HomeMy WebLinkAbout18180-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19156 Date JUNE 19, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 1045 WAGONWHEEL LANE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 108 Block 3 Lot 12.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 30, 1989 pursuant to which
Building Permit No. 18180-Z dated JUNE 7, 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 FENCE ABOVE GROUND SWIMMING POOL & DECK ADDITION TO
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RALPH & SUSAN TUTHILL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-087019 - AUGUST 17, 1989
PLUMBERS CERTIFICATION DATED N/A
CAL ~ _
uilding Inspector
Rev. 1/81
n~osa~ Na 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 O 8 ~ $ ~ Z Dote .......~,etf..:r4rS,,:.... 7 19...1.
Permission is hereby granted to:
~.~.~~.a....r,~...~........
ro ..~:e:~'~.~C.i1:N..c.~'....A,m....~.tr.r!?:~.ur.El...~st:~......~R.f.IK...I~.. Y:~!'1 ~.^~......41z::v.J....
of premises located at ~.~a'~......~.4q,{~,~.N~.a~!„~`~2,,~ „~;C.~~
.......................................................................I.........................................................................................
County Tox Map No. 1000 Section ....~.0~.......... Block Lot No.....~..a~.:~..z".
pursuant to application doted ..w~ 19..9., and approved by the
Building Inspector. '
Fee $.L~"Q.:...~"
r
Bu ng Inspector
Rev. 6/30/80
Form No. 6
t 1;:~
TOWN OF SOUTHOLD ~ ~ ~
. - BUILDING DEPARTMENT fr~~l,
TOWN HALL
76s-lsoz ~ JUN 1 8 ~
~
APPLICATION FOR CERTIFICATE OF OCCUPANCY TUWN
UFSOUTl10Lb
A. 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 17 lead. ;
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect cr eugiaeer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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. I
If a Certificate of Occupancy is denied, the Building Inspector shall state the
' reasons therefor in writing to the applicant.
r
C. 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
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporarcy~Certificate of Occpu~pancy - Residential $15.00, Commer~cjiGal $15.00
-YDJI i ~ ~~Col~-- Date , i', ,I. ! .
New Construction........yy..//.~''Old Orjj,,~P~re-existiuung Building.. _'_n
Liii.a LiilLi of Property...lr?.7; ,tea, W,~~~~L1,~~~... G-K~1.1 ~....~T~1
House Ny~o. ~ St~r-e~-e~~t p p Hamlet
Onwer or Owners of Property, ~\~!~~.,~.°J^SA(J~"""`^"~,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
County Tax Map No 1000, Section. ...Block ........Lot. ~ , , , ,
Subdivision ...Filed Map...... .Lot......Y
Permit No.~g.~o.~.Z.....Date Of Permit.~~.~.~.o..+. .....Applicant~'!w~r1 ~.~o.~oo'.~.`.:',~~!
Health Dept. Approval ..........................Underwriters Approval.~.:~!
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...~......
Fee Submitted: $....~~•.GJd
C a ~1Q15/ APPLICANT
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IIISULATIOI7 PER N. Y, • •
STATE ENERGY
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THE NEW YORK BOARD OF FIRE UNDERWRITERS '
r BUREAU OF ELECTRICITY
yy 8S JOHN STREET, NEW YORK, NE Wq Y~ryO!}RK /10038 y q
Yt7tr(fµ~f~ ,l i, «j ..N p~.}+SV I~~~~i F~~ f~l M<F ~F i~I
Date Application No. on file
THIS CERTIFIES THAT
only the electrical equipment as deacrihed 6e/ow and introduced 6y the applicant named on the ohove application numher in the premises of
'C[YZ'pl7bt,, C?~i',(If~47kTfiL='I, (IA7Vir„ Nd.'9'P'~"a'E'Utai, Y~,V~
11--~~ E~CI'6`
in the following locate (i',.LJ(jBae¢rp~nit ? Ist FI. ? 2nd FL Sertion BIoK;k Lot
NY~i,t. A~ ff It ~JJ .1
was exornined on arzd found to 6e in cmrtplianre with the requireneents q(this Board.
iIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DEGK$ OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER PMi K W. AMi K.W. AMi. KW AMT, K W. AMi. H P.
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DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gELI UNIT NEATER$ MULTI-OUTLET DIMMERS
AMT. K. W. OIL H. P GAS M. P AMi NO A W. G AM1. AMP pMi AMPS TRANS. pMT M P SYSTEMS AMi. WAiiS
NO.OF FEET
L ?f3 1 •~0
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER I NO.OF CC COND. A.W G
EQUIP' ~YW I'e BW 3,e RW 3,e'4W PER% OF CC. COND NO OF HbIEG OF~HI-~LG NO.OF NEUTRALS OF EIITRAI
OTNFR APPARATUS:
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9II f.5lilPC;Y t.OT] irTj.~,~« i'l rr3i7ali i:be" Ukl ix.r3 i)7~,
sa ltV1PC29iTnf?19975 7t Y,~ 7(1VX3~lYl l~ to <
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mails by ~ quiilxfiect }'rccon~ _
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;,tJfl~'[~1~i.Ai illy, 17'1.5 t, ~ GENERAIMANAGER 1
Per ? d I
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by }heir credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
~y~~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING [ FINAL
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REMARKS:
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DATE ~ ll INSPECTOR
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If CO TOrwnt v< rJ~' OCJ7"HUC.D /~/.Y`~~~;-'~~ c,
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Own~ws' f~~..idd`ncer . aYetHflf;-prp~ ~ NOtIFY 111)MIO 'OEPAR?MENT A7.,
F'D.fSOx 306:. o+typ~q~r~~p~~pbA T8618D2 $ AM TO 4 PM FOR,THE
A/IgfFr•Fwa~, N.Y; Jl~ , ~,1q~:+i ~r',` ~ fOLL(7~NINGt INSPECTIONS: ~ ~ `
~ ~ ~Te•l. 29!'f•46~d~~~ ~ . ' 1. FOUNt7ATION ° . TWO REQUIRED ~ ;
FOR POURED CONCRETE
~s ~ _ ~ ~ 2rltOU6N aFRAMIN6 &,PIUMBIN_C,
i ~ ~ 3, ~ INSULATIQN
< ~ ~ ~ 4. FINAL °r CONST~iUCTION MllfiT ,
~ - , - ` E-COMPl.E7EEQ~S L' ~ - _
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Stcri1-~ ~en•h a ln~snt ~ g~ tk CONSTRUGTION HALL MEEj" ,
ATE N~-&."~NEff2'iY ~ r
'TNe niafer apply ahc~ s~wcr~E~ di~~bas-~l ~ ~ , fx+r .4~~r/ C~gg~+~y(gjgy,R
sysl~nt3 fb? f'hi 3 r~•Sidence w1/l coi+~/u~ rrx ~~ti, . pESI(iN OR CONSTRUCTION ERRORS
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TEL. 7G5-1802
O, r;, OG~,, TOWN OF SOUTIIOLD
t ~s ~ UI~i~ICL' Or I3U[LDING iNSPECTOR
T P.O. BO\ 728
~ T01VN HALL
0~1/Ol ~~Q~' SOUTHOLD, N.Y. 1 1971
1~1~1~y ~R, l9 4e
To C^7hom This May Concern, `
We are unable to complete your Certificate
of Occupancy because of the following reasons.
An application for Certificate of Occupancy
i s not o n L i l c. e'H-~'-Pa-.~.~eQ
No Underwriters Certificate on file.
Tlie check is (/not on file.) ~ dS'-oo
No Ifcalth Dept. Approval on L-ile.
Ne final inspection has been made.
Please contact our office on this matter.
Thank you for your coorrperation.
73uild9.nr1 Permit fl ~ 6 ( ~ Z V~
13u.ilding Dcpt.
No Plumber Solder Certificate on file.
( all permits involving plumbing being
.issued after April 1,19II4 )
1
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80.\F.D OF HEALTH ,
3 SETS OF PLANS .1~,
FORM NO. 1 '
SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC r•oart
TOWN HALL
SOUTHOLD,N.Y.11D71 NOTIFY /~(J
TEL.: 7551502 CALL , , , , ,
Examined ~..uMR....~ 19 gg MAIL T0:
Approved A~!!\-4 19 Permit No.J !7.~ ,a ,
Disapproved a/c
~ MAY 3 01969
BLDG. DEPT. ~
' ' TOWN OF SOUTHOLp
(Building Inspector) ~
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
~ a. Tlus 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
yr 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 Pctmit 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 whale 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. t ~~Q ~ ~ ~
Cei:
r\. V `~"':`i :mot' .
(Signature of applicant, or name, if a corporatton)
~.,~.~4?~.~~ . ~M~~~t:~ t.~lS.a~..
' (Mailing address of applicant) V
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
®l~?tJ..~
~j, p
Name of owner of premises . l 1G.7~~`1.~...., ~ . ~ : , l ' ( „
(as on the [ax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. . ,7,OS.~:',lf.~ , , ,MUoGs~J Flo-..
Plumber's License No . .
Electrician's License No .
Outer Trade's License No . .
I, Location of land on which proposed work will be done. , .
~vr
House Number l_c.J M ~ ~ L 'LANE Street. ~ 0 yamlet
County Tax \fap No. 1000 Section Block , , ~ ; , Lot 1Z: , , , , .
Subdivision F.ilcd t<fap No. Lot .
(Name)
State existing use and occupancy of premises and intended tttus~~'e and occupancy of proposed construction:
a. Existing use and occupancy SI~.'~!..~ml~~q ..~W ~~Il.).~,
b. Intended U ~ 1 ~
use and occupancy i~~[~
....~i:'?~:.~~
.~'.c
I
" 3. Nature of work checl, which applicable): New I3uildin
Repair g ' • • • • ~ • • • d ition .Utcration .
- Removal Dcmolitian .Other Nork .
4. Estimated Cost 5~,~, ~ ~ (Description)
Fee
(to be paid on filing this application)
S. If dwcllin~ g units •
If garace• nuntbcr of carsvellm • • • Number of dwelling units on each floor
6. If business, commercial or mix%;d occupancy, specify nature and extent of each type of use , •
7. Dimensions of existing structut'es, it any: Front •Rcar Depth .
Hcigltt Number of Stories . , .
Dimensions of same structure ~ith alterations or additions: Front ~ • • • • • ' ' ' '
Depth , ~ . Ilcight . Rcar .
' 8. Dimensi"atis f e`ntirc new construction: Front • • ' ' ' ' ' ' • • • • Number of Stones .
~ Rear............... Dc
~ Hci,ht Nmpber of Stones pth .
' 9. Size of lot: Front , i.. Rear .........:.............Depth .
10. Date of Purchase
' ' ' ' ' ' ' ' ....Name of Former Owner •
1 1. Zone or use district in which r ~ • • •
P'emisesaresituated........
12. Does proposed construction violate any zoning law, ordinance or regulation: .
13. Nill lot be regraded • . \Vill excess fill be remov d from prcmises• Yes No
14. Name of Owner of premises i -f~~r~ (t~,Q• AddressQ.f~~~k.~~a. 1'{p~', "~,j~; ,C~ , • •
Name of Architect 1 • Phone No. .
.................Address . .Phone No. .
Name of Contractor . .Address . • Phone No.... ~
y P P y ~
IS.Is this ro ert located within 300 feet of a tidal wetland? *YES... NO
*If es Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly ally buildings, whether existing or proposed, and. indicate all setback dimensions from
property Lines. Give street and blocknumber or description according to deed, and show street names and indicate whether
interior or corner lot. i
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STATE OF\EIVYORK, II
COUNTY OF .
SIS
• ~ • • ~ ~ • • • ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ~ ' • ~h • • • • • • • • • • . • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
I
f Ic is the ~ •
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly authoriacd to perform or have performed the said work and to make and file this
=PPlication; that all statements contaiti~cd 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 filed therewith.
'worn to before me this
~~//d .day of..~'..):1;Ltu.;..........,19~,~
lotary Public, lw~;~;=', , •r~•., ,~~L, ~~i-'L,
. •
County
.:t:~v
N4TARYplEIBLIC bYa~M~NewYork ~ • • ~ ~ • ~ ~
No. 47071+"!A, SuNolkCo~untyO~~ (Signature of applicant)
Term Expires Msrch 30, ly_,~t,l
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