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Home My WebLink About22942-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-23837 Date AUGUST 28, 1995 THIS CERTIFIES that the building Location of Property 1175 BRIDGE LANE House No. County Tax Map No. 1000 Section 118 Subdivision ADDITION & ALTERATION Street Hamlet Block 2 Lot 6.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 11, 1995 pursuant to which Suilding Permit No. 22942-Z dated AUGUST 13, 1995 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 ENCLOSE AN EXISTING PORCH AND INSTALL A FIREPLACE IN AN ACCESSORY BUILDING AS APPLIED FOR "AS BUILT". The certificate is issued to ELEANOR NOHE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Build lng Inspe~or FORM NO.3 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22942 Z /~ ~,~ .............. ~fl: ........... ~ .............. ,~..e.<.~ at premises located at ................ ~--~."~.. ...................................... .................................................. ~~.~ ......... /...~: ........................... CounlvTax Map No. 1000 Section ...... /~,~.....~..... Block .......... ~ ..........Lot No..G.,~...~'.. p~rs~on,,o opp,eo,,on ~ote~ ............. ~? ....... .,'z ............. ,9....~d o~roved by,he Bulldlng Inspector. ~ee*..2~..~ .... Rev. 6/80/80 Form No. 6 TOWN OF SOUTNOLD BUll,DING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOIl CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the folIowing: 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 featnres. 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 certi[ying that the solder used in system contains less than 2/10 o{ I% 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 "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, tile 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.O0, S~eimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildin2 - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00 Date 8/28/95 X New Construction ........... Old Or Pre-existing Building ................. Location of Property. .llZR~I~.~ANE ' CUTCHOGUB NY House No. Street Hamlet Onwer or Owners of Property.. ELEANOR NOtl~ County Tax Mai) No 1000, Section. 118 ILlock. 2 .Lot... 6.2 Subdivision .................................... Filed Nap ............ Lot ...................... 22942-Z 8/! 3/95 GARY OLSEN AT~ Permit No ................ Date 0r Permit ................ Applicant ............................. llealth Dept. Approval .......................... Underwriters Approw~] .......................... Planning Board Approvol ........................ kequest for: Temporary Certificate ........... Fiual Certicate..~ ....... Fee Submitted: $ ............................. FIELD INSPECTION REPORT FOUNDATION ( IST) DATE ,' COHt4Et~S FOUNDATION (2NO) ROUGI1 FRAHE & PLUHBING INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COI~4ENTS: BOARD OF HEALTH 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N.Y. 11971 ,.FPLICATION FOR BUILDING PERMIT NOTIFY CALL ;d: ..............' MAIL Date .A. qqqs. t..1.0. ..........199.5., INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 o~ public street~ or areas~ and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. 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 issued a Building Permit to the applicant. Such permil shall be kept on the premises available for inspection throughout the work. e. No ,b. uilding shall be occupied or used in whole or in part for any purpose whatever u/hi, Certificate of Occupant} shall have been granted by the Building Inspector. J / APPLICATION IS HEREBY MADE to the Building Department for the issuance/6f a Buil~ng Permit' pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, a~d other ap~l!ca, ble Laws, Ordinances el ?,egulations, for the construction of buildings, additions or alterations, or for reid/oval or d96~ihou, as herein described 'lhe applicant agrees to comply with° all applicable laws, ordinances, building cgde,~ousi~//ffBdg~and regulations, and t¢ admit authorized inspectors on premises and in building for necessary inspection (S+gfiatfire of a~Spli~ant, or name, if a o potation) .. " (Mailing address of applicant) State wlmther applicant j~_own~{~ lessee agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) a corporatio ] signature of duly authorized officer. '~ ':'- (~;me, apd titl~ of co.~orate officer) · ALL:"-OON~RA.C;I~OR.,' ~ MUST ;I~[]~H,~'UFFOLK COUNTY LICENSED Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... work will be done] Location of land on whicil proposed ................................................ Bridge Lane, Nassau Point, Cutcho§ue, Ne?.York 11935 House Nulnber Street Hamlet County Tax Map No. 1000 Section 1.1.8. ............... Block ...0.2. ............. Lot..6...2 ............... Amended Map B Sec B Suinlivision..~a~akl .P. Qi. FIt ....................... Filed Map No. 7~,9 ............ Lot P./O..lJ2. &..1.1.3. · (Name) 2. State existing nsc and occnpancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . .E.n.c.l.Q~e.~ .por. qkl .~llC] .f. ir.e .p.l. qqe..i.n..a, qqqs. s. qry..b.u.i.l.d.i.n.g. ............... b. Intended use and occupancy .[0ql. Q~ed .oqcqh .and .f. ir.g~liaC~?.],n. ~,~.qqe. q~.qr.y..b.u.i.l.d.i.n.g. ................ 3. Nature of work (check which applicable): New Building ..... ' ..... Additiou ........ Alteration ){ ......... Repair .............. RemoVal ............ Demolition ............ Other ~¥ ~i e~scr'il~ii~&i 4. Estimated Cost .... $3, PPI}, POi ....................... Fee .................................... " (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on eaeb floor ................ If garage, number of ears ..... , ............ : ...................................................... 6. If business, commercial or mixedloceupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure% if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ..................... i. Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Nunlber of Stories ........................................................ 9. Size of lot: Front ............: .......... Rear ...................... Depth ...................... 10. Dat~ 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 14. Name of Owner of premises .... ................ Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... ; .............. Phone No ................ 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trus,tees Permit maybe required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nbmber or description according to deed, and show street names and indicate whether interior or corner lot. Enclosed ~xisting porch and construct fireplace in accessory building as bui 1 t. IS UNLAWFUL i JHOU1 CERTIFICATE OCCUPANCY STATE OF NEW YeP, I(., SiS COUNTY OF , SUFFOLK ......... : .......... Garj .F. lanner..Olsen,..Es.q ................. (Name of individual signin]g contract) above named. ApPJIOYED AS NOTED OAT.: Sfi r' NO~I~Y BUILDING 76~-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNOATION ' ~0 REQUIREO FOR ~URED CONCRETE 2. RO~H - FRAMIN~ ~ PLUMBIN~ 3. INSU~ON 4. FINA~ - CONSTRUCTION MUST BE COMP~ ~R C.O~ ALC CONStRUCtION ~HALE ME~ THE REQUIREMENT~ OF. ~E N.Y, ~TA~E CONSTRUCTION ~ ENERGY CODE~, NOT RE~PONffiBLE FOR being duly sworu, deposes aud says that ho is the applicaut He is tile /~l~l;Qr. rIey. .... .. i (Contractor, agent, corporate officer, etc..~ of said owner or owners, and is duly authorized to perform or have performed th.ffsakl ~,vork and to make and fi e t lis application; that all statements contained in this application are tree to the best off'his kn~?wledge and belief; and that the work will be performed in the manner ~et forfl~ in the application filed therewith./ / Sworn to before me this . '." . 95// .......... t0th...v ....... day of..~ .August ............ 19... / //' ( ................. i No. 4e~eaT~ / · · · ~ .... / .... ' ............................... ~llfled tn Suffolk ' · (Signature ora hcant) Co..,lielon Expl,~ Nkov. 3C~0./~? ? D-- PP