HomeMy WebLinkAbout18455-z FORM NO. 4
TOWN OF SOL7THOLD
BUILDING DEPARTMENT
Office of the Auilding Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18593 Date NOVEMBER 27, 1989
THIS CERTIFIES that the building ADDITION
Location of rxepercy 90 STERLING ROAD CUTCHOGUE, N.Y.
House No. ±reet _.=.e.~lat
County Tax Map No. 7000 Section 104 Block 4 Lot 3
Subdivision F?lec ixap No. Lo± No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 25, 1989 pursuant to which
Building Permit No. 18455-Z dated SEPTEMBER 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 GREENHOUSE ADDITION TO EXISTING ONE FAMILY DWELLING .
The certificate is issued to CHARLES C. & BLANCHE WATTS
downers)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
'
ilding Inspector
Rev. 1/81
r+oss: xa 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° ~5~+~~ Z Date ....9./•••`~ 19.~.1~.
Permission is hereby granted to:
. C . K~.w.~i~
~..I... 1~r!~2.~}..~~............
...G.Q....... ~di.......~+~.I~,~fL.C~.....
at premises located at ....:5~.~~..7~.
Caunty Tox Map No. 1000 Section~..........,1,~1.fL.. Block ........1,~..........~Lot Na......:~.
pursuant to application dated ....f~~l...~,-c.T`~ 191J-~..., and approved by the
Building Inspector. ~
~H
Fee $~.....A
~ ~ i
g
B in I for
Rev. 6/30/80
TOWN OP SOUTIIOLD
BUILDING DEPART:IENT ~ ~
TOWN HALL f ~`°~.,,I~°/~,~'
SOUTIIOLD, NEW YORK 1 197 1 "'++Y
mow.
765 - 1802 °"°~,p~E~vgi CS:;;~ i~
APPLICATION FOR CERTIFICATE OF OCCIIPAP7CY pg
' / DATE. J~~yZ~,°, C......
NEW CONSTRUCTION .~C....,OLD OR PRE-EBZSTING BUILDING......VACANT LAND....,...
Location of Property...._...,~~e/.'~/~j~_,~~~__..__...~V~~,rove.
UOUSE NO_ / /STREET UA ET
Ovner or Ovners of Property...(~~s~.~:6GS,,.L_:~ll//~_~_,~
Couaty Taz Map No. 1000 Section ~ Q ~ Block ..j:.... LoC
Subdivision...~~..~~.°. /.~^1:~~... Filed 'Map .,.,....Lot.1./~~.,_, /
Permit No. ,(,~~~~,Date of Permit ~,~~,d_9__..Applicant~~./K~..4:f':~.~c£,,,,,
Bealth DepC. Approval Undcrvriters Approval......._...._.
Planning Board Approval
Request for Temporary Certificate Final Certificate
Pce Submitted: $
/gyp/ ~ G%~!~ GCFI ~
APPLICANT.4-.~.~~.. a'
re°• 10/14/88
~~•.38"~G!
eo ~.~$5~3 .
FORM NO. 6 •
TOWN OF SOUT110LD
BUILDING DEPARTMENT
TOWN BALL
• 765 - 1802
s' .
~PLICATION FOR CERTIFZCATE OF OCCUPANCY INSTRllCTI0N5
A. This application must bel~filed in typewriter OR ink and submitted to the Building
Inspector with the folloKing; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual gatural or Lopographic features. '
2. Final approval of Bealth 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 solder used in system contains less
than 2/10 of 1X lead.',
5_ Commercial buildings,lindustrial buildings, multiple residences and similar.
buildings and installations, a certificate of code compliance from the 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, 1957 non-conforming uses, or buildings
and "pre-existing" land Vises:
I. Accurate survey of property showing all property lines, streets, buildings and
_ unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire Iot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of. buildings or premises, or other
pertinent information, required Co prepare a certificate.
C. For Vacant Land Certificate of Occupancy: _
An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, 1957 shall also accompany
the application. If !a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES: II
1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate o£ O~+cupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over S years - $10.00
4. Vacant Land Cert}ficate of Occupancy - $20.00
S. IIpdated Certi£ic~te of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $25.00 Residential
$50.00 Commercial
i '
Q°• 10/14/S8
~ ~
,1
THE NEW YORK BOARD OF FIRE WNDERWRiTER$ PACE 1
~ 10015R5 BUREAU OP ELECTRICITY
B8 JOHN STREET. NEW YORK. NEW YORK tO03fl
Date NOVEN$ER 13,1991 AppficaNonNo.onfile 74&45591/31. N 212905
THIS C:ERTIRIES THAT
`'3 only the electrka! equipEnent a descrifASd hsloTO end tnetndaced fsy the applicant nalnsdon the afAOw appNeation numker lra the prem4es of
.HARLES NATTS, 3TERLING ROAD, PL.14, Ct1TCHOGUE, N.Y.
in thefollowinq location; ? Basement ? let FI. ? Ynd Fl. GAR/ATTIC/OIIT ,Sertiun Block Lot
was examined on NOVEMBER 07 ,1991 and found to fx in rnmpliance with the reyairemente of this Bosrd.
AXTURE RX UElf COOR1116 tNtllS DIfN W OINAUfT MNf
tNETUETS Alf f11NTC71l4 INCAN[kSCENT nUOI1ESCFNT OTNE11 AMi. t. W. AMT, W. AMT. t. W. AMT. E. W. AMT. H, r.
DRYERS RlRNACE MOTORS IUTUM ANUANCE lREOERf Al REC91 iIIAE f WCRi ~ UNIi INATpf At
i
T
T~ WIAkIIRS
AMT. K. W. Oll H. r. GAS N. r. AMT. NO. A. W. G. AMi. AW. AMT. AMrS. ?RAMS. AMT. N. r. ~ RET AMr. wArra
SlRVK7 DISCONNECT NO.Oi S E R V - 1 C E
AMT. AMI. T1TE 1 / tW 1 / SW 9 / SW J / /w NO. Oi COND. A. W. NO. Oi N4lEG A. W. G. NO.OF NEVIIIAIS A. W.
~ EDUD. re~i or a Ilwto or NEU~iAE
1 zoo ca 1 x 1 a/a 1 fo
oTNa ArrARATUS:
37'ON A1C-1
FRACT.A:[R NANDLER-1
.tea(
FOGARTY ELECTRIC LIC./777.E
BOX 1060, SOUND AVE.
~ NATTiTUCK, NY, 17.952 OENERAt MANAEEN
~ 11 r:
Prr ~
. This csrtificaN must twat kle albrad is a anmsr; raWra. to M».offinaf dr bard if.incorraEt. rt 6e idinKfiad bY..1Mir cndeMias.
a,.
00~'r 'bE .11iK Ct1rC CERTiH~ =1~1 NO!F ~rE KITIRED 17f! ` IAAIIlR.
1 Li/ ~ ~~Jnib ;;UiKME?NT~ ~
'a
1 . I ~~p``
- H '1
FOUtIDATION (1st)
ti
FOUNDATIOt! (2nd) _ _ ~
2.
z
o "1
ROUGH FRAME & V
PLUMBING
•
H
3 , x'
m`
ca ~
IIISULATION PER N. Y. • • '3
STATE ENERGY
CODE x
4 . ~ 7 ~ y
FI;IAL
4
ADDITIOPIAL COMMENTS: ~~e
X\
b
H
71~
H
H
O
~ _
m
}
r\
H
x~
d
m
H
BOARD OF HEALTH
3 SETS OF PLANS
FORM N0.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORI•f
TOWN HALL
SOUTHOLD, N. Y. 11971 NOTIFY
~j- TEL.:7G5-1802 CALL
Examined 19 MAIL T0:
Approved /J........, 1~Pennit No. ~~'y~s-~
Disapproved a/c
+G ~ 6 Lf3`iddm~ nnpectbr)
APPLICAT/ION FOR BUILDING PERMIT
iT T ~~~/~~CT Date Is .
CCPr° 1 INSTRUCTIONS
a. Tltis 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 ar demolition, as herein described. .
Tke 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 inspect' ns.
~~~M . .
(Sign/a9tu~re~oi' applic~ant~or n/ame, if a corporation)
' (Ming address of applica •
State tv}tether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises • DAtE: ~ •pr~~~J~' . .
(as on the tax roll ~EEate e ~
If applicant is a corporation, signature of duly authorized officer. NOTIFY I phi
766-t8O2 8 AM l0 ! PM FOIL tIIE
FOLLOWINCIN ECTIONS:
(Name and title of corporate officer) t. FOUNDATION TWOpEQU1REO
FOR POURED CONCRETE
Builder's License No . 2. ROUGH -FRAMING r] FlUM81Nt3
8. INSULATION
Plurnber's License No . 4. FINt~L - CONSTRUCTfONMUBt
BE COMPLETE FOR C.O.
Electrician's License No . ALL CONSTRUCTION 5HA1.1 MEEt
THE REQUIREMENTS OF tNE N.Y.
Other Trade's License No . STATE CONSTRUCTION 8 ENERGY
Ct7t3ES. N07 RESPONSIt3t~E FOR
1. Location of land on which proposed work will be done . Dr.'S!c?NOR CONSTRUCTION ERRORS
(louse Number SSt/reet, Hamlet
County Tax \tap No. 1000 Section ~ T"• • • • • • • • . Block . ~ . . . . . . . . . Lot .
Subdivision Filed t<lap No. Lot .
(Name)
State existing use and occupancy of
/premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy L':~ S L ~+i n
- b. Intended use and occupancy . •~i~~'~~'`-~^' ~:°~~'Q~'' a
I /
P , , . • Rc applicable): New Building , , , , , Addition Alteration .
3. RNet air of work check which',moval . . Demolition Other SVork , , , , ,
o-o (Description)
4. Estimated Cost . it
Fee....................................
(to be paid on filing this application)
• If dwellm~ number of dwelh
If ara~e, number of cars ng units , , , , , , , , , Number of dwelling units on each floor , , , , , , , , , • , .
s
6. if business,commerctalormi.••••.•.~~..~~~•~~~~•~•~~••~~~~~~~~'""~""""""""•
^ ~ eed occupancy, specify nature and extent of each ty a of use .
7. Dtmenstons of extstmg sttu Ntres, if any: Front , , , , , , , , , , , ,Rear P ~ • • • ~ • ~ ' ' ' ~ '
Hni~ftt Depth .
Dimensions of same sttucture~mber of Stories , , , , , , , , , , , , , , , • , , . •
',with alterations or additions: Front ,Rear , ,
Depth ,height . , , , , , , , , . Number of Stories . ~ ~ ~ •
8. Dimensions of entire new con§truction: Front , Rear 9: Depth . , (,Q
Height ....~~1..v.....
. Number of Stories .
9. Size of lot: Front........ Rear .........:.............Depth......................
10. Date of Purchase
~••••••••••••••....,NameofForrnerOwner
1 1. Zone or use district in which 'remises are situated , , , , , , , ~ • • ~ ~ ~ ~ • ~ ~ ' • ' ' ' ' ' ' ' ' ' ' ' ' ' ° '
12. oes proposed construction violate any zoning law, ordinance or regulation: ~ ~ • •
otberegraded I,,,,,'
14. Name of Owner of remises . ~ • ~ ' ' ' ' ' ' ' • Will excess fi b removed from premises: Ye Nc
P 1.~°..~'. ~4~1s.... Address ~'.tl~C~~. ~.C..... Phone No.~~v: ~9J`L
NprrteofArchitect ,,,,,,,,,,,,,,,,,,,,•.•,,,,Address .PhoneNo..
Name of Contractor . .:.........:........Address .•.••.•.~~~~~•...•.PhoneNo..•~•.~~•~~~~~~
IS.Is this property Loclated within~00 feet of a tidal wetland? *YES....NO.f.`.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly ayl buildings, whether existing or proposed, and, indicate all set-back dimensions fro;r
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
r)
t ~~9
~ I i,,'
5
Y ~ ~ ~ 9 ~
I l
~ ~ti~ .
~
ie
//LO eAC~ I.
c iavSe vrM
~V't3~~4' ~e~btt~llis~! f , ~ ,a
~u~x ea
s~lTt 1RK.1t! tJMr? ~ t'et ':-9 , 5" ,t ~ .
- ~
~Cdb#:"RC3'ro ~j:~.tt 7i t'I' ~ r. - ,3~
r~
F~!r~„_
lS~l~Rdlf 3'1 ~ '
~ s-
STATE OF NE1V YORK, ~
COUNTY'Cp'ICtYA4~f1)`i`.:.'..... S'S ~ +
t' ~ ~ ~ l
• • t}~`a•{~i9 oflrritdtvidual,~tgn!'tg coat ~
about nampdf~~ty-a ~ , ,,~i
He is the , liL3~1 ~af3lRai"': ,
;1t,p eftN'~l PSi.~ : -air, . .
(
of said of
vner
or ow
Hers and is dul ' • u
y a thori
application; that all statements contained in C
work will be performed in the mannerset fort)
Sworn to before me this ~ -
.......,19 ~,t
Notary Public, .....l~~`~"~'Y• .'•`•'•'ti?C~~. ,
County
wYork
NOTARY PUOLIG
She
u/ Ne' • " - 6~!`,r/~.
No. A70787R, SuHolk0o (Signature of applicant)
Term Expires March 30,18