HomeMy WebLinkAbout17848-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18951 Date APRIL 3, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 1295 HYATT ROAD SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 050 Block O1 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 31, 1989 pursuant to which
Building Permit No. 17848-Z dated FEBRUARY 16, 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 ADDITIONS TQ EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to RONALD Q. LOWELL
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-111155 - JANUARY 19, 1990
PLUMBERS CERTIFICATION DATED MAR. 16, 1990-MATTITUCK PLUMBING & HEATING
~'~L
uilding Inspector
Rev. 1/81
goaai xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
i'
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL '
COMPLETION OF THE WORK AUTHORIZED)
Nfl17848 Z Dote .~..~.~..'.L.:`5 19.~'i~
Permission is hereby granted to:
.~.:...1.%.9..~s.`..~.......
4t~..... ...............................................................v................J.............................1..
ct premises located at . ~.~9 ~...t~,9,?:1.....~ ..................SSA.-:~t.X.t/i.R~.~..............................
Caunty Tox Map No. 1000 Section ......Q.4.~....... Block ........5'l.I........ Lot No.....~r.~
pursuant to application doted ....~I.in!:!:4......r~~ 19.~.~., and approved by the
building, Inspector.
Fee $...l.~a:../....
Building Inspector
Rev. 6/30/80
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FORM NO. 6 ~ ~'~-.1 t ~ ~ t I
TOWN OF SOUTHOLD ' ~,~i;
Building Department ;i ' ~aR ~ ~ i9~o
Town Hall + ,~3:
Southold, N.Y. 11971 al ~
765 - 1802 th c.i~ 4, ;
APPLICATION FOR CERTIFICATE OF OCCUPAI~IIx~(~,{'Vi~`I~,?,aiu;,t,`iy7?t,t{'h
Instructions
A. This application must be filled in typewriter OR ink, and submitted a s~~ to the Building In~ec-
torwith the following; for new buildings 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 of Healih Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $2.5.00
1. Certificate of occupancy New Dwelling, $25.0.0, Accessory-$ 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling - $ 50.00
3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10.00 (
4.Vacant Land C.0. $ 20.00 3.I.p 1 Q O
S.Updated C.0. $ 50.00 Date l .:1
NewConstruction_„_..OldorPre-existin Buildin ~ acantLand
~ 9 .....g
Location of Property ......~y~.`.Y.~1.,!~':~ .!~y~,Tl:{:+ie.;~.........
Nouse No. Street Hamlet
IG a u. Zf ~ O W t~
Owner or Owners of Property
County Tax Map No. 1000 Section ......r~..~.... Block , , Lot Z~ .
Subdivision .................................Filed Map No. ..........Lot No. . .
c c L ..~CI~
Permit No.~~ Ry:'9.L Date of Permit~l~~ ~9..Applicant ~~!H!'~~"~'"~ 4~~'~
Health Dept. Approval !"'t.~...........Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval ...!'~.A...............
Request for Temporary Certificate .....................Final Certificate ? .
Fee Submitted $
Z ~
Construction on above described building and permit meets all applicable codes and reguljjations.
Applicant.....~~,M.ti!'O~v~b01i'lfrt Ivt„.
Rev. 10-10-78 A,I
~ (~95~
TEL. 765-1802
~pc~VffRw~Op TOWN OF SOUTHOLD
yc OFFICE OF BUILDING INSPECTOR
o z P.O. BOX 728 , i~~~i''
TOWN HALL ~:.'s ; -
O ~ ~ SOUTHOLD, N.Y. 11971
1 ~
~0 ~ MAR 7 d 1990
€ 4
~ ;.e:~.
C E R T I F I C A T I O N
Date ~ (y R
Building Permit No. 1 ~ ~ ~ i 2
Owner ~ ~ A-t_. 7 -1-~ w z---
(please print)
P 1 umber ' c.'l};'~'v c~ PI u v,nb i c, d~~ew'~'; C~z r p ,
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
____~`a~ W.cQ
lumber's sign ture)~
Sworn to before me this
.5'ikrEC,~rH day of /L/s2.PC/~
19 /r~' i
Notary P is
Notary Public, ~SaFFa/-.~ County
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PLUMBING ~
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IIJSULATION PER N. Y.
STATE ENERGY
CODE
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VICTOR LESSARD O{f, ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR ~ m P.O. Box 1179
(sls) 76s-leo2 y0~~'° ~ ~ Southold, New York 11971
FAX (516) 765-1823 ~°S~
`n1,.~4~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 1, 1989
Thomas Samuels, Architect
25235 Main Road
Cutchogue, New York 11935
Re: LOWELL PREMISES
1295 Hyatt Road
Southold, New York
Suff. Co. Tax Map If1000-50-1-21
Dear Mr. Samuels:
We return herewith plans received from you in reference
to the above property.
Building Permit No.17848-Z was issued on these premises
on February 16, 1989, and we already have the plans on file.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Victor Lessard,
Principal Building Inspector
VL:gar
encl.
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
Date . ,December 13, , , , , „ 19.88. .
TO THOMAS C. SAMUELS (ARCHITECT) RONALD 0. LOWELL
25235 MAIN ROAD
CUTCHOGUE, NEW YORK 11935
PLEASE TAKE NOTICE that your application dated December 7, , , , „ 19 . 86 .
for permit to Construct additions to one family dwelling ,,,,.at
Location of Property . , ,]295 Hyatt Road Southold, New York
House No. Sheet Hamlet
County Tax Map No. 1000 Section 50 Block .....l......... Lot I........ .
Subdivision Filed Map No. Lot No. .
is returned herewith and disapproved on the following grounds . Under Boning Chapter 100,
Article XI Section 100-119.2 A C1) proposed construction will be closer
than 100 feet from top of Sound bluff, action required by Zoning Board of
Appeals.
-ya.. .
ildi I~ spec or
RV 1/80
i~
S T E E L M A N FED _ 7 Ir~By f
February 7, 1989 ~
~s`.~~;. ~;t.' i.
ADDENDUM TO BUILDING PERMIT APPLICATION
TOWN OF SOUTHOLD
Re: Lowell Residence
1295 Hyatt Road
Southold, NY 11971
Project has been bid to four local builders.
Contract will be awarded to one of the following:
1) Harrington & West, Inc.
Southold
2) Robbins & Speed, Inc.
Greenport
3) Dick Romeo, Contractor
Cutchogue
4) William Conway, Contractor
Southold
We shall supply the town with the name and license
number of successful bidder and his electrician and
plumber.
Sincerely,
SAMUELS & STEELMAN ARCHITECTS
~,MnrJ4 n,~,,~,.t,2.d
Thomas C. Samuels
encl.: Certified Survey
TCS:lf
ARCHITECTS
25235 MAIN ROAD
CUTCHOG UE, NEW YORK 11935
(516) 734-6405
SAMUELS=STEELMAN ARCHITECTS ~~~f'~[~~ Up ~ ~f ~D e~T ~~'~]Q`~~e L.
25235 Main Road
CUTCHOGUE. NEW YORK 11935
(516) 734.6405 DATE i ~ ~ JOn NO
A~(//.~ ~p ATTENTI N P~
Cebu e ~ ~a 1~~ _Adtiuvin' r~ ~b-rra, o t^
! WE ARE SENDING YOU }y Attached ? Under separate cover via the following items:
? Shop drawings ? Prints ? Plans ? Samples ? Specifications
i
? Copy of letter ? Change order ?
COPIES DATE NO. DESCRIPTION
i
't
THESE ARE TRANSMITTED as checked below:
? For approval ? Approved as submitted ? Resubmit copies for approval
` ? For your use ? Approved as noted ? Submitcopies for distribution
i- ? As requested ? Returned for corrections ? Return corrected prints
? For review and comment ?
? FOR BIDS DUE 19 ? PRINTS RETURNED AFTER LOAN 70 US
`REMARKS
\ V Vi
t ~nl~nn,lA R~bh ~~[Q, `
I
i
COPY TO_ I~~W PN~ '
SIGNE~~~~~jQfJ
vrtooucit141 ~ im, c,aN. Wa, utail ll enclosures are not as noted, kindly not(ty us at once.
r-T-/
~~y~ ~ 765-1802
G BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN TION
[ ]FRAMING ( FINAL
REMARKS:
DATE o INSPECTOR
T65-1802
BUILDING DEPT.
~NSPECT~oN
[Y ] FO NDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND INSULATION
[ ]FRAMING [ ]FINAL
REM KS: ~~~,c
DATE ~ V ? INSPECTOR L
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ !ROUGH PLBG.
[ ] FOUND ON 2ND [ ]INSULATION
[ MIND [ ]FINAL
REMARKS: .6f~
DATE ~ INSPECTO r
17
THE NEW YORK BOARD OF FIRE UNDERWRITERS "A~
1007093
EUREAU OF ELECTRICITY
t8 JONN §TREET, NEW YORK, NEW YORK 10031
JANl1ARY 19,151U0' b2'1F17789/99 N 11.1.75'
! ft~1d' . - - ' .tpplication No. on jtle -
TNIS CERTIFIER THAT - ~
only tM alaetniad puip,nant tat deaart6ed 6alo[e and tntrndueed bY. NM a'plicant narrted on the okow appBoatton nu,nker in tkepronttsa of
RONALD LONRLi,, 1295 NYA9'T R7)., NOLM. 15 ^aQUTNOLD, N.Y.
in tkejolbtetnR locations rn ~gtawant ()UT
JAN~fAI
Y 08, 7 ~'4U ~ 1"t Fl. ? End fl. .Se,•t:on B(aek Lot
Ten stomined on and found to be in compliance with the reyuirementt of thu Board. -
RIITIttl COOKING t1ECK5 OVENS W EXNAUS .
CIMETE A~ E~~ atKEM HUntItUM OTNEfl M1T. W. AMT. R. W. AMT. [.W. AMT. N. W. AMT, n. 0i
21 19 19 ?:I i p
ORYrf fVRS1AC[ AgTOK N1UY ANNANCE RERMf EMOAI RRC'?i iUM C10CKS ENL IIItIT11RAfERS AA111A011fllt DISAIAlRS
AMT. R. W, ql K I. OAS X. I. AMT. NO. A W. a. AMi. AAN. NAT. AMTS. TRANS. AMT. M. A. ~E f NAt. WATTS
9 F 6110
SMMt</ ORCONP~CT. S E R V I C E
AMT. AMI. TTN t / tW t 1 TV 7 / tW 7R AW NO.O~tCC. COND. d: C
C ~ NO. q Mbltc a• ND. q N[NYLS q 'NWEIITCIIAI
7 X 7 2/U 1 /n
OTtM ARMIRATUk
MIRING FOR BED.RN,DINING RM.I3UILR 1
RBPLACS SXTEAIOR SRRYICK EQUIPNSNT-:l
KLKC. ROOM NEATIPAS:7-7 K.N.
G.ir.C.l:-2
SMOKfi i)RTI~CTOR: - 7.
.r~o~
C,ARY DOROSKf LIC./2991.-5
920 NONSELL LN.
CUTCMOGtIIti, NY, 11935 oERwa11,MIWAOM
1 f
, ~
Per _
That etxiifkpta aapf not ba alNaad in am, Inannar; rNUrn fo 1111 ofiia of 1Fn Ibard if incorrM. Intpsctors May ba idiatill4tl bY~ fhair cndsntiak.
FOR BUILDING DEPARTMENT. TNIS COPY OF N:A AElST lE ALTERED IN ANY ANNHER. i
~:.-r~,:
~ o
THE NEW YORK BOARD OF FIRE UNDERWRITERS WAGE 1
1001071
EIUREAU OF ELECTREICy~I(TyY~gK -
l1UNE 1),1990 83 JOHN STREET, NEW YORK, NbYUYbY9U 7838 N 135281
Dote Applieoeien No. on file YP U/
THIS CERTIFIES THAT ~
only the sfectrbd equipment w dsacribed 6ebw end introduced 6y the applicant nerved on the ohooe appBeetion number to the premises of
RON LOAELL, HYATT ROAD, SOUTNOLD, N.Y.
GAR
in thefdbuinq loca~T; 2~~ment ? let F(. ? 2nd Fl. Section Block Lot
rasa examined on and found to !x in complionre with the reyuirementx of this Buord.
RXTYRE RXTURlS RANOlf COOKING DLCKS OVlNS DISH WASNERS EXKAUST FANS
DIIT~S ACLES SWITCHES INGNDESCEM FlUOMSCENT OTNEn NAT. K. W. NAT. K. W. AMT. K.W. NAT. K. W. AMi. N. 1.
1 3 1 1
DRYERS p1RNACE MOTORS p/TUR! ApR1ANC! ppDRRS f?lOALMC~T 71ME CLOCKS pLL UNIT HEATHS MIILT4011rilT DDAMlRS
AMT. K, W. dl N. P. GAS N. P. AMT. NO. A. W. O. AMT. AMP. AMT. AAVS. TRANS.. AMT. N. P. ~
~
~T AMT. WATR
SHVIQ OISGONNKT NO.Oe S E R V- 1 C E
METKK NO.OF tt CONa. A. W. A. W.O. A. W. G
AMT. AMI. TYPE ROlgr. 1 / ]V/ 1 / ]W ] p 3W ] / AW ~ tt. COND. NO. d IR.IEG OP NO. p NEUfRAlS d NEUTMI
orNER ArrARArus:
WIRING ON GARAGE ONLY-1
G.F.C.I:-1
G & S CONTRACTOR LIC.S578-L
BOX 215
.SOUTIIOLD, NY, 17.971
OMRA/ MANAOlR
11 ,J
Per
This canificete mutt not bs eNarod in any rlanner; return to tM offiu of fhe Board if incorrsd. Inspectors may bs idsmified by their croeMntiels.
r
COPY FOR NtNLDING DI~AaTMBIT. TINS COPY OF C~TtfIGtE ANKT N~1' EE ALTERED IN ANY MANNER.
----ni-
LI~°.d l.~ BOARD OF HEALTH .
~ ~.,......._.x,..~__..._._<\„°J.~ FORM NO. t SURVEY OF PL.1NS
~il8o~
+ TOWN OF SOUTHOLD CHECK . .
si ~ JAN 3 i (98g .
~tY BUILDING DEPARTMENT SEPTIC POari
~ ll~ TOWN HALL
HI~OG. fiEPT. SOUTHOLD, N.Y. 11971 NOTIFY H L~ /
TO~PJtvpFSOUTHOLD TEL.: 765-1802 CALL /~:T.: •
MAIL T0:
Exammcd ..~?~n!--M.. ~ fie..., 199. ,
Approved 1 19?~.. Permit No. ~ 7
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .January- 31,•,,.• 1y 89
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
,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
Re;ulations, 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 authorised inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporatron)
25235 Main Rd., Cutchogue, NY 11935
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Architect
Name of owner of premises Ronald Q . LoFrell
' (as on the tax roll or latest deed)
' If applicant is a corporation, signature of duly authorised officer.
n/a
(Name and title of corporate officer)
Builder's License No . )
Plumber's License No . No contracts awarded
Electrician's License No . )
Otfter Trade's License No . )
1. Location of land on which proposed work will be done. ,West of Horton' s Point
1295 Hyatt Road Southold
House Number ~ Strcet~ ~ ~ ~ ~ ~ ~ ~ ~ • • • •
Hamlet
County Tax ~9ap No. 1000 Section 50........ Block ........l......... Lot 1........... .
Subdivision ..................n~a................ F.iled 1,1ap No. Lot .
(Name) 'v
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy , ,single family residence
b. Intended use and occupancy single family residence . ,;~,.~y~
~...v
. ~a''f;o-r.
E
3. Nature of work check which w•a. •t.. • . • • • • • •
P • • • • • • ' • Re applicable): New building Addition X Alteration .
Re air ( ~rtoval X , Demolition Othe
4. Estimated Cost ,x!$75 ~ 000. (Description)
Fee
(to be paid on filing this application)
If arage, number of cars g units 1• . , , , , : ; Number of dwelling units on each floor .
5. Ifdtvelhng,numberofdwellirj........•...n/a,•.
s
6. If business, commercial or m~ked occupancy, specify ature and extent of each type of use , , , , ,
J res, if any: Front .
Rear , 3?' Depth 3.5 .
Hci~h tS1On30f ~x~stin stru Number of Stories , ,
Dimensions of same structure with alterations or additions: Front , 37; , , • •37' ' ' ' ' • ' ' '
Rear........
Depth ; Height .....30 Number of Stories .
8. Dimensions of entire new cons~tntction: Front ..12!-,15 , , , , , , . Rear Depth . 2028
Height 1,6",,,,,,,.Nu'mberofSlories, 1
9. Size of lot: Front 1Q0 Rear 100 .
De th
10. Date of Purchase p , , , 370 •
1972 ~ Withers oon
••••••••••••••••...NameofForrperOwner P
I1. Zone or use district in whidt p'~emises are situated , A residence
12. Does ro
P posed construction viblate any zoning law, ordinance or regulation: No
P ' ' ' ' NQ' • • • • • • • • • • • • • • . • ,Will excess fill be removed from premises: Yes
14. Name of Owner of remises
NameoobArchitedctd, , Lowell , • , , , , , , , , ,Address . , ,Southold , , , , Plione No. 765:-5403
& Steelman Address . , , Cutchogue 734-6405 • ~ • • •
Name of ContractorSamuelsj n/a , , , , ,phone No.
• ..Address . ..Phone No. .
Y . P P y
S.Is this ro ert located with in 300 feet of a tidal wetland? *Y$S.X.NO....
*If es Southold Town Trustees Permit may be required. Long Island Sound
PLOT DIAGRAM
i
Locate clearly and distinctly all bubdings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and blocl4 number or description according to deed, and show street names and indicate whether.
interior or corner lot.
See enclosed drawings
I~
i
II
I
STATE OF NE1 OR
COUNTY OF` i~~~. , ~•S
Thomas, C,.• . , amuels'
(Name of individual sigma ' ' ' ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
tig contract)
above named. i
He is the . .Architect
(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 Glc this
application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the mannerlset forth in the application filed therewith.
Sworn to before me this ~ '
G / ~.1. G.l,llt.vrGG.h. ~ c
r. ~F-.day of • 19 .4~
Notary Public,a , , , , , , , , , County
~I ~~~~16~. .
ELI$A ETHANNNEVILLE (Signature of a hcant)
Notary Pu Ib, Steto of New York PP
No. 52•'8128860, Suffolk Cou
Term Expires Octobsr91,18~