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HomeMy WebLinkAbout14933-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z19286 Date AUGUST 13~ 1990 THIS CERTIFIES that the building. PROFESSIONAL OFFICE BUILDING Location of Property. 32495 MAIN ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 097 Block 05 Lot 4.4 MINOR Subdivision JOHN MIESNER Filed Map No. 303 Lot No. 2 conforms substantially to the Application for Building Permit heretofore SEPT. 30, 1983 filed in this office dated MAY 30, 1986 pursuant to which 12698Z OCTOBER 21, 1983 Building Permit No. 14933Z dated JUNE 3, 1986 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 NEW PROFESSIONAL OFFICE BUILDING - FIRST FLOOR ONLY The certificate is issued to ANNE H. OLSEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N646395 - N753927 PLUMBERS CERTIFICATION DATED N/A UPDATES C.0.Z16248 and COZ16249 OCT. 5, 1987 FINAL PLANNING BOARD LETTER 4/19/90 C26 - MAY 31, 1984 ~ - ~ ~uilding I~spec~or ' ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) Permission is hereb/granted to: -- ...... ~.....~....C2..~......./.....~.. .... ~....~....~..~.. ........................................ ,o ....... ~o~.~..~:.....~~_~ ....... ~.~.......~...~.~ ............................. ..... ,~,. ....... ~..:~.....~~....~./....~~. ............................................... o, ~,,~, ,~o,~ o, ....~..~...~?.~......~..~...~..~ ........................................... County Tax Map No. 1000 Section '~"~'"'Z ...... Block .....~....~.. ...... Lot No.-~..~...,~...~...~4:~' pursuor~t to application dated ........................................ , 19 and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN ~7 SOUTHOLD BUILDi.;G EEPARTMENT 7?%%; ii~LL 755-18C2 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector 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 Approva% 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. ~bm__ 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 a 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 UPDATE C.O.Z16248 Date .... ~G~. 10, 1990 Z 16249 New Constructmon ........... Old Or Pre-existing Building ................. Location of Property 32495 .I~.~ ~q.Aq. CUTCHOGUB ~ House No. Street Hamlet Onwer or Owners of Promertv ~ H. OLSEN County Tax Map No 1000, Section... 097 .Block .... 05 ...................... Lot .. 4.4 Subdivision . ................................... Fmled Map ............ Lot ...................... Permit No ....... Date Of Permit ........................ Applicant ................... Health Dept. Approval ......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Fee Submitted: .......... Certicate ........... Temporary Certificate . Final 50.00 FOR UPDATED C.O. ~ARY OLSEN .............................................. c 7 APP ZC., -z Southold, N.Y. 11971 (516) 765-1938 September 30, 1987 Mr. Victor Lessard, Building Department Town Hall Southold, NY 11971 Executive Administrator Re: Site Plan for Gary Flanner Olsen Dear Mr. Lessard: The following action was taken by the Southold Town Planning Board at the regular meeting of Monday, September 28, 1987. RESOLVED that the Southold Town Planning Board, following a field inspection, recommend to the Building Department that a certificate of occupancy be issued for the site plan for Gary Flanner Olsen located at Cutchogue, SCTM# 1000-97 5-4.4, subject to a one-year review. If you have any questions, please don't hesitate to contact our o~fice. Very truly yours, BENNETT ORLOWSKI, JR. CHAIRMAN' SOUTHOLD TOWN PLANNING BOARD FORM NO. 4 'TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16248 Date October 5, 1987 Z- 16249 TttIS CERTIFlES that the building CONSTRUCT PROFESSIONAL OF. FICE BU.ILDINGS 32495 Main Road Cutchogue, New York Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ...0.9.7. ...... Block . .0.5 ............ Lot ...4...4. ........... MINOR · .. M/o John Miesner 303 2 Subd~v~smn ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept. 30. 1983 12698 Z Hay 30, 1986 pursuant to which Building Pem~it No.. 14933 z oct obp~r ~g61983 ,lune 3, dated ............................. 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 ......... NEW PROFESSIONAL OFFICE BUILDING - FIRST FLOOR ONLY The certificate is issued to ANNE H. OLSEN (owner, Xel~eXo~ l~avc~JX X of the aforesaid building. Suffolk County Department of Health Approval ....C.2. 6.. 7..M.a..y..3. 1.:..1 .9.8.4. ................. UNDERWRITERS CERTIFICATE NO N646395 - N 753927 PLUMBERS CERTIFICATION DATED: N/A Building Inspector SUBJECT TO ONE YEAR REVIEW BY PLANNING BOARD FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hal/ Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink. and submitted m~ to the Building Inspec- tor wkh 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 Engineer 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 p~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: 1. Certificate of occupancy $25.00-- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50,00 3. Copy of certificate of occupancy $ 5.~00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date February 4, 1987 NewConstrucbion X. OIdo P existi 8uildi ..... r re- ng ng ............ Vacant Land ............. Location of Property .. 32495 Main Road, 'Cutchogue, New York 1!9,35 House No, Street JYamler Anne Ho 0]sen Owner or Owners of Property ............ County Tax Map No, 1000 Section 097 Block 05 004 004 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No...........14933Z Date of Permit .?,3/86. ..... .Applicant .An.ne. H. 0Isen, by Gary Flanner 0Isen Health Dept. Approval ........................ Labor Dept. Approval ........................ N753927 ..................... planning Board Approval ...................... Underwriters Approval . . . Request for Temporary Certificate '~ X ................... .~,, Final Certificate ....................... Fee Submitted $....5.0:99 .. / Construction on above described building and'perm}t~l ap~le co~ and regular,ohs. //~ - .... .j ......... ~...~. .............. Rev. 10-10-78 P.O, ~0;< 706 Town Hall, 53095 Main Road P.O. Box 1179 Somholfl, New York 11971 PLANNING BOARD OFFICE TOWN OF $OUTHOLD SCOTT L. HARRIS Supervisor Fax (516) 765-1823 Telephone (516) 765-1 MEMORANDUM: TO: FROM: DATE: SUBJECT: Victor Lessard, Principal Building Inspector Bennett Orlowski, Jr., Chairma~ ~.~/;/~ April 18, 1990 Construct Professional Office Buildings SCTM~ 1000-97-5-4.4 An inspection of the above referenced property was made on April 17, 1990 in conformance with the Certificate of Occupancy condition that a one year review be made by the Planning Board. The Board finds that all conditions of the site plan have been accomplished. B.P. 12698Z Z16248 B.P. 14933z Z16249 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 Engineer 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 p~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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date February 4, 1987 NewCons t~'uc~.ion......X Old or Pre-existing Building ............ Vacant Land ......... .... 32495 Main Road 'Cutchogue New York !!9.3.5 Location of Property , Hou~ No. Street /-/sm/et Owner or Owners of Property .Ann .e.H: 01sen County Tax Map No. 1000 Section ............. 09,7. Block .. 05 Lot ..... 004..0.04.. Subdivision ................................. Filed Map No ........... Lot No .......... Permit No...........14933Z Date of Permit. ........6/3/86 .Applicant. Anne.. . . ....H' 01 sen,. ..... . ......bY Gary. . .F.1 .a.n.n.e.~..01 sen. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ...N7.5.3.9.2.7 ............... Planning Board Approval ...................... Request for Temporary Gert f cate .... d~ O. ertlfi~-~tm X Fee Submitted $....5.0:.0.0 ..................... / Construction on above described building and permit~~le co~ and regu lations. Applicant ...... ;?~.. ,¢~.~, .~/., ,~ .... ~ ............ .o,. GARY " ANNER O[SEN, ESQ, ' ¢,,a:.33323 P.O. 80X 706 c o aq [ curc.o uE, mas FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted -, aammma 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 Eng neet responsible for the building. 5.Submit Planning Board approva 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 p=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: l. Certificate of occupancy $25.00 -- BUSTNESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.'00, over 5 years $lO.0O 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date February 4, 1987 New C on s ~. r u c ~. i on.. X.... Old or Pre-existing Building Vacant Land LocationofProperty .. 32495 Nain Road, 'Cutchogue, New York 11935 House No. Street Ham/et Owner or Owners of Property Anne H.. 0[ sen County Tax Map No. 1000 Section 097 Block 05 004.004 Subdivision ................................. Filed Map No ........... Lot No .............. 6/3/86 · Anne H. . ............ Permit No.. ! .4.9,3.3.Z... Date of Permit .......... Apphcant ......... .0,1.s.e.n:..b.y. Gary Flanner ?.[sen Health Dept. Approval ........................ Labor Dept. Approval ........................ N753927 ....................... Planning Board Approval ...................... Underwriters Approval . Request for Temporary Cart f cate .......... .~al C.,r,;f;,~.~ X Construct,on on above described bui,ding and perm/~/eets/a~/olicable~?des/..._ ~ ///J~ / and regulations. Applicant. · - ................. ~LANNER OLSEN, ESQ, P.O. ~0X 706 FIELD INS?ECTI~ ~ DATE COMMENTS FOUNDATION (lst) FOUNDATION (~nd) ___ , ROUGH FRAME & __ PLUMBING INSULATION PER N. Y. STATE ENERGY ~,ODE - FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N,Y, 11971 TEL.: 765-1803 ('Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. Tins 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 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 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,~gs~l other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~mg'val or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildirl~ ~.od, S, housing cA~de,,and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~J~ ~,/.,~ ~>~/// ,~ .... .... ~i~n'at~ )f applicant, or ha. mo, if a corp_ ~io ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ..................................................... .... ........................................ (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 ..... ~ .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which propo~ed work will be done. /~1~ ~.~.~/..~.~.~/~..~ ....... House Number Street Hamlet ~t:~ ~,OCJ ~ (Name) 2. State exlstmg use and occupancy of p~2 ~nd intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~. ~ ~~ ...................................... b. Intended use and occupancy . .~.. ~~~*,~,.":.>~: '~ ':'~:'- .................... 3. Nature of work (check which applicable): New Building .......... 'Addition . ..~. ...... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work .............. I (Description) 4. Estimated Cost ...~. ~.~..'12. ........................ Fee .~. ~..(~...(~...'.~. ..................... (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i .................................................................... 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 ofantire new construction: Front ............... Rear ............... Depth ............... Height ............... Nu~nber .of Stories ........................................................ 9. Size of lot: Front .......... i ............ Rear ...................... Depth ...................... 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated .............................................. 12. Does proposed construction viblate any zoning law, ordinance or regulation: ................................ 13. Will 10t be regraded ........ i .................... Will excess fill be removed from premises: Yes No 14. Nam0ofOwncrofpremises ..i .................. Address ................... PhoneNo ................ Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ., Address Phone No 15. Is this property located within ti00 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town T~ustees Permit may be required. i . 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.~'i//~:~,j..~ f ,~-/~-,"~2Z2/~f~ STATE OF NEWzYO~/ cou .Y OF.. ...... ~~ ............. being duly sworn, deposes and says that he is the applicant ~ (Name of individual signing contract) above named. Heisthe ........ ~.~..~ ............................ ~ ................... ' ........ , ......... / (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfo~ed the said work and to m~e and file this application; that all statements cofit~ned N this applicatio~ are true to the best of his.knowledge-and belief; and that ~e' work w~l be perfo~ed in the m~er set forth in the application filed therewith. before me this .......... ~ ...... 9 Notaw Public .......... ' .... ........... t ,q,*' --.-4-- / Iz'--o ~ -:- (t 2. SEP 7 REO'B PL~t,q PROFESSIONAL OFFICES GARY FLANNER OLSEN, at f, UC#OGUE, K.Y. MII)OLE~ P-,O~,O , .bA~%TITUCK, N.Y. SITE PLAN APPROVED BY PLANNING BOARD TOWN OF SOUTHOLD ,~A~.~'e,"~ /=r. ac>e.. $ \ 0 L addition to this document is a violaFo, of s~ct~on 7209 of ' PLTI~r~E~ CE~.~T[FT-CAT[0I~ ON L~:: 4 D CON'?~¥.HT ~ ~FORE ~PI~p[,'ED AS NOTED NOTI~ BUILDING DEPARTMENT AT LI. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ~. ROUGH - FRAMING & PLUMBING ALL CONSTRUCTION SHALL MEET THE REQLUR~MENTS OF THE N.Y. STATE CONSTRUCTION & ENERGy DESIGN OR CONSTRUCTION ERRORS.