........... • 11. Zone or use district in which premises are situated S\ 12. Does proposed construction violate any zoning law, ordinance or regulation: NO . . 13, Will lot be regraded NO . . .Will excess fill be removed ir, r mises: Yes 14, Name of Owner of premises CNJt ,W.4,5~ 1~ 1. 2~1 , Address .395.. CYCiC AV4.~...Mne NoL51.G3.j~q- Name of Architect Address . Ph n N . Name of Contractor ~p~~ s~. 15. Is thisroeSrtsl wTd B2Ckr?S~t........... Address e 0! P P Y QO feet of a tidal wetland? *Yes:....... No.. *If y pwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all setback 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. ` III 6( I~ 'TATE OF NEW Y .S _'OUNTY OF nCo\L' S . , . (Name of individual signing , , , • , , ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant contract) ibove named. le is the . (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 cork will be performed in the manner stet forth in the application filed therewith. worn to before me this e of.!..,. ~.".4a .&Ak. 19 •V votary Public, . County ROBERT 1; SCOTT JR, C!J.~VYG~ !fib NOTARY PUB 11 Stafe of , po.4725039, Suffolk (S ture of applicant) Term Expires May 31,1 I I zo" ra,sT„. S 2 0' New . iY ~P rb£I CCA LATt/CF c~C-R1R ~ PrYn Ly y/q Ll GIRDER _ pnc[ u CPC[ Ls HOpSL 2t-V r ¢ FLASH P'S, N~ ~XIST;N6 9US; P44 6R'3F DE[.b(Iri F)Ih 9US: P4MR, / J - a.DE6 k 5Vr UeClflnj E@~CP-2%B I fPGEXI5*pPVp c_~E 2CG Z•8 'I CCP CY6_I1._e r:--g-'`~ ~L ~51KI bo J 2-CCn 2t¢ + ~ ~v,` M`~ 1 NEN [FCO EM1 " - r~- g'a erg 1EC,K RAIL --T+.r? J~> _ 1 ~.''-2tcn ax p,•-~I Imo'.. rF'r-srE1Q5l 15 T16S!r Ff El- A'pwtDEC KX~SYr-fG ~~occ~~ uel,Qlrr~ F-,tssu r,~ LIP NO WOL r MIM1I 90 USE GIRDER 6FZ, x UNDEL Cc.o p T j>,~{-OKf Gr.n~e GRP OI.: Li l[ _ CROSS L~M~DEf K;M(t ~o ~ F-,L,4 v I, ~ I r ~ 'f fog LYTO A II Y ~h GF AF L l+DD 51- I r 'I ~ 1 I FOO NOA,; oM ilk,' 7, . f ~iEw _ j2;kG l~ i ccn "ege 51 ODE I, TNFIF~AL LBR; Ot I I' I~~ ~I ~InSrHhPV ~ ~ I jl _ I k 71E.,° G, m~ (V I M. ;I NEw ~n'SL'DE'R Z 4y y lV ~ ' i ' - " [~evaMP~ vUI~i iQ) ML.. ?s4 Cry>Ge%s (i, P.pEF- C.- I i I I ~r:dc ~j ;i ri F DUN,a)ATJ G IN F)_ !3 r t ~ AP OV D AS NOTED DATE R.P. it Z//M7 ,I NOTIFY UI G OEPARTM AT'~~6.YA~~C~ OR 765-1802 9 AM TO 4 PM FO THE 0' FOLLOWING INSPECTIONS. FOUNDATI i FOR POUROC CONCR OE REQUIRED USE IS UNLAWFUL 2. ROUGH FRAMING & PLUMBING 3. INSULATION rr OTHOLIT CERTIFICATE A. FINAL - CONSTRUCTION MUST pe¢ ,Ay~y y&qep COMPLETE FOR CO. NSTRUCTION SHALL MEET flU- ~~C'1 UP Ftl ICY I ALL6ECO THE REQUIREMENTS OF THE N.Y. ' STATE CONSTRUCTION & ENERGY ' rnnpc NM RFSPnNSIRI R FnR DESIGN Ofl CONSTRUCTION ERRORS I; I: i I j'I i I N~T~ - VeNtr~ D~MCr~srnnis ~ contflrriaras US - I y L' m `L+ F . O C F'- T~~ l`•_I ! "j p~ ,1, 41992 i j~ Phone 477.0400 Main Road eicc.D-€pT: GREENPORT, N.Y. 11944 TOVil~a TOVilV OF g1 OLD 11 ~i~C Y Jn -7-92 AN an I) f- Sr,ALF '7.!' fl r .