HomeMy WebLinkAbout17702-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219258 Date AUGUST 1, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 5655 NASSAU POINT RD. CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 13 Lot 03
MAP OF SEC. A
Subdivision NASSAU POINT Filed Map No. 745 Lot No. 38
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 13, 1988 pursuant to which
Building Permit No. 177022 dated DEC. 16, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & DECK.
The certificate is issued to HAROLD V. & GLORIA M. MC COY
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-153 JULY 26, 1990
UNDERWRITERS CERTIFICATE N0. N095707-OCTOBER 3, 1989
PLUMBERS CERTIFICATION DATED PECONIC PLUMBING fi HEATING-JUNE 22, 1990
uilding Inspector
Rev. 1/81
i
BOBM N0. ~
TOWN OF SOUTHOLD
6UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
I
BUILDING PERMIT
(THIS PERIy11T MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N G 17 7 0 2' Z Date ~~,1i,6 19..~`~..;~
Permission is h reby ted to
.r,~.{. - .
to
ct
prG%~ocated at .~~7..s.1. ..!""J;~ . .~°f
................................................................rr.... .
County Tax Map No 1000 Section II,/... Block ....~~......yLot No.....1~
pursuant to applicatroj~ dated ~..t~ ~C 19 r/~ and approved by the
Building Inspec~to~r.
Pee 3..~ii..~i7•.+.r..t 4J~''
ByN~I"n I actor
Rev 6/30/80
i
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT ^ (7
TOWN HALL U~~ ~]~~/J h
765-1802 f ~
APPLICATION FOR CERTIFICATE OF OCCUPAN ~T 2 S 1sMr~
A. This application must be filled in by typewriter OR ink and a EI,p~~~e building
inspector with the following: for new building or new use: 1~F 'HO'
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of elecitrical installation from Board of Fixe Underwriters.
Sworn statement from plumber certifying that the solder used in system contains
> less than 2/10 of 12 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 µses:
1. Accurate survey ~f property showing all property lines, streets, building and ,
unusual natural pr topographic features.
' 2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificatelof Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
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 accP~ssory building $25.00. Businesses $50.00.
2. Certificate of O~cupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $LD.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00 Commercial $15.00
/9
- Date ...~j! 2 ,S~ a
New Construction... Old Or Pre-existing Building
Location of Property..5.'~~S.~~SSAu..~j.../~o C v..~HaG.~.~ ,...~V_^J r 3)
House No Street Hamlet
Onwer or Owners of Propert'y...C7~Ra :,o.... U...!'!!'I ~ C`Y d ~ caft~.A
3
County Tax Map No 1000, Section....~/~.......Block....J.(3.........Lot
Subdivision... N';~,SS A~ ~ Sw < f~- Filed Map.. ~ ......Lot. 3.~
Permit No. J.?~o 2' ......Dilate OF Permit..~ZJC~/'~~.....Applicant. N.~y.'~: ~ . v.:~..~:~.......
Health Dept. Approval ..........................Underwriters Approval..
li
Planning Board Approval..
i~
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: ~ 3~{5~ .
8 ~19a - I
• APPLICANT
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( ] ROUGH PLBG.
[ ] FOUNDA7~'ION 2ND [ ] INSU TION
[ ] FRAMING ( INAL
REMARKS: -
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DATE D ~ INSPECTOR
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T ( } ROUGH PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ ] FRAMING [ ]FINAL
REMARKS ~~'~~.~X r~k 7~-c.~~
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DATE S INSPECTOR
765-1802
BUILDING DEPT.
I NSPECTI4N
[ )FOUNDATION i5T f ROUGH PLBG.
[ ] FOUNDAlf10N 2ND [ ]INSULATION
MINQ [ ]FINAL
REMARKS: ~~~d~~
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DATE ~ INSPECTOR
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765-1802 _
~ BUILDING DEPT. ~
SPECTI N~
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765-1802
BUILDING DEPT.
INSPECTION
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FOUNt~ATION 2ND ~ 1 INSULATION
[ ]FRAMING [ ]FINAL
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REMARKS r ~-+"y~
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ter.
DATE ~ INSPECTOR
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? BUILDING DEPT.
tNSPECTt4N
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REMARKS:
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DATE~~2G INSPECTOR '
New York State Department of Environmental Conservation
Buil~diTng`40-SUNYy~Sntony Brook, New York 11794 J J o
~,,~0`~- U ` m~ CO DATE 1/~//~i
I/~~D~Q '1 f(~
UO ~ • V 1~ ~ol.~~ 1~\`-'~I ~~i Re: f l1`Z~ O-C~o~
q~ ~h'~'Ot~l s~V111 ~~„„O_~I~_ Thomas C.Joriing
~V~ t, / ~Y~ (JO Commissioner
Dear ~Y. ~ ~3 3
A review has been made of your proposal to:
~GhS~vC~-- S ~ ~
cis ~Y c~c~~ec4 p~~.v~ ~ ~u\S~c~ 1oc~
6~ ~r~SSr~u ~o~n~- i~c~.~, Sov~-v~~l~ '
Based on the information you have submitted, the New York State Department
of Environmental Conservation has determined that the parcel
project is•,
_ Greater than 300' from inventoried tidal wetlands. ''nn
Landward of a~ substantial man-made structure ~ ~ KJ~ ~
greater than 100' in length which was constructed prior to 9 20 77.
Landward of ,the 10' above mean sea level elevation contour on a
gradual, natural slope.
Landward of !the topographic crest of a bluff, cliff or dune which is
greater thanil0' in elevation above mean sea level.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law). Please be advised, however, that
no construction, edimentation or disturbance of any kind may take place
seaward of the 10' contour or topographic crest without a permit. It is
your responsibility to ensure that all necessary precautions are taken to
prevent any sedimentation or other alteration or disturbance to the
ground surface or'ivegetation in this area as a result of your pro3ect.
Such precautions shay include providing adequate work area between the
10' contour or to~iographic crest and the pro3ect (i.e. a 15' to 20' wide
construction areal or erection of a temporary fence, barrier, or hay
bale berm.
Please note that any additional work, or modification to the pro3ect as
described, may retluire authorization by this Department. Please contact
this office if su~h are contemplated.
Please be further advised that this letter does not relieve you of the
responsibility of obtaining any necessary permits or approvals from other
agencies.
r1~~~~ i!\~~~L~~~ Very truly yours,
~~l ~ U ~ ~ ' ; CIS-o~~~
~ ~ 2 ~ Deputy Regiona ermit A ministrator
~ ~t~.~.~,n _.;R._.•
TCiV'f~H; C-',
. ~ -
TEL. 7G5-1802
~~FFatKc
o~p t O,,ry TOWN OF SOUTIIOLD
~ ' ~c OI'EiCE OE BUILDING INSPECTOR
j. F, ,rn P O. BOX 728 ,
~ ~ TONN HALL
,~01 ~ ~a~~ SOUTHOLp, N.Y. 1 1971
May 31, ]940
Harold V. McCoy
4270 Wunneweta Rd.
Cutchogue, N.Y. 11935
To Plhom This May Concern,
we are unable to complete your Certificate
of Occupancy because of the fallowing reasons.
I •
At4 application for Certificate of Occupancy
i~ not on file.
NO Underwriters Certificate on file.
Tlie check is (aStsffSdfck/not on file.) $25.00
No health Dept. l~.pproval on file.
No Final inspection has been made.
P~eacc contact our office on this matter.
Thank ~rou for your cooperation.
I3uild~.rig Permit 1I 1 7 7 0 2 Z
Builds Dept.
***/_i//iNo Plumber Solder Certificate on file.
( all permits involving plumbing being
i:,sucd after April 1,1984 )
' ~I
d
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l
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a, . ~ _ ~r e
BOARD OF HEALTH ?
3 SETS OF LANS
FORM NO. 1 SURVEY ~ .
TOWN OF SOUTHOLD CHECK . ~I: ~'fys~ .
BUILDING DEPARTMENT SEPTIC FORPi .
' TOWN HALL
SOUTHOLD, N Y. 11971 NOTIFY JJ// c(
~ p TEL. 765-1802 CALLf"r.U.rl~~u~.J3,[-?~7~
Examined/~~~?.. , 19V ~ MAIL T0: _
Approved . „ 19 O.~ermtt No n
~ v
1 ~ 3
Disapproved a/c ~ D IZ
15
. E
Building Inspector) t~
5~ GO DEPT
i m+ ~ [ c•r,, iTHr3t tl
APPLICATION FOR BUILDING PERMIT- - -
Date ?f~~°••`-•• ••••,IS
INSTRUCTIONS
a Tlus application must be completely filled m by typewriter or m ink and submttted to the Building Inspector, wi
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 adlommg premises or public st,
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this a
catron.
c The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this apphcahon, the BuIIdmg Inspector will issued a Building Permit to the applicant Such pe
shall be kept on the premises available for mspectron throughout the work.
e No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occup
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
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc.
Regulatrons, for the construction of buildutgs, additions or alterations, or for removal or demohtron, as herein descn
The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulattons, am
admit authorized inspectors on premises and m butldmg for necessary mspe tons.
~G.r....Si~ {.t, /Yyc
(Signature of applicant, or iisfie, tf a corporation)
i 27D I,J J ,u,v ~w eT.¢,~0~'u c yaGu1.!V j
(Mailing address of applicant)
//`7 3~~
State whether applicant is owner, lessee, agent, architect, enaneer, General contractor, electrician, plumber or buiL
.....~Li,! N. ,414
Name of owner of premises ~~Z'4 1. vT " '~~`/-g t'~'~'~ V• h/~•
. . . .
(as on the tae roll or latest deed
If applicant is a corporation, signature of duly authortzed officer
(Name and title of cprporate officer)
BuIlder's License No . ,
Plumber's License No
Electrician's License No
O[her Trade's License No
I. Location of land on which proposed work will be done ~ S6J s bASSAU PT ~O Cu; c HaGu.Z/t/~
.~~_S.S'~ N!4SSgy ~ .~Q.. ~LTc%/o.G~~ . ti''Y. !/~3.I"./t1.95y°.9u fj-... .
House Nmnber I Street Hamlet
County Tae Map No 1000 Section L ~ I Block 3 Lot . 3.
Subdivision MA Sorg u. ~ S$.~ 1, Filed Atap No Lot
I (Name)
2 State eeishnr use and occupancy of prenuses and intended use and occupancy of proposed construction
a
• inn use an occu anC
. . .
p
ey . S l./u.G« l`9at/4Y /./~os~,yy~lo~i"° '~'^'~'~'%~4.cN;~Q.. .
b. Intended use and occu an ~
r ~ r.-
3. Nature of work (check which appltcable) New Building • • Addrtton Alteration , , .
Repair .Removal , Demolition Other Work . .
(Descnptu
4 EstimatedCos~~.~~ ~.4 ° Fee
(to be pmd on filing this application)
5. If dwelling, number of dvvelhng units j Number of dwelling units on each floor , , , ,
If garage, number of cars 2..
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~7. ti::9 , , , , , , , , ,
7. Dmiensions of existing structures, if any. Front . /1!?'.~?':~-... . ,Rear . Depth .
Height . . . Number of Stones .
Dmlensions of same structure with alterations or additions Front . N.° N'~........... Rear .
Depth . Height . ......Number of Stones . ~
8. Dimennons of entire ne onstruchon. Front . .$~~.-7t Rear Depth ~Z.`,Z t, 3E ;
Hei_ht Number of Stones ...fie-.F'O.".+"'~..!:~°°~ ~vid. nJY3~.'C"'':': ,~rl,
9. Size of lot roFn't .."L~..... Rear..9`~>9?. Depth ..36~...........
10 Date of Purchase . p~U..j (S ...............Name of Fom}er Owner . /Pa (je!PT, t~ • Nc Rk u s
11. Zone or use distract m which premises are situated ...'.,f~ ~SFd.B',~ ~:4 .4.-.~''. ~?!S!'47,~2~t. .
12. Does proposed construction violate any zoning law, ordinance or regulation N ~
13. Will lot be regraded . `~.1~'S'.. .Will excess fill be removed from premises. Yes
14, Name of Owner of premises /~•`R".~0. V.M • Address(??6. L!':°x~w'~Tq Cu?~'hone No. 7.? Y:.7,~7!•
Name of Architect . . ......Address . ..Phone No..........
Name of Contractor (s'R-p.R~1r.. ,~p,K : i .....Address 3`ft4.u~'i er ~.va:_ Cu;
cr{, phone No.7 SL ~t~.
IS.Is this property located within 300 feet of a tidal wetland? *YSS....NO...
*If yes, Southold Town Trustees Permit may be required. ~ES ~l' Pi?C c: ~,iC
PLOT DIAGRAM /f,qy ~s A 7'~°9L w Z~~9ND
Locate clean and distmctl all buddm s, whether existin or °T F,ruisR ''-J°
y y g g proposed, and indicate ail set-back dimensions f
property fines. Grve street and (?lock number or descnption according to deed, and show street names and indicate whe
intenor or corner lot.
.Biz f}i%/)ctla~ /pc.gas'
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~xl~fL'Rr o.R Lei S6S5 FlA SSAU Pi RD.
I
STATE OF NEW YORK, S S
COUNTY OF ~z' F=.~ arc i .
• • • . • • ./`7/it Rac,/1 . • 4~ N1 C C+ 7 being duly sworn, deposes and says that he is the apple
(Name of individual signing contract)
above named
He is the . C`7 C,C~ 1~
. . .
(Contractor, agent, corporate officer,ete.)
of smd owner or owners, and is duly authonzed to perform or have performed the smd work and to make and file
application, that all statements contained m this application are true to the best of lus knowledge and belief, and that
work will be perfoimed in the manner set forth m the application filed therewith.
Sworn to before me this~~~~-vp~
..~.~~J~/~~: ;day of 19~.SD
Notary Public,~`~-~'_ _ 2E' County
d't n'1 ~j
CLAIRE L. BLEW •••••,v c
NogrY ti~wYork /
(Signature of applic;
<3uefltfed in Sut?o1k CwiMy
Commissron Expinra Oacembsr $.19~
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