The URL can be used to link to this page

Home My WebLink About21520-zFORM NO. 4 TOM OF SOUTMOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23700 Date JUNE 13, 1995 THIS CERTIFIES that the building. ADDITION Location of Property 1835 MASON DR. & 55 HICKORY DR. Mouse No. Street County Tax Map No. 1000 Section 104 Block 6 Subdivision Filed Map No. CUTCHOG~E, N.Y. Hamlet Lot 15 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29, 1993 pursuant to which Building Permit No. 21520-Z dated JULY 6, 1993 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 ADDITION TO EXISTING DECK, 5'x8' AWNING ADDITION GABLE END OF ATTACHED GARAGE TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The oertificate is issued to CURTIS WILLIAM HORTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 /ding 'Inspector FOgM NO.3 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N_° 21520 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: .~.~i~~......:~.~ -~ ..1>~...:........~.~.../.2.~ ............ .~.~.,.~..?........'~,../../~> ...... ~, .......... ~.....~....~..,~...~.....~,~_-/. .......................................... .:.....':..: ...... coun~TaxMap,o. ~ooo sect,on ...... ..~.....y.. ..... Block ......... :&.. ........... Lo, No..../...:...'.....;: ....... pursuant to application dated ......~ ....... ~;~...,,~.,,,.,, 19~...?.... and approved bythe Building InspectoT, Fee $,, .~. ~.."~, .~.....~.,.... Building Inspector Rev. 6/30/80 [:ora Ilo. 6 TOWN OF SOUTIIOLD BUILDING I)EP~\RTHE!IT TOWN IIALL 765-1802 APPLICATION FOl~. CERT£FICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildin§ insucctor 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 Hehlth Dept. of water supply and sewerage-disposal(S~9 form). 3. Approval of electrica~ installation from Board of Fire Underwriters. 4. Sworn statement from!plumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations,iai certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo 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 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.O0' New Construction .... Old Or Pre-existing Building .... ~ ...... oeat on of Property .... l 31. ......... ............ House No. Street Hamlet Subdivision ............ Filed Ma ....... Lot ...... "ealth ~ept. Approval... ]~/, ~. ................. Underwriters App royal ......... /~/ I ~.: ....... ?lanning Board Approval...~....~. ............. ~,equest for: Temporary Certificate ........... Final Certicate....~--.... '" ...... -' "CO' '~3 7~ 0 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 May 3, 1995 Mr. Curtis Horton 1835 Mason Drive Cutchogue, NY 11935 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. 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 # 21520-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOU~DATION ( 1 st } FOUNDATION (2nd) ROUGH FRAME & · ?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~c tI FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N.Y. 11971 TEL.; 765-1803 Examined ................. 19... Approved~. ~. ..... 19 .~. Pea'mit No. ~../~. a~..~ Disapproved. ale ' (Building Inspector) APPLICATION FOR BUILDING'PERMIT mSTRU6ZIONS BO,lED OF HEALTH ....... 3 SETS OF PLANS ....... SURVEY ................ CIIECK .................. SEPTIC FORH ............ CALL ................. HAIL TO: a. This apPlication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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'eets or areas, and giving a deta/led description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. 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 Buildffig Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Coun{y, 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 author/zed inspectors on premises and in building for necessary inspections.. ~. . .., ......... -- (Signature of applicant, or name, if a corporation) ...... .y...,-XZ: ....... (Mailing address of applicant) State whether applicant is owner, lessee/agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Name of owner of premises ...................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ." (Name and title of corporate officer) Builder's License No ..... Plumber's License No. Electrician's License No. ~ ........ '.. Other Trade's License No ...................... Location of land on which proposed work will be'done ...... ~. ................... ' ....................... ..... · .......... .......... Iio se Number Street Hamlet ~ CountyTax MapNo. 1000 Section ./.~...~. ......... Block ..... ~. ..... ' Lot...~..~../ ......... Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) , State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existin~ use and.occupimcy .... ·: ~?-/~, ..~..~'. ..................... . , . ..,... , .' /~ /7/ , ~'ZZ.-- ~ /_ ,~,"7-'~ (.-" ./ ~' o. intended use and occupancy.......,~..-~/'~>9..~-- ~ .... ~... ............ Nature of work (check which d~,q: ...... '. ~ i ' . . Repair .............. Re · I t · J J... er Work .............. · ' ' (Description) 4. Estimated Cost .... ~i ....................... Fee .. ......................... '" (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor· · If garage, number of cars .. i ............... . ............... 6 If business "! ........................... 7 Dimensions of existing structures ,~_v~, w~ ....~ ,,amre aha extent of each type of use · if any: Front ' Rear .............. Height Num" ber of Stories ;' :" Depth Dimensions of shine structure With alterations or.additions: Front Rear Depth ~ ~ i Height ' 8 ....................................... ,. · Number of Stories ...... · Dimensions of entire new construction: Front ......... Height Number .............. of Stories ~ Rear ...' ............. Depth ~, Size eliot: Front i Rear 10 Date of Purchase ' ' ..................... Depth ...................... · ' ......... ~ ......... ' ......... Name of Former Owner .............................. I 1. Zone or use district in which pr~mises are situated 12. Does proposed constructkm vio e any zoning law, ordina ce or regulation: ......................... 13. Will lot be regraded ...Zr'~,...-f~.~7..._.,.~ .......' ' ,-m----Will exces~ fill be removed from premises: Yes~..~,'.~.f' 14. Name of Owner of prem~ses [.f.,d,v.q.~.~.~ '.,~'ff/~--~dd~ /.~.~..."'~../-f.a;x~.~,,,Eph ?..~..~. Name · . ess. one No. of Architect .......... ~ ................ '. Address .................. Phone No ................. Name of Contractor ........ 5'. ............... Address.. . . · u f · · ........... Phone No ...... 15.' Is this property within ~ 0 eeC of a txdat wetland? *Yes ~)~... ' ......... i ~If yes, Southold Town Trustees Permit may be requir~.~'\' No ......... .... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, ~heth~r existing proposed, and. indicate all set-back dimensions from property lines. Give street and block ~umber or or description according to deed, and show street names and indicate whether interior or corner lot, ]TATE OF NECp]~K, ,~ S ~ :ou v 'i .... .......... ......... (Name of individual signin :contract) bore named. being duly sworn, depose~ m~d says that he is thq applicant [e is the ............. (Ctr ;[ate ffi ;i 'e't i .............. ' .............. i on actor, agent, cor o c , . f said owner or owners, and is duly uthorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in t e manner s~t forth in tbe application filed therewith. worn to before me this t, ,~ '. a, ~OIIO[R County O, / (?) ... ~...,t.2.. (..Slgnatlare of app cant) i Z