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HomeMy WebLinkAbout17252-z . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18246 Date AUGUST 4, 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 35500 MAIN ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 097 Block 02 Lot 03 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 1988 pursuant to which Building Permit No. 17252-Z dated JULY 20 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 ABOVE GROUND SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to ANYONE & ROSEMARY WYSOCKI (owners} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-029692 - AUGUST 24 1988 PLUMBERS CERTIFICATION DATED N/A ~~L _ Building Inspector Rev. 1/81 vows 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~ 017252 Z Date 19.~'.g Permission is hereby gron o: ~S O 0......~. 1 ~ It .~.'.M...~M~._ 9.~~.... ~ ~ n - . _ t~o .O\'T~S-~.. ;4d.~::f~!....... ~:?......4t,~-O' "5.~.~.)...~y,?!-5..~.... 44.......~....~t//- _ " l . . . . . . . . . . . . . . I . 1. . . .J . . . . . . r . . . . . . . . . . . at premises located at ..°~.S ~.Q:'^:' ~ 4~t~" Caunty Tax Map No. 1000 Section ....x.9.7....... Block ........4?'.~°:..... Lot No....©..~........... pursuant to opplication doted .........~.A~q...~.++1~ 19.~.~., and approved by the Building Inspector, ` Fee $..L.a..~.:../.. r~iJL Gt.t Building Inspector Rev. 6/30/80 FORM N0.6 (JD o`~-~r M~~~ TOWN OF SOUTHOLD t j~,~ Building Department W " U~ Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building In~ec- 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 asto 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 BrYsiness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10 .00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date NewConstruction,,,,,,OldorPre-existingBuildinyg Vacant Land Location of Property .,~s? ~,Gl,~ ...............~llAl.Ily!. F.~....~~~c~O~~CC'', House No. Street Hamlet p v Rn-1:7to,oO~~.:¢:...Q~S.~ /~?/.~2~/... l.~C~,~!soc.~~......... . Owner or Owners of Pro ert County Tax Map No. 1000 Section Block . , . Lot . Subdivision .................................Filed Map No. ..........Lot No. . permit No. Q~7~:5:2?Date of Permit . ~,~.~r~Applicant .~?~?~O/i~ :f. ~6,5~??~?--1/. ,~/5~~~ Health Dept. Approval . ...............Labor Dept. Approval j Underwriters Approval ........................Planning Board Approval ~ . , , . Request for Temporary Certifica'te/, . . . . .Final Certificate , . c, V ~I ~ ~ -t Fee Submitted $ , . . Construction on above described building a~~n~~d~,,~~p~~er--mit meets all applicable cod~d regulations. Applicant t!.ls!~?".".~`r:~ Fev. 7010-78 ll.~ Q,~~c ~ 3°~gos ~o iga~P~ -1ELD Ii:SP2C.iU;+ ~~UATE ~ OOMMEN7~ r b~ ~ cn 1. ~ H l3~ ?OUNDATION (1st) f OUNDATIOW (2nd) - ~'j' c~~ 2. o yl ROUGH FRAME & PLUMBING .S y ~I H 3 . m ro p" H I1ISULATIOII PER N. Y. STATE ENERGY CODE x / ~ 4 . ii ~ FZi~AL ~ o z ADDITIOPIAL COM NTS: x m x ^o H 71 H ~ O +0 O . ~ RI A • r ~ H x c7 m ^o H 5a THE NEW YORK BOARD OF FIRE UNDERWRITERS °A 1f100719 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date AU6US9' 24,19$$ APPficotionNo.onfile 5585$gR$/$$ N q'I.9E+92 THIS CERTIFIES THAT only the electrlcal equipment oa described 6ebw and introduced by the opplicont named on the above applicotien number in the preMUUS of ANTONS J. NYSOCXI. JR., riAIN ROAI),HOX 29, CUT('HOCttJE, N.Y. OiIT in thefollotcing lceotion• gage~ept ~ 1st F6 ? Ynd Fl. Section Block Lot um examined on AIIG~IST 4 , 1.7 t58 ondfound to 6e in compliance frith the reyuirements of thia Board. R%lUR! R%TURES RANGES COOKIHO DECKS OVENS DISH WASHERS E%HAUST FANS OUTLETS ECR/TAC1E5 SWITCHES INCANDESCENT FIUDEESCENT v AMT. K.W. AMT. N.W. AMT. K.W. AMT. K.W. AMT. M. P. 1 t 1 DRYERS WRNACE MOTORS RITURE APPLIANCE RW!!5 SP[OAI REC'Pi TIMl CLOCKS YLL UNIT HEATERS MWT40UTIET DIMMERS AMT, t. W, ql M, P. GAS N. P. AMT. NO. A. W. G. AMT. AMI. AMT. AMPS. TRANS. AMT. N, e. SYSTEMS AMT. WAiT$ NO.OF PDT _ 2t1 t U SIRVIQ DISCONNECT NO.OP S E R V 1 C E AMT. AMI. TYPE pU1P. 1AtW IASW 7ATII SA AW ~~COND. OP CC.fOND. NO. OF N4lEG Of~N NO.aNEUTIIALS Dj'NEVTGNAI ATUS: PANELBOARoSc~l-?. C_CR. 5U G.:P'.C..J:-1 *(SNIririLNE; POg1,? '['hi.s Cert.lfi.l-afe clovers comp3iance at the date cii inspection only. $ecause of unusual environments it. is advisat~ln to nave frequent test land or repairs made by a anglified person. R.C. F1aF:CTRIC CORP. 11?, itRYLAND COURT O~ HOHENSA, NY, 1.1715 Psr 11 This certificate must not bs ahered in any manner; return to ths~~'fh~9oar~.~iQcorrM. Inspsttors may bs idenKfjad by their credentials. COPY FOR, WILDING DEPtiRTM@IT. THIS COPY OF CERTIFIGTE MUST NOT 6E,M.7ERHD IN ANY MANNER. ' L n R.~~~ ~ ~,.--a - 4~. M ~ ~ ----~.,,V"" ~"mot ~ ~ ~ ~ ~ ~s ~ ~ 3 - ~ F ~ 1 ~ e ~ 0....M..... i i ~~~v 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [FINAL REMARKS: ~ DATE ~ VINSPECTOR O I~ UI O W \ ry O Q 2 ~o° A , `o - -Y N Uf . tv f ~'c Q W ` ~ F '9 " o . ~ 9 0 ~ N ~ l~ 0 l!~ ~ 'Q X ..S~i~~nn,i+rq ~ ~ ~ 6~ k~ glToaN~ 1 N.40°09 E 46•zo ~ I k~ , w~ ~ r O IV . ~ o OCCtlPANC4' OR n , .USA 1S UHLA~'OL ~ N WITHOUT EERTIFtCATE ~ " p m .9REA ~ ~z. SB6 ,9cRE~F OCCUPANGY 'N G. ~ ~Q R a _ ~ 7 ~ a S R.1! M l 7~ ~ ~ q ~ • BY: ~ 'C'. L. ; o N~~ Y~~ UIWDNrQ~0EFi4RTM~ ENT A~ ` ~ t Z lr6-tAtM 9 AM TO A PM FOR T446 'e r~.~ e ~ fQLLOwING MISPECTIONS: ~ ' i. FOUNDJ1710N TWO REQUIRED ~ fl ~ + ` ~ , o !4111 MQUNE4 ETE ~ , ~ ~ ~,r. ~ 3. 110114111 • FIUUNNrO PLUMBING .•4, E, N4B1M~1E10N - s ~ ~ 41E I~44PLETE POR 4:.0. Ali. C011iwINICi1fIM l11A+lL MEET ~ ~ ~ MIII~~ ~ 711E MIG _ ~ i1NIGNOG~.1w10M491111~41i 9p1,/'~ 3 °s/;: 3 ` i r o s k stGP • 5ror° s ~ c ~ fi ~ A ~ MAP Of LAND ~;r r, SVRVEy60 FOR ~ t • ANTOl1/E:'WYSOCKl.4N0 MRRY WY 3/T(/ATE r~iT t''S'', EAST C UTCHOGUE 4' SuF-FOC.x COUNTY, N.Y. Ainri 1.Z9, l944 • BOA~.D OF HEALTH + FORMNO.1 3 SETS 'OF PLe1NS SURVEY TOWN OF SOUTHOLD CHECKt~..~.~0.f~ . BUILDING DEPARTMENT SEPTIC FORPI TOWN HALL vOUTHOLD, N.Y. 11~J71 NOTIFY - Q'~ TEL.:765-1802 CALL Examined 19~? MAIL TO ~~pproved ......~r{~ 19~ .Permit No. ~ e~$^o~ G p Disapproved a/c ~ i ~ t p (Building Inspector) ~~;~~AP~ APPLICATION FOR BUILDING PERMIT $LD(3. EFl: ateT,pWpf AF $0 . ' INSTRUCTIONS a. Tltis 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 t}tis 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 Department for the issuance of a Building Petmit 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 of 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 inspectio~ns./~' , Signat6rfe o~ plicant~or name, if a corporauon) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................~.+.,.I...c.....//...............,p...•.-•~........................................ ' Name of owner of premises .l,N ~~1.~.C/~ .~~~'~1~~4.. J ~ L.- . (as on the tax roll or latest deed) !f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No . Electrician's License No . . Outer Trade's License No . . I. Location of land on which proposed work will be done . ..3.S:~.oo fY~tr~..Ra~~D .................~...~~,~~I~~ House Number Street ~ ~V'~' ' ' " Hamlet l County Tax Map No. 1000 SCCtlO? ...q?.- BIPck , , , , , , , , , Lot Subdivision Filed Atap No. Lot . (Name) r State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~j y..... ~'~C.¢t~,~,'u:". :1.118.1.9 . ~ ` F< v. b. Intended use and occupancy ...........F?~':~. • • ..r.rlrl~. ~C J r a~~( ...`y ~ lfd~.~1 C+IfaNitMU~. . ~ . , pplic~ • • . • • • • la ble): New fluildin ' 3• Ratair of work (ch~k whichmoval , . • • • • g ~ ~ ' ' ' • • • Addition Alteration p Demolition . `~~°7 i~/a__ C~l.....e~ c~~a eue.i ......:.......Other ~Votk 4. Estimated Cost ' ' (Description) Fee..................................... g I (to be paid on filing this application) 5. If dtvellin~ number of dwellinf S • ~ • • • • • • • • Number of dwelling units on each floor , , , If ara~ c, number of cars ed occ ' ' . 6. If business, commercial or mtx upancy, specify nature and extent of each type of use . . . . . . ~ • 7. Dimensions of existing structutes, if any: Front . Hcighf Number of Stories , ...........,Rear Depth . Dimensions of same structure with al(erations or additions: Front • ~ • • ~ • ~ ' ' ' ' ' ' ' ' ' ' Depth . . Ileight . car . 8. Dimensions of entire new construction: Front , • ' ' ' ' ' ' • • • • Number of Stories . . . . . . • • • • height ,.Number of Stories • • Rear . .Depth . 9. Si~egflot: Front. Rear 10. Dgtg ofP Depth ' .Name of Former Owner • • ~ • ~ • • 11. Z~ne or n hich pl'emises are situated , ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' 13. ~o ro~osed constructiq~iyiglate arty zoning law, ordinance or regulation: ~ • • • 6.~•Fesruded t•,._. P 4 - r • • • • • • • • • • • • Will excess fill be removed from p emises: Yes No 14. nme•of Owner of rem'ses=,',!~, , , , , , , ,Address . Name of Architect "••••••••••••••••PhoneNo........ , ,Address . . Pho~~ne No.. . Name of Contractor...... ' ' .••.••.Address...~•••~•••••••••• ..Pho eNo.. 15.1:s this property looted within 3100 feet of a tidal wetland? *Y);5....NO....• *:Cf yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al) buildjngs, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block'numb$r or description according to deed, and show street n es and indicate whether interior or corner lot. /7'f'e ~ ~ l 4'~'L i i i I STATG OF NE~V~~ S ; COUNTY OF ~~,~g ~~'a'mc of i~ ividualsi~iri cont • ~ ~ ' ' ' ' • being duly sworn, deposes and say that he is the applicant ract) above named. ~9 Ile is Ute ......L/.~'~./~~Lro~...~~^K~~C~~/'•#~ . ontrac or, ,agent, corporate officer, etc.) of said owner or owners, and is duly ~uthor~zcd to perform or have performed the said work and to make and file this application; that all statements contained in this application are tnm to the best of his knowledge and belief; and that the work will be performed in the manner set fo tit in the application (tied therewith. Swom to before me this ~ daY l 194 Q \"otary Public County /fMNfr~~ ~dN~MYork~ t/ O~NNINdIh SuHoIkC only iSignatureofapplicant) OemMNNon l3tptre~ pecemb~r B, t>