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Home My WebLink About19423-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. CERTIFICATE OF OCCUPANCY No Z~19466 Date OCTOBER 22, 1990 THIS CERTIFIES that the building Location of Property 25675 MAIN ROAD House No. County Tax Map No. 1000 Section 109 Subdivision ALTERATION CUTCHOGUE, NEW YORK Street Hamlet Block 2 Lot 7 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 21~ 1990 pursuant to which Building Permit No. 19423-Z dated SEPTEMBER 26, 1990 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 ALTERATION TO SECOND FLOOR OF EXISTING DWELLING AS BUILT The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED DOROTHY K. VERDERSE H-018702 - OCTOBER 17, i990 ding Inspector Rev. 1/81 FOR,H NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIUvIIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~942] Z ............................ at premises located at ..,~..Z~:.~~....~ ..................................................... co..~ To~ ~o~ ~o. ,0o0 s.~.o. ..... /~,~ .... B,~ ..... ~ .......... Lo, ~o...~ ................ pu~uant to o~lication dot~ ........... ~ .............................. , 19...~and approv~ by ~e Building Inspector. ~B "~ Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 :, . APPLICATION FOR CERTIFICATE OF OCCUPANCY ~'~ : · %- This appiication'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 ~lectricai installation from Board of Fire Underwriters. 4. Sworn state'eat from plumber certifying that the solder used in system contains ~ less than 2/10 of 1% lead. $. 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. For existing buildings (prior to April 9, 19~_7) 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 o£ 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 $2§.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certif'ic~te of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated C'~rtificate o~ Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..0,0, Commercial $15.00 ~ ~' Date : · ::ew Construction .... ~ ...... Old Or Pre-existing Building ................. Location of Property.. <~ 2~-- '/~/~..~.;~ ...... House No. Street Hamlet Onwer or Owners of Proper .. County Tax ~'p No 1000, Section. ~. ~.,~. ...... Block..~.~...' ......... Lot..7 ........ Subdi~ision ....... i ..... 2 ..... Pe~it No./.~.~.%.~..Date ...... ' ........... Filed ~ap ............ ,~ot.: ....... .. [{ealth Dept Approval · ' ......................... Underwriters Approval App ' ' Planning Board royal ........................ ,, Request for: Temporary Certificate ..... ~ ..... Final Certieate ehmi=tedl ..... ' .......... " "" THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY E5 JOHN STREET, NEW YORK, NEW YORK I003B THI~ CERTIFIES THAT only the electrical equipment ~ ~seribed below a~ intr~uc~ by t~ applicant ~med on the able application number in the prem~es of ~RS.LOUI~ T. VEROERESE, 25675 HAIN RO., CUTCHOGUE, N,Y, in thefotlowlng location; ~ B~,ement ~ Ist FI. ~ 2nd ~7. ATT ~ C Section Bilk Lot ~s exatnined on OCTOBER [1,~990 and found to be ln compliance wlth the requiretnents ~f this Board. OUT.TS ECEPTACLES SWITCHES FtU~ESCENT OTHER ~l K W, D~YERS.. FURNACE MOTORS FUTURE A~LIANCE ~EDERS SPEOALREC'PT TIMECLOCKS BE~L ~ SYSTEMS SERVI~ DI~ONNECT NO. OF . S E R V ~ C OTHER APPAR~US: ~NO VISUAL DEFECTS: 'mAn electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition was found. EXHAUST FANS DIMMERS HRS. LOUIS T, VERDERESE P.O. BOX ggo CUTCHOGUE, NY, 11935 SINtI&~MANAGIR This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credenilals, % FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BLDG DEPT OO · ' ' · ~ THOLD, NY 11971 u,.24P TE ' ' ~ - "~ ........ L.: 765-1802 ' pp e a/c ............................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK NOTIFY~ CALL Date. · .......... / a. Tiffs application must be completely filled in by typewriter or in 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 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 tkis 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 shall 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 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 ~:emoval or demolition, as herein described. TLie applicant agrees to comply with all applicabq'e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ~spections. - - (S,gnature oI appl'?~?'~"~arporanon) ........... ..... (Maifing address oaf applicant)~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................. (as on the tax roll or latest deed) If applicant is a co'rpOration, signature of duly authorized officer. (Name and titl~ Of corporate officer) . Plumber's License No..~,.. ?:. / 6`/( [~( ./'L .... IcctncmnsLcenseNo.. - ..~ ;4~L__ Other Trade's License No ...................... 1. Location of land on which proposed work will be done; ". Ouse Number Street, Hamlet County Tax Map No I000 Section /.O ~. ' Block '~' ~'~ ................ Lot Subdivision ..................................... Eilcd Map No. Lot (Name) ............................. 2. State existing ,se and occupancy of premises and intended use and oCCUpancy of proposed construction: occupancy Df~J/L/~ ~ C C- ~'~'~' J A. Existing use and ........... .~. ........ ~. .... B. Intended use and occupancy...~..~. 7~..~..~...~).c{,~ ~j~/. .-~. .............................. 3. Nature of work (check which appl cable): New Building .......... Addition ....... Alteration Repmr .............. Rpmov~l .............. Demohtlon ........... $~im ....... ' ..... Tennis Court ...~.~... A~eessory Building .......... Fence ....... Ot..~..~,~t.~;,n~n- ........ 4. stim te i ....................... Fee ..... ito ........................ 5'' ' -- ~ be paid on filing this applicat!on) i $. If dwelling, numberofdweilingudits..............' Numberofdwel[ingunitsoneachfloor..............o.. If garage, number of ears ...... i .................................................................. 6. If business, commercial or mixed OccupanCy, specify nature and extent of each type of use ...................... 7 Dimensions of existing structures iif any: Front Rear Depth . Height Number of Stories · Dimensions of same structure witti alterations or additions: Front ................. Rear ........... Depth ' Ileight Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...... ., Haleht Number of Stories ' 9 Size of lot: Front ' Rear Depth I0 Date of Purchase ~ Name of Fon~ner Owner 11. Zone or use district in wliich premises are situated ....................................................... 12. Does proposed construction viola!e any zoning law, ordinance or regulation: ................................. 13. Will lot be regraded .......... i .................. Will excess fill be removed from premises: . Yes .... No.. 14. Name of Owner of premises .... ~ ............ ~ ....Address ................... Phone No ................. Name of Architect .......... 2 ................ Address ................... Phone No ................. Name of Contractor i ' .. Address ................... Phone No .......... ,..~ .... 15.Is this proper located within OO feet of a txdal wetland.'/ *YES .... NO .... ~If yes, Southold Town!Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ]lumber or description according to deed, and sho~v street names and indicate whether interior or corner UNO£RWRITERS CF-,RTIRCAIE RF. QUlRrd) OCCU?ANCY USE iS UNLAWFUL WITHOUT CE '- ,i F CA'tE CUPgN ,y STATE OF NEW YORK, ~ , S.S COUNTY OF ................. I AP~PROV, EO AS NOTED N~YI[9 BUfLD'ING D[:'F)ARTI¥/I[r'NT'AT 7~-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1, FOUNDATION TWO REQUIREO FOR POURED CONCRETE 2, ROUGH - FRAMING 8~ PLUMBING 3. INSUI.~TION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FoR DESIGN OR CONSTRUCTION ERRORS ............................ ! ..................... being duly sworn, deposes and says that he is the applicant (Name of mdw]dual slglnnlg contract) above named. He is tile i ' J (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dilly authorized to pe,rform or have performed tile said work and to make and file this application: that all statements corttained in this application are true to the best of his knowledge and belief; and that the work will be performed in the meatier set forth in the application Qlcd therewith. Sworn to before me this i ' ............... .,~/....,,..day 9f.- ~ .......... 19.'7.. ,o,a ub,,c ........ .O*ARYPUBLIC. .............. ' 0 S~ff0k~0 my 80. 470787 Tmml Expires ~roh a0. tg_ .-~/ (Signature of applicon t-- ~o_u~aot~ ' C "<oq F ~ rtl .< m f