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Home My WebLink About27338-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27715 Date: 05/29/01 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 900 MASON DR CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 7 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 2001 pursuant to which Building Permit No. 27338-Z dated MAY 25, 2001 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 FRONT DORMER ADDITION & COMPLETE REAR DORMER ADDITION & WINDOWS AS APPLIED FOR "AS BUILT" . The certificate is issued to KAREN A & JESSE F SKELTON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED n N/A tho zed 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. 27338 Z Date MAY 25, 2001 Permission is hereby granted to : KAREN A & JESSE F SKELTON EAST SETAUKET,NY 11733 for CONSTRUCT FRONT DORMER ADDITION & COMPLETE REAR DORMER ADDITION & WINDOWS AS APPLIED FOR. "AS BUILT" at premises located at 900 MASON DR CUTCHOGUE County Tax Map No. 473889 Section 104 Block 0007 Lot No. 004 pursuant to application dated MAY 16, 2001 and approved by the Building Inspector. Fee $ 300 . 00 "'14 < Au- o zeo Signature ORIGINAL Rev. 2/19/98 r BUILDING DEPARTMENT i TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildir. 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. r 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 12 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 I. 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 - .25c. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 a5 Na J� 2001 . . . . . . . . . . . . . . . . . . . . . . Second floor dormer and windows 'S btriylta . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . , 900 Mason Drive Cutchogue House No. Street Hamlet Onwer or Owners of Property.. . Jessie A. .Skelton and.Karen.A. Skelton . County Tax Map No 1000, Section. 1q4 . . . . . . . . .Block. . . . 07. . . . . . . . . .Lot. . 0Q4 . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Kap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . Permit . . .Date Of Permits/. A I aJ. . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . .. . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . Fee Submitted: $. . .85.00 . . . . . .. . . . . . . . . . . . . . . . ; GARY FLANNER•OLSEIt It . . Main Rd, PO BOX 706 APPLICANT Co t: cg'? 71 -5 Cutchogue,NY 11935 GARY FLANNER OLSEN ({ y pL! ry4 ATTORNEY AT LAW gg +; '14AY ASSOCIATE: ' DAVID WORTHINGTON OLSEN 9"°""°^�- Q ATTORNEY AT LAW - ,v,� P.O. BOX 706 • MAIN ROAD CUTCHOGUE, LONG ISLAND, NEW YORK 11935 PHONE 631-734-7666 FAX 631-734-7712 May 17, 2001 Re : Skelton to Blair Our File 7315 Dear Ed: Enclosed herewith please find an addition c eck in the sum of $225 . 00 in re the above matter. Very tru G Y N R OLSEN GFO: lmk Enclosures Southold Town Building Dept. Attn: Ed Forrester Town Hall - Main Road Southold, NY 11071 a THE NEW YORK ; BOARD .O 'FIRE, UNDERWRITERS PAGE 1 1115101 BUREAU OF ELECTRICITY 40 FULTON STREET, NEW YORK, NY TOOSB , Date JULY 26,2000 AppltoationNo. 00Jile 10531900/00 N 531427 THIS CERTIFIES THAT i only the electrical equipment as described below and Introduced by the applicant•named on the above application number is in the premises of KAREN & JESSE SKELTON, 900 MASON DRIVE; CUTCHOGUE, NY in the following location; ❑ Basement ® ]st Fl. ❑ 2nd FL " OUT Section104 BlocR07 Lot 04 was examined on JULY 20,2000 and found to"be In compliance with the National Electrical Code.. FIXTUREFIXTURES 1 RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCRNi FIUOpWCENT OTHER AMT. I K.W. I .AMt. I K.W, I AMT. I K.W. I AMT. I K.W. AMT, H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT, TIME CLOCKS I BELL IUNIT HEATERS MULTI-OUTLET DIMMERS AMT, K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT, AMP. AMT, AMPS. TRANS. AMT. H.P. NO.OF FEET AMT, I WATFE SERVICE DISCONNECT NO.OF S fl_ IT V I C E METER o.or ec oxo. A. o, A.w.o. A. AMT. AMP, TYPE FQUIP. 1 e RW 1 R JW S e SW J 0 4W ppR a 01 CC.CONR. NO.Of NI•lE0 OC HI•LFO NO.01 NFetRAlt OF NEUTRAL 1 100 CB 1 X 1 4 , 1 4 OTHER APPARATUS: K.F.C. ELECTRICAL CONTR. LTC.#4718—ELL P.O. BOX 2123 AQUEBOGUE, NY, 11931 GENERAL MANAGER 11' O NPer This certificate must not be altered In any manner; return to the office of the Board If Incorrect. Inspectors may be Identified by tholf credentials. J BOARD OF IIEALT11 . . . . . . . 3 SETS OF PLANS • • . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OF SOUTHOLD CHECK - • - • • " " BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . • - TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL - • - • • - • • - • • - - - • ' TEL.: 765-1802 MAIL TO : Examined ; . . �5.Ia. Approved . . .$.La5�0►. . :. ., 19 . . . Pen-nit No.o1.) 32. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i; i�Ai Inspector) APPLICAI ION FOR BUILDING PERMIT' '2001' Date . .t%Y. . .16. . . . .)[XH.. • . 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. s 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 whate until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for t/eufa of Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, Newof er applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, oral demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildsin code, and regulations, andto admit authorized inspectors on premises and in building for necessary inspe(Signalicant, or name, if a corporation). Gary Flanner Olsen, Esq- . . .Main-Rd., .P... .0- (Mailing address of applicant) State whether applicant is.owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . .Gary•Flanner Olsen, esq•. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jessie A. Skelton and Karen A. Skelton Name of owner of premises . • , . • • . . (as on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) - ALL CONTRACTOR' S 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. . . . . . . . . . . . . . . . . . . . . . . 900-Mason Drive. . . . . . . . . . . . . . . Cutchogde . . . . . . .. House Number Street ., Hamlet ' 104 . 1 07 004 County Tax Map No. 1000 Section . . . . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Completion of �iiWt dormer started before 1957 and •addition of a. Existing use and occupan�,y � •do�ei 'arid ' * ' *d * ' "as Built • • • • • • " " " " " " " " Completion of dormer starte before 1957 and addition of• • • b. Intended use and occupancy •dormer'arid 'wfridows '"as 8un-V o'• • • • • • • • • • ' ' ' • ' • ' • ' ' ' ' ' ' • ' ' ' �PDN[� Addition . . . . . . . . . Alteration . • • • • • • • I,check which applicable): New Building • • • • • • • • • • , Other Work . • • • • • • • • • • • • ' Removal . . . . . . . . . . . Demolition (Description) . . . . . . . . . . . . . . . . . . . ' . . . . . Fee '. . . . . . . . . . . . . . . . . . . . . . . . 4, Estimated Cost . . . . . . . . . . . • • • • • • • • • • ' ' ' ' ' ' ' ' ' ' oto be paid on filing this application) Number of dwelling units on each floor . . . . . . . . . . . . 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . . • . . • • , . • . , • , • • . • • • • • • . • • • . . . . . . . . . . . . . . . • . • • • If garage,number of cars • • • ' ' e of use . . . . . . . . . . . . 6. If business, commercial or mixed occupancy,specify nature and extent each typ. • Depth . . . . . . . . ... • : . 7• Dimensions of existing structures,if any: Front ... • • , • , , , • • • . . . ..... • • . • • Number of Stories . Front Rear . . . . . Height . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . : . . :. . . . . . . Dimensions*of same structure with alterations or additions: Number of Stories . . . . Depth . . . . . . . . . . . . . . . . . . . ru Height Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth. . . . . . . . . . .. . . . . �8. Dimensions of entire new construction: Front . • . . • • , • , , Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Rear . 9. Size of lot: Front . . . . . . . . . . . . . . . . . • • . Name of Former Owner . . • • • • • • • • ' . • • • 10. Date of Purchase • • • • " remises are situated . . • • • • • • • " " " " • • . . • • • • - 1 l. Zone or use district in which p ' ' ' ' • • • • - •remises: • • . •Yes No 12. Does proposed construction violate any zoning law,ordinance gill excess fill be removed from p 13. Will lot be regraded . • • • • • • • • • • • . . " � • • • , Address . . . . . . . . . . . . . . . . . . .PhoneNo. . . . . . . . . . • • • • • • 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . , ,phone No. . . . . . „ • , . , . Address , phone No. . . . . . . . . Name of Architect . . . . . . . . . . . • • • • • , Address . . . . : . . . . . • - • - • • ' No wetland? " ' Name of Contractor • • • • • ' ' ' 'Within 300 feet.of a tidal w ' ' 15. 'Is this property located be gg � *If .yes, Southold Town Trustees PermitPLO& DIAGKAMed. whether existing or proposed; and,indicate t all and indicate whether Locate clearly anset-backdimensions from d distinctly all buildings, ,, ; { property lines. Give street and block number or description according to deed, and show street interior or corner lot. STATE OF NEW YORK, S.S COUNTY OFXIMIX. • • • • • • • • lica� er Qk�en • • , • , • , , , , being duly sworn,deposes and says that he is the app • •q��']V1q' • • (Name of individual signing contract) above named. . . . . . . . . . . . . . . . lie is the . . . attorney• • • • • • •.' ' ' ' ' ' • (Contractor, agent, corporate officer, etc.) and file t of said owner or owners, and is duly authorized to perform or have performed th said work and to make application; that all statements contained in this application are true t t hi knowledge a herewith work will be performed in the manner set fond belief;and that rth in the application file t Sworn to before me this f� day of. ?' Y. . . . . . . .2001 • 7�. . . • ffolk, , , County Notary Pub Lc, I. . . . . . . . . . . . . . . . . . . . . . . . . . . LORRAINE KLOPFER (Signature of applic Notary Public,State of New York No.4828373 Qualified in Suffolk County Commission Expires Nov.30,1) E 1 I 2- 2&-34 203D Z 20')4 r I � N 3 � 1`� �g 2Ys{/7�cJO�y 1(i°G?G. �2RnSISEI'#7.1]'alU�R.,II�'+rll'ZSUI S1StT 'II C C .i au rxm r-1 QL �i d 4 �• : I 1 l 32 vr _ ------------- !4—Ila, __.—.._-_!4-I'a' t n j i 11 t�17��G I''Ld i I� �-•nl IJ Isla f�M P 12�3'-� I _ .-f : 1 i p �F�sc oy GvTGI�OCncJ� I I� � 1�3� , m N� 0525"'`y2� 2 A