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HomeMy WebLinkAbout23023-z c FORM NO. 4 TOWN OF SOUTHOLD BUILDING. DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24000 Date NOVEMBER 1, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 2375 HARBOR LANE CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 136 Block 1 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11, 1995 pursuant to which Building Permit No. 23023-Z dated SEPTEMBER 25, 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 ANTENNA TOWER AS APPLIED FOR. The certificate is issued to KARL JOHNSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B in 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) Date............qI............................................. 19.. NS° 23023 Z Permission Is hereby granted to: _ .......... , ............. .✓......... .............. ............ � ..�.�.. �.................................... .................. ...................................... % r .........j�� ............................................................................................................ .................................................................................................................................................................. ........................................................................................ ....................................................................... .................................................................................................................................................................. at premises located at......................... . �...... .... ............................ ...................... ...........................I........................... /1 County Tax Map No. 1000 Section ../ Y�'............ Block......��,�.......... Lot No. ....../. ............ pursuant to application dated ... ���.:........//....................... 19.... v..., and approved by the Building Inspector. Fee $... ... ..�.... �` Building Inspector Rev. 6/30/80 Corm NeD. 6 TOt-]H OF SOUTHO LD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOIL 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 or 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. 6. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1.7 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 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4 . Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00-, Commercial $15.00 Date . .C. . . . °.MCA1 M5. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . ✓. . . . . . . . . . . . . Location of Property. . . . 3� �. . . . . . . . . .ON;' pp' . �-wv. . . . . . . . . . . . . . CUTC .G VF . . . . . . . Rouse No. Street Hamlet Onwer or Owners of Property. . . P1AN15.o(V). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ounty Tax Map No 1000 , .Section. . . �3 rp. . . . . . . 13.tuck. . .qk. . . . . . . . . . .Lot. . �8. . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F�il.cd Map . . . . . . . . . . . . �Lac. . . .I . . .1.A.�. . . . . . . . . . . . . ermit No. . .a�J0.`'-Z7. . .Date 01 Permit. . . .°�. .� . ..�. . . .Applic;tnc . .«l�.�L. , CJ©�. . . . . .� . . . . . . . . . . . . Underwriters App.ovai . . . . . . . . .iiealtlt Dejtt. Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'canning Board Approval . . . . . . . . . . . . . . . . . . . . . . . . request for: Tempornry Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . 7= Submitted : S .as'o . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . co _ _ o�®guFFO(,�coG O 1 N Town Hall, 53095 Main Road p • Fax (516)765-1823 P. 0. Box 1179 Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 25, 1995 Mr. Karl Johnson 2375 Harbor Lane Cutchogue, NY 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx 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 # 23023-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001093 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NEW.YORK 10038 Date SEPTEMBER 21,1995 Application No.on file 88237295/95 N 364202 THIS CERTIFIES THAT ill only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of KARL JOHNSON, 2375 HARBOR LANE, POLE#20, CUTCHOGUE, N.Y. in the following location; ® Basement ❑ 1st Ft. ❑ 2nd FL OUT Section Block Lot was examined on SEPTE14BER 13,1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. T. K.W.' AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. N SYSTEMS O.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER No- CC.COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP 10 2W 1.0 3W 3 0 3W 30 4W F C d' OF CC.COND. NO.OF.HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL 1 150 CB 1 K 1 2/0 1 2/0 OTHER APPARATUS: 0 DOROSKI ELEC. INC. LIC.#2941-'E 425 MONSELL LANE CUTCHOGUE, NY, 11935 GENERAL MANAGER I� 11 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 their credentials. ,, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. A zl;l.0 I1151%,c CiuN REPUI(•f DATE __ _- -_---(:OMMENTS tTl _ I I li --I{----- -------------- --- -------- C -OUNDATION (2ND) I �h ---------- -------------------------17:77-77-11 II I ,000I1 FRAME 6 -------.1 — -- — — --- (� PI.UM111.NG li -- II -- � ---II NSULATION PER N- Y. ------i� -- _ H STATE ENERGY conE --------- ---------------------- i u FINAL II o c, ----ADDITIONAL COMMENTS! G 1 Q ----------------- BOARD ' OF HEALTH . . . . . . . . FORM NO..1 - 3 SETS OF PLANS . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . SEP 1995 BUILDING DEPARTMENT CIIECK . . . . . . _ . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 EL G5 2 t� T • 7 180 _- aCALL . . . . . . . Examined . . . . > ., , 19 tIA I L T O : Approved . . . . . . � . . ., 19/. Permit No. 3©-z 3 . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . I spector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to scliedule. b. Plot plan showing location of lot and^of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app; 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 perm shall be kept on the premises available for inspection throughout the work. e. No building sliall be occupied or used in whole or in part for any purpose whatever until a Certificate Of Occupanc shall have been granted by the Building Inspector. APPLICATION IS I-IEREBY MADE to the Building Department for the issuance of a'Buhlding Permit pursuant to tl Building Zone Ordinance of the Town -of Southold, 'Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions'or alterations, or for removal or demolition, as herein describes. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. �. . . . . . . . . . . . . . . . . . pP Sian�attir of applicant, or name corporation) if a cor ( b nn ` CUT . . . . . . . . . . . . . . . . . 1 � I . (Mailing address Of applicant) qIU i ,:State,:whether whether applicant' is-lbwner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder . . • . . • . . . . . . . . . . . . • . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . Name'of owner O(prenlises' 1C �� AtiQ . RAP�A . cso��(NSON. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J - (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. :'. E.LF• • , , , , , Plumber's License No. . . . . . ... ... . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. .�©U'Cl-� . Sl��'. CQE, k IOWIF , , , , ;I , , , , , , , , • , , , a3�s N,A �oR L NG : . . . . . . . . . . . . : . . . . . . . . . . . .e(JTC _%U . ... . . . . . . . . . . . [-louse Number Street Hamlet County Tax Map No. 1000 Section . . . 3�. . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . .1.8. . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . I . . . . . . . . . . . . ... Filed Map No. . . . . . . . . . . . . . . Lot ; . . . . . . . . (Name) 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . _}:` 95„a :9.i i'..... t.A:_)5•.:•j•C.t t:A.2i .'P. . . . b. Intended use and occupancy R Cr RNTEN&J A T J.L'.• ? �ii ro MWI5 b:/l•1 ..'!•14li.":� • 3. Nature of work (check which applicable): New Building . . Repair Addition . . Alteration . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Demolition . . . . . . . . . Other Work . . . . . . . . . . . . . . . Q�j� (Description) 4. Estimated Cost ;y . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . .... . . . . : . . . . . . . . . . 5. If dw (to be paid on filing this application) If garage, number of cars . . . . . . .elling, number of dwelling units . . . . • Number of dwelling units oil each floor . , , , , • _ 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 . . ' . 1-Ieight . . . . . . . . . . . . . . . Number of Stories ' . Depth . . . . . . . . . . . . . . . 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 Fonner Owner 1 I. Zone or use district in wllicli 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 Name of Architect , . . , , , • • • Address . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . ' • • • • • • • • • • • • • • . . . . . . Address . . . Phone No. Name of Contractor . " " " " " " " " " • • • • • • • • • • • • 15. Is this Address . . Phone No. . . . . . . . . . . . . . . . property within 300 feet- of a Lidal 'wetland? *Yes. . . . . . . . No. . . . . . . . . *If yes,• Southold Town Trustees Permit maybe 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 or corner lot. To u1 pow N 4 �r A LkX YLt VOOT(NG WILL GIE fJTRCW Q' fia `THE FdUNOAT( oK) 5©LjTk4 510E 0 F- CAd M JT.. ASI tJNVF RGROUND aPPROV ' S .NOTED N O ov F kkv-�� � �C ' .L I S FEE: BY: f NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION''= TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE'REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW.YORK, COUNTY OF . . . . . .S.S . . . . . .`.I� cS. . . . . . , . . . . . • . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ibove named. le is the . . . . �. .�. . . . . . . . . . . . . . . (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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the .vork wi11 be performed in the an er set forth in the application filed therewith. ;worn to before me this is of .e�.�... , 19��. 4otary Public, . . . . . . . . . . . . . . . . — ounty ROBERT1. SCOTT,JR . . . . . . . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC,State o N.Y. Q No.4725089.Suffolk Cou tyy�� (Signature of applicant) Term Expires May 31. 19tP `}I �'i4rrgslr?Al, .ayhlt?f� j 74 „I 7-51 7F i 7 y C_ 't •�• : t7WELLINGS /OO.00 •.h,t, , (21.t) �D. irK -.... _. _C «D.•TX is //6 //5 DATUM 14PPROX/MATf� . I �i� 'l,1I //9 LoT AREA /2,600 do.s "�" • - W � O N�•AR!'ST IVAr�-R MAIM' 11 /N EXCESS ox SOQ/r7. N TAX MAP n/ST, ro'oo t' S E•'C. /34 91 Pr•: <•.'rF I s7oaY IU W TEST ®OR/MG ~ 00 �^ I Fa dwE' .. N /t7 l7 (AS PWq AAft/CA/I( ) L I L to I SArm WA7 E R qu 1? vi 114 arr sstx N 07"S8'.50,w /00.00' asrr salt '"• U 'DERWRITERS CERTIFICATE �1► REQUIRED OCCUPAN CY OR FUL . t ,;.'t• . DWELLINGS (WEL . .) pEi�� �� y •`�� GER IFICAt"' -- 1'176 DWELLING UND "` OCCUPA C I r r ER CON S'j" !i• IY7t, . FINAL '-,URV Y LK UNTY D E EFT C:F THE NATER SUN ,EWA(,-E NAME: II S1�RV10E! "Irt�R. `1fh5F'iUSAL ' F(,R I. '.I RESIDENCE~ IAL `I` Ct NST C'N<~.r WILL CONFi:k1.1 ' 10 THE STAND - _ -- ARD!, CF THE SUFF(I.K COUNT I'L I NO -- -- ... DEBT OF HEALTH SERVICESED I.�1 ,_. ... . 1=HC•.IE _.. � :•I FROM IM11 .r•t•It an:i mil lip fill:. r'iN °n,mc -.. ._ t � NC 78•.790/Nli s Ir,•n:: I:; rl:r. P L C 1 £ AW./v-/emrs r s rP,ne fin,. r -rn. ern fir Ir, I,!„Ir to +►fr ,^ ��rIYII`r ? rr ��, ! ,!•,,,.. enu'ntoN. SURVEYED FOR In plot 9 1,• •rI ..1•l, +'l,•t wI, still h..t'; e...•,.,:i I - :•�•".r:,� l,� ,r.rtoltia LOT NUS. //_9 //6 INCL. I,�,.r:l„qua-�1I•r To r+.ItI0N11I, MAP OF EUGLrIVE HIE/G-H_cunaqmr r /L"7 !.,' tf,• �1 b S!TUATED ,if //T/•IJ�G+uE• rl'1 f• 'vo1 or r 1^•r.^+ f r rtlli 1'11YF.Y MAP NOT + 1111AIC soua►rI011 rr•-rt; fill, tANn alevr.Yon'sk TOWN OF SOUT,4/O(p_ .SUFfOL/Y COIMITV, /I!Y. slil oil runo,srn xrn� �'. snt t n'ol fir ConsloCeso to 24 A VALID TRUE Corr. SCALE1 " .30' DATE 6-20-/97a !Et D ONLY TL) LED MAP NO. 956 DATE /0•29-/928 t )OK NO L.L, PAGE ;o✓I;rT1I fl'.DER/� �ii1Vln,:� / ,(fiA./ /Iy�,,/, '1ERIG^rI _r1TLC /NSVR"CLr Cnr'tA-,NY OFr/ Y IIAk� )I,f`, l: TN.:";CN(�N JI: PC a I1.•I- S- %(r-14 LAIJL` SI,hVEYOP !l, :UC'(' k'SSl tlt Tt_ ''llll.' I.;I�I G MEIER ' N0I:TII COLIkTRY I?OAD - V1 DING FIVER t TLt-Nrw(IN IIJ N Y LIC NO. 048992 NCY/ Y;DRK 117Q2 l