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HomeMy WebLinkAbout18644-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219784 Date MARCH 11, 1991 THIS CERTIFIES that the building ADDITION Location of Property 25 MOOSE TRAIL CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 004 Lot 003 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 6, 1989 pursuant to which Building Permit No. 186442 dated NOV. 15, 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 2 DORMER ADDITIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to BURRIS fr VIVIAN JESTER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 9 Building Inspector Rev. 1/81 sosns 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~ 8 G 4 4 Z oate ..?./~1:~ 19.9. Permission is hereby grouted to: to ...~.....G.;x`f7i't~...~i~.*.fiJ.~..... . . ....~~~B~G7CG~......~Gr..... at premises located at ...........`~...,.r........ .CSr`,~G....~1~~ ~~a-~~ . . County Tax Map No. 1000 Section ......1~.~.... Block Lot No.......~ c~ pursuant to application dated .........../,l~lut 19.~./., and approved by the Building Inspector. ~Og Fee $.5..l..~. ,.E9.n...... B ild g Inspector Rev. 6/30/80 Form No. 6 sfi TOWN OF SOUTHOLD ~ ? ~e.- BUILDING DEPARTMENT 5"""" TOWN HALL ~ ~~~``1 765-1802 ~ ~ dyy~ " t } ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY 70VNfU C 'ii€,t~ O 1. 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-O. 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 17 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. i. 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. 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 i 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 - Residentia1l $15.00, Commerciattl~~ pp$,,15.00 Date .~YL.//.4~/....L.l.L.~ :ew Construction......... Old Or Pre-existing Building.....fl....... .ocation of Property...F~.~,~ .............~.1`}©:.f ? ~~~1 ~:..........~~T~i.~~.,~r.U.~:...... House No. Street _ Hamlet ~nwer or Owners of Property..~U~,/'~,IS.?.Y~(~f/~/t''.... ~G-;-~?~~{~ ounty Tax Map No 1000, Section....l.!":~.....B1ock ................Lot..... ubdivision .Filed Map........... .Lot............. / j op ermit No...'~.~l:L~~/.....Date Of Permit.,l.~~l:~. /X11.Applicant...~~".f..~rv:~...~.: ealth Dept. Approval ..............Underwriters Approval.. . lanning Board Approval..~~~~.~U.~........... / . quest for: Temporary FCertificate........... Final Certicate....J/..... =e Submitted: 5t??~? ~ / I ~c.. (3 3 / ~ ,~ft.M-yam ~ ~j~/~7'~f=:. ,iM. t.,4 ...v . .a ~~.r APPLI .~w`~rrr~~.,.»s:vt"~:i£.a~s '~y`~'~'?, o~UFF Olk~'~• TEL. 7G5-1802 S OG ~ TOtVN Or SOUTIIOLD 4L:~~; 'c1 U1~ (~1CE Or BUILDING INSPECTOR ` ~ { }r ; ° ~ ~ a try; .iaj~."'~ P.O. BO\ 728 # ~C ,LS,L! 1~ [_'~.--_1~~`~~ y ~ ~ ~ ~ TO1VN fIALL ~ ~ ~ ~ ~ ~"'A ! ~ ~y~/~~ ~ ~~~t' SOUTiIOLD, N.Y. 11971 MAR ~ 1 ~y~~ ~a~~ t ~ MARCA 5 , 199 1 ~ ~ ,.~:,i_~. ";:~,r'-; ~..v„S3-~%r'~'' BURRIS ~ VIVIAN JESTER BO% 619 CUTCHOGUE, N.Y. 11935 To S•Jhom This May Concern, we are unable to complete your Certificate of Occupancy because of the following reasons. nn application for Certificate of Occupancy • i.^, not on Life. ENCLOSED / / No Underwriters Certificate on file. The check is(~Y~~~~~/not on file.) $25.00 / / No ticalL-h Dept. 1lpproval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building{ Permit 1f 1 8 6 4 4 Z DORMER ADDITIONS Building Dcpt. No Plumber Solder Certificate on file. ( all crmits involvin lumbin bein F 9 P 4 g issued after npril 1,1989 ) r'lELD ii;s:°ec.lo;i ~~uA.F, q oorrntcNrs ~ t . ~ a 6~ 3 _ _ _ H\~~ FOUNDATION (1st) - "n FOUNDATION (2nd) 2. ~ z o t~ P,OUGH FRAME & "1 PLUMBING 1 r.~ y H 3. ~ m ItdSULATION PER N. Y. • • '3 ~ STATE ENERGY j rD I b~- ~ ~ tip. r-~' ~y CODE x a FIiJAL 0 z ADDITIONAL COMMENTS: x~ ' x G ro H 9 H z 1 Z C+7 A r \ _ H x~ d m -o H y~ 3{~ of ! i lt' b S ~ V!F 'rj I~b N v d w'u .l.r,..o- z.wz.u.~..,,tas.+- us. ~,.5. P ~.w.-...x. .v"k.w.E. J,.. .,r~n+.+.y a.i A4y~}Ls~a'$+-r°+f.~i`Ma^~wJw x'e~ }k4ra~ INk 4i ~'4 t'e ~ r ;a q tt e i tz~" t c L,.,.tyyf ~ .~at„I ~.w;.r~ .N,.k.,,,ai ~r vEea- v a. 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'I-N-. ,I ' } ~ r~ts'~k~a`dx^~`~r G^s~..x3.~~N''r;~ b w! l ~#`~3 ~oF dF#i S r` ~ ~ ~~T IF' a'j `u ~ ~i.~ ~ ~C~ y aj' ~ 3~"+ r d' t 4 r r r d c 9 T '3 r ys k tip ,~k yfi i ur<,'~ Q'~",1 F 1 i t~ " 4 O . ~ ~ ~ fib ~m\ }~;,~ef f Y"~1 f r r p y Y 6q, 1 '3 k° c B Ii 4 0 err t, ~`xrrc z~°~"i~~a a > 1+ {#~t 4a "~A3 ° x ep N i~ J' ~ ' dG .r r to 3d ciz {tear ~(~3•t kMy r „'~rwai .,'2Y. 3w ~$:xa,,. ,,....a ...........-~.y.:..u_.tE..k-,.=..w.-t...-..*r~ r r .u~. t~~ .~,4nr +i~. ~ , i, @'~ i.. j~ 765-1802~~~` BUILDING DEPT. 1S~PE~I [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION~,2ND [ ]INSULATION [(~RAMING~~ ~ ~ [ ] FINAL REMARKS: ~.~~~~r_..~ c9-~ ~ -~-~-~-e-C_ _~-~-a ~ _;~.u.:~-~..> t.~ 1~ DATE ~ ~ INSPECTOR C~i 4 1 765-1802 BUILDING DEPT. fN5PECTfON (]FOUNDATION 1ST [ ~ ROUCH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: DATE ~ INSPECTOR /V~ y L CDX 1dL,~_~~r4.~rZ~,~ F~,4 ~m ~ a~~..~ ~j ~EAd~l,~F ~,~rU l..Uiiva~or,~~ ~ ,etp ~ ~ ~ ~ ~ V ~ i y~+~~-'-•--' y, 1 _ - - - -....~"i -i _ - - - - - ~ ~ > ~ _ j ~ ~ t l r --------------a - - ~ - - j _ _ - ~ " 2 i . _ T .N. . _ _ __W 'h i._. _ - _ ti A ~ ``e'.a~ _ H _ _ . l .aaQ°'p rn~za~ ~ - ~ 1_ 6 _ _ _ ~ ~ _ _ / , ----4--- BOARD OF HEdLTH 3 SETS OF PLr1NS FORM NO.1 SURVEY TOWN OF SOUTHOLD CHECK ~ ~:.aa~~.......... BUILDING DEPARTMENT SEPTiC FORM BLDG. OEPT TOWN HALL TOWN OF SOU-I't;!?I ~y ~ SOUTHOLD, N.Y. 11971 NOT I PY 73y S~ - _ TEL.: 765-1802 CALL Examined 19~ ~~tt MAIL T0: Approved ..,ll~~,~......, i~ Pennit No.~~!.6~I'~ Disapproved a/c ( ildin^ nspector) APPLICATION OR BUILDING PERMIT ( Date ...................19... INSTRUCTIONS a. Tliis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 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. Tlie applicant agrees to comply with all applicable laws, ordinances, building code, housin^ ode, nd regulations, and to admit authorized inspectors on premises and in building for necessary spections. .~fila/.i:z~.. ~ . (Signature of applican , r name, if a corporation) ~~~f~2'~ E')'~~1d~'t'1~ . is~~_._~.z..W.., r ~:C~,~~?k.~~~.4~!~~O.gtd~'..~•.~...~~4'~.,J ' (Mailing ad ess of applicant) vli. State whether`~ap~iilca'f1'tY'is io(vner';`feSsee; agent, architect, engineer, general contractor, electrician, plumber or builder. •,ri aa~ ,r . . .....C~ ~~~r/~. ' Name of owner of prem;saes ' . , l~fL~ ...4 ~ . (as on the tax roll or latest deed) If applicant is a eorptrpa:ti' n(y,~jsignature of duly authorized officer. (Nam~p+an¢~gi 1Btof corp'ofatd+aflficer) ,a 111 ~ ; Builder's EiroensgtNt}i^, :fir . Plumber's License No. !J/.f} . Electrician's License No. ...N.(~ Other Trade's License No . . . . . . . i. Location of land on which proposed work will be done. , . ~.......f.. . Ffouse Number Street. ' ' ' ' ' ' ' " Hamlet County Tax Iviap Na. 1000 Section ~ U.3....... BI'ock ,T, , , , , , , , , . , , Lot Subdivision F.ilcd biap No. Lot............... (Name) State existing use and occupancy of pr/e~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy /4 ~.~i~~~~,~a.L . b. Intended use and occupancy ...~C~~S./. G .:.c ,GLBZyKp:~ .G~aCo~ :-S-f~P.+t~:.......... •~i . { d 3. Natpure of wort. (check whichnpplicable): New Eluilding Addition gAl on Re air R~ 'oval Demolition ~£1~'0........... . ,~r'~ (Description) 4. Estimated Cost ~.c~il-~!!.4!~ Fee . (to be paid on filing this application) 5. If dwellin„ nurnber of dwellin g g ^ ^ ~ units N.1,~, , , , , , Number of dwellin units on each floor . , 1U./.~ , , , , , , , , If ata~e, num bcr of cars . 6. If business, commercial or mis~d occupancy, specify natur and extent of cacti typ of use .../!!(/T... . 7. Dimensions of ex' ling structuFes, if any: Front . . r?U~ . , Rear Depth , Height Number of Stories , ,/.l!/~~~... . Dimensions of sa a structure with alterations or addi ons: Front /.f?.~~. , Rear , Depth ........L IIeight ,/,l/~'x~........... Number of Stories . Dimensions of a ttre now construction: Front . Rear Depth . . Height ..~!~f~ Nu ~ ber of Stories . y. , . 9. Size of lot: F ont , Rcar ~~~if Dep .!`'J~~.. 10. Date of Purchase ..../.U~ . . Name~f Former Owner r~~ . 11. Zone or use district in .v tell p#emises are situated , , ~ , ..j? . . l2. Does proposed construction viol to any zoning law, ordinance or regulation: , . !V ~ is . 13. WiII lot be regraded R/~J9.... e r , till excess fill be removed f pm premises: /v~ Yes Nd 14. Name of Owner of premises r31~ic21,S~1,G.'U3~;!~~i~'~ress ~~a~r. T/'<.~. ~r?C~~•. Phone No. ray: ,'7~;? 1<:r . , Name of Architect , .Address ...................Phone No............... Name of Contractor • ............Address ..Phone No.. 15.Is this property located with in~00 feet of a tidal wetland? *YES....NO.~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al( bulldings, whether existing or proposed, and, indicate ali set-back dimensions from property lines. Give street and 61ock',number or description according to deed, and show street names and indicate whether interior or corner lot. ~ H~" ,~LTE.PI4 T/!9N . cYe~ d I S ~ar`L %/~5?«9L~.F ~~oti ~~~o ,~d~F ~s C d~~ hd~~~,. ~o,~~~-mss , ~Tti~s. f ~ F~©o~ s~,~~~ o~ ~fh~ h©t~s~,. c~,,;GL w~ ~NC,er~~s~ ~fti~ APR D A8 NOTED • - DATE: S.R N NOTIFY S 1 ~ d PA AT 768-1802 8 AM SO 4 PM FOR SHE FOLLOWING INSPEGTIONS: 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH • FRAMING & FN.t1M81N0 3. INSULATIQN A. FINAL - CONSTRUCTNON MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION 6 ~ERGY CODES. Ndt RESPON8IS FOR DESIGN OR CONSTRUCTION ERRORS STATE OF \E\V YOR ' COUNTY OF..,St~.~rf~G~:... S'S I••••••••........... being dulysworn,deposesandsaysthatheistheapplicant (Name of individual signii'ig contract) above named. /Y •--~^n I [Ie is the C~?./.i/:•'T..~~.1.~.4'. ~ Ut/` . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly' authorized to p5rform or have performed the said work and to make and file this application; that all statements contai{tcd in this application are true to the best of his knowledge and belief; and that the work will be performed in die manner het forth in the application Gicd therewith. Sworn to before me this y ...............(o. ....day of.,.. Z~?'Sr:...........,19~ Notary Public, ....1:'•`:`:".`:. ~ .~Ll.e:.f!~....... County HELEN K. DE VOE ' • ~ • ~ ~ • ~ ~ • HOTApyPUBUC,SteteofNewYerk S ^nature of applicant) No. 4707578, S4ffalk County ~ Term Expires Merc 30,19...