HomeMy WebLinkAbout18681-zFORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19437 Date OCTOBER 11, 1990
THIS CERTIFIES that the building ADDITION
Location of Property_ 320 BROADWATERS ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 10 Lot 6
Subdiv
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 1, 1989 pursuant to which
Building Permit No. 18681-Z
dated DECEMBER 5, 1989
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 SOLAR SUNSPACE ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to BARBARA KUNEN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-147458 - SEPTEMBER 6, 1990
PLUMBERS
DATED
7 i
ui ing Inspector
Rev. 1/81
uosas xo. s
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+, 18681 Z Date i~,J~..,......,..e ................ . ~~ ~'~'
...... ... „ ...o...
Permission is hereby grantyed~to: /~
...~.a.r~....~.~ .... .......~~
p y.3~
ro ..~.~.1,1, ~~.4,..GLr....~~/..Ar.~.....r.~zs!~7~~~....4?~. '... `~. ~??G
ct premises located at ....~'..~t~i:l..,G,:l...~1~~~......~~-r .....................................................
....................
Caunty Tox .........................................
Map No. 1000 Section .. .............,,.LL.....
.....~~T....., ..................................................
. Block ........,~.~...... Lot No. ............................
.....~ ...............
pursuant to application dated ......... .l..r~~~ ...... .......................... 19.~J~.., and approved by the
Building Inspector.
Fee $.~Q ~/`.•
~~~'• ~~9~~ ..... .. ...... .~.'t..~~...................
/ Buil ng r~,vpector
Rev. 6/30/80
' .. Form No. 6 ,,.~.,,~~„_:,`,_ Ii Al°~~~.~'....,_..;.9
~' '' TOWN OF SOUTHOLD ~ ~~~~~~ ~~~~~~~~~~
BUILDING DEPARTMENT ~'~ ~ Q ~ 5 ! I~~
TOWN HALL ~ ~ `~"' d
765-1802 ~, ~ ;
~EfL~C~. G3EP'f S
I01fUW,£)F S(Jl1TMC?Li?{~._.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
.~. 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 2J10 of 19, lead. '
S. 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 o£ Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
;e Fees
!. 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 huilding 525.00. 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. Cpuated Certificate of Occupancy - $50.00 ,
S. Temporary Certificate of Occupancy - Residential $15p.00, Commercial $15.00
,,/ Date .. ?~(~Z ~ ~t.~ ..............................
::mow Construction...Y....... Old Or Pre-existing Building.........
.....
,, n,..~--}},,,,,, ~~~~
:.~catlon of Property....~~..~?...~.~::°~!'.S. ~~........... .~ .................
House No. p- J Street 'Hamlot
'lower or Owners of Property..~Q;CY)C22Y,~...~CUNf;~1......11 ......................................
County Tax Map No 1000, Section.... ~~......Block...! v ....r/-~......Lot.. ~ .................
Subdivision. ti,~~ e01ylY .................Filed Ma ~~54.....Lot ............."
tt nn ......... p.... .........
Permit No.,J~,4.~ ~~,~...Date Of Permit ................Applicant..~~~?'r: ....................
~•
icalth Dept. Approval .. ......................Underwriters Approval.........................
;~ ••
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate..~.....
~ ~
?ee Submitted: ~..... ~? J:d . ........... ~~ ~'4'` ~ .
... t
~ ~ I ~ -1 3 ~ APPLICANT ~ .
THE NEW YORK BOARD OF FIRE UNDERWRITERS t'~rs~:
f l10 4 (1 ~ ~ BUREAU OF ELECTRIGITY
85 JOHN STREET, NEW YORK, NEW YORK 90036
5~1''P.1;lRT+N;It (7P: ~ 1 ~JiYt7 4i8~~G79Ct/+3U+ kl '! 47?l~,h
paw Application No, on file
THIS CERTIFIES THAT
only the electrical equipment as deacri6ed 6e/aw and introduced by the applicant Homed on the a(tove application number in the premises of
n. leslsarnr, ~~ll Fsa~in'I~w~~rfa~s hl,, l:~rl~l:.t~rtcafl;,, ~.~.
in the following locati q• z„ 4~ ase t ~ 1st Fl. ^ 2nd Fl. Section 8toek Lot
~t`ft
9J
.1 1 ~
! ~~
,
,
,
was examined mt and found to be in compliartre with the requirements q(this Roord•
FIXTURES RANGES COONING DECKS OVENS DISHWASHERS EXHAUST FANS
FI%7URE
ECEPTAClES SWITCHES
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT K W AMT K. W AMT K W. AMi K W AML. H P.
f l ~ f
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET
DIMMERS
SYSTEMS
AMT K. W. 011 N. P GAS H P. AMT NO. A. W G AMi AMP. AMi AMPS TRANS. AMi H. P NO. OF FEET
AMi WAiiS
SERVICE DISCONNECT NO.OF 5 E R V 1 C E
AMi AMP TYPE METER
EQUIP. 1 ~, YW 1 ~ 3W 3,9' 3W 3)~' 4W NO OF CC COND
PER % A W G.
Of CC [OND NO OF HIAEG A. W' G
OF H4LEG NO OF NEUTRALS A. W G
Of NEUTRAL
OTHE0. APPAgAT1f5:
Cd.F.t1.;1:_1
~2~ "~~
!31)K 2~ 5
SUU'CldOSdJ, fdX~ 11.9'71 GENERAL MANAGER
21
Per ~, U
This certificate must not be altered in any manner; return to the office of the Board if incorrect. laspectors may be identified by their credentials.
i
COPY FO BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TEL. 7GS-1802
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TOXIN . OIL' SOUTIIOLD
O~riCE Oi: BU1LDiNG iNSPEGTOR
P.O. IIOX 728
TO`VN HALL
SOUTI10Lp, N.Y. 11971
August 20, 1990
Barbara Kunen
320 BROADWATERS RD.
CUTCHOGUE, N.Y. 11935
To PJhom This.May Concern,
t
We are unable to complete your Certificate
of~Occupancy because of the following reasons.
/;f/ An application for Certificate of Occupancy
~15 not on file. ~ CENCLOSED)
/^,/I /No Underwriters Certificate on file.
/ i The check is( ,not on file.) $25.00
f / No ltcalth Dcpt. T.pproval on file.
% / No final in~pc:ction has been made.
` Plea~o contact our office on this matter.
Thank you for your cooperation'.
l3uil.di.ng Permit 1I 1 8 6 8 1! Z
C3uildinq Rcpt,
***/ I No Plumt~er Solder CerL•i.ficate on file.
( all pcrmita involving plumbing being
iasucd after npril 1,1904 )
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765.1802
BUILDING DEPT.
INSPECT~tJt~ll
[ ]FOUNDATION i5T
[ ]FOUNDATION 2ND
[ ]FRAMING
( ] ROUGH PLBG.
[ ] INSULATION
[; FINAL
DATE ~ INSPECTOR
~~~(
765-1802
BUILDING DEPT.
INSPECTION
[ )FOUNDATION 1ST ( ] ROUGH PLBG.
[)FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING ( FINAL
REMARKS: /V ~ ~"G£f~
DATE ~/~~/ 7 0 1
TEL. 7G5-1802
o~p~~~Efl(1{~OG~ TOZVN.OI' SOUTIIOLD
~? ~~ (;~,~~~~ .'c OPPiCE Of BUILDING INSPECTOR
o ~"~~ ° ~ ~~ z P.O. I30X 728
~ '~ ~~ ~'`~i'~Y rn T01VN HALL
~' ~ ISCr~ ~
t- SOUT1iOL1), N.Y. 11971
/~41 ~ ~a° August Z0, 1990
Barbara Runen
320 BROADWATERS RD.
COTCHOGUE, N.Y. ]1935
To 4lhom This.May Concern,
We are unable to complete your Certificate
ot~Occupancy because of the following reasons:
J_,// An application for Certificate of Occupancy ~~
is not on file. ~ (ENCLOSED)
/_//I~lo Underwriters Certificate on file. ~~C~eQ~
/_~/ The check is ( .not on file.) $25.00 ~~ ~~
/_/ No itcalth Dept. Approval on file.
/_/ No final ins.pc:ction has been made.
Please contact our office on this matter.
Thank you for your cooperation'.
13uildi.ng Permit ~( 1 8 6 8 1 Z
Uuildinc7 Dept. '
***l_/ No Plumber Sulcler Certificates on file. '
( all permits involving plumbing being
.issued after April 1,19F34 )
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FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 7G5-1802
Examined . /.e'1.~,,1.`/~......., 19 .~j. p
Approved .. l: ~!.~......., 19 Permit No..`~~A ~~
Disapproved a/c .....................................
APPLICATION
BOARD OF HEgLTH ............
3 SETS OF PLANS ../.........
SURVEY .......... Y..........
CHECK ......................
SEPTIC FORM ................
NOTIFY ;
CALL ..~~~
MAIL T0:
Inspector)
BUILDING PERMIT
INSTRUCTIONS
,~?6d........
Date . ~.°~. ~.~..........., 15.~-1
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building I Spector, with ~,
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 s~ppli-
cation.
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
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 removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
.. .Q~,:6~ ~ ..
(Signature of"applicant, or name, if a cdorporation)
...3a"~..'~ .~a~'e~rs.:2a .............
/1__ t (jvfailing a~res~f a pli ~'t
State whether applicant is owner lessee, agent, azchitect, engineer, general con actor, electrician, plumber or builder.
vw~cl~-
Name of owner of premises . ~.~:{~:'~ ~~.~ ..... ~U /J ~/~ ....................................... .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.............................................
(Name and title of corporate ~~o--f77fi~~c//er)
Builder's License No. ...~~~~~.<tx:,........
Plumber's License No . ....................... .
Electrician's License No. .... ...... . .......... .
Outer Trade's License No . .................... .
1. Location of land on which proposed work will be done;
Flouse Number Street ~ ~ ~ ~ ~ • "'
~j Hamlet
County Tax Map^N/a. 1000 Se~cytionp.. ~~ /R ~~N DE.P • . Blbuk ..~~, , , , , , , , ,, , , , Lot .t~l .......... , ,
Subdivision ... /Y./.~~.~.~.F...h ~ .....M, t4 P. !`~ .... Filed Atap No. ~~l~J......... Lot ..~~ 3....... .
(None)
'-. State existing use and occupancy ofJp~remises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..,.G.J.~~f~ .......................Gv~iSl............................. .
b. Intended use and occupancy .. ~'/~lCL, ~?;S',~'• ~~~` ~~.~,~; ~~~~ ~~/,~r,(~,~/~,r~, , , , , , ,
i
3. Nature of work (check which applicable): New Building .......... Addition . .......'. Alteration .......... ,
Repair , ; ..... R~movaj ...... , . Demolition ............. .Swimming pool .... ; ....... .
Tennis Court ....... Accessory Building..........Eehce .......~•{Wa~,..,,,,,:,
4. Estimated Cost~~Q~ .... ...................... Fee ..................................... •
(to be paid on filing this application)
5. If dtvclling, number of dwelling units ..:-...~, : ; ...... Number of dwelling units on each Cloor ................
If garage,numbcrofcars ..... ...............................................................
...
6. If business, commercial or mixed occupancy, specify pt and extent of each type of use ........ ,r ........ , , ,
7, Dimensions of existing structures, ~f any: Front .. , ~s~ .~s~; .... Rear ..:............. Depth . tom, .......... . .
Height .•~ ............. Numbo;r of Stories .:............... _ ............................ . .
Dimensions f same structure with alteration~,or additions: Front ../.J`. ~~........ Rear ................. . .
Depth .. , ~ ............... J~ Height . ~, , .................Number of Stories . ............ .. .
8. Dimensions of entire new constnrction: Front ............... Rear ...............Depth ............. ,,., .
Hci;ht .......... . .... [lumber of Stories ...... , ................................................ , .
9. Size of tot: Front ............~......... Rear ...................... Depth ...................... .
1D. Date of Purchase ............ .......... ... . .Name of Former Owner ........ , ... , ............... . ,
1 !. Zone or use district in which prenises are situated .................................................. ;
t2. Does proposed construction violate any zoning law, ordinance or regulation: ..I~.t~ ..................... ~. : ~.
13. 1Vi11 lot be regraded ............................Will excess fill be removed from premises: ,Yes .. ,' No .r
1~. Name of Owner of premises .. , ..............Address ...................Phone No............... ,
Name of Architect ~~11 ``~~ ~~~.~ ,~. ...... , .Address ..... ...... ..Phone No... ...,.
Name of Contractor ./.7!yJ~!L7:':`:', ~~1Gl.kr.. .Address ~ C?:l GG!'~4a~~SI:. Phone No. ;T. ~y~ yc~./:... .
IS.Is this property locat,!ed within 100 feet o£ a tidal wetland? *YhS....NO„1(..
*I£ yes, Southold Town~',Trustees Permit may be x"e~uired.
PLOT DIAGRAM
Locate cleazly and distinctly all puddings, 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.
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STATE OF NEN YORK, ' S.S
COUNTY OF ................
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C~I.t,,gp~i:Ows'1~IpN ..,.
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.......... ..... .. . j .................. . . being duly sworn, deposes and says that he is the applicant
• (Name of individual sigging contract) .,
about named. ,
He istlte .................... .... ............. .:........ ...... .. ...:.....................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Gle this
application; that all statements conjained in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application Glcd therewith.
Swom to before me this ~
..............l... , .....day o;lf .....yN:?f..........., 19~~. 2.
Notary Public, ........~-s~J.~~/f-l~,-.~~.. County
pEIEN K. OE VOE ..... ............... ^ ............ .
lt9TARY PUBLIC, Stale of New YorN (Si,naturc of applicant)
Nu. 4 07878, Suffolk Counry~
Term Expires March 3(1,19.,1.,1 '