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Home My WebLink About22942-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23837 Date AUGUST 28, 1995 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1175 BRIDGE LANE CUTCHOGUE NY House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 2 Lot 6.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST, 11, 1995 pursuant to which Building Permit No. 22942-Z dated AUGUST 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 ENCLOSE AN EXISTING PORCH AND INSTALL A FIREPLACE IN AN ACCESSORY BUILDING AS APPLIED FOR "AS BUILT". The certificate is issued to ELEANOR NONE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspe 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........................... ...®. .............. 19.9,E N2 22942 Z Permission Is hereby grqqted to: A... 70.4�..................................... to... <"4j- -Ar1z '.... /., .�-'......��... � ... s..lac- .................................. .................................................................................................................................................................. .................................................................................................................................................................. at premises located at......... .......... ....................................... ......................! ........../Yy............................ County Tax Map No. 1000 Section ......//.c?"... Block..........7........... Lot No. .,�.. pursuant to application dated ............. .......�/.............., 19.... ✓...., and approved by the ��f Building Inspect Fee$.. .............. . .....`.... . .. ....... ............. Building Insp or Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1.802 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: I. 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 Mess than 2/10 of U 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: I . 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 I. 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 $15.00 Date 8/28/95 R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . Old Or Pre-existing Building. Location of Property. . .11. A .$R1AQX LAM . . . . . • CUTCHOGUE. . NY House No. Street Hamlet Onwer or Owners of Property. . . . . ELEANOR NONE County Tax Map No 1000 Section. . . . .118 . . . . . . � . . . 2 6.2 L.locic. . . , . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F:i.i.ed Map. . . . . . . . . . . .Lot 22942-Z 8/13/95 GARY OLSEN ATTY Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval.. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X . . . . . . . Fee Submitted: $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � - l: " 3 > / APPLICANT. . . . . . . . . . . . . . . . . . . . . . . FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION ( IST) FOUNDATION (2ND)___ ----------------- _11 _ ROUGH FRAME & PLUMISING I �N INSULATION PER N. Y. STATE ENERGY -- II CODE - r� I H --- I; e�,K 260 - i II ;I I FINAL II{ it ^� ---------------------------------- ------------------- ---------- ----------------------= V' ADDITIONAL COMMENTS: trl z d� r ro H BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO.-1 SURVEY . . . . . . . . . . TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM IM , TOWN HALL NOTIFY. ,OUTHoLD, N.Y. 11971 CALL TEL.: 765-1802 MAIL TO : Examined . . . • !. . . . ., 19�� Approve -Z /Or��. . . . ., ISO Permit Nol� . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 (Building Inspec r) . A PLICATION FOR BUILDING PERMIT t Date August .1.0,. . . . . . . .. 1995 . 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. i b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street:. or 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 u Certificate of Occupancl shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance f a Buil mg Permit.pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, other ap licable Laws,Ordinances o: Regulations, for the construction of buildings, additions or alterations, or for re oval or d 11ition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building c e, ous' ode and.regulations, and tc. admit authorized inspectors on premises and in building for necessary inspection . ( ' nature of a •plicant, or name, if a corporation). . . Gary Fl anner Olsen, Esq. ,•, .P, Q, BqN .7.R6,. Cutchoaue,. .NY. .1.1.9.15 . . . . . . . . . . . ,.., (Mailing address of applicant) .7 State whether aphlicant_Js owner, ,lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. 4:..-... :A .fori:ow,n°e,r' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . Name o`f ownerof.premises..F..,1r�1`eanor:,S. ;Nohe ,Re...... . . ,Trust , , , • , , • , • , • , • „ (as on the tax roll or latest deed) If applicant is� a�i corporation,lsignature,of duly authorized officer. . . . . . . . . . ? e and title of corporate officer) 4✓V. .w ALL,1.cONTRACITOR', MUST BE&�S:UFFOLK COUNTY LICENSED. 1 Builder'sLic_mse NP'' �$,, Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . i. "Location of land on which proposed work wiii be done' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . Bridge Lane, Nassau Point, Cutchogue, New York 11935 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [-louse Number Street Hamlet County Tax Map No. 1000 Section 1.1.8 . . . . . . . . . . . . . . . Block . . q? . . . . . . . . . . . . . Lot . -. . . . . . . . . . . . . . Amended Map B Sec B Subdivision . .NaSSau .PQi.nt . . . . . . ... . . . . Filed Map No. 7.99 . . . . . . . . . . . Lot P../:0. 142. &. 11.a. - (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . .EggIo5ed ,pQrch .and .fi.re .place. ,i n ,accessory, bui 1 di ng • . , , , , , , , , , . . b. Intended use and occupancy .�nQIQ5ed .PQrch .and .firye.,p'lsa ';a r R.ae°ces• ory. building , , , , , , , • , , , , , {l::ice �kr..:. ir'Ji��'• %1' 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . . . . . . . . . Alteration X . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other.ly-wk� .1. �. . . . . . . . . (Description) 4. Estimated Cost . . . . $3.,000.00. . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` (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 . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . : . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Nameof Architect . . . . . .. . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . .. . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . 15. Is this property located 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. Enclosed existing porch and construct fireplace in accessory building as built. W11"'UPANCY A P OVED AS NOTa`O� OR DATE: �� B.P.# U""E% N ULAVEUL NOTIFY BUILDING 0 �z��°� 765-1602 9 AM TO 4 PM FOR THE � � FOLLOWING INSPECTIONS: HOUT 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE g b 'U � � 2. ROUGH - FRAMING Bt PLUMBING 3. INSULATION 4. FINAL. - CONSTRUCTION MUST BE COMPLETE FOR C.O., ALL CONSTRUCTION SHALL MEET !yam THE REQUIREMENTS OF THE,, N.Y. STATE CONSTRUCTION t ENERGY UNDERWRITERS CERJIFlCA E 's CODES. NOT RESPONSIBLE FOR dam, REQUIRED DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S COUNTY OF .,SUFFOLK. . . . . . . . . . . . . . . . . . .Garde .Elanner. .Q15Qri,. .�s.Q.. . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . .MQrtleY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... (Contractor, agent, corporate officer, etc. of said owner or owners, and is duly authorized to perform or have perforated tlt said vork and to.make and file this application; that all statements contained in thi -application are true to the best o his kn wledge and belief; and that the work will be performed in the manner set forth`in the;application filed therewith. Sworn to before me this . . . . . . . . . . 1Oth. . . . . . .day of. August . . . . . . . . .... .. 19 .95. Notary P lie . . . `:� . . . . . .`. , SpffP1 k County WRRAINE KLOPFER Nmq Public.State of New Y" No.4828373 . . . . . . . . . . . . . QaelHletl in Suffolk County Commiasion Expires Nov.30,1 t/99S (Signature of applicant)