HomeMy WebLinkAbout17546-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19441
Date OCTOBER 12, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 4980, pEQUASH AVENUE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 110 Block 3. Lot 26
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 14, 1988 pursuant to which
Building Permit No. 17546-Z dated OCTOBER 19, 1988
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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JOHN & ETHEL JL+SSUP
(owner}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
CERTIFICATE NO. N-055292 - JANUARY 26, 1989
PLUMBERS CERTIFICATION DATED OCTOBER 3, 1990 - MATTITUCK PLUMBING
uilding Inspector
Rev. 1/81
Foam xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON TtiE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ G 17 5 4 6 Z Date ...~.~~~:......!..9 ................ 19~~.t.
Permission is hereby granted~t+o: ,
...~/.Y.1. ~ u1~LwM~.a^.~. 1. ~-a ~ ~?.~.........
. ~ ~n~ : i~ ~ ....~ a:. r~ .....o.~..--.......... .
...
~.. ..r ~~
rc~..:D1...... ~ .....,..... ............T.. - .~. .................................................
~Q~~ .. ...~~ .. .... ....
cY premises located at .....~~.9/.~......J:Q..:~-Y?....124.F.~`X ~......~ri..GJ~...........
County Tax Map No. 1000 section .......(.~.Sa......... Block .....Q:.~........\~Lot No.......~F'!....
pursuant to application dated .....S~.~t:h...~..~ ................ 19.15.., and approved by the
building Inspector.
Fee $.~.~~...:5~.......
Building Inspector
Rev. 6/30/80
Form No. 6
'=-""''" ' ' ~~~ ~~ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
3 +C~ 4 TOWN HALL
~ 765-1802
ION FOR CERTIFICATE OF OCCUPANCY
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 1~ 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.
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
v reasons therefor in writing to the applicant.
C. v 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, Commeprcial $15.00
Date ... ; :'~:'~3~ ~~1~ .. ................ .
New Construction.......~.,/. .. Old Or Pre-e/~xist/i~ng/1Bupil,/ding. n.~,.(r~;(~/.,?`~~,p /
Location of Property.../.~~........N~Ly:~/.).-J,TI...,i:,Y~i~C~..........5.1~!~G4~~~':~ir~..
House No .p Street Hamlet
Onwer or Owners of Property.. Nit/,T/Lt'.:~..~?`..l'Tt~~...9/..~.~~:C~1~........PP ...............
County Tax Map No 1000, Section.~~f`?: .........Block....~..........Lot....vt .4`a ..............
Subdivision ....................................Filed Map............Lot......................
Permit No.. ~~N.'l.~ ....Date Of Permit. ,~.~~ 7/.~..Applicant..~,(d,(1/,T/®.N ................
Health Dept. Approval ..........................Underwriters Approval.. ,.. ....................
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate....~....
Fee Submitted: $~f.5~ F~ .....................
~,O,G, yobs( . ~ • •"f :..°) i . ,~, ~- /~``~/
C0'L ~ Y ~~ ICANT G%~~~~. Y/
TEL. 765-1802
oS~~F°~~o, TOWN OF SO'U~'IIOd.D
~~,,. ° he OFFICE OF IIUILDIiQG INSPECTOR n ~ ~r f
to E~, ',~~.r ,=„ P.O. BOX 728 Am.
~j~~l ~~~~ SOUTHOLD, N~ Y 11971 ~+( W 3 ~~
~~.~tl. [J~~~ "'Vme.
C E R T I F I C A T I O N
Date 0 ,~ O
st-
Building Permit No. r75~(®
Owner ~' ): SS yP 3'GNN
(please print)
Plumber It')la'77 t7vice QLVrv~(3/w4
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1g lead.
Sworn to before m this
~ day of ~ ,
(plumber's signature)
19%6 ~
Notary Pu c
Notary Public, County
EDRN P.
~7 Pub9c, SraN d rkw Yorr{
No. 4920786
QUaIfEx gyres Febulk ~9,~
?6,Fi~1 P
d ?)
WF'
/, )y~,^//~Jrf/^/y^
/V-~~
~ ~a~a6~ioPirrc~~ ~
December 1, 1988
Southold `Gown Building Dept
Tow,^, Ilall
Mai*i kaad
Southold, 1VY 11971
Re: Permit # 175462, Jessup
llear Sirs,
_ ` 9
Environment East, Inc.
R. R, No. 3 - 3075 Indian Neck Lane
Peconic, New York 11958
516-7347474
Ln regards to the above mentioned permit for Mr. & Mrs. Jahn
Jessup of 4730 Pequash Ave., Cutchogue, we have fulfilled our
abligation to the owners. We contracted to construct the
faundation and the shell with exteriar siding. Our
z~esponsibility ended with the foundation arxd framing inspections.
A11 additio alwor and inspections will be the owners
respansibilit ~,
Sincerely, ~ ~~~~
Peter k. Sto tenburgh
President
>nvironment 1•;ast, Inc.
PRS:jm ~„ B~
1 LD II:SP~CTiUIJ ~ ~UATE ~ %OMMLNTv ~',
;~
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- '7 ,~
_
FOUIJDATION (1st)
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OUNDATION (2nd) _
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ROUGH FRAME & o~
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PLUMBING
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IIJSULATIOPI PER N. Y. H
STATE ENERGY
CODE
®
x
4 . .-3
F I id A L ~ .~-l`
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z
ADDITIOIJAL COMMENTS: ~y
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~ ~'~ ,~ Environment East, Inc.
i ~ R. R. No. 3 - 3075 Indian Neck Lane
Yeconlc, Naw York 11958
516.7347474
r~~~
Revised window schedule- Jessup addition
H- AnJorrun 28210
C- Anerron AW 28310
D-Andersen A 31
F- Arnlel~ruq 3052-2
V- AvewRS~-H1 ,70210
R. o. 2'1o i/a" x 3'1 1/2n
R. 0. 2'10 l/8" X 1}'1 1/2"
R. 0. 3'0 1/2" X 1'9"
R. o. 6'3 13/16" X5'5 1/~"
R. 0. 2'2 1/8" X 3~1 l~l}"
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BUILDING DEPT.
i NSPECTION
[ ]FOUNDATION i5T f ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING
[ NAL
DATE 1 ~' I 1 I "1 [~ INSPECTOR
I`,
REMARKS e ~~~
~~~~~ ~~
765-1802
BUILDING DEPT.
1 NSPECTtON
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ }FOUNDATION 2ND C ]INSULATION
[~RAMING (]FINAL
REMARKS: ~P.~t~~-~~r~.+ ~~~ , lets,
t
DATE lg" ~ ~_INSPECTOR ~ :~~
r
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765-1802
BUILDING DEPT.
NSPECTIO
[ ]FOUNDATION 1ST f l ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
DATE INSPECTOR
4
6
[ ]FRAMING [ ]FINAL
~ 76 ~~
7ss-1802
BUILDING DEPT.
tNSIPECI'~ON
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING
REMARKS:
[ ]FINAL
~.
DATE ''Z y INSPECTOR
~~
-~~-~~
l7 5-y~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ UGH PLBG.
[ ] FOUNDATION 2ND ~ULATION
REMARKS:
Cgs
~ ~~
DATE ~ (~ ~~ INSPECTOR
C ]FRAMING [ ]FINAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS ''~t°
$00,9!~l,~f ~ BUREAU OF ELECTRI¢ITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
;tiYP~E 1E;,3<i`> ±~y941}2Y,~i~9 if t?~it7_~su
Dote APPlication No• on file
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced 6y the applicant named on the above application number en the premises of
hkiN 3Y~15i;iJ!', h.7:d(? I9Y;C}1fA;iFI ,3`ort;,. C!1'('t_k!cliyl3~,, tda"f,
in thefollouing loco o se ent ~ lst F'(. ~ 2nd FT, Section Block Lot
,~~tt~aP, t!~ ~~.~~"
was exmnined on and found to be in compliance with the requfrententc q(this Board.
FIKTURE
OUTLETS ECEPTACLES SWITCHES
I FIXTURES
NCANDESCENT FWOAESCENI OTRER RANGES
AMi K W. COOKING PECKS
AMT. K W. OVENS
AMi KW. DISHW
AMi ASHERS
K.W EXHAUST FANS
AML H P
t 4 l 6 i .3 1 ~~
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMF CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS
AMT.
K. W
On
H, P.
GA$
H P.
AMT
NO.
A, W. G.
AMT.
AMP
AMT.
AMFS
TRANS.
AMT.
H P. SYSTEMS
NO. OF FEET
^Mr.
wairs
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMT. AMP. TYPE METER
EQUIP. f~, rv F P ~ ~A, 3W 9AAW NO.OE CC COND.
PER .9' A W. G. NO. OF HbLEG
Of CC COND A ~`' O
OF H4lEG NO.Of NFUIRALS A. W G.
OF NEUTRAL
OTHER APPARATUS:
alt>T}tv" JA;~aSl1P
4'13€! Fi<,Qi17iSff t~VF;.
P,rJ. HraX 42a
This certificate must not be altered in any manner; return to the office of the Board if incorrect
~~
GENERAL MANAGER
~s
Per ~~
ay be identified by their credentials.
COPY F,DR BUILDING DEPARTMENT. 7NI5 COPY OF CERTIFICATE MUST NOT BE ALTERED
THE NEW YORK BOARD OF FIRE UNDERWRITERS '`~``"`
I ryca, ut( ~
f- BUREAU OF ELECTRICITY
BS JOHN STR
EET, NEW YORK. NEW YORK 70038
` '
,)P,:dll$k b
;. IL3a,'i r:.5"!7?~r{ii%3JsZ~ tr 'Pa~;.y; rd ~`
Date
App(icgtion No. on file
THIS CERTIFIES THAT
only the electrical equipment qa described below and introduced 6y the opplicgnt named on the above application number in the premises of
e%it- ,?t>,ini ~f+~.`;.NY>J, .~d `!tf) AYait(f3.'r'IF e~+'a;. (Pt)3,b: }t~"1., t". ii'CC`F~.'7C:Clt;,, SIS .'V'.
of&t~p,
in the fo(lowinq loco io fipaerrken[ ^ lst F'(. ^ 2nd F7• Section B(
k L
ft3~a(~r
~
.
ce
.
ot
,.. rsu
was examined on and found to be in compliance wide the requirententr of this Board.
OUTLETS ECEPTACtES SWITCHES FIXTURES M
RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
Y
INCANDESCENT FWORESCENi vnROR AMi K W AMi K.W AMi KW, pMi. K.W AMi H P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W OIL H P GAS H
P SYSTEMS
. AMi NO. A. W G. AMT AMP. qMT. AMPS TRANS, qMi H P NO.Of FEET AMT. WAiiS
SERV ICE DISCO NNECT NO.OF 5 E R V I
qAp.
AMP
LYPE
METER
EQUIP
t RTW
I Af yW
3.9 3W
3,e' 4W
NO. OF CC. CONO,
PER .9
A W G.
Of CC
COND
_
NO Of HI-LEG C
A W O E
NO OF NEUTRALS
A. W G.
i
I °t (1
i'F!
I
~ .
.
1 OF HbLEG
I OF NEUTRAL
~
OTHER APPARA7U5:
I'll! '~f!AIS i`;i.i~ L,h+.
I +d'PL: FN)Z.fPh:, ?dV i,iufa~ ,~"t
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified
tsznmxc~~ ~>,
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANPIER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765.1$02
xamined .C;1 e~..'~?44 . ~ `~.., 19a'?;
Pproved o~.".'i°ah:.) `~ ., 19 ~~ Permit No. / ?,b,',~ (o, ~' .
isapproveda/c ....................................
.....7 .......................~.. ...,,......,,
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
J~~~c°~~
Received..........,19...
Date . ~Rtr4bp.r~-3.. , ..., 19 .$$
a. This application must be completely filled, in by typewriter or iri ink and submitted to the Building Inspector, with 3
is 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
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
tion.
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
all 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
all have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to the
iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
;gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
mil authorized inspectors on premises and in building for necessary inspections.
.. ~nyirgnme.rlt.~.zi~~,..Zt?9a .................
(Sign lure of applicant, or name, if a corporation)
30(5 Indian Neck Lane
...~e~on~.~,..~...~.~958 . ........... . ....... .
(Mailing address of applicant)
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.....aenar.lal..Contr.actor ................................................................ ..
Q Q .., .
arse of owner of premises .. , ...,~!~~''.'...~ .. °l. ..................... . .. .
V V as on th tax roll or latest deed)
applicant is a corporation, signature of duly authorized officer.
........................ . ..... Pr.~sid.ant... .
(Name and title of corporate officer) -
Builder's License No. ..~~5,(aHI ............... .
Plumber's License No . ....................... .
Electrician's License No . ..................... .
Other Trade's License No . . . . ................. .
Location of land on which proposed work will be done . .............................................. . . .
...4738 .......................p@ qu,~s h• Aue .............'.........Ctz tc•ho~ue....... , ........ .
House Nutnber Street Hamlet
County Tax Map No. 1000 Section .......llp........ Block ....3..„.......... Lot...~6 ..............
Subdivision . ~.a 9 tw0od , lip s,t~to,~ , , , , , , , , , , , , , , , , Fited Map No. .~ (1$3......... Lot .............. .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..~.~e,family, dtgelli,n~,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
b. Intended use and occupancy .One, ,family, dewllin~ with addition
~~ '
3. Nature of work (check which ;applicable): New Building .......... Addili n . $:... , ... Alterat,(c~ ...... , .
Re air ........... Removal ..... . . . ...... ~y~~g ', . , , .
P Demolitiqn ...i ~ t.; . OYhe~ "1"s!t . t'k3.~ .... .
~, z ~ ~ ~ g ,-, , (Dscription)
}
4. Estimated Cost ..11.1.,.640.Q.0 ... . .. . ......... . ........ Fee ................ , . , ..........{......... .
• (to be paid on filing this appliication)
5. If dwelling, number of dwelling units ..... 1......... Number of dwelling units on each floor ............... .
If garage, number of cars .. . . .............. . . . ............... ...... .. , , , ......... , ..... .
... .,. .
6. If business, commercial or mi>Fed occupancy, specify nature and extent of each type of use .......... . ......... .
7. Dimensions of existing structures, if any: Front • , ....'......Rear ........... . .. Depth . .3Q! ~" , , ... .
Height . . ............. Number of Stories .... , .4rx9................................ ..... , . , ..... .
Dimensions of same structure,with alterations or additions: Front ... . ............. Rear , ..... , .......... .
Depth ..~9 ~.9,tr, ......... , i... ,Height ....... . , ........ Number of Stories . .. , ,
8. Dimensions of entire new construction; Front , .. 2Q ~ , , .... Rear . , ?~ r .........Depth ...3'~a'~ (? °, .... .
Height ............... Number of Stories ...,',+..'. ., ... , . , .... , ..... , . .... , , .. , . .
9. Size of lot; Front ..1.00! . ............ Rear .. .1A.R t ...... , .... , . Depth 1,7,~ T, ................ .
10. Date of Purchase ......... ~, ........... ........Name of Former Owner ..................... , ...... .
1 1. Zone or use district in which premises are situated ; ...I38 Aida tztStr.~ ...... .. . .......... . .. . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . , . ~Toi .. . ..................., , .. .
13. Will lot be regraded ' ...1}3'0. ,',,,, , , , , , ,,, , , , , , , , , ,Will excess fill be removed from premises; Yes No
14. Name of Owner of premise~q.~t}. JO.nSUP... , .... Address47.3P..p~ 41)~.dS17. A!78 Phone Na, .7,34-53.~,~ .... .
Name of Architect , , , ,„ , , .. .. . AddressCutchogtze,a. ~, . Fhone No..
Name of Contractor E,nvirgnme nt, ~as,t.,. ,Inc, Addre q~5 Iridiant9bcklnphone No, , .74-.7474, ...
eco~riltir h~'ii95g
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blogk number or description according to deed, and show street names and indicate whether
interior or corner lot.
See Att$ched
STATE OF NEW YOItK, S,S
CQUNTYOF ................:
(Name of individual si I~ ~ ' ' ' ' ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant
fining contract)
rbave named.
~Ieisthe ................... .., ........,.,,.,.....,,.. .
(Contractor agent, corporate officer, etc.)
~f said owner or owners, and is duly aut erform or have performed the said work And to make and file this
tpplication; that all statements contained in this application are true ko the best of his knowledge and belief; and that the
Nork will be performed in the manner sat forth in the application filed therewith.
iwprn to before me this
.............. /, ~~~.~... ,~./.daynpf ././ ...1~. S~:..... , ..., 19 ~~
Votary Public, . , ~?~f-~~!".7.t.~. N.Q-.U>~... ..... County
•~• ,
HELEN K. DE Vt1E
NoTARY_PUDIIC StitoatNeurYarN (Signature of applicant)
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