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HomeMy WebLinkAbout17220-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217544 Date NOVEMBER 28, 198$ THIS CERTIFIES that the building ADDITION AND ALTERATION . Location of Property 6125 SKUNK LANE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 04 Lot O1 Subdivision NASSAU FARMS Filed Map No. 1179 Lot No. P/0 130 conforms substantially to the Application for Building Permit heretofore filed in this office dated SLILY 7, 1988 pursuant to which Building Permit No. 172202 dated JULY 15, 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 AND ALTERATION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ELWOOD AND CAROL HUGHES (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N045307 NOVEMBER 11 1988 PLUMBERS CERTIFICATION DATED N/A uildinq Inspector Rev. 1/81 r~oeas 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) NO ~1722~ Z Dote 19~1...t~ Permission is hereby granted to: to ~.f~41~~'..~...~.~2...l-.~'r~.r.~~ 9.:. rte...-.~~~'. ~ Q/!~?K~ ........~tla<.........~~`~• , ct premises located of . . . . . . . . . . . . . .....~/..l!....... . . . . . , . . . . . . . . . County Tax Map No. 1000 Section ....../...~.7......, Block ...............T.. Lot No.........Q~...... pursuant to cpplication doted 19..:1/, and approved by the Building Inspector. v a Fee t ;rp . ~ ng nspector Rev. 6/30/80 . D ~ o FORM NO. 6 ~ ~ imD TOWN OF SOUTHOLD I Building Department l~ - avr~ Town Hall ~ _ : i'CHOLt7 Southold, N.Y. 11971 765 - 1802 p~ ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY (claS Cui~'. Instructions A. This application must be filled in typewriter OR ink, and submitted ~ e~si to the Building lnspec- torwith 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 or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 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. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory $10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 A/ ~ /~Q~, 5.Updated C.O. $ 50.00 Date C~ NewConstruction,,,,,,OldorPre-existing Building Vacant Land Location of Property ~2 J vlf.1~~-, , , (,.-s ~,/(,1~, , , , . ~:'~1 ~ Nouse No. Sweet Ham/et Owner or Owners of Property . ~L:G~?4'?s?? ~ . ~E, ~jQ ~,~J,L , ,~f,,,~~~ /~(>~°s- f' . County Tax M,(ap~No. 1000 Section Block ~ Lot . Subdivision Y~S~S.I,~v , ~f;~ j~!Jf , , , , , , ,Filed Map No. ~~.7~ , ,Lot No. 1~, C,'~ 7.711 '7 c2 ~ Permit No.~l ?G: G~.Y~ate of,,P//ermit !/~:S/4?~/,gpplicant . r7~~e.~{.f~-.fir,. , /~L.Ge?e?G1J ~/,e%~-~ Health Dept. Approval /Y.~.... ...Labor Dept. Approval ~r.~... . Underwriters Approval ../Y. ~~?~~G~ , , ,planning Board Approval . Request for Temporary Certificate ............Final Certificate . . Fee Submitted$...~',5.~„C.~,U.,,,,,,,,.„..,. Construction on above described building and ~ eels all p e codes regulations. APPlicant . Rev. 10-10-78 3Ga0~ ~°a z ~ 75~ ~ _ i~~a~/~8 -1ELD II:S:'ECTIUN (~llATr. ~ i;OhfMENTS ~ . FOUIJDATION (1st) ~ FOUNDATIOIJ ( 2nd ) m~~j Z . ay - - ~ X~..., o~ P,OUGH FRAME ~ T '~h~~~~-K- PLUMBING ti 3. ~ cn rn IIJSULATION PER N. Y. STATE ENERGY CODE x 4 . ~ © r FZiJAL z ADDITIONAL COMMENTS: ~ x 1 tf ' x ~ ro H ~ l"n` • 9 H H p.~ O \^V 2 Sl ' ~ R7 a A~\~ r y ~l x d m H l THE Nf W YORK BOARD OF FEE UNDERWRITERS a_oaaa2t BUREAU OF ELECTRICfTY lVC>V:F:afRJE:t2 21 , f i R~'~HN STREET. NEW YORK. NEgY~V 240R$/k8 3H Id {?t1,53(7 Date Application No. on file _ THIS CERTIFIES THAT only the slectrlcd equipment to described helots wsd inetvducsd by the tgtp/Iwst roomed on the oboro epp/iwtion number in [he promises o f YIIGitH7>I) HUC,HiT3, 6125 nSKL)NR YIANi;, CII`C't'gUGUk1, N. Y. in thefdlotcinR klc EM1)~~."Ft9F;K Berelp's$tR ~ Ist Ff. ? Ynd Fl. .Section Block Lot msr examined on lM nrlta [J ~ 7S Md found to bein rnmplionce with the reyuirementa of this Board. HX1uR! AGl6 ST[ITGIlS ~ RAFlOlf GOORIPI6 GlCRS OVlNS WASNlRS lXNAUSi FANS OUTLETS INCANDE[CENi FIUGRNCENf v AMt. K.W. AMT. K. W. AMT. K.W. AMT. t. W. AMT. M. P. G 6 6 ~ p. DRYERS RIRNAC! MOTORS RITW MNIANIq IEpRi SMICIAL RRC'fT TIAAl GCCRS UNIT MEATlRS AWLT40UpET dMMlRS AMi. K. W. pl N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMT. AMT. AMIb. TRANS. AMT. N. P. a ~T AMT. WATt] 2?~ SW VICE DISCONNECT tq.Of S E R V 1 C F - AMT. AMT. IYP! ~ 1 N TV 1 A ]W ] 6 TV 3,I ~W ~ Cf. COND. A. W. O. NO. OF N4LEG A. W. G. A. W G. PER / ff fC. COND. OF NI.IEG NO.OP NFUTRAlS OP NEUTRAL Q OTNM MIARATU4 r c_x--t itAttC, N.. HUt?NB X75 'C!!IiN HAi?R?>}t :I,ABt; St>IJ'rHpT,U, NY, l14'li olNtµ 1;S I ~ lISCF~NSF; N0. 2R2iti Per ~ This t»rfiiictde must tat be altgttd in any manner; rdurn to tlw oHics of. t~tt , ilinctsrrM. Inspectorsmay 6e iMttlHad thttir credsmials. - 'F QOrY QEPAltTM~lT GF CE~TtFIG4T! #RT NQT ~ ALT 111' - I I uJ4?!1 ~/dK I 1 ' 2!6.93 ~ ~ ~a: ~ 1 6. X6'34"G"~. ~O . n ' m I `4 . ~ T ~ 1 ~ N col , r u! 0 10 N ~ z ~ ; y' o 5+~ b , ~ k ~U ~ y~ 1~1' p~' ~ i VI O !U ~ i ' h j!• ~ {1112 ~ 7 N 3 I;yl gaf P°~ i~ ~ Q{ a ~ 1 l~ ~ ~ ~ ~ I a' ~ ~ isa..^! i G ~r~`'^ 1a~~ r, ddd / ~~~~'jsy 36 ~ $nrll~ ""t 4-.r-..._. 2.7.OO~l .L.'.a3' .d1 tj5 / ~f a9 538 ~an~~f i v. ~ V d. bl ~ n I-~.._~ L"G N i i o N s Q s l~eO~ 4f b C. % ~ ~~i M 0 Vl 2 ~u b ~ Z V MUD I lo' •,i,r ~ ~f 1ryJt~ Z i. ,v~~ ~ n ~~U. o o u ~ l LC ` CO ~ ~ ~ J t, t ~ b ~ C~. ~ ~J .Q h ~ Vie. ~ 41S'r ~ ~ It1{ ~ V a yl m V~ u i / C1, 3 J 4 ~ a h~ k 4 u c b >,4 { y i 1 I o W U e ~ ~ l 7LZ~ ~~.~802 BUILDING DEPT. INSPECTION [)FOUNDATION 1ST [ ) R GH PLBG. [ ]FOUNDATION 2ND [)INSULATION [~RAMING [)FINAL REMARKS: t ' DATE INSPECTOR l 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL RE ARKS: ~"'6~~~a.~~ DATE 4 INSPECTOR ~ ~v~~ tss-1soZ BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] 1NS CATION [ ]FRAMING [ FINAL REMARKS: DATE J~ ~ ~ ~ INBPE~CTOR • . . Y._ ~ - , 765-1802 BUILDING DEPT. INSIPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: d < DAtE INSPECTO y + v _ _ BOARD OF HEALTH la!~~3,_!-!\..1... 3 SETS OF • PLANS . ~'7 .7 ~ FORMN0.1 SURVEY 'f ~I TOWN OF SOUTHOLD CHECK ~ BUILDING DEPARTMENT SEPTIC FORM . ,,,__~~~„JJJ TOWN HALL u SOUTHOLD, N.Y. 11971 NOTIFY FsLDG.DE~tT. TEL.: 765-1802 CALL ` TOWiV OF SOUTHOLO • MAIL T0: Examined . ~//s' • • • • • 19 ' Approved ...`7,//S.~ 19~~ Permit No.l~°.2• °z ~ Disapproved a//c . (Bui mg In ctor) APPLICATION FOR BUILDING PERMIT 4 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 whote 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 iemoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances~buil~ding code, housi code~tegu ions, and to admit authorized inspectors on premises and in building for necessary i~='.~-ions. . . (Signature ova licant, /name, a corporanon) (Mailing address of applicant) 77~-~-> State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..T.~~C.e1QG?XZ..f.T.~.~?z~~S•~•/~17~~~..•••••••••••••••••••••••••••••••••• (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate of~fJice~r)/ Builder's License No. . •(•~~•jj~• ~ Plumber's License No. ........c(.4 0(..4. • Electrician's License No . . Other Trade's License No . . I. Location of land on which proposed work will be done . . / / .~a./.~.~..~~vu~..~r~!t!~".(.~~.r~l~?~Y..7'~.YFv~ ..Gd.~Tc,E!'c?~~t~.../~T House Number J S~/treet / Hamlet County Tax Map No. 1000 Section 1. U.. Block Lot Subdivision . 7a~J~.-~!~. ~ Filed Map No. ~ 79 Lot . ~ . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~gsl17.G''7th.G~ . b. Intended use and occupancy ~~7•~~~~r•••••••••••••• s i 3. F etuur= of work (check which a Ilplicable): New Building Addition ~ Alteration . p Removal . . . . Demolition , Other Work , . 4, Estimated Cost ! . ~ Q. < .D. ~ Fee . g' (to be paid on filing this application) S. If dwelling, number of dwellin 'units , . ~~L...... Number of dwelling units on each floor . If garage, number of cars ~ F . 6, If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front ~.Jr........ Rear . ~.ar•......... De th , , , , . P Height ~ Z Number of Stories ~~Z, .d,',/, , . Dimensions of same structure with alterations or additions: Front ...~4.~~........... Rear . /lP.~ . p r~ 8, I)imension~~ e t rye new const 'Height 2.G....... j .......Number of Stories Lfz.4! . , , , , , , , ` v ruction: Front /.~t Rear .....Depth .7i.~3, , , , . Hei ht Nunlbe~ of Stories Q . v . ...lP.::93 Depth .~//~~:.....33~.......... 7 •I~g~ Rear : Name of Former Owner !S..:~!1r1.9~e.~t?.. . Date of Purchase f1~./~ 11, lone or use district in w~ h ~ ~ p~misesaresituated,,,,,,,,,,,,,,,,,,,,,,,,,, • 12i Does proposed construction~ v~o(ate any zoning law, ordinance or regulation: . l3. Will lot be regraded ....lY.Q......... .Will excess fill be removed from premises: Yes Nom .....L P 14, Name of OArchitect remi~~ ~~,~eroc?b.. , ,U4,~fyjrAddress~/ZSS,ru.<!r C,u • , ,phone No. ~/~.:?3.T.?c.?!~ . ................Address ...................Phone No. Name of Contractor .Address ...................Phone No............:.. . S'l" !%n ,~aac/ c g PLOT DIAGRAM Locate cle ly and distinctly alll buIldings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description acco~r~d~g to deed, and show street names and,indicate whether interior or corner lot. ~ D VYa r'?`s ~ l y ~ ~ 93 Z~ 3d ~t3.GO o \ ~ v3- g 7' 4 i ~ ~ { A .~K ' i ~ 'S ~n vJ .w ~ T ~ 4 ~ - ~0 o ~ 0 ~ N~cc~ g'orch ,~,rz~cns~n ~ ~ W N ~ Ql ~ s o ~ N , y STATE OF NEW YORK, i ti>9tl ~S.S 92._ COUNTY OF ~ Sd • • • • • • • • • • • • • • • • • • • • • • • being duly sworn, oses and says that he is the applicant (Name of individual sign}ng contract) above named. \ ~d ,3q,6/' He is the. ....569°23'6d"............ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dull 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 ...............].........daffy/ofi.!~. r/ 19 ~g Notary Public, : IH!R-: Y,~~-:.. , County C=: ~ ~py HELEN K DE VOE No PUBLIC State of New York • . " . ~ Nc 470%8%B,Sufr°IkCounyk'Q (Signatur of applicant) Term Expires March 30, ly.._! i y. t ' ` try ~ i, .4 Ci ~ • . ~ ~ rl t~ 4 U 7t1 ~n "t~ = -t h a . G 9 c, s r Ail ~ b ~ ~r n ~n G ;,C ,r~~.t M1 p o! to 0 ' ,4 nl. ~ - ~~GV ' t ~ 0 ~ s; ^ SFr ~ ~ t ~ o ^'i t,, r ' , • ~S V ~ ~ p A° Tea ~ i n • •6~ f E. ~ ~ ~ RG ~ a t1n`~ ~..hn r ~ ~ ~ ~ ~ 1 (1 i - ~ ~ _ ~p~ ~ ~ r.A; ~ ~ s4 t ~ ~ t~ ! ~h~ ~Or~,~ A ~ ~ ~ ?J IZ} ~ y ~ ~ i ~ ti~ ~ n I ~ ~ i ti 't ~ ti, } ~ ~V~ ~ f Sr P7 Q ~ .F' r~U t Q ~ j~ ti ~ ~ 1 Pd ~ ~ ~ t .lf, t~l ~ ~'~^IZ i rr