HomeMy WebLinkAbout17164-z
_ . FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18147 Date JUNE 27, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 2245 HAYWATERS ROAD CUTCHOGUE N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 07 Lot 04
Subdivision SEC.D NASSAU POINT Filed Map No. 806 Lot No. 377
CLUB PROPERTY INC.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 23 1988 pursuant to which
Building Permit No. 17164-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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to JOHN & FRANCES SHEA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-069037 - APRIL 28, 1989
PLUMBERS CERTIFICATION DATED N/A
L2.t.<
uildinq Inspector
Rev. 1j81
aoaat xo. s
tOWN OP 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 ° 01716 4 Z Dote ~n
:e~... ~.7 19.Q.
Permission is hereby granted to;
~:......Ll..e~..~..-.~.-~::........
,~s' i s ~ `I.~.a.e L~.al .
......................~-!~P............................................. .
.
::..:o~.-......:.....
.....J
J,..~,- s~...~
.E~.ep,~-`p.....
at premises located at .~-,.?::~....~.4~k~,?-RX?+~!.a.....~.e..........~:t,t~nt.l.~.............
Cvunty Tax Map No. 1000 Section Block .......4..~...... Lot No......~..3............
pursuant to application dated .....~..~^:l~C...:~-...+~ 19~.~, and approved by the
BuildingsS Inspector.
fee $..xJ~.:....
9 nsfleo
Bu din I for
Rev. 6/30/80
....a
yy I.G"' I
~ f ._.~,..M.....~..,..°r°
r` ~ ~ TOWN OF SOUTHOLD L i pug' q
BUILDING AEPART?LENT 2,~2i9~
TOWN HALL gLpp DE
TOWN OF SOUTHO '~t~`~
SOUTIIOLD, NEW YORK 119
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION .......OLD OR PRE-E%ISTING BUILDING. ~7
....VACANT LAND..._
P y.......... _ _ _ _ _
Loca[ion of Pro ert HOUSE O. .~~.w~.
ST,"RE,~E~T~ A ~ HAMLET
Owner or Ovncrs of property. ~--~A^ ~ ~c.~t~l~-°~ v we Gl.
Coun[y Taa Map No. 1000 Section I!~,,, Block v _
Subdivision .l .l;;?;',~'`,~~'~-~.__. Filed Map ._...,..Lot......//~~~
Permit tio. lj~,l_~S1_~.,Datc of Permit ,,QQCC~~ ~~4l1~.1,Q}'~ ~'l~-••••
-~~-31'~V4Applicant ( h
UcaLth DepC. Approval Undcrurriters Approval..............
Planning Board Approval
Reques[ for Temporary Certificate
Final Certificate
Fcc Submitted: $ ~
I
APPLICAN
r¢v. 10/14/88
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PAGE 'l
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1. 1'75U4.t BUREAU OF ELECTRICITY
86 JOHN STREET. NEW YORK, NEW YORK 10038
Date APR:LL T.S,1N8y APPltcationNo.onfile F111lflHy/ey N gti9{)3'/
THIS CERTIFIES THAT
only the slectricd puipment m deecribd 6sbro and ineroducd by the opp/icont nomad on the abode application number to the promtees of
SRp:A,.l(1HH, 2245 HAYNA'1'ERS ROAD, POLEYLTG~7, CU9'(;HOGUE, H.X.
GAk
in the folbrrinq bcotion• goae nt ~ Gt F/. ? Ynd Fl. .Section Block Lot
APRf.L p7,7.9R~
rase examined on and found to 6e in compliance with the reyuiremend of this Board.
pXTUR! ACVf SYYITfMES RXTUREf RANOES COOKtllfi olctcs OVENS qSN WASNHS RXNAUST FANS
WTLlTS NUNDESCFM FlVOI1ESCEM OTNER AMT. K. W. AMi. K. W. NAT. R.W. AMt. K. W. AMT. N. P.
f+ 1 Ei 6
DRYERS FURNACE MOTORS plTgt! AFFUANC! p~lRS SFlCIAL RlC'eT TNAl CIOClS RKl WNT XlATlRS MUlil-0IIM DIMMERS
AMi. K. W. dl N. P. GAS N. t. AMT. NO. A. W.O. AMT. AMP. AMT. AMPS. TRANS. AMT. N. P. ~
~T AMT. WATT]
SRRVICE gfCONNIKT ttO.OE S E R p~ V 1 C E
AMT. AAV. TYPE ~ 1 / TW t / ]W 3 R ]W ] / AW ~~%CONO. OF CC
COND. ~ NFIEG Of ~ FLEA NO, p NEDTtAI.S ~ 'NWEUTGRAI
O1/1ER AMARATUS:
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This csrfificab must not be altered in any monner; return to tM office of tha Fbard if inwrred. Inspectors may ba idsMifiad by tMir cndaMials.
COPY FOR WILDNRi DEPARTM@IT. THIS COPY OF CERTIFICATE MUST NOT 6E ALTERlD IN ANY MANNER.
FIELD INSPECTION DATE COMMENTS ~
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rss-isoz
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: c~J~4trtal~ ~.ll~u1~ ~~;~~a~
DATE ~ Z3 INSPECTOR r
7 -1802
BUILDING DEPT.
INSPECTION
[ ] F~OUyD TION 1ST [ ] ROUGH PLBG.
[ ] FO^~IgjNGD~ATION 2ND iNSULATIO
N
[ ]FRAMING [ ]FINAL
REMARKS: ~
-------tea
DATE / /a INBPE~CTOR
_ 1
~ 7Ga-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T f ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN CATION
MIND ~ FINAL
[ ] FRA
REMARKS:
DATE ~ ~ / INSPECTOR
' ~ ~ ~ ~ 765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ ~ ]FINAL
REMARKS: ~~c~,~ z~ ~ _
DATE ll~ ~ ~ fNSPECTOR
BOARD OF HEALTH
3 SETS OF PLANS d.-!°C:.......
FORM NO. t SURVEY U•. ~ .
TOWN OF SOUTHOLD CHECK ~..LL-~~ .
BUILDING DEPARTMENT SEPTIC_FORM
• TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
TEL.: 765-1802 CALL ...~7~~'.S.a!'.7.... • .
MAIL T0:
Examined ~A 19 p~
Approved y.~ 19~ Permit No.~.~
Disapproved a/c ,
. 'a'y'............
(Building Inspector)
,APPLICATION FOR BUILDING PERMIT
Date .....June 21....., 15~~.
INSTRUCTIONS
a. This 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 Depaztment 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 inspections.
Burger Construction Tnc.
(Signature of applicant, or name, if a corporatron)
2~1~ Pine Tree Roari, Cixtchogue
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
G~~nera.l Contractor
Shea °
Name of owner of premises
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. 11 ~1i-l6EiT
Plumber's License No. Il .1~.+.\ .
Electrician's License No. • • • •
Other Trade's License No . q9a ~s
1. Location of land on which proposed work will be done. 'Ia,gwaters Road. , "Tassau Point
Cutchogue
House Number Street Hamlet
11.1........ Block Lot .......l .
County Tax Map No. 1000 Section r 1
rrassa,u Point Filed Map No. ...806........ Lot ....37'7...... .
Subdivision .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Residential
a. Existing use and occupancy
Residentia.]. ~ ~ '
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building X
Addition Alteration .
Repair Removal , Demolition Other Work .
(Description)
~p20,000.
4. Estimated Cost Fee.......................
(to be paid on filing this application)
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 mixed occupancy, specify n~~r~ and extent of a jype of use .
7. Dimensions of existing structures, if any: Front Rear Depth .
Height 1.......... Number of Stories i....:.. .
Dimensions of saFne structure with alterations ori~~itions: Front ~ 66'
Rear..................
Depth ......................Height ......................Number of Stories ......1........ .
Dimensions of entire new construction: Front Rear Depth .
Height Number of Stones .
9. Size of lot: Front 100' 1 OQ ~ ......................2 0 y .
Rear Depth
1972
10. Date of Purchase .............................Name of F rrpe Owner
1?esidenotia~.
1 I. Zone or use district in which premises are situated .
2. Does proposed construction violate any zoning law, ordinance or regulation: rTA .
13. Will lot be regraded PTO Will ex ss fill a rem d from premises: Yes X No
14. Name of Owner of premises . • John Shea • , , • Address ~~aywa~e rs ~c~, phone No.
•
Name of Architect .....Address ...................Phone No...... .
Name of Contractor . Surge r , • . , , , , • • ,Address ...................Phone No. 73~•-5217 ~ ~
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.
STATE OF NEW YORK,
COUNTY OF S.S
• • ' ' ' ' ' ' • ' ' • ' ' ' ' ' ' ' • • • • • • • • • • • • • • • • • • • • • • • • • • . • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the
(Contractor, agent, corporate officer, etc.)
of said owner or owner, 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 performed in the manner set forth in the application filed therewith.
Sworn to before me this
.......day of....... 19.~~
Notary Public . lt'.... {fit ¢1/d-?~, County ~
x~ K o~ roe .
ro?~rtr roeuc, stiu a ne.1?it
T~
F~pr~aa
~s
~ lt~b~ y (Signature of applicant)