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HomeMy WebLinkAbout24391-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25666 Date: 04/21/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 1540 GLENN RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 2 Lot 33 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 2, 1997 pursuant to which Building Permit No. 24391-Z dated OCTOBER 1, 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 SHED AS APPLIED FOR. The certificate is issued to GEORGE W & MURIEL JOHNSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspeoftor Rev. 1/81 10RX NM 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) N9 24391 ,Z Date ......./Q. . ..................................... 19�/ Permission is hereby granted to: / ....................... ..�.E.�.................................. �a ... -....................... . ...... ✓ ...... ..... .............w...... ' -............. .. .. ............f�r..........� d, ..... .e..............................................�................................................................................ ................................................................................ ................................................................................ at premises located at ..I&�r......... .... ............... .............. County Tax Map No. 10D0 Section ....1 ........... Block .....az....... Lot No. .:3 ............... pursuant to application dated ........... /...:......r ......., 19.1. 1, and approved by the Building Inspector. �'DC1 Fee5...........`...:..`...... 70;00X tor Rev. 6/30/80 .......__- Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 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 - 4. ccupancy -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. (�- .)Cc l . / House No. Street Hamlet Onwer or Owners of Property. . .. .. ... ... .... .. .. . . . . . .. .. .. . ... . . .. . . . . .. . . . . . . .. . . . . . . . County Tax Map No 1000, Section. . .. . p. . .. . ..Block. . . . . . . .. . .. . . . .Lot. . . . .. . . . . . . . . . . . . . . . . Subdivision. . . . . .. . . . . . . . . . ... .. . . . ... . . .. . . . .. .Filed Map.. . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Jr �!� � .Date Of Permit. J' .�:.� � . . . .A Applicant Permit No. .�c ! PP . . . . . . . . . . . . . . . . . . . . . . . . . . . HealthDept. Approval. . ... . . . . . . . . . . . . .. . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval.. ... ... . ... . . . . . . . .. . . . x Request for: Temporary Certificate.. . . . . .. . . . Final Corticate.'. .". . . .. . . . r Fee Submitted: $. . .:�.):�. . . . . .. . .. . . . . . . .. OAO* i- � S �lP(p :. (. �1� . :. . . .��. . . . . . . . . . . . . . lle.�- 5`I3�.� PL• O _0 Gym Town Hall, 53095 Main Road y Fax (516)765-1823 P. O. Box 1179 %k Telephone(516) 765-1802 Southold, New York 11971 O t OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 17, 1998 George Johnson 1540 Glenn Rd„ Southold, New York 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) ;25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT # 24391-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 1E.L,''.%I;: 12 ECT10:1 ��Di.TE �_ WfMrNTf FOUNDATION ( 1st ) FOUNDATION ( 2nd ) —_ — 2 . S ROUGH FRAME & PLUMBING 3 . rn rn INSULATION PER N . Y. STATE ENERGY CODE x a .y C � r 4 . i'Gv y FI14AL o z ADDITIONAL COMMENTS : m X b H A a „j H O z s x rn a r a ' x o m y M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ :INAL [ ] FIREPLACE A IMNEY REMARKS: DATE �� INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: / DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ vle-FINAL [ ] FIREPLACE A CHIMNEY REMARK'S: Z! DATE 9 " INSPECTOR P�SUfFOC/rC � Albert J. Krupski,President Town Hall�p G John Holzaprel, Vice President = �� 53095 Main Road c Jim King P.O. Box 1179 �' 2 Martin H. Garrell O Southold, New York 11971 Peter Wenczel y'hp� �a�l. Telephone (516) 765-1892 Fax (516) 765-1823 BOARD Or TOWN TRUSTEES TOWN OF SOUTHOLD 7uly 7.2, 1997 George Johnson _.540 Glenn Road >outhold NY 11971 Re . SCTM #78-2-33 Dear Mr . Johnson, The proposed construction of a utility shed measuring 16 ' X 24 ' is out of the Trustee Wetland jurisdiction as per inspection by James King, Trustee on Friday, July 18, 1997 and a survey received in this office the same day. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh CC. BLDG. DEPT. �SOFF0J,fc Albert J. Kmpski,President �O� OG Town Hall John Holzaplel, Vice President A 53095 Main Road c P.O. Box 1179 Jim King Co Martin H. Garrell Southold, New York 11971 Peter Wenzel y�Jp! �.a0� Telephone (516) 765-1892 ow Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 7uly 22, 1997 George Johnson -540 Glenn Road Southold NY 11971 Re: SCTM #78-2-33 Dear Mr . Johnson, The proposed construction of a utility shed measuring 16' X 241 is out of the Trustee Wetland jurisdiction as per inspection by James King, Trustee on Friday, July 18, 1997 and a survey received in this office the same day. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, J' :filbert J. Krupski, Jr. � President, Board of Trustees AJK/djh cc. BLDG. DEPT. BOARD OF HEALTH . . . . . . . . . . . . . . . -FORM NO. 1 3 SETS OF PLANS ...... . .. . .. . .. -`- -TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . << IIILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . - --- TOWN HALL SEPTIC FORM . . . .. . . . . .. . . . . . . . . 219WLOL765-1802 11971 NOTIFY: q �(CALL . . Ol Examined......./OLL..., 19.?yz MAIL TO: . . . . . . . . . . . . .. . . . .. . Approved......1.d�L..., 19 .7 Permit No. ..43 (./, ................................... Disapprovala/c .................................. ................................... ........................................................ / (Huilgi g Spector) APPLICATION OR BUILDING PERMIT . . . . . ,19q.?. INSTRUCTIONS a. 'Ibis application =at be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 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 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 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 BCREBY 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, ordinancesor Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building axle, housing code, and regulations, and to admit authorized inspectors on premises and in buil) nems in tions ..... .. . .. .{� .................. (Signature�li t, or name, if a corporation) .......... ?..��..�?c .. /1971 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0WA OL .............................. ................................................... Name of owner of ........................................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. I Z;4-0 C-�,L" 0 f.c)r��......................... Tdcl� � 1.1.9.7/ ............................ i... ...... ........................... House Number Street77 GG Haslet Canty Tax Map No. 1000 Section ...©1-c-'...... Block .... .......... Lot ...Z:�)........ Subdivision ........ Filed Map No. .`�.�."..`{' ...... Lot ......... (Nave) 2. State existing use and occupancy of premisgA and intended usetooc� of construction: _ a. Existing use and occupancy ........... ... m �PN C 2R...7.:..... `se ...... .................... b. Intended use and " � � '�t"�` .fi-. 7TOO 2 i Tt;sL'„e; 10 63E12":;&It rmlow ml%f1w2 ni "eitelrtuo C'bi;%SSAo't0.att 3. Milure of wurk (cheek wtnioh applicable): ttew ]krilding .../�.... Addition .......... Alteration .......... Itepair ............ Rauval ............. De of it ion ............ Other Work ................. ................. (Description) 4. Eslinwted Cost ....V 61e /.................. fee .......................................... (to be paid on filing this application) 5. if dwelling, muter of dwelling runts .. ... timber of il%eII ing units on each floor ....:"...... If garage, tinier of cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use....... . ......... ... r r 7. I)hwnsiats of existing structures, if any: Front.............. Rear ...X ........ Depth .....73:. ...... :?� 11eipiet ....... �L ............ rimier of Stories ......�./?.. .... Dinensions of sore structure with alterations or additions: Front ............... Rear ............... Depth .................... Ileiglut .................... Mnix:r of Stories ............... g. Dinensiwkdt entire new construction: Front ....../.�.. ..... [tear llei&t .........�.:r..- .r....... Nutter of Stories ....... ............. 9. Size of lot: [hrxuC .....ItrC)........... Rear ...... .7........... Deptlu ...f =� .......... lo. Ikrte of purchase .s.1�!�'��.qtr99(.... Rine of Pourer (u+uer ........ K ........... I1. Zane or use district in %Juno premises are situated jZ t(?)F�<' proposedr .... ... ........................................... 13. Will be ranted / late any zoning law, ordinance or regulation ,,LL 12. tiesofa v)c '�......••. Will excess fi 1 be removed from premises: YES ll. Nems of owner of premises &7. 4f.........Z2C:r-KA , klress !rJYO.9.gyk7 ......... Ptxxe No. ..d.".1.... Nemo of Architect .................................... Address .................. ............ Ill tone No. .......... Nam of Contractor ...Ci �'vEIZ....................... h ss ..... ....................Phone No. ......... 15. Is this property within 300 feet of a tidal wetland? * YES . NO .......... *IF YIS, SOIInUD TUN 114lSITY.S PEIAII•I' MAY ISE FIAT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fruit property lines. Give street aid block ruder or description according to deed, and slow street names and indicate whether interior or corner lot. - a tri- - z- 33 NJ c`en 24' f' I HQV4C ruW, .22 �St Horhl P.fYrf 25:3_ S io 4 LL-9 as MME' O NW Y(A?K e�EF_IC SS (X711NIY .. ................deity; duly :worn, deposes and says that be is the appl icant (Nrne of iwlividual signing contract) alxwe witted, ilk: in ilio: y:4- .:.............................................................. (Ccalractor, agent , corporate officer, ele.) of said awtler or overs, and is duly enlhoriwd to perforin or have performed SSB said wrk and to nuke awl file this app] icaLion; Wal all sLalcoeuLs coettairxd in this algilical ion are title to the txest of his knowledge and NO icf; and IhaL [lie work will W perfornted in the manner set forth in the application filed therewith. awrmt lulOote nq Ibis yy . ...?AOR..........clay of .. ?.^;. .... 9 C.... Nutnry Ihuhlic .. .... ........ ... .. ... .. .......... (Sitlnctt ore f pill i •a rt ) OBERT 1.SCCITT,JRR,, Notary Public,State of Neyi York OaN O1SC4 2lk 6Q Cntlil %M E*r"May pe LA. A44 P or gRc, J�( 1 g r Of SS 0(/ Q ? 721-D, r:: -7.: SCD .- l 6041 (-JF=FGLlG C. 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