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Home My WebLink About23540-z r ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24548 Date AUGUST 5, 1996 THIS CERTIFIES that the building ALTERATION Location of Property 2515 PINE TREE RD. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 3 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 11, 1996 pursuant to which Building Permit No. 23540-Z dated JUNE 27, 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ie ALTER 2ND FLOOR OF GARAGE TO NON-HABITABLE STORAGE SPACE IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT". The certificate is issued to EUGENE & ANN BURGER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-225513 - FEBRUARY 21, 1992 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 !'OHM NO. a 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) 1V° 23540 Z Date ..................5 Z/..................... Permission is hereby granted to: t..11.."!......f�' ..........................�.J.?g.... ... ? ....... � zx7fr.. . ........... s... /. ....... 1. 3� to .. "— .......lyell.. .d. .... ......... 1_4 4C- ...... . . . ..... . .. at premises located at f �2 ......................................................................... - .................................................... .................................................................................... . . ................................................ � .... .... County Tax Map No. 1000 Section ..,1� /..../... Block .......6 ...... Lot No. ...... ........... pursuant to application dated .....................lQyl 1......................, 19.,1 ?, and approved by the Building Inspector. Fee $....✓.//J/pe.......�.... .l .... ........................ ingilnspector Rev. 6/30/80 i Form No. 6 754ILD +, : TOWN OF SOUTHOLD 119 3 5 �y�. I BUILDING DEPARTMENT AUG q TOWN HALL (� 765-1802 C TOWN OF SOUTFtn�n APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitter( to the building inspector with the following: for new building 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 from 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 the solder used in system contains less than 2/10 of 19 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. Y 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, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of 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 accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25C 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.000, IComme/rcial $15.00 Date . . . . .010m on;. . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre- sting B>ding, . . . . . Location of PropertyvAnj. . . . . . . . .IYon. . GT. . . . . : (� 5�.(} , House N/o �, Street Hamle t� Onweror Owners of Property. ,,. . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .f`� ..1. . . . . .Block. . . . . . A. . . . . . . .Lot. . . / . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . AtaA I c/../�Lot. . . . . . . . . . . . . ."�. .�.�. Permit NOARI Y&. . . .Date Of Permit. Q . `�7 HealthDept. Approval.. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval Request for: Temporary Certificate. . . . . . . . . . . Final. �e�ticate. . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'SI73Y / APP CANT C M * Iucuo� 22 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1861871 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK.NEW YORK 10038 Date FEBRUARY 21,1992 .lppiirationNo.onfue 74845791191 R 225513 THIS CERTIFIES THAT �4y the slectrieal equipment as described bolom and introduced,by the applicant"mad on the above application nutnber in the premiier of EUGENE BURGER, 2515 PINE TREE ROAD, 2ND FL. , CUTCHOGUE, R.Y. .in thefallotcinx location; D Basement ❑ 1st F1. It --d Fi. ATTIC =Section Block ][,at some examined on FEBRUARY 18,1992 andfoand to be in eomplionre,rith the requirementx of this Board. FIXTURES I RAWAS 10DOKING DECKS I OVENS VISHAVASHERS EXHAUST TANS OUTLETS �KWJ ACNES SW1TUfE5 Hcu Dtstcw nuoetscEM oTxEx IMT t W. AMT. r w. AMT. t.w AMT s.w. 15 25 25 11 3 F mayor +RIRNACE MOTORS lUTURE AMUANCE IBM REC►T TIME CLOCXS ,WUttNRyIEAItlS AtAMWILET: ZMAMERS •AMT. x.w. 011 KP. 'GAS K}. MIT. w0. AW.G, .ANT. AMP. ANT. MVS. 7eAN5. --,T---,—]' [Nt)--0F,Wsystm AMT. WAr" 1 2 8 I lR1IIff<OISLOlItilCT - OF . _ E _ . _V " I �C . 1E JJI,T. AMr. TTIE �. I.e'1W 1 X AM t/7W 3 R M' �'OiECC f�D. a CC.COMD. ,NIEG ':N.4 G. NO Ce HEUrtAt2i FIT At OT/IHAltAIlATUS: _. _ . . H040RSt1-8.58 B.P. ,1-F H.P. PANELBOARDSt1-9 -CIR. 166 G.It.C.Ie-3 SMOKE DETBCTORt-1 1 TRACE LIGHTINGt-8 G & S CONTRACTOR LIC.=578-E BOX 215 SOUTHOLD, NY, 11971 °OMM AtAwAon 11 QV per- This n•This eartifitate must not be altered in.any moaner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ } FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 421L Z2 DATE INSPECTOR BOAFD OF HEALTH . . . . . . . . �ORMNO. 1 7 SETS OF PLANS . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . . . . TOWN HALL SEPTIC FORH . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY ; CALL . I _,.. . Examined . . . . . SR .� . . ., 19 1.7:' - tIA I L TO : . . . . Q/ t Approved . . . . . 1�,��7 . . . ., 19(. J 'Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6)a /nsp tor) APPLICATION FOR BUILDING PERMIT Q/ Date :. d^Q . . . . . . ., 19 `h INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stiee or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl 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 perm sl}all 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 Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and t( admit authorized inspectors on premises and in building for necessary inspections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) - State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises .Lt,��I n ! . .(./U. (1. 1.4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (a 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. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'yn/ Z S .S . . . . . . . . . . . . . . . . . . . . . t !J L�. . . . . . . . .� . . . . 11-. . ., . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . :4Q. . . . . . . . . Black . . .3. . . . . . . . . : . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) , 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . .f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . .� >. �� L. . . . ' -3. Nature of work (check which applicable): New Building . . . . . . . . . .. Addition . . . . . . . . . . Alteration : . . . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition Other Work . . . . . . . . . (Description) 4. Estimated Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. I:f business, commercial or mixed occupancy, specify nature and extent of•each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front � � �. Rear . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . Num a of S ries . . . . . . . . . . . : . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . .Height . Number of Stories . . . . . . . . . . . . . . . 9. Size of lot: Front . . .X04, Rear . . . . .67..g�. . . . ... . . . . . . . epth 1 zSQ. 10. Date of Purchase !l.(. .�. . . . . . . . . . . . . . . . Name of Former Owner � -(�! . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . , . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . .Q. . . . . . . . . . .. . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an&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. APPROVED AS NOTED DATE: B.P.# FEE: BY: 9 NOTIFY BUILDING 'DEPAATMENT AT 765-1802 9 AM TO 4 PM FOR THE ^q a FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED ._.s.... FOR POURED CONCRETE w STJJZ�Q 2. ROUGH - FRAMING & PLUMBING 4. FNSULATION INALL CONSTRUCTION MUST C BE COMPLETE FOR C.O. J ALL CONSTRUCTION SHALL MEET 6THE REQUIREMENTS OF THE N.Y. c STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS UNDERWRITERS CERTIFICATE REQUIRED TATE OF N PE. . . . OUNTY OF . . . . . . r. . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individu signing contract) bove named. le is the . . . . . . . . . . . . . . . .v or... . . . .. . . . . . . . . . (Contractor, agent, corporate officer, etc.) Ip f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to. the best of his knowledge and belief;and that the ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . . . . . . . .�'� d . . .day of. . . . . . . . . . . .. 19 . �otary Public Y`". County CLAIRE L.GLEW Notary Public State of New York No.4879505 (Signature of applicant) Qualified in Suffolk County Commission Expires December 8,19 J rJ IF I N. it 4