Loading...
HomeMy WebLinkAbout17040-z FORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217908 Date MARCH 31, 1989 THIS CERTIFIES that the building ADDITION Location of Property 550 WEST' CREEK AVE. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 13 Lot 5.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10, 1988 pursuant to which Building Permit No. 170402 dated MAY 27 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 DORMER ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to LINDA FAULKNER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N057655 FEB. 7, 1989 PLUMBERS CERTIFICATION DATED N/A r Bui di Inspector Rev. 1/81 8oaae< xo. s TOWN OF SOUTHOLD BYiILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BURDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLEi'ION OF THE WORK AUTHORIZED) NO 01740 Z Date l~.Y7 Permission is hereby granted t~ _ ..~~.2~SGG~. / / at premises locoted at ~~2;...~.~u7.••..,............................................. .~!f`s ~iti~" County Tax Map No. 1000 Section ...~~.3....... Block ......~':3....... Lot No...... 5..:. pursuant to application doted 19 and approved by the Building Inspector. ~J ,3-v Fee $./~?•9... Bulld{ Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 ~9~~ to the Building Inspec- 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 buitdings, 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 1. Certificate of occupancy New Dwelling, $25.-00, Accessory ]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 i 4. Vacant Land C.O. $ 20.00 ~ ~ ~ ~ S.Uodated C.O. $ 50.00 Date ....1.....~....~ NewConstruction,,,.„ Old or Pre-existing Building Vacant Land S3 J tt~~ C to . Location of Property ~ Y."Q............................ . House No. / l Street Hamlet Owner or Owners of Property ...I-~ .l.r~~xr~ 2, i~.1.~.» ~ !Z . County Tax Map No. 1000 Section . d.3......... Block r,3.... , Lot . , Subdivision . . . ...Filed Map No. . ' .......Lot No. . Permit No.vi7 v QED ~ S/d / Date of Permit ~,1~.~..Applicant ..,C~,r_ 6 r~t , ,l~ 2 ~„cp, , , , , , , , , , , , , , Health Dept. Approval :...............Labor Dept. Approval / Underwriters App(oval ........................Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted . . Construction on above described building an rmit mee'ts~~alJl ap licable codes and regulations. Applicant ..`.".4.°.1 Rev. 10-i0-78 ~ l~ ~ ~ e~ q ~0 l q~,~'Jt~~ 1 =i~LD I.:Si 'C:iU~i ~~Ui„c ~ ~~:KMLNT° ~ - V i T - H~ H FOUNDATION (1st) ~n,O FOUNDATION (2nd) _ - cn3~ z . dx(o c~_ t4 x ~ a1 ~ o ROUGH FRAME & PLUMBING J , , H 3. " ItdSULATI0P1 PER N. X. y STATE ENERGY CODE x a FI;dAL~ ~~y~ ~ tLd~LC ~v o z` ADDITIONAL COMM NTS: _ _ Yx ~ ' x~ ~n H H~ H O~ z . ~ b r r~~ m ~n H THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ tSQr) i BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK T0038 Y'7;}s ti'I,iE1kY a'i ,'l yg;y rr (.l. r~`t.?K$lq"e,~ s"i %y16 rLi'i i~ pate Appliro[ion No. on file THIS CERTIFIES THAT only the efectricaf equipment as described 6ebw and introduced by the applicant named on the above application number in the premises of .7 !ti. l: Ai,f.~K?<I h~1_2; WM;:+'1" ('k~~}ti l( A4T`r;,, t'if`)'4'tjL)i$fjiti, I~,~Y. in the folfowinq locations ~ $ se Cryt ? Lst Fl. Ll 2nd Fl. .Sertion Block Lot .f H1Vtr lxk . .,Yi , F;"h nna exornined orz and found to be in cornplimu•e with the requirentea6r o/this poard. FIxTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FWORESCENi OTHEH pMi K W AMT K W AMT KW AMi K.W AMT. H P u Zu t t I ,I la DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI-OUTLET DIMMERS AMi K. W. OIL H P. GAS H. P AMT. NO A W. G AML MAP AMi AMPS TRANS. AMT H p SYSTEMS AMT WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP rypE METER I YW L 3W 0.a 3W 3 B 4W NO. OF CC COND. A W G NO OF HI-LEG A' W' G NO OF NEUTRALS A. W. G. EQUIP. PER A OF CC.COND OF HbIEG OF NEUTRAL OTHER APPARATUS: h;llk?(', (~<is )r.f 9'i N;'A'I'1',k~tl~-',Ql,i K,t'f i,_(:){'LEI i(,ul., I,-!hilt? K.~7 R7.na'. (tii Xtrl lTl":,^~2`i4H~^.t-S~(Itlll lt.§f, ,.4 -'7, I~ft{)'i;.bl. f~. ~',t' f'. 1+~,(i r, N- ijlilt Pdti / ?FI 'I'tYdV+~I Il/1}2,iHUd; t,nll?}; 5(+i3'(`f{{Pr„). ~'y', i i'~7"I GENERAL NAG R i I !',i.T"~~f'<:;hi Nti?, ~;3;: R Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their crede ials. COPY FOR BUILDING DEPARYMENT. THIS C®PY OF CERTIFICATE MUST NOT BE ALTERED IN ANY HANDIER. / 7 O ;~o ~s~-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] (FRAMING [ ]FINAL REMARKS: r~~~~-e- .~Q~~~ ~ ~ ~~~e DATE C~ /7 C~ INSPECTOR tf 7~ I ~~©~o 7sS-1802 6cU1LDiNG DEPT. INSP~CTI~?N [ ]FOUNDATION 1ST [ 1 ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I//NS' ULATION [ ]FRAMING [v}'FINAL I~ ~ L DATE ~ 02 INSPECTOR C ~a ~~s-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ~ FOUNDATION 2ND [ ]INSULATION [~RAMlNG [ ]FINAL REMARKS: _~~f~ r.,~_ DATE ` INSPECTOR ~'~l. r' BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ]ROUGH PLBG. [ ] F UNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: i /9 ~ ~yL i u DATE ~ INSPECTOR CP~c~- ~j~~ _Y FORM NO. 1 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ( 0 TOWN HALL I` SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined./~•~7••••••••~19j Receive,d~..',4........,19... Approved . /R~y~• • • • • • • 19~~!. Permit No.~7~ Pte`""'' ~ Disapproved/a/c ' (Bzlildin Spector) APPLICATION FOR BUILDING PERMIT _ Date ~ 19 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 Department 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 necessa ections. (Signature of applicant, or nam , 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 h ! I.v T~0..v'~/.JrsI . (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. . J..3. CJ • • ~ -i' Plumber's License No . . ' Electrician's License No. . Other Trade's License No. . 1. Location of land on which proposed work will be done . . ~a c~?~- Cr.~.eK... Vie::..... ~ ~ :t~-~~~ . House Number Street Hamlet County Tax Map No. 1000 Section Block ~ ~ 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 ...~I-~.-.~lt•c~ e.r:'i. C,.'~ . 11 b. Intended use and occupancy ...'E-..S..I..d..e . y1,C• f', • ' n i 3. Nature of work (check which applicable): New Building Addition ` bilteration . Repair Removal Demolition ..............Other Work . ff,, , (Description) 4. Estimated Cost . °~:.'7: i . C? . Fee . (to be paid on filing this application) 5. If dwe lling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars - . 6. If business, commercial or mixa',d occupancy, specify natu~e and extent of each t}~pe of use ~ . 7. Dimensions o existing structure s, if any: Front . Rear S. De th . ~ 1 P Height 2 Number of Stories . . ~ , . ~ ith alterations or additions: Front . S..~............ Rear ,S.. ~ . D ptehnsions~same stmcture w Height Number of Stories ..2---................ . 8. hem h{sio~n~s o`~f e tire new c Num ction: Front Rea; 5: De th ~.4 g ber of Stories ~ ~ P , 9. liize of lot: Front 'y Rear Depth 11. ;Lone or use district in whi he pr ' ' ' ' ' ' ' • ;~ame o/EFormgr Ownyr . ' 10. Date of Purchase emises are situated . ...n.. /.s"~ . 12. Does proposed constructi vio g g~a late any zoning law, ordinance or regulation: ~d.G? . 13. Will lot be re raded 6 Will ces 11 be r m ved from premises: Yes 14. Name of Owner of remise5'~'~~a ~ }"ak~Lh r Addres~eS'~~oP~ ~ve Z, p ..........Phone No7,~~/~. . . . Name of Architect ........................Address Phone No............... . sec>~- ~@-Q.2 ......Addres~°o.S~.~Sero~~/~!%f?honaNo.'?6:~.-S.~f.~Z. ame o ontractor ~ 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. ' / / P ~ o? hcl S7~ar1 ~1 ~.~9~~ ~2S t on ~ t"1~ S'c`T aa~g a~••t-'~ ~ ~'r-~• , i STATE OF EW YORK, ~ S.S COUNTY ~ being duly sworn, deposes and says that he is the applicant (Name of individual sfgriing contract) above named. He is the. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements conttined 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 I ~1:. ....day of ......./.~4. 19 Notary Public, ~C4~ m'L' (~Q:e-! County . NELEN K. 0 T~xEm~Exp~res'hOG~ New Yak . No.470787R Sut%~u~ ~Q (Signature of applicant) J ~ O°-~"/ v ~ ~ ~ ~ {tt ~ ~ ~ ~fG l~~ n ~ ~ Q ~ k r~ o ~ ~ , ~ a lit ~ ~~~~i. 504.58 ~ ~r'4~re e y t<~`~,~ ~ ll ~ ~ ~ ~ Ave, uJ i5~': ~ ~e ~ Rt ss ~ ~ ~y~ 1 ~ tip, ~ ~ 4~~., ~ ~ ~ ` icy > ~ 1 ~ ._f C,, ~ y`~ 'D ~ -4,, ~ ~ Q, ~ ~ `-k ~ ,I R1 " 1 /f~~ ~ ~ ~ ~ do i~ ~ v ~y. `w ~ r 4 ~ ~ v A ~ b` , f ~ ~ i ti y ="v U', / f, i ~ 1 "t- C~k, 9;~ 1 ~ ' ~ i~l ~ A X ~~t~ i . ~ ~ VV p R, (~y0 l~~y F ~~t y~ ~ ~ j m M ~ . Yr ~ ~ O ~ ~ ..l ~z~gg m . 1~ tJ ,e m ~ r ~ T ~ ~ WS ~6 p O ~ q. r`' Z y ~ . 1 i<'ta-i-i©rz fbr ?~rtrcul . - °m ~ to D= b o m c c O{ 2 .~~..~-`t~ t m m R Y \J ~ C ~ N m cZn -mn m c ,.-3 l,; ~ n . r~ ~ 4~ ~ ~ y O t~.' ~ ~ it~ni ~I p ~ .q < p in p p m f ~ ~~3' ~ ~ U~ D Any ~AN-D+ o 3• ~ ~ tTt ? c~ 2' s~` D r m e D 3 m r ~ ~ ~ umi ~n ~ p z D m -i ~ x ~ ~i x { ~ x D ~ r ~~~6roo~ ~S ~a ;~c- ~ a o z 3 <®bo c~ ,y~ tQ~~ Q~ 'D D 'mo m Z ~1 to Q m $ ~~§x.N,~ ~N~~ f~s~ m t O ~ 0 g ~ ~ 'iA ~~c°~i; m=o` ,ice ~ 4~` ~ tp A r D D m ~ RI ~ o°zpO°r. Fa ~ ~ p ~ A m 4l Z D r a ~~i tv ~ D D m ~ N n p v ~$~~vo$ y r 2 ~ p ut O h e~~ ~ rD- n -1 ~ vOi D ~ O m 2 r D r x !n m r r ' i