HomeMy WebLinkAbout19857-z FORM NO. 4
TOWN OF SOU7."HOLD
BUILDING DEPARTMENT
Office of the Building. Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20310 Date OCTOBER 29, 1991
THIS CERTIFIES that the building NEW DWELLING
Location of Property 7645 ALVAHS LANE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 101 Block 1 Lot 14.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 1991 pursuant to which
Building Permit No. 19857-Z dated MAY 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 ONE FAMILY DWELLING WITH GARAGE IN CELLAR AS APPLIED FOR.
The certificate is issued to RRNEST & SEAN SCHNEIDER
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-26- OCT. 25, 1991
UNDERWRITERS CERTIFICATE N0. N-208904 - OCTOBER 21, 1991
PLUMBERS CERTIFICATION DATED OCTOBER 4 1991 - K & K PLUMBING & HEATING
V`
uilding Inspector
Rev. 1/81
7'ORM NO. ~
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)
Na 1 9 8 5 7 Z Date 19.9.1
Permission is hereby granted to:
~s '
9.
.
. . . . . . . . . . . . . . . . . . . . ;
y,
.d~ . . .
.4'4? ~~~~d /
at premises located at ...'J..~~./~,-~~F...~.v..G~~~'?'....fr.G??~
............................................4~••~:
,t~z••
.
County Tox Map No. 1000 Section ....,~~/,1......... Block Lot No.......9P.`.<....-~....
pursuant to application doted ........~.1.~'y„f 19..1, and approved by the
Building Insp~/ector.
Fee S.•:3~+i!..r^~/-
~Bui ng Inspector
Rev. 6/30/80
' ~ Form No. 6
TOWN OF SOUTlIOLD f i"'"~ v ~
BUILDING D);PARTMENT , ~
~ Q ~ C
.76 y^
~-ln ~QJ TOWN lIALL ~ ; ~CT Z J I~gI 4
W~^+ ~ ~ ~ 765-1802 t~ ! ~ 6
~r 1
APPLICATION POR CERTIPICAT); OF OCCUPANCY :.i",' r'"~ ~ '
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 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 ly, 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
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 S years - $10.00
4. Updated Certificate of Occupancy - $50,00
5. Temporary Certificate of Occupancy - Residential/ $15.00c7, Commercial $15.00
/ Date ....1~~~ S~l1
::ew Construction.....v.'.//... Old Or Pre-e~Cisting Building............~6
Location of Property.. ~Y.~~:r..~`.~/~t~-^', , ~lj;/U'~ t C f~0 t3'-G~ C= ~l
House No. Street Hamlet
Unwer or Owners of Property./: ~f~~,~ ~~~~~,~~flllG=;1~ER
County Tax Map No 1000, Section... .~Q.~......Block..... ~..........Lot...~y':~'
Subdivision ....................................Filed Map............Lot......................
Permit No.. ~q.~S; 7 :
Z": • ,Date Of Permit...S~J/S p, ,~I~?A7 T J~,C, 1~7?E,7l~t
/ .1~...Applicant.~is,.... ..7.t~,,.
Health Dept. Approval!~iQ_,./~~5~91............Underwriters Approval:y.Q'2l
I'l:inning Board Approval
tiequcst for: Temporary Certificate........... Final Certicate....t~..
Pee Submitted: $v1~oca ,
l1 ~ c~ 0 3 ~ Q ~~j1/•w~;':APPLICANT .
~f
THE NEW YORK BOARD OF FIRE UNDERWRITERS
Ioo..o7J
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Of.TOBF.R 71,194'( 741.4ti191/9'I N 'l.ii8vt)d
Dote Application No. on file
s THIS CERTIFIES THAT
only the dectAcd equipment w dwcrihed below and introduced 6y the appNcant named on the aftws application numher in eke promisee of c
F7RNIR SCHNT.F.DER; AtIVAH5 !~AMi:, CUY'CHOG[Jr„ N.4',
1!I (it1T
in thefolbwinp Inca e ~ la[ £f. ~ S!nd F'l. .Section Blcek /wit
ww examined un and found tv 6e incompliance ai[h the reyuiremenU of thia Board.
RXTUM RXTi1RlS COORIlIG DECRf OVlNf qSN WAfNERS EXHAUST FANS
GiITLETf AClES SIMITONS INCANOltClMr. rlU01I!lCEM OTHER AMT. K. W. NAi. K. W. MAT. [.W. M1T. K. W. Mfr. X. v.
?.4 18 ?.9 17 ? 12 1 1.7 5
_ glY9S RMNACE MOTOES HJTWE AFlIIANCE REtIMf SMCIAL MC?i TIRIE CIOCRS ENL UN17 HEATERS MIILTI.OUTilT gMMERS
MAr. K. w. a[ M. r. GAS w. IJAT. no. w. c. AaT. .wv. MAr: Mgrs. TEAKS. AMT. r. NO
~
~ ,vnr. wArrs
3 £ ? - r
_ SERVICE OIECONNECT NO.O! f E R V 1 C E
Mnr. Mo. rvrt ~ ~ w tw t / sw s ? 7w s,e rev w. ~i
yCOno. or c cgiro. no. a a4ue Os ~ w rq. of neureMS a ~t
oTHER AnARATIfS:
SllOltti DST};CTOR:-l.
~ _
E
_ tr~
C, & S CON1'RACTO[i t.IC„~57kF;
B()R 215
SOtJTH07,D, NY, 1'19'/~~
ORQAI MANAGER
II
"V
Per
This cartificaN mwt not be olNrsd in an manner; return to fM office of the Beard if incorracl. Lnpectori may bo idanfified by their crodentials.
COPY Pqt /IlILDIl16 DEPARTMENT. THIS COPY OF CERTIPIG3E Ar9ST-NOT BE kLTERED IN ANY MANNER.
,$~'1 .
' ~itN
g~~F~LkC' rtEL.7~saaoz
o~~ oy Town or souTIIOa,~
r ~ .4 ' OFFICE OF DUILD1i4G INSPECTOR
~'~a uQ~i t.'` -',~f. ~ r-n P.O. UOX 72FS '
t0 TOWN IfALL
~~p'~"' SOUTHOLD, N.Y. 1)971
~ s
C E R T I F I C A T I O N ~
e~ ~U~`~1~~i\
Dat
.
I3uildingrPermit No. ~ 1 ~5 l
Owncar' C - SC~1~'e~C~~~
(please print)
Plur,.ber ~ ~ ~ ~~uc~~(~~ ~ t'l~A~\(~~
(please print)
n'
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
;;a
s.,
'.a
`f ~
°
{plumlaer°s signature')
Sworn to beforo mo this
~:n,
19~~ w ~
~ o b 1/ ~ a
9 Notary Public
Hotaty~Pubi~.cbk~,~.~"~~=~.._Counby •~:~.r
HffIENE D. HORNff
Haery Pubp~, Stets of NpW York
~ualNt~
in
8uHo~k
Couun~ty
Comm)sston Explr~ Mey x,18 g~
INSPECTORS
Victor Lessard $UFFO(,~
Principal Building Inspector OHO COG
Curtis Horton Z~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector y Z Southold Town Hall
Thomas Fisher v- P.O. Box 1179, 53095 Main Road
Building Inspector ~ • ~
p! Southold, New York 11971
Building IFnspector ~O1 ~ Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspectrn
Robert Fisher
Assistant Fire Inspectrn OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
October 10, 1991
Ernest Schneider
915 Lakeside Drive No.
Southold, New York
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)
XX No Underwriters Certificate on file.
XX The check is ( /not nn file.}$25.00
XX 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 # 19857-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
I
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING FINAL
REMARKS:
C r
rl
DATE ~O INSPECTOR
l
765-1802
BUILDING DEPT.
1 NSPECTION
[ OUNDATION 1ST ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ]FINAL
REMARKS: _~~~~~~~G~~
_ ~~~r'~--.~
t
DATE L~INSPECTOR
t
C~~7
765-1802
BUILDING DEPT.
1 N~PECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [L,~N'~LATION
[ ]FRAMING [ ] FIN.,~AL
REMARKS: ~d~~-!~
~a~C~c.JYI
{ L,
DATE ~ ~ INSPECTOR
1
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG.
' [)FOUNDATION 2ND [ ] INSU ION
[ ]FRAMING INAL
`
' REMARKS: G~(°
DATE 1~ C INSPECTOR
U
765-1802
BUILDING DEPT.
INSPECTIAN
[)FOUNDATION 1ST ( ) ROUGH PLBG.
(~~]~FO~tihIDAT10N 2ND [)INSULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE ~ INSPECTOR 1
r'lELD I::SPEC:iU;J ~IUt'iTr, ~ OOMMENT°
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FOUtJDAT20N (1st) ~
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IIJSULATIOf1 PER N. Y. ~ •
STATE ENERGY •
CODE l ~1
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ADDITIONAL COMMENTS: ~ `
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 15T [ OUCH PLBG.
(]FOUNDATION 2ND [)INSULATION
[ ~MING [ ]FINAL
REMARKS: ~ ~
DATE ~ INSPECTOR
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~~'-=r' B 0,1 R D O F HEALTH , , , ,
I I c/
U ~ ~yh~ ~."_i Lfr61 ~ h FORM NO.1 J
SETS OF gL \.7S , ,
y~y ~Ii, TOWN OF SOUTHOLD SURVEY . . . . . .
1111 ~~~r~9~ 11 E +1~ BUILDING DEPARTMENT CIICC(:
~'~k.;{ TOWN HALL SEPTIC roR:f
' - SOUTHOLD, N. Y. 11971
l3t.t5<a, 1:it~:6~~T. k
TOVVN tai=~'::'f3"ilt't. r: ' TEL.: 765-1II02 t;OT I F'f '
CALL • .~~~I: ~b~~....... .
ixamincd 19~/. MAIL T0:
199.. Permit No......... ,
)isapproved a/c _ .
(Bui d155spcctor)
APPLICATION FOR BUILDING PERMIT
Date 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
is 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
- areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
~tion.
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
.all be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
all liave been granted by the Building Inspector,
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
gilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
:gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
ie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
:mit authorized inspectors on premises and in building for necessary inspections-
. ~p F-
(S'dnatu~pplicant, or name, if a corporation)
9~~",~R.tc~s.~~ r.~.o.~~... .
(Mailing address of applicant)
.ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........~.GQ N.~l~'
sme of owner of premises ~ /.~/~t S.T . R N u .:~CJ'II'(.. ~C$( nf~l.A~. R .
(as on the ta~X roll or latest deed)
applicant is a corporation, signature of duly authorized officer. -
(Name and title of corporate officer)
Builder's License No.l y~I,Ygy(, ~ , ,~p~3/.N~'. q-~/oc'.S'D ~hfC
Plumber's License No.~?t'n , , (nL,GUI~~/ NG Y-K~}'T/N G-
Electrician's License No. ~t-.qt-r$. ,1;.L~-C.7/Q (G , , .
Other Trade's License No . .
Location of land on which proposed work will be done . .
.76Y~ ~.c.vr~H.'s. N~ TChFO GGt,c-
House Nwnber Street Hamlet
County Tax Map No.l000Section .....,,.,1~~...... Block .,p,Q[„.,..,.,,, Lot.../y~.~,,,,,,,,,,,
Subdivision Filed Map No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..~,~7'!Q ~CGC L'T, lr( p , ,G,~ (4t E~;n/~{pt~~'~ 1., .Ik.J~t a~ ~y~~+~,
• ~~,1(iwre',ItueseY~''.r~t~:fv'i~y~en~.....
.Intended use and occupancy ,~~r,'~1,1C(;(,L;T/,(,-jZ,C,I„~YR~N~{ouSs Yf+~t '~~i ,ta rd~~`~~l~A ~il~
3, A'ature of work (check which applicable): New Building , , Addition Alteration
Remot<
Repair al . Demolition
Other Work
4. Estimated Cost ,D,DD,.
; , , , , , , . Fce ,
(to be paid on filing this application)
I dwellin number of dwellm u
• g g g, grits Number of dwc!!in units on each floor , , , , , , , ,
If ara a numberofcars ..•.°Z ..................................E
6. If business, commercial or mixed 'occupancy, specify naturo and extent of each type of use . .
7. Dimensions of existmg structures, if any: Front Rear ~ • • ~ • ~ ~ • • •
Height Depth
••••....Numb~rofStories... ,~,~,,,.I.~T.TN~lfEZ~ LLR,Vt~
Dimensions of same sttuctur~ with alterations or additions: Front
Rear
p ^ / .Height Num er of Stories .
8. Dimensions of~te~ntire new c Numb tion: Front , , , , , , , , Rcar ~d , ~
Hei ht G ........Depth .~Q .
/9•~$grofstories.,.o~,,,,,,,,,,,,,
9. Size of lot: Front ~ Rear Depth .
10. Date of Purchase
• }••••••••••......N mcofFonner Owner
1 1. Zone or use district in which premises are situated , , C. ~ • ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' '
12. Does proposed construction violate any zoning law, ordinance or regulation: ,r~
13. Will lot be regraded • Y .
14. Name of Owner of premises~~,ql~,sr'~T,~jgnr,~erZH~`E8e'9tddress ~'yS~i~Vi.?El. t?Nrr~ p(~one No?,~~(: ~~'r3 ,
ame o rchitect i
...........:...............Address...................Phone No,..........
Name of Contractor .
l5. Is thi* property within 30 " " " •••Address ...................Phone N
Y 0 feet of a tidal wetland? ~ ? " " " " " " " "
If es, Southold Town Trustees Permit may be required. No......,,,
PLOT DIAGRAM
Locate clearly and distinctly all bµildings, 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.
i
~~l
~
9~h~~~
III
I'~
~ N
I
fATE OF NEW YORK,
AUNTY OF S.S
g Y p
(Name of individual si nin c ~ • ' ' ' ' ' • • • bein ciul sworn de ores and says that tre is the applicant
E g ontract)
ove named.
Isthc
(Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~ ' ~ ' ' ' ' ' ' ' '
said owner or owners, and is duI auf • • • . • • • • . • . • • • ' . • • . •
>ltcation; that all statements contained~'lin this application are trne to the best olf lus know] dge and belief; and that the
rk will be performed in the manner set i'orth in the application filed therewith.
orn to before ma this
• ....day of .~i/~~ ' U , 19 ~
Lary Public, ../.r.`~,
; ,~-,S!:!;f
:Q,~,f-S-; : County
JOYCE M. WILKIN$ '
~~y Pub114 BNt~ of NewYOdt .
' Na3962~AU.luflaNt
TirmE~aplraJuMlx,1 3 (Signature of applicant)
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