HomeMy WebLinkAbout33415-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32709 Date: 11/01/07
THIS CERTIFIES that the building ADDITION
(STREET)
Block 2
CUTCHOGUE
(HAMLET)
Location of Property: 33900 MAIN RD
(HOUSE NO.)
County Tax Map 11Io. 473889 Section 97
Lot 11
subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24, 2007 pursuant to which
Building Permit 11Io. 33415-Z
dated SEPTEMBER 24, 2007
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 TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ROBERT W RICHMOND
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPAR~ OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N609123
07/13/83
PLUMBERS CERTIFICATIOlII DATED
N/A
~~
Authorized Signature
Rev. 1/81
.
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 i"Ic and submitted to the Building Department with the following:
A. For new building or new Use:
1. Final survey of propeliy 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. Swam statement from plumber certifying that the solder used in system contains less than 2/10 of I % lead.
5. Conunercial 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 buildiugs aud "pre-existing" land uses:
I. Accurate survey of propeliy showing all propeliy 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 tIlerefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Celiificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Celiificate of Occupancy - $50.00
5. Temporary Celiificate of Occupancy - Residential $15.00, Commercial ~15.00
Date..IO I J ') L~7
New Construction: -----.1...
Old or Pre-existing Building:
(check one)
Location of Propeliy S ~ qoo ~ tf.-cl c
House No.
Street
C;;kkAA '_
_~_c~
Owner or Owners of Property: ~,G<, ~O"f'.-(.L
Suffolk County Tax Map No I 000, Section ~ 7
Block ~_._ _______ Lot
/I
SubdiVISion
------"~--_.._-~--- ---
___ Filed Map
Lut
Pennit No _3~Lf I_~ ..::c Date of Permit. _3l2'LLO 1- Applicant '..
Health Dcpt Approval:
UnclCl"\vriters AppnJvaJ
Planning Board Approval
Request for
Temporary CeI1ificate ______
Final CertIficate:
____ (check one)
Fee Submitted $ :< 5, cf7J
l?Nud~~
Applicant Signature
fN.L. 'l7?1.f1
c..O ~3;)70q
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.
33415 Z
Date SEPTEMBER 24, 2007
permission is hereby granted to:
ROBERT W RICHMOND
33900 ROUTE 25
CUTCHOGUE,NY 11935
for :
ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
THIS PERMIT REPLACES EXPIRED PERMIT #12138Z
at premises located at
33900 MAIN RD
CUTCHOGUE
County Tax Map No. 473889 Section 097
Block 0002
Lot No. 011
pursuant to application dated SEPTEMBER 24, 2007 and approved by the
Building Inspector to expire on MARCH
24, 2009.
Pee $
15.00
e
ORIGINAL
Rev. 5/8/02
]? 3lf IS- :2-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING ~ FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ~
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DATE / 0 ~?-6 -07
,
INSPECTOR ~ ~
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1000771 THE NEW YORK BOARD OF FIRE UNDERWRITERS
ns BUREAU OF ELECTRICITY
r- 85 JOHN STREET. NEW YORK. NEW YORK 10038
Dote July 13, 1983 Application No. on file 211260-83 N 609123
THIS CERTIFIES THAT only the electrieal equipment 08 described below and' introduced by the applicant named on the above applicotion number in the premUe8 oj
Robert Riclm>nd, S/S Main Rd. 1000 E/O Eugene' 8 Rd., Cutcbogue , N.Y.
in the following location; o Basement [jt I., Ft. D 2nd Fl. Section Block Lo,
was examined on July 7, 1983 andJound to be in compliance with the requirements of this Board.
FIXTURE ~.C.PTAC"S FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES INCANDESCENT flUORESCENT M~MY AMT. K.W. AMT. K.W. AMT. KW. AMT. K.W. AMT. H.P.
6 7 6 6 2 F
DRYERS FURNACE MOTORS RJTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BEll UNIT HEATERS MULTI-OUTLET DIMMERS
TRANS. SYSTEMS
AMT. K.W. Oil H.P. GAS H. P. AMT. NO. A.W.O. AMT. AM'. AMI. AMPS. AMT. H.P. NO. OF FIET AMT. WATTS
1 30
SERVICE DISCONNECT NO. OF S E R V I C E
AMT. TYPE METER 3H3w NO. OF cc. CONDo A.W.G. NO. Of HI-lEG A.W.G. NO. OF NEUTRALS A.W.G.
AM'. EQUIP. ,..ZW ,,,3W 3j1{4W PERH OF CC. CONDo OF HI-lEG OF NEUTRAL
OTHER APPARATUS:
1-G.F.I.
l-SIroke Detector
~ ~~_~" rnr/: .I
Ruland Elect. Co. '{ -if 7 "
P. o. Box 143
Mattituck, N.Y. 11952 UC./242 '" _RAL ANAG~
,., ......
p" 1 / '
This certificate must not be altered in any mannerj' return to the office of the Board if incorrect. Inspectors moy be iden~eir credentials.
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COpy FOR BUILDING DEPARTMENT. THIS COpy OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
~ TEL.: 765-1802
Examined. . 4f. . X . . . ., 191)~ ~ 3:) I~
Approved .i.~ ..5.. . .. ., 1.J5~ Pennit No. ~.
Application No.. rdf..f.cf.......
Disapproveda/c .. .............. -:....... 'X' .~......
................................../!i:b...:
..... ...... ... ,. ....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .0.11... . C!. . . . . . . . ., 19 .F:~
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 Penn it.
d. Upon approval of this application, the Building Inspector will issue a Building Penn it to the applicant. Such pennit'
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 Pennit 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.
. /;r4P~/: .1~/~..............
. (Signature of appli~aL ~~~~e, if a corporation)
.~ Po. .J.1'I!.rt:1( !-/f(V,{0(l(!(,lf:o.f.t?0IJU(!(OC.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
eo flITIfr4 O?)/(
........ ..................... -...-.............................. ,.... -.................... -.....
Name of owner of premises IU;I3.~f..7... .R,(<If.fI!!.~~i.?..................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.1!/!-.I-.~If11... .$.'. .)jI?J.6:!-F.r.. .::r~..............
(Name and title of corporate officer)
Builder's License No. .?--/?-:-...................
Plumber's License No. ........................
Electrician's License No. ......................
Other Trade's License No. .....................
1. Location of land on which proposed work will be done. .S: 0. . ,[(,~ ~. . . . . ~7~ . . ?- r. . . .c. <:.T,: (fq . c: ~ t:::. . . . . .
.. .~.3.'(. ~.O..................... ~fr. .J:F................... .C:.tr((((q.c:p'~.................
House Num ber Street Hamlet
County Tax Map No. 1000 Section ...... ('. f.7. . . . . .. Block........~ .?-:-. . . . .. Lot... .fY?/(. . . . . . . . . . .
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 ...8 f .f//)F (1/ ~ I.{ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy . .fl..G:.~(I?c:!V.(t;. .. . . . .. . ... . .. . .. ... . .. . ... ... . ... ... ... ... .. . .. ..
)..
3. Nature of work (check which applicable): New Building. . . . . . . . . . Addition. . r. . .. Alteration ..........
Repair .............. Removal . . . . . . . . . . . . .. Demolition .............: Other Work. . . . . . . . . . . . . . .
"# _"""" ' (Description)
4. Estimated Cost. . .I? ~.'. . . . . . . . . . . . . . . . . . . . . . . . . . . Fee. . (;>. .~. . . . . . . . . . . . . . . . . . . . . . .. . . . . .
(to be paid on ming this application)
5. 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. . ..3~. ~ . . . . . . . . Rear ...}il; ~ . . . . . . .. Depth. .?.'If: . . . . . . . . . .
Height .....~ 'f/. . . . . . . Number of Stories. . 1.1:. ~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front ....:3.-?f'.......... Rear...J;z. ~ . . . . . . . . . . .
Depth..... p.~.~............ Height... (.ff.'............... Number of Stories .. .,(',-k................
8 D. . f t' t t' F t ;2/"bl'( R ;l.Lr'h" D h /,"1'
. unenslOns 0 en Ire new cons ruc IOn: ron .....7.......... ear.... -, . . . . . . . . .. ept . ."...........
Height ... ./7-'.'. . . . . . . . Number of Stories. . . .I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front.. .. !.t:>.~ .~/... ... ... Rear..... P. . .. . .. . .. . .... Depth ..1. .'15.,., 7./.. ...... .. ...
10. Date of Purchase .. N-tf. . . (.1.R. . . . . . . . . . . . . . Name of Former Owner . .1(. Rt:?f(C?5/;('/ . . . . . . . . . . .
II. Zone or use district in which premises are situated ./c#( P./F,IY. 7A-k. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: Iv./J.. . . . . . . . . . . . . . . . . . . .. . .. . . . .
13. Will lot be regraded . MI? . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes ~
14. Name of Owner of premises 1.'l.t?~7. . ~1C#.i1(tI:'l'L? Address . .C.':'7.<:fI(J.f(l'.~ . . . . Phone No. 7;5Y-:-.Cff~. .
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
Name of Contractor ir!~ /-IM#..l-. .-ft.l/! ~/R.r. fTlV Address . Ct/.T.t;"I.!.D.tfP F.. . . . . . Phone No. X;J~T.-:o;;$~r.-:..
PLOT DIAGRAM
Locate clearly 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. Ii r. ~ r
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STATE OF NEW YORK, K S S
COUNTY OF . . ~ YF./.'=:t?{-. . . .. .
. . . . {I! //1 la,!"/. . . . $. .~1 /d q ! c::.y. . . ':??:" . . . .. being duly sworn, deposes and says that he is the applicant
(Name of individual siglt\ng contract)
above named.
He is the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and me this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application med therewith.
Sworn to before me this
...... .r:;2J?~:....... .dayof. ,;J;(i;l!fl/'!j........, 19.r~
No,"" fub~;~~),~: ~^!:~.. O-"'#,~g~~...........
QlI:U~;J iJJ~:,;~',:/: (Signature of applicant)
~~omr.Ji:;; . J ;~,-",'.I,\ ,,~i:'!:lt'l
SWn Exp"cs a1:.r::h ~O, HJ1<.~
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1'0_ NO. J
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD. N. Y.
BUILDING PERMIT
!THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
f(<:f) ~34J5
N<<! ~ Z
F.-6"V;1~ ..:J e":J
Date .......................u...~........................, 19.......
....- "-'~..~(rSif~'.'I~t;.::.~.
........O~.~~i.......Al...c:;;;t........;;?3~
Cb,n;f7;-.d .~:7~....~...~L.~;;;;;;;7:na'" C4t-/hHtY'
10 ::;r;;:.~...:::..........."?Qb;;7...~c::X;;;(,)nCl.........:~......................~..
............:..............................f$<;oa.........~......Zs::.........rt'Eh;;;-:;.........'j;~
. at premises located at ...........................................................................................~...~.........IC .
.................................................................................................................................................................
.................................................................................................................................................................
. 09'7 oo? 011
County Tax Map No. 1000 Sect~..................... Bloc} 1...............~ No. ........................
pursuant to application dated ..........~.r......................... 19......... and approved by the
BuildIng Inspector.
IS SlIt
Fee $........................
.
............0...0 ..... ..........................................................
Bulldlng Inspector
Rev. 6/30/80