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HomeMy WebLinkAbout19758-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 220111 Date JULY 25, 1991 THIS CERTIFIES that the building ADDITIONS Location of Property 2105 COUNTRY CLUB DR. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 109 Block 03 Lot 2.22 Subdivision COUNTRY CLUB EST. Filed Map No. 6736 Lot No. 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1, 1991 pursuant to which Building Permit No. 197582 dated APRIL 3, 1991 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 ADDITIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to KAREN LIZZA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING SLIP 7/23/91 PLUMBERS CERTIFICATION DATED FRANR J. MEYER 7/15/91 B 'lding Inspector Rev. 1/81 roses xo. 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~ 1 9 7 5 8 Z Date ....~~sU .....3 19 .~.1. Permission is hereby granted to: .~~...~..:.y.:......?..~.7 1 . 1 at premises loeoted at . .".I.~ s.~.~:,.: County Tax Map No. 1000 Section .....~.Q~......... Block Lot No...Q~...:~ z'....... pursuant to application doted ..~+CSI.~r~.....1 19~.~..., and approved by the Building Inspector. Fee S.• ~ ~~'.:t Building Inspector Rev. 6/30/80 Form iJO. TOWPJ OF SOUTI(OLD ~ ~I ~ 1' r-rr• \~,J' BUILDINO DEPARTHCNT X11 TO[JtJ IL1LL ~ ~ 2 51991 ~ ' • • 765-1802 ~ ! ~t;~__~..~.. 9LDG. C.'L PI. s TOWN CF SCU,~tr~f C' APPLICATION FOR CGRTIFICATC OF occur.lNCl.••...---~-.~-•--°--•°°-~• 1. This application must be filled in by typewriter OF. ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property eoith 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 [lnderwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 lead. 5. Commercial building, industrial building. multipLc residences and similar buildings and installations. a certificate of Code C~.mpliance From archi~_ect or engineer responsible for the building. 6. Submit Planning IIoard Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) lion-conForming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property show in,^, 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 Guilding Inspector shall state the reasons therefor in writing to the applicant. Fees ' 1. Certificate of Occupancy - New dwelling $25.00, .\dditions to dwellin; $25.00, Alterations to dwelling x25.00, Swimming pool 725.pU, lccessorv building 725.00, Additions to accessory building $25.00. Busir.esse5 $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 ~/S~~/~ :w Construction.........,. Old Or Pre-exisrin~ ilding.~ ,cation of Property... 1°s~......... r iio use No, L7 ,c~,/~ L/ Street Hamlut wcr or Owners of Property.... ~~.~,zA • ~~&~/Y unty Tax Pfap No 1000, Section...~~.~.....Bluclc...:3..........Lot....~.??~~~....,....... ,divi~on. ~ .............Filcd ,tap. `[:3G.....Lot.........L............ =FP rmit No. ,~~...Da~c Of Pcrmi.t ................Applicant.~"1~!.~ ~~~v~ . ~lth Dcpt. Approval.. .................Underwriters A1lproval....~................. nning Board ,lpproval....N/~ uest for: Temporary Certificate........... i'inal Curticatc. Submitted: ~ z d a ~ ~~a~5 ~ Gr/- ~Aa~/s~~?~'.. .nrPLICnNT ~~2 ~~9/ TEL. 765-1802 o c~~Ef~LI(~~Gy TOWN OF SOUTHOLD ~c OFFICE OF BUILDING INSPECTOR ° a 1., - TOWN HALL O ~ ~ SOUTHOLD, N.Y. 1 1971 - `~'~Ol j~, ~~o ~ ~ 2 51991 °~r„a C E R T I F I C A T I O N Date (~J~~ Building Permit No/ ` Z Ownerl~~~'~ (please print)A ~ ' Plumber ~/y° ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. (plumber's sig ature) Sworn to before me this nn ,~J day of ~ Q%~ , ' Notar~~ Public Notary Public, do County (~:Ci!'c0) MARGARET M. BLOEY P.:; 1"RS;Y PUBLIC, State of New York P:o. 52-0323300 C!~alifieG in Suffolk County Commision Expires //~~~~i ~ nr~I~ ~ ~ TEY,,,7G5-1802 S~tiFa~x~ o OG~ TOWN OF SOUTIIOLI) „ . ~;;a, ; ~ ~c OrPICE OP BUILDING INSPECTOR ~ ~`~5 P.O. BOX 728 ~ TO1VN HALL O~Ol. ~ rapt- SOUTIiOLp, N.Y. 11971 Suly 3, 1991 D.W.P. CONTRACTORS 1 12 SOUND .AVE. RIVERHEAD, N.Y. 11901 RE: RICHARD SPANBURGH To Whom This May Concern, We are unable to complete your Certificate of /O`c~cupancy because of the following reasons. An application for Certificate of Occupancy is not on file. (ENCLOSED) /i~/ tVO [lnderwriters Certificate on file. /The check is( /not on file.) $25.00 No llcalth Dept. P.pproval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui]di.ng Permit i! 1 9 7 5 8 Z' Building Dept. ***/~D10 Plumber Solder Certificate on file. ( all permits involving plumbing being .issued after npril 1,19IIA ) r1cLD 11"i:SP~CTION IIUAi i;OMMENT.°. H ~ FOUNDATION (1st) ~ ~ c FOUNDATION1 (2nd) m - - C z . t v ,~~..ri,-P z o ~ P,OUGH FRAME & ~ p ' ~l PLUMBING ti 3. ~ ~~z-- '~S m IIJSULATIOPI PER N. Y. y STATE ENERGY " ' d CODE Itf . x . 5 4. •-~"y ' ~ _ FINAL o~ ~ ~p ~ J3 z ADDITIOPIAL COMMENTS: ~ x • ~ ' . • ca ' - x . O H b • H H ..Q O z . ~ y ' ~ ~ S , sit. .ti s H s ,ti 'c h M3' ~ +kn...~cf..~5.~x`~Sfh~,'~-, ,,a # 5~..~ ~ net~Aa~bAattek ,n.as. sa t.z z„~..,l,d.~~7Mn~ riif ati*(_.~~,x~^`.'d. at»..aa3xa rss-zsa~ _ ~ .BUILDING DEPT.= ~ ~ . ~~L~NSPECTIO~N ~ [ ] FOUNDATION ~iST ~ ~ [ ~ "aUGH PLBG. [ ] FOUNDATtON~ 2ND [ INSULATIaN ~ ~ ~ [ ]FRAMING [ FINAL . REMARKS: .G~ ~j-~~ DATE ~ ~ lNS~ECrt'OR gym, ~ I~ . 765-1802 ~ ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1St [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~RAMING [ ]FINAL REMARKS: ~~~~z.~ DATE INSPECTOR z ~~jj 77 ~G`~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS TION FRAMING [ FINAL ~ REMARKS: DATE 0 INSPECTOR 765-1802 BUILDING DEPT. ~ I NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~NAL REMARKS ~ ~,~R~~- ,-,L~. ; ~,.5~ ~,f.~ DATE INSPECT 1~~~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]G ROUGH PLBG. [ ]FOUNDATION 2ND [ NSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ , DATE INSPECTOR r `~7~ 765-1802 BUILDING DEPT. 1 SPECTION [ FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REM RKS: ~ ~.~-~c. DATE INSPECTOR t 758' ~ THE VIEW YORK BOARD OF SIRE UNDERWRITERS ~ rzns'a;~~ ' ' (IOCi~ Qi~ BUREAU OF ELECTRICITY ~ ' 85 JOHN STREET, MEW YORK, NEW YORK 10038 ~ . ~~DatP .11U(=U$'a' fl2r7 X97 APPlication No. on file 729~299~„/^^~.( i~ ,'I ~R7,t~ THIS CERTIFIES THAT only the electrical equipment as described befoto and introduced by the applicant named on the a(ROVe opplicotion number in the premises of [CARi:N T."1'P~itA., 2:f,Oki f,(itiN'CR`( C:LfiB t1k. t Ct1'fGrfT)riJni, N.'t', ~~yy--~~ UiTP in thefollou:inp location• ? ~~F.te eat L'7 Ist Fl. ? 2nd FL .Section Block ~ Lot J'CIi,~' '1. t,'_ ly~ u~os exmnined an andfonnd to 6e in compliance with the requiretnentaq( this Board. FIXTURE FIXTURES RANGES COOKING PECKS ,OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FIUOAESCENi OTHER AMT. K W AMT. K.W. AMi K.W AMi K.W. AMt H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PY TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS, AMT. N. W. Oll H. P. GAS N. P AMi. NO. A W G ,AML AMP AMT AMPS.' TRANS. AMT q P SYSTEMS 'PMT. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E METER NO OF CC COND. A. W G. A W. G - P. W. G. AMi. AMP. TYPE EQOIP. 1 q 4W 1 q 3W 3,e' aW 3,e' 4W PER d Of CC COND NO OF HbLEG OF H4lEG NO OF NEUTAAIa OF NEUTRAL OTHER APPARATUS: ~;fla,<°, apart t~rn1~~,~,:.i--1..a Ir,w.,~~-•i,a,~; x..L~r.,l.-1..'~5 ~.~r. MaF01tSz1-Q.'ia f#,Y. `CRANS~FakNk:R;'i-.'1,5 Kgic 'f'L~AC'K. r,Jr.fl•['7.NC,.--'1,L t)»Id.A, CfttV'l'ittiL"It'tFiG i,'lC,#i2t17F; f.ION YAI~hI7Nitk 'iA-3R R.~C(1HsatlNi) {SIIV'(I GENERAL MANAGER - , if7S~'SHf~RId, Pf, ~ .f 9f7r, - "t'i ' Per . Y This certificate must not be altered in any manner; return to the"office of the Board if incorrect. Inspectors may be identified Eby their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST=NOT ;BE ALTERED IN ANY''MANNERz" 75 ~ ~ ~ ~ aT~tnr: ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS I t.a~o t I BUREAU OF ELECTRICITY ' 85 JOHN STREET, NEW YORK, NEW YORK 1003EI At1GR;i'i` t7~,.1°>91 171~,'il+.~s6L~:f/~1 tv :4~t~;3di Date Application No. on file THIS CERTIFIES THAT only the electrical equipment oa deaeribed below and introduced 6y the applicant named on the above application number in the premiaea of ~ ttklkF~CN' "t:l.'/.7,Ar 210?i C;(')P3N'l'Rt' (~C~UK 17N.., Ci)'['(aic)GiJxl~ Id,"~, in the following loca ' t~[I'~' tfpn.i~ 9~,~~~e~tEent ? lat Fl. ? 2nd Fl. SerUon Block Lot was exmnined on 7/1177 ~ andfound to 6e in conep[ionee uith ake requfremeata of thin board. iIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT fLUORESCENT OTHER AMi K W. AMi K W AMi K.W AMi K.W. AMT H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MUITI-OUTLET DIMMERS SYSTEMS AMi K. W. OIL H. P. GAS H. P. AMi NO A. W. G AML AMP. AMT. AMPS TRANS. AMT. H P NO. OF FEET AMi. WATLS SERVICE DISCONNECT NO.OF 5 E R V I C E AMT. AMP, TYPE METER I~,RW L%3W J%3W 3%4W NO. OF CC COND. A W G. NO. OF HbIEG A.W.G. NO. OF NEUTRALS A.W.G. FOUIP. PER% Of CG COND Of MbIEG O4 NEUTRAL orHEa avPaaarus: flCl'(' TfJR-'i Wak)'NC l7NlN ld/hKW Ht+;71'1'1~:R°7 i).CJ.'P. C;O[T'i"fil1C~"{,1V(s i17C.>r`I?Olil PC)'N PAJLAFiIE1tH 1, ~,'f$ RJ (;if(IA.N±) RI.V(7 GENERAL MANAGER f fl~YCNORK;, NV, 1970 1:9 Per ~11 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 OP CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~ BOA60 OF HEALTH ' ' FORM N0. 1 J SETS OF L 13S . 1:, SIIRVEY _ TOWN OF SOUTH L r,~l ~ " ~ ~ BUILDING DEPARTMENT CIICCI; 1'1:. 1~~} . i TOWN HALL serrtc Foam _ . - SOUTHOLD, N.Y. 11971 ?,1(S i..._.._r-" ' TEL.: 765-1802 t: Or I F F ; ?j , t~~ 3P/ ~ , Examined 19 F Ptn I L TO ~~PProveCC"`/~ ..3.... 199 .Permit No. 1. I S~.O.~ ~ . . DisapprovedaJc (Building nspcctori APPLICATION FOR BUILDING PERMIT 'l. Date 19 . INS'T'RUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to t}te Building inspector, with 3 ets'of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shoGVing 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 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 call be kzpt on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purposz whatever until a Certificate of Occupancy hall 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 wilding 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 demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building cod ou ng code, and regulations, and to imit authorized inspectors on premises and in building for necessary inspect[ l`~~~~ C~S (Signature o pplicant, or name, if a corporation) (i\failing address of applicant),s-r!%f~f~f?~ 7a7- jld" 37- te whether a lican[ is owner, lessee, ~/gent, architect, engineer, general contractor, electrician, plumber or builder. / ~J ne of owner of premises ..........i:f~ (as on the tai Yoll or latest deed) pplicant is a p~f~tion, signature oFduly authorized officer. (Name and title of corporate officer) r' Builder's License No. Plumber's License No.~~~~~f!~:~~ .C'1~..f~' Electrician's License No. ~?4~.E... ~_'`7"~P / OtherTrade's License No. ~l.!'............ ` xation of land on which proposed work will be done. . ~!~f~° .~~~f~~r ~ ~`EY<~ !~4~~ (f~ . !Y rJ . /--~T _,~i, ; ` ~ . ~,F'%f/~, .~ft/.tf;*r. ~G,~~ .~r~~xlr~.~1?'~cL~ ruse Number ~ treet Hamlet unty Tax Map No. 1000 Section w(.. Block Lot . ~i rdivision .C'~(/Af'!'~• • C'~~/?..~~5% r...... Filed hiap No. ~}-/.~5'. Lot .~r.~........... (Name) to existing use and occupancy of premises and /i`n~tended use anpdnoccupancy of proposed construction: :xisting use and occupancy ....<!?!J ~.~.;..'t i~!!~! /.4.~...~?.!tl2?LL~~7~ . ' . ntended use and occupancy ..S~,f~i.~1:~'.6~". ...~il~:~. L~j~~-~(~~~.. f . _ . l.: t~,~:. i~ 3. A'ature of work (check which applicable): New Building Addition Alteration , , Repair . , . Remolval , Demolition .Other W~ ,~l~,(,~'~_~ . , . i (13e ct~tion) y~ 4. Estimated Cos :..............Fee....,....,..................,......... (to be paid on filing this application) 5. If dweiling, number of dwelling, ~ nits Number of dwelling units on each floor . If garage, number of cars . , s11, 6. If business, commercial or mixedi occupancy, specif nature and extent of each type of use~sd:.... 7. Dimensions of e~cisting structure, if any: Front S. t~... , ,Rear , ,~``.-,j,'.~: Depth ~~r f......... . g Num Del tht er of Stories . Dimensions of same stru wi~h alterations or additions: Front ~a?'~~ : r ~t}'3~ ~ ~ Rear .lr~.-~:.. . P . Hei t ...~,,,R?f??~: f~vs....... Number of Stories ,~.......4 . 8. Dimensions of entire new constn1ction: Front . fP?:~ r?:. , , , , . Rear t"!-~1$:.... ,Depth ..~~0......... . Height . ~°f, Ex Number of Stories ~ . . 9. Size of lot: Front ' Rear . ~.3~i Depth . . ]0. Date of Purchase , . ~ ~ ~ Name of Former Owner (1%C~/~'t~.. ~f.~i#x(J.l~.(f~(~.~, , P P ises are situated . . P 12. Does ~ o osed coast u tlion vtgla~te any zoning law, ordinance or regulation: ~ , , . , , , . ]3. Will lot be regraded ..Will exc ss fill b rer~ ovcd from premises: ~Z Y No 14. Name of Owner of pre se (~C4,~' Name of Architect ~ ~f~Address C~,x 1~<.kf~~s~~one No . • ~L~ Address Phone No . . Name of Contractor~GV,i<'t~ . , , , , , , Address~~~:~~1!r~k ,1~~,/:... Phone No. ~Z~. ~S~~,_. , , 15. Is this property within 3Q0 feet of a tidal wetland? >tiyes„ y, , , , , No......... *If yes, Southold Tgwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all Buildings, whether existing or proposed, and, indicate all set-back dimensions from ' property lines. Give street and block nthmber or description according to deed, and show street names and indicate whether interior or corner lot. i ~I I~ ~I III - i i n ~I I STATE OF NEW YORK, COU Y OP S.S - s ' ' ' ' • • • , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. "Ieisthe ~ (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~ ~ • ~f said owner or owners, and is duly auKhorized to perform or have performed the said work and to make and file this ~PPlication; that all statements containedli in this application are true to the bast of his knowledge and belief; and that the vork will be performed in the manner set forth in the application filed therewith. worn to before me this • `.........day of , 7 19~/(. Jotary Public, , , T "~yv7""„`" County ~'"ace~ ~ a~, a a ) lIND14 CdppEq fi~y ~ Netaly PubIIC, ~hlt6 Of New • • • • ~ ' " T s~1~' ~ ~ No 462266$ Suffolk Courny~ (Signature of appUcant) 7erryr Exp~reg De ember 37,19._,,.. ~ ~ .Y, E ,a .83.r. w,... .«aa ~ a:w=.~,e~~.W,...a1 ~vlu~ki~'fiYt'lip~lraS`.vr`~X',:axa~ ,Fa' ¢<uY~i~, v,,,. sW li,. . x++~ ~ s ~ I~ ` ~~s-s - s-- f: LO/ ~ I ~ ~ ~ ~ ~ . i ' w ,drpo=d0,9 s ~ ~ p , a ! ' ~ . ~ ~ ~ ~ A4y ~~ei{ . ~ A' 'i ~ ~ ,v n' 4 ~ iwl,: .W.tY~ , q t)a;fijt~ ~ tot %3 I t -'A'. ~ ~ ~ b ~ ~ W , iAA•. - , e,r ~ Je. y - - _.a4e, ~ ..3._ ~ J - I ~ _ - - i. w' ~ J ' , j V ~ b °6 u- I i __.~tr,.,.....~...,_-^-----r+.~. '?5:.._r'~~'! IEdSEMENr ~~''..~,;~,1~"~~~.3. 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