HomeMy WebLinkAbout22241-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-26365 Date APRIL 12, 1999
THIS CERTIFIES that the building ADDITION
Location of Property 530 CEDARFIELDS DR. GREENPORT
House No. Street Hamlet
County Tax Map No. 1000 Section 40 Block 5 Lot 1.20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 19, 1994 pursuant to which
Building Permit No. 22241—Z dated AUGUST 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to BRIAN P. & BONNIE E. BRACKEN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ov Building Inspec r
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)
G-
Date ......... .. :......... ..... ......................., 19.
N2 22241 Z
Permission is hereby granted to;
..��v...... .c - .. i e(...:....b
....... ®.A4............r.4.`(..................
to ....... ........A' ......
.N.......... xi..S: �.rn�..�.............c .. .... ,�4i.�..� .... ? l..r�►q
14S....... . I......................................................................................
........................................................................................................................................................
...................................................................................................... ........
...........................................
.......
at premises located at....... .�........ ......... 1 ..... . 2.�........................
1%
............................................. . .. .... .,...... .............. ..:. ..........................
County Tax Map No. 1000 Section ........T...O....... Block...... .............. Lot No. .. ,2-0.........
pursuant to application dated `� ..., 19. ...7........, and approved by the
......`. . .....
Buildinginspector.
/5 �a
Fee$................''^.....
....... C ..... .. ,,.
Building Inspector
Rev. 6/30/80
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 - " .25,,-. -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $1 .00, Commercial $15.00
Date . . . .1�1L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . A . . . Old Or Pre-existing Building. . 1. . . . . . . . . .
Location of Property. . .. .S.s.�p-. . . . .. . . .C��te)c .. .. . :/.�_k(.x. . . . . . . . .. . . .�?°�9�:*:���� . . . . . .
House No. Street Hamlet
Onwer or Owners of Property.. . ja , ..*A).Omcv, ..Q. .. .. . . . . . . . . . . . . .. . . . . . . .
County Tax Map No 1000, Section. . . ��. .. .. ..Block. ... . . . .. . . . . .Lot. . .t "rV . . . . . . . . . . . . .
Subdivision. . .4-�: R��: . . . . . . .. . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . .. . . .. . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HealthDept. Approval. . . .. . . .. . . .. . . . . .. . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . ... . . . .. . . . . . ..
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . .
APPLICANT
o��g�FFO��cOG
Town Hall,53095 Main Road y Fax (516)765-1823
P. 0. Box 1179 Olt Telephone (516)765-1802
Southold, New York 11971 Oy • ��
Rio! � Sao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 22, 1998
Mr. & Mrs . B. Bracken
530 Cedarfields Drive
Greenport, New York 11944
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 #22241-Z Second notice
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
®�OS�FFO�,��o
c� Gyp
CA _
Town Hall,53095 Main Road p • Fax(516)765-1823
P. O. Box 1179 y Telephone (516) 765-1802
Southold, New York 11971 ��j `1►a�
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 11, 1996
Mr. & Mrs . B. Bracken
530 Cedarfields Drive
Greenport, NY 1.1944
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 # 22241-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLB
[ ] FOUNDATION 2ND [ ] INS ION
[ ] FRAMING [ INAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
DATE � �� � INSPECTO
_ r
WU
)UNDATIOY ( 1st)
UNDATI01'1 (2nd )
UGH FRAME
ICA
►-3 i u
rri
SULATI0P1 PER N• • Y. II • . ;-� }�^
STATE ENERGY
CODE I ^
•FINAL
I km
• ADDITIONAL COMMENTS : �.\
�,7 .
• x
H
.iG+iCf!h�.....-iwr.��h..:�:.►rJ.tL'�*..r.•.r ."-..•P v'Sii" r r .. ` _
D R. Q V N [ OAr%0 OF HEALTH . . . . . . . .
FORM NO. 1 /3 SETS OF PL.XN5
199� # TOWN OF SOUTHOLD ,JSURVEY . . . . . _✓. . . . . . . . . .
BUILDING DEPARTMENT C1IECK . . . . _ _ . . . .
TOWN HALL SEPTIC FOR:I _ . . . . . .
B O SOUTH•OLD � SOUTHOLD, N.Y. 11971 • -
• . � TEL.. 765-1802 t:o<iF'f ; ���.�O[A �
Examined . . CALL ,j . _ . . . . .
19 HAIL TO Approved .�, ,, 19 . . Permit No. r
Disapproved a/c . . . .. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
(Building Inspector)
A)LIA�TION FOR BUILDING PERMIT _
Date . UIt . . . .1Q.ti. ., Igm
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 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.
1 d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shrill 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 MADE to the Building Department for the issuance of a Building.Permit pursuant to the
Building Zone Ordinance 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, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
-
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) 1tq�{y
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician,. Zlu builder.
. . . . . . . . . . . . : . . . . . . . . . . . . . . . . . : . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . APP 0 �AS-NOTED
Name of owner of premises 1�..pc1r1`� �• BY.
(as on the tax roll or latest Y �UiLI�INi; O�F�A e F"
If applicant is a corporation, signature of duly authorized officer. -�802 9 AM TO 4'PM FOR THE
FOLLOWING INSPECTIONS;
. CC�PANCY 0� �. FOn�QATIt?�a - rV� :t
(Name"and title of corporate off FOa� '€�U sEw �,ft"
O: (:
officer) USE IS UNLAWFUL > _ �;���...,..r.,. C
Builder's License No. . . ;
U L gtAA
. . . . . . - WITHOUT CERTIFICATE: }}`
Plumber's Licens ®� �"`" ?elrf
e No. . . OCCUPANCY
Electrician's License No. . . . y• ��~�
f�
Other Trade's `1
License No. . . . . .
1. Location of land on which proposed work will be done. ►� Q; . � '1'`��1e1� �'�11e. ��( ,n }(
house Number . . . . . . . . . . . . . . . . . . . . . . .Street . . . . . . . . . . . . . . . . . . . . . . .Ham. . . .let. . . . . . . . . ... . . . . . . .• .,.q! . .
County Tax Map No. 1000 Section L{Q . , , , • .. . . Block . . . . Q �0 . • • • • . • .
.�:'P IC). ?? 1 . Lot . . . .
Subdivision . . . . �c-0ta �e,�ds . ... . . . . . !_ /t�Filed Map No. �p(U. - - , , Lot . .-. S.J.
(Name) . . . . . . .
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . :. ..: . . . . . . . . . .
b. Intended use and . . . . . :. . •, . . . .
. . . . - . . . . .
'3. Nature of work check which
( applicable): New Building ; OJ
Repair Removal Addition . . . . . . . . . . ylterac'ion
. • . • . . • . • • . . Demolition .. . . . . . . . . . . . . Other Work
4. Estimated Cost � (Description)
Fee
c� �.
S. If dwelling,number of dwelling (to be paid on;fting�abis application)
b units
If . . . . . . . . . . . . . . K floor
.
garage, number of cars . . Number of dwelling units oil each-17 - - .
6. If business, commercial or mixedSpecify " " " " • ' • - • • • • - - • • • • • . . . . .
occupancy, �S tore and extent of_ea-! y e of use
7. Dimensions of existing structures, if any: Front . ' ' ' ' ' '
Height . . . . . . . . . . . . . . . Nil
. . 5 . . . . . . Dc th .
Hei • . . Rear. p : " "
ber of Stories . .�. . ram, . . . . . .
Dimensions of same structure with alterations or additions: . . • . • ' ' . ' ' ' ' ' ' ' ' ' '
Depth . �. . . . . . . `� ' , ctions: Front . . . . ram. . . . . . . . . . . . . r( . . . . . . . . . . . .
th t . Height Rear . . . . . .
8. Dimensionj 06eptire new construction: Front . (,�' ' ' ' ' ' • Number of Stories .,r . • - , • � • • • � • � •
Height s. tuber . . . . . . . . . . . . Rear . . .�� . . . . . . . . . . Depth .1��. . . . . . . . . . .
9. Size of 1 .16• • . .of Stories . . . . . . • . . . • • . . .
lot: Front ,� Rear. . . .� c . . . . ' . ' -
10. Date of Purchase . ,�• ����• • • � ��� • • - • • • • - • . • • - . Depth .c��(o,dS�, • • � �
11. Zone or use district i wlii h ' ' ' ' ' ' ame of Former Owner . . . .f • - ' ' '
premises are situated . . . iF�$fdr ,t � - • -
12. Does proposed construction violate an ' ' ' ' . ' ' ' ' • • • • • • • - • • • • • -
13. Will lot be regraded . , • • y zoning law, ordinance or regulation: . . . .�•f� , • • • . . • • . . � • � � • • ' ' ' '
14. Name of Owner of remises • • ' ' ' ' ' ' • • . Will excess fill be removed from premises: • •Ye
P dr.�0. e�:� hAddress Ste• s .
v Name of Architect , • e t�� :� . Phone No. .:-�
Name of Contractorfi'Y( rn;�,• . . . • • ' ' ' ' ' ' ' • • • Address . . . . . : . . . Phone No-
Name
Is this property with �cc ICe�r�' ' ' • • •Address53 �P�q�•, c}s l�.r • phone No. .77:�SOi,3 in 300 feet of a tidal wetland? * _ . . . .
*If yes,- Southold Town Trustees Permit may be required. No. . . . . . . . .
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 whe'
interior or corner lot.
aer
SPt,C-
r
{ �,Pl
r lot. NA
'
}} aU p 1 4 F
J [//�•� '((�� I d I A a yS i�r � .'s ,�p� da f 5 •i �
l'� V �.`� ,� t:.l.yN•`rc ('Pti q•V l N l)'S� 'p [ +� x` A ` �'+' � _.
3 ATE OF NEW OR
:OUNTY F I S.Sr 0
. . . . . . . . . .
being duly sworn deposes and says that
(Name of individual signing contract) p y he is the applicant
bove named. �Donvit �.
(e is the . .,. . . . . . . . .
. . . .Caw.yuv,
(Contractor, agent, corporate of ' er, etc.)
f said owner or owners, and is duly authorized to l)crform or have performed the said work and to make and file this
)plication; that all statements contained in this application are true to the best of his knowledge and belie
ork will be performed in the manner set fortis in the application filed therewith. f; and that the
vorn to before me thi
.t . . . .day f
• • 19 .
Mary Pu ic, • . . . ... County
Cl.AIRE L GLEW
Notery Public,State of New York
No,4879505
Qualified in Suffolk County . . ' ' ' ' ' . ' ' . • • • • • • • .
Commission Expires December 8,19` (Signature of applicant)
wW ---
r�r� .
C60ARFIELf)S : 76.10'
R: 739.69'
576.531
Oe ro 99
• ry 51 0 G -
� O
• �. O �� \ Zp.� �' 1pf O
n
N t�+• F;� a �
�+ 2 in
5�5 N
vJ
tx
0
/ LOT 21
OPEN SPACE
PARKLAND SGEN�G 9�FFER
LOT
N
m
SURVEY. OF o n
4OT 20
SUBDIVISION OF CEDARFIELDS . 0011
FILED JUNE 27, 1990 FILE NO. 8986 ,j5
A T GREENPOR T Z s 58
TOWN OF SOUTHOL D
SUFFOL K COUNTY, N. Y.- Of
E
V���AO
1000 - 40 -�05 - 17 l9 01 oaf Rt
Scale 1 = 30 N� GREENpO
July • 11, 1990
July 31, 1990(found. loc.)
Nov. 16, 1990(final) ,
CERTIFIED TO:
BRAN P. BRACKEN&
BONNIE P. BRACKEN
HARTFORD FUND/Nth, LTD,
FIRST AMER/CAN TITLE INSURANCE
AREA = 20,446 sq. ft COMPANY OF NEW YORK
77TLE NO. 605-S-8658
H. S.REF NO. 90-So-60
i7 n
N.Y.S. LIC. NO. 49618
Prepered in eccordence with the minimum ECON/C
etendude rot title Burr®yr ee eetebliahed SURVEYORS, P.C.by the LLA.L.S.and epprored end adoPPtrd (516)765-5020
for such use by TM NNow York Slete Lend P. O. BOX 909
Title Aeeocietioa MAIN ROAD
SOUTHOLD, N.Y. 11971