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Home My WebLink About15403-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. Z15003 Date October 16, 86 THIS CERTIFIES that the building deck addition Location of Property 1650 Mason Drive ~ Cutchogue, N.Y. House Ho. 1 04 ~eet 0 1 1 Hamlet County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .P, ug~.s.t,. ~.7., .......... 19. ~.6pursuant to which Building Permit No..1.5.4..0.3..Z. ............ dated . .O..c .t.o.b.e..~..1.5. ,. ............. 19.8.6., 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 ......... ·. v.~.~.~, o.d.d.~. ~..~ p.~..~.9..e.x. ~..~.~.~.n. ~..o?...r.a.m.~..Z .y..d?. ? .~.~?. g.: ....................... Tbe certificate is issued to .. George & Katherine Schneider ................... /o'd.b;, 'a/sh/o ~'ti~;-~'x' ~ ................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDiHG PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ~5403 Z Permission is hereby granted to:, ~ f s Z~.~.~....~.:.~..~.....~ ................... ,. ...~.~.~.....?.?..,~. .......................................... .... c~~.~._.~.:~.,...u...~..~.. ....... . County Tax Map No. 1000 Section ...... I...O....~. ....... Block ...... ..<~.....'~. ....... Lot No ...... ,C~.~ ........... pursuant to application dated .............. ..~- .'].. ............ , 19.~..~.., and approved by the ~uildlng Inspector. Fee $...~..~....:,.~. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11071 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I Ilmmmmam to' the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Enginee~ responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 Deck ~te~B~ci~j~ .... ~ ...... Old or Pre-existing Building $15.00 ......... Vacant Land ............. 1620 ,M. aso,n, D, rive C.u.t,,choque location of Property ......................................................... House No, Street Ham/et Owner or Owners of Property .G. ,~,o?,qe,, ,~....S. ,c,h,~,e, ~_.d,e?, .~, ,~,cl..K, ,~,h,e?, ~_,~,e..~, ,...~.c.h. ,~?~.~.? ,~ .... County Tax Map No. 1000 Section .~.Q~, .0.0. ....... Block .... 0.7., .0.0 ...... Lot'.. ,0.~..~...0.q 0. ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~ ................ Fee Submitted $ J 5.00 .................... Construction on above described building ~n~~_~ll ~p~i~_ Je_co~es and regulations. Apphca ............ Rev. 10-10-78 ~// . FIELD INSL~ECTION FOUNDATION (1st} FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~b..~..o:~ .I. ~..., 19~?.~. Approved Q.?~.....+~...l. ~..., 19~.{~, Permit No./..~..~.0..-5..-~. Receive~ ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date.~Ug¢~.¢~ ...... ,19~5. 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 t'o 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 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 pr,e..mises available for inspection throughout the work. e. No building sh/ill 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, xfor removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ord~cesr.¥uildi'l~ code, housing code, and regulations,, and to admit authorized inspectors on premises and in building for, zfO~ssary i~spe.~Jona. _ ../ . // ,q · ~ · ,- -~ff. v . (~'gnature of applicant, off. o~e, if a corpbration) ~' ~ [ t~50~ Mason Drive , ' ~?.q .hgg. u.e..,. ~.e.~. _Y.o.r.k ~,.1.1.9.3..5 ............. · ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. '. ,, ..................................................................... Name of owner of premises . .G.e..o~g.e..P. :..S.q .h,n.e.~d..e.r. ,a.n..d..K.a.~..h.e.r.~.n..e..T.....Sg.h.n.e. ~.d.e.r. ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............. .... i ....................... x (Name and title of corporate officer) , Builder's License No ..... ~/A .................. PI ber's Licens N Ixl/..¢ um e o ...................... Electrician's License No..N/.A .................. Other Trade's License No. N/3 .................. Location of land on which proposed work will be done] ................................................. 1650 Mason Drive Cutchogue, House Number Street Hamlet County Tax Map No. 1000 Section . . .1.0.4... g 9 ......... Block ....0.7. .. 0. 9 ......... Lot... O ~..I....Q O f) ........ Subdivision ..................................... 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 ...... .d.o. qk. .......................................................... b. Intended use and occupancy .................................................................... If garage, number of cars . .I~/b. 6. If business, commercial or mixed ~ 7. Dimensions of existing structures, Dimensions of same structure witt Depth .... N./.A .............. - 8. Dimensions of entire new constrm Height . .Ixl/A. .......... Nu,nbl 3. Nature of work (check which appii~able) New Building Addition Alteration Repair .............. Removhl .............. Demolition .............. Other Work...d.e.e.k.... ' (Description) 4 Estimated Cost ' ................ i ........................ Fee .................................... , (to be paid on filing this application) 5. If dwelling, number of dwelling uflits .... ~/.A ........ Number of dwelling units on each floor.. ¢7/.A. .......... ~ccupaney, specify nature and extent of each type of use .. iq/.A ............. ~gSaxa~ ........................................................ alterations or additions: Front .. ]N/A ........... Rear . .~J./~ ............. Height ....N/.A. ............... Number of Stories .... .-N/.`5 .............. r of Stories .... N../.A. ................................................ 9. Size oflot: Front .... N/.-% ............ Rear .... I,I/.`5 ............... ..Depth ..1%/.-6 ................ 10. Dat~ of Purchase . Auffus t 2 5 ~ 19 5 2 .. Name of Former Owner ~.q.i.l.l.i.a[n...H:..&. t.~.r.zTf E. Mason O~ ' r dlZ ............... · .... 12. Does proposed c .... onstruction wolate any zoning law, ordinance or regulation: ..... No ........................ 13. Will lot be regraded . NO · · i ' ...... ' fill be removed from premises: 'g~x No 14. Nmne of Owner of premme~e{de~..t~a...t?.r..3:9.~ddress ~,~9,),///////,)~qgr~ .D-r,qV e. Phone No ............... ........................................... rhone Pqo .... '~-. ......... Name of Contractor ...... : ............... Address ..... ' .-.~ ........... Phone No ..... ':r ......... 15. I.~ t:h±s property locat:ed wtt:hin 300 feet: ot= a t:ldal wet:land? ~¥es ..... blo ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give stre6t and block m mber or description according to deed, and show streetnames and indicate whether interior or corner lot. ]TATE OF NEW YORK, See attached survey. ;worn to before me this ........ ~:~ ........... day of.. ~ .~.u. 9 .u.s.L. ..........,19 ..8~ ~ Iotary Et~l~c, ...c'f-f~N..../,f . i ..... .. . ~//~'~ Notary 15ublJ_e" ' ] WILLIAM D. MOORE , ' ,~I/6'i'ih'~ 'T;' 'B~t NOTARY PUBLIC, State of New ~ork~ ] No. 4832728 Qualified in Suffolk County Comtnission Expires Marc I 30~ 195~ ~h'~d~- .................. --(Signature of applicant) 2OUNTY OF. ~.U.F.~. 9~X ....... S'$ ,..C~D...~ .C,~.~ .F......... SCHNE .I~.ER....&...KA.T.~..... . T....SCHNEIDER. ... .. · .... . being duly sworn, deposes and says that he is the applicant (Name of individual signingicontract) tbove named. te is the ........................ ! ................................................................ ~f said g~7o~r owners, and is duly ~ ~thorized to perform or have performed the said work and to make and file this pplication; that all statements contain~ ~d in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner s~ t forth in the application filed therewith. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ ,19 ... Approved ................. 19... Permit No ............ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date August 2~ 19~. 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 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 coveied 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 pre,.mises available for inspection throughout the work. e. No building sh~.[l 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 la/q, ordinanc~uilding code, housing code, and rel~ulations, and to admit authorized inspectors on premises and in build, for n~'e~lsllryri, fispeqtions. J. /) ? ff/) ' _ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Own'er Name of owner of premises ...G.ep~g .e..F.... S.g.h.n.e.i..d.e.r...a.n.d..K..a.t.h.e.r..i.n.e..T.,..S. qh..n.e.i.d~r ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer, x (Name and title of ~orporate officer) · Builder's License No ...... NAP, ................ Plumber's License No ..... .N/.A. ................ Electrician's License No....N/.A. ................ Other Trade's License No.. ¢l/.g~ ................ I. Location of land on which proposed work will be done] ................................................. 1650 Mason Drive ...... ......................................................... ............ ....... House Number Street Hamlet County Tax Map No. 1000 Section ...1.q 4.: 9.0 ......... Block .... 0.7.: .0.0 ......... Lot....0.1.1., 9.0.0. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Nalne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~ ...... r~'../2!4-.....~...... · .a'2~ ~.'.. · ' .,c~. ~. · · -~-~ ..... b. Intended use and occupancy ............. /d.~ ................................................ k ( ppli ) ' ti 3. Nature of wot check which a cable: New Building ..... Addition. Altera on ..... Repair .............. Remora! .............. Demolition ............. Other Work....d.~ ¢¢ ....... ~ (Description) 4. Estimated Cost..~.. .......... , ................................ Fee ;I % (to be paid on filing this application) 5. welhng, nmnber of dwelhn n s ........... Number of dwelling units on each floor ............ n garage, number of cars ...bi/& .......... ~ ......................... 6. If business, Commercial or mixed o~cupancy, specify nature and extent of each type of use ...N/.% ............... 7. Dimensions of existing structures, ir any.h'3~rffi~q [I ft X ~.0 ~ ....... ~ ............... ~I~tkSO~l~, ........................................................ Dimensions'of same structure with ~lterations or additions: Front ... 3I/.A .......... Rear . .~l/& ............ Depth .... N../A . Height . .bi/.& ....... Number of Stories.. ~.,{.g, ...... - 8. Dimensions of entire new construction Front ...bix'& .... ' ..... Rear ... N/.h ........ Depth . ~/.A .......... Height ...~,/& ........ Numbef of Stories ..... N/A ............................................... 9 Size of lot Front bix'& i Rear lax'& Depth V.,(.~. 10. Dat~ ofPurch~tse .A..ug.u.s.t...2.5.,. i .1~52. 11. ZoChre ~J!~)~rict in which premiies a'r; sit~t~i~ti .... Name of Former Owner [g~J.J-~iara. l-I,. b. I-Ii~rrT. E,. ~¢80~. ·['&"..Residential .-&c~ric~d.t;ura.L ................. 12. Does proposed constructinn violate]any zoning law, ordinance or regulation: ..... N~ ........................ 13. Will lot beregraded..3IO......,................~ Will excess fill be removed from premises: Yes 14. N ' ~ ' amc of Owner of premlses~e.p~eXg, l~L.._,~. Ka.ther.LneAddress .~.0..~..sp.n' .D..r.iy..~Phone No.73.4..:5~B.8' ... Name of Architect .. ¢l/.b ...... ; .............. Address .C.u.e..c.h. qqu..e.,..~.... Phone No ................ Name of Contractor. .~/.A. ......+..........' .... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trust~es Permit maybe required. .. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block nm ~ber or description according to deed, and show street names and indicate whether nterior or corner lot. TATE OF NEW YORK, OUNTY OF . · 8IJ~.F..OLK. (Name of individual signing Contract) hove named. ' See attached survey. being duly sworn, deposes and says that he is the applicant ie is the : frx~d~x~mm~:~x owners, and is duly aqthorized to perform or have performed the said work and to m~e and file this ~plication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the 'ork will be perfo~ed in the m~ner set forth ~ the application filed therewit~ worn to before me this ......................... ......................... ota-,Public, . . ~ugffi&k J ~ ,,, ~~aor NOTARY PUBLIC State -f New York ~ ~ No ~83272~ / ~ . / _ ~u~lified [n S~ffolkjCounty ~~' ~' ~;~' ;;,'~.~' '';'' '2' ''.~ si n res ~ar~h 30, Z98~