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HomeMy WebLinkAbout21736-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Mall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22859 Date FEBRUARY 2, 1994 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 1765 VANSTON ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 6 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 12 1993 pursuant to which Building Permit No. 2173(-, dated OCTOBER 27, 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 DECK ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM P. & ELLEN T. VOGEL (owners) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM N0,3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT 001'j,t IS PE)2MI MUST BE KEPT ON THE PREMISES UNTIL FULL CO PLETIbN OF THE WORK AUTHORIZED) Date....` ......................................• 19!` ... N® 21736 Z Permisslon Is hereby granted to: ...... . ....T..... ' ........ ?. . 5' ............ ..........................•. ... .. .......................... x to ... .... ........ .... kd'rJ•...,.. i .......lX C! ............ ....... ..... . :s. ... •..... ehky -. E .u...•. {$ .a.......... ......... .�... ` � ... .....� c t _ ....................... ..........7C..G1` .. a: . .. ........ .. .. ....... at premises located at....l.. ..�t.S........1/d ..... .. .. ... .................................... County Tax Map No. 1000 Section ...../ ............. Block.......... ......,..... Lof No. ,...,. ,...,........... pursuant to application dated •. ••""' 19" �� ' and approved by the Building Inspector. Fee$•• V - ./... .�.i i. ii ii 11 X11111111111111111111/11111111 BulldIng Inspector ' Rev. 6/30/80 Form No. 6 7'j-j-/- D p 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. 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, 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date New Construction. . . . .`�. . . . . o7Old Or Pre-exis�tiipg Building.. . _ r Location of Property. . . . . . `AXr. . . . . . . . . .{ ,..` v-.; �. .'J. . . . . . . . . . . . . . a7�cf7� ./� . . House No: ­ o. j�� / Street jHamlet Onwer or Owners of Property. . . . . . .`:.'/[�;tm , , ,�rG 21 , , , Y .�,�' " . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . ./!. . . . . .Block. . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . Subdivision. .. . .. .. . .. . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot . . . . . . . . . . Permit No.rL1_A6. . . . . .Date Of Permit. �dIYJ��3. . . . .Applicant. . Health Dept. Approval. . . . . . .A/, , , , , , , , , , , , , , , ,Underwriters Approval. . . . . ,, , , , , , , , , , , , Planning Board Approval. . . . . .41'�, , , , , , , , , , , , , , Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . '' . Fee Submitted: $. . . . . . . . . . . . . . . . .. . . . . . . . . . . . / . '. . . . . . . . . . . . APPLICANT - . IELD I;;Si DS: U;J JJUAi_ I� OPiMENTv m v FOUNDATION ( 1st ) FOUNDATIOIJ ( 2n d ) 2 . z\ ov ROUGH FRAME & �\ PLUMBING Co 3 . Hx m . IIdSULATION PER N . Y. , , y 9r F �\ STATE ENERGY CODE x a 4 . FINAL / % �'� L Plies �, Ct/, e f _ ADDITIONAL COMMENTS : x �§ 3 x \H 1, � tV . y V H .> S 9 v y Y, - 4r— rti4 ` . �nJ\7�\ Z�cl '' FCcY- ``�C'• ` ?` F.k4o i r - — cQrF.^EF, 24,3 ; .F �- Zi.PAKh IY' M�a D7 Ln, N t..s sere -'-'.IPn er c r I vKn �Liu 7 n r " ,n P fY 1 —-\j ocari3n Na, Law. a Na,roe M. C t� P c /T••�� Ehc-0+=,of this s,,bsr n„» rr Ct!°C'{EV i CQ em;a.'sysssslnr-'nt'ia�:o,�_ & to.+e• G ire s•",a1!A3 N»P;,nsi:.O � f .._ _ avair uc ec : inacae_ s Jn rhe Demon 6 Karver,s`,atr run i'w i r ,� —.-- - / is Preu3n_1.antl t'Vlyenrhrsxrtral.ho t` rsi fafw.Ofn'�int.go r niPnL?{ o n'!.ii,v ' 4r'.A^c,"` a. Y iii GT to tmfce '"^^>•'a&s af,h ) h ,n;•? .`JJ sa�snglevr s 6L374(2WTEEti To 7DRAZ AB5T?1,C1' (1JuF, TTl(kf� MIDi_,A•ND TJARTG14�CsE C fZp. — NOTES: A 3JQ�tEYEG J4! t�' F, GT ,rs5.QEFER.7; MAP SEcT. Z -- 4Ar5hl: 0ih1T TcY�{SBdiKV 'AN TIJ�j rP..0 . CLUB PlrPEfc"IES�NG `lLES7 IN Tf E 1)FF_vL4` tO. r' C-LE CS OFFS E AS MAP NO,o` i$ Y 2•^rJFe. CC,iA31 SAP GA'A_1^�A'-1I�_6- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ON [ ] FRAMING FINAL REMARKS: b o zer i 1 r r k DATE j �� /-INSPECTO i M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING tA-IiINAL REMARKS: DATE 7L INSPECTOR ) BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLAYS . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 MaTIFY ; _1(A LL _ . . • • . Examined .IQ/,J%;�. . . . . . . ., 19 ,:p MAIL TO : Approved ./o .�. . . . . . .. 159.'.x. Permit No. . : 7 . . . . .. . . . . . . . . . . . . . . . . . .. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . / i (Buildi Insp or APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . 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, 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectiof S. . . . . , . . . . . . (Bieo n ture of applicant,or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. © . . NZ^� 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) ' Builders License No. . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .��!r/w < . . . . . . . . . . . . . . . . . . . USG . . . . . . . . . . . . .: House Number Street / Hamlet County Tax Map No. 1000 Section . . . : .//'/ . . . . . . . . . Block .`. . W. . . . . . . . . . . . . Lot . . .J. . . . . . . . . . . . . . . . Subdivision . . . . . . . ... . . . . . . . . . . . . . . . .. . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . : . . . . . . . . . . (Name) 2: State existing use and occupancy of premises and intended use and occupancy oflpr posed construction: a. Existing use and occupancy . . . .. . . . . . . �. . . . . ?!! Z`IZ. . . . .G �.� . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ) • • . • . •: New Nature of work (check which applicable Building • • • • • • • Addition di / . . . . ". . . . . . . . Alteration Repair �,+ . . . . . . • • • • • , . . . • . . . . Removal . . , , , , , , Demolition . . . . ; . . . . . . . . . Other Work . . . . . ... . . . . . . . . - (Description) 4. Estimated Cost . . . . , . .?cv-p . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling'iunits . . . . . . . . . . . . . . .. Number of dwelling units on each floor . . . . . . . . . . . , . . . . If garage, number of cars . . . , : , . . . . . . . . . . . . . . . . . . . . . . 6, If business, commercial or mixed occupancy, specify nature and extent of,each.type. .of.use . • . . . . . . . . . . . . . . . . 7. Dimensions of existing structure's, if any: Front . . . . . . . . Rear Depth . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . Dimensions of same structure with alterations or additions: Front • • • •. • • Depth . . . i . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . Height . . . . . . . . . , :. . . . . . . , .. . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . ; Rear . . , , . , . . . . . . . . . Depth Height , , . . . . . . Number of Stories . .. , , , " " " " " " 9. Size of lot: Front . . . . . I . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . .Depth. . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which re' 10. Date of Purchase , , , , , , ,,, , , , , , , , , Name of Former Owner . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . Premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • g ate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded ed P • • • • • • • • • • • , • . . . . Will excess fill be removed from premises: Yes No 14. Noma of Owner of construction remises viol • • . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . : . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . ... . . . Name of Contractor . Address . . . . . . . . . . . . . . . . . . . Phone No. 15. Is this property within 300 feet of a tidal wetland? *Yes, , No. . If yes, Southold Down Trustees Permit may be required. 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 dumber or description according to deed, and show street names and indicate whether interior or corner lot. OPP OV AS NOYED Ip.:r,a,�: �� 73 6'F-18P2 &'S AM 10 4 PM FOR THE � I a')t.t C3SAltY�t1 lfuf3R�F4:'TlfJI�S. 1. FCbE,J;AfiiATlCShf • 'iWOREI'1UIRED FOR POEIHED CONCRETE . ROUGH . FRAMING & PLUMBING 3. 1a SULATION 4. FINAL • CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION Ik ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YOR COUNTY OF .. S S (Name of individual signin•Ig• �•G contract) • . . . . . . being duly sworn, deposes and says that he is the applicant above named. He is the . . . . . . , . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly iauthorized to perform or have performed the said work and to make and file this application; that all statements contai ed 'in this application are true to the best of his knowledge and belief;and that the ,vork will be performed in the manner�yet forth in the application filed therewith. Sworn to before me this . al. .z . . .". . .day of. . . .. . . . ., 19 R. Votary Public, �4epVs/. .� �f�CQunty HELENE D. HORN R, . Notary Public,State of Now York' No,4951364 (Signature of apple t) Qualified in Suffolk Cqunttyy ��,,115�r Commission Expiras May 22, t9 L; I I DRAwWG- t3y QmT PR - �I leu, 4Jt�voous I f / FRONT /Gb + rJTgI' Pr b if� 4 i � DE:JC SASGS Q7 .4�2�iL j � I i, / qz� CwiceE.e S*sr5 I Y__