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Home My WebLink About29744-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29765 Date: 10/09/03 THIS CERTIFIES that the building REPAIR Location of Property: 5455 DEPOT LA CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 96 Block 4 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2003 pursuant to which Building Permit No. 29744-Z dated SEPTEMBER 16, 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 REPAIR & REPLACE PORCH ON EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT" . The certificate is issued to JOSEPH & SABINA ZUHOSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A a Au q iz d Signature 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. 29744 Z Date SEPTEMBER 18, 2003 Permission is hereby granted to: JOSEPH & SABINA ZUHOSKI PO BOX 615 CUTCHOGUE,NY 11935 for "AS BUILT" PORCH REPAIR/REPLACEMENT AS APPLIED FOR. ADDITIONAL CERTIFICATION WILL BE REQUIRED at premises located at 5455 DEPOT LA CUTCHOGUE County Tax Map No. 473889 Section 096 Block 0004 Lot No. 006 ' pursuant to application dated SEPTEMBER 10 , 2003 and approved by the Building Inspector to expire on MARCH 18 , 2005 . Fee $ 300 . 00 % i Autho Si re COPY Rev. 5/8/02 r P�,lL�a s Form No.6 /S33- TOWN OF SOUTHOLDI� 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 or07 topographic features. Z. 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.4 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. 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$35.00, 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. I. 3b -03 New Construction: Old or Pre-existing Building: (check one) Location of Property: S 41-5-S D-tA e aw'yyt'.9w his y House No. yy Street Hamlet — Owner or Owners of Property: Suffolk County Tax Map No 10 0, Section Block Lot Subdivision Filed Map. Lot: Permit No. 9 7 5l Date of Permit. Applicant: qo�_ . d A Sa ,4� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ —Applicant Sign ure Lo 2-�Q� TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET U VILLAGE DIST.1 SUB. LOT �b/aoJlc / ,� Q a ,mare �v7�cfoo ✓e �,� FORMER WNER 9T Z5Ct b f HGS N E ACR. GG'1�v�it., r �e o_`_/ _, k b � . ' S W TYPE OF BUILDING RES2_1 O SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS - 6 a o 2 Ye a 3 Q a a to /31 - - � a Click 1'10 3 c�oc� op Qo G 2 /.IG 171 �(S 9/ - BP 19g 6- e- 0 Gs Re levee - CD a3�45'�p ota Asn - cohgf flcoes S s4ot-age s�l,ec{J sa.c, e �Jo 5 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE /o o ' L� G � fl - foo FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland ` FRONTAGE ON ROAD Meadowland DEPTH - — House jkt...e BULKHEAD Total DOCK ■■■■■■�■■■■■I■■■■■■■■N■■N■■■ ■■■Ner■■®■®1�7■N■■ ■■■ COL TRIM j Extension I ■■■■ii��■moi■■■■■■■ ■■■ Extension ■■■■■■■■■■■■■■■■■■■nN■Nn Foundation Porch ® a Basement Floors Porch �Ext. Walls 9G-" Interior Finish _ � DR. Garage Roof Rooms 1st Floor FloorPatio 9/91 4, Kecreation Room Rooms 2nd - FIN. B • Dormer ®-- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ) ROUGH PLBG. [ ] FQi7NDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /c h DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) �INTION [ J FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Igo- DATE 1013103 INSPECTOR FnMD.INSPECTION REPORT DATE CONAYIENIS J FOUNDATION(1ST) ae FOUNDATION(2ND) S y ROUGR FRAMING& 3 FLUN]W NG INSULATION FERN.Y. y STATE ENERGY CODE FINAL ADDTIYONAL CObIl naves Z m .o x 1 � b t� i TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING,DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health VC) SOUTHOLD, NY 11971 "` e 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval 0 FAX: (631) 765-9502 Survey 120 www. northfork.net/Southold/ PERMIT NO.al�'4`(Lf 27- Check Septic Form N.Y.S.D.E.C. Trustees Examined 1 20_'3 Contact: il Approved (ct , 20_ Mail to: Disapproved a/c Phone: Expiration ,20 i r Inspector 6 APPLICATION FOR BUILDING PERMIT i.. - Date D 5 20 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 publiw 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 perrtlit 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 pursnrant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc s or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein describ�d. 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,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 060 99 Name of owner of premises JC S�� 4 5Qa1/74 241 OS�C/ S (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. j/o.5 WT Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of landONvhich pro osed work will be done: House Number ' Street Haml-¢t i p County Tax Map No. 1000 Section Block / "�- Ilpyw Subdivision Ul� Filed Map No. 1?aucAa tuE,84W-� :, I r 2. State existing use and occupancy of premises and intended use apd occupancy of proposed construction: a. Existing use and occupancy f��7 t,r /Zc�/ ////,'�& b. Intended use and occupancy f TGOyj I Po,e Floo Z 3. Nature of work (check which applicable): New Building Addition Alteration Repair i/ Removal Demolition Other Work (Description) 4. Estimated Cost �q,S-00, Fee 7001 (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, 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 3/' Rear 2>(' Depth Height .Z 0' Number of Stories Dimensions of same structure with alterations or additions: Front SearF — DepthHeight Number f Sf&�ies��, S f Iii 8. Dimensions of entire new construction: Front � _ ear Depth 7 Height 4(6 Number of Stories 9. Size of lot: Front 7T 6 Rear �tOD ' Depth Sn�L 10. Date of Purcha ` Name of Former Owner EL 'A to ZZ c,) 11. Zone or use district in which premises are situated k'S5(I f' N z 12. Does proposed construction violate 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 v'L _losfp/,d S413i171q 14. Names of Owner of premises Address SSSSAt AV phone No. Name of Architect 94l Addressv Phone No Ad —T-- Name of Contractor E ir��s dress/ 5 'n l2J Phone No. 70 U �AS�MQ/usYr, �'j 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO ✓ * IF YES, D.E.C. 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) SS: COUNTY OF 1 ,:105-P—Rd. S • 3 K being duly sworn, deposes and says that(s)he is the applican� (Name of individual signing contract) above named, (S)He is the 0_ck -vZRiL (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 Ipplication; that all statements contained in this application are true to the best of his knowledge and belief,' and that the work will e performed in the manner set forth in the application filed therewith. Sworntobefore me t day of � ., VzR,( 20 (33 /] 1 (..o7q-Gy-•l� . Nota blie Signature Applicant BONNIEL DONOSIII Notary Public,SM0lN@01111 t NTOM EXOM*7.30 01 lltMwMd E1NMMrns II Of N E W PA am 98 i; , y09 Ert Wfi011 NY 11>ISO Q r r OVED AS NOTEDLu �- .P. E p� v Xtra y i 03225+1-1 i1V EE: BY: NOTIFY RPUILDING DEPIRTMENT AT. r r , .,, �w-. AOFESSIONP. 765.1802 , FOLL INSPECTIONS: 1s o 1. FOUND TWO 2. FOR - 3— .ED CONC FRAMM # , 3. HULA 9 . 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