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HomeMy WebLinkAbout17974-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219662 Date JAN. 16, 1991 THIS CERTIFIES that the building ADDITION Location of Property 930 HOLDEN AVE. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 110 Block OS Lot I8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed i.n thts office dated MARCH 31, 1989 pursuant to which Building Permit No. I7974Z dated MARCH 31, 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate i.s issued to RICHARD A. & PATRICIA J. NORRIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. H018046 JAN. 3, 1991 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 1WHM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N o 017 9 7 4 Z Dare ..3~':3.~ 19 r ~ Permission is hereby granted to• ~rG ~1-r~~.D A . ~~~vu~-- W `.1.~~......~~...~-~~~t! Avg C~„?..7.'.4.~.°. G-c1 ~...fi.'~.-.`~r..~.......1 f `-r~~5 y . . to ..e~glrt.l~....... ..r,~'L.........L17..._...A yk~,.~.~... . O'...... . ..~.....~ci ct premises located of ~?....lf....~-H GFtI. "5.... ~ . County Tax Map No 1000 Section Block ..~J...~'.'~..-.. Lot No.........I A... . pursuant to application dated .......3~3J 19.~~., and approved by the Building Inspector 0~ Fee . ~s~~ C uil ng I for Aev 6/30/80 Form No. 6 TOWN r c SOL'THOLD BUILD"":O '_:^ARTMENT =iI.L "~5-18~ _ S~P I ~ ~~U a t, APPLICATION FOR CERTIFICATE OF OCCUPANC " 6LD(i UEPT TOWN OF SOUTHOLU 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 res~.dences 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. 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. ~ If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. F 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. Temporary Certificate of Occupancy - Residential $15.00/, Commercia4l $15.00 Date .:,~°C~!°OteYH°l~°t:~':. ~?.~J.pU New Construction.... Old Or Pre-existLi~ng Buildiyn7g Location of Property..../.:3~ ..............//°I~G'kl.l7kdN.4.E'.......... L+~~.4LtP~bC~....... House No. ,!Street Hamlet Onwer or Owners of Property.. ~LG~[,"th(r„~,,,!X,/;~c~Y(G12.~~,•.~a.l.~;lS„°,,,°,,,,,,°„°°°. County Tax Map No 1000, Section....~~©.......Block.....d.S........Lot.. Subdivision ....................................Filed Map............Lot...................... Permit No..~~.~~.7.!.'Z...Date Of Permit.:~~`3~1.~.d....Applicant.lt!4~ff!u~ ~.1:'.~ha! C`yr- ° Health Dept. Approval ..........................Underwriters Approval.. Planning Board Approval Request for: Temporary Certificate........... Final Certicate....V Fee Submitted: $..;~..ZS„ y,, ....~',~,~.~r'.r:. l~ld/y/ APPLICANT Co z f y~G,Z r3P1~97 Z i THE NEW YORK BOARD OF FIRE UNDERWRITEi~S~ ~ fpA~ 1 R0218$1 BUREAU OF ELECTRICITY ~ 88 JOHN STREET, NEW YORK, NEW YORK 10038 Dow JANIIARY 03,1941. q licotionNo.onfftle 70$16590/90 N 0180$6 THIS CERTIFIES THAT I~RNIT N0. 07.7974Z only the electrlca! puipment as described beloFO and introduced by the applicant named on Cher above application number in the pramtses of ~ RICHARD A. NORRIS, 930 HOGDEN AVE., CUTCNOGUE, N.Y. in the follou~inq location; ? Basement n let Ft. ? Ynd Fl. GAR Sa,tion 110 BlaA05 Lot 018 u~as a:ermined on SEPTBN9ER 0$, 199c~ and found to be in rompliance with the reyuiremenG of this Board. s AXiUt! AClES SWITOIB RXTURES RANOB COOKING DECKS OVENS OBN WASIIEK lXMAU T FANS OUTLETS INCANOESCFM FIUGRFFCFNT OTNER MAT. K. W. AMT. K. W. AMi. K.W. AMT. K. W. NAT. N. P. z 1 2 DRYERS WRNACE MOTORS RtiURe AMtIANCE INONS sRaAIRK'FT TIME CIOCxs RB? IXMT WATERS MULTI-0UTIlT DIMMERS AMT. K. W. OIL N. P. GAS X. P. AMT. NO. A W. G. AMi. AAV. AMT. AMPA TRANS. AMT. M. P. ~ ~T NAT. WATTS E SERVIC7 DISCONNKT NOOK S E R p~ V I C E AMT. AMP. IYPE MEOIN?. t / t`M i J tW t J 3W 3 J AW MR%COND. OF CC CGND. NO. OF NI.IFO NO.OF NEUTIIALS ~ ~~~~~t I r OTHER AMAl1ATUS: GARAGE VIRING-1 G.L~.C.I:-1 3 .Ero'~ RICHARD A NORRIS 528 S.NAIN STREET GENEVA, , NY, 14$56 BRFIRRAt MRNAOR 11 Per T'"l -l / ,I This wrtifkoM mutt not be altered in any manner; return to the offiw of 1M Board if incomd• M n may b• identified by Chair crsdentak. COPY FOR lUILDIIK: DEPARTNErlT. TNIf COPY OF CERTHRICATE ArliT NOT RE ALTdRW IN AMY MANiER. : 1c;LD I;.S:'EC:iUw I~DnT ~I COMMCN7.°, F t . ( a N FOUt1DATI0N (1st) c FOUNDATION (2nd) b 2, 0 a }r' ~ P.OUGH FRAME'& ~ ~ PLUMBING 3. ~ m c~ IIISULATZOP7 PER N. Y, STATE ENERGY CODE x 4 , a't ~ - y FIiJAL c ADDI IOPIAL COMh7ENTS: e } e~ 7ss-isoz BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST f ) ROUGH PLBG. ( ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING FINAL REMARKS• ~ - r/ DATE ~ ~ INSPECTOR ~ v ~ ~ 765.18!12 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ j ROUGH PLBG. [ ] FOU ATION 2ND [ ]INSULATION [ RAMING [ ]FINAL REMARKS: DATE d~~ INSPECTOR v 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ]FRAMING -~z [ FIN/~AL~~n REMARK ~ L-~ I/4zC~ ~.5~/ l DATE ~ / ~ 9 INSPECTOR Y w BOARD OF HEALTH 3 SETS OF PLANS FORM NO 1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' T04VN HALL SOUTHOLD, N Y 11D71 NOTIFY - TEL.: 765-1802 CALL i9~ MAIL T0: Gramincd .3 . . Approved ~/•-1 ...,I90j.PennttNo/./.~?T.~ ~ ~ >`~~.i~ _ . ,l • C- Disapproved a/c / N / MAR 3 I r BLDG. DEPT. '~pWN~UF SOU, HOLD (B dm nspector) APPLICATION FOR BUILDING PERMIT ~y~__-D Date ~`l°"-^.`.31.. 15g: INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showing locarion of lot and of butldm~s on premises, relationship to adloinmg premtses or public stree or areas, and giving a detmled description of layout of property must be drawn on the diagram which is par[ of t}us appl capon. c. The work covered by this apphcatton may not be commenced before tssuance of Budding Permit d. Upon approval of this apphcatton, the Budding Inspector will issued a Building Permtt to the apglicant. Such germ shall be kept on the premtses available for inspection throu~ltout the work. e. No building shall be occupied or used m whole or m part for any purpose whatever untd a Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the tssuance of a Btulding Permtt pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c ReculaLOns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe~ The applicant agrees to comply with all applicable laws, ordinances, building code, houstn~ code, and re;ulauons, and t admit authorized inspectors on premtses and in butldm~ for necessary inspections (Signature of applicant, or name, if a corporation) . • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or butlde, Name of o•.vner of premises . NQ~`h./.Sy. ~!'la~~d..A. ~vj........ . . (as on the tax roll or latest decd) If applicant s a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No , DW NFz~ , , , , , , . , , . . Plumber's License No ~/.~:..p. . . Electrician's License No . ,OGt) NC^ . • Other Trade's License No. ..`.i:1~.NS~, lrl1~ I. Location of land on w}iich proposed work will be done . . ...........93.0 h..'a ~d~.n.. .H.K~~u~ Gv~caE .ca~~,tv.~...... . Ifouse Number Street ~ ~ • Hamlet County Tax \tap No 1000 Scctton .Block QS......... Lot . Subdivision . . Filed tap No Lot . (Name) State e~tsttng use and occupancy of premises and intended use and occupancy of proposed constnuUOn: a Existing use and occupancy . !~!Y%~,~• • ! l4 C•~L,'~, ~1=1M IL Tj w f;LL-!~(-_- (~j~ b. Intended use and occupancy~• • •~~~49~° ~~'~!•T! b•~• . . 'M~•f4 F._ 3. Nature of work (check which applicable) New Building Adddion C..... Alteration . Repair Removal Demolition Other 1Vork . (D: scnptton 4. Estimated Cost .~t Q. rr.°... Fee . (to be paid on filing ilia apphcation) 5. If dwelling, number of dwelling anus Number of dwelling amts on each floor . If garage. number of cars . 6. If business, commercial or mixed occupancy, specify natii~e aid extent of each type of use . 7. Dimensions of existing structures, tf any Front , 7~. Rear Depth . !:e ~.~i!,~~, , , Haight ...............NumberofStones...../..~a..................................... Dimensions of same~>; ~c pure with alterations or additions' Front ....9.3 Rear 7.~'~4 • , • . • . Depth ; . , . (i...... IIeight Number of Stones . 1s . 8. Dimensions of entire new construction Front t~4t Rear ....Ft.......... Depth ...~y. . Height ...............Number of Stones . . 4. Size of lot. Front , . t.K.f: Rear . f ~14•.~f ~ Depth ?,0,7,.x/ i';/;t ~ , 10 Date of Purchase y~f. ...Name of Former Owner ...E./,etuot w~tk,~4tf!1, , . - 1 1. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation' 13. 1Vd1 lot be regraded ...........tfR 4....... .....1Vi1! excess fill be removed from premises Yes % 14. Name of Owner of premises . ..................Address , , P ~ne No............. . Name of Architect .~4~'!l N.lC!'4r/ Address 139.N,t,Y*i~,,SY., (ye}$Ydp~one No.... . Name of Contractor ..............Address Phone No. lS.Is this property located within~00 feet of a tidal wetland? *YES....NO?... *If yes, Southold Town Trustees Permit may be required. _ PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dunensions frc property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. STATE OFtE1VY c~ SS COUNTY OF ..~~-~a/ . • • • • • • • • • • • • • • • ~ ~ 141`: • ~ . J/..v.~ being duly sworn, deposes and says that he is the applica (A'amc of i dividuat signing contract) above named. He is the Q. ~N.~r':r (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 file tl apphcation, that all statements contained m this application are true to the best of lus knowledge and belief; and that t work wdl be performed m the manner set forth m the apphcation filed thcrcwuh. Sivom [o before me tftis ~ "'c, .t~.~~~-day of~'~.Y.. ,19a/, :votary Pubhc_ S`'~.d//\County . . 1~~ 8~ ~N Y~ (Signature of applicar ~rs~.