HomeMy WebLinkAbout21885-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23475
Date FEBRUARY 2, 1995
THIS CERTIFIES that the building ACCESSORY
Location of Propert~ 1400 ~BT CREEK A~NUE CUTCHO~UE NY
House No. Street Hamlet
County Tax Map No. 1000 Section 110 Block 1 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 10, 1994 ~ursuant to which
Building Permit No. 21885-Z dated JANUARY 25, 1994
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 AN ACCESSORY GARAGE LOCATED IN THE FRONT YARD AS APPLIED FOR.
The certificate is issued to
MARY MC GAHAN
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N333021
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
(owner)
H/A
NO--ER 9, 1994
NA
Building
FORM
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y,
N_° 21885 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ............................................................ 19 ......
Permission is hereby granted to:
...,~..~ .........................................................
/,~ .~,,~,,,.~......~-~,....,~...~..,.,. ...........
........ ..~....~.~..~,~ ........ ~....//..,..~-
........ .........
. ./.~ ...... ~ ........ ~~..~...:_._~.....~...~.....
............................................................... ~,,,~,,,,,,~~ ~, .......................................................
Coun~yTax Map No. 1000 Sectlon,./(../..,(~.. ............ Block ...... ~.../.. ........... LO" tNo .......~....~..... ..........
Building Inspector,
~ee,....~.~,~. .......
and approved by the
/ / ~ilding In: p
Rev. 6/30/80
THO-f.!,~ _
P CATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTI~LD
BUILDING DEPARTMEMT
TOWN HALL
765-1802
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
'.'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 ~pplieant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
i. 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~ - $i00.00
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 ... ~ .ZAP. ~... ~.~..Z~¢ .~. ..............
.New Construction ........... Old Or Pre-existing Building ..... ~. ..........
Location of Property...f.~.~...~.t.~'~.~f~..~.z.p...~..~..'.~..~.~.~--. ................... . .... .
House No. Street Hamlet
Onwer or Owners of Property ~ ~ ~~ ~
co~ty ~x Xap No ~000, S~tfo~ .... ~. ...... ~o~ .... ~Z ......... ~ot .... ~.~. .............
~Subdivision ........................... Filed Map Lot
Permit No...~...Date Of Pe~it.~ .~ ........ Applicant..~..~ ...............~~
Health Dept. Approval ........................ · · Underwriters Approval .... ~. .......... . . .
Planning Board Approval .....................
Request for: Temporary Certificate ..... Final Certicate. ' . . .
Fee Submitted: $ .... ~
................................................
~PLIC~
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 9, 1994
Mary McGahan
1400 West Creek Avenue
Cutchogue, N.Y. 11935
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
XX An application for Certificate
XX
Occupancy
of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21885-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
COMM£NT$ -. '
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
.FLUMBING
INSULATION FERN.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
PLOT PLAbl
gCALFJ !,"= 40 FT,
b~,~,~-~E ~ DEC',< LOCaTIOi',
!400 ¥/, CREEK
il
Ci G, NT,
F-
Iq
Fq
140~ ~-/-
LOT 110-1-4
140.1g'
$, I 49'£0'
WE~T C~EEK AVF',
PLOT
SCALE~ 1'= 40 FT.
PLAN FOR PROPOSED GARAGE & DECK LOCATION
· ~,, Hco,~HAN PROI~Ek i t
i400 'W. CREEK AVE,., CUTCHOGUE, N'Y !/6/94
7G5.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
REMARKS
765-~802
BUILDING DEPT.
~ ~o~~NSPECTION
ATION IST [ ] ROUGH PLBG.
[~FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c ............................ '
· (B/u~l~(ng Inspector) ....
APPLICATION FOR BUILDING PERMIT
INSTRU6~IONS
BOARD OF HEALTH
URVEY ..........
/~CIIECK ....
Date /~/oo'. ..~] 19.~
a. This apI~lication must be completely filled in by typewriter orin ink and submitted to the Building Inspector, witl
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 sti'e
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apt
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 pern.
r 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 Occupan
shall have been granted
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t
Building Zone Ordinance of the Town of Southold, Suffolk County, New.York, and other apphcable Laws. Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit author/zed inspectors on premises and in building for necessary inspections.
(Sionat~ure of .a?p~,li.c~a~t~,c~r~name, if a corporation) ' '
. (Mailing address of applicant)
State whether applicant is owne,r., lessee,'agent, architect, engineer, generai contractor, electrician, plumber or builde~
me ownero fetuses ... , . ·
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.'
; . Nam a d title fcorp rate officer)
Bu'lder s License No ' '
Plumber License No '
Electrician's License No '
Other Trade's License No ......
Location of land on which proposed work will be done '
¢.4. .tp , . . ./_3. . .a . . . . . ZlOtys"'
, lIouse Number Street ' Hamlet "
Cou;ty Tn×No. 000 Section ...: ..... /./. 0 mock / Lot .el..
Subdivision
........ ' ........ (~/'a~) ............... '. Filed Map No ............... Lot .............
Stat~ e×isting use and occupancy of premises and intended use and occupancy of proposed onstl'uction:
a. Existing use and occupancy ' /'~&'"~/Z)~?~C/~'.T&~. ' '
b. Intended use and occupancy ~..'~'/zOg>/t/C~-- . ·
3. Nature of Work (check which ap,, ic-t,, ...... ~,~.-- ' , ~
.. . ~,,, -4'-' vel .. :'. .......... Demolition .~.. q.~.~..~/~3 -~7'. Other ~.V~rl~ Y
4. Estimated Cost . .4~.(/a/O'~ . ' ' , . (Dcsd4ih~ ,-,-
i . . . ....... ,~, . . ~..
5. It~ dwelimg, number o f dwellin~ uni$, . . , ( o be paid on filmy thru apphcatmn)
· Ifgarage, number of cars . I ~F¥'~. ........ , r~umber ofdwelhng units on each floor ....... ,.
6. Ir business, commerc al or mixed ~'~' ................................... '
· · i ,,-cupancy, specify nature and extent of.each type of use.. i ~; ~ i~ ~
7. Dimansions,ofexistingstructures, ifan,,.~ .... F.~;~ . ' ....... ~. ' ....
Height · '/'qSP'/ ...... ~'~u .... ' ' '2 ........ : · Rear' ~'.~· r~.,,~h
n: ..... ' ' ~ moeror,Stories d.9'v'C'~... ' .............. ~,,, ~.--. ......
!0. DateofPurchase .../.p/,p-.-~, ...... "'' aear..(;,../3~..~./ ........... Depth ..,~.~?.~.. . ' .... "'
11. Zone or use district in which .... ;~_.'-'_'-' L' ' i ': .... l~ame of Former Owner ,/.<-'../~-C.~.'--~'2'.. ' ........ ','
12. Does proposed construction ~iolatc any zoning law ordin
13. Will lot be regraded /vD , ance or regulation: ...,~.Q. ' ' ' ' · '
14. Name of Owner of premises ~-~,~.' 9 "~;' >'~ ;,'~'A' ' ' Will excess fill be removed from premises- '' ',', ......
NameofArchitect . , '"'"-'/n4'.~.'"t.'~'Fq~...Address /F~.z?·,.d...~../b{/~PhoneNo'~,,.~.ffff&~,~:, c,~
15.' I.s. this property withia' 300 feet of a tidal wetland? *Yes.. ~ .... No ....... ' .......
· Iii yes~'$outhold Town Trustees Permit may be required.' ''
.. I PLOT DIAGRAM
Locate clearly and distinctly ~11 buildings, ~he~h~r existing or proposed, and, indicate all set-back dimensions
property lines. Give street and block number or '
i~terior or corner lot. i ~lescription according to deed, and show street names and indicate whelhe:
'l
STATE OF NEW YORK,
COUNTy OF ,'SIS
(Name ofindividua ;'g'c'o'n't;act) ' ' ....... being duly Sworn, deposes ;md says that he is the applicant
~bOve named.
lc is thc ' ~ " '
! (Contractor agent corporate officer ' ~ ................
etc ' ' ......
>f s.aid .owner or Owners, and is duly authorized to perform or have performed the ~aid work and to make and file this
P rmca in the manner sqt forth in the application flied therewith.
worn to before me this
............. day of g0. ...........
mary Public .......... 6'~.4 ~ ..... County .'
~ota~ Pubtic, State of NewYo~ ' (S~ture of applic~t) ·
_ 'No~4822563, Suffo k Counw
~ mrm ~xpires'Dece~r 31, 19~