HomeMy WebLinkAbout44721-Z ��p�g�FfOl,f Town of Southold 3/13/2020
P.O.Box 1179
0
�"• 53095 Main Rd
oyayo! pp�� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 41148 Date: 3/13/2020
THIS CERTIFIES that the building SHED
Location of Property: 6405 Alvahs Ln, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 101.4-16.7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/10/2020 pursuant to which Building Permit No. 44721 dated 2/20/2020
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:
"AS BUILT"ACCESSORY SHED AS APPLIED FOR
The certificate is issued to Hagzan,Donna
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Auth e Signature
�saETOWN OF SOUTHOLD
��o yyy BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
"oy • o� SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permits#: 44721 Date: 2/20/2020
Permission is hereby granted to:
Hagzan, Donna
6405 Alvahs Ln
Cutchogue, NY 11935
To: legalize an "as built" shed as applied for.
At premises Located at:
6405 Alvahs Ln, Cutchogue
SCTM #473889
Sec/Block/Lot# 101.-1-16.7
Pursuant to application dated 2/10/2020 and approved by the Building Inspector.
To expire on 8/21/2021.
Fees:
AS BUILT-ACCESSORY $328.00
CO-ACCESSORY BUILDING $50.00
$378.00
uilding In pector
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:
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,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
I. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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/n
Date. 01
New Construction: Old or Pre-existing Building: ✓ At V (check one)
Location of Property: 6 q 05- A4 V 6 h s 1A4 g_ cv A,/n I-< iv Y //'73s—
House
/13SHouse No. Street Hamlet
Owner or Owners of Property: da i_-L ¢ G Z �,J
Suffolk County Tax Map No 1000, Section !D � Block Lot l (�
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: +/ (check one)
Fee Submitted: $
Applicant Signatur
OF sou Ty��
` ` # TOWN OF SOUTHOLD BUILDING DEPT.
�ycourm '' 765-1802
INSPECTION,
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND- [ °] SULATIO ;WCAULKING-
[ ] FRAMING/STRAPPING [ FINAL s h ✓ � ���� y
[ ] FIREPLACE & CHIMNEY '- J [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
DATE -30 113 01MV INSPECTOR
LELD INSPECTf6N R-PORT DATE COMMENTS
FOUNDATION (1ST) 9
•
FOUNDATION (2ND)
H �
ROUGH FRAMING&
PLUMBING y e
. r
INSULATION PER N. Y. y
STATE ENERGY CODE
FINAL
ADDITTONAL COMMENTS
a 0l (r A a�
0
Azrn
k
0
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 120 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c
Phone: 6 3 1 z7 -S-�fJ 0
Expiration ,20
Building Inspector
EB 1 O 2020 -APPLICATION FOR BUILDING PERMIT
,, ; • , - ,, , Date F- ��«✓y !o , 202-0
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
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 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 amendments 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 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 na if a corporation)
(Mailing address of applica t)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
o w;i-e-u
Name of owner of premises Dorvw�
(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.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
61-163— S Gay►- c,,)fcAog ti� /J`� /lg 3S-
House Number Street Hamlet
County Tax Map No. 1000 Section 10I Block Lot 1 1p 7
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy : Le 0 �✓ tJ ,�
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work _ {- '
(Description)
4. timated Cost Fee
(To be paid on filing this application)
5. If d elling, number of dwelling units Number of dwelling units on each floor
If ga ge, number of cars
6. If busin s, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimension of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of ame structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire ew 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 pr ises are situated
12. Does proposed construction violat any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Naives of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wet nd or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D. .C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetlan ? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale,with accurate foundation plan nd distances to property lines.
17. If elevation at any point on property is at 10 feet or below, ust provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this pr erty? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Naive of individual signing contract) above named,
CONNIE D.®UNCH
(S)He is the Notary Public,State of New York
No.01 61 B5050
(Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County
Commission Expires April 14, 2
020
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
I D-4) day of 20
Notary Public Signature of Applica
,PEr",# Rio-94-00,16
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F1 L ED NMA>- 271 1992 - eIL E# 9225
S/TUAT,p AT CUTCA106UE - TOWAJ OFSOUJJ)0LD • SUFFOLK CbUJJTY• /�Y
GUARANTEED TO FIRST AME,Q/CA,;-1 TITLE /1(1SVPAAZE: 000PA,1J1'-" Off' A)gk/
O01VAIA ICIAGZAA1
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F/NAL $/��19q,6- SED T/E
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SCALE * 1'=d0
—HARRY P. HIL LEBRA ND
LAND SURVEYOR
SUFFOLK COUNTY TAX MAP /I CHURCHILL LANE - SMITHTOWN, N.Y.
DISTRICT SECTION BLOCK LOT TEL. 543-5139
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Additional 5 - SOUTH OWN PLANNING BOARD
Certification S THOLD TOWN TRUSTEES
May Be Required. R.Y.S.DEC