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20299-z
5 ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCITPANCY No Z-20765 Date JUNE 1, 1992 THI5 CERTIFIES that the building ADDITION & ALTERATION Location of Property 2995 PINE NECK ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 6 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 21, 1991 pursuant to which Building Permit No. 20299-Z dated NOVEMBER 26, 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 & ALTERATIONS TO E%ISTING ONE FAMILY DWELLING AS _ APPLIED FOR. The certificate is issued to WILLIAM & AUDREY M. NORRIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-234358 - MAY 7, 1942 PLUMBERS CERTIFICATION DATED MAY 15, 1992 - JOHN E. WALTERS PLUMB & HEAT ilding Inspector Rev. 1/81 roauu xo. a 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) No 20299 Z Date ......rl..,~~ ~9~/ Permission is hereby grout d to: . ' t0 .l,f~frflG9... .2......16:....... 4~ ?E/~ .....................~x ~ of premises located at °.~...9.~... ........1.....~'~....~~+~-T~ ....f...................................... ' ............................................~s5'x+c~•.••... County Tax Map No. 1000 Section Block Lot No..../..~.7 ~ pursuant to application dated .....ll~"~:.( 19~~.,, and approved by the Building Inspector. ' Fee S.::~~ B ng nspector Rev. 6/30/80 _ . ,.~..-~~l~~i~z:l°'~ Form No. 6 ~ , s ~ ~ " TOWN OF SOUTHOLD i~ ~ BUILDING DEPARTMENT JUN - f 1.992 ~ ~ ~ , TOWN HALL ~ 765-1802 ' - ~ APPLICATION POR 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 elecCrical installation from Board of Fire Underwriters. 4, Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19 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. ~§'or 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 Building - $100.00 3. CoI>y 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, Commerc(i~al $15.00 Iew Construction..... Old Or Pre-existing Building „ v . .ocation of Property.,'".?~7~5„-,~1~~"' /~~~j~ /~Pj,/~-~ ~'©Cl7~~L~ Ilouse No, ~ ~ ~ • ~ / / J ~ .yStreeC Hamlet nwer or Owners of Property..~:Y.~4=.k~~~',7~ „Lr't / 1~~~ ir. ounty Tax Map No 1000, Section....../. o.....Block....... %,Z ......Lot....... ubdivision..........--.77 ........................./Fileed Map..........////.,,Lotjj...../..~.... ermit No,~!V ~ G; , ,Date OL Permit, 1 p „Applicant.7(.~!:.4?',•. ,N Q, ~,~Q/,~, , , . , ~alth Dept. Approval ..........................Underwriters Approval......................... tanning Board Approval quest for: Temporary Certificate........... Final Certicate., e Submitted: $c~~..~.7 ~ q Qom., v39~ y . . ~~a~~, ` . ('O ? ~O~~vS APPLICANT aSUFFDL{-CO TEL. 7G5-1802 o~,l!N. ,,:•1~ TOT~N Or SOt1TII0bD • l: L~ • • . ~ OFFICE OF BUILDII•IG INSPECTOR u~ '-y1;~*, rn P.O. BOX 728 p/ c?si Y TOIVN HALL ~'0,( a Y,b~ SOUTHOLD, N.Y. 1 1971 C E R T I F I C A T I O N Date Building Permit No. Owner ~i I~IMt~ Na~~ --tt'~ (please print) Plu:,,ber Jol{vJ 5 {~Lltut6lnl~ ` 0 (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1; lead. ?IL~-~ • (plumber''s signature) Sworn to before me this daY of , 19~, Notary Public notary t>ublic y County NotaryPubli~c,StateofE eiouLYork Na. 52.8126&50, Suffolk CQUK ¢ • Term Expiros Oc¢ober 31, 19 ' INSPECTORS Victor Lessard ~g~FFOt:xc Principal Building Inspector O Curtis Horton ~j2 SCOTT L. HARRIS, Supervisor Senior Building Inspector y x Southold Town Hall Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector ~ • y pb Southold, New York 11971 Building Inspector ~O'~ ~ Fax (516) 765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD May 29, 1992 William Norris 2995 Pine Neck Road Southold, N.Y. 11971 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 an file.)$25.00 No Health Department Approval on file. No final inspection has been made. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20299-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS eACr9 7. 1175003 BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 70038 Datr NAY 07t1L1R2 AppliratlonNo.onfile 78210397192 N ?„34351! THIS CERTIFIES THAT only the electrical equipment as deacrihed below and introduced 6y the applicant Homed on Lhe shove application number in the premises of P1R & [1R.^r NORRI3, PLNL NIICK ROAM, i70ti'1'HOLIi, N, Y. in the following locations ? Basement ® /.at Fl. ? 2nd F!. X111` .Section Block Lot ~ At' R 11' 30 F 7. ~ ~ Z oad ound to hr in coot 4anrc with the rwr uiremeats o this Board. was examined on f p ~ l f FIXTURE FIXTURES RANGES COOKING OECK$ OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT RUORESCENT OTHER AMT. K W. AMT K.W PMi K.W AMT. K W AMT. H P t 7. 7. f, 16 7 3 1P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT NEATER$ MULiI.OUTIET DIMMERS AMT. K. W. OIL M. P. GAS N. P AMT. NO A. W G AMi. AMP AMT. AMPS TRANS. AMT N P SYSTEMS AMi WATTS NO.OF FEET 1 G00 SERVICE DISCONNECT NO.OF $ E R V 1 C E AMI. AMP, rypE METER L YW t 3W 3 % 8W 3%4W NO OF CC. COND A. W. G. NO Of HbIEG A' W' G' NO. OF NEViRAlS A. W O. i EQUIP. PER % OF CC. COND. OF N61EG OF NEULRAL 39 OTHER APPARATUS: 4,5KId iA11NA-7. G,F.C,Is-2 5#1GKE DF1'FCTORI°7. TRACK LTG1f1'1NGt-20 ~ Q,f`,. BL4CTkiLC INC, LIC.~3&?3°E F.0,110R 57.fl l• LAURf'Lr NX'r 119411 GENERAL MANAGER 11 Per 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 NOS BE ALTERED IN ANY MANNER. ..ail; I::~:`EE:'L~:i j~J:,:E j~ ::CC-(i9~NTS ~ l'~ J ~ ~ m _ ~ - . j ~1 ?OUI7DATIO:J (1st) \n' r k FOUt7DATI0:J (2nd) _ c*w 2 . ~ 7/ `o ~ POUCH FRAi1E & I ~ °3 PLUMBING C~ ~3. ~ m m J II7SULATI0;1 PER N. Y. I , , y STATE EIJERGY s CODE T . J~~ 4 . _ I s` _ s c „ FILIAL ,g ~ • ~~w ADDITIOIIAL COMMENTS: 9 d ~ - i ~ X '9\ H 9 ,j O W C7 y v i ^v _ H a 7 ~-0~-9 rss-isoz BUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ]FRAMING [ ]~F,I,NpAL REMARKS: Z-~~~-1~ c~ _ f DATE ~ v INSPECTOR /'~.V''~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [~'~OUGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMA S: , DATEL ~ % INSPECTO f~ +~sa Q T i F 4 v hf~.s;;~..P ~ SQ Pt~k'~laA`T:E .CLGAt? a ta17"IB f?4~.E, ~ ,0.22 ~ 9a ~~Ym' 1 ~ nr° ~ ~ : 1 i \ xQ_ M ~ x = ` ~ ~ i ~ ~ 7R. A (X1 s~ ~WN~ f i ,.r." v - ~ ~ - ~fQ Flo ~ 7~ ~ A t a' I /q 'm ~ ~ ~ ~ m~ ` ~1 " y5, ~ o l~ * ~ ~ d'a ~ r,.r^^.••~.~: ~"O'-,': :=„r)t,.::, a ryrn:rmc:A'.c~- . `t,, Q, / z _ f 5- m ~ ,p {'~.lb; ~'~E,4G~ ~ S2PJl ,v~.~, z' t 1*~ 4-iff, ; ,p; ` . t m ~ 1, ~ri yCf Y A• f. tri ~ ~ ~ ' " ~~y- ~j. 's., t1 _ '''fl .'u ~ ~ ' ti~ _ _ ' R~ 1 ~x i~ a ~ ~ ~ ~ a~i ~a"` 'r,.' ~ . j ' 1 ,n N ~ ~ ~ ~ x:x ~ . X•" r.. ~ . S ° , ~ ~ ~ 1 ~ ~ _ w~, $ ~ ~ - v t ~ ~ ~s"3 ~ti x~~~ g.l ern iNa ~u~w ~ a~ ~ L ~ ~1 w ~ 3 a ~ ~ w ~ ~ ~ ~ } r v W, - •i s ~ 7 ' ,r H~,. n tl$y~gT 7'N i'°y'~9 a~s~'~$P:{ > ~ ~ U ~Y t ~ ~ ~ ~ ~ -r b~ ~ 9s ty ~y q~c~ah O' aml i- v~ T11 ,~+~~9 ~ x ~Y i ~ Cn` "1 ~ ~ M (F ~ e 4 ar s,~ ,.y~ ~ ~ - r „ _ ~ . h` ~ ~ lc L n A~ ~ ~ Y r ra"';' ~ ~'#,,,........a,.-s....._.._.x~~...t^+~±p,"»- ..«....-ems..-.-..,yam.:-..+'•, t i~ 5 to ~ 't4s f*, - _ _ ° ~ r , - ~ ;r~~ a, r a + c ~ - ~ - ~ {4 a s ~ ~ N _tl. 1 F~ r 1 ~ ~ ry ~n ri1~h (Y { rp` ~rI 4 \ ~ ~y ~ ~ ~ ~gL i 1~~; . ~~~111 ~I~~. i ~ ~?tjj n` ~ 1 T ~ t 'tteenn~~~yky ~ 1 yd~~ t,'~ ~h~ ~ ~o T ~~j ' t ~ P4 ~ MtQO.&, PE~AkyE ~ 1 - s - y 1 ~ it 1a '~1 0_,.,:. _ 9t '°°,Cf^ • _ .-.59t':r'. ~asa.~',ii"F...p'_ k Y) . ,fir%._ ~,r. ~ ~J" ~ ~ ~,~~t. ~p ~ , ~i)~Cd,L7 } Y ~t +c 4~. - w u_' .+-k~ - W t~~ t " a ~`9'~' -nl 4i j.l R L~,, p'ry` d ..l:a; ~.i. 'p-. d+~ a , 4d, f~~.. ~ ~ _ 1F7 ~ r ra. . ~a nr . ;.5,~ int. ~ a.,, i ~ i '1.~, Y' 4 k{j{t~ 1, ~5 X~~ ~ - "j~ l4 yI1~. N ~ t y . irk - c rr1, t-. ~i it s ~ y~; ~ ~ ~ ~ ?z ~ 1..,! { !.2 r, ~r: nl . i r r - ~ - V 1 ~M I i ~ ~ ~ i~ ~`1 ~ a3' - „i to „art' 'v ~ . G _ h ~ ~t ~ . ~ C:7 , ~ m n ~1 ~ ~ ~'1 ~ ~ u ~ ~r ° ~ . ~ ~ , ~ ~,'a' ~ ~ ~ ~ r~~ ~ ~ x~;~~ ' ~ 1 iti . ~ ~tr ~ ~ ~ . 1 x ' a ~ c ' ~ ~ z~tr . i ~ }w ~ F L ~ 5 D r I~,~ ~ ~ ~ O L~ O~ ti N ~ 6 N 'j C~ 1 (J1 d G; YIrQ^` Nlnf ~ ~ N n f 0 tl K ~ ~ ~ h ~ ~G ~ ~ J 1rt.w~ t tCi . ~ n m bT 4 F t+ 1' ~f M ~ 02 ~ of i a ~a 3 > E ro y K t""¢~. ~.a illy ;f N i~P:~„Sty 2 ~ wL ti 79 ~ 3 o ry' 3 41 t v ~ k .~..~,~t ~~~~a~~l~Vf Ir~~ BOARD OF HE.ILTH SURVEY OFjPL.1NS 1, ~ ~ ~ FORM N0. 1 v NOV 2 ~ 1991 t~ TowN of sourHOLD CHECK ~ .1,623 . p 1 yid~~~ ~r QUILDING DEPARTMENT SEPTIC FORM ~ l~P.l1C. I%C'k''t. 2 `~~:ta»~.::,ir1:`t ~~'rs~YSLf~ iL TOWN HALL ' SOUTHOLD, N.Y. 11971 NOTIFY - e~ TEL.: 7G5-1802 CALL ss [ S-?........ , Examined . l~~~P..Y.~...., 19~/ MAIL TO c Approved ...~~y~..... „ 19~,Pcrmit No~ ,U~..~~ Disapproved a/c . (B ilding n ector) APPLICATION FOR BUILDING PERMIT Date . ,November 21 19 91 INSTRUCTIONS a. Tlus 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 shalt 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 Buildin; Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Reculations, 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspec ' t (Signature of applicant, or name, if a corporanon) 'Garrett A, Strang, Architect ,P,Q,.BO~, 14,1,2,, Southold,,N,Y,, 11,971,._.. ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................architect..................................................... Name of owner of premises ,MI2,, .&..Islrs.,..Wi1l.iam• G.• .Aloxr.is . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ' Builder's License No. Not selected yet . „ „ „ Plumber's License No . „ „ Electrician's License No . „ „ „ Outer Trade's License No . . 1, Location of land on which proposed work will be done. , ' ,,,2775,,,,,,,,,,Pine.Neck,Road,,,,,,,,,,,,,,,,,,,,,,Southold Rouse Num bcr Street. ~ ~ ~ ~ ~ ~ ~ ~ ' ~ ' ' ~ ~ ' ' ' ' ' ' Hamlet ~ County Tax i~tap No. 1000 Section Block , ,06 , , , , , , , , , , Lot 1 7 Subdivision Filed hlap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy SriX191e. F.amily..Dwe.l.17 riJ. , , , ~4r^ ~ltifi.l~ ' ~ti.ii.4s. i:~K: ~.fix'.ki~..,'Xr{I=~kt~•~{'C~lkt~.. K=-~~ c~t4 .Q~ d use a ......Same....... x^ =..*'1 k .~"..•.3 r« ~r+ht~at.? b.Intende nd occupancy ,,...:~.r:6a?1:~4,•rR',e ista`~,,~5'e32fr» 3. Nature of work (check which (applicable); New. [1u' ' Repair , ~ ddmg • • • • • • Addition X rUtcration X . Re,imoval Demolition Other Nork 4. EstimatcdCost. S4?,000. 00 (Description) .i Fee (to be paid on filing this application) 5, 1f daragcnnumbcr of carsvellin'g units one , , , , Number of dwelling units on each (loot , . g } 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use • • 7. Dimensions o(oxistin~ structures, if any: Front . , 5 5 2 ' ' ' ' ' ' ° .Rear Depth . • ~'p r . Height ~ 9. , , . Nuln bet of Stones . 1 -1 / 2 • • . Dimensions of same structure with alterations or additions: Front 58' • • • • ~ • • • " Depth 5.Q ~ . IIcight . 1 9 ~ Rear . 5? ~ 8. Dimensions of entire new constntction: Front . • ~ ~ ' ' ' ' ' • • • • Number of Stories • 1 / 2, • Height I Rear............... Depth . Number of Stories . 9. Size of ]ot: Front • .9.0.•.64:... Rear . ] 00 Dc• ~ ...21 6.5' . . . . . 10. Date of Purchase • " ' ~ p h 24 0 .2 1 Name of Former Owner ~ • ~ ~ • • • " 11. Zone or use district in which f ......P'~cmises arc situated R..4 Q . P P q Y g I3. ~ViII lot be regraded , , , , , , No • • • 14. Name of Owner of sr mises v~'Qte an zoom law, ordinance or regulation: . • Will excess fill be removed from premises: gYes No P hIAZx.l+3„.•.,,,Address..$q>rttjiolyl,rl•,y,,,PhoneNo..765.:1.276..... G, St Name of Architect xang , ,Address .Southold Name of Contractor Not. selected ,yet : • . • Address . ' ' ' • • • • • Phone No..765.:5455... , . 15.Is this property located within 300 feet of a tidal wetland 3n*YES..,.NO.X,. *If yes, Southold Tow' Trustees Permit may be required, PLOT DIAGRAM Locate dearly and distinctly alb 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. See Attached i l II (III ST,1TE OF \ O i COU;JTY OF~~, ~ ~ , , S~ S ••••••••••...Gax'r.ett.A...Stx' r about namcd(~amc of individual si~nir~g ~ • ' ' ' ' ' ' ' ' bcmg duly sworn, deposes and says that he is the applicant g contract) ilc is the ~ ,Architect • (Contractor, agent, corporate officer, etc.) • ~ • • • • " " ~f said owner or owners, and is duly'iauthorired to perform or have performed tltc said work and to make and file this =PPlication: that all statements contair)cd in this application arc true to the best of his knowledge and belief; and that the vork will be performed in the manner ct forth in the application tiled thcrewidt. sworn to before me this 21st ...day of. ,v,~m ~ 1991. rotary' Public, , •`~~~`!.4:Q. • , • • ClA1R@L~ • • • County NoaMttY Publlo, Bute of New Mbtlt No. 4978606 r, / . ~-r. . QwlRled in 9ufldk C ue~ty L/ ~ • ' ' ' ' ' ' ' ponwnlalon E>tpiros r 19~ (Signature of applicant)