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HomeMy WebLinkAbout26977-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27511 Date: 01/12/00 THIS CERTIFIES that the building ADDITION Location of Property: 3130 PEQUASH AVE CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 13 Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 2000 pursuant to which Building Permit No. 26977-Z dated DECEMBER 15, 2000 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" . The certificate is issued to KENNETH C & LUCILLE M. ETZEL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A J.", )- /"� //h,o ized 6ignature 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. 26977 Z Date DECEMBER 15, 2000 Permission is hereby granted to : KENNETH C ETZEL & WF 3130 PEQUASH AVE CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN "AS BUILT"DECK ADDITION AS APPLIED FOR at premises located at 3130 PEQUASH AVE CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0013 Lot No. 025 pursuant to application dated OCTOBER 2 , 2000 and approved by the Building Inspector. Fee $ 75 . 00 Auth<iVrized Sdgnature ORIGINAL Rev. 2/19/98 cO��gOFF0j,t O � Gyp Town Hall,53095 Main Road N Z Fax(631) 765-1823 P.O.Box 1179 $ Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD January 12 , 2000 Mr. & Mrs . Kenneth Etzel P.O. Box 181 Cutchogue, N.Y. 11935 Re : Premises @ 3130 Pequash Ave . , Cutchogue, N.Y. Suff . Co. Tax Map #1000-103-13-25 Dear Mr. & Mrs . Etzel : Enclosed is the Certificate of Occupancy for the "as built" deck addition on the above property. Please be advised that the fence around the Inground Swimming Pool does not meet the New York State Pool Enclosure requirements, and should be corrected immediately. If you have any question regarding this matter, please do not hesitate to contact me at this office . Respectfully, SO�iHOLD TOWN�B�UILDING DEPT. Ga�J. F ' sh, Build ng Inspector GJF :gar BUILDING DEPARTMENT TOWN HALL 765-1802 F._ ... %.. APPLICATION FOR CERTIFICATE OF OC60F4NCY"" A. Thts application must be filled in by typewriter OR inkk and- u0;,[tcedW't;© i�hemb ildir 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 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 buildi 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 a '.'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 applicar 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - •251�. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . GT,. .Z. . . . . � �70C� . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . Location of Property. . . jkaPA. . J.4? �1 /�.I�Vk- . . . . . . . . :�.'i e�q;!�' .. . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . . .} . .�• • ' • • " " ' County Tax Map No 1000, Section. . . . . . . .Block. . . . f a . . . . . . . .Lot. . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . Permit NodA 9.?7.-r. . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant.///r�?,;=: "&. Health Dept. Approval. . . .)-Nl�. . . . . . . . . . . . . . . . . .Underwriters Approval. . . ' '' ` . . . . . . . . . . . . Planning Board Approval. . . . A.)I+- . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate_ . . -A� . . . Fee Submitted: $. . . 2's-: . . . . . . . . . . . (ties. 58 9$ Co�o2�51 (;6 '�77-4 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGLBG. [ ] FOUNDATION 2ND /[ FINA LATION [ ] FRAMING igo L [ ] FIREPLACE & CHIMNE REMARKS: I ,DATE �� �� �� INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS: ov DATEINSPECTOR r rT 9' .SLD INSPECTION REPORT DATE COMMENTS 6' II II ry )UNDATION OST) jj n if - vqi )UNDATION OND) u n ------------------------------------------ �, n ii c ILLI SII 1UGH FRAME S PLUMBING d II II Itt- II eC f if cn ,SULATION PER N. Y. u—moi H STATE ENERGY _ I CODE Lif u it II II � H FINAL it ADDITIONAL COMMENTS: -._,. m U� N qac z I r --- - rda ro H BOARD OF HEALTH . . . . . r 3 SETS OF PLANS • • • • • • - FORM NO. 1 SURVEY . . . . . . . . . . TOWN OFSOUTHOLD CHECK . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . : TOWN HALL NOTIFY q I 1 FOUTHOLD, N.Y. 11971 CALL . . . .4 • •t t 4 • • •TEL.: 765.1802 MAIL TO; Examined ,///� �q� �j w e'STrpm Approved " . . . . . /(�. . . . Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ---...0.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r. . . . . . . . . . !; (Build ng Inspect r) APPLICATION FOR BUILDING PERMIT Date . . 0.4`r. .. . . J•;�� 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 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 ` 4nuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances of 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 ' s tions. . . . . . . . (Si ature of applican ;or na if a corporation) pwr�ca x /f,1 . . . . . . . . . . . (Mailing address of applicant) State whether applicant is-owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QL . .? . iZ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . F ea��Ar. ' � (as on the tax roll or latest deed) 1 If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . I . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTORS MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . 1 Q.3 . . . . • • • . Block . . . . . /.�� . . . . . . . . . Lot . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: �la I tJA ice- S'?baa f�+ a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . .y.,-.:. ,.. .,. .,,.,, ,�.•,;:,. . . . . . . . . . . b. Intended use and occupancy . . . . .4i 9!� i " aas� �� d {-'. . �� ...-1.. . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . .Sl. . . . . . . A1tetat,ion . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . .` . • • . . . . . . . ' (Description) 4. Estimated Cost . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` (to be paid on filing this application) 5. If dwelling,number of dwelling nits . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage, number of cars 6. If business, commercial or mixe occupancy, spec>fy nature and extent of each type�f use . . . . . . . . . . . . . . .t. . . . . . . . . . . . . . . . . . . . . . . . nater . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structure, if any: Front . .S`J? ?r`• . . . . . Rear . �`�-� . . . . . . Depth Dimensions of same structure. . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Height . . � with alterations or additions: Front 2: . . . . . . . . Rear Depth y.. . . . . . . . .L . Height . . . . . . . a f. . , . . . . . . . . Number of Stories . . . . . . . . . . .i. . . . . . . . 8. Dimensions of entire new construction: Front . . . .?-�. . . . . . . . Rear . . .Y. .t. . . . . . . . Depth . . J.A .. . . . . . . . . . Height . . . . .L.� . . . . . . . Num er of Stories . . . ./.t!1ek- . . . . . . . . . . . . 9. Size of lot: Front . . . . . //G? . . . Rear . . . . . ./(®. . . . . . . . . . . . Depth . . . r ./. . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . �'� ? ?sG^'.�l i{ : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . 13. Will lot be reg radedp / . . . . . . i �+. Will excess fill be removed from premises: Yes No 14. Name of Owner of remises/444 Address 4utSJt!¢ f%'?'!kfwePhone No. 77 ?`.f, >. . Nameof Architect . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . r . . . . . . . . . . . . . . . . Address . . . . : . . . . . . . . . . . . . . Phone No. . . . . . . . . . 15. Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all lbuildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block r}umber or description according to deed, and show street names and indicate whether interior or corner lot. i STATE OF NEW Ax�'.COUNTY OF . . . S . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual sigmgg cont> ct) above named. .5Heistlte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer,etc.) -4-� owner er-vwn rs, 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$et forth in the application filed therewith. Sworn to before me thi . . . . . . . . . . . . . . . . .day of. . .4D2 .. . . . . . ... Notary Public, . . i . . . . . . . . . . . . . . . . . . County GARY PLANNER OLSEN . . . . . . . . . . . . . . Notary Public, State of New York ( nature of applicant) No 020L2959600 / pmmissilon Expires March SO,n_7� otoC3. 00 `R r 0. AA IM, Asa .•a r° I .+' : : i(y'� M1'7 ; V'�f n 'j• \y fly ,.� ',��I,R�'n iso Iy % f{ O I x 41 01•�, 6 C,f' ':W `K vc x REVISIONS YOIUNG;'dt;''YC�V DEC. 30F/916, 400 OSTRANDER AVENUE, RIVERHE 1 MAft.'/B,�/8T7 ALDEN W.'YOUNG 'Iq': ' PROFESSIONAL ENGINEER AND ' LAND SURVEYOR. N.Y.S. LIC.NO, 1204E ''{v.•' '' tE OF ryp `. W SURVEY. FOR:.. Iyr :G� , RD NAUTHONIIED ALTERATION OR ADDITION TO Rp,% H18 A IOLATITFSECTIT KENNETH C ETZEL n ko 1209 OTHE NEW YORK SATE EDUCATION . fy LAW ni COPIES OF THI$SURVEY MAP NOT BEARING 1 Ir • .:' 'I ' INE LANOISURVCYOR'B INKED SEAL OR 7E EMBOSSEO �CR4'BHRLL NOT BE OON9IOERCD _ 10 BE A VR M NM/E torr ; ',„ ' tl,i i .AT . AU i� a, 45893 :iUARANIE ATED HEREON SHALL RUN I ” Y"=H T �JA 70ors-r /V; �n APPROVED AS NOTED DAA. FEE BY: NOTIFY BUILDING DEPAATVENT AT N 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: t FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING I INSULATION i j 4 INAL - CONSTRUCTION MUST �ovrcc- iN x S&,4,m S i �E COMPLETE FOR C.O. Z A4� CQN_STRUCTION SHALL MEET t -THE REQ-UIR"EMENIS -THE X'Y -. _ ANCU pS741F CONSTRUCTi. NZ& ENERGY CCU1 /'1111 OR— =CO ESQ N4�-USP0NSIBLf-FOR DESIGN OR CONSTRUCTION ERRORS S � A &A/ SE IS UNIAWFUL 1 ITNOUT CERTIFICATE X' F OCCUPANCY T&P� 55 D , N 1 - - - - - - -� - - - - - - - - - - - - _571fA �5 -- - - - -y- - ytf�kDF;2 _ i z J'a..Syj-N r (ScftErrui r m M l�/zcil��ssrw�h- �Nf,,n,y�rZ / a 1 Z Y J 7 �ys'f{osrre�r AD y . 0525, ?�� S-. o .OFESStO�P� S�,OrnJt� Dao,zs i s t i 3 fr i 1 � TDIST t=i1t_ i Ro i f —T y'LFi I�.F"'�/O� KL1.IN4i{F,} � LUGILLL i'T�1;L 3 r ;o /��p its/� �✓� of NEW;, * 9 Q r -+ w Lu 1'0. 0525 �� Applicant/ Date Owners Namc. - =-1- --- — - RevI*VWed: Architect/ Date Engineer: _�U rI's C i�� 1 - t -- - SubmittedC SCTM ll: District 1 .000 Section ��� `— I Mock )-_� i_ot Project l Location �_ U �5� �/`� � tY�u� �{L�� Subdivision ----- - --- —fir Name Single separate Required certifkatioll (Yes / Nod Rcy tcy. -- - - — /.onme I)utrict II-o(sizc L)100 Actual 5d Loi covcra c — — — I / l E �Ni�)pirii it_ � RcqReq / Q lFronr Pard 3-<�proposed [Side Yard Req Proposed 1� Rear Propo;cd Yard JrS l [ Project Description: G'2— AGENOVERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. ✓ New York State D. E. C. Town Trustees Town Zoning Board approval: I/ Town Planning Board approval: v Flood Plane Elevation ??? Flood Zone: Notes: