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HomeMy WebLinkAbout25294-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26090 Date: 11/09/98 THIS CERTIFIES that the building ADDITION Location of Property: . 910 OLD SADDLE LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 95 Block 4 Lot 18.7 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 1998 pursuant to which Building Permit No. 25293-Z dated OCTOBER 28, t998 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 DYSART A. & SUSAN M. RAVENHALL (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 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26089 Date: 11/09/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 910 OLD SADDLE LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 95 Block 4 Lot 18.7 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 1998 pursuant to which Building Permit No. 25294-Z dated OCTOBER 28, 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 ACCESSORY SHED IN REAR YARD AS APPLIED FOR "AS BUILT" The certificate is issued to DYSART A. & SUSAN M. RAVENHALL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMSERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A 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. 25294 Z Date OCTOBER 28, 1998 Permission is hereby granted to: DYSART RAVENHALL~ JR. 910 OLD SADDLE LA CUTCHOGUE,NY 11935 for : CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD AREA AS APPLIED FOR "AS BUILT." at premises located at 910 OLD SADDLE LA CUTCHOGUE County Tax Map No. 473889 Section 095 Block 0004 Lot No. 018.007 pursuant to application dated SEPTEMBER 16 1998 and approved by the Building Inspector. Fee $ 35.00 Building VInspect~ ORIGINAL Rev. 2/19/98 Form No. 6 '(' 8LDG O[PT. i;'!/APPLICATION FOR CERTIFICATE OF OCCUPANCY '" TOWN OF SOUTHOLD... ',"/ This application must be filled in by typewriter OR ink and submitted to the building 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 buildings 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 and Vpre-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. . 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-existin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Location of Property .... q/~...a/~...(~dJ/~.~'. ............ .de. ........ House No. Street Hamlet County T~ Map No 1000, Section .... ~.?~ ..... Block..~ ........ Lot..OZ~, ............... Subdivision.. ~..~7~..~q~ ..... Filed Map..&.e~(....Lot...~. ................ Pe~it No.. .Date 0f Pe~it ..... Applicant.. . ~.. · ~ Health Dept Approval Unde~riters Approval .... Planning Beard Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ......... .. '- ..................... ~('559~ APPLICANT Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~. 8LDG. DEPI. .~ ?LICATION FOR CERTIFICATE OF OCCUPANCY ' TOWN OF SOUTHOLD This application must be filled in b7 typewriter OR lnk and submitted'to the building 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 buildings 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 and 5!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 Buildin~ - $100.00 ~ 4 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ate .... ~.~ ~...~/. Z~3' ........... New Construction ........... Old Or Pre-existing Building....~.. ........... Location of Property ..... ~/.~ ....... ~f.~....~.~. ¥.~.J~. ~.~., ........ ~--~ ~-o~~ House No. Street Hamlet Onwer or Ow=ers of Property ..... ~/~..~....~ g ~.. ~a .~.//.~ .~... ..... ~. county Tax ~ap No 1000, Section...O..~.~ ..... Block...c?P..O.~ ...... not...~PA$~.P.~.V. ....... Subdivision .... ~<~Q~.. ~.. ~-~..~.~-~..Filed Map.. ~ .~...~Z...Lot....~. ..............--- Health Dept Approval . · Underwriters Approval.. ........ ....... ... Planning Board Approval ......... Request for: Temporary Certificate ........... Final Certicate..~'A. ........ Fee Submitted: $...~. .... ~ ................. ~.~ % .......... ~0 ~2,~0 ~ ~ APPLIC~r~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] IN~.ATION [ ] FRAMING .... · ~I~NAL [ ] FIREPLACE & CHIMNEY DATE ///~I ~ INSPECTOR II CODS ADDITIONAL COI~IENTS: TO~q OF SOUTHOLD BUILDING DEPARTHENT TO~q HALL SOUTfl0LD, N.Y. 1197] TEL: 765- 1802 19. f~ Pe~dt No ................. Disapproved a/c . . · ' '" (Building In~ector) ~ SURVI/Y ...................... .. - Cfll/CK ................, ,.o.... · SEPTIC Ii'ORH... .............. . · NOTIFY; cAL~ P...~..~.~¢.· HAIL TO: .................... APPLICATION FOR BUILDING PEP, HIT INSTRUCTIONS a. 'finis applicetion mast be ex~pletely filled in by typewriter or in ink and submitted to the Building Inspector w 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings an premises, relationship to adjoining pm~atlses 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 applicat ion. c. ~1~ work covered by this application may not be comeenced before issuance of Building Pemit. d. Uix~ approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pemit shall be kept an 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 untll a Certificate of Occupancy stroll have been granted by the Building Inspector. APP~ICATICI~ IS I~gBY ~ to the Building Department for the issuance of a Building Pemit pursuant to the Deilding Zoee Ordinance of the To~n of ~athold, ~affolk Cotmty, New York, and other applicable Laws, Ordinances'or Regulations, for the constroction of buildings, additions or alterations, or for removal or ~litian, ns herein described. The applicunt agrees to cc~ply with all applicable laws, ordinances, building code, housing cede, and rngulatians, afl to aamlt authorized inspectors on premises and in building for necessary inspectioas. .... ~.~...~. ,...d~ ..................... (Signature of applicant, or name, if a corporation) (Mailing -~t_ tess of applicant) State ~tmtber applicant is~ lessee, agent, architect, engineer, general contractor, electrician, plm/~er or build~ ............................................... ~..~..~.¢..~ ................................................ · .............. (as an the tax roll or latest deed) If applicant is a corperatioa, ei~anm of duly authorized officer. NOTIFY BUILDING DEPAIITMEf~ AT ?~-1~0~ S AM TO 4 PM FOR THE (Nane aad title of corporate officer) Builders Lieense No ....................... · · · Plt~ers License llo I/lectriciaan License No ...................... FOLUIWtN~ ~ 1 FOUNDAlIO# - ~NO REQUIRED ~. ROU~ - ~ & I4,UMBING $, INSULJEtO# 4. FINAL - CONS?RUCTION MUST BE COMIR. ETE FOR C.O. ALL CONSTRUCTION SHALL MEET Other Trade's License NO ..................... THE REQUIREMENTS OF THE N.Y. · ~:~//~ .4/~/ ~-~_~T/~ CO,~TION & ENERGY I. ~ti~ of 1~ ~ ~i~ ~ ~rk ~11 ~ ~ .... ~/' a · ' '~: '~ · · ' ~ci ~: ' N~~ ~S~LE' ' FOR .... ~ z / D~IG~ OR ~NST~ION ERRORS ............. ... ........ ~ ~r Strut ~ ~et ~ T= mp ~. l~ ~ti~ .... f.f~ ..... m~ ..... ~.~ ...... ~t .... ffl,.:Z .... ~v~,~..~fC;z/~...._ .~ ...... ~ ~ ~ ................ ~, ...... ~ ....... 2. State ~ist~ ~ ~ ~ of ~s ~ int~ ~ ~ ~c~ of pro~ ~t~tion: ~. ~,,i~ ~ ~ ~ ............. ~ .... ~ ..... /~---~.~ ............................. ~. ~,~ ~ ~ ~ ............ ~ ..... ~ .... ~ ................................... 15. ~mture of ~rk (check ~id~ appl Repair. ......... .. lten~al .... Estimated Cost .. .; ...i... fee (to be paid on filing this If Oaelling, m, nber of d~elllng mite ...... /. .... Nmber of dwelling onite on sad~ If garnge, n~ber of ears ...................................... If business, c~mv~rctal or mi~ec occupancy, specify nature and extent of each type Dimensions of existing structures, if any: Front ................ Rear ........... Delght ....................... ! Nt~r of Stories ...................... Dlmenslorm of ~ame sttxlcture wl~h alteratio~s or additions. Front ......... Depth. ............. . . . . .. Helg~t .................... Ntmlber of Stories.. ..... .. Dimensiot~ of'entire new c~aetl~ction: Fro~t.... o........... Rear ........... .... ]]eiEht ........................ ~ Nt~ber of Stories ..................... / "'/. A/~ of lot: Mt .... ..... Reer .... .... Dapth ..... Nam of Contractor ............ Is this property within 300 feel le Ne~ Iluilding ...... Mdit,on ......... ~ iAtte 's,~ ...~ ...... .... Damelltion ............ Other Work ~ .~;~'.~.?F~.7. .... appHeation) -- ' · Dapth ................. Depth .............. I0. Date of Purdmss .............. 1 ...... Name of Former Owner~_.~ .,.t ~. , ........................................ II. Zone or uss district in ~hich pg~nlees am si~t~ ..... ~C~l.q~ ...................................... P ~ ............. ~ Of ait~t .................................... ~reas ............................ ~ ............ PLOT DIAGRAM Locate clearly sed distinctly a~l buildings, ~l~tl~er existing or proposed, and indicate ail set-back dimensions ,, ribber or deeeription according to deed, and aho~ street frames and indicate fran property lines. Give street and ;Esther interior or earner lot. above na~l, .......... heing dul.y swots,, deposss ~fid mays that be m tbs a~li~nt De ia the ............................................................................. ~. .......... (Contractor, agent, qorporate officer, etc.) :"' of said ~er or o~aere, and ie duly authorized to perform or have performed the said *a>rk and to make and fil.e this applicatiim; thet ail stati~eets contained in this nppl. icatio~, are tn~ to the beet of hie kno~ted8e n,~l b61iefl a~ that the ~rk wilt be performed i. thq mem~r sst f~rth in the appl. icatiea .filed therewith. Smm to before,me this I .................. day o~ ...... Notary l%lblic '. HELEN/D. HORNI~ Notary Public, State ,?f NeW Yolk Qualified in ouffolk qoonty Commission Expires May 2~, 19 (Slgnamre of Applicant) TOWN OF SOUTHOLD BUILDING DEPARTNEHT TONN HALL SOUTfl0LD, N.Y. 11971 TEL: 765- 1802 SURVEY ...................... CHECK ............... SEPTIC FORH ........ NOTIFY: cALL .... HAIL TO: .................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS l)ate .... .-I//3 ....... ,19 ~.~.. a. 'Ibis application mst be cmpletely filled in by typavriter or in ink and sutmitted to the Building Inspector w 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shoaing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layont of property mast be dram on the diagram ~ich is part of this application. c. 'lira ~vork covered by this application may not be canm~nced before ismmnce of Building Permit. d. Upon approval of this application, the Building Iaspector will issue a Building Pemit to the applicant. Such pemit ~hall be lmpt on the premises available for irm~ection throngh~t the ~ork. e. No beilding ~hall be occupied or used in ~/nole or in part for any purpose ~hatever until a Certificate of Occupancy 8tmll have been granted by the Building Inspector. APPLIO3kTIC~I IS ~ P, b2[E to the Building l)epart~mt for the issuance of a lhilding Permit parmumt to the Building Zone Ordinance of the Tm of Sonthold, ~uffolk County, Ne~ Yoxk, and other applicable La~s, Ordlnme. es or Pa~gulations, for the constnmtion of buildings, additions or alteratiorm, or for rmOv~ al or demolition, as herein ~escribed. ~ne applicant agrees to cmply with all applicable la~s, ordinances, building cede, housing code, and ~ngulations, and to kit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or ru~ue, if a corporation) (gailing ~ess of applicant) State ~mther applicant i~ les~, ~nt, ~it~t, engi~r, ~ral contr~tor, el~trici~, pl~r or ~il~ ~ o~ ~ o~ pr~ .~ ~..~A~..A ~ ~.~ ,..~.....~... ~¢~.~.... ~,.. ~ ~c~ ~/d... (~ m ~ t~ mi1 or latest ~) If applic~t is a ~rati~, si~ of ~ly ~t~ri~ officer. and title of corporate officer) Builders License No .......................... Plmbers License No .......................... Electricians License No ...................... Other Trade's License No ............... . . .. .. {. Location of land m ~ich proposed ~ork will be dome .............................................................. ..... q./., ..... ..... ~/.d...-c,c...~.d.,.~ ............ x,~. ~....&.~,:d.~.o ~,.~ .... .~./... z.~.s'/ 'sa.. ............ &,r~o~..~.. Mouse ~i,~her Street ltmulet 0 .... 0./~,.0..o..7 County Tax gap No. {000 Section..~.~.~.. ...... Block ........ .~- ..... Lot q Z Lot .... f. ........ Subdivision...~..~0.O.. ~..,.~,ze..~e'..: ........ Filed mp No. ...... 2. State existing use and occupancy of premises and intended use .and occupan~ of propased cOast~mc, ti.on: - . a~e......~,m;/.x..de.e/d.;.no ..... /.....4ec.,./<...,~->.k.~ .... a. F~dsting use ana occupancy ... w. -- -- -- ~' Il"/' ~ '"/' .... n'" .... 3. 10.ature of ~ork (check ~hid~ appl icable): ~ Building .......... Addition .......... Al. teratlon .......... Repair ............ ge~ovat ............. Demolition ............ Other ~ork ...~.¢£~. ..................... , .(Description) 4. Estimeted Cost ............ ~. .... , ..... lee ............ (to be paid on filing this application) 5. If d~lling, n~t~er of deelling mits ............ somber of &~elling nalts on each floor ................ If garage, m~ber of cars . ........I ............................. 6. If business, c~m~rcial or mir occupancy, specify nature and extent of each type of use ...................... 7. Dimensions of existing structur~ ~, if any: Front ................ Rear ............... Depth ................. tleight ......................... lx~ber of Stories ................ Dlmenslees of ~e structure wil~h alterations or additions: Front ............ . .. Rear ............... Depth. ............ ... . . . . Delgtit.. ............. . .... Ix~ber of Stories.. ....... . .... . g. Dimensions of entire ne~ eonstn~ct~on: Front ................ Rear ............... Repth .............. tlelght ........................ I~ber of Stories ..................... I0. Date of I~rd~ase ....... .'.'.'.'.'.'.'.'.'~.. ~ ...... lqame of Former O~ner ........................................ I I. Zone or use district in uhich p~scs are situated .... .~. ..................................... I~. Daes proposed constru~tlon vioI~te any zoning 1~, ordinance or regulation: .... .~.R ............... 13. Will 1o~ be rngreded .......... i ......... Will excess fill be removed f-rna premises: YES Rame of Arddteet ...'~. ..... i ...................... Mdreas .............................. Fbene so ............... Name of Contractor ....'~...~. .... ~ ...................... Mdress ............................... ~one No ............... 15. Is this property within 300 fee~ of a rida! ~etland? * YF~ .......... N0 . ....t.:-:~T... PLOT DIAGRAH tocate clearly and distinctly a!l buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street ondlblack number or description acco~dlng to deed, and sho~ s~reet nines and indicate ~bether interior or corner lot. ...... ~.. C. .......... being duly ~m, deposes ned .~ys that he is the appl. icant (Name of iedivldual signing contract) above rimed, ..... :. .......... (Contractor, ng~nt, ~orp~rnto of~ieer, ere:) of seld r~n~er or ~mera~ sad ia ~Ry uthorlrJ~,l to p~rfom or ha'~m'I~rfotn~d the ~ald ~rk m~l to mira and file appl. lcatiee; that al! stat~nts ceet~ [ned in this npplleation are tn~e to the beat of Ills kro~ledgu s~l bel. lefg and that the ~ork wilt be performed in th~ metmer set £orth in the application filed tberewLth. (Signature of Applicant) Z Z --4 rl ]> ;;~-- 'ID "5 ,+ 0 C 4~ TIT£ENO III- S-533~ SOnY FOR LOT NO. 7 ' O~EGON VIEW ESTATE~ ". s~r ~, ~98~ ~WN ~ SOUTHO&D sc,~. I = 50 ' ]. YOUNG a YOUNG .,v~o..[w ~o..