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HomeMy WebLinkAbout22080-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23337 Date NOVEMBER 10, 1994 THIS CERTIFIES that the building ADDITION Location of Property 55 HARVEST LA & 33610 MAIN RD. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 2 Lot 13.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1994 pursuant to which Building Permit No. 22080-Z dated MAY 24, 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 OPEN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID & MARYELLEN GAMBERG (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uil ng Inspector Rev. 1/81 FORM NO.3 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) Date ...v/ 19 n~ 7. N°_ 22080 Z Permission Is hereby granted to: ~ s . A2y, 5 ;;a~- '5~ to ....C? I r~s~r 4. efZ,9A%~1)..'4%x"e...... a~rnn~ ......~.~,,~r . .//1l..//..............L.....................,................................................ at premises located at.... lr...... 7...'~~... County Tax Map No. 1000 Section Block .........f ..q Lot No. ....13!...2 r........ pursuant to applicatIon ' aced .........1 19..<GG...... and approved by the ~y Building Inspector. Fee $...i °f-V d ....Jldh~ Inspecto Rev. 6/30/80 Form No. 6 6 I • ~ 0 TOWN OF SOUTFIOLD ~ n1 BUILDING DEPARTMENT . TOWN HALL 765-1802 DEPT . LtSL,DG N _DF TNOLD 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, dditions to dwelling 2 Alterations to dwelling $25.00, Swimming pool $25.00, Accessory uilding $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential P15.00, Commercial $15.00 Date ...~1?if1 New Construction....... . Old Or Pre-existing Building Location of Property... ~f' lit L. House No. StreetV Hamlet. Onwer or Owners of 05? fir . County Tax Map No 1000, Section Block G2J......... Lot.... ( J77:.. Subdivision. Cf^. . Filed MaCOO . ~ot 220 © Z Permit No ........Date/Of Permit. 51~5?! . ~....Applicant.S<''.': ~ Health Dept. Approval...... r/ A ..............Underwriters Approval..../V/11.............. Planning Board Approval _ :tequest for: Temporary Certificate........... Final Certic.ate..Vl/ gee Submitted: Chu. yg~4-5 0~lr APPLICANT 1. --L D {i9tNT _ II m c,- a a\ OUIIDATIO'1 (1st 1 I ~ OUNDATION (2nd) .OUCH FRAME & I -PLUMBING y H 3 . ~I n =77SULATI0:1 PER 77. Y. I • • STATE ENERGY II CODE n~ I FINAL I - y ~nX ADDITIONAL COMMENTS: x j H \ 9 f~ O \ fi \ • m 1- • r -v BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765.1802 t:OT I PY ; - V4 CALL J l Examined , 19pp~! MAIL TO: Approved 5 y..`.. , . , , 191 (4ermit No.,oP;:2_0.X¢ Disapproveda c (Bu' m spector) `.It 1, ~ MAy . 2 ~ APPLICATION FOR BUILDING PERMIT Date . t l99/ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, aC~urate 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryspections. (Signatuie`of~applicant, or name, if a 6el~proraattiionn)) . . . . . i (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ /fin I...................................................... Name of owner of premises lU. . JY'! q l r ...l~1")urlb (as on the tax oil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. -e-1 Plumber's License No. Electrician's License No. ....4 Other Trade's License No . 1. Location of land on which proposed work will be done. .Guti..s " C.i ~G~1cI~l House Number Street Hamlet County "fax blap No. 1000 Section Block .....c2 Lot .....15-.'21 7 Subdivision tN~G Filed Map No. Lot , . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy . . . f dv ocr !"C liff" 3. Nature of work (check which applicable): New Building Addition ....1//... Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ......t Fee (to be paid on filing this applic 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars //'l J'1 . b. If business, commercial or mixed occupancy, specify natdye,~a d extent of each ty~e~of use . . . . 7. Dimensions of existing structures, if any: Front Rear Depth . Height Number of Stories . Dimensions of s Te structure with alterations or additions: Front 3~. Rear . , . Depth Height Numbe f t dies . , . 8. Dimensions ont)'Fy new construction: Front Rear .....Depth ...l......... . . Height !...Y....... Number of Stories ?V~ . . 9. Size of lot: Front , Rear 10. Pate of Purchase , , , , , , , , , , , , ,Name of Former Owner ..a~~1 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 D . Will excess fill e re7ngv from p em No/ 14. Name of Owner of e i Z /tdyddress L Name of Address`//!.. 1. d~:~~! fx.. Phone No.~~.,,_~."" , . Name of Contractor . e ! , J 4:.. Address ~ ? Phone No. Pr/ " 15. Is this property within 300 feet of a tidal wetland? *yes........ lff-o~ *If yes, Southold Town Trustees Permit may be required. C> 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. AP PROVO AS NOTED CkA1"E: 5 Et P tP _22A f-# l F. E . s By r'Kj Fy t? dL G DEPARTM AT cb'iFst12 9 AM TO 4 PM FOR THE ilid:u CtAT'ON - 1f WO REOt11REP G; POURED CONCRETE :},3C,t•i . rPANII C, P PLUM€:,NCa . °°=:l. C:f)e~~: f3!.bCT7(},y M' SST G l Compi-E4E Fee a' C..:3. a:F';d.lE3 ;§fiz"NTS OF TH A,, NTL : ON'STRS/t;TION & FNEF': v die NOT pIrsi-I NSl1xL1= h'3's ~-~+','!?:r i t[? d:CtPl.iRCfCaIU(\ EsR!ia3 STATE OF NEW YORK, S.S d) being duly sworn, deposes and says that he is the applicant (Name of indivial signin~tract) above named. He is the (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; and that the work will be performed in the manner set forth in the application filed therewith. Swom to before me this q . I) a .............day of ...1) lcl-t 19 Notary Public . l.U....... County / LINDA J. COOPER Notary Public, State of Newyork (Si ure of applicant) No. 4822563, Suffolk Term Expires December 31, County - I/omesn0w to S6Go Or for?77 OD 55/2 F. / kOren~Y ',~y. YChe Are SG,-. f o~ ' 2 20?sf ,ya OC l~ ~wN. ~-n. i 7 9 W. i ~ 8 Jul P ~ ~0. A¢,zH A , 1 V`k AT N~ c`'E ~ ~~~~O , I a , .;P L 9 b \ \\9a/S' "0 Ol 01, /yam\R~ ~ co SOLI W / Cc, ORO, R/ \ PO BO,SNO C BOA' h\ 5~ as ~ now //a W r for SO1 L, Ors/on~~Y ~ ~ °sG \ \ W q\ ss` /n N88o/ Y \ / or E~~ENE, $ / fr now s 00 w S' ed or / 3. S A. 60 for o 0 RO 4 hor/ nh0 "/er/ z O G. on/? Se~ % ryob OSSe/ IA-no,,, IV rea, Of / n/nnC y B. enuorgl Fnde en onn $ n) 0,7/1 SURVEY FOR R@ M DAVID GAMBERG 9 MARY ELLEN GAMBERG MMrrll Name. ~ . t5 U AT CUTCHOGUE DATE JAN 16, 99 MAY _ 2 TOWN OF SOUTHOLD SCALE I 60 il.`l.. SUFFOLK COUNTY, NEW YORK No 92-°°25 P wAUTHONIEED ALTERATION OR AOOl+IOw TO THIS CERTIFIED T0: ~G. DEPT, SURVCT D A VIOLATION OF SECTION Txo, OF THE DAVID GAMBERG XEW OMA STATE EDUCATION LAO Irm: cm ~yyN UTHOLD MARY ELLEN GAMBERG i COPIES OF THIS ANNE. NOT [[ABED THE LAND L SuR VErows IwKEO SEAL OREM@OSSEO SEAL SMALL AFFORDABLE MQ RT~GR P NOT BE CONSIDERED TO BE A vAL 10 TR1,E COP? CHICAGO TI fH NGUM AYT[EE INDICATED HEREON y141 RUN OIL. TO HEALTH DEPARTMENT-DATA FOR APPROWRL TO CONSTRUCT THE PERSON MR INHOY THE SURV[+ Is PREPARED (TI TL 910 b AND OR HIS [[HALF TO THE TITLE COMFORT, GOVERN- A 2 B NEAREST WATER MAIN ~R All NSOURCE AT MTER OPIATE-PUBLIC MENTAL A" CT AND LE PAIRS INSTITUTION LISTED DT R NIF CO TURBO DIST,wv SECTION 9? [LOCK 2 LOT IE.E HEREON, AND TO THE ASSIGNEES GE THE LENDING I *MLPM AIL[ M OWELLIMS WITNIw 100 FEET OF THIS PROPERTY INSTITUTION QYARANT[ES ARE HOT TRANSFERABLE OTHER THAN THOSE SRO" M[R[ON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N THE MTER SUPPLY AND S[WABE DISPOSAL SYSTEM FOR THIS RESID[A'S OWNERS N MOPE RTY LINES Cf D' X158 WILL CORFORM TO THE $TOMORROW OF THE SUFFOLK COUNTY DEPARTMENT R DISTANCES SHOWN XER[ON FROM OF HEALTH SERVICES TO [E ISTNIG STRUCTURES ME FOR aSPECIFIC Urw . APPLICANT- PURPOSE AND ARE NOT TO BE USED TO ESTABLISH Ll ,1 PROPERTY LINES OR FOR THE ERECTION OF FENCES kND SU E A"tu YOUNG a YOUNG ~RH~"w NOTE i n K STAKE • v MONUMENT RE: LOT I , MINOR SUBDIVISION "CREATIVE VENTURES ALDEN W.YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N IS LICENSE NO 12845 HOWARD W YOUNG, LAND SURVEYOR 8 •M l0CATO10I W6llW1,S[PTIC TAMISTIB C[SSPOOLf1O1 YIOIIN MGEOM NY S LICENSE NO 45893 AR FROM MEW OBSERVATIONS AND ON DATA OBTAMILD PRIDE OTHERS / IQLL\voKk j7H41.1. a mMY W/ HY(7 WWIWW fo HOT I~xdJ,~ rA,%/(*. 40WOOr- OW4 3'J 4W P~KM TO WOK. ~ 4L F"IIA -ro et f Favo ft TWAW h14L. ~7 rlr~N or ~ ro p p~'(fKl`(IN~ IN 'nl~ ryEl.n to - - Luc ~ohly hfalr(.nN~~ C~ I r '17-71 LLLI rtAMyNq A4L W rKw4. or Palta#I Rao r r 14.1V~i - - 3 a &w rile. w. co.e nrsc~,z, - r.~UNq Lug. ~ +J-a" y d y ~TUK rwocEL ~e+w,G To rk p ~NaieN 0,(R.o. r 11 rlr1FIL - V[!ac UNE. ~ ~ Mull - Z &rmy~ ~n1Iy ~ryI~K"n IAfflc~. 0 ~~aN1 EI,~v~Tlo~l _ 5fd•LE; I~,~II, Il.pll ~ao~nu~N~wwED I/all,l~,~ll ilb Vj PR a? 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