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HomeMy WebLinkAbout20635-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21132 Date NOVEMBER 6, 1992 THIS CERTIFIES that the building ADDITION Location of Property 975 HORSESHOE DR. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 95 Block 4 Lot 18.30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 13 1992 pursuant to which Building Permit No. 20635-Z dated MAY 18, 1992 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 TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RUSSELL & MARLA ZELLNER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A c ildng5 Inspector Rev. 1/81 YORK NO. S 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) N°-1V'° 20635Z Dare ~ /zr I9'.;;~ Permission is hereby granted to: 97............. to 4........ . ........t~.....~1 ~i ...d9y.. at remises located at ....01..7,7 .k Kr...... County Tax Map No. 1000 Section ,1... Block ple-/I. Lot No......./.. f:...7.. i pursuant to application dated ......".,l/ . 195.7.2,--and approved by the Building Inspector. ? Fee 3.... . ` . B din for E i 4 Rev. 6/30/80 f E Form No. 6 TOWN OF SOUTHOLD NOV 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}sed in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences ancf 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.' 1. 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. 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 :w Construction....... -Old Or Pre- e "stping BuUi(l((ding :cation of Property :...:..kJ5 .........lY.. QJS.Q~nCra~I/ C~ I•„C 7~ /t House No. Street y' p Hamlet wer or Owners of Property... 4.• unty Tax Map No 1000, Section ...0g6y;' ,Block... R.4.. e.'7 .......Lot... l.c..~............ "division...........................:...... .FFilled Map............ Lot.. _it No.... rV~Q S... Date of Permit... ~ Applicant. 11th Dept. Approval ..Underwriters Approval.....,,,,,,, :nning Board Approval........ uest for: Temporary Certificate....., Final Certicate..... Submitted: (1J LCD SO ~I~. y . C O a cZ J~32 APPLICANT d.. DATE jl UAti4(NT° _ - H Cdd FOUNDATION (1st) I c FOUNDATION (2nd) 2. I z o ~ ROUGH FRAME & .PLUMBING ti 3. ~ Di m INSULATION PER N. Y. STATE ENERGY CODE I x~ ° I o ~C,~cr~ic FI:JAL ADDITIONAL COMMENTS: x H ~ r H H O t' . x - m • r~ H H 76S-t802 BUILDING DEpT. (]FOUND INSpECT eoN AT ION 1ST FOU ( ] ROUGH pLBG. NDATION 2ND INS ( ] FRAMING LATION FINAL REMARKS: DATE INSPEarOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING FINAL REMARKS: DATE INSPECTOR l l 44>I.1~~fi..a...,`.' BOARD OF HEALTH FORM NO.1 3 SETS OF ANS ?;J~^ TOWN OFSOUTHOLD SURVEY~ f 5 MAY 1 1992 BUILDING DEPARTMENT CIIECF - i TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 HL~ ss, Y d~S;~'~°'¢;'t"sts~ 1 TEL.: 765-1802 t:aTIFY; TOWN CALL Examined <J ...,R, • • „ 19 MAIL TO: Approved/" 19 Permit No. PIP rq :2~ Disapproved a/c 2(B lding specter) APPLICATION FOR BUILDING PERMIT Date qy 19C?.~ 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 nece, inspectio ~J f • y . C~JGU~. K~ . (Signature of pplicant, or name, if a corporation) (Mailing address of applicant) 3.5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. I..............55...~! / ! f..... ../...(?J~: Name of owner of premises 13~(t..;? -4 ! O?VL. (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. Qi. 0 Plumber's License No . <57 Electrician's License No . Other Trade's License No. y 1. Location of land on which proposed work will be done. . q?,~ .o2s ..1~2~'ct e House Number Street Wmlet ! J County Tax Map No. 1000 Section !295 Block Lot d Subdivision 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 ....SC.N. ~/,0 .....(.R e . b. Intended use and occupancy3 ,P. - •i~T y . F •p 1,• . ~3~ . qlO 3. Nature of work check which applicable): New Building Addition Alteration . Repair 'val . Demolition Other Work 'be CA (Description) 4. Estimated Cost ` lp 0 0 Fee ...`s0 (to be paid on filing this application) 5. If dwelling, number of dwelling nits 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. inhtS1 existing lN.ple S~A/l tru Nums> if any: Front ....f{. r. Rear Depth He it , , ...N berofStories....../ Dimensions o ti s th alterations or additions: Front Rear . Depth Height ......................Number of Stories ...............I . 8. Dimensions of entire new construction: Front Rear Depth Height . • . . .Number of Stories . 9. Size of lot: Front . . . . . .T..e? Q . Y Rear Qj~ X0,9-~ Depth 7~u~-.O n 10. Date of Purchase ; I, , , , , , , , • • , , 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: /,vQ..... , . regraded • • • • , , ll excess fill be removed from premises: Yes No 13. Will lot f Archit uSS. ?~!7?F~/L~ ~ ~ adiess ii!~ 14. Nameof Owner of premises . Name o 9Y~~ Phone No. l~v ..7. x./70 00 Name of Contractor , 12 J/ Address Phone No.....'!......... . Address . . Phone No. 15. Is this property within :00 feet of a tidal wetland? *Yes No j~ o *If yes, Southold Town 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 number or description according to deed, and show street names and indicate whether interior or corner lot. , II II I ~I STATE OF NEW S.S COU Y OF . OS~ (Name of individual siting` . . ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant contract) tbove named. r le is the © ?f.-W (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in the m ner sit forth in the application filed therewith. ;worn to before me this ............C3~ .day of . .rI r119 lotary Public, .I,, . - Count ~l ppg~ ~p, 24 M! AkYPU 1. KY (Signature of applicant) lIo.4M~9 "uulfogt term Expites'AI®y 31, W ~U5S~-~nr RtA Z2Il~tl' / h~2sesf,oe s)2;v 73U70 6 6 .a s \ O 'X e \ IJIDO ~0 0 ell • O 22T ~ 60° K + 13 N 32 \ `r s: ~NZ t \ LA. 0 r 35 10 N bAe a9 d 61 s' Q 5~+ in o e~ p SfK es.e415 owu . o A •~F'S yAe a 0. pQ ~ ' ~M LOT 30 / v Paso : e `0 ID Self cv~fJazCe o k plb N .p . <T tS~ o i ~ - 2 Z ~ .y ~ Zm 4 ti n Il-j.N o _ h ~"I ago ~Py6 O v LOT 29 N P SAO ~ \ • V~ vy / 3p. aO r v 00 qG e ata'~ SURVEY OF <ry o ro F ~ s set LOT 30 401 4'q~ k " MAP OF OREGON VIEW ESTATES" yiF FILED APR 4, 1975 FILE NO.62 41 AT CUTCHOGUE TOWN OF SOUTHOLD AREA 49, 297 SQ. FT. SUFFOLK COUNTY, N.Y. 1000 - 095 - 04 - 18.30 CERTIFIED TO: SCALE 1" - 50' FIRST AMERICAN TITLE MAY 9, 1986 INSURANCE COOFNEWYORK JAN. 16, 1987 LONG ISLAND MORTGAGE CORP. RUSSELL ZELLNER FEB. 5, 1987 MARLA ZELLNER MAY , II, 1988 ( FINAL ) Prepared in accordance with the mirMbm / standards for title surveys as eN°blishod by / i ~l the L.I.A. L. S. and approved and adopted for such use by The New York Stare Land ?~~O LAND rG9 N .Y.'S. L IC . N 0. 49 66 8 Title Association. .._PL Q 171 c S 8 ENGINEERS , P. C. 1' 16) 7 O ELEVATIONS ARE REFERENCED R n * TO AN ASSUMED DATUM. M 1q 6e$ Q~ THE LOCATION OF WELLS B CESSPOOLS SHOWN $0 `k 119711 _fawnd roc. 6-2?-467 HEREON ARE FROM FIELD OBSERVATIONS 'AND DATA OBTAINED FROM OTHERS- .86 -261 I I I I I I I I i ~ I( I ~ I I, I ~ I . ..q i , I a F S~N~j f ~r. - IC I o ON -P i _ y - ~ 01 I I I ~ I ~ r I , ~ e I S' I -•Ta Zw , to CIS ~I I I ~ I (it, Nj I I I ~ i~ i I I I I ~..a NI i I I ~I ; I` j I 0 I I I i- . I I _ I _ I I I iC I s I ~ ~ _ I CTL n i ara ! i ~ - I I I ~ it n I I tw ~1 , a I o 41 II { O t` \ 1' S I I , I 1 I I I I i! I ~ i, I~ i l ~ ~ I I I I Y j 1 I O !9 U) -4 }v fi> ter Vie) °n -a -n sS .immr-nC)C ~rri~ m C) m woojCc:oc -00 MOO >XOuZ M M C: 4i\41 j r.. i C.° -0 'm. 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