HomeMy WebLinkAbout24470-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25620 Date APRIL 1, 1998
THIS CERTIFIES that the building ADDITION
Location of Property 445 ALVAHS LANE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 1 Lot 30
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 30, 1997 pursuant to which
Building Permit No. 24470-Z dated NOVEMBER 7, 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 ADDITION TO AN EXISTING NON-HABITABLE ACCESSORY GARAGE AS
APPLIED FOR.
The certificate is issued to ROBERT A. & LOUISE SCOTT
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Bu4ding Inspector
Rev. 1/81
FORM NO.3
TQVVN 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)
NOVEMBER 7 . 97....
2Z
.4470 Date..................I.............................. ,
19..
Permission Is hereby granted to:
ROBERT A & LOUISE SCOTT
.........................................................................I................
ALVAHS LANE
..........................................................................................
CUTCHOGUE,NY 11935
..........................................................................................
to CONSTRUCT AN ADDITION TOA NON HABITABLE ACCESSORY GARAGE
................................................................................................................................
IN THE REQUIRED REAR YARD OF A SINGLE FAMILY DWELLING AS APPLIED FOR
..................................................................................................................................................................
................................................. ............ ..............................................................................................
............... ........... .................................................................................................................................
............... . .....................9.......................... •..................................................•1.........................................
445 ALVAHS LA CUTCHOGUE
atpremises located at...............................................................................................................................
................................................................................................................................................................
473889 109 0001 030
County Tax Map No. .......................... Section ........................ Block ........................ Lot No
........................
SEPTEMBER 30 97
pursuant to application dated .......................................................... 19................ and approved by the
Building Inspector.
35.00
Fee$..................... . c--
.... ....
... . . .. ... .. .. . . .. . ..
Building Inspect
Rev. 6/30/80
Form No. 6S�
• J.0 J1 TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
TOWN OF SOUTHOLD 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 Undefwriters.
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 - .25V,
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. . . 7,75, . . . .. .t� . .::.�.'?:q. . . . . . . . . . . . ' ��: � .V.Q. . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . /.V ./..�. . . . . .Block. . . . . . . . . . . . . . .Lot. . . .-�P. . . . . . . . . . . . . .
Subdivision. . .. . .�./. .. . . .. .. . . . . . . . . . . . . . . . . . . . . . . . .Fil/end Map. . . . . . . . . . . .L,�ott. . . . . . . . . . . . . . . . . . . . . .
Permit No. .��. f. .!.�o.L . .Date Of Permit. . . .1�.. !. . . .Applicant. ./&` .�� . . .
Health Dept. Approval. . . . . . . . . . . . .... . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . .. . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
M-1W2
suiLuiNG DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
-4,
RE KS - d;�41rloe�-
oilr �-
DATE INSPECTO
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BOARD OF HEALTH . .. . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
�J CALL
Examined..� 19.... S� 7
4a
MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved...l.. .�.��. 19.... Pernut No.� ..................................
..
Disappa/c ....................•--.. ..... ....................................
...................................... ..... .. SCD
0
7
.... .. . ..... .,......
Building Inspecto•
A ICATION FOR BUILDING PERMIT
. Date. . . 30. . .. . . . . .
INSTRUCTIONS
a. 'Ibis application must 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 p►d)lic
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. lbe 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 be,kept 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 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
dehcribed. 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 for necessary inspections.
.....................................................
(Signature of applicant, or name, if a corporation)
1A 45 .. .. .Cu N.. ...�.19 �
(Mailing address of app ant)f.
State whether a licant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
........... ���Gw ..�. ..7.`� ....�? n �!:...... ..............................................
1
Name of owner of premises � :�tc�.(.... ti�!1.. 1� .. ..C:......................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
BuildersLicense No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Incation of land on which proposed work will be done..............................................................
....1.4-'.ci..................!!.�V,0. �S.... !�??,.. ...................b4
•. house Number Street 44 .• Hamlet
' County Tax Map No. 1000 Section ....Wi....... Block ...... ......... Lot .. . .........
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........... ..f.............................................................
b. Intended use and occupancy ..../.� x.�o........... �a . ................
od bail""
"NsTsae to AN
3. Nature of work (check which applicable): New Building .......... Addition ...4!..... Alteration ..........
itepair ............ Removal ............. Demolition ............ Other Work ..................................
lop, — . .. (Description)
Estimated Cost 4. . D^O
7777 .•
fee ........................................
(to be paid on filing this appliraCion)
5. If dwelling, number of dwelling units ..7777777..7 Umber of dwelling units on each floor ................
Ifgarage, rxnber 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.....`?.7L Rear ...��. Depth .. d ..
Height ......................... Umber of Stories ...0!�S'...........
Dimensions of same structure with alterations or additions: Front .......... Rear ...............
Depth .................... Ileight ................. Number of Stories ...QIV h....
8. Dimensions of entire new construction: Front .. Rear l...... Depth ....... ..
Ileiglht .........................( Umber of Stories ..G'r1k.. ........
9. Size of lot: Front' 7777 .Q.Q.T. ..... Rear .!.d Q :.......
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
14. Nares of Owner of premises. .
-'. :Q!� Rhone No. f.�
Name of Architect .....(.*Kk)..................... Address .............................. Rhone No. ..............
Nameof Contractor ................................... Address ...............................Rhone No. ..............
15. Is this property within 300 feet of a tidal wetland? * YES .......... N0, .. �
*IF YES, SOLMIRD IUWN MISIFE.S PERMIT MAY BE REQIIRF.D.
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 names and indicate
whether interior or corner lot.
AJ
@�
SrnH: or. Nov YORK,
OOIINL�YO�jC 7777
...=•' Q-'�� �• ...........................being duly, sworn, deposes and says that the is the applicant
(Nene of individual signing contract)
above named,
Ileis the ................. .�W. . .................................................................
(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 and.belief.; olid
shat the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
........ ...`........day .. .. .I .7.
Notary Public .. .. (Signature ofApplicant)
' . ' .............
1N•�irN1A�r�
. .
i
now Or former/y
✓. a M. Higbee n
r
N.72°0930"E. rZ,�
* ,so PIPE FOUND /RON POST FOUND
0.9'SOUTH
1.1'EAST o.�'sourN � 249,93'
Z N 20'x• frame chicken
V coop i pipe
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icka
fnd.
/ t`p
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1 1, , -
-h •Areo=247 a Z..a• T.q .____-�-.� -----
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o 26 sq.
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t°.,• r
o '�h �
O (�-.1 from
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now or forme,'/y 252.62'
i
C. L. McCoffery,
i
00
o -
MAIN. ROA
N.Y.S. Rle 25�
Iv - -- 30
SURVEY FOR
ROBERT SCOTT a LOUSE SCOTT
A T CUTCHOGUE
TOWN OF SO!/THOLD DATE 14N. /9, /978
SUFFOLK COUNTY, NEW YORK. SCALEI '_3O1
•
At UNAUTHORI2E0 ALTERATION OR ADDITION t0 NO , 78-18
SURVEY IS A VIOLATION OF SECTION 7209 OF THEHIS
NEW YORK STATE EDUCATION LAW*COPIES OF THIS SURVEY N , GUARANTEED TO
SURVEYORS NKED SEAL OR
T BARINGOSSED THE SEAL SNADLL RIVERHE
BECU t go le BANK
NOt BE CONSIDERED TO BEA VALID TRUE COPY, tj �� NTY CO,
THE*OUARANTEE9 INDICATED HEREON SHALL RUN ONLY TO
MENTAL
THE SU
AND ONRH S BEHALF TO THE TITLEEY 18P REPARNY D. WD K;
MENTAL AGENCY AND LENDING INSTITUTION LISTED O
HEREON,AND TO THE ASSIGNEES OF THE IN'LIST G
TOom.ADDITIONALTUT ONS OR SUB EQUENT
OWNERS. TRANSFERABLE
TO
*DISTANCES SHOWN HEREON FROM PROPERTY LINES
PUR FOR A SPECIFIC
OSEIAND ARE NOT TO BENG STRUCTURES USEDTO ESTABLISH
PROPERTY LINES OR FOR THE ERECTION OF FENCES. (,
• ■MONUMENT PLACED SH 4589,3
YOUNG a YOUNG 400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK
ALDEN W.YOUNG,PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S,LICENSE N0.12845
N.
HOWARD yy,YOUNG,LANG SURVEYOR
Y.S.LICENSE N0.45893
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