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Home My WebLink About22303-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25763 Date: 06/08/98 THIS CERTIFIES that the building ADDITION Location of Property: 4875 NASSAU POINT ROAD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 111 Block 9 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 7, 1994 pursuant to which Building Permit No. 22303-Z dated SEPTEMBER 8, 1994 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 RAISED PATIO ADDITION TO AN EXISTING ONE FAMILY DWELLING AND INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to SELIM & JUDITH SAMAAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 364763 09/27/95 PLUMBERS CERTIFICATION DATED N/A C L Buil 'ng Inspeator Rev. 1/81 n 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 ............................................ 19 . N2 22303 Z Permission Is hereby granted o: .. .......................:......................................... y,......../ to ...4!,A,-A ' a..... ..... .... .Qr7. ........ Lam.. . .. ........ .. .. ... . ..... . ... . .. ........�.. . . .. ........ ............. . .. ........ ......... .. .... ......... ...... ......................... ......................................................................................................................................................... ..........................................,..................................................................................................................... .... at premises located at...... 7 ......�.V.... .. . ...... ... ................................... eow/ C' 'Vn County Tax Map No. 1000 Section ......�r ....:..... Block.........?............ Lot No. ...... d............... pursuant to application dated .........Z/F/...................................1 19.. ., and approved by the Building Inspector. Fee ............. .... .. .. ��.............................. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 l` I APPLICATION FOR CERTIFICATE OF OCCUPANCY X. 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 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. 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 Buildiniz - $100.00 3. Copy of Certificate of Occupancy - _ .25e,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.06, Commercial $15.00 Date j.1:e: .. :`�tiL�Q . . . . . . . . . . . . . . . . . . . . . . . .4ew Construction. .. .`... ... old .Or Pre-existing Building. .. . .. n 1 Location of Property. �.'1 S.... . . .�SS� �c��E . K�. . . . . . .�c�Rs� House No. Street \ Hamlet Onwer or Owners of Property e_�� 'Y' . ... . ..-. .. . .. ` . . . . . . • • - - • - •• • • • • • • • County Tax Map No 1000, Section. . .. .U.1. . . . ..Block. . . .. 1. . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . .. .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . ... . . . . . . . Health Dept. Approval. . . . . . . ... . .. . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . .. . . . . . . . . . . . . . . . . .Request for: Temporary Certificate. . . . . . . . . Final Certicate. . . . . . . . . . . �5 -$. L Fee Submitted: . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,< . . . . . . . �. . . . . . . . . . . . . . . . . APPLICANT �< G O o�O Gy1 Town Hall, 53095 Main Road y 2 Fax (516)765-1823 P. O. Box 1179 W Telephone (516)765-1802 Southold, New York 11971 �p OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD Sept. 22, 1997 Mr. Gene Chituk P.O. Box #9 Cutchogue, N.Y. 11936 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) r.X 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 # 223037Z (SAMAAN) Please contact our office on this matter. Thank you for cooperation. lb -THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1. 1195099 ! BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date SEPTE14BER 27,1995 Application No.on file 87676195/95 N 364763 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 EUGENE CHITUCK, 4875 NASSAU PT. RD. , POTS,, 121, C:UTCI HUE, N.Y. in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. GAR/OUT. Section Block Lot ans examined on SEPTEMBER 13,1995 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES S FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS WITCHES OUTLETS INCANDESCENT.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1 1 1 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 1 20 SERVICE DISCONNECT NO.OF S E R V 1 C E AMT AMP TYPE METER I-,YW 1.5 3W 3 0 3W 3 0 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A•W G• EQUIP. PER AY OF CC.COND. OF HI-LEG Of NEUTRAL OTHER APPARATUS: MITT n4ING POOL-1 TIME CLOCKS-A14P.40-1. G.F.C.I-1 (SWIMMING POOL) This certificate . covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test/and or repairs Made by a qualified person. «< Continued on Page 2 >>> GENERAL MANAGER 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 credentiols. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. PAGE 2 .THE NEW YORK BOARD OF FIRE UNDERWRITERS 1195099 BUREAU OF ELECTRICITY F 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date SEPTEMEP 27,1995 Application No.on file 8767E 195195 N 364763 THIS CERTIFIES THAT ow mi the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of S 'C;naav) EUGENE CHITUCK, 4875 NASSAU PT. RD. , POLE 121, CUTCHOQUE, N.Y. in the following location; ❑ Basement ❑ Ist Ft. ❑ 2nd Fl. G'A-P OUT Section Block Lot ams examined on SEPTEMER 13,1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. 1 K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. I H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF S E R V I C E AMT AMP TYPE METER �,7W 1 0 3W 3 0 3W 3,0'AW NO.OF CC.COND. A.W.G. NO.OF HIAEG A.W G. NO.OF NEUTRALS A.W.G. EQUIP. PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: JIM SAGE ELEC.. INC. 35C� riARIA3E PLACE GENERAL MANAGER GRFEItiTPORT, NY, 11.'�49 11. Per L ate 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. 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS CATION [ ] FRAMING [ FINAL i [ ] FIREPLACE & CHIMNEY REMARKS: 9 c DATE / i�/,�77 INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 7ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]�FINAL INS [ ] FRAMING [ [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE � 3 � INSPECTOR 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE 7 9 9 -7 INSPECTOR__J W/4 L:7 %::;: -CUMMLNTs ,3 7 0UIJDATION ( 1st ) ^OUNDATION ( 2nd ) 2 . z 0 ROUGH FRAME & •PLUMBING ' 3 . y IIJSULATIOPJ PER N. Y. • • .� STATE ENERGY CODE . x 4 . \� FINAL 5pl3h ' r s IO • z ADDITIONAL COMMENTS : 'm C7, rri y V H y • T 1 ' t • y. U BOARD OF HEALTH . . FORM NO. 1 3 SETS OF PL,1;15 •. . . Al iG 1 7 1994 !} _ TOWN OF SOUTHOLD SURVEY . . . . . _ _ • . . . • • . . , , BUILDING DEPARTMENT CHECK . . _ . . _ _ . . . TOWN HALL SEPTIC FOR:I _ BLDG.DEPT. SOUTHOLD, N.Y.. 11971 TOWN F SOUTHOLD TEL.: 765-1802 Examined . , 19 '�� CALL . . . . . . . . . tIA I L To Approved . . . . . . . . . . ., 19� Permit No. � . . . . . . _ . . . . . . . . . . . J Disapproved.a/c . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . _ . . . . . . . . . . . (Building I ector) APPLICATION FOR-BUILDING PERMIT Date . . .Q . . . . . . . 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 schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ca 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 appi� ration may not be commenced before issuance of Building Permit. d. Upon approval of this application, tiae Building Inspector will issued a Building Permit to the applicant. Such permit- shall be kept on the premises available fer 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 Ordirn<mce 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, a d regulations, and to admit authorized inspectors on premises and-in building for necessary inspectio s. (Signa ure 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. . . . . . . . . . . . . . . . :. . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . (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. Plumber's License No. Electrician's License No. , , , Other Trade's License No. I. Location of land on.which proposed work will be done. . . , . . . . . . . � . . . . . . . . . . . . . . . . . . . . . . . . . J . . : . . . ff.//�. . . . . . . . House Number Strcet Hamlet County Tax Map No. 1000 Section . . . �� . , . , , , , . : , . Block . ... , , , , : . Lot . „ . /i!�—�. . .� %v A / . . . . . . . . . . Subdivision Filed Map No. (�, . Lot (Name) . . . . . . . . . State existins use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy , , • , • . _ . . . - • • • . . .;�.,. . b. Intended use and occupancy /` � ,/cJ "' ` 444` ' �,r 0 x' -3. Nature of work (check which a Pplicable): New Building Repair . .. . . . .. . . . . Removal . . . . . . . . . . Addition . . . . . . . . . . Alterati . . . . . ov on • • • • . . . . . . . . . Demolition ther Work . • 4. Estimated Cost,/��pUl� • : _ _ • • _ • _ u . • . - • • • • . • . • (Descn) . . . . Fee . . /a'��, 1�,b. . . . . . . . . . . . . . . . . . . . . . . . . 5•. If dwelling,number of dwelling units . , i (to be paid on filing this application) Number of dwelling units on each floor . her of cars ... . . . . . . . . . 6. If business, commercial ormixed. • • . . • . • • � • • • � • � � � • � • • � � � • " " " " " " • • • • • • • • • • • • • • • • • • . . . . . • • • - 7. Dimensions f e occupancy, specify natur? and extent of.each type of use . . Height , . �fisting structures, if any: Front -S5 . . . . . . . . Rear. . . . ,� • • , , , , • • . • • • � �, ' ' ' ' • . . . . . . . Number of Stories .�. Depth . ,yz7, �, - Dimensions of same structure with alterations or additions: F . . . . . . . . . . . . . . . ' . . ' ' • . . . . Depth . . . . Front. . . . . . . . . . . . . . . . . . . Rear . . . . . 8. Dim • • Height . . . . . . . . . . . . . . . . . . Number of Stories . . . . ..• Dimensions of entire new construction: Front ' ' ' .Height . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . 9. Size Number f Stories . . . . . . . . . . . . .- P . . . . . . . . . . . . . e of lot: Front . . . /.J`,�•.lo. Rear . . ./I`, J,1,r• . . . . . . . . . . . . . . . . . . . .f . 10. Date of Purchase Depth . , �? `;U6 11. Zone or use district in which • • • • ' ' ' ' ' ' ' ' • Name of Former Owner . . . . . . . . . . . . . . . . . � premises are situated . .1 . Does proposed construction violate any zoning law, ordinance or re • • • • • • • • • • • ' ' .13. Will lot be'regraded gulation: . ,I.�.Q. , • • . . • , • • , • • • • • • • • ' ' ' ' "5 ' ' ' • • • • • • • • • • • Will excess fill be removed from premises: Yes • • • . 14. Name of Owner of premises�./�.,L , � ! Address ,?Si I_!-- Q`�•� ,'� .Phone No. Name of Architect '� • • Name of Contractor W11.(�' ;' �� . f . ' • Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . - 15. * Is this propertywithin • • Address"�p.r�at',9L • Phone No. ?.�f.!s?��.'�� • • 300 feet of a tidal wetland? *Yes•A . . . : . .*If yes,* Southold Town Trustees Permit may- be required. No. . . . . . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, wl:c ..er existinn set- ack dimensions fro property lines. Give street and block number or d=t:, ;L*on according to deed,land howlst eet catielnamesand indicate whether interior or corner lot. AP ' D AS NOTED FEE: E'4!O'I'IABUILDIDERARTI AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FQ4U 0 DXF1Of i - `I WO REQUIRED FOR POURED CONCRETE . ,.,ROUGH - FRAMING.& PLUMBING 3. 1N AAIt3i4i . 4. FINAL. .. CONSTRUCTION MUST RE COMPLETE FOR C.O. ALL CONSTRUCTION (SHALL MEET THE REQUIREMENTS OF THE NX STATE CONSTRUCTION & ENFERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ;TATE OF NEW OR , 'OUNTF .� t,,t S.S . . . . . � F . . . . . . . . . . d,4! . . . . . . . . . . . . being duly sworn de pp individual signing contract Poses and says that he is the aPP][cant hove named. - e is the . .. . . . . . . . . . . . . (Contracto , agent, corporate officer, etc:) • • • • • • • • . ' ' ' ' ' said owner or owners, and is duly autlio ' _o perform or have performed the said work and to mak e and opk will b that all statements contained n this,..application are true to flit best of his knowledge.and belief;and that File the crk will be performed in the manner set Forth in the application filed therewith: vorn to before me t-hhiishr , . . . . l. . . . . .dsy f '6— Mary P . . County CLAIRE L.GLEW �. Notary Public,State of Now York L No:4879505 . . . . . . . . . . . . . . . . . . Qualified in Suffolk County (� ( ignature of applicant) Commission Expires December 8,19' T E R R0 fk.CARP J�J LOT 1 i1` f 5•C.•..•`e�i fY p1 00 fix} 1. z-.",;�u O w yJ'E Qf 20, E �8• 36 fro ' J ta's LrE LOT O PF N ww I R O 33► Y } corac � ae e a, I &CEStr ITc R�uf A fy T! �(� xti K '�l C t1tS Oh u :r. ON 1 a I _ a•, '�t7fe�YA1f2FrLYi�y1Ufa �� l `ay'r7cy{�� . �... T .' �F AN. ! _ w0c LAIR ( k4 L �3 ` t� { jtA ORA ORlVEMAY ,p.7• 0 p --(� � � 7.� poi 0 us cc ul TO h �o rr^^ L co ` t �pWALL 40 c ( r 328 LOT BLDG.DEPT. r y�af�(t a Ott+ t TOWN OF SOUTHOLD LOT NUMBERS RED` Of NASSAU PWIr" SUFFOLK COUNrr. c,, r NO. log Prepared ih�cco�dance with-tlas minimum --standards for title ourveyS as establlahed . by the L.I.A.L.S. and a proved and adopted 7711 AREA 67,000 SCE.ft. far suoA use by The New York State Lend (TO TIE LINE) - Title Association. D ;r f : .3 6 a 1-2 4 wm UNDERWRITERS CERTIFICATE REQUIRED �v fop OF -5r-LF Ctasi� �E" IU1ME® MIME POOLTO C041E UPON COMP EWN BEFORE*%VATER s q f�},,,y,A; 4 a W/LL F--F �DiVSTi�c�CT�� dr '`7EZFL W�{,[,L 5 k�/r.�l � L,v�a,JYL L� Esc �/�� ✓� f{oe� �/�r Pat. ��o� �Al1.at.�S a�k.W��•� B/vLrF GcyL,L. y� /`�/' �i�i?//(i L//lJ t�?/�/✓ St L� L�LGiL ��/TC /�ov/' D N p 171994 BLDG. DEPT. �L_TQWN OF SOli7'F-0OLD