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HomeMy WebLinkAbout29664-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29714 Date: 09/16/03 TI{IS CERTIFIES that the building ACCESSORY Location of Property: 300 BLOSSOM BEND MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 6 Lot 28 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 22, 2003 pursuant to which Building Permit No. 29664-Z dated AUGUST 22, 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 DAVID C & MICHELLE L SCHEER (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTME~T OF HEALT~APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~U Rev. 1/81 N/A N/A N/A FOF, M 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) PEP34IT NO. 29664 Z Date AUGUST 22, 2003 Permission is hereby granted to: DAVID C SCHEER 300 BLOSSOM BEND MATTITUCK,NY 11952 for : CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. THIS PERMIT REPLACES 27559. at premises located at 300 BLOSSOM BEND MATTITUCK County Tax Map No. 473889 Section 115 Block 0006 Lot No. 028 pursuant to application dated AUGUST 22, 2003 and approved by the Building Inspector to expire on FEBRUARY 22, 2005. Fee $ 75.00 Authorized Signature COPY Rev. 5/8/02 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. 27559 Z Date AUGUST 14, 2001 Permission is hereby granted to: DAVID C SCHEER PO BOX 251 LAUREL,NY 11948 for : CONSTRUCTION OF ~2qACCESSORY SHED IN THE REQUIRED RFJ~R YARD AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 115 pursuant to application dated MAY Building Inspector. 300 BLOSSOM BEND Block 30, 2001 MATTITUCK 0006 Lot No. 028 and approved by the Fee $ 75.00 Authoriz~ Signatm~re COPY Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAI~;f-~}' This application must be filled in by typewriter or ink and submitted to the Building Department witlkth~ f_oll_o_wing: , Z, l3jtr ., A. For new building Or new use: 1. Final survey of property with accurate location of all buildings, property lines, streels, hnd unu§u~F(iaT~t'al 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 coutains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildiugs and installations, a certificate of Code Compliance front architect or engineer responsible for the building. 6. Submit Plmming Board Approval of completed site plan requirmnents. B. For existing bnildings (prior to April 9, 1957) non-conforming nses, or buildiugs and "pre-existing" land uses: 1. Accurate ~mwey 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 Ccrtificale of Occupaucy is denied, the Building Inspector shall state the reasoos 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, Sxvin~ning 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 Old or Pre-existing Building: Street . (check one) Hamlet New Construction: Block Location of Proper~y: House No. Owner or Owners of eropel~y' ~'~(~ IC~ Suffolk County Tax MapNo 1000, Section Subdivision Permit No. Date of Pemfit. ~5'/,~-' J ~> Filed Map. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee r't~ Submitted: Applicant Si~ture h NEW SUFk'ISV. K ,d V£NU£ YOUNG ~ YOUNG BUILDING PERB~IIT RE\qEW CHECK LIST Applicant/ Owners Name: Architect/ Engineer: SCTM #: District: 1,000 Secdon: )//3"~ Block: __ Re¥iewed: Date ' '<-'~- . Submi,,ed: I.ocalion: Single & separale Required cerllfica(ion: (Yes / No) .~v~' ' [From Y~d Prt~s~: ] [S de. Yard /-~/O::;50t,-m /~.¢~_T_('~.~ SubdivisiOnName: Proposed: Req. Req {Rear Y~d . . ~ Po0posed -- I .I Project Description: ]R~OUIRED FOR REVIEW Suffolk County Health Dept. New York State D.E.C. Town Trustees Towfi Zoning Board approval: Town Planning Board approval: Flood Plane Elevation 777 Flood Zone: NOtes: No Permit Number ~ of BIi~ ~Ldde.Roofod Hhed mum _.~'~ 76S-1802 ~~ *'/~2~UILDING DEPT. INSPECTION [ ] FOUNDATION l ST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ] INS/UI~TION [ ] FRAMING [~]~FINAL [ ] FIREPLACE & CHIMNEy' DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ~J FINA/~_~ R£MARKS: ~ ~? INSPECTOR INSPECTION P~PORT FOUNDATION (IST) DATE ROUCH FRAI'ffi & PLI~ING IRSULATIONPER N. ¥. STATE ENERGY CODE FINAL ADDITIONAL CO~fl~IS: BUILDING .EPARTN~T ~gmt 3 0 ~00 TOWN HALL ~a ~m , TEL: 765-1802 ~OWN OFSOOTHOLq ..... ~ ~ Approved ~, 20 0 / Disapproved BUILDING PERMIT APPLICA?ION CHECKLIST Do you have or need the following,'~oefore applying ? ,' 3 sets of Building Plans ~ Survey. . Check Contact: Mail to: ~1 k,', _f~ Phone: ~q [--' ~ 3% Building I~ector u APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 O[ 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 adjoiuiag 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 a Certificate of Occupancy is isCued by the Building Inspector. APPLICATION IS ItEREBY MADE to the Building Department for the issuance cfa 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 name, ff a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (~ on ~e ~ roll or latest d~) DAng:~ ~~.R.~ ~ g~ Ifapplic~tisa~oration, si~a~eofd~yau~ofiz~officer FEE: -~" BY: ~ N~I~ BUILDING DEPA~ ~e ~d title of ~orate office) Builders License No. Plmbers License No. Electricians License No. Other Trade's License No. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 1. Location of land on which proposed work will be done: House Nmber Street County Tax Map No. 1000 Section Su &WSlOn ~4~'h)c)L (Name) Block Filed Map No. 765-1802 9 AM TO 4 PM FOR'THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCR~m E 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ~(.~,jff~ jt._U~_.,~GN OR CONSTRUCTION ERRORS ' ' · ;'//IA~G;I 2. State ex~sting use and occupancy ofpr~ermses and ~ntended use and occupancy of proposed construction: a. Exfsting use and occupancy '~.C,%ir4 eDC. t'_ b. Intended use and occupancy ,,~>r'~e., 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Alteration Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee (Description) (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. 7. Dimensions of exlsBng structures, ~f any: Front 70 ~- -fib. Rear ~'70 tl..~.-~t- Depth Height /~ 45~ Number of St-ofi~-~ [ Dimensions of same structure with alterations or additions: Front Rear 9. 10. Date of Purchase Depth Height Dimensions of entire new construction: Front Height J & ~ Size of lot: Front /©O f~ Number of Stodes [ Name of Former Owner Number of Stories Rear /0 ¢¢- Depth Depth c~5~'~, qg fP' J 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: /q O 13. Will lot be re-graded ~ 0 Will excess fill be removed fitom premises: YES NO 14. Names of Owner of premise~x~'d ~Ofllchdle_ ~c3e0'Address3zo BI~. ~ hk~r. Phone No. ~D-q'~ -o~, ~ Name of Architect ~ Address Phone No Name of Contractor ~ Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 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) S: ~t'~ C_...-~2, [ob[,~-- being duly sworn, deposes and says that (s)he is the applicant '"(~lame of individual signing contract) above named, (S)He is the ~_~t~/~._.-~,a. (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized tO perfo, maor haye performed the said work and to make and file this application that all statements contained in this application are tree tbthe b~t of his knowledge and beliefi and that the work will be performed in the manner set forth m the applicataon filed t~erew~tll. Sw_.om to before me this :. ,.i i. ' ~'~0~ dayof ~ r~k.~ 20'0~' ~ ' ~ Not~ ~blic L~DA M. BOHN NOT~Y PUBLIC, ~e ~ N~ ~ffi No. 01BO6020~2 Ouall~ In S~olk Cou~ Te~ Expires March 8, 20 ~ Signature o"'¥ Applicant