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HomeMy WebLinkAbout29139-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29270 Date: 02/14/03 T~IS CERTIFIES that the building ALTERATION Location of Property: 335 HIGHL~2~D RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 109 Block 2 Lot 16.2 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JANU2LRY 31, 2003 pursuant to which Building Permit No. 29139-Z dated JANUARY 31, 2003 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 RECONSTRUCT RAFTERS AiqD RIDGE ON AN EXISTING ACCESSORY STORAGE BUILDING AS APPLIED FOR. The certificate is issued to FREDERICK W KAELIN JR & WF (OWNER) of the aforesaid building. SUFFOLK COUlqTY DEPARTMENT OF ~RALT~APPRO%r~L ELEC"~RICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~u3 Rev. 1/81 N/A N/A N/A ignature 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) PERMIT NO. 29139 Z Date JA/qUARY 31, 2003 Permission is hereby granted to: FREDERICK W KAELIN JR & WP PO BOX 1 CUTCHOGUE,NY 11935 for : RECONSTRUCT EXISTING STOP_AGE ACCESSORY BUILDING (R3tFTERS & RIDGE). THIS PERMIT REPLACES BP#il031. at premises located at County Tax Map No. 473889 Section 109 pursuant to application dated JANUARY Building Inspector to expire on JULY 335 HIGHLAND RD CUTCHOGUE Block 0002 Lot No. 016.002 31, 2003 and approved by the 31, 2005. Fee $ 75.00 Autho~d~z'ed -S igna~qire Rev. 5/8/02 COPY FORM ~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P,ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N©. 111)31 Z Date ....~:4':.,(~...G,~'x~..y.....~...~. ...... , 19..d~.'./ Permission is hereby gronted to: .......... ~...~.~.~.:.~.~. ........................... ...................... ,..,.,..~..,.....~.~.~....,..,~. ............... ,. ~ ~ ....................... .d.~..~.~.~..~,.~.?..~..:..~ ...... to ............................................ ~ ........... ~ .............. ~. ..... ~ ~.~ ~ ~ ~.~.... ~..~.~. ~.~-.,. ~.~ .... ............ ~.~.:..~.~z.~ .................................................................................................................... -- / pursuant to oppJicotion doted the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY .... This application must be filled in by typewriter or ink and submitted to the Building Department 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. 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 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 $15.00, Commercial $15.00 Date. / New Construction: Location of Property: Owner or Owners of Property: 0-~ Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: House No. Street ~ (check one) Block Lot Subdivision Permit No. {~5{7~ f//~q Health Dept. Approval: Filed Map. Lot: Dateofeermit. /:///o ¢ Applicant: :/LA~,( ~-~/~( Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ (check one) 0 o o I Iii 2 Z 0 U~ o (D .~- X 0 ~ Eh · ~- 0 x ~ 0 o ~T NUMB~t~S REFER TO MAP OF ~HLAND ESTATKS %WHICH t~ ~1~ OF TN~ ~RK OF S~FFOLK ~ff~F W~E~ M~IN = ~ MILES REVISIONS MAP PREPARE[) FOR: IFt~ffDL~RICK W. K,~EI lN g t~RGAR£T £. i FI~D ~NSP~ECT I0N I. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N.Y. STATE ENERGY CODE ADDITIONAL COMMENTS: FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 19': . . Approved ................. 19... Permit No ........... Disapproved a/c .... . .~.-~.. ....................... / (gu'tiding l~hspector) Application No /dC' 3 APPLICATION FOR BUILDING PERMIT Date .f,~. ·.. · .]..~ .... , 19~rf. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 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 Buildin~ 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 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 buildings for necessary inspe.c~j~ns. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~./~.Le.7.~)../-.~..~ ~.~... /tJ.,..~.~.. L~'~.~. f.~.. (..':~.~.. ?. ~/~.."~.~"..~.dff~i~-~../?.. ~.,~. Z.~?../..'f~' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... t~./.~ .............. Plumber's License No .... ./~..J...~. .............. Electrician's License No...,"~'./../~.. ............. Other Trade's License No../'~../.~. ............ 1. Location of land on which proposed work will be done .................................................. ...... ............ ./../2 ........ .c.' ................ House Number Street Hamlet County Tax Map No. 1000 Section ..... / t-7.~. ..... -. Block .... C~ ........... Lot.../.~..:..,~.. .......... Subdivision../~./.6a/']] [,~,~..,q/~... ~:f. ?.~.Z/-.'.-~. ..... Filed Map No. ~?.~-.'~. '.~. ...... Lot. ~ ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... :,~]/.-"~../~'.~.{?.L.Z'.....~.~./~..t.,~. ~.~. {: ................................. b. Intended use and occupancy ...... .--5./.---Z//5'.-q..6..~... ~..~./..t./~../..,~..~. ................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . ~ ........ Repair ..... ~. ....... Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ............. F.~. X .0: 0. ?. ................ Fee ...... .~/.~. :~.. (to be paid on ~ing this application) 5. 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 [ype of use ............ j ........ 7. Dunensmns ofex3st~ng structures, ~fany: Front .... /~(.-' ........Rear .. !.~ .......... Depth . ,n°.-~. .......... Height ....... 1.0 ....... Number of Stories ..... ./. ................................................. ! ............. Rear ........... Dimensions of same structure with alterations or additions: Front ... o t .... {.a. t Depth ....... ~2,¢.1. .......... Height ....... /.o. ~. ............ Number of Stories.../ ................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories .......................................... . .............. 9. Size of lot: Front ..... ~D.I. ! ........... Rear ...................... Depth .~t2.~..~ .............. 10. Date of Purchase . . . 1~....j.7~. .............. Name of Former Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate a. oyzoninglaw, ordinance or regulation: ..z~Ad.~ .......................... 13. Will lot be regraded ......... ~..b'.. .............. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ....... 44{) .-~'..~ ............. Address ................... Phone No ................ Name of Contractor ..... -~5..q./t/...~. ............. Address ................... Phone 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 whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF. ~.qt~.F.at, bE. ..... · 4~.~ g~)1~ .~[.c.t~...~..//../~dg..~J., ~..4/.... ~. .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (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 all 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 ~r ........ /7..?..--/.~ .... day.of.. ~.~q&...4~c~.. ...... 19 ?./. . $otaryPublic, ..' ~-~' ~:- ~.~.~-.c'x~x~ County ~, ~ ' (Sign~ure of applicant) No. 52-4665A18. Su~{oik County,.. C,~mmi~ion ~ires March 30, 19~.~.~~-'