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Home My WebLink About21904-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANC~ No Z-23938 Date OCTOBER 5, 1995 THIS CERTIFIES that the building Location of Propert~ 1650 HORTON LANE House No. County Tax Map No. 1000 Section 63 Subdivision ACCESSORY SOUTHOLD NY Street Hamlet Block 1 Lot 14 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 2, 1994 ~ursuant to which Building Permit No. 21904-Z dated FEBRUARY 7, 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 BUILDING IN '1'~ REAR YARD AS APPLIED FOR. The certificate is issued to of the aforesaid building. JANE E. WELZ (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N318976 PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A JUNE 29, 1994 N/A Building I ns~pector~ FORM TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N~ 21904 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..... ~..~......~.~...z. ............................................... ...... ~:..~ ........ ~ ...................................... ..... ~....~....,...~..~.....~./~: ..................................... ~ to...~,-~.~,~ .......... ~ ........ ~.~.~....~z~..: ....... ~ ...... ~ .................. .... ~ ........ ~-~...../¢z~,,~. ............ ~: ......... :~~ ......... ~..~ ..................... at premises located at ................ ./...~,. ~..."~..~. · ........... ~,~¢~...~...~'~.. ................................... CountyTax Map No. 1000 Sect[on......~..~..-~. .......... Block ........ ..~../.. ........... LotNo ......... ~ ........... pursuant to application dated .......... d~ .................................. ]9 ...... .~ and approved bythe Building Inspector. ~ ~..,..~.~ ...... /~' Buil~ing Inspector' Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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. 7 6. Submit Planning Board Approval of completed site plan requirements. B. ~or existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-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-existinK Buildin¢ - $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 . . .......................... . . New Construction...~.. .... Old Or Pre-existing Building ................. Location of Property ..... ./~.~.-~... ~..~.~..F~..~..~...~. .......................................... House No. Street Ha~et Onwer or Owners of Propert~ ................ · .................................................. County Tax Map No 1000, Section .......... Block ............... Lot .................. Subdivision .................................... Filed Map ..........· . Lot .................... . . Permit No...~ ~.~ ~.~..~ .Date Of Pemit.. ~.~ ..... Applicant. ~..~'. ~ ......... Health Dept. Approval.' ......................... Unde~riters Approval ...................... .. . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.. .~. ..... Fee Submitted: $ ....... 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 September 15, 1995 Ms. Jane E. Welz P.O. Box 557 1650 Horton Lane Southold, NY 11971 ***** SECOND NOTICE ***** 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) xx 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 # 21904-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 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 August 23, 1994 Ms. Jane E. Welz P.O. Box 557 1650 Horton Lane Southold, NY 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) xx 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 # 21904-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 76~-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION ZND [ ,]~SULATION [ ] FRAMING [/~f FINAL /' / RE:MARKS: /~~f FOUNDATION [ 2nd ) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIC C OM.~IE NTS: WOlte~ t.~ke olher modul'~, th~' doubte doors are and h' h~qh ~duch ,~,1~ accomodale everv- from vour ~)ols ha :t~(~ heavy lawn & garden m~clor~. Avmk~ble maximum 10' h~gh. DUTCH BARN ?m t)ld-la,4~io,~'d k)ok ,,vllh storage capacily Ii',' ~);)'¢, ihts ~,' k' is hiqhc'r th~ any other model ~/olter FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... (,WuildSng Ifispector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH' . ............. NOTIFY .CALL MAIL TO: Date ............ i INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 jets 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 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 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 described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorizedinspectorsonpremisesandin building fo r neces~ons;/. .... /~.~v.. ~..e~..,~...,¢~..~.....~,:..,p/~....~.,. ~,.Y: ...... (Mailing address of applicant) ¢1 q-h~-] State whether applicant is owner, .lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ DW ~Ie.-F~ ......................................................................... Name of owner of premises i~r~i~' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. _APPROVED AS NOTED N~I~ 8Ui~ING DEPA~ AT 765-1~2 g AM ~ 4 ~ FOR ~E ~O~ING INSPE~ONS: FOUNDATION - ~0 REQUIRED FOil POURED CONCR~E ROUGH - F~MING & PLUMBING IN;U~TtON FINAL CONSTRU~ION MUST BE COMPL~E FOR C.O. Builder's Liceuse No .......... USE' UNb%5 FUL P1 tuber s LJcense No ............................... Other Trade's License No. ~,~ ~$.~. F'% , ALL CON~RUC~ON SHALL ME~ ]. Location o~hnd o~ which p~oposed wo~ will be done .... ~ V~ ~THE ~Q~qEME~ OF ~E N.Y, l~..~,..~, coo;$. N~ R;S~.S,e~ ;O; House Number Street co,my r,~ ~,p ~o. ~000 s~,io~, f6.O .... ~o~k ...~t .............. lot. ~. ~.~ ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existiug use and occupancy of premises and intended use and occupancy of proposed constr.uction: a. Existing use and occupancy ...~..~Tff..~..,-t~q~-'~...~qi~Zl), ,, ~., .... ~, ~ ~ ' ............ ~ ~,~.~ .,..., -...,;~ · :? ~f~ ........ b. Intended use and occupgncy Locate clearly and distinctly all property lines. Give street and block: interior or corner lot. 3. Natpre of work (check which applicable): New Building .......... Addition qF......... A'Ew$ ./f~..~>Alteration .......... Repair .............. RernovalO.,5' o/,.~. 5..~. Demolition Other Work ' (D ripti ) 4. Estimated Cost . :~ ............. '. ...... i (to be paid on filing this application) 5. f dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ . If garage, number of cars .... ] .............................................. ! ....................... 6. If business, commercial or mix,Id occupancy, specify nature and,extent of eaqh type of use ..................... 7. Dimensions of existing structures, if any: Front · · .~'. Rear Depth . I.;3r/. · ight i~b ~ : He ............... Nu er of Stories ............ ............................ ~'i ........... With Dimensions of same structure alterations or additions: Front ............... Rear ......... Depth Height Number of Stories 8. Dimensions of entire new construction: Front /'~--. Rear ~' /~. .................... . ..... .. Depth ............ Height ............... Number of Stories ....... 9. Size oflot: Front l.O.O.t. ~ . Rear. [.Off."i"iiiiiiiiiii'iii~ .~Depth, .............................. .ZO..~..4:... Z~/. ........... 10. Date 0fPurchase ~.~/.ff~... i ill. iiiiiii ...... Name of Former Owner r~.~.,/~.4~..~.g.q.~.$'. ........... 11 Z di i i whih ~'"' it d · one or use strct n c premises ares uate ........................ l 2. Does proposed construction violate any z6ning law ordinance or regulation· /q'O . . 13. Will lot be regraded /~) I. . . ........................ ..... ~ ................. Will e_xc~s fill be removed from premises: Yes 14. NameofOwnerofpremises ~ t~::. W~Z- Addres~'O/,~o~.&_-.-Sg~d /,0,~t~- ~. ,, .. . , .......... ~ow.l,~r~o .~.-::w.. ~none l~o. 7~... /.~4-~...~. marne of Architect .......... ~ ........... Address ................... Phone No ................ Name of Contractor ......... i .............. .... Address .......... : ....... .._Phon~ No ............... 15. Is th£s property with±n 300 feet o~ a tidal wetland? ayes ...... (~..; ..... · If yes, Southold 'own Trustees Permit may be required. '' PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all Set-back dimensions from lumber or description according to deed, and show street names and indicate whether STATE OF NE~tQRI~..~ f~-/ SiS COU _Y_OF.. id .... ................. (Name of individual sig~g contract) above named· I being duly sworn, deposes and says that he is the applicant of said owner or owners, and is duly. ~uthorized to perform or have performed the said work and to make and file this application; that all statements continued in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application filed therewith. Sworn to before me this ~ , : .. Cou nt(~ - · CLAIRE L, OLEw · . Notaw Publlo, NO. 4879505 Qualified in Suffolk County i Commission Expires De~!em.b?r 8, 19~,.. (