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20289-z
f ~ ~ FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22682 Date OCTOBER 27, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 1140 CARRINGTON ROAD CUTCHOGUE H.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 6 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1 1991 ursuant to which Building Permit No. 20289-Z dated NOVEMBER 22, 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 ENCLOSE PORCH FOR A BATHROON IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EILEEN DEBANY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-036324 - AUGUST 9 1993 PLUMBERS CERTIFICATION DATED JULY 10, 1993 - K&K PLUMBING & HEAT. Bui ding Inspector Rev. 1f81 POEM NO. f 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 o 2 0 2 8 9 Z Date 19.x./ Permission is hereby granted to: ......••••./••h?. to .~~i.,~.~......~......:~ ~ oft re isesL~ ~ ...lh~~~.... Gam' r'!" .4~/" E County Tox Map No. 1000 Section Block .........a..~;>...... Loot No.........~~........ pursuant to application doted j~~.~ 19.9/.., and approved by the Building Inspector. Fee 5... ~.`Q..-~... Buil g nspec or Rev. 6/30/80 ~~rnmvheax~ u~q.+~.aw~<ttvouc . • ~ • TOWN OF SOUTIIOLD {e/~(.~~~y r~-'~~~?.' ~ 1~ l bd BUILDING D$PARTMBNT 6J ` TOWN HALL ~ q'' i. G~~,S 7es-lsoz ~`t`~~i~~~a,a~a ~ Ia t n MPLICATION POR CERTIPICATC OF OCCUPANCY T0~1;q ~<.a„~,,,M, 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). - 9. 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 ehgineer 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. ,lc curate 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. 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 $15.00, Commercial $15.00 Date ....RGtDp ~x:204..1~93 ::ew Cunstruction........... Old Or Pre-existing Building..........:...:. Location of Property.. ,11,4,0,~~x~$ngton,~tQ~.d,,,,,,,, ,,,,,,,,,,,,,,,,,Cut~chogue, , House No. Street Hamlet Unwer or Owners of Property....~,ila@Qr~. R?~~nY.. ~:wnty Tax Map No 1000, Section.,:.~~~.......Block:........+.....Lot.... 10~.... :;ubdLvlsion ................................:...Piled Map....:. ..Lot.......,........:..... Permit ~0.20289:'Z. ..,,.Date Of Perm it..l.~~22f9~...:.A .Eileen Deb2n~ pplicant. '.!cal tli Dept. Approval... NIA . .....Underwriters Approval 89/93.. H036324 . , :'l:uu,ing Board Approval,N~A ::equcst for: Temporary Certificate........... Final Certicate..X. `cc Submitted: $.~S.:QQ I'Yi,OP~d~-'I' ~Ek~VRCES [ U Je:mms v. v"~tx~eeaisi, Jr. ' ' ' ' ' ' 170~~. 94x 617, Cu9cho~uo, MY 11295 APPLICANT CU £ a~6&'2 9hana: (S 1 b) 734•SSOn r' ~ a`~ ~,i~ +a , $ ~ ~ 'w ~ , f, ; ry. 'fEL. 7GS•1801 ~ ~ ~ s~. SV~~O~c ~ ~~t Ole TOWN OIL' SOI)TIIOLn 'S orr•IC~or• Bu~1.DUrc iNSrccrolt ~ ~ ~ ~ P.U. pOX 728 r ~ ' Q~' SOU"ifiOLD, N. Y. 11971 ~ ~ ~ _ ~ ' r 01 r'~ Yob ` t . ' or ~ ~ ~ ~r,: C E 1i T I F I CAT I O N ' ,.,>t a. , ~ + . yN `f. Date ~ . ~f A ;4 =.c ~ ~ i Building Permit No. 7c.©~ 2- ~ ~ Owner ~~\4~ed. ~ ~ ~ebos~ r ' p ease print) ~ j ~ ~ Ip ease ~C~~~ hf . . print? ~~~er~~e-k `~"bS\ ii ' I eorti£y that the saldnz used in thr_ water supply eyate?m `,Gy '~F'`eontains less than 2/10 ~f 18 lead. ',.1. ~ { y'I~ i , I + 5 1 ~f t^ ~ (plumbor's signatur¢1 ` °''r' Sworn to beEvr~ mQ this ~ ~ /,¢a~ day of ~~~u.Q,a 19~, _~x~e~ ~ ~eR-ra ~ll~~ ~ t, ~ No ary P blic ~ ~ ~ ~?flotAt'y ~>'uhbl~o~ County L.IAIDAJ.000PEQ ~s``' Ndesery Publfc, State of New York ~ ` ' No 4622563, Suffolk Count~/,~ ty ~ ' ~ ,r~ germ Expires Docember 31,18.:.0 x, _ r ~ , f , _ * c~ k ~ 1~ . ~+~r ~ _,c~,~q.,a~ 3 ,5 k ~tk J . _ y. m p F 'O (U N x lT) = 3 T ~ ~ i m m m fc-j zo ~ s ~ < ~ s ~ A ~ ~ ~ N w n'3 n c x °v y ~ N M m O ~ 2 ~ n C c.] m n K H O a 3 0 £ a o b l yf 9 t~ fA (C Y. VI f1 y y1 rtp~ q rf CJ 7S ^S (.il _ w w w a-~ O o W ~ c x ~ ' r orf n Y. f--a rcn Z = p a ~ ? m . w r lr a C 2 ~ .C H r z k n c rD '~v C~ ? CA r w N- v CTJ K: ° D £ G] ~ I'-` b 4'] T ' ' 9 0 O tb ~ i3 H r Dm~ m V n y ~ ^ i y . m ro Od a R. m w cn D Z H'i h^i C'~ _ CT (U ' 9`1p +f pn 0 m~ .1~" ~ ~ L n ~ O a M a ~ F+q ',A n w? ' r Cam! a "L ~ ~ m b~ H a. ~D r+ O C't N (O ~nR z B w O (D (D .V m ~ H S N '1 ~ m s n F ~ o m d H h] f+ o o ~o h ~ m ~ C ~ p 2 b LTJ ~ a rrya m n F s ~ ~p o. ? Z h' P s m n~z io f, m\ o ~ ~ ? me ~ y p? G n n i m O H'~~7~h1W ~ > c a~ A ro ~ p w D D CrJ t~] C r ~ o' ~ "o' G1 t~J m E p a c, o a a m C r`0 ' '~~U]U] tom 'y^, ~ 0. ~ ~ ~'11 0 ~ 0 Zt~~1~~1 0 / ~ ~ £N ~ z o TI t ~ m~ _ zw~1 V ~ ^ ~x ~ a ~o - zze ~ x a ~~x C m a fnxx ~ = Ym FN ~ p ~O v = O~cHn ~ 2 ~ ro _ m O' t]7 ~ . z.. a 'X CC G J 1 H wN~f) F m £ qq A ti, 1s] rcl'tpen ti~ O~ ° H C n 7 ' ~ ~ Yn sb~ ,zo ~iy ^ C m x Y `~rJ T+1 A~Q'n.K~ ~ \ z ~7;"C x ~ i w Ul V : yN(e F N 7 ~ ~ ~~r ~ ~ a ~ n ~X %~p o ~ Z b c~ ro ,r ~>9 ~ 3 ~ ~ F~,.. > . d a~fn~s ~ ~ > ~ W ~ > e N ~ e. _ t ~ -~~R. I (m N 1 . H FOUtIDATION (1st) it --3\ ^ a I _ c FOUtJDATION (2nd) _ m 2 . ~ O` o P.OUGH FRAME & •PLUMBING 3 / l~ ~ c., H b7 ;IIISULATIO;I PER N. Y. ( y STATE Et1ERGY II CODE ~a. ( s . FI;lAL ~1 P~ ADDITIOIlAL COtdMENTS: ~ ~I x 1~~ ~ 7 - • x ^o H \ f ~ ' ~ H ' O e'er--- m > r S f7 y ~ C*7 ^o H ~ t 1 _.9 ~~.isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: ~r I I' DATE ~ ~ C~ INSPECTOR S~FFOLS ~ TEL. 7~s-I$oz o _ o~~ To~rr or sor~~~oa.~ ~ ' . 'I' . `c OFFICE OF BUILDIt•IG INSPECTOR ~ c.;_~ - ~E y rn P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1 1971 C E R T I F I C A T I O N Date 10/1/91 Building Permit No. Owner Eileen Debany (please print) Plumber Paul Debany Cambridge Associates Of Nassau LTD. General Contractor (pleas c- print) 'Licences x1894620000 I certify that the solder used in the water supply system contains less than 2/10 of to lead. 100% lead free ~ Paul Debany (plumber's signature) Sworn to before me this ~0 day of OVPh~ ~ ~ ` Notary Pu is Uotary Public,~j/~i(S ''~L~ County Lutsa a FiuPE N67AItY PUDLIC, State of New York No, r,313646 Qualified itt Nassau County / • Commission Expires February g, ig ,.1=. ~ ..r~. - . - - - ~ nom" q' { i ;,•k+>~. ',6"'., ' rr ~ ~ °o o~ o~ Sao <~o u'Z~ ~ _t'M~ ~ ~.!•`~r,.~.'~~4.. - a00 Z~~ Z~Q'~°~N Z~f~ ~ ~ ti~.. , N~o y C~~~~p~o `7 M'x c g i q,p V'IryVj'p ' ~V ~r ~ NZV.. ~ O`~U~ p Ham[ ~ '/I. I, b~ X0'7 ~ 1•;, a " m > x] e ~ ~ ~ ~ - - 1 I Z ~ fie! `i ` / ~ ~ ut ~ u V a ~ F t- - m c ~ ~ ~i ~ N : r ~ J p ~ ~ ~ J - ~ z _ 1;~ i ~ 1 ~ . I ~ ~ ~ ~ ~ v ~ %t ~ ~ ~ ~ 3 C 1 } r r~ tl N , y i y DAA~II \rlll {fj\ • A y 4 ~ , ~ ' C] 9g~ I I„ Y.`„~ `'e,?~ a tiy'• `\~,~b . N.1#" ` ~ 5,.. ~ ~ h u ~ `s - ~ ~ ~ 1 i•. . s : • fi, ° M . I ` ~ n is A 4 • n ~w ~ . 'fi . , fa..,.,~;:rA;'r',c':1~:" { ~f=,...,.;',~ BOARD OF HEALTH r pi i~~ FORMN0.1 3 $ETS OF PL1:1S i; ~iS ~ ~ ~i~ TOWN OF SOUTHOLD ~ SURVEY . . y ,1,^ BUILDING DEPARTMENT CIICCK ~ t. "k` ~ TOWN HALL ~ SEPTIC FOR:I . . . , „ , ~~~.'f~'.1't~" t' ~ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:oTIFY; G7CALL ~~-f?c3~4 _5417........ Examined 19l~ h1AIL T0: Approved • „ 19~permit No..°,~.'~'.~/.~~ b5. Cambrid~e.A¢e.. ~q Gardan.C1CY.N,v. Disapproved./c 11530 _~re~c . (B ildin Spector) ~ , APPLICATION FOR BUILDING PERMIT 10/1/91, 19... Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :atior,. 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 ,half be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupancy hall leave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Clte applicant agrees to comply with all applicable laws, ordinances, building code, house code, and r gulations, and to idmit authorized inspectors on premises and in building for necessary inspections. •Pau•1,Debanv (Signature of applica t, or name, if a co ion) 65 Cambridge Ave. Garden City N.v. 11530 CMailt:,o address of applicant) State ~vllether app]icant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........4wttQx.,..Creneral Contrator, \ameofownerofpremises .,,Eileen Deb any (as on the talc roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .........Cambzidge•Associates of Nassau County LTD, (Name and title of corporate officer) Builder's License No. .......H.189A.fz200.0,0,,,G,eneral Cotractors license Plumber'sLicenseNo. ....Contrator will be daing the plumbing. Electrician's License No. .,Contractor will be filling forUnd~writers Otltcr Trade's License No . . I. Location of land on which proposed work will be done. ...111+.0..CaZ=x.ington. ,Road Nassau Pt. ...................................Street [iouseNumber 1140 Carrin~•t'oxi'Rbad•••••••••C~u•rehog•ue••••••••••... Hamlct 06 010 County Tax Map No. 1000 Section 111• • • • . • • • • • • • • • • Block • • • " 806 • • " " Lot . Nassau Pt. Subdivision I'iied Ma No. Lot .0{0. 362-363 ' p (Name) ' State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residence b.lntended use and occupancy • „Add second ,bathroom, ' T r r 3. Retau of work (check whtRemPplicable): New Building Additio , ,Bathroom~teratton • • • • • • oval Demolition Other 1Vork . $50 , 00 (Description) 4. Estimated Cost 5000; 00 .!I Fee g' one (to be paid on filing this application) 5. If dwelling, number of dwellin Units . . . Number of dwelling units on each floor , ,one If garage, number of cars . , , . , , one 6. If business, commercial or mixed occupancy, specify nature and extent of ca8h type of use . r i ......s.u........... Dimensions of existing structure's, tf any: Front ~Q : , , . , , , , , ,Rear . Height ..8 Num',ber of Stories one Depth . tmensions of same structur„ with alterations or additions: Front s.a,tne , Rear . De th , . P ..8 ~ .Height ......................Number of Stories . 8, Dimensions of entire new coast ction: Front ~ ' '8' ' ' ' ' ' ' ' ' ' ' ' Height 1. .10....... Rear Depth Num 9. Size of lot: Front .......250'i........... Rear , ...251 . 10. Date of Purchase 19 75 • fiber of Stories one ~ Depth ,..12.4...04 • • • .Name of Fo er Owner ' 11. Zone or use district in which prc~nises are situated Re•s id en t a~ : ' ' ' ' ' ' ' 12. Does proposed construction violate any zoning law, ordinance or regulation: N.o . 13. Will lot be regraded , , , , , ' ' ' Will excess fill be removed from premises: Yes Rn 14. Name of Owner of prrm;cac Address ...................Phone No. Name of Architect ' ..............Address ...................Phone No............... , Name of Contractor P.au]-. P.?b' 15. Is thisIfryes,tSouthold T any "'Address ,65 Cambridge eve pho~~~10. 35k.:~4X7...... ' QO feet of a tidal wetland? yryeS•,,,,,,, N _ * pwn Trustees Permit may be required.~~~ ~ PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed, and,i di ate~~et-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. ' 1140 Carrington Road Nassau Pt, Corner lot, ~~w~~avru ~s ~o~rEu ' te1O"?1F1/ F3 ILDtNC.•, t?0=,P~~TMENT AT ' ]'f)Fi-afS02 ANt TO `Y ~M FOR THE ii FOLLO1fJtNt~ Nt~P~C IONS: I . FOtINt7ATl N '11N0 REQUIRED FOfR POUR NCRETE 2. ROUCxH - FR MING Fi PLUMBING 3. INSULATIO 4, FINAL - CO TRitCTtON MUST BE CAM ETE F C.O. „ ALL CON RUCTIO SHALL MEET THE RE IREMENTS ,OF THE N.Y. STATE ONSTRUCTION & ENERGY DESIGN OR ONSTRUCTION ERRORS . PATE OF NEW YORK, OUNTY OF Suf f o1•k , , , S.S~I ,,,,,.,,.Paul Deban••••,.,. (Name of individual signing ~ ~ ~ ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant pontract) ove named. :isthe. ,,,,Paul Debany I (Contractor, agent, corporate officer, etc.) • ~ ~ ~ • ~ ~ ~ • ~ ' ' ' ' ' ' said owner or owners, and is duly authorized to perform or have perforated the said work and to make and file this plication; that all statements contained in this application arc true to the best of his knowledge and belief; and that the irk will be performed in the manner sef forth in the application filed therewith. orn to before me this tary Public, ~ , II County ` NOT/ tUISA 0. FILIPE I/I ] RY PU6LIC, State of Now YorH ~ 1'1.. _ No. 4913646 17 . • • . QualiricA in Nassau County /~/yf ( ature of applicant) Cammfssion Expf res Februmy 8, 19[_