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Home My WebLink About21580-zFORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22507 Date AUGUST 6r 1993 THIS CERTIFIES that the buildin~ ADDITION Location of Property 275 SOUTHERN CROSS ROAD CUTCHOGUEr N.Y. House No. Street Hamlet CountF Tax Map No. 1000 Section 110 Block 5 Lot 31 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27~ 1993 pursuant to which Building Permit No. 21580-Z dated AUGUST 6~ 1993 was issued, and confoms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWR~,LtNG "AS BUILT" The certificate is issued to SUZANNE CARROLL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A "Building Inspector Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOID, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 21580 Z Date .............. ~..~.. ................................. Permission Is hereby granted to; ..~..'.z~ ........ ~.~. ~.... ~...~Y.. ....... .~..,..~.~..,., yy ~,...~.~ .......... ~ ........ ~..-..~ ....... ~.;ii~.>'i.iiiii,'ii~.;.'.'i.'.'.'iii~;~ ...... ..,..~......~... .... ~..~ ......... ~..;.~ ....... ~....~...~L(~ ............ ~.....~(~.-..~.......-~.-c pursuanf 1o opplicot~on dotod .............. 7./~...2. ............................. 19,...~-~.. ..... and opprovod / Building Inspector. ,~:~ F~ ,.....~: ............ Rev. 6/30/80 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ..... ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ TOW'q?.:: A. ~is. vapplication 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 user 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 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 o~ Occupancy on Pre-existing Building - $100.00 3. Copy of C~rtificate 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 0g~ ~6~ ,19.9.3. ........... existing New Construction, ~e£k- ..... Old Or Pre-existing Building ................. LocJtion' of Property,~..~...Sp.u.~.h.e.r.n .C.r.o.s.s .R.og,d Cutchogue . House No. Street Hamlet Suzanne Carrol I Onwor or Owners of Property ................................ County Tax Map No 1000 Section ..I1.0. Block,...5 ........... Lot 3.! ....... Subdivision .................. ,, ,, ,,,,,,,,,,,,,,Filed Map ......... ,,, Lot ................. , ,, , , Permit No .............. .. Date Of Permit ................ Applicant ......................... . . .. Health Dept Approval ....... Planning ~oard Approval ............. ;.. .. Request for: Temporary Certificate .... '' Fee Subm' ~ ~ 25.00 ..... Underwriters Approval ........................ . ........... Gary F]anne '-OFSenTlsq.' P 0 Rn× 706. CHfrhnnu~ NV 1 ]a~ DONALD J. TASE, L.S. -- SUCCESSOR TO ~ RICHARD WILHELM ~,N~ASSOC~A¥~S LIC~:HS[:D LAND SUf,IV[:YORS ~ - ~,~;;.~-~;~.. ........... GARY FLANNER OLSEN COUNSEllOR at LAW P.O. BOX 706- MAIN ROAD · CUTCHOGUE. LONG ISLAND. NEW YORK 11935 · PHONE 515-734-7666 July 26, 1993 Re: Carroll to Lobosco Our File # 5576 Gentlemen: Enclosed please find a building permit for an existing deck, along with an application fee of $75.00. Also enclosed is an application for a Certificate of Occupancy for a deck along with a separate check for $25.00. I have been advised by my client that the deck was part of the original house, but when the Certificate 9f~upancy was issued there was no reference to the dec~. A c~py of Certificate of Occupancy Z5809 is enclosed~The real estate broker is Marion R. King Realty, Bob Scal~a, 734-5657. / GFO.lmk Enclosure Southold Town Building Dept. Town Hall Main Road Southold, NY 11971 DONALD J. TASE, L.S. -- SUCC~:SSOR TO -- RICHARD WILHELM A~OASSOC~,rlS LICENS£D LAND SURVEYORS T.,. ~,~o ~ / = i .n:; FORM NO. 1 TOWN OF SOUTHOLD ~.b 7 "::' BUILDING DEPARTMENT ' TOWN HALL 8OUTHOLD, N.Y. 11971 ~:L:: ,, ::,,., .... TEL.: 765-1802 Approved ........... Disapproved APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY CIIECK SEPTIC FORrl CALL HAIL TO: Date ,~U]Y..~ .......... 199.3.. ~ INSTRUCTIONS a. This apl~lication must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 ~ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and o£ btiiId~ngs on premises, relationship to adjoining premises or public sfi-eets or areas, and giving a detailed description of Iayout 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 Departm6nt for the issuance/df/"a Build!rig Permit pursuant to the Building Zone Ordinance of the Town of South01d, Suffolk County, New York, anti other appllcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for rem~Sval or demolition, as herein described. The applicant a=rees to comply with all applicable laws, ordinances, building corfu, housin~o~ie~ and reoulations, and to -- (Si=nature 9f applicant, or name, if a corporation) Suzanne Carroll' by G~ry Planner Olsen, Esq. ' P. O..[l~x .ZQ6..Ma~ ~Rd...Cutcha~ue,./rY..1.1.935..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Attorney for owner N~ne of owner of premises Suxanne Carrol 1 (as on the tax roll or latest - :' ~ ~ · de,ed If applicant isa corporation, signature of duly authorized officer. NOTIFY BUILDING DERARTMII~T AT U~'- t'~ , ,F%~". ,~"~..I ,, ,--m~..I I/U~LAWi. UL 765-18029 AM TO 4 PM FOR THE Builder's License No FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED Plumber's License No ......... IMIT It HT. O 'DTII IO tITle' FOR POUREDCONCRL~'E ' : .2. ROUGH - FRAMING & PLUMBING Electrician's License No ....... ~,. ,~,~,~,,~, ~,~,, 3, INSULATION UUUUFANUY 4,FINAL CONSTRUCllON MUST Other Trade s Lmense No ...................... 8~ COMPLETE FOR ALL CONSTRUCTION SHAll ME~T $~ATE CONSTRUCTION & ENERGY '~'7~. ' Southern Cross' Road ' ' CtltXI:~UeqOT REsPONSIBL£ FO" ' ltouse Number Cou'nty Tax Map No. 1000 Section 11.0 Block 5 ' Lot...3.1 ............... Subdivision ........ . ............... · ....... ~ ...... Filed Map No ............... Lot ...... : ........ (Name) . Statd existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... '...~.x.i.s.t.i.n.~ .d.e. qk. .................................................. .. b. Intended use and occupancy ..................... · ................ . ........ : ...................... ex4sting · 3. Nature of work (check which applicable): New Building . ~ ........ Addition . .d.&c.k. .... Alteratio*n ... ;.... ~.. Repair .............. Removal .............. Demolition .... : ......... Other Work ........ '.. ~'.~... · ~ ' .- .' ' . (Description) 4. Estimated Cost .................. 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 ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use ..................... 7. Dimensions of existing structures, 5f any: Front ............... Rear .............. Depth Heigkt ............... Number of Stories ........................................................ Dimensions of shme structure, with alterations or additions: Front ................. Rear .................. Depth ....................... Height .......... : ........... Number of Stories ........... 2 .......... 8. Dimensions of entire new construction: Front .............. ; Rear ............... Depth ............... Height ............... Number of Stories ....................... , ........................ >. Size of lot: bront ......... , ......... ~... Rear ...................... Depth ...................... 10. Date of Purchase .................... ' ......... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ....... . .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ I3. Will lot be regraded ....... '. .................... Will excess fill be removed from premises: Yes ' No 14, Name of Owner of premises .................... Address ................... Phone No ............. :.. Name of Architect .............. , ............ Address ................... Phone No ........... .:..;.. Name of Contractor .......................... Address ................... Phone No .......... "' ' '.r ' 15.' I.s this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southoid Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a/l buildings, whether existing or proposed, an&indicate a/1 set-back dimensions from property I/nes. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. See attached survey ST,~;rE OF NEW YORK, cOUNTY oF.S.U.F.F, qL.K. ......... S.S ......... '..Gary. ~.i.~B.eY. ~.¥9B.,. ~Sfl, ...... . ......... being duly sworn, deposes ~d says that he is the applicant " (Name of individual signing contract) above named. He is the..~..attQnneg .tqq .S. Kz.qn.ng. ~.ayyg.l.1. (Contractor, agent, cor'porate officer, etc.) 3f said owner or ownem, ~d is duly ~thorized to perform or have perfo~ed the said w~nd to m~e and file this 2pplication; that all statements contained ~ this application are tr~,e to the best of his ~wledg~ and belief; and that the ~ork w~l be perfo~ed in the manner set forth in the application filed therewith./~' _/ . ~wom to before me this . . . 26 . duly . 93 / / ........................ ..................... ~ ~.~' / ~ .... ~";'"'~ .......... ";2~"t .... ;~ ','" U / ...... ~am _ · t~gnature Ol appdc~r