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Home My WebLink About23819-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25012 Date MAY 6, 1997 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1975 CEDAR DRIVE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 1996 pursuant to which Building Permit No. 23819-Z dated NOVEMBER 23, 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 ADDITION & ALTERATION TO EXISTING ACCESSORY STORAGE SHED AS APPLIED FOR. The certificate is issued to BRIAN & CATHY CAMPBELL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A c Rfi" ildin Inspector Rev. 1/81 FORM NO. f 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) N° 23819 Z Date ...�1.. .. ..-'.................................... .. 19. 1 Permission is hereby granted to: ........ .. . ,�........... ............... ... ............ . -......: � ..... lo to y ''�r..� ...�?1: :..G?. �i... v?7..j.. ..... ... . . .:� .. .... ......... ..... ... .. ... . .. .. ...�........ ..... ...... ... .................................. at premises located at ..19.�.7r........ .....�... .�.�. .. ......................................................... ................................................1.`..... r .` ...( ......................................................... ............................................................................................................/...................................................... County Tax Map No. 1000 Section ..........7,�.......... Block .......l............. Lot No. ::7� ............... pursuant to application dated 1! 19. �., and approved by the ........ ..................................... ..... Building Inspector. . Fee . .. Build' g Inspector... .................... Rev. 6/30/80 Form No. 6 b TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, 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 tc a ng $25.Z2 Businesses $50.00. 2. Ger licate o1 c re-existing Buildinz - $100.00 3. Copy of Certificate of Occupancy - .25v�- 4. Updated Certificate of Occupancy $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .wL ,��,, . . .. . . . . . . . . . . . . . . . . New Construction. .. . . . . . .... Old Or Pre-existing Building.":�6L—,/ ' L.0-yt-:.6 Location of Property.. .��.� .. . ..� . . .s'1�L�.2_. . .f . S .�?L(. �n0.(.d . . ..f..l.�.� . . . . . House No. / Street Hamlet Onwer or Owners of Property. Sx(_C.(fYl.s=� ..��_�6:�.[ /� . .��(f1:>� .��.. . . . . . . . . . .I. . . . . . . . . . County Tax Map No 1000, Section. .. r. ...�... . . .Block. . . .0 .1. . . . . . . . .Lot. . . �.4[l. . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . ... . . . .. ... .. . . . .. .. .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.a S�. � .. .Date Of Permit. . ... . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . ... ... .. . . . . . . . . . . . . .. . . :Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . PlanningBoard Approval. . . . . . . . . .. . . . . . . . . . .. . . Request for: Temporary Certificate. .. . . . .. . . . Final Certicate. . . . . . . . . . . 0 o .Fee Submitted: $. . .�. ) �. . . ; .641 L.16A, . . . . . . . . O ono Gyp Go Z Town Hall,53095 Main Road p • Fax (516)765-1823 New York 11971 ox 1179y��l � �aO� Telephone (516)765 1802 Southold OFFICE OF-THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 25, 1997 Brian H. & Cathy Campbell 1975 Cedar Drive Southold, N.Y. 11971 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. )$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23819-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. " rIFLD INSPr.CTION-REPORT--_-DATE ---COMMENTS---------_________ II II u i ii u i u ; FOUNDATION ( 1ST) II ii i u u u u II i u u n If u II - -2=UMATION (2ND) -------------------------------- v u u u u u u � u n I o ROIIGII FRAME & tr —il PLUMBING ----- �—il �—u u u ;n H INSULATION PER N. Y. STATE ENERGY if I CODE u II I� jl -_--- ---_-- —�---- a -- — —_ — I y II II II II jj II j FINAL u ADDITIONAL COMMENTS_ -- �— — I I x I I . I —t'f w i I i i • � i i s .._...._._...... l �` 11i1 pop _3� .�— DEN C j � 4 BE: Fon ; I ALL P I k y �^�' �. N�f E9 n 4 4 fn��tS!ic�R p t H s S•^' e i ',r`�' EWER R�t.? ! ! ES. N C,df��••��,, pp�FrSaryryPtt0�65;aI`�ap"sc�Lf��p� @ay0��. � k��.":;}'�a'o$�� FH�AnC!'YatE n6p�¢,.q�L,.O��.n"8'k3•T,;,B`6P ft.r'�uw" - i 0 c C: Fzo i I- arz- r Q ry yj -i 1 S .41r Al jr ! I -- - : `s. ff— Ec) 1VAf D F. . I. ozo- {e ,. ,,. ;cc a5 • 1 JNAUTHOCIi ED ALTE TTON OR ADDITION GUGYG J �\ TO THIS SU:VFY 15 AlVIOLAT:ON Of - -•' • 1 SECTION 72C'? OF T-4 NE\i YOw'K STATE �r r,�nl•T Ti+le !n• EDUCATION LAW. I - f COPIc5 CF 7-FIE E'7'1-'Y VAP NOT EEARII��'a � O THE LA:.0 '.:..'-,4�:.A :D S_AL OR .. �. EMEC:::r.,:A: _-`_ t.:T 3: C3',SIDERE[ TD GUA=A'.TE:S b' .._ :'.o c.,e.n et;NOO E1-c'iGK ONLY Tv is . . ... --•.•THi'SI:AVET IS F...:A.:._ A'..,, C.._._ ._...... TO TH- T:P.: C:7:.-vJ•___ _....._.•1.A•. A8, I AID l .._n_Jn. AID TO :_ AS:.....,_c LE:.ZI..G INSTI- TIJT.;:I.GL;ARANT:.3^'--T'TaA7-5F-VkBru �jr tl 0�0 r-+ ' - - TO A:J.ROIvA: OR S-UitSEOUENT , 23 � I9 � 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ /] ISULATION FRAMING [ NAL [ ] FIREPLACE & CHIMNEY / REMARKS: DATE 3heh7 INSPECTOR_1�d�G<>�� BOARD OF HL'AI.TH . . . . . . . . . . . . . . (' ,! FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . .10V — 7 19,Oi8 TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL 765-1802 NOTIFY: O CALL a ru.di-ed../.� 4. .--- 1ga MAIL TO: . . . . . . . . . . . . . . . . . . . . APProved..��•�>-.�-----� 197:6. Permit No. ............ .............................•---... Disapproveda/c .................................. .................................... - (Bui ng Jpector) APPLICATION FOR BUILDING PERMIT Date. . . . . . . 19. . . . INSTRUCTIONS a. ibis application mist 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. r b. Plot plan sharing 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 mist be drawn on the diagram which is part of this application. c. The work covered by this application voy not be comienced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 MARE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tam 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...........: �:.................... .............. (Signature of..'applicant, or name, if a corporation) %1-7 S ce-oA L- o r SD vTt*?,,0 --- - - ---.-- •(Mailingaddress ofapplicant) � - State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..........mac, .- )-tll('z ........................................................................ .... ............. Nam of owner of premises C f. .... ....-C. �(r. .. .......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .......................................................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which(/pfroposed work will. be done......_ ..............`...........................__......_..____ ........5� � .` !..... . .. .................... House Number Street Hamlet County Tax Map No. 1000 Section ..- - ..... Block .....V...) ..... Lot ....�... Subdivision ...................................... Filed Map No. ............... Iot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a_ Existing use and occupancy ..... �!l.:Y .-. 1. .......................................... b. Intended use and occupancy ....✓...../t:....... ..�> ........................................... 3. N•uture of work (check which applicable): NeW Iktilding .......... Addition ... .... Alteration ......... Repair ............ Removal ............. Denx)lition ............ Other Work ................................... I ( (Description) 4. Estimated Cost .......1.� e.� - .-• fee .............................................. (to be paid on filing this application) 5. if (haelling, mviwer of dwelling units ............ Ntxti)er of omel.ling uni.ts on each floor ................. IT garage, txniuer of cars ...................................... G. If lxtsiness, amnercial. or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of exisrrtiin�ng structures, if any: Front......5�....... Rear ....e........ Depth .... � ......... lkigttC ....._.... 11........... Nud)er of Stories ...._..I............... Dimensions of sane structure with alteratiIons or additions: Front .....�.�. Rear ......�.�.... Depth ........h..c_ ....... ileigIlt ------- ......._ Mni)er of Stories .....I.. 8. Dimensions of entire crew construction: Front ...... ...... Rear ......!1j ..... Depth ..1 Z....... lieiloit. ............r.0........, Nxtiter of Stories ........j............ 9. Size of lot: Frrxtt ......�.(o O........ Rear .....1.44.0.......... Depth ....f..v.......... 10. skate of Purchase ..................... Name of Former Owner ..0 K �-... ..CC?�' '�d`JC......is.ays II. 7Aw* or use district in which premises are situated .............................................................. .. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will. lot be regraded ........N.v...... Will excess fill be removed from premises: YES NO ► M- Mans of (kanner of premises ........................... Address .............................. Phorx- No. .............. IJ,-xne of Architect .......................... Address .............................. Phone No. .............. Name of (contractor ................................... Atklress ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ... ..... *IF YES, 9OUI11(A.D IU14N ITOMITS PEI4II'I' MAY BE, REQUIRED. PLOT DIAGRAM 14)caCe clearly and distinctly all buildings, xitetlter existing or proposed, and indicate all set-back dimensions from property lines. Give street and block nuni)er or description according to deed, and show street names and indicate cAteLlter interior or corner lot. /(x'- Cam" CAD - Duly" srn•rn. (x� rx; (Nat '_ SS OUI IN IY OF ...... . ...... �.... .L.�..........being dul.y sworn, depo.ws and says that he is Lhe applicant(Nave of indiv.iduav'signi.ng contract alxuve nartvd, Ile- is Ute ....... ........ ................................................................. (UmitracCor, agent, corporate officer., etc.) of: said uwt)er or owtx�rs, and is duly authorized to perform or have performed Lhe said work and to ttrtke and .fil.e Lhis appl.icati.rnt; that all statements conLaine.d in Lhis appl.icati(m are tnR to the hest of his ktxywl.edge and lxfl.ieH and Lhal Lhe work wil). be performed in the trrtmtev set forth in the application failed therewith. Sworn to Itefore rrte this U-1' / .clay of ..U.v.. l Notary I.'ubl.i .. ......... / CLRt1RE L.GLE{i1l 'mature tfim) icant)l. Notary Public,State of New York No.4879505 Qualified in Suffolk County Commission Expires December 8,19LT