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HomeMy WebLinkAbout21230-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22763 Date DECEMBER 2, 1993 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 2750 NASSAU POINT ROAD CFITCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 12 Lot 16 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 17, 1993 pursuant to which Building Permit No. 21230-Z dated FEBRUARY 22, 1993 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 ADDITION & ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KENNETH & MARGARET MONAGHAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-291965 - OCTOBER 8, 1993 PLUMBERS CERTIFICATION DATED NOV. 15, 1993 - HARDY PLUMB. & HEAT. NORTH W uil ing Inspector Rev. 1/81 FORM NO. A 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) t N°-N° 2123O Z Date c 19` , Permission is hereby granted to: Qkj q...........'- . .y.:....~a.o... to Qla. ! ! aAf -!r4CM. a . JOM at premises located at ?~a 0 q . a. i County Tax Map No. 1000 Section .....~.Q. Block Lot No...1 ! pursuant to application dated a~k!?4.4f Ate...... 7.......... 191.1., and approved by the Building Inspector. RI Fee . 3:. ~S?. r Building Inspector 4 Rev. 6/30/80 N a2 s, zo cc~~e . Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential ~$f15.00, Commercial $15.00 Date 19;3 . New Construction........... Old Or Pre-existing Buildiin~g... Location of Property..?'? l".~ ,G!+'....9 ..A House No. Street Hamlet Cower or owners of Property ......./a~:...tS County Tax Map No 1000, Section ...Q 0 4......Block....1L.........Lot.../.6 Subdivision ....................................Filed Map............ Lot...................... Permit No..I IyrJ.~ ..Date of Permit.M..... F~..... Applicant Health Dept. Approval ......:j~ ................Underwriters Approval......................... Planning Board Approval..... Nlk Request for: Temporary Certificate........... Final Certicate.t~..... Fee Submitted: $ 1 4 kAIL41 . . a 33 APPLICANT . 1~LD L..~.. u <<:•/ If:~n.'. ~I ..1..`~L'tlvNl~ f C OUiIDATION (1st) ~ ~ ' OUNDATION (2nd) _ =9+ OUCH FRAME & ~ d -PLUMBING y f V11 1 n 4 NSULATION PER N. Y. STATE ENERGY CODs m y I 1 FILIAL q~ ADDITIONAL COMMENTS: X ' N 00 y ~i • O _ r H 7b v• I ^v H I 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ( ] INSULATION [ ] FRAMING [ FINAL REMARKS: c Lip.. ~ w^ ^t T~ / _JC~ (f D Ali' v DATE ~f INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ROUGH PLBG. [ ] FOUNDATION 2ND [ ]'`INSULATION [ ] FRAMING [ ] FINAL REMARKS. l DATE ` INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ 4J F NDATION 1ST [ J ROUGH PLBG. ( FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ' DATE ~ INSPECTOR, J M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ( ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING I FINAL REMARKS: DATE INSPECTOR TEL. 76'5-1802 ' C Cp TOWN OF SOUTfioi:D OFFICE OF BUILDli 1:, I JSPEC CC! R TOWN I:..LL 4 SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date a?~3Q Building Permit No. / 1 Z ~ Owner /ylDi?Aft, il/ .7ae-3 f~ (please ~ print) Fr I Plumber pa(-AV ! I" lurvgkIY1G`F Ra,41n4 Mo tk (please print) J I certify that the solder used in the water supply system contains less than 2!10 of 1% lead. • w (plumber's signature) Sworn to before me this 2S day of z~ r 19 9.3 16taL Pub c - Plota." PUhlic, S~ oLI~ Coun'.y Notary Pubic, State of ENRIGHTNow York No.4979701 Qualified in Suffolk County Commission Expires April 8, 19 THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 r1015088 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date OP9Ytin 08,199.1 Application No. on file S1CA13S93193 N X91955 THIS CERTIFIES THAT only O the ^ ~I vm mment dese *bed below and introduced by the applicant named on the above application number in the premises of tTt7 NA`u;AU P`'. ROAD, POLE 103, CUTCHOGUE, N.Y. in thefollowing location; M Basement Ist FL ? 2nd Fl. (.AR/ATT.IC/ONT Section Block Lot was examined on O C T 08 R R 0 5 , 19 9 3 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 K W. AMT K.W. AMT. W. T. K. W. AMT. H.P 38 41 111, 37 I. 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS 5?ECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. AMP. MIT. AMPS TRANS. AMT H. P SYSTEMS AMi. Is AMT K. W. OIL H. P. GAS H. P. AMT. NO. A. W_ NO. OF FEET SERVICE DISCONNECT NO. OF S E R V I C E "T. I AMP TYPE METER %]`tY 1,9'3W 993W S,e'4W NO. OF CC COND A W CO NO. OF HIAfG A.W G. NO. OF NEUTRALS A. W.G EQUIP. , PERe OF CGCOND. OF HbLEG OF NEUTRAL 1 200 CB 1. X 1 210 1 2/0 OTHER APPARATUS: EI,1;C. ROOM IIPsA'TERSt I.2, Y„W. MOTORStI-5 N.P. ,1.-Y N.P. PAREI,BOARDEII.1 C'LR. 60 SMOKE DETECTOR,, 2 G Fx G ELECTRIC LIC 43733 18 K,LANDLNC RD. HAMPTON BAYS, NY, 11916 GENERAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors moy be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. I BOARD OF HEALTH FORM NO. 1 3 SETS OF PLANS . TOWN OF SOUTHOLD SURVEY . . . BUILDING DEPARTMENT CIIECR F 7 TOWN HALL SEPTIC FOR:1 SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOT I F'[ ; -VA CALL Examined . 19 ~ MAIL TO Approvedc Y. , „ 22 199 A-Permit ' . . Disapproved a/c . ( ui mg Inspector) 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 3 ats 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 r'areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. e. 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 :tall 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 tall 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with ail applicable laws, ordinances, building code, housing and regulations, and to 3mit authorized inspectors on premises and in building for necessary inspectiotas? (Signature of applicant, or name, if a corporation) 2S z 3s. "-w Ica- urT~~Y~~ ov y (Mailing address of applicant) late whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. f//zch~!?,~7........... . . . , . ame of owner of premises (as on the tare roll or latest deed) 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. Location of land on which proposed work will be done . . . (louse Number Street Hamlet County Tax Map No. 1000 Section . , .14~9:5 Block / 2 . , , , , , , , , Lot Subdivision Filed Map No. Lot (Name) State existing use and occupancy of premises and intended ~uusee/and occupancy of proposed construction: a. Existing use and occupancy i1~12as1G~ Ntat'1....... . b. Intended use and occupancy , ii y.4mmtoArE'a ^:II41Y.00" ylwa YlMIU2 Agee) A..... I 3. Nature of work (check which applicable): New Building , Addition V/. - Alteration' Repair Removal Demolition Other Work . 4. Estimated Cost OOQ (Description) j . Fee . 4_.s (to be paid on filing this application) If dwelling, number of dwelling units , . , . , ~ , , , , Number of dwelling units on each floor , , , • • . garage, If business, commercial r or mixed I'' . occupancy, specify nature and extent of each type of use stontst~ structures, if any: Front Rear . . . . . ~ ; s . . Depth : . 7 Height ber of Stories .454}.................................... Dimensions of same structure Pt with alterations or additions: Front . i, , , , . Rear . • . , Ca... • • • • . . . Number of Stories 8. Height of enti ne / ..Height ' * . 5 Dimensions of entire new const~ R ~ eo Numberrof.SFrories nt ,~vo.......Rear Depth . 9. Size of lot: Front ~q,? . . 10. Date of Purchase ear , • Depth ..©Z ,,o© ' ' ' ' Nam of Former Owner ' 11. Zone or use district in which premises are situated , ,W- . O 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded . Q Q• • • • • Will excess fill be removed from premises: Yes o 14. Name of Owner of premises !!e ,~{/.rP$, ,/ylOKi~(YN.c~ p Address p; . S~Bf(y,.WuTyPhone No.-S/K r3Y.c~f,~ Name of Architect 9t9!y14B $7 t, Address z52J5 iri g~aJ.Zj. , Phone No.446! ,'73fAlwS ame of Contractor . * y Address Phone No........ ' . 15. Is this property within 300 feet of a tidal wetland? " " " " Yes........ No..... If es, Southold Tpwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all setback 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. ~I i I ~I M rATE OF NEW YORK, JUNTY OF...~ .............p~S..S~i being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) ove named. is the (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,rk will be performed in the manner set forth in the application filed therewith. om to before me this ` .day of 19 7, tary Public, County 001; LIRA FOFOSICN Ntivy P&A, Side of NewYoAt No. 4986583 SuHAk (Signature of applicant) CIO* Tom EvirnW 3,16