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Home My WebLink About29077-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29277 Date: 02/19/03 T~IS CERTIFIES that the building ACCESSORY Location of Property: 805 HARBOR LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 97 Block 6 Lot 13 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JAi~JARY 2, 2003 pursuant to which Building Permit No. 29077-Z dated JANUARy 7, 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to GLEN L & DOROTHY L PETERS ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~ALT~ APPROVAL ELEt-r~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'r~ N/A N/A N/A nature 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) PERMIT NO. 29077 Z Date JTkNUARY 7, 2003 Permission is hereby granted to: GLEN L & DOROTHY L PETERS CUTCHOGUE,NY 11935 fo~ : CONSTRUCTION OF A 200 SQUARE FOOT ACCESSORY SHED IN THE REQUIRED R EAR YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 097 pursuant to application dated JANUARY Building Inspector to expire on JULY Fee $ 75.00 805 HARBOR LA CUTCHOGUE Block 0006 Lot No. 013 2, 2003 and approved by the 7, 2004. ' nature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN 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: A. 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, bailding 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, SwimnUng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I 00.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Conunercial $15.00 Date._ ~/{'_~/(23x(~ ~ New Construction: ~,,~- Old or Pre-existing Building: (check one) Location of Property: House No. Owner or Owners of Property: ~O,/F t_~ Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ q C377 ~[_ Health Dept. Approval: Street Date of Permit. ! / 7/O ~ Hamlet Block Filed Map. Lot: Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ __~.. oo Final Certificate: (check one) Applicant Signature NO, FY'BUILDING DEPARTMEI/,IT AT T65-1802 9 AM TO 4 PM FOR. THE FOLLOWING INSPECTIONS: I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ; 2. ROUGH - FRAMING & PLUI~BING ~ INSULATION 4, FINAL . CONSTRUCTION MUST BE COMPLETE FOR C.O. ALI. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF TH N.Y. STATE CONSTRUCTION & Eh ERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION EF RORS OCCUPANCY OR USEI$ UNLAWFUL W~iHOUT CERTIFICATE OF OCCUPANCY .I OS:SI II IIIJ 118111, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION FRAMING [ FIREPLACE & CHIMNEY ' /do DATE INSPECTOR~~ ~ INSPECTION RIEPORT, i DATE COlVIM~I~rS '- ... . FO~A~ON (~) ~ ROUGH ~G & ~ STA~ ~ CODE ~ A ~D~ON~ CO~S ~ TOWN OF SOUTH. OLD BUILDING DEPARTMEN~,: i TOW~N HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved aJc Expiration BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, §'el'ore applying'? Board of Health 3 sets of Building Plans plarmmg Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: ctor Mail to: APPLICATION FOR BUILDING PERMIT 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. Fec 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 waterways. c. The work covered by tiffs application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amen&nents or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 constraction 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) State whether applicant is owner, lessee, agent, architect, eng/neer, general contractor, electrician, plumber or builder Name of owner of premises (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. Electhcians License No. O~er Trade's License Location of land on which propo.sed work will be done: House'~Number Street County Tax Map No. 1000 Section Subdivision Hamlet Block ~ Filed MapNo. Lot (Name) 2. State existing use and occupancy of premi, ses and intended use and occupancy of proposed constm.c, tion: a. Existing use and occupancy ~)~/2/9A ~/fg/t[~ ~r ,h~],/' -- ~o00~ ~ S/~g_[~ b. Intended use and occupancy /OX~ 6! .~ [1> h 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~,~.--~OO, O O 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear _Depth Height Number of Stories Dimensions of game structure with alteration~ or additions: Front / O t , Rear Depth ~ O ' Height j ;J Number of Stories ff/-J-0 (~ Dimensions of entire new construction: Front Height Number of Stories I 9. Size of lot: Front / 0 '~ Rear J 10. Date of Purchase, c) )~ ]/~ 6(~ ~-- Name of Former Owner 11. Zone or use district in which premises are situated Rear .Depth Depth 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~ 13. Will lot be re-graded? YES_ NO ~ .Will excess fill be removed from premises? YES Name of Contractor ~'oA'~ -ffZ,4~5/t' Address ~ckf' [qt~l.,~^ (~'~'Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY B.E R_~E~QUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. __NO 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY OF <5o~'~[~-~S: / U'/~.P.~ ~"~/4 ~---../~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)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 ~ :~'~.o~,~o · ~'~-~///Notary Pubffc ROB~T' JR. NOtn~ Public. Stat~ o{ N*w Yo~ Qualified in Suffolk Coun~ No. 01SC4725~9 ~ Term ~pires May 31, ~ . Signature of Applicant