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30575-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30512 Date: 10/22/04 THIS CERTIFIES that the building ADDITION Location of Property: 950 OAK ST CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 136 Block 1 Lot 37 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 19, 2004 pursuant to which Building Permit No. 30575-Z dated AUGUST 19, 2004 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 PATIO ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ERNEST M GUETTINGER & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -"�L � - /"-� A ori ed S16nature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 30575 Z Date AUGUST 19, 2004 Permission is hereby granted to: ERNEST M GUETTINGER & WF 950 OAK STREET CUTCHOGUE,NY 11935 for CONTRUCT PATIO ADDITION TO AN EXISTING ONE FAMILY DWELLING. THIS PERMIT REPLACES BP#11017 . at premises located at 950 OAK ST CUTCHOGUE County Tax Map No. 473889 Section 136 Block 0001 Lot No. 037 pursuant to application dated AUGUST 19, 2004 and approved by the Building Inspector to expire on FEBRUARY 19, 2006 . Fee $ 150 . 00 .ti Autho I ized ignature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 I% 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 uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and 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 Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. 10 - �)"q A Q New Construction: Old or Pre-existing Building: (check one) Location of Property: C7 1:"r) d 0,1k,- s- - 0,u._ ck© . House No. Street Hamlet Owner or Owners of Property: 2-- c (S L'�-r Suffolk County Tax Map No 1000, Section_ (ra Block3 Lot_ Subdivision _ c� Filed Map Lot: Permit No._ ,�06-7 5)_ Date of Permit. O '1°r oy Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:.. (check one) Fee Submitted: $ - L a '(�Q �i 30 t�- C(C'To3 Applicant Signature 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE � INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ . FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: s d� CQ-L Z3 8� DATE INSPECTOR- FIELD INSPECTION DATE COMMENTS ro 1, VA FOUNDATION (1st) : FOUNDATION (2nd) m CD 2. ROUGH FRAME & PLUMBING c 3. r CD m INSULATION PER N.Y. `� STATE ENERGY CODE f� Co &A�,� c+ FINAL c F w 4 /Z ADDITIONAL COMMENTS: �1 W w C+ W 0 • x C+ d ct FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined " '." . . . . 19 . 3 l�J� Application No.ll�� . . . . . . . . / -,Z Approve / ., 19 . . . Permit No. j . G— Disapprov a/c . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . ... . (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspections. c :. . . . . . . . . . . . . . . . . . . . (Signature of applicaanntt,;br name, if a corporation) (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. r Name of owner of premises . . . i c1.�j. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tdx 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 .-�. . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . .,,� . . . l . . . . . . . . . . . . . . . . .��,�r:�`1 c� �.�1. . :. .. House Number Street Hamlet County Tax Map No. 1000 Section . . -' ... . . . . . . . . Block . . i l. . . . . . . . . . . . Lot . . 6 3 �'. . . . . . . . . A-1 ' . . . . . . . Lot . . .. . . . . . . . . . . . Filed Map No. . . . . .f (Nme, 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .� . .Fl-. � �J • .r� '�� � 4�. . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy r . . .�' . . .l��Q. .��/?r�1��'Q .1. . . . . . . . . . . . . . . . . . . . . . . . c::L-: vI (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . .. ... . . . . Repair . . . . .. . . . . . ... . Removal . . . . . .: . . . . . . . Demolition . . . . . . . . . . . . . . Other Work. . . . . . . .... . . . . (Desmiption) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . f` . . . . . . . . . . . .. . . .. . ,. .. . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . .. . . Number of dwelling units on each floor. ... . . . . . . . . . . . . If garage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If 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 . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . .. . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . .. . . . . . . . . . Number of Stories . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '°9. Size of lot: Fwnt . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchm . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from xroperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. TATE OF NEW RK S S OU F . . • g• • • being duly sworn, deposes and says that he is the applicant (Name o 'ndividual si in co ract) bove named. eisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I. . .. .. . . . ... . . . . . . (Contractor, agent, corporate officer, etc.) 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 applicationare 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 . . . . . . . . . ,� . . . . .day of. . . . . . . . . .44.- . ., 19 . u of Public, . . . . . . . County ELIZABETH ANN NEVILLE $i atf NOTARY PUBLIC, State of New YA ( gnure oapplicant) No. 52.8125850, Suffolk Co"V-7 Term Expires March 30, 1 __ yV '•�`a `f#" r 1& 1 5'la.i q•. . ." AYr 3M I' „ y ,x .'s {.� - '� x •` 4 yr ,Y.. '4 � .y,1•}� • •„ttt5.x� C „t-,• ..��e.R} ,,.•}y, +f"".'��" yy S/�¢. ,+ •5+9•�` ��± rw.�,~y �,;��m'�'t� M1�..� `•a+^ ��& �.�^G° '� a .� `'� -�: .; i'"` . Q. 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I'��' r,1�•p�'er r `r.. a.., c ' _' c� - ;v r" V�(+ '• � Y yti �i � �• 't �t. � 1 1�� t.Fes\` ,Fr.y`��Z,` '.N 7 '.�,s,r,� • . of 6 3 i t_ ��` 's � �i", } .iY� � {+, s ;��i.� +� xt�'e a21v'� � ice"• �: i � �,.y.',F:r. r •, s t4a. ,��.�} - ', tom, +s a � } e. �� � r <'. F _ Y .._ ',, , � - i- r}�Y. t sy t �'} 3 �,r -v e" iJ i ..n.. # �•! t i. -}a_'.• 1 fr- w T ` #T ` '�� " 1 gYCt�a 1�I► Y ,y ' t�:'$ i•7 { Mme`, r — �� �� � l f•'2. •'t � flw J- `fit . .a.. f� lr .rt "fit ��•'�:. St . - _ - u..z ,y',: � •� •� 7 �`s L�+n� r `ice ..�,�� �s,'�'eY-�'!I •� ,,4 Y t C 26 47 k< t -Si L + 01 '_`� — J s ` tri N i R� 4114?4 �Vt% O T �WISTIJac opo x , XV L JE� APPROVED A5 'NOTED ` r { DATE: iP B.P. • �,~�/ lNFE Y BUILDING DEPARTMENT AT" 765-18Q2 9 AM_TO '4 PM' 'F0�2 r FOLLOWING INSPECTIONS: 1. FOUI rr ATION - TWO REQCJIaED . FOR PnURFD CONCRETE 2. RCU 7Y - FRAMING & PLUMBING sir 3. INSULA T!:�N A - Q. F!R' L - C'?`wST1.UCTION . MUST BE C"",AP' T.E FOR C. 0. . 1 ALL CONSTR'.;CTION SHALL MEET THE REQ!l IRrMEN T S OF THE. N. Y;. STATE CONSTRUCTION & -ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. F