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Home My WebLink About23454-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-24578 Date August 19, 1996 THIS CERTIFIES that the building accessory Location of Property 385 Pine Tree Road Extension, Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 1 Lot 7.19 Subdivision Filed Map) No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 3, 1996 pursuant to which Building Permit No. 23454-Z dated May 17, 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 is an accessory garage in the required rear yard as applied for. The certificate is issued to Harold & Maureen Wicks (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N 393932 dated August 13, 1996 PLUMBERS CERTIFICATION DATED N/A lz,B4i-lXng Inspector 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) Date1..7................... 19..... N2 234541 Permission Is hereby granted to; . . s.............................. ......................... ............ ............ ....... .............i�. to ........................ ..... .,, .................. 4., .... ....... .......... . ......... ........ .. ... .. - ... �...... ... ........... .................................................................................................................................................................. .................... ......................................................................... "�'/*.... at premises located at..... (., ../ �...........' :. ., ............................ ....................... .............................................. ..! ................................................ . ........... County Tax Map No. 1000 Section ........ .,.. Block............ ......... Lot No. !.l... ............ pursuant to application dated ........... W..V-3 I ................. 19.. �.... and approved by the Building Inspector. Fee $..� .. ............ ................... ................... Building Inspect Rev. 6/30/80 Form No. 6 12 TOWN OF SOUTHOLD BUILDING DEPARTMENT 0V Gsri� ��J� TOW N1HALL 765 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted 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 1% 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. a 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 Building - $100.00 3. Copy of Certificate of Occupancy - .251• 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential 115.00, Commercial $15.00 Date . . . .)�� C., �. . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .v . . . . . . ;,-Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. ..� . . . . . .. . .�.GjL�. 1. . . . . . . .. . . . . . . . . . . . . .. v..�. . ..i/�. . . . . . . . . House No. Street Hamlet / Hamlet oLoOnwer or Owners of Propertyw. . . . . . .... .� �2E" . . . . .. .% . (/1�. . .. . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . Subdivision. .+.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot ''. . . . . . . . . . . . . . . . . . . . . . Permit No. f!.'/. .p.�. .Date Of Permit. . . . . . . . . . . . . . . .Applicant. ,, . �'�!. ck . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .. . . . . . . . Fee Submitted: $.�`�.. . 1. . . . . . . . . . . . . . . . . . . . . 6-1796 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS pAcE 1t 00418 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date RUGi.ST 13,1^96 Application No.on file 121.851.96/96 N 39'3932 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 14ARRY 1'1ICKS, 385 PINE; `IREE ROAD EM. , POLE 3, CtPfCEi0G[JE, N.Y. in thefollowinq location; ❑ Basement ® 1st Fl. ❑ 2nd El. G MUOUT Section Block Lot was examined on AUGUST 09,1996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT OTHER MIT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 5 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP, TYPE METER L�,4W 3W 3,B'3W 3,e'IW NO. CC COND. A.W.G. NO.OF HI•LEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER Ar OF CC.COND. OF HI-LEG OF NEUTRAL 1 100 M 1 x 1 2/0 1 .1 OTHER APPARATUS: M-ANDER G. HUBBARD LIC.;#?�]�Y � LL BOX 222 1. 1 r< GENERAL MANAGER :�QI.IEEOi✓CTv L.S. , R�r, 11931 1� _ 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. f THE NEW• YORK BOARD OF FIRE UNDERWRITERS PAGE 1 000418 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date AUGUST A3,1996 Application No.on file 12185196/96 N 393932 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of HARRY WICKS, .385 PINE.TREE ROAD EXT. , POLE 3, CUTCHOGUE, N.Y. in thefollowing location; ❑ Basement [2 Ist Ff. ❑ 2nd Ft. GAR/OUT Section Block Lot was examined on AUGUST 09,1996 and found to be in compliance with the National Electrical Code., FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. I K.W.' AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 5 4 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E. _ _ ._R V I.,,, C .... ., E- ME1ER NO.OF CC COND. ' 'A.W.O. "' A.W.G.` A.W.G. AMT. :'AMP. TYPE EQUIP. 1 p'sw 1,9 3W 3 0 3W 3 A'IW PER B' OF CC.COND. �NO.OF HIAEG�� OF HI-LEG NO.OF NEUTRALS OF NEUTRAL lil F, 00 " 'CB 1 X 1 2/0 1 1 OTHER APPARATUS; • ` ALEXANDER G_I HUBBARD LIC.#304 E � L L BOX 222';': OE Al MANAGER AQUEBOGUE`L'' I '� NY; 11931 Per 11 Thii certificate must'not be altered ink"uny manner; return'to the office of the Board if incorrect. Inspectors"may be identified by heir credentials. o�Og�FFO(�c0 o� G?1 y Z Town Hall, 53095 Main Road - • Fax (516) 765-1823 P. 0. Box 1179 y� �� Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD Harold & Maureen Wicks P.O. Bog 298 Cutchogue, NY` 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file. (Enclosed) %Zg No Underwriters Certificate on file. ggg The check is �� E Vnot 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 # 23454-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Dix I V ij IIIIIIIIA I'l Oil N U I I D ATI 0 11 IMUCH FRA11F. & H-111111111c ------------------ --------- 11INIIIAI-1011 1-1;lt 11. y . ------- - SI'Alli Vjllilt(iy Comr .......--------------- . .70o.... ............. —--------------------------- F I IIAL C ADDITIMIAL ,c,ulun+llL��;. e_.....A ,m..�.. ,...��... ,... ., j ------------------------ II ------------------ N 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � C DATE Z INSPECTOR � 765-1802 BUILDING DEFT. INSPECTION [ FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR �� r6s-isoz BUILDING DEFT. INSPECTION [ I FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY 6 REMARKS- DATE O INSPECTOR BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ri a C I Fy . . CALL . . . . . . . . . . . . . . . . . . . Examined �� 19/ MAIL TO : Approved 01 . ., 19' Permit No. % < . . . . . . _ . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - (Building Inspector) (Ti� � AP LICATION'FOR BUILDING PERMIT F Date . . . . . . . . . . . . . . . . . .. 19 . . . BLML DEFT 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.p'lan 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 'fshall have been granted by the Building Inspector. 'a 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, b� ding code, housing code, nd regulations, and to admit authorized inspectors on premises and in building for necessary i, �pe ti S. G,� _ � . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. OtI.V�I1� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . %��' vi . . . .V . . �. . . . . �t??!lZ�z=. . . . . . �. .:. . I!`. .1 . . . . . . . . . . . . (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. . �/1". . . . . . . . . . . . . . . . . . . . Plumber's License No. /1�� . . . . . . . . . . . . . . . . . . Electrician's License No. / . . . . . . . . . . . . . . . . . . Other Trade's License No.lfll� . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . .�':� .'./. 2r..!�� . . ...e . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . House Number SStreet Hamlet County Tax Map No. 1000 Section . . . . . q90. . . . . . . . Block . W . . . . . . . . . . . . . Lot . . .� . Subdivision bision . Al/.n0X . 4_1:C-'. �. '?0n. . . . . . . . . . . NI d Map No. �0.1.. . . . . . . Lot �. . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . i). . . . . . . .F`.fi. :i'. _'::._..F:;.i e...... . .q. . . . . . . . . . . . . . . . . . . . .-J., °`'� b. Intended use and occupancy Y , ?GX 3. Nature of work (check which applicable): New Building . . . .Y. . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . qq (Description) 4. Estimated Cost . . :1. '(O. . • _ , . , , , , , . Fee (to be paid on filing this application) 5. If dwelling,number of dwelling units , , , Number of dwelling units on each floor . Ifgarage,number of cars . . v.ne_ . .0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions ol existing structures,if any: Front . . . . 9: . . . . . . . Rear .JV . . , , , . . . Depth . :` ).e ... Height.2.).9 �'. . .v� .2 . Number of Stories . . .�Wo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . Rear Depth . . . . . . ... . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire.new construction: Front . . . .` ... . . . . . . . . Rear 2 .?-, Height a�?' .. . . . . Nu . . . . . . . . ; Depth ��.��-... . . . . V• . . Number of Stories . . l. . � a 9. Size of lot: Front . .t f! .�.�g:./�. . . . . . . . . Rear . �1��:,.�'. . . . . . . . . . . . Depth- : '•l. 10. Date of Purchase . . . . . . . . . Name of Former Owner . . . 11. Zone or use district in which premises are situated . . °`1 °!. . , . , , , °' r r. 12. Does proposed construction violate any zoning law, ordinance or regulation*:* egulation: .�•, . 13. Will lot be regraded . . . . . . . . . . . . . . Will excess fill be removed from-premises`�- 14. Name of Owner of premises .j Cc--IM A,'!._, , , , , . Address . . . . . . . . . . . . . . . Name of.Architect . . . . . . . . . • • •-•-P-ho'n"eallo:�_..'� .-�•a. . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . Address . . . . . . . . . . . . .PhoNNo. 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, 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. STATE OF NEW YOg�C, COUNTY OF : �5 fi°l./C. . . . . S.S �-S• • • • • • • • . • . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. . Heis 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 contained in this application are true to the best of his knowledge and belief;and that the work will be.perfonned in the manner set forth in`ilie application filed therewith.' Sworn to before me this ay of. . . . . . . . . .. 19".6 Notary Public, . . . . . . Coun ROBERT I. SCOTT.J / NOTARY PUBLIC,S a of N.Y. j (�C No.4725089,S k Coyt�t� Term Expires y.31, 197d� (Signature of applicant) � N V j IN. 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