HomeMy WebLinkAbout25241-zFORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26063
Date: 10/26/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 75 HORSESHOE DR
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 95 Block 4
CUTCHOGUE
(HAMLET)
Lot 18.24
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 27, 1998 pursuant to which
Building Permit No. 25242-Z dated OCTOBER 19, 1998
was issued, and conforms to all of the requirement~ of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ACCESSORY STORAGE SHED IN REQUIRED REAR AS APPLIED FOR "AS BUILT"
The certificate is issued to JOSEPH P SHIPMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
Building I n sp~ct/
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26064
Date: 10/26/98
THIS CERTIFIES that the building ADDITION
Location of Property: 75 HORSESHOE DR
(HOUSE NO.) {STREET}
County Tax Map No. 473889 Section 95 Block 4
CUTCHOGUE
(mUlET)
Lot 18.24
subdivision Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 27, 1998 pursuant to which
Building Permit No. 25241-Z dated OCTOBER 19, 1998
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 JOSEPH P SHIPMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. l/S1
N/A
N/A
N/A
Building Inspecyor
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.
25241 Z Date OCTOBER 19, 1998
Permission
is hereby granted to:
JOSEPH P SHIPMAN
985 ELIJAHS LANE
MATTITUCK,NY 11952
for :
CONSTRUCTION OF A DECK ADDITION ON THE REAR OF A SINGLE FAMILY
DWELLING "AS BUILT" AS APPLIED FOR.
at premises located at 75
County Tax Map No. 473889 Section 095
pursuant to application dated AUGUST
Building Inspector.
HORSESHOE DR CUTCHOGUE
Block 0004 Lot No. 018.024
27 1998 and approved by the
Fee $ 75.00
Building Inspec~6r
ORIGINAL
Rev. 2/19/98
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. 25242 Z
Date OCTOBER 19, 1998
Permission is hereby granted to:
JOSEPH P SHIPMAN
985 ELIJAHS LANE
MATTITUCK~NY 11952
for :
CONSTRUCTION OF AN ACCESSORY STORAGE SHED
IN THE REQUIRED REAR
YARD OF A SINGLE FAMILY DWELLING "AS BUILT" AS APPLIED FOR.
at premises located at 75
County Tax Map No. 473889 Section 095
pursuant to application dated AUGUST
Building Inspector.
HORSESHOE DR
Block
27 1998
Fee $ 35.00
CUTCHOGUE
0004 Lot No. 018.024
and approved by the
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the buildin~
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 I% 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or Buildings an
Upre-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 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 Buildinm - $i00.00
3.Copy of Certificate of Occupancy -
4.Updated Certificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ............................
New Construction ........... Old Or Pre-existing Building.. ~. ............
Location of Property ...... ?.~.. ....... /~(;.~p[~.
...
House No. Street Hamlet
Onwer or Owners of Proper · .
County Tax Map No 1000, Section.~.f~..~ ....... Block...~. ............ Lot ................./..~..~..~.
Subdivision ......................... .... ....-- . Filed Map ............ Lot ........... ;.. .......
Permit No.~.~.~ ~ Date Of Permit
..................... · Applicant ................... ... ? ......
Health Dept. Approval ............. · ---.-..---- · Underwriters Approval ........................
Planning Board Approval ..............
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the buildin~
inspector with the following: for new building or new use:
I. 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 buildin
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, ~957) non-conforming uses, o~'~uildings an~
'!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 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 Buildinm - $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 $15.00
New Construction. . Old Or Pre-existing Building ...... ~ ........
Location of Property .................... ~.~.]~.q.~.. · CO
House No. Street Hamlet
Onwer or Owners of Property.J$~.~.~.~. ~...~.~.,~-f~7.~.~.. ZQ(.W~... ~ .... ~_~.~7~..f~.~.~..
County Tax Map No I00~, Section..~.~.~.'Z ...... Block...~. ........... Lot./~.~.f~..i ...........
Subdivision ................................ Filed Map ............ Lot .....................
Date Of Permit Applicant
Health Dept. Approval ............... Underwriters Approval ........................
Planning Board Approval ..............
Request for: Temporary Certificate ........ Final Certicate .........
Fee Submitted:
APPLICANT
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] IN~JL~TION
[ ] FRAMING [/.]/t~INAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROU~PLBG.
[ ] FOUNDATION 2ND [~._~] ~,~JLATION
[ ] FRAMING [~/FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS~ .... ,~
DATE '~/~'~/~N SP£CTO ~~_
TONN OF SOUTUOLD
BUILDING DEPARTI~NT
TONN HALL
SOUTItOLD, N.Y. 1197 I
TEL: 765- 1802
SURVEY ....
CHECK .........................
SEPTIC FORH ...................
NOTIFY:
CALL . ~.. &.~.¢.~.
HAIL TO:
BLOG DE~ ' INSTRUCTIONS
TQWN,QF SOUgHeD .
a. '~is a~licatim at, t ~ ~letely fill~ in by ~iter or in i~ ~ ~itt~ to ~ ~ilding I~tor ~
3 ~ts of pl~, ~ate plot pl~ m ~ale. F~ aco~i~ to ~ale.
b. Plot pla ~ l=tim of lot ~ of hildi~s m priam, relatlo~ip to ~joini~ pr~s or ~lie
struts or aec, ~ givi~ a &tail~ ~aipti~ of last of pm~ ~t ~ ~ m fie diem ~ifi is ~rt of
als a~liati~.
c. ~ ~ ~ ~ fils a~liatia my mt ~ ~ ~fore isae of hildi~ Pe~t.
d. U~ ~aal of als a~liati~, a hildi~ I~etor i~ll is~ a hildi~ Pe~t to the a~liat. ~
p~t ~11 ~ ~pt m ~ ~s avail~le for i~ti~ a~t a ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~atever mtil a ~rtificate of
~ fiall ~e ~n ff~t~ ~ a hildi~ M~tor.
aI~ IS ~ ~ to t~ hildi~ ~nt for ~ isme of a hildi~ Pe~t ~at to t~
hildi~ ~ O~ia of ~ ~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~er a~li~le ~s, ~imes or
~lati=, for a ~t=ti~ of hildi~, ~iti= or alteratia, or for r~al or ~litia, a ~in
~ari~. ~ aDli~t ~s to c~ly ~a all a~li~le las, ordlms, ~ildi~ ~, ~i~ ~, ~
~latims, ~ to ~t a~ri~ i~tors ~ ~d~s ~ in hildi~ for ~es~ ins~tlms.
~e or a~ti~, or m, ir a m~ )
................. ........... ........
(~ili~ ~ess of ~licmt)
State ~m~r a~li~t is f/ le~, ~ent, ~t~t,' engi~r,' ~mral contr~tor, el~t~iei~, pl~r or ~il~
~ o~ ~ o~ pr~ ........... ~ ............. ~ ........... ..,..,,_6{~...:z,.~.~,- ....................
(~ ~ ~ t~ ~I~ or latest d~)
If applicator is a corporation, signature of duly a~thorized officer.
(1~ ~ title o~ corporate officer) OCCUPANCY OR
USE IS UNLAWFUL
..n~rs Lice~ NO ................. WI~OUT CERTIFICATE
Plumbers License 1{o ................ '" "OFOCCUPANCY
Eleetrician~ License No ..........
APPROVED
AS
FEE: ~s-.~ ~ K~r~ d
NOTI~ BUI~ING ~P~AT
765-1~2 9 AM ~ 4 ~ FOR ~E
FOLdiNG INSP~ON8:
1. FOUNDA~ON - ~ORE~IRED
FOR ~URED ~NCR6i~
2. ROUGH - ~ING & PLUMBING
3. tNSU~TION
Other Trede's License NO ..................... , 4. FINAL - CONSTRUOTION MUST
~. ~ocation of lm~ on ~ieh ~ ~ork ,in be du~e .. 9-5' J~O ~..~ R, fi~.C.O~..~...E.P.O. RRO,:, ................
............. ALL '~{JNBTRUCTION SHALL MEET
""' /.t.O~;/{..o~.- k~ (~ THE R F',~!lltll ~l=_.~l~IUI ~F~l{l_ .lit~})"~ tl3,l~:~_..T~..E N,,Y... .
.5.
......... ..................... · :r- ............................. ......
BotmeNmtmr atreet ~ ,--__ ~ODF.$. N~J~'J~E~PON~[BLE FOa
Subdivision ................. Filed ~q~ NO ........ Ix)t .........
(sam)
2. State existing turn and occupancy of premises and intended use and occupancy of propo~'d c~truction:
a. Existing use and occupancy ..............................
~- -.c.L¥ ...........
~. ~.~ u~ ~ o~ ......12./k.l ........ /3.~. ......................................
~.atere of ~ark (cheek ~bich appli( able): NLm l~filding .... Addition ......... Alteration ..........
l~ir ............ ~1 ............. I~1 iti~ ............ Oiler ~ . ~).~.~l~..~. ~, ~. [~.~ ............
~ripti~)
Estilmt~ ~st .... '~'l' ~ ;'~ ...... f~ ..............................................
(to ~ ~id ~ filing this a~licati~)
If &~lli~. ~mr of ~llt~ u4its ............ ~r of ~lling tmtts ~ ead~ fl~r ................
If ~ra~, ~r of ars ~ ...........
If I~i~$s, ~mereial or ~M ~, ~ei~ ~re ~ ~tent of ead~ ~ of u~ ......................
Di~nsi~s of ~sting at~a~ if n~: ~t ................ ~ar ............... ~pth .................
I~i~t ......................... ]~rofStorlea ....................... : . ~ ~'~ ,{ f
Dimnst~ of ~ st~e ~th] alteratt~s or ~it~s:
Dt~i~ of entire ~ ~at~ ~. ~L ~ar .... ; .... ~p~
Si~ of lot: ~t ..Z&~. ..... ] ....... ~ar .... J ........... ~pth ....................
). ~te of ~dm~ ................ ] .....~ of Fo~r ~r ........................................
I. ~ or u~ district in ~*i~ p~i~s a~ si~tM ..............................................................
Z. ~s ~ mt~ti~ violate a~ ~i~ lin, emile or re.latin: ........................
t. Will lot ~ ~ ............ I ........ I~'D~Will ~ess fill ~
~ of ~it~t ............... j ..................... ~reas .............................. H~ ~ ...............
~ of ~tr~tor .............. ~ ..................... ~ress ............................... H~ ~ ...............
S. ts ads ~r~ ~min ~ f~t ]of a ~i~t ~tl~? * ~ ..........
PLOT DIAORAH
I~ate clearly ~ dlsti~tly M; ~ildi~, ~m~mr ~iati~ or ~, ~ i~icate MI ~t-~ di~naions
~ ~r~ li~s. Oi~ at~t ~ ~1~ ~ or &scripti~ ~co~i~ to ~, a~ ~ strut ~s ~ i~icate
teller interior ~ ~r lot. m
.....
o,o ............ ....................................................................
of ~id ~r or ~rs, ~ is ~ly ~tlDrlt~ to ~rfo~ or h~ ~rfo~ tile ~id
a~licatlon; that ail stat~nts c~t{f~ in ~is a~llcation are t~ to ~e
that the ~vk will I~ ~rfo~ in th~ mmmr ~t forO~ in ~e a~l. lcati~ f~l~
RODERICK VAN T~YL, P.O.
GREENPORT NEW YORK
SUFFOLK CO. HEALTH DEPT. APPROVAL
~.S. NO. 0~-
STp, TEMENT OF !NTEN~T
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO. DEPT. OF HEALTH SERVICES.
(s)
APPLICANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCT ION ONLY
DATE:
H. S. REF. NO.: ~.' ~.
APPROVED: .......... ,, ,
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
OWNERS ADDRESS:
.ZED: L. P.
SEAL
Z85. Z~
JOS£?H
¢.