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30224-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30193 Date: 05/13/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 1600 HYATT RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 50 Block 1 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 2004 pursuant to which Building Permit No. 30224-Z dated APRIL 23, 2004 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 GARAGE AS APPLIED FOR PER ZBA #1145 DATED 10/26/67. CONSTRUCTION CERTIFIED BY DONALD A DENIS PC ON 5/11/04. The certificate is issued to ELIZABETH K WURTZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized Signa re 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. 30224 Z Date APRIL 23 , 2004 Permission is hereby granted to: ELIZABETH K WURTZ HORTONS PT BOX 122 SOUTHOLD,NY 11971 for ACCESSORY GARAGE AS APPLIED FOR PER ZBA #1145 DATED 10/26/67 . THIS PERMIT REPLACES BP#3692 . at premises located at 1600 HYATT RD SOUTHOLD County Tax Map No. 473889 Section 050 Block 0001 Lot No. 006 pursuant to application dated APRIL 23 , 2004 and approved by the Building Inspector to expire on OCTOBER 23 , 2005 . Fee $ 117 . 19 i 77� utho zed ature ORIGINAL Rev. 5/8/02 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 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. �� 3 -o New Construction: Old or Pre-existing Building: (check one) Z61 Location of Property: D tT l� kOGi 6� House No. Street Hamlet Owner or Owners of Property: u r'EZ Suffolk County Tax Map No 1000, Section y22 Block Lot (p Subdivision Filed Map. Lot: Permit No. �O D,�L q Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $_ S f)® 30 19-3 Q pplicant Signat e 30. 765-1 802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ 4-FINAL INS TION [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPEC FIELD INSPECTION REPORT DATE COMMENTS 71wm FOUNDATION(1ST) H -�- FOUNDATION(2ND) • z ,6 0 ,o ROUGH FRAMING& �.� PLUMBING H INSULA t TION PER N.Y. � STATE ENERGY CODE H FINAL ADDITIONAL COMMENTS g' N z0 Z m d b x � r � H x d CrJ Wo H FORM NO. 1 r TOWN OF SOUTHOLD BUILDING DEPARTAi ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............................ ~�......... 19..�r`.?,� APPllcation No. ..... ,................ Approved ......... ...... ...I......... 19.k.Z. Permit No. 3. a .. '�.... Disap roved a/c . /!V�A �...... ... ' 4....Y... .�<:.. ,..,,.. .C....`. ...... , . . . }. ....................... ....... ............................:.........:..... (Building Ins....P.. tor)........................ APPLICATION FOR BUILDING :PERMIT Date4..........................00tobar..... , 19...6. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on prem des, 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 application. c. The work covered by this application may not be comme�ced before issuance of Building Permit. d. Upon approypl'?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 progress of the work. e. No building squall 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 f� r the issuance of a Building Permit pursuant to the Building Zone Ordinonte of the Town of Southold, Suffolk County,,New York, and other applicable Laws, Ordinances or Regulations,for the construction of buildings, additions or alterat4o� s, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinan4es , building code and regulations. Roberttt....,Aj.G..W4...1 t►................................................. (Signature of applicant, or name, if a corporation) ............. a thald N, .................................................. (Address of applicant) State whether aicant is owner, lessee agent, architect engineer,j general contractor, electrician lumber or builder. P 9P ..................... .� ......Coutractor...+.agent........................ ................................................................................ Nameof owner of premises `:.. It.•11&m...WxZ........................::.....:........................ .......................................................... If applicant is af�corporate, sionoture of duly authorized officer ...........: .......... . .................... . ................................................. (N*e and title of'cor' orate officer) 1. i Location'of land on whic�,proposed work will be done. Mop No.: .......sa=:...................... Lot No.: ............... Street and Number ...WraU,• ... ortan...Rta lat1r..,outho2dy... .toy.*...... Municipality 2. State exi$ting.use and oCcc a' y of premises and intende&use and occupancy of proposed construction: a. Existing use and occ�lncealle.. BJidJ.y...dWIl ........ j. ... b. Intended use and occupancy ,same vlth.•detaQ d. .gara.ge...in-Xr—ont..,y..arA...ara&..................... 3. Nature of work (check which applicable): New Building .... .... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition.................. Other Work (Describe) ........................................ 4. Estimated Cost -� (0.........................Fee .. to be paid on filing this application) 5. If dwelling, number of dwelling units ......none............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 ........................... ....................................................... .. ...... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... ..::............. Rear .....24i%%&............. Depth ......1Ow8........ Height .................... Number of Stories ... .o11W....... . ........................ ............,.................................... 9. Size of lot. Front .......12.,5.., ......... Rear ............ 2. ...... Depth .....�h..i�.- .............. 10. Date of Purchase ........................................................NarrSe of Former Owner ........................................................ 11. Zone or use district in which premises are situated ......!A!...dUtr..................................................................•......... 12. Does proposed construction violate any zoning law, ordinance or.regulation? ......ya9.............................................. 13. Name of Owner of premises .Wi.11;LaMJf.=tZ........Address .....Hyat'1;..'l&....SauthWYCone No. .................... Nameof Architect ......................................................Address ............................................ Phone No. .................... Name of Contractor AlObt..27-att...........................Address .....SoU.tht SoUtIMLI................... Phone No. .................... r :. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether-existing or proposed, and indicate all set-back dimensions from perty lines. Give street and block number or description. according to deed, and show street names and indicate w ether interior or corner lot. VO • .tr+� r` C 0. c.TA OF NEW YO 1 5.S. OUNTY OFi ..... Oberya .....................................being duly sworn, deposes and says that he is the applicant (Name of individual 'signing application) above named. He is the ...... aontx'SCt.OT w..&...'.".agent.. ........................................... ............................ (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 ................9...... day of ...........Ucta�aer................ I9..k?. `� , ' a ................................... ............ Notary Public, ........::..MjfDR {ihftPMfaid County ' 1 (Signature 'f pplicant) NOTARY PUBLIC, Stare of New York / No. 52-0618100 Suffolk Count Commission Expires March 30, 19 DONALD A.DENIS, P.C. 2 A R C H I T E C T S Aquebogue Square 508 Route 25/P.O. Box 565 Aquebogue, New York 11931 (631)722-3511 FAX:(631)722-3859 Donald R nrlalld A. Denis,A.I.A. Fr1vl 1,niL664R.A. Building Dept. Town of Southold Main Road Southold,NY 11971 RE: 1600 HYATT ROAD SOUTHOLD,NEW YORK SCTM#1000-50-01-06 Dear Sir/Madam: Today I inspected the Garage on the subject property to certify to the best of my knowledge and belief this structure conformed to the 1967 Building Code and Standards when constructed. I understand that this certification has been requested by the Building Department in order to issue a Certificate of Occupancy for the Garage structure. If there are any questions,please feel free to call. Very ours, DONAL A. DENIS PC, A: . DAD:dmh Ep ARC. A LA/y O O y ' .w Ab �r s� ~° b �Tt` OF N�� FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV - ....... 9.. 3692 Z Date ............................ ...... ...... I Permission is hereby grante, to* ...... ..................I.............................. ............. .............. . . .:.. .............................................. ..................... ► ................ ................................ toi .. ? + IHki .. + ........ !:.... 3N 'k ..:....... .....................................:.... ................................................................................................................................................................ at premises located at ."..�ato, �r�d (HyD.t .................................................:............................................. en Polattx ld$ 1.Ywi .. . . .. ............................................................... ................................................................................................................................................................ b�pursuant to application dated ..........................�@............. ............... 19..... , and approved by the Building Inspector. JIM$ -APPIrOVed by IM of Appeals Fee $511 ............. ................ ................. Building Ins ectar FORM NO. 1 TOWN OF SOUTHOLD � BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .........[�.r���.........(......... 19... ?.I Application No. ............................ Approved ......... I....... 19.6..(.. Permit No. ....�.�. T _ ` Disapproved a/c ...................:�......(1.`..u::'..:....../..r...... .�'... 7...... ........... ��.(J.6...................................... /777 .................................. ... .......:........... ...............................,....... (Building Inspe tor) APPLICATION FOR BUILDING PERMIT Date ...........................Octo vv.....9........ 19...0•',7..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the. Building Inspector. b. Plot plan showing location of lot and of buildings on prern'i0s, 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 application, 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 permit shall be kept on the premises available for inspection throughout the progress of 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. i 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 and regulations. Robert Hyaut....A/..G.Mli.....Wurtz................................................. (Signature of applicant, or name, if a corporation) .............ar................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer,] general contractor, electrician, plumber or builder, €; II........................................................................................ .. ....... QT1trS:tCt.4.L^...wct 6'S1t......................... Name of owner of premises ........................: .............................. .......................................................... If applicant is a,�corporote, signature of duly authorized officer,, ......... ........ ..%.................... ........................................ (Name and title of'corp?rate officer) 1. 1 Location,of land on which•proposed work will be done, Map,No.: .......�....................... Lot No.: .X3t C................ Street and NumberNlr A :p: ka4)...Horton...RW3ltq...Smth-oldv.....N.,Y.........p Municipality 2. State existing use and occupancy of premises and intended'use and occupancy of proposed construction: a. Existing use and'occUpancy0ne...f r2 ;1.11Y... iAAIJAY1kJg...................................................................................... b. Intended use and occupancy ..Std.€tie...W1.th-da1<t3.Cxaed..g.;bra-ge....ia.X.Y'.orit..V.ar. ,...arp-a..................... i � 3. Nature of work (check which applicable): New Building ....XXXX..., Addition .................. Alteration .................. Repair .................. Removal .................. Demolition............:..... Other Work (Describe) ........................................ 4. Estimated Cost .. �d © f(T ..........................Fee ..... to be paid on filing this application) 5. If dwelling, number of dwelling units ......gA§............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 ................................................................................................................. Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories ................................ B. Dimensions of entire new construction: Front .........2+4 a...:............. Rear .....2.14„8.............. Depth ......3Ow$........ Height .................... Number of Stories .....one........,........;........................................................................................ 9. Size of lot: Front ......1,4.5..;L....... Rear ............1?1.t...-........ Depth .....�75..t.............. 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......Al!...Slyt............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ......yyes............................................... 13. Name of Owner of premisesw aliam..W..Urtz........Address .....Hyatt...Ed.....iiGU hf)lthone No. .................... Name of Architect ......................................................Address ............................................ Phone No. .................... Name of Contractor .Robt...Hyatt...........................Address ....."gQ1bt1lal .................... Phone No. .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from perty lines. Give street and block number or description according to deed, and show street names and indicate W ether interior or corner lot. r G 'T407�L < !?AtGS � Y � 130- ��..."�.—�.-..�-•-�,-d. � A C�� ATE OF NEW 40?K, , Z OON TY OF ..... Lk . ax; ......:,7S.S. ... .. RobOrt I aft . .........,�............................................being duly sworn, deposes and says that he is the applicant (Name of individual signing application) Cisntractor •� & -a ent .......... shove named. He is the .........:............................................... ..�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 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 _ ...........9...... day of .... Q00%3r.... 19..b.�. .................1................................ ................................ Notary Public, .... ••.••• " County (Signature "f pplicant) NOTARY P06lIC, Slave or Clew York No. 52-0618100 Suffolk Count Commission Expires March 30, 19 4hs s*SG V DD E N, h t'I h Ftl w "W I WOOU OFLN I \ Ag 3 'TRC WOOD WECN N 'gt4(Ii{( Bw SG GGA W NOR, ROOF overt Z�J wrooD DecK WO dr °vLV °Kw tqf� 3 .ems .* /i�Wt// 4Ti lk :/ AOSO .•es"uI+G`E sr{ps [Y °ti` /�(, / G§ Q G GaRWICF m y q xr oIh ry �§ �F ;, • "Sher.. �°" �/F� // (/ pf5• .�� � •.egOnY•., t\q. ///•rye// I j �4T4 4s&.RSOpk M / I / I � I / �l l 1 1 1 I I ; / I / I i / I � I z I / it/ I I I 1 jo " V w / lI� SURVEY OF PROPERTY / I SITUATED AT w 1 MORTON POINT ba / I TOWN OF SOUTHOLD SUFFOLK COUNTY , NEW YORK Fo S . C. TAX No . 1000 - 50-01 -06 SCALE 1 "=40' APRIL 18, 2004 AREA = 34,699 sq. ft. / (TO TIE LINE) 0.797 ac. / PREPARED IN ACCORDANCE SURVEYS THE MINIMUM BY THE FOR TIME PROVE AS ESTABLISHED BY WE L USE AND APPROVED AND ADOPTED I / FOR SUCH USE BY THE NEW YORK SEAR LAND IATON of NEyy S \\ o SpFT 2`p9�Q9 is = �6 \\ 9 504 A I N.Y.S. Go. No. 50467 \\ \\ UNAUTHORIZED ALTERATION OR ADDITION \ TO THIS SURVEY IS A NOTATION OF \ SECTION 7209 OF lHE NEW YORK STATE Nathan Taft Corwin III SUCTION LAW COPIES OF THIS SURVEY MAP NOT DEMINC \ \ LAND ADAL OR SURVEYOR'S INKED SEALand Surveyor \ \ THEEMBOSSEDREAL SHALL NOT BE L OR SED \ TO BE A VAUD TRUE COPY \ CERTIFICATONS INDICATED HEREON SHALL RUN \ \ ONLY TO THE PERSON FOR WHOM THE SURVEY \ IS PREPARED, AND ON HIS BEHALF TO THE TRE COMPANY, GOVERNMENTAL AGENCY AND 5 LENDING INIGNOES FTLISTEpHEREON, AND 992 Roanoke Avenue I TO THE ASSIGNEES OF THE LENDING TR INBN- � I TUTOR CERIIFlGTIONS ARE NOT TRANSFERABLE THE EXISTENCE OF RIGHTS OF WAY Riverhead , New York 11901 SOUND VIEW AVENUE IF ANY. NOTE SHOWN TARE FNOT CGUARANTEED. PHONE & FAX (631)369-5473 WURTZ