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Home My WebLink About22306-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25088 Date JUNE 16, 1997 THIS CERTIFIES that the building ADDITION Location of Property 2260 SKUNK LANE CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 3 Lot 18.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18, 1994 pursuant to which Building Permit .No. 22306-Z dated SEPTEMBER 7, 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 DORMER ADDITION & ALTERATION TO ROOFLINE OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DOUGLAS J. LOVETT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bui ding fnspector 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 .....................f•••91,7 19...V �!® 22306 Z .. Permission Is hereby granted to; 7...... ................ � o.....�5 ,................ ......................... 1, re .9. .......i�....... to ..... s% r-1f....... ...... 42 'ir. .........�� . .7r ................................ .................................................................................................................................................................. .................................................................................................................................................................. ............................................................................. T........................................................... . � F�� atpremises located at............................................................. .................. ................................... .............................................................................�--/. 41-fe...................................I............ 0 County Tax Map No. 1000 Section ......... ........... Block....... .......... Lot No. ...., .................. pursuant to application dated .................................... ..../ / ............ 19.....1/..., and approved by the Building Inspector. Fee$..../J."... .. .. .............. .�. . ............................. Bui ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY -1. 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. ' 3. 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 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 $15.00, Commercial $15.00 Date . . . . . . . ' �. . . . . . . . . . . . . . . . . . . . . . . . . ;ew Construction. . . . . !. . . . , 0 /ld Or Prev-exi/�s-ting Building. . . . . . . ./ . . . . . . . . .ocation of Property. . .�VG/o. . .��C� �I:y. . .� . . . . . . . . . . . .? . . . .»Q' House No. Street Haml( tiI )nwer or Owners of Property. . . . r4 . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . ;ounty Tax Map No 1000, Section. . . . ..q.7 . . . .Block. . . . . .. . . . . . . l.d.: .. , , , .Lot. . . . . . . . . ;ubdivision. .z!.�Q!�! . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . 'ermit No. ._V306_. Z_ ,: . Date Of Permit. . . . . . .Applicant. . .. . . . . . . . . . . . . . . . . . iealth Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . ... . . . . . . . . . . .. . . . . . . . . 'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . ' request for: Temporary Ce��rtificate. . . . . . . . . . . Final Certicate. . , ee Submitted: $. . . . . . . .ei- . . . .. . .. . . . .. . . . . . . .. . 08 _ . ors-1802 BUILDING DE". INSPECTION [ j FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS CATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: cJ Lot,601mf (94 DATE l INSPECTOR j 765-3802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH P G. [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � � ,,-sYo �l•G'-o DATE � INSPECTO COMMENTS JIIDATIOI . ( 1's t) •� � INDATIOtI (2nd ) 0 IGH FRAIIE & - +. `:` •�: •PLU2`IBING ;-• • .. , :; :: . I H :UL„TION PER N. Y. II m STATE ENERGY II CODE I •FINAL gill ADDITIOPIA COt•1�1E1dTS • !� m 41 ' x '�'•�i'�-�-1►.•"�.r�"'•—.Y?.'L^si�+i^a►'!'.w� ......J l v.3AT•. .i.'l'+..r • ... .. .. :. .� .� ... .. .s .. � ..il>.t1fi[ BOARD OF HEALTH . . . . , FORM NO. 1 3 SETS OF. PLANS- . . . • . . . . . • TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CIIECK . . . . . . _ _ _ . . . . . . . . . . . TOWN HALL SEPTIC FORM _ . . . . . . SOUTHOLD, N.Y. 11971 . x�s` TEL.: 765-1802 t.O L Fy PLDG.DEPT 7�pV�1lV OF SQUTHQLlJ C� �` CALL . . �1 . . . . . E_xarnrnt? . ..��., 19 /. MAIL TO : Approved /�j . . . . . ., 19'?,XPermit No. . 0.�. . . . - - - Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Bu• d•• b In pector) APPLICATION FOR BUILDING PERMIT Date AIP(Is ./ , INSTRUCTIONS . a. This application must 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. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o: 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 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 inspection (Sigrurture of XplicaQiYt, or name, if a corporation) (Mailing address of applicant) //C135- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . / � . .�1. . .�. .' . . . . . . . . . . . . . . ?'. .°. . . . . ... . . . . . . 5 �lfrdPt r ?,. . (as on the tax roll or latest deed 4 APPROVED AS NOTED' If applicant is a corporation, signature of duly authorized officer. DA� B.pm 1 1-3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FEE. 7L.W BY. (Name and title of corporate officer) NOTIFY BUILDING DEPARTMENT AT 765-1802,'9 AM TO 4 # FOR THE Builder's License No. . . . . . . . . . . . . . .ON' IPANC 1 OR FOLLOWING INSPECTIONS: USE IS UNLA�IFUL � 1:• FOUNDATION - TWO REQUIRED Plumber's License No. FOR POURED CONCRETE WITHOUT CERTIFICATE, 2. ROUGH - FRAMING & .PLUMBING _._:l. . • 3. INSULATION l..l$L.Ll llall J L1CCI1J8 No. O�, OeCUPANC 1 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR,C.O. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . ALL CONSTRUCTION SHALL MEET UNDERWRITERS CERTIFICATE THE REQUIREMENTS OF. ,THE N.Y. 1. Location of land on which proposed work will be,done. . . REQUIRM. . . . . . . . . .STATE .00wslRU!--Tlolo.:il. ,E�r;ERO t , d! LD,, ,�! Ill T i-1E-POi4� 9EBzE FOP House Number -- Street Hamlet 13 County Tax Map No. 1000 Section . . 6l. -e'�. . . . . . Block . . . . . . . . . . . . . . Lot . . . ./.0.t: . . . . . ... Subdivision .� . !�t° �•-•`'• -1'Ji ��{..�•. . . NPH Filed Map No. . . . . . . . . . . . . . . Lot . ... . . . . . . . . . . . . (Name) 2. `State existing use and occupancy of premises and intended use and occupancy of proposed constriction: a. Existing use and occupancy . . . G�'�� . . . == . . . . . . . . . . . . . . . . . . . . f'd,_.;. b. Intended use and occupancy . . . . . . . .S>`.V.VF . . . . . . . . . . . . . . . . . . . . '.!f• S ,i= •.., p. , , , , . . . . . , , 3. Nature of work(check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteraf n ;v`' Repair . . . . . .. . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work'. .i. . ..." (Description;) 4. Estimated Cost . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . 7 ®�. . . . . . . . . . . . . . . . . . (to be paid on filing,this application) ... 5. If dwelling,number of dwelling units . . . . Off. . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,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 . . . .�f . ,. .Ti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear Depth . . . . . 1'5. . . . . . . . . . . . Height . . . . . . ... . . . . . . . . . . . . Number of Stories . . . . . . : . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . Rear . . . . :. . . . . . . . . . Depth . . . . . �/.'°g. .�. . Height Number of Stories . . r ?' . . . . . . 9. Size of lot: Front . . . . .Q_- - e?tea . .�% . . . Rear . . . . . . . . . . . . . . . . . . . . . . �e,pt . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . .G - ./.'��. , , , , , , , , , , • . Name of Former Owner . . . . . . . . . . . . . . . . . . ... . 11. Zone or use district in which premises are situated . . . .peqle?cliu�. . IrwP . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . .,AAZ:) . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No " 14. Name of Owner of premises _9 S' ,(.0057_11. . . . . Address d&960. . .5;tv /K. . . . . Phone No. .73.¢®��. c ... . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . Address . . . . . . . . .Phoneallo. . . . . . . . . . . . . . A . 15. Is this property 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. ,��r�� STATE OF NEW YO 3 � F�S.'S J J' f �� COUNTY OF . : �. 46 • . • • • • • .� �;az#i°>�leiig`dul`y sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. . He is the .'ti . . . . . . . . . . . . . . . .0(�U, i�. { : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that akl statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this G0 9� o . . . . . . . .day of. . . . . . . . .119 Notary Public, . . . . . . . . . . . . . . . . . . . . . . . . . . County d't"L'O'�� SUSM J.NAGY �' NoWy Public,St&of Nam Yak No.4896735 . . . . . . . Ckpirod to Sdek CMM .ignature of applicant) O�nnnWt►6x'ira►IA�I f8,1� x M" Flk -'a ILL, 4-19�a RA"a4 MA -(DAYETT I L < _T -7 1 Of-ItiE 4 1 P TO",A/,W OF SGUTHICU C V lf�,,e�ei_ of� N LU :Z :fi QL ch > 00 on VC- > a Wol,?V,Or LA ND _nt . ze aw of Ct; Ct Cc, .0 P J 0, k L E_ - S NIP ft to 70"a. pe Al- ftbCb Wma 42 !q %lo"c� . - a - the M0 lo 1&4T 4.. 1p IPE K ib p -ZP VC, T!TLE wq,9L508 u �_U ?MTEE V 0�.,CRIC 0 T. 11_113u 181994 fT LE % F OFItAL CIZ P17 UNION''." BLDG.DEPT. TOWN OF SOUTHOLD p up D Y IV J- it 4 J�; .�rsa `S tSe �6 NY /-<oi 71 7qog5E , i6' oCU-1i 1 N, 4p "O-Y 30 4' (6`'oG, �4 To 1151/iM ooa--i4,� To A4474 i 1 Lovrr- Fn r= U � � BLDG.DEPT. 'tP�. _ ^1'OWM OF SOUTHOLD - 0 �Sr Wes" f� �� T�F Ai VE grnVI5101V' To . �2So sKc{,vK LANE Cv�-c�a�oGu MA1 11c(3 S Tb AAATGtq ol 6 i �� Any s,oF -rb mAMw c isn