HomeMy WebLinkAbout20324-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 2-20537 Date FEBRUARY 18, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 785 FISHERMENS BEACH ROAD CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 1 Lot 31
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 10, 1991 pursuant to which
Building Permit No. 20324-Z dated DECEMBER 10, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ~ JOSEPH & JANET GOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
V
Building Inspector
Rev. 1/81
IP08M NO.
TOWN OF SOUTHOLD
BUILDING pEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
D Date ...Ir.?.:4.FF'r'~4~4r.... 19.~.~..
N- 20324 Z
Permission is hereby granted to:
`~J.:ar.... ~ 9..~.~
ro ..(?-~^~.5~^M.~.:...ar'?.....4...~!~w.CYM:f~.....1t,.r;1?sd~....vs.....°):....:.~.............
a~ ises ated..at~.,"' Y °~t.... ~Ys.lt.."c9~.4C:~t4@::^~..O.CY.t.~.....L~.~.".:~... .
~ 6^ r L 5 eiG°2. u4i~ k ~s (3 is~ctF
~ 5:...~9.4~t..
~.....~.~..Q~EI
County Tox Map No./1000 Se~ct~ion~......~.~..~............ Block Lot No....".5.~1...
pursuant to application doted ..A,...~C~a.~•.t.~ 19.g~..., and approved by the
' Building Inspector.
Fee S.
Buil ing Inspector
Rev.6/30/80
„ Form No, 6
TOWN OF SOUT[IOLD
BUILDING DEPARTMENT
FE8 14 1992 TOWN HALL
765-1802
APPLICATION POR CERTIFICATE OP OCCUPANCY
„ .
This application must be filled in by~'t~ypewriter OF, ink ahd~submiteed to'~the~,hui~Yd3ng~ "
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 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.
!3. 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 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 $1n5.00, Commercial $15.00
Date ~a;/( ,
::ew Cunstruction...,:'~7.G.~.COld Or Pre-existing Building
Location of Property....(. p.J..........~~~!l,P,~(.~~$.~Q(4fl~ e . , . ~'w(.6 y~
House No. Street Hamlet ....o..
Unwer or Owners of Property..7.~.':~. ~e~,,~,~„,,,...,.....
County Tax Map No 1000, Section....~.~.~.....,B1ock....~2~.........Lot...,
((yy7~ RR \ .
3ubdivisionU.Q~I.`J~,}~-c„~,~„~~~K~Filed Map..aO,Y?.....A.Lot.'L..'~.~h-'
Permit No..v~tit 3~ , , , ,Date Of Permit.. ./Q.(.'Z~.....Applicant~t L'~.U~!~1W,Mp,,;e /~J~.
1 ~ tl et/1~11a-aj, .
!tealth Dcpt. Approval.+`.~.~
.....................Underwriters Approval...~.l.D,~:~:'................
Planning Board Approval.~1.~.`~-
i:equust for: Temporary Certificate........... Pi 1 Certicate...G'
ree Submitted: $,~°~.i~.o
cry-~a~s~~ APPLICA
INSPECTORS ~ ~,Z
Principal Building Inspector ~ a~~~~a3;FI)(l~~,c7
Curtis Horton ' „'Ai `~G~ SCOTT L. HARRiS, Supervisor
Senior Building Inspector ~ e ~ Southold Town Hall
Thomas Fisher , ~2n t:`'';~','y`
Building Inspector Oy' . P.O. Box 1179, 53095 Main Road
Gary Fish ,~~Q!` F~ .~a'~"b' So Fax (516) 7 50 $~~971
Building Inspector Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTIIOLD
FEBRUARY 14, 1992
ENVIRONMENT EAST, INC.
3075 INDIAN NECR LANE
PECONIC, NY 11958
RE: JOSEPH 6 JANET GOLD
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. (Enclosed)
No Underwriters Certificate on file.
Rxx 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 # 20324-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
c'IcLD I;:S: EC;_0;1 ~
~~JnTE ~ ~Ohf~+1GNT°
s'. S m 9~
~O
~ H
FOUIJDATION (1st) `jL
FOUiJDATI0IJ (2nd) y~
m
2. ~
`o~
P,OUGH FRAME & ,J ~
Wi
•PLUMBING
m
~
3.
IIJSULATIOPI PER N. Y. ~
STATE ENERGY
• 'n
CODE
FIIJAL
• ~
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ADDITIOh1AL COMhfEilTS: m
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BOARU OF HEALTH
.,r~' ' ~ ~ 3 SETS OF ~ PLAN ; . n. .
' FORMN0.1 SURVEY,
TOWN OF SOUTHOLD CHECK , . ? ~ " '
~ G J
UE ~ ~~~1 6UILDING DEPARTMENT SEPTIC FORM +
' ~1' ' ~ TOWN HALL
.,OUTFI
Fs ~;r,. ~k-,:-f, OLD, N.Y. 11971 ~ NOTI CY
"I•f9bVit, (.3t~ OtiJ';'hgC3L0 TEL.: 765-1802 CALL . , .
~~...R~a... y.,-.w.~.,A,„ ,
• - Examined . w~tG1ni^~:^.~*- 19 °l, l• MAIL TO
. Approve ~ .D 19°t.l. Permit No.ar? $d.~ L~".
Disapproved a/c
(Bw dmg Inspector) ,
APPLICATION FOR BUILDING PERMIT
Date .~PC,,,~.......':.'15~~
INSTRUCTIONS
n a. Tltis 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 Buildin; 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 art for an ~
shall have been granted by the Building Inspector. P Y Purpose whatever until a Certificate of Occupancy
APPLICATION IS HEREBY MADE to the Building Department far 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 Iavis, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections-
_Fi, N V (2,O,A,1(1'1~N:~. . ~ST I i~5 L' . _ '
(Signature of applicant, or name, if a corporation) '
' 3oZ S ~ hcC;c~• •~V e~O~; ,C..,o~ne, . P2con cam. .
(Mailing address of applicant) ~1~i85
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......~'.~t~tpx.~:1....eo~-:k.
a~.-Eor .
'Name of owner of premises ~,~'l~- , , , , G"~ ~ d •
(as on the tax roll or latest deed)
If app is a rpor lion, signature of duly authorized officer.
(Name and title of corporate officer) -
Builder's License No. 55~ ~
..Plumber's License No . .
Electrician's License No . .
' Other Trade's License No . .
Location of land on which proposed work will be done.
' House Number Stree ' ' ' •
~ Hamlet ;
County Tax Map No. 1000 Section ~ Block . , ,
~ Lot...,.:~~~,~,,.~.
Subdivision e~nlC~~, ~Co,~??ft?~S,- Hiled Map No. Lot ....I.
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....cJ?~~.4-...` <<, , , {~t~J~~ l~ry • . ' , • • • . !
b. Intended use and occupancy ~~~~~-.•...:~f3.~fYlS . , ,~Q~(tv~'
3. Nature i~ •
of work (check which applicable): New IJuilding ,
Repair . Removal . Addition , Alteration , .
• • • • • • • • Demolition Other 1Vork .
'4. 'Estimated Cost , ~;2 a ~ QO• - (Description)
S. g i Fee
(to be paid on filing this application)
,5, If gdwelglin number of dwcllin wits , , , , , , ~ , , • , , , , , Number of dwelling units on each floor , , , , , , , ; , '
If era e, number of cars
6, If business, commercial or mixed occupancy, specif ~ ~ • • • ~ • ~ ' • ' ' ' ' • ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • .
y nature and extent of each t pe of use .
7. Dimensions of existing structures; if any: Front . ~ • 2 Rcar • • ' ' '
Hei ht • • , Depth . ?.-4, , '
g •i•~.~....... Numb',cr of Stories . °L • • • ,
' Dimensions of same structure with alterations or dditions: Front 55.••2 • • • ' • • • • ' ' ' ' ' ' ' ' .5'S• •`2, • • • • •
Deplh....~Q:~....,. „
. height . ~ . Number of StoriesRca~ , • •
' 8. Dimensions of entire nett' constn~i;tion: Front , , , , (S'-C?!'' • • • ~ ' ' '
-Height G~~~,........ . Number of Rear ....l?, :4.. , Depth ..18,0.'.".. '
9. Size ofiokFront „ •~$'-p~' Stories.....,,N;/~
10. Date of Purchase , , ' . . • • . • . Rear , , , , ,5~? • Depth 7t~IO • • •
................Nameof
~ormcr Owner ~
1 I. Zone or use district in which prerrJises are situated . , j'~ es•i • e~-(~c~,( ~ t • • • • 1
'12. Does proposed construction violate any zoning law, ordinance or regulation: lv, • ~ • • ` ' '
13.;, ;Will lot be regraded N o .f? . 1
1 • • • • • • • • • • • • ..Will excess fill be removed from premises: Yes No 1
14: Name of Owner of premises t~~ ~Q;nef, ,G,oldAddress •~Sb, F,'«skj GCuz ,
' Name of Architect (=f¢e~ooc~ rite • • • • • Phone No.:7,$,4,-~a,3,7, 7, ~
Name of Contractor ~~};oytgttovi,{i Gq~{: ;lie; ' ' • • Address , , , ,phone No..
1S..Is this ro ert • • • • • Address 3P75 lv~d;'cu-~ Ale Phone No:. ~,~~},^"Z~ Z1~:
P P y located within~00 feet of a tidal 'we~'~aad? *YES....NO..'.."'
*If yes, Southold Town Trustees Permit may be required.
-..1.-.,;. i PLOT DIAGRAM , . ~1'~'; ,<< ~ I
~~""'~~i'Locate clearly and distinctly ail buildings, whether existing or proposed, and, indicate all set-back,dimensions.from ~
property lines. Give street and bloc~u'mber or description according to deed, and show street names and indicate whether
interior or. corner Iot.
utst ~;1.
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TE~TE_4FNE1V_YOt S.SI
tom~,.,
"E.
OU _ - '
F v4M.~~ ,
~ • ` • bein dul sworn de oses and sa s that he ' `;ta
>ov' (Name of individual si~ni • • • • ~ • • • • • • • g Y •
' d contract p y is the applicant
e named. 1 ~ t ; ~ r-
e is the ~ '
F n•.•.~ 1
' ' ~ (Contractor, a• ~nt,• ~ •poratc offic • ~ • ~ `
'acid owner or owners, and is duly au~~thorized to rfor ,etc) ,
P~ r have performed the said work and to
plication; that aq statements csntaine~ in this application are true to the best of his knowledge and belief; and thlat tlhe
trk wilt be performed in the manner sell forth in the application Gled therewith.
+orn to before me this
i
~ .day o t~w,~0'? , 19 q
nary Public, ~+~1)F-.
• .County
~ ~ =1
- ~ 1 ,.~R. •
4 BI.1 State - - . . .
(Signature lof applicant)
' ~ II"^ r.bs' cl ILe fJuw fork Stale Eduenllon Lalw,u vlolalloq of
7.1d,~;,ba~%' Pisa of 11us WrvoY mop not bearlnp the land surveyor's Inked ':~''~~~':;:i b'~~'i i'r~i l:
I ;x°;~ l.a•" . aoal or emboaaod aoal shall not be conilderod to be a valid copy,
n; I''bs
r. Guamnleos or carrilicatlom Indicated hereon shall run onl I
r%^'; ~ Parson for whom the curve h re Y o the ~ ~
;a" tllle Y P Pared, and o tt •i<.~„ t'
r~ V . , company, governmenlah agency and le n Ms behalf to the ~'`s~
' ~~/~,I''•'. ~ ~ hereon a g g ndin
~,n, r.. ~ , nd to the asst pees of the londln Instllu llonlilCuaranllans SAM ~ ~ •~'~iy ~f,f
f~ q IRS:,; "r~ c ' ~
;}~6: or cergllcallons are not Irandatable to ~ 's~~$
",;:i;i.. ;~.+ubregwnlownen. addluonal Intlllwlomor ;.,;.;'r~l,~:+~,•(^'y~`4~i'
r jltr )I i ~ s rIP Il ~i frn~~"L~ r fl~~i:
rr~ L - 1 . ~ r'.'1J:.,Ij, ~~ifr~": rYr, rf
`I~'. •t,. 'pry !'i;i';i~Ri'r4,~" i~l'r;~ij:
I a i
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. , ,,,ova,,: , y...
VQ ~ • i shy' rk.
+~~?'r,:' Q p / y I .aR . r...~;.{~ of f' m`<.
'li 0 ~y„
~ yy>- dry. ,o. a a o~ / ' ~ . s~ ;`i'=.
.Gf' a :
2t i'
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p ? ~
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"fi.;i qs'- Fy. p'C ; is ;iY~,~;
C,,
~~i`:ii": ~ rwafs'~H~gar~~jr•t{y~'.:: '^r"I
l~~~F'1 ~ ~ ~ ~ N/ r~t.r rt~,~~tr~~~rp ~.l. a~!
:s`•yJ';:.'''• ~''•r by + ;~,74~~'r.~a'.L ' 1~6~'If;~TrN~~{; ;a.+',.
.try',, -ti ~ ~`i: 4t,?,
s , w+rK9~F -
~iy G ~ arm. r.~.,;
~~`i'f : ~ ~ ~ ; : , .a,'+' i rya ;
,y~~.5'r'r.gi ~ y:..I:,~r.rt ~Tr~.~ rr 5~~~'' ~~i'~;
i's; , All dislanem to wsl6.and cesspools are '
by locallon from house owners and hold '
I~ obsenalions, alnce most wells and cess-
a~'~ra~ pools are nal visible Iheae dimensions
1'~(cannot be cetli0ed, ,
r~a,.il. I -~3,~
;;4'~f ,
REFERENCEr ''i
' ~~r'H A.J,AN~'T GOLR Pcconfc oNq~ibe (cs fNC::~~,.,,,,y=.~':'.,~.,..
=i~~A~sAU pa~NT Ff~Ea y ~a An.~,pr~rp~;str,~~~'?1,:,
o O~ ~ ~'ti9 •''ttl.~.',p~,:,,P;,ih y}:~"?lri, ~'~r„'.i;:
.~tIgF.S: VTHOt.,p 9J, iiri.:.,:,,,.
If'~~,11,K ~ COUNTY N. Y. CNfCA +i"'h4ie,'ti;:i~':n%J:
TL AQIK ' r 't
IT s N CtI A T r yr~ Kry,,.,
~ u s JOSfP JAN l.lp'" a lif't' 'r3 itF .
s ~'i f ! ' s .4.Q i {I r' t'I rt [;~h~}]~I'x I•ry~s trt~~~~;
w4{:~''i. `ten ~ Q. r:f,~"t.4,C•,Ny.~,"~r~rl,+('lrly.r'a.
`'~CH•~~ Derr. "SFO yr~~^ ~~(~k~'y~YY(i s(Pyf'p 'ir.
r I~^,~~r'~Z~T7 ~ r V[+Y Ii~il Yi~4' IN f~{r':' •::t,
~'~pt' ~S A. :p .
t~ rdy 1~. ';..I. 'C' .r: ~ ~ r: if u.f: ( Dili r~, kj rr'~
f
...v~+:'.^:2.'1Yn_'~._r•w•...-v~~.. inFne9 ir...r..~u`fM.~....Hn.r.....`...~~..~....._..~ . ~.Y.r~ w~.w.w. 41 '.:tr[Illltif
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