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HomeMy WebLinkAbout17162-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17944 Date APRIL 13, 1989 THIS CERTIFIES that the building ADDITION Location of Property 37720 COUNTY ROAD #48 SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 69 Block 04 Lot 10.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1988 pursuant to which Building Permit No. 17162-Z dated JUNE 24 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 & DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to ROBERT & CATHERINE BURNS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-062421-MARCH 13 1989 PLUMBERS CERTIFICATION DATED NlA Building Inspector Rev. 1/81 ~osu xo. 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° 017162 Z Date .........~,c~.n,R:......~:.~ )9.:~.~' Permission is hereby granted to: ~ s . ~ . t0 ..............S.T.......~ l.L.....4G~X.~I.KSSrA~~ ~ ~ . J 4 of premises located ot ..~7:~~3;0.......?.Q.14?:...~.~t t................................. . . . . . . . . . . . . . . . .....Q . . . . . . . . . . . . . County Tox Map No. 1000 Section .....©~P..g..•.... Block .....Q...l........ Lot No.....I.~:.~..... pursuant to opplication dated ........~,.A.!~!?~.....~"2' 19.~$., and approved by the Builds ng..,I`nspector. Fee Bu ding Inspector Rev. 6/30/80 t , TOWN OF SOUTIIOLD BUILDING DEPART2IENT U ~ ~`~iI TOWN HALL ~ ~ SOUTIIOLD, NEW YORK 11971 765 - 1802 S UTiipl,p APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE.:7.~ . J.~1....... . X144 iri an( NEW CONSTRUCTION ..,.OLD OR PRE-E%ISTING BUILDING......VACANT LAND........ Location of Property...:~~~:~~,,,,~~~E HOUSE NO .n / STREET HAMLET Ovner or Owners of Property.. Rs~n1~R~ .e~977t€.~/~~~, .?~.uk'i1/~ . . . . a / County Taa Map No. 1000 Section 0~ ~ Block n~G.. Lot Subdivision Filed Map .......,Lot........./. p~ Permit No. f.~~~4~.z-..Date of Permit ~/~~/~~.Applicant ~~~~T,'~C~:~iP//~~ 4;YlQi(~~ Health Dept. Approval Underwriters Approval.............. Planning Board Approval Request for Temporary Certificate Final Certificate .~J - ~v Fee Submitted: p~y5 APPLICANT. L_"~~"GC~Lc~-e~,~lEcx~~":~:~£~ G~,Re,. ~ X03 t f Co~l7gyy rem- 10/14/88 -x " FORM N0. 6 TOWN OF SOUTHOLD BIIILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with 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 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 solder used in system contains less than 2/10 of IZ lead. 5. Commercial buildings, industrial 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 uses: 1, 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 lot 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 to prepare a certificate. C. For Vacant Land Certificate of Occupancy: I. 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: 1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00 Addition to Accessory buildings, $10.00. - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $15.00 , rev. t0/74 /$8 r'lELD I;:SPcC:lU;7 ~~llATE ~ %OMMENTS =a ~ - v m J 1 . 3 6.. _ _ _ y u FOUIIDATION (1st) = c~ ~-t~ ~ ~ m 4~ FOUNDATIOIJ ( 2nd ) ~ OK.. d0 ~ ~ ~ 2. / ,T ~ ROUGH FRAME e~ a a ~ N PLUMBING ~ ~ H 3. ~ ~ m IIdSULATI0f1 PER N. Y, y STATE ENERGY CODE x a _ ~ m a. ~ ~ .may ~ FIid.9.'L G o z ADDITIONAL COMMENTS: x r~ , x ro• H ~ H O N ~ "F 00 1 ..,-p . ~ a r.~ H - x C7 P7 ro H '1772.7.,, , ~ TEL. 7G5-1802 ~p5 ~ ~O~ T0~'1V OF SOUTIIOLD Q ~'a~~; ~,t ;~N rc~- OFf'IC(:OP fiU1LDING INSPECTOR o ; ~ P.O.ISO`C 1179 . ~ ~ ''?"i`~~ ~ TOWNlIALL ~ SOUTIIOLD, N.Y. 1 1971 ~~o Sao March 29, ]989 ROBERT & CATHERINE BURNS BOX 155 PECONIC, NEW YORK 11958 To I9hcm This May Concern, 4.e arc unable r.o complete your Certificate o_f/OCCUnancy because of the following reasons. /V! An application for Certificate of Occupancy is not on fil.c. (ENCLOSED) *lo tlnderarriters Certificate on file. j~'t'he chr_cl: i::(c~aclsc3m~ast<I)tnot on file.) $25.00 A:o 11cal.th Dept. Approval on file. No final insC;ect:ion has been made. Pleasr.. r_ontact our office on this matter. - Thank you for your cooperation. Ihi.ilclincY Perm.Lt: 1! I 7 I 6 2 2 }3ui1c7incl Dc:pL'. tkk/-/ tkt Plumber :;older Certificate on file. ' ( all pc:rrtiits involving plumbing being .issued after ~1pri.1 1,1984 ) J ' ' ~117:;T„_ TEL. ,"GS-1802 5~fF0l.,~C , ,,c~ Cl,¢ s T01~ P~ OI' SOUT~IOY,I3 ::"~6;;;~,,•'s ~c OFS'iC1~ OF BUILDING INSPECTOR 4' ~ I'.O. BOX 1 1 7 9 ~ TOWN HALL ~~y~ SOUTIIOLD, N.Y. 1 1971 Oj' a~ March 29, 1989 ROBERT & CATHERINE BURNS BOX 155 PECONIC, NEW YORK 11958 '1'o plhom This May Concern, 47e are unable r.o complete your Certificate of~/OCCUnancy because ,of the folloc•ting reasons. /V/ An application for Certificate of Occupancy 15 trot cn file. (ENCLOSED) Tlo [lnderwriters Certificate on file. /~'Chc chr_cF: .i:; (wtakadxtis~a~~not on file.) $25.00 Dlo tlcal.th bept. Approval on file. Nn final insl-~ection has been made. Ploa:;c r_antact. our office on this matter. Thank you for your cooperation. 11u.i1c7ir.cJ Perm i.i-. 1! 1 7 1 6 2 Z Building Dept. *kkJ_/ tkt i'lumber Solder Certificate on file. ' ( all permits involving plumbing being insucd after ~~pril 1,1)84 ) n 1 THE NEW YORK BOARD OF FIRE UNDERWRfTERS PasE i I00 (}709 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 pate NARCH 1311969 App(irationNo.onf((e 51^^<OBSi37f67 N 062421 THIS CERTIFIES THAT only [he electrical equipment as described below and introduced by the applicant Homed on the above application number in the premises of 606 6URN61 ACKERLY PDND LANE, 37, 50UTH0LDr N. Y. in thefoUotcing Gwgtion; ? Bosement ® lot F'l. ? 2nd FL Ser[ion Blork Lot u~qs examined on FEBRUARY 2711989 msdfoundto be in contplianre with the requirements q(this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS ~!I OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FIUORESCENi OTHER AML K W AMi K W AMT KW AMi K W AMT. M P. 9 5 i DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS ~ BELL AMT. K. W. Oll H. P. GAS H. P aMT. NO A W G aMT. aMP AMi AMPS. TRANS. AMi H P NOYOF FEET PMi WATTS SERVICE DISCONPiECT NO.OF S E R V 1 G E METER NO. of CC.CGND a W G. A W G A W.G MIT. AMP. TYPE EQUIP. I'a YW l,a 9W 3%•JW ~.B AW PER% OF CC. COND NO.OF HLLEG OF H4LEG NO OF NEUiRAlS ap NEUTRAL OTHER APPARATUS: 6. F. C. I:-1 j 4 I I SALVATORE C. PRATO LIC.#104RE C/~~~ NIGSINS LANE R.ft. 60X 2118 GENERAL MANAGER 6REENPORTI N1', 11994 ii Per 1 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 17r~ v ~sS-iso2 BUILDING DEPT. [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL REMARKS: ~C~ DATE ~ 02~ INSPECTOR ~ 765-1802 BUILDING DEPT. lNSP~CTIC~N [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN ULATION FRAMING [ FINAL [ 7 ' REMARKS: c i DATE - INSPECTOR r ~ ~ _ ~1 / 'ss-isoz RUtLDING DEPT. [ ]FOUNDATION 1ST [ ] ROUGH PLRG. [ ]FOUNDATION 2ND [~ULATION [ ]FRAMING [)FINAL REMARKS: ~ c~.~ DATE INSPECTOR i `~~~z 765-1802 BUILDING DEPT, INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [!i]'FRAMING [ ]FINAL REMARKS: ~".,~t r9'~~~' i DATE I~ ~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION i5T ( ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ~ FRAMING [ ] FINArL REMARKS: ~ ~J-a~~~ ~r,~Q ' ~~l~.Lrl Aw Q t 'r c~( JJ1 DATE ~9 ~ B ~ IN~iPECTOR IV U_ , . D ~~('7 BOARD OF HEALTH ai,U___ ~1~~ 3 SETS OF PLANS ~ , FORM NO. 1 SURVEY ~~21~~ TOWN OFSOUTHOLD CHECK ......[1,6.9.,,,,,,,,,, BUILDING DEPARTMENT SEPTIC FORM TOWN HALL RLDG. $ SOUTHOLD, N.Y. 11971 NOTIFY TOVUN t~~ ~ TEL.: 765-1802 CALL S' 3 ........z~.9.......... Examined ...y!~-(!~~ 2Uf.., 19~. MAIL T0: Approved /~i~4.Z7.., l~g Permit No. f .7.~ ~O. . Disapproved a/c . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..lP~~~.........., 15~ P 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 tltis 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 gr~ttted 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 inspection~s../ (Signature ot" pplicant, or name, if a corporatton) P0. ~X /ss ~ECO~tI/~ /~l ~ /19~~ ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...........P.Ct711~/~ Name of owner of premises ~!~~eR/NC ..~1.. >~U~~c' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of c~opr~p//o~~rate officer) Builder's License No. F1.. . v Plumber's License No. . Electrician's License No. .~jlp.~rr--........ . Other Trade's License No . I, Location of land on which proposed work will be done. ..^:~'7w?d. , , ~~~E ~Ora7~fOU~ ........f Ilouse Number ~ Street Hamlet County Tax Map No. 1000 Section 9 Block ...6.Y'.. , , , , , , , , , , Lot /O e . Subdivision ~ ~~/A/~U. , Filed Map No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~:~C FAIrJ/t.~ DLe~~~L/stJ~y- b. Intended use and occupancy • • ~.R!n • • • • , ~ . /I ,,-;its :i applicable): New Building Addition ~ Alteration Re air 3. Napure of work (check whine Imoval Demolition Other W.71t'. ~ , . ; ; (Description) 4. Estimated Cost : ~(J. ~~R Fee . 5. If dwelling number of dwellin ~ (to be paid on filing this application) ig units . . . Number of dwelling units on,each flo r , , , • , , , , , If garage, number of cars p U , - ~ r. K , 6. Tf business, c'ormmercial or mi ed occupancy, specify nature qnd.extent of each type oE,use . , ; , • e g res, if any: Front Rear ...3~.....:... Depth : . imensions of existin structumber of Stories , , , , , '-7..........Nu Hci~ht a2, Dimensions of same structure 'with alterations or add~))'tions: Front ....3.1~........... Rear , , bepth ....`~~P... . ; ...Height e? . Number of Stories ~ . 8. Dimensions f entire new construction;` Front . Rear . .Depth Height 'N/uinber of Stories i 9. Size of lot: Front ...~3.1e 7.~ Rear a?S.Q . .......Depth'-'~ ~ . 10. Date of Purchase , . S~SSI i~, ; , , , , , , • , , , • , , • , • • , , Name of Former Owner~~1gR. GF-!3~../,~,,, ,P;.c!?N~ • • 1 I. Zone or use district in which premises are situated :A,'; ,Rtsf?~;T/ • • • ' ' ' • ' 12. Does proposed construction viplate any zoning law, ordinance or regulation: . NR? . 13. Will lot be regraded , ,lV, ~,i , , ,Will excess fill be removed from premises: Yes P 14. Name of Owner of premises . 9~fGg/(?.~ ,dj7, ,~;(,~NSAddress ~?X, , ¢;={'qn,~;c N. Phone No. 7~a,S; ,'3~ y Name of Architect . . . . .Address . .Phone No. . Name of Contractor , , , ,j, , , , , , . ,Address . ..Phone Na. . y P P Y 15*Is this ro err located within 100 feet of a tidal wetland? *YES..~,,, If es Southold Towjn Trustees Permit may be required. ~ PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. i P i _ II i I I~ STATF: OF NEtiV YORK, COUNTY OF . ss.~l¢GQCK • , , , , S.S ~(3~I-I~R/N~ m . (Name of individual i/~nlS ~ • • ~ ~ • ' • ' ' ' • • • being duly sworn, deposes and says that he is the applicant ng contract) above named. i He is the (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 this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perfotnted in the manner set forth in the application filed therewith. Sworn to before me this ' i a .day of ~ . 19 . Notary Public, f~:'~/, , ,~y .ltJ~- County HEIEN K OE VOE . ' J , ~J 70 879 S~utfolkCounY~ ~ :'.`.~lt/!%~~........... . TermEKpiresMatsh30,19.~ (Signature of applicant) t ~ - Q i- Q ,c° ~ 2 2 m g L i `m 8 r-. ~ ~ m ~ w r~ H tt 4 UU~ ~ ~sg ~ts'm;~~~ awe ao~ , Q~0 ~ Q {11 ~ E" Ek. 5 € ; ~ g € m r $ `c a m ~ ° ~ ['t C ~ ~c~7in Oy~ ~ y (~a ~8= E~~o rpr ~YZ m~ z >P N G1 . 0..."" y~j ~ t 1 ~ ~ -~j ~ C~ c t N' m ~ ~"n a ~ St `E m ~ vy~~d~ w :,ao''~O Q Q' ~ ~ < ~ tt~!:~ ~ o $o~ m ~r m•: c ~ o~ CAN I E{. t 4'2' .T r m c y p c m c r D` ~ L! F G ~ 4~ of ~ ~ ~ ~ ~ ~ Q ~ I V ~ u. ~ ~ ~ ; _ ..,E -„,"-~T} «3 j ~ i~ W W w z p ~ ,n,~ ? Yl ~s p iw ~ 1 ~ 3 ~ cE uE' ~ > ~ ~ qua QQ W tt3' q~r~ ~ : ~ ' ~ ly _ ~ w vri L w 4 ~ ~l ui ~ C1'3 Z ~ ~ F U ~ y=..YN~O~ ~~OC1s ~ p I 0 F ~ ~ ~ E ~ r a 11 ~ } v ~ ~ E C ~ R~~A y a.~., rc F n , ~ 7 a+ s ,fy r tv. ; ~ a r , ~ ~ 4 r ' ~ ~ ~ ~ - , ~ J 46 t.. c , ! e v ~ ~ °o~ ~ . ~ ~ y1. a ` yM1 i I+ I , 'Y' 'rV `.'1 r ( ~ ~ ' ~ w E- , i EEYY°°YY .r• ~ . - n I . p~- _ ~ k e _ < '~,av ~4 ' Y ~ 3 ! , vi ,I SUFFOLK CO. HEALTH DEPT. APPROVAL ' ~°>E/"'\k~ tJF""__P"'1~')C„„,}~',_7-_:.~!~~. HS NO. ff6':'?CJ~A7 `1`, ~ C 4. i W+ ! I . ~~s`l .:%C)l: j,', ~ ~;,,Ii.~.~~tC.~~ f,.,.,,,- ~ ~ P ~ . 1....a t c...: ti+ti.~1 e:U THE WATER SUPPLY AND SEWAGE RISPOSAL I f nom'-~ •J~U„T I-~+L~i~'L_=..JC~ _ SYSTEMS SFOREMTH SOFRESIDENCE WILL ``I ='I~Qa, ~ / ~ rf1Wt',+I S~~' ~•ai~J ~r'~"f C~~,. Cl ~a~';; CONFbRM TO THE STgNDARDS bF THE _i i ~ ~ Aa'f{~ea~ ~ 4 - V - SUFFOLK CO. DEPT. OF HEALTH 5ERVICES. ~.'2 4C~'~ . ~ (51 to I p.,, f APPLICANT i i !!y~ ' 'S'J~J ~,ti, ~ _ ~~I ~ ~G ~ ~ / SUFFOLK COUNTY DEPT. OF HEALTH - 1 ~~y: w~'~~'•, d,~•~~ SERVICES - FOR APPROVAL OF ' +`I ~4 I I ~ ~ - ~ ~ 4 ~ ~ CONSTRUCTION ONLY ~ ; +.i ~ 4•.! 1 + /1// DATE: l to ~ ;H .a•6, I ~ `r / H. 5. REF. NO . ~C "t~.~7 i 1~ ~ ~ APPROVED: I ~ ~ ~ ~ ~ ij - ~ ' a,e ~ 5UFFOLK CO 7AX M'AP 4ESIGNATIpN: ~~6\ DI5T. SECT BLOCK PCL. ! ~ ~ ~ If Tp, ~ ~ 'x~ ~ ' IC)QC> Gw ti 2'E. ~ 1=/~% :G tIi ~1 ~ Gr...FYl~~~30 <L ~ 'Y ;i~ ~ ~ OWNERS ADDRESS ~I ~ . a i j ~ ~`l - 1 ~ ~C r~L E:"~_':~~~;a+ r ! ~ DEED. L_ 6E,¢"_~ P. 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Cal'2R~lLr._ ' - ~ I ~ ~ R©~EFtfCK VAN TyIYL, P.C. ` ~~~~~,~y ~ < . pry. e~ ~K1~^Y p n~ y' ai~,~r>O ~ LICENSED LAND SUR 2~FA<s zecJ~~ ' I GREEN~ORT NEW YORK lgNO`'