HomeMy WebLinkAbout23891-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall'
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25551 Date: 02/23/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 6145 BRIDGE LA MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 84 Block 1 Lot 6.11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 30, 1996 pursuant to which
Building Permit No. 23891-Z dated JANUARY 15, 1997
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 ACCESSORY GARDEN STORAGE SHED IN THE REQUIRED REAR YARD AS APPLIED FOR
The certificate is issued to RANDY & DIANE SMITH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H-058690 02/06/98
PLUMBERS CERTIFICATION DATED N/A
Building Inspec r
Rev. 1/81
FORM NO. f
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)
M23891 Z Date ................ ...................... .......... 19.......
Permission is hereby grant to:
,.,�7r1/if ;oe-"
. ......... .............. ..... ............
.......�:�t . .../..... :1 6 ..`"*::........
v '
to/rc�G YfQ GQ .G C 2 .(off-'.v G • S�,a 1.,d
ofpremises located at .................. 7.5... ! '...• .............................................
....................................................................... �...........................................................
.................................................................................................................................................................
County Tax Mop No. 1000 Section ........O•T..... Block ......`............. Lot No. .. .".�1......
pursuant to application dated .............. 19.�5� and approved by the
Building Inspector.
Fee $.. �...?� ...
.......
......... . . L- :
... .... ........
Building Inspector
Rev. 6130180
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8069757 BUREAU OF ELECTRICITY
F_ 40 FULTON STREET, NEW YORK, NY 10038
Date FEBRUARY 06,1998 Application No. on.file 15439498/98 H 058690
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application: number is in the premises of
RANDY & DIANE SMITH, 6145 BRIDGE LANE, CUTCHOGUE, NY
in tine following location• ❑ Basement ❑ lst Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on FEBRUARY 02,1998 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT1 FLUORESCENT OTHER AMT. K.W. I AMT. I K.W. AMT. K.W. AMT. K.W. AMT. H.P.
1 1 1 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
A AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. MPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S - E R V. I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
STORAGE SHED-1
RANDY SMITH I L L
6145 BRIDGE LANE
CUTCHOGUE, NY, 11935 GENERAL MANAGER
11
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 credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
�...♦ i VL ..V u_�V L.:J
3ULJI_3G DEP iLRMI—E NT
i TOWN 9A1 L
763-1302
ri APPLICATION FOR CZRTI_TC.__ Or OCCUPA1`TC'_'
A. 7-1=5 aDDliCatJOn bust be filled ?n by t'rDewr_ter OR ?n{ Ana SLm1t ? O etQ �+ ouildzn�
i_75Dector with the following: for mew bui1Q?ng or ne•.v use:
1 L . Final survey of .property wiC:i accurate location of all buildings, 7ropert7 11aes,
streets, and unusual natural or coDographic features.
2. Final Approval from Health Dept. of water supply ar_d se*Nerage-disuosal(S-9 _Ora) .
3. Approval of electrical insral atc.on from Board of "__e Underwriters.
1. Sworn statament from plumber certify�`ng that the solder used System contains
less than 2/10 of 10 lead.
5. Commercial building, industrial buy?ding, multiple residences and similar buildings
and installations, a certificate of Code Compliance from arCaitact or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requiremeurs.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'-'pre-existing" land uses:
1 . accurate survey of proper,7 showing all proDervy limes, Streets, buill dim- and
unusual nacural or topograpnic features.
?. A prOperly completed appilcation and a consent to aspect signed by the applicant.
1f a Certi-icata of Occupancy 1s denied, the Building aspector Shall State the
reasons therefor in writing to the applicant.
C. _des
Carr;f icata of Occupancy - New dwelling 525.00,, additions to- dweling 325.00,
Alt=_rations cO dwelling 325.00, Swimm--lg ocoi S25.00, Accessor;7 bui l ding �25.00,
Additions to accessory building 325.00. 3usinesses 550.00.
L. Certificate of Occupancy on Pre-eYiSting 3uidinsz - �100.00
3 . Copy of Certificate of Occupancy -
updated Certificaca of Occupancy - 550.00
l imp orarl_,Cer,tificate of Occupancy Residenrial $13.00, Commercial $15-00
Date . . . . . . . . . . . . . . . . .
Ne*a Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . `SfsL
Location of Property. . . . ... Al y� . '64�JDG�.L :. . . . . . . . . . . .. . . .. . ... . .. .. . . . . . . . . . .. . . . .C.IG
House No. Street Hamlet
Onwer or Owners of Property.. . !L . . `& . . .. . . ._. ... . . . . . . . . . .. . . . _. • -
�i /I
County Tarr dap No 1000, Section. . .. . . . .b. I . .Block. . _ . . �. . . ..... . ..LOC. . . . �: . . . . . . . . .. . . . .
Subdivision. . . . . . . . . . f . . . .G ,. . . . . .F;?ed Hap.. . _ . 11� . _Lot. . . . .11. ... . . . . . . . . . . . .
Permi c No. . . . �.�.y.�. rate Of Permit_ . .. . .��`/�7. . .3DDliC3nt. . .'. .. .. . • -- - - . _ . . . . . . .
'Teal7-h Dent. Ar)oroval. . . . . . . . . . . . . . . . . . . . . . . . . .Under-writars Approval.
Plann_ag 3oard Approval. ... . . . . . . .. . . . . . . . . . . . . .
V
JAhI 619,93
Request for: TemDorar3 Certificate. . . . . . . . . . . Final Carcicate_ . . . . . . . . : :
Fee Submitzed. . .. . . . . . . ... . . . . . . . . . . . . . . . . . �F'T..
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . _
12D7 T�a�l:
�Qti, �Y�sa
e0 ass/
o��S�FFO�,�cOG
Town Hall,53095 Main Road y Fax (516)765-1823
P. O. Box 1179 W- Telephone (516)765-1802
Southold, New York 11971 ip • ��
viol
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
JANUARY 16, 1998
RANDY AND DIANE SMITH
6145 BRIDGE LANE
CUTCHOGUE, NEW YORK 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
The check is (not on file. ) $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23891-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
I I loll 1wrolt-l-
1)A*lA
Uu I It)I HT.11
1`01111DAT I ON ls,r)
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F U 0 1`11)A T 1 1-1
ItO114:11 FRAfW
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FINAL
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765.1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
BOARD OF IlEAi.'I'll . . . . . . . . . . . . . . .
F0RM NO. 1 3 sl;'1'S OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOII'L'1OLD SURVEY
ISl1Ll.D]:NG DLPARTMi3NT CURCK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN IIA1.i.. S['sl''l'IC FORM . . . . . . . . . . . . . . . . . . .
SOl1T1I0i.1), N.Y. 11971
TEL.: 765— 1002 NOTITY:
CALL
rx.>,mirx'd._ . ., 19Z MAIi. -1.01 . . . . . . . . . . . . . . . . . . . .
Approved � 19 /� Fermi L IJo. rJ) c?' ! ...................................
Disapproved /c .. .......... ................ .........
IArildinl; .insl)ector)
Al' .ICATION FOR BUILDiNG P13RMIT
r �j�
Date. - - - . . ! XX: 19.�_�
' INSTRUC'I'1.ONS
a. 'Ibis application nest be cagiletely filled in by type-wriLer or in ink and sulxmiLted Lo Lhe Wilding TnspecLor w
` 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
h. Plot plan showing location of lot and of lxrildings on premises, relationship to adjoining premises or public
streets or areas, and giving; a detailed descripLion of layout of property must be drawn on the diagran which is part of
this application.
c. 'Ibe tx)rk covered by this application Priy not be camenced before issuance of. Pluilding Permit.
d- llpon approval of this application, the Building Inspector will issue a Wilding Permit to the applicant. Such
pertnit shall be kept on the ]rremises available for inspection throughout the work.
e. No ixtilding rrhall be occupied or used in whole or in part for any purpose iAtatever until a Certificate of
Occulunrcy slial.l. have been granted by the Wilding Inspector.
APPLI(wrioN IS lllsl(1'sllY M11TE to the Ikrilding department for the issuance of a iktilding Permit rxirs iant to Lhe
Wilding 7xxie Ordinance of Lhe '116,91 of Scxithold, Suffolk Ccxtnty, New York, and other applicable Laws, Ordinances or
Regulations, for Llbe construction of buildings, additions or alterations, or for removal or demolition, as herein
descrilwd. 'Ilse apgilicant agrees to catgtly with all. applicable laws, ordinances, IxAlding code, housing code, arxl
regulations, and to adnit auLhorized inspectors orb premises and in Wilding; for 11 necessilry inspections.
.....6,��--A9--Xtyu'7'� ....................
(3igwiture of applicant:, or nwk-, if a corporal:ion)
(
(Mailing address of appl.icant)
Stare wlteLher applicant is�ow/ner, lessee, agent, arc:ltiLect, engineer, general contractor, electrician, plumber or ImiIde
GT ...........................................................................................
Mxw of cxdner of premises ........12..P' ?q ...�t...TJI�>✓.... r.,� ........................................ .
(as on the tax roll or latest deed)
If yplicanC is a corporation, signature of duly auLhori•red officer.
.........................................................
(Nairn and Lille of corporate officer)
W ilders License No. .........................
Plumbers license No. ........
Electricians License No. .....................
Other Trade's License No. ....................
I. incaL-.ion of larxl on wltidt proposed work will be clone..............................................................
............ .L15....----.........r.......... .......C !........................4. ..............
Ikxbse Ru ber Street luldet
('.cxtnt:y Tax Map No. IWO Section .... Block ...'...!.. .U.�.. Lot ....4!A!......
Sulxlivision ........., YL.. 'T Filed iLip No.' ..... l.nt ......j..l......
Mine)
2. State existing use and occupancy of premises at'xl interxled use and occupant of proposed construction:
a. GxisLitq; use and occupancy ...................................... .............
r n ...
b. ]ntetxkt<l use and occupancy ..........:.=:- ::.::. •:�: :.�. .... .........
Si.............. . / i2�
NUure o[ %joik (t:lrecl( vhiffi aplrlicahle): t�nw Ikiilcling ... /.... Mkllfion Alteration ..........
14:luiir ............ Itenoval .......... ... Dew iL lot t ............ 01.her Work .... ...........................
q (i)escription)
list:itivitecl G)aL ... ..9.1 ........... fee ....... ...!. ...............................
(to-be paid on filing; this application)
1 f Axel 1 ing, ixatiier of dwelling imiLs lkxtiier of rh.rel l iog units rxt each floor ............ ....
Ifgarage, otnher cif cars ......................................
if Ixtsioess, c(xnnercial or mixed oc:ct pancy, specify nal.ure and extent: of each type of use...�1.a �.,5,4'n
1)iniensicxts of exisl.:ing ertnNLurea, if arty; LTratt...... hear .., !....... I)epth .. ........ .......
Ik�.iglil: 1•knix:r of SLories ......................
Wiliensions of sirrie st'riN.ture with alterations or addil:ions: Front ........... .... .Rear ...............
IkeltlII ............... ..... Ikeigltt ..._........... ...._ Mniier of Storie:o .. ........ .....
Dhiensions of entire ixn+ ccxistriwA:icxt: Front: hear .... ... ........ Depl.lt ... . ...... ....
Ileiglit: ................... Umber of SCoriecr .. . ...................
Size of log:: Piotit Rear Dept 11. .. ................
(l. Rafe of hirchaee ......... . ll:xite of 1'onixer (vitx:r 1
I. 7xx►e or use clistricL io t,Aii(J► prenises are situal:ecl . .... ......................................
1. lkxes proixised coosi rtxaicxr violate itoy zoning law, ordiomic:e or regulal:lcxt: ... .....................
:I. Will lot: lx-- regriacled .....:.............. Will excess fall. Ix_- retitoved Fran livenises: YES 14.)
/i. tdaittes of OwrN:r of premises ........................... Acklrens .............................. Pllorre 1•kr. ....... ... ....
11:nr_ of ArcldLec:l' Mklress .. ..... .. .....
1'I►orxa No.
Name of (cxtt:riic:lcir ................................... AtWress ...............................iltcirxe Nta. ....... ......
1. is ibis properLy within W) feel' of it Lidal wetlnird'1 * YL'.S .......... N0 ..........
*1 F YES, SQlIiII(N D 'IMN '11A)MIMS 11i11M1-1' NAY IV,? 111!-4i111 Rlil). _
PLOT DIAGRAM
I.cx:ate clearly nixl clisl:inctly all Ixiildings, t.A►efher existing or, proliosed, nixl irxlicate all. sea—hack diniensions
rc><n prolierty litres. Give street aril block r>trii)er or descripLion according to deed,-arxl rJtow street runes aixl irxlirate
Aielher interior or corner lot.
RP ROM E®AS NOTED
le A �42 &Ae
DATE:
FEE: I�
CTiF°( BUILDING
7R5-1 E02 9 AM M 4 FOR THE
FOLLOWING INSPECTIONS:
�i F�tai 1. FOUNDATION T9�'C3 REw�1JIRE
FOR POURED CONCRETE
d `I a��t r " " 'r . ROUGH - F1�AI1�IiG1 PLUMBING
r d E l` �� . y 3. INSULATION _
GF ts+�J 4. FINIAL a CONSTRUCTION II US,I
9 BE COMPLETE FOR C.O.
1 tz`t v ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE NX
STATE CONSTRUCTION & ENERGY
r, ;=� '3�`:�•s u �u �a u CODES. NOT RESPONSiBLE FOR
DESIGN OR CONSTRUCTiON ERRORS
;17VIE.. (A, iF.W Y(N1K,
X Jf It1 I Y A'
5 . �
.�.�... . .. .{!c'W.... ....... .... .....Iwinl; clnly ra-x)rn, delxiseir aril a<rytr ghat he ict Lhe al>pl'cranl
,Man of iixliviclual. sil;nini; contract)
alxrve INittted,
k: it, Ilse ............. ......... .. ................. ................. ..................................
((knttrnctor, ngent, corlxirate Officer, ete.)
of :raid ciwtier or cawtx:rs, mil is duly authorized to lxerfonn or have lx-rfoniied the said work aril Lo nwilte utxl file liiiit
cippl icaLioit; Thal: ail. sLaletroLa ccinLaimil in I.Itin nppl icatioo nre true Lo. the beat of his krxiwledge mKl IXII.ief, atxl
I hat Lhe work wi 1.1 Ire tier.formed io the ncinrx:r set for.11i in the nplAicatioo filed therewith.
,:;'.xirn to fov( din Ihin J . l
clay c f ...J�.,.. 19..
i,Io t n ry 11 ih 'c .........
......................
CLAIRE L.GLEW (Sigoauire of: Applicant.)
Notary Public,State of New York
No.487950b
Qualified in Suffoik County
Commission Expires December S,19
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ANY'AL TION oR,�WTION TO T18S SURVEY IS A VIOLATION
sEcr� 2o9 IVLw roRx sTaTE EDuca rloa LAw Y t
FxcEPr A PER SECTW-J2Os-suBDAgSM.2 ALL cER�I�icA'r s N� LIC. NO: 6/8 .
\ HEREON VALID F06I tfi§MAP.AAV COPIES THEREOF ONLY IF . .
;:SAID MAP COPIES BFAR THE IMPRESSED SEAL OF THE SLI4VEYOR PECQ ' , P•C
\ WHOSE S a-'i E APES HEREog _i i
;. (516) 7
.ADDITIONAL`jL-Y TO COM;t `WITH SAID LAW 'THE TERM 'AL TERED BY' P. O. BOX 909
/� p /f �5 !/'A S f t MUST BE LAD BY ANK'AND ALL SuME-YORS UTILIZING A COPY
r't1S t f ,�A .7 �J *{ OF ANOT!#$;-,SURVEYoRS4W, ::T, R—.SUCH.AS INSPECT T AND' 1230 TRAVELER STREET
:.y BR0i7GHT 7i�DA TE'ARE FOT yy Co�IANCE WITH THE LAW. SOUTHOLD, N.Y. 11971
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