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HomeMy WebLinkAbout19716-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20532 Date FEBRUARY 18~ 1992 THIS CERTIFIES that the building RENOVATION Location of Property 24500 COUNTY ROAD #48 House No. Street County Tax Map No. 1000 Section 84 Block 4 Subdivision Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15, 1991 pursuant to which Building Permit No. 19716-Z dated MARCH 15~ 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 REPAIR~ RENOVATION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. THOMAS McCARTHY (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-213542 - NOVEMBER 18~ 1991 PLUMBERS CERTIFICATION DATED FEB. 14~ 1992 - RAYMOND KRUK Rev. 1/81 Bullding Inspector FORM NO. II TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, Ho Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19716 Z Permission is hereby granted ~ ~, _ ........... ....... .......... '"'~ £~-~'"~"'";g':~T'";'7'~:'""i' ....... . ,o .~...~...~..~....~~....~..~~......~..~ ....... ............. ~.~ ........... .~ ..... : .................. :~....~:..~;..~,. .................... ::....~ ............................................ at premises located at .....~...~....~....~.....,....~ ........................... ~~.(~ ......................... ~ .... ..~...~ ........... pursuant to application dated ........... ,/..~. .................... , 19.~.~.., and approved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN Ib\LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN( This application must be filled in by typewriter OR ink and submitted to the building inspector witb 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 i% 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: .l. Accurate survey of property showing ali 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. I. 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, Cormnercial $15.00 Date ....... .~. 0 .~.. ~...~ .... / .~.~. ~. ............... :ew Construction ........... Old Or Pre-existing Buildin~ ..... ~. ........ onwcr or Owmers of Property ..~.~ ~.~ ~dC .~..2 . County Tax Map No 1000, Section ..... .X%. ..... Block...~. ........... Lot..Z ................... '.iubd ivision .... Filed Map ......... Lot .................. No.. I .~ .~. l~...~...Date 1, I ,,,i .. ,,I Permit Of Permit .... '.~.L/~ Lq~...,\pp 1 ican t..~..~; .~..~....~.. ....... Health Dept. Approval ........... ?/~.. .......... -- [ ' --Underwriters Approval ......................... ;'lanning Board Approval.. .... ..~g~ .... .. .... [leqncst for: Temporary Certificate ........... Final Certicate....~ ...... Fee Submitted: $~..~ ........... (0 TO~ZN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 C E R T I F i , ' ...... _ _CEA_? :ton O~ne~___ ~p±ease pr in t )~----~---- ' I certify that the solder used in the COntains less' than 2/10 of 1% lead. Water SUpply system Sworn to before me tkis 19 qa . ~/Otary Pub 1 ic, J0$£PH $. GRArrAN County Nota~,~ui~ ui New ',%~ NO. 480330i-Suffi:Ik Cour'y Commission Exph-as C ~, -" ]'¢~ /(plumber's signatu--re) -- THE NEW YORK BOARD OF FIRE UNDERWRITERS "" ~l.()()) ,~'J. BUREAU OF ELECTRICITY ~- 8B JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT oniy ~he electrical equipment ~ ~serib~ be~w and introduced by t~ applicant ~med on the a~ve application number in the premises of in thefoltowlng location; ~ Basement ~ Ist FI. ~ 2nd ~2. OiJ'~ Section Bilk Lot (~ ~ ~ wasexamlnedo~t ~'~OX/~ ~,~ ~[~ [~ I~q] andfoundtobelncontpiatcewththerequirements~fthisBoard. EIXTURE FIXTURES RANGES C~KING DECKS OVEN5 DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLU~ESCEN~ OTHEFI DRYERS SYSTEMS NO. OF FEET S E R I NO OF HI-LEG OF NEUTRAL GENE~,.I~ 'MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorreCl, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & ·PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITION A'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING .~ FINAL DATE INSPECTOR ~.-~, 765-1802 BUILDING DEPT. ~oo ~ ~~ INSPECTION ~~N ~TIO [ :)ND N REMARKS: DATE INSPECTOR///~ O0 ~/, ~(~ .................. :'ii'"i"ili .... ' .... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ FORM NO 1 3 SETS OF PLANS ............ · SURVEY , TOW O OU HO D ........... TOWN HALL ' $OUTHOLD. N.Y, 11971 NOTIFY; TEL.: 765-1803 CALL INSTRUCTIONS a. This application must be completely filled in by typewriter orin ink and submitted to the Building Ihspector, 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 -' ' - cation. =tvm~ a detailed description of l~yout of property must be drawn on the diagram which is part of this appli- ¢. The Work covered by thi~~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 pen'nit shall be kept on the premises available for inspection throu~out the work. e. No building shall be occupied or used in whole or in part for a.ny purpose 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 ]uilding Zone Ordinance of the Town of Sbuthold, Suffolk County, New York, :md other applicable Laws, Ordin:mces or ~egulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances bu' ' · dmtt authorized mspectoiz on premises and in building for necessarv'in~fl, d~g co~ouszn~ c,ode, and regulations, and to ]ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. :amc of owner of premises ..... s n r lares 'applicant is a corporation, signature of duly authorized officer. Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trnde's License No ...................... Location.of land on which proposed work will be done; -'- ....... ..... u . I louse Number Street, ' ' Ha,nlet ' ' 1000 S ' County Tax Map No. oction ................ Blbck .... ............. Lot... ,' ~ubdi¥ision ............. .................................. Eiled Map No S (Name) ......... ..... Lot ......... I:Stc existing nsc and occupancy of prcm ' ' .... i~6s and intended use and occnpancy o ............ '"'"' .......... B. Intended use and occupancy .............. ~ ~.' ' ' "~ " ' ......... · Nature'ofwork (check which applicable): New Building .......... Addition .......... ,~dteration ........... Repai.r . ...~ ......... Rbmova! .............. Demolition .............. $~imraing pool ............ Tennzs ¢O~u£t ......... Acnessory Building .......... Fenee.~...,,..:...Other ~4ork ............ Estimated Cost .... [~ .O.~.~9. .~..; 77. ................... Fee ....... : .................... :. ....... . . ~ (to be paid on filing this application) , If dwelling, numberofdwellingunits............... Number of dwelling units on each floor............... Il'garage. number of cars ....... , ............................................... Il, b e ify h typ '' i ............. usiness, commercial or mixed o cupancy, spec nature and extent of eac c of use ...... Dimensions ofexistingstmcturcs finny: Front Rear Depth .......... Heieht .... ' ..................................... Number of Stories ' Dimensions of same structure with 9Iterations or additions ........ Depth Height ............................ ...........................................· Number of Stories. ....... . Dimensions of entire new constrncfion: Front Rear Depth .......... Height Numhe~ of Stories .................................... Size of lot: Froot Date of Purchas~ ........................................... Depth ..................... · Rear ............................. Name o£Former Owner ....................... . .. .. Zone or use district in which premiies are situated Does proposed Construction violate!any zoning law ............................ ~.' ~)i ........ ~ ~ , ordinance or regulation: ........... Will lot be regraded Will excess fill be from premises: ............................ removed Yes No Name of Owner of, premises ~ " Address Phone No ....... Name of Architect ..... ~ ............................................... ' ' ' ' Address Phone No Name of Contractor . . ..........- , .............. Address ................... Phone No ................. · ..Is this property loei]tted within 300 feet of a tidal wetland? *YES .... }10 .... · If yes~ Southold Town TirusEees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly,~ll bugdings, whether existing or proposed, and, indicate all set-back dimensions from ~perty lines. Give street and block number or description according to deed, and show street names and indicate whether erior or corner lot. ' i - ~TE OF NEW YORKr'. /-v-. u T¥ ........ :. s.s ." ............. "~' ' t~'~'~"~': 'flA'~'i' '~'~{]'-O ......... being duly sworn, deposes and says that he is the applicant . . (Name of individ ual signi;~g d'ont ;~'~i/' )ye n~med. ........... . ' corporate Yfii~;; 'e't~ ') ' .......... ' (Contractor ............................. , agent, , . ;aid owner or owners, and is duly auihorized to pe,rform or have performed the said work and lo make and fil~ this lication: lhat all statements contained in this npplicatioo are trne to the best of his knowledge and belief,; and that the, ~ will be performed in the manner set[forth in the applicatioq filed therewith. ~ ~rn to before me thi~ ~ . /drY'-// ......... ~. ..... /x.<'..day o.f...~]~ . .~,' .\.4', ........ , 19 ?/. m a0 Ea l. SmU t:' ' .... ...... .. .