Loading...
HomeMy WebLinkAbout25242-zFORM 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. 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. 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. 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. 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 ¢.