HomeMy WebLinkAbout23010-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23868 Date SEPTEMBER 13, 1995
THIS CERTIFIES that the building ACCESSORY
Location of Property 900 YENNECOTT DR.& 80 TUTHILL .RD. SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 6 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 30, 1995 pursuant to which
Building Permit No. 23010-Z dated SEPTEMBER 13, 1995
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 POOL SHED IN REAR YARD "AS BUILT" AS APPLIED FOR.
The certificate is issued to ARTHUR H. STEWART
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-355678 - SEPT. 13, 1977
PLUMBERS CERTIFICATION DATED N/A
Building Inspec or
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)
Date........September 13............................. 19...
............ .
NP 23010 Z
Permission is hereby granted to:
Deborah Doty, Esq. A/C Arthur H. Stewart
................................................................................
P.O. Box 1181
...............................................................I..........................
Cutchogue, N.Y. 11935
...............................................................................I.........
.
to ......Accessory Pool Shed rear yard.."as.,built" as applied for.
.................................in...... ................... ...... ...........................................................................
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
...........................................................................................................................................I......................
at premises located pt.,,,,,,, 900 Yennecot Dr. & 80 Tuthill Rd. Southold, N.Y.
.......................................................................................................
................................................................................................................................................................
County Tax Map No. 1000 Section ..........55........... Block.........6.............. Lot No. ........ .................
pursuant to application dated .......AuFust. 30?.............................. 19...95.....;.., and approved by the
Building Inspector.
Fee$.........35.00.....
f�
.................... . ........................................ ............
Building Inspe r
Rev. 6/30/80
V y Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL AUG 3 01995
765-1802
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.
B. For- exist ing 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
"As built" 4x6' detached shed Date August .29,. .1995 . . . . . . . . . . . . . . . . . . . . . . . .
. New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
Location of Property. .900.Yennecott.Drive, .Southold, NY . . . . . . . . . .
House No. . . . . . . . . . .Street . . . . . . . . . . . . . . . . . . . .
Hamlet
Onwer or Owners of Property. . . .Arthu.H; ,Stewart. . . . . . . . . . . . . .
County Tax Map No 1000, Section. ,055;00. . . . . .Block. ,06:00 . . . . . . . . .Lot 007.00
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .X. . . . . .
Fee Submitted: $.'. 25.00. . . . . . . . . . . . . . . . . . . . . .
�G�'... . .9 . . . . . . . . .= :
CIO Z� G 0 APPLICANT
THE ,. NEVII:;.:YORK BOARD OF FI I, I + RE UNDERWRITERS
ak �E3UREAU.OF ELECTRICITY --`
85 JOHN STREET NEW YORK NEW PORK 10038
I
°ate_ September . , 1.977 !lPPlicatioriNo onfcle 9221Z1
N35 6f
THIS.CERTIFIES THAT :: „
only the electrical equipment as described below and introduced by the applicant named on the above applocati'n number sn Lhe premises of
M.' TICKernani -.900 Yennecott.:.Drive Southold, 1 I
❑ :1st F1 ;'❑ 2nd Fl a Section Block Lot
illthefollowinglocation; Basement OLitS1d
tcrss examined on September $' `1.9.77 and found Lo be rn compliance with the requirements of this.Board.._
FIXTURE ECEPTACLES SWITCHES. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
.:.-OUTLETS_ INCANDESCENT FLUORESCENT M APURr : AMT. '. _K.W. AMT. '- 'K.W. 'AMT. K.W. AMT. K.W. ' 'AMT. H.P.
VAPOR
1 -
DRYERS FURNACE MOTORS,;`_` .FUTURE APPLIANCE FEEDERS. SPECIAL REC'PT -.TIME CLOCKS „-,'BELL;. UNIT HEATERS MULTI-OUTLET DIMMERS
•AMT. K.W. OIL I H.P. ..GAS H P AMT NO. A W.G AM .AMP. AMT. ' AMPS TRANS: AMT H.P. 'AMT..- ..WATTS
SYSTEMS
NO..OF FEET
SERVICE:DISCONNECT NO.Op :;;S .i E R V I
_ -METER' NO.OF.CC COND :A:W.G. --A..W.G. Ls A.W.G.
AMT: 'AM :TYPE - EQUIP. 1,�2W 1,8•3W 3,0'3W 3,B•aW NO OF HI LEG NO.OF NEUTRALS PER 0 .- OF,CC COND..' � .. � OF.HI-LEG � OF NEUTRALViT
' -
OTHER APPARATUS.
-
-.
1
_ I 1
imming PoOI) This ;certificate covers compliance ;at tYie."'date Of
inspection only. Because of. unusual-:environments :it is :.a8visable
o have frequent test and/or -repairs .made_-'by a ,;qualified- person. .
,
F.T. E1.e6tric '
'160 1?orthern B1 vd i�; " I , I
ST..' James, L I•:= 11780 LIC. I102E_' GENER N G 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 t 'r re e Ualss..
130ARD ' OF HEALTH . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . .
TOWN OFSOUTHOLD SURVEY . . . . . - -
A19� 3 I996 BUILDING DEPARTMENT CHECK . . . . . . - - _ - - - , - . .
TOWN HALL SEPTIC FORK . - . .
SOUTHOLD, N.Y. 11971 ��JJo�•�C -
. . , TEL.. 765-1802 t:o<<FY ` . ._7�?
CALL
Examined r. .� . . . 19 ./. MAIL TO :
Approved , . .�J� . . 19 Permit No.a�.�010.� . . . . . . . . . . . . . . . . . . . .
. . . . . - - - . . . . . . . . . .
Disapproved,a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . August .29 . . . . . . .. 1995•
INSTRUCTIONS
J 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
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 regu tions, and to
admit authorized inspectors on premises and in building for necessary inspe •ons-
/� .: . . . . . . . . . . .
(Signature of applicant,.or name, if a corporation)
Drive
900 Yennecott Xvgmg,• Southold, NY.11971 _ . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer; general,' contractor,, electrician, plumber or builder.
owner
Name of owner of premises Arthur: H-.. S.tewaxt. . . . . . . . . . . . . . . . . . . . .
as on the tax roll'or latest deed)
If-applicant is corporation, signature of duly:authorized officer: • ..',`,,,
(Name and title of corporate officer)
Builder's License No.
Plumber's License No. . . . . . . . . : . . . .
Electrician's License No. .. . . . . . . . . . . . .
Other Trade's License No. . . . . .
l. Location of land on which proposed work will be done. . . . . . ... . . . . . . . . . . . . . . . . . ... . . . . . . .
900 Yennecott Drive, Southold, NY 11971
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . .... . . . . . . . . . . . . . ..
House Number Street Hamlet
County Tax Map No. 1000 Section • 055.00 Block . • 06:00 Lot . .
007.00
. . . . . . . . . . . . . . . . .
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 . . . ..ore-�wrLJi ,y.•..ceaidence. . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancyone—family residence
. . . . . . . . . . . . . .
-3. Nature of work (check which applicable): New Building . . . . . . . . : Addition . Alteration
Repair . . . . . .: . . . . . . . Removal Demolition . . . . . . . . . . . . Other Work . . . . . . • • .
(Description)
4. Estimated Cost . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . Fee . . 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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 . . '
Height . . . . . . . . . . . . Depth . . . . . . . . . . . . .
g • • • • • • . . . . . . . Number of Stories . . .
Dimensions of same structure with alterations or additions: Front * • ' . . . . . * . ' '
Depth . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . .
• . Height . Number of Stories .
8. Dimensions of entire new.construction: Front . . . Rear
.Height . . . . . . . . . . . . . . . Number of Stories. . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
9. Size of lot: Front . .: . Rear. . . . . . . . . . . . . . . . . . .Depth. . . . . . . . . . . . .. . . . . . . . . . .
10. Date of Purchase . . . . 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: . • . .
14. Name of Owner of premises . . . . . . . . . . . . . . . Yes . No
. .. Will
. Phone No.
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . Phone No. . . . • . . . . . .
Name of Contractor . Address Phone No. . . .
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.
See survey
AP PR I'D AS NOTED
DATE: 3 Q.P.#
c ' FEE 3_�BY:
IeIOTIFY BUILDING DEPARTMENT AT
OCCUPANCY OR 7Br5-i 802 9 APA TO 4 PM FOR THE
USE IS UNLAWFUL FOLLdWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
WITHOUT CERTIFICATE
OF OCCUPANCY . ROUGH - FRAMING .& PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
If copper tubing is used. STATE CONSTRUCTION & ENERGY
for Water distributing .CODES. NOT , RESPONSIBLE FOR
system; piping shall be DESIGN OR CONSTRUCTION ERRORS
'Of.types K or L only .
UNDERWRITERS CERTIFICATE
'REQUIRED
STATE OF NEW YORK,
COUNTY OF . SUFFOLK . . . . . .. . . .S.S
ARTHUR H. STEWART
. ' . ' ' ' • ' ' ' ' ' . • • • • • • • • • • • • • • • • • • • • • • • • • • . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the . :,. . . . . . . . . . . . . . , owner. . . . . . . . . . . . . . . . . . . . ...
(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 performed in the manner set forth in the application filed therewith.
Sworn to before me this
. . . . . . . . . . . . . . . . . . . . . . . .day of...August• • . . . . . . ., 19
votary Public, . . Cou
Notary Public,State of New Yolk • • • . . . . . . . . . . . . . . . . . . . . . . . . .
No.4V9478-Suffolk County
CO®m10I0 I;X01r00 rya.04, tom
.y. . IjFM Cd.NLAL7t1 bti ___ ------
OWNER; e. s1' is �i, x. i;il:, • PT. PPROVAL H.S. Flo. --
OWE ItF.
AUG 3 01995
AREA-
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• � _ '' 1� AusNE\n1iEt>-./.ucn�uo>�u_,.Dnrtrox—_-
7 + •a35LYIed et4N. 10 7111S SURVEY IS A VIOLATION OF
tl+ ttT ,SECTION 7209 OF THE NEVI YORK STATI
T _ jDUCATIOfi LAW.
�I 7 COPIES OF TIIIS EU^V;Y MAP NOT VAPINQ
JIIE LAND SU-VEYOP.'S IT:I D EAL OR
EMDOSSfD SEAL EHA:L t:.T L!COIISIC[P.ED
70 DE A VALID T,..UE COPY.
t 6 GUARANTEES INDICATED SIIAI.1.f.UII
+ d }l K' ONLY TO TI@ CE;.S—!:x••• �.,• .•,Y+t!.e 110\'[Y
\ O IS FREPACIO.A;Z•
TITLE COM-ANY, G--,7.::'.....
: r,b;t•KY ANC
.1 f LIMING 1:�.7i^7il•:+ ! 'i.71•�,AP:D
TITLE TO MEASS' :"�S•r:(.r, ,.' DI,I+7�I>IST,I•
CERTIfi, tuttm^.cerr:,,.w......t?r IIv.A�isrEnnnlc
ID n�l2rlSlu tL t12�'llllltlOt+S:cr.SueSIQIIIHI
40ewd"teLbd 'b -Hi n
M P OF LOT '1 S STAMr
"56o+k6ld 'rJ'dVIHtl3 F3dYtV- mocl to SEAL
�f�1Ar OF YENNECCITT RA2K" .-rifle t 6aaral. cb.
I'":��\ •�.Ik. Coof1hI Ma+11k5I8-I) as Survel_jed Jori.19,11379.
AT
RODERICK vAN TUYL P. C.
SoUTH0LL
LIC. LAND SURVEYORS-annn RT. N.Y.
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LE4T HOLE SUFF.CO. DEPT.OF HEALTH SERV1Ck S STATEMENT OF INTENT
O'
FOR APPROVAL OF CONSTRUCTION ONLY
ma
THE WATER SUPPLY AND SEWAGE
DATE: DISPOSAL SYSTEMS FOR THIS RESI.
DENCF$ WILL CONFORM TO THE
�H.S. REF. NO.: STANdARDS OF SUH OLK CO. DEPT,
OF' HEALTH. SERVICES.
APPROVED:
($) 16
17' APPLICANT
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