HomeMy WebLinkAbout26516-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27225 Date: 08/02/00
THIS CERTIFIES that the building ADDITION
Location of Property: 620 IHAR LA CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 83 Block 4 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 7, 2000 pursuant to which
Building Permit No. 26516-Z dated MAY 23, 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.
The certificate is issued to GARY M & LINDA M LONG
(OWNER)
of the aforesaid. building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
4 f -
Aut orize 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. 26516 Z Date MAY 23, 2000
Permission is hereby granted to:
GARY M & LINDA M LONG
PO BOX 1016
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF DECK ADDITION AS APPLIED FOR.
at premises located at 620 IHAR LA CUTCHOGUE
County Tax Map No. 473889 Section 083 Block 0004 Lot No. 014
pursuant to application dated MARCH 7 , 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Authorized Signs t re
ORIGINAL
Rev. 2/19/98
_ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
•����� Z 4 20 TOWN HAIL
765-1802
TOVV�.a g-U
LICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the 'allowing: 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-di5posal(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 12 lead.
5. Commercial building, industrial building, multiple residences and similar building
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 and
'.'pre-existing" Mand 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 - I .25q,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $115.00, Commercial $15.00
Date . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or�a� Pre�istin Building. . . . . � f1 ��� .g. . .��the . . . . . . c �v
Location of Property. . . . • ��. � �.. . . . . . . . . •
House No. Street Hamlet
Onwer or Owners of Property.. . . . . �l� t�. .. � 4.�. . .L0/1 �j:. . . . . . . . . . . . . . . . . . . . . ...
County Tax Map
/N/o 10/00, Section. . . . . . . . . .Block. . . . . !.r. . . . . . . . •Lot. . . !. . . . . . . . . . . . . . .
Subdivision. . . !.Df� G:�� . . . .! l� a� . . . . . . . .Filed Ma o 3�. . . .Lot. . . . .Y
q �l p. . . . . . . . . . . . . . . . . . . . .
Permit No. 9X5_4. .2. .Date Of PermitQ•76 C . .P Applicant . . . .
Health Dept. Approval. . ... . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . .
PlanningBoard Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . � .. .... . . . . . . . . . . . . . .
APPLICANTT
Co �. 02,E 225
O��gUFF0
Town Hall,53095 Main Road p '� Fax(516) 765-1823
P.O. Box 1179 W �? Telephone(516)765-1502
Southold,New York 11971-0959 Oy
poi Sao
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 14, 2000
Gary & Linda Long
P.O. Box 1016
Cutchogue, NY 11935
RE: 620 Ihar Lane, Cutchogue.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
G e ed
XX An application for Certificate of Occupancy is
7 not on file. (Enclosed)
111{ ��j XX No Underwriters Certificate on file.
_ X The check is (not on file. )$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26516-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
O��gpFFO(,�C
°°yam
Town Hall,53095 Main Road p :� Fax(516) 765-1823
P.O. Box 1179 W _ Telephone (516)765-1802
Southold,New York 11971-0959
poi � Sao
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 14 , 2000
Gary & Linda Long
P.O. Box 1016
Cutchogue, NY 11935
RE: 620 Ihar Lane, Cutchogue.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX The check is (not on file. ) ;25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26516-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
j ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
i
I 1 //fNt
DATE - � INSPECTOR /N VVV 1
765_1802
BUILDING DEPT.
XVINSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
( ] FOUNDATION 2ND [ ] IN,SiJLATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
r
DATE INSPECTOR Maj
FIELD INSPECTION REPORT DATE COMMENTS
--------------------
II fl
FOUNDATION ( IST) p
FOUNDATION (2ND)
---------------
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II II
ROUGH FRAME & Tr
PLUMBING It
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ADDITIONAL COMMENTS: �
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BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS
; TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
MAR _ 7 M BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . .. . .. .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
E>amined.,,.s!JCJt7-9r.P?c)et7 MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved..d/il ....... 1W�w Permit No. ................ .....................................................................
Disapproved/a/c ...................................
......................................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application most be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
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 most be drawn on the diagram which is part of
this application.
c. The cork 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
permit shall be kept on the premises available for inspection thraj&mt the cork.
e. Nor!muilding 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.
APPL1CM(IN IS If= 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, 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'f r nevesinspections.
. ..( :�. ............................
(Signature o applicant, or nam, if a corporation)
(Mailing address of applicant)
State ubether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
.............. r................................. .............................................................
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)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
I. Location of land on which proposed work will be dobe......
lti:��........r�535:...................................................................................
House Number Street 4/ Hamlet
County Tax Map No. 1000 Section .....S�A...... Block ,...f........... lot ....(.y.........
Subdivision ....J�1...4. l.11 ..1.`?�nUr......... Filed Map No. .............. lot .....l y.... ...
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..............................................................................
b. Intended use and occupancy ,.....�li�s���.....r��c f/....v7°?`..rP�, ...��....d/a✓S�
Nature of writ (dirk wlhicu applicable): New Building .......... Addition .: Alteration .........,
Repair ............ Removal ............. Demolition ............ Other Work ..................................
n (Description)
Estimated Cost ....¢ ............. fee ........................*.................... .
(to be paid on filing tis application)
If dk elling, nutOber of dwelling units ............ Number of dwelling units on each floor ... ... ..........
Ifgarage, nunber of cars ................... ...................
If business, commercial or mixed occupancy, specify nature and extent of each type of use.......... ..... .......
Dimensions of existing structures, if arty: Front......... ....... Rear ............... Depth .......... .......
Height .... ..................... Number of Stories ......................
Dimensions of same structure with alterations or additions: Front ......... ...... Rear ...............
Depth .................... Height .................... Number of Stories ...............
Dimensions of entire new construction: Front ................ Rear ............... Depth .. ............
Height ......................... Number of Stories .....................
Sizeof lot: Front .................... Rear .................... Depth ............... .....
). Date of Purdhas. ..................... Nam of Former Owner ..../.�'....... .............................
I. Zone or use district in which premises are situated ..........K. .:C:..rY?t��Y/.fr-. �............................
?. Does proposed construction violate any zoning law, ordinance or regulation: ......A., Y.............
3. Will lot be regraded .......(V.v.......... Will excess fill. be removed from premises: YES
i. Names of Owner of premises �? 6; /• 07Kk.�!.ryAdclreas C. �
. t Phone No. 7.3�
r. ..
Name of Architect .................................... Address .............................. Phone No. .............
Namof Contractor ................................... Address ...............................Phone No. '
i. Is this property within 300 feet of a tidal wetland? * YES .......... .........
*IF YES, SOLMU D TM MMM PEI M MAY BE RF LMD.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, rhetber existing or proposed, and indicate all set—back dimensions
ram property lines. Give street and block ember or description according to deed, and show street names and indicate
Nether interior or corner lot.
rAIT, Of NU YORK, SS
MIT Or .....5✓, .........
•••••••G�•� ,Y••��°•!?I ..............................being duly :worn, deposes and says that he is the applicant
..
Jam of individual signing contract)
xrve named,
t is Lhe ... ...... ... ..UW 1'1 e/^
............................................................................
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work auxd to make and file this
pplicatioh; that all statements contained in this application are true to the best of his knowledge and belief; and
Ihat the work will be performed in the manner set forth in the application filed tberewith.
worn to fore me this ` \
ZC\ . ....day of S�>��t�l!` 19.0�L��
Notary Public �� .
....
SONNIF W. MAZZAFERRO (Signa re Of Appli.
NOT,'2Y r'� "t t i Y•rky�+�
JT AR ❑48,850 5C1. — -
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99-132
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5-27-1999 STAKED PROPERTY CORNERS LOT NO 17I TOWN OF SOUTHOLD
4-22-99 FINAL SURVEY
2-10-1999 LOCATE FOUNDATION CESSPOOL a SEPTIC TANK a 'WELL LOCATIONS
12-IS-9' RE 4 F-p H- SE Y.0 ER
3-3D- )R REil_l-i; Noo:,e The existence oprtg�i 01 ways and or easements
I Z6 9t'i PRop of record, if any, not shown are not guaranteed.
,c G"SQS IvR IMsv°�oNsl G�.....I. -.. -., MER,_ JOB NO. 97- 269 FILE NO. WOODBINE MANOR
MOWN HEREON FROM THE SHALL RUN O^RY TO 1M fERSCN
TRUCTURES TO THE PROPERTY POR WW?M THE SURVEY IS PH4 SURVEYED FOR
^ ARE FOR A SPKLFIC PUR. PARED, AND ON 116 BEHALF TO
1k AW USE AND THEREFORE THE TM GOWANY, GOVERNMEN LCT NO 14
,RE NOT INTSIM 10 3 tt IHt
RECTION OF PT:NCES, RETAINING TUTION LISTED HEREON. AND TO t'' VF 'irO^vD�lt:� M+�;C�;
EC
MAUS, POOLS, PAPERS. PLANTING THE A56IGNEES OF THE LENDING
aRSA . ADDITION TO DUKDINGS INSTITUPION. 3U ARANTEES ARE
MANYOEHIROONILMUCTRGH.
INS TUTIONS OR TO ADETIONX
JNAYlHORIZED ALTERATION OR O Rs. SITUATED AT CU TC ROGUE
` 5 A
,fmATm NOF SSvCnOON THA me OF COPIES OF Tm KIRALY "P NOT TOWN OF SOUTHOLD - SUFFOLK COUNTY NY
HE TX Y0a, SFAX SIDUCATION BEARING THE LANE+ SURVEYOR'S
Aw. FPWj0 ;RAL OR EMBOSSBD SEAL SCALE 1" 50" DATE 7 - 23 - 1997
ENALL NOT RE CONSI•HIED To EF
FILED MAP NO. 8239 DATE 12 — 15 - 1986
GUARANTEED ONLY TO E OF NEW
<� YO TAX MAP NO. 1000 -83 -4 - 14 (REF. ONLY) DISK 1
GARY M. a LINDA M.LONG gr,P 'IRAN
RIDGEWOOD SAVINGS BANK QF' OHO HAROLD F. TRANCHON JR. P.C.
COMMONWEALTH LAND TITLE INS. y
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HAROLD F. TRANCHON JR. PEry{L 21995 516 929.4695
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