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HomeMy WebLinkAbout24450-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25363 Date: 11/12/97 THIS CERTIFIES that the building ACCESSORY BUILDING Location of Property: 275 HAMILTON AVE CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 137 Block 5 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 22, 1997 pursuant to which Building Permit No. 24450-Z dated OCTOBER 30, 1997 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 BUILDING IN REAR YARD AS APPLIED FOR. The certificate is issued to DOROTHY E BURDULIS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r Buildi g inspect4r 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) Date.. ..OCTOBER 30 19...97... 24450 Z .. .................................. Permission is hereby granted to: DOROTHY E BURDULIS ..............................................................I........................... PO BOX 447 ................................... ................................................... CUTCHOGUE,NY 11935 .......................................................................................... to.. BUILD AN ACCESSORY BUILDING IN THE REAR YARD AS APPLIED FOR .............................................................................................................................. ................. ......................t..............................................................................................I............I...I......... ............. .................................................................................................................................................... .......................................................................................................................... ...................................... ..................................................................................................................................................... ............ 275 HAMILTON AVE CUTCHOGUE at premises located at............................................................................................................................... ...............................................................................................................................................:................ County Tax Map No. ...... 7 .. 3889 Section ....137........... Block ...,,,0005 ,. Lot No. 018 ...................... pursuant to applicatlon dated ....,SEPTEMBER 22 , 19 ,97 .. and approved by the Building Inspector. Fee$.........35.00... .................................... Bull din Inspector Rev. 6/30/80 TOWN OF SOUTHOLD v L S 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 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "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 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 Date . . �.v: 7,.!3.9.7. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . OldJ Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . : .75.. .� T1�. .iC„foN . . � ,. . . .0 [/ c� GvE . . . . . . . . . . . . . . . . . . . . . . . House No. Street • . . . • Hamlet Onwer or Owners of Property. �! °. . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit . . . . . .Date Of Permit. . v/�1.�. . .Applicane..gee � �plQU 41 . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . ./.. . .UUnderwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Dy Fee Submitted: $ :5:.1,.4'. . . . . . . . . . . . . . . . . . . R�, 5 '>JW APPLICANT C <>75563 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING [ FINAL l/a> [ J FIREPLACE 8 CHIMNEY REMARKS: v DATE II171f 7 INSPECTOR LD I;:S:'Z-:Iu;� �va`tMENTS m T H OU11DATI0N ( 1st ) �. FOUNDATION ( 2nd ) 2 . zp , o l.� ROUGH FRAME & PLUMBING H 7d r� I2JSULATION PER N . Y. • H STATE ENERGY CODE x 1117 19 4 . FI NAL ADDITIONAL COMMENTS : x x -o - Z \� V • x - - M H - x - d. BOARD OF HEALTH . . . . . . . . . . . . . . . FORM N0. 1 - 3S . • • . ' OF PLANS TOWN OF SOUTHOLD SURVEY 7 2 1 97 BUILDING DEPARTMENT CH . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TES.: 765-1802 NOTIFY: 117 3 � 0 CALL . . . . . . . . . . . . . . . . . . Examined....�Q 7v...., 19?,. MAIL TO: . . . . . . . . . . . . . . . . . . . . �Approved...,Q ...., 19�� Permit No. !:-:. .................................... Disapproved a///c .................................. .................................... ...................................................... 2 '"f . ............ ( ld'mg Inspector) APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. This application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 must be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit shall bekept 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MALE 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 remval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regilations, and to admit authorized inspectors on premises and in building for/necessary inspections. crL dt-KZ ..... % (Signature oficant, or name, if a corporation) (MaiIi address o� �i - State �whether applicant is owner, lessee, agent, architect, engineer,'general contrac a ltyier or builder .... ............................................................................. walIT� .......... Name of owner of premises ..!4�. .. �u,!• /........S © (as on tax roll or latest deed) s 0� pa-.I — n If applicant is a corporation, signature of duly authorized officer. NIMH •(Name.and title.of•co•••rate•offi -•--••.•'•-• • wo �° Cel .CUPAMPY �OR ,,� M USE IS UNLAWFUL 2. Rou�aw• I aluman Builders License No. ..........���o� CERTIFICATE. 4: FIN""'�i°" I �* Plumbers License No. .......... (firr (�(�( PANCY BE COWL MRM Electricians License No. .......OI..Q��l�. ALL CONSTRUCTION IIIAU MEET THE REQUIREMENTS OR "d N.Y Other Trade's License No. .................... STATE CONSTRUCTION & ENERGY 1. I.ncation of land on which proposed work will be done.................... CODES. NOT RESPONSIBLE FOR •-•. 'DESIGN-OR-CONSTRUCTiON•ERROR&- House Number Street r� �•Qet County Tax Map No. 1000 Section .../3.7...... Block o�`2 O .../ .............`... Lnot ......... Subdivision ..��....T�?' ................... Filed Map No. ...,7.• .f...... Lot ,...,l ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... :t: :/.!rliIN..4�^.9Pf�.'m`.;t......................................... b. Intended use and occupancy ......... ..................t.................................. -�-_ ----.WSO = 3. Huture of work (check whid► applicable): New lkiilding ..✓....... Addition .......... Alteration .......... w Repair ............ Removal ............. Demolition ............ Other Work .................................. / (Description) 4. Estimated Cost r'./`O P ................. fee .............................................. (to be paid on filing this application) 5. IE dwelling, nuhber of dwelling units ............ tkuber of dwelling units on each floor ................ Ifgarage, mnber of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... Rhmber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height ................. . Rnber of Stories ............... 8. Dimensions of entire new construction: Front ......[1...o........ Rear ......!...... Depth ....�! ....... Ileig)ht ......Y.l.--':.......... IU"r of Stories ..................... 9. Size of lot: Front .................... Rear .................... Depth .................... 10. Date of Purchase ..................... Name of Former Owner ........................................ 11. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES No Iii. Nares of Owner of premises ........................... Address .............................. Phone No. .............. Name of Architect .................................... Address .............................. Phone No. .............. Name of Contractor ................................... Address ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO .X..... *IF YES, S"I" 1UWN IMSIEES M441P MAY 1E MQUIRI-. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street nares and indicate whether interior or corner lot. some i1M�iY1 VOMP SOWN MA• Mt-W slnlr or N� flow r 1 � . ` .being duly sworn; deposes and says Lhat he is the applicant (tkmel > ►s bract), Ileis Lhe ................. ........................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge aod.lhelief; and LhaL- Lhe work will be performed in the manner set forth in the application filed therewith. Sworn to before this ........ clay of ........ .19..4q Notary A lic 4y (Signature o' Applicant) S£\TAKE FD `SLATE KMi KA4Y CAI METAL 5' ED 4.0' M 4.4' Q) All OUTDOOR o F P c� �00 SHOWER 10.2' e a ro.1' N 1/2 S Q o WOOD CELLA Q ; FRAME ENT, cy M PES. M OO J O 8.o' BLO m Lr)12.4' 13.5' S£T STAKE "'NEEM � FALL TIE = 2 1.70' N 320 15' W 99.50' AK HA MIL TON A VE. FM# 539 SURVEYED 8/08/97 FILED DEC. 22, 1930 SCALE 1"=30' TM 1000-137-05-18 SURVEY OF AREA= 7,462.6J SF OR LOT 19 0.1713 ACRES nrantees indkaW bM alp IN fy to the p._rs�n for whom thesures► MAP OF PROPERTY OF is pro r,c r gid, cnd on his behrlf b RAVATONE REALTY CORPORATION the SITUATE itlA r^i^rcn;; Covermentcl A-gency, if lis, ' hereon, and CUTCHOGUE, TOWN OF SOUTHOLD to the cssignees of the lending institution. SUFFOLK COUNTY, N. Y. Cuorontetes cre not transferoble to additional inslitutions or s.b"quent owners. SURVEYED FOR DOROTHY E. BURDULIS GUARANTEED TO SURVEYED BY DOROTHY E. BURDULIS FIDELTY NATIONAL TITLE INS. CO. I nauthcr?z^d clterction or athiblon t3 #4 STANLEY J. ISAKSEN, JR. TOWN OF SOUTHOLD s rvey is u viclotian of Sect;" 7209 of P.O. BOX 294 the New York State Education Caw. NEW SUFFOLK, NY 11 6 5 —734-5 5 coos 40 #& Now as*" Itecring Mie I,arnp Surwyton nnnbe d teat a}tarp LICe E LAND let not be Considered to be a valid taw n/Y LIC N0. 49273 �HOtrSI.ATF K,1LKw4Y IRSFPT97 Copy. O. 492