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HomeMy WebLinkAbout20841-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20883 Date JULY 23, 1992 THIS CERTIFIES that the building Location of Property 840 PINE TREE ROAD House No. County T~x Map No. 1000 Section 104 Subdivision ALTERATION CUTCHOGUE~ N.Y. Street Hamlet Block 01 Lot 11 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 1992 pursuant to which Building Permit No, 20841-Z dated JULY 20~ 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 ALTERATION TO ENCLOSE OPEN PATIO "AS BUILT" TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ROGER & MADELYN STOUTENBURGH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-778003 - NOVEMBER 7~ 1986 N/A / Bu~ing 'Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT COMPLETION OF THE WORK AUTHORIZED) NgN? 208~1Z Permission is hereby granted to: /~:...z .~..~....~ ............. : ......... ?.~... ..................... ...~.~..,.'~...~/..........~/..~.x.. ........... ~o ~'o,'~ ~ .o~'~,,.,,' ,'~,. .,'~£.. /~(../.,.~. ,.~..~. ............. .-~ ~/,/ ../....~::.'~.~.,..~ ........ ~....,~..~ ...... ....,~.~:~/... ..... ,/-).~../..~:~ ................ at premises' located at ......................................... a~C) ~.'.~.~.. .......................... ..~-...,,~'.....~.. ~L/, ......................................... ............................................................... ~.~.~..~.x. .... ~.,./... ........................................ ........... ...... ........ ............ County Tax Map No. I000 Section ..... ./...~..~.. ......... Block .....~..~.. ............ Lot No ....... ../'.../. ............ pursuant to application dated ................. .~/.../...~.. ........................... , 19./~...~..., and approved by the Building Inspector. - //~Gildlnjl Inspector Rev. 6/30/80 Form No. 6 TOWN OB SOUT[IOLD 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 them 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 Cesponsible for the building. 6°, Submit Planning Board Approval of completed site plan requirements. 3. For existing buildings (prior to April 9, 1957) non-c~nforming 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 ~w Construction ........... Old Or Pre- existing Building. ... Ilouse No. Street Hamlet iwer or Owners of Pro~ert~,~ ~ %.~..~~ unty Tax Map No 1000, Section..j.~.~ ....... Block..j ............. Lot..~l .................. dzvzszon ...................... . .... Filed Map ................................ ......... Lot rmit NO ................ Date Of Permit, alth Dept. Approval ......................... .~.~. · Underwriters Approval ................... arming Board Approval ...... ]uest for: Temporary Certificate ...... Submitted: .............. ..... Final Certicate....~... .... ~ APPLICanT '! ............ z13§o2! ....... ' "' .... 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',. ,~. jW .1~ . h Ho~'r:oN ROAD '1 7'2.. ~o~D TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR TOWN IiALL SOUTI]OLD, NEW YORK CERTIFICATE OF OCCUPANCY NONCONFORMING PREMISES THIS IS TO CERTIFY that the /R -~ / / Building(s) /_-/ Use(s) · C.0.~Z12907 Date October 50 Hortons Lane located at Rko P~n~ Tr'o~ R¢~a,] Cutchof~ue' Street Hamlet shown on County tax map as District I000, Scctiou 104 , Block 19, 1984 Lot 11 , does[not)conform to the present Building Zone Code of the Town of Southold for the following reasons: I~,qufficient Total Area, On the basis of information presented to the Building Inspector's Office, it has been determined that the above nonconforming ~_X/Laad /--/Building(s) /Z/Use(s) existed on the effective date the present Building Zone Code of the Town of Southoid, a'ad may be continued pursuant to and subject to the appli- cable provisions of said Code. IT IS FURTHER CERTIFIED that, based upon information presented to ~t~the Building Inspector's Office, the occupancy m~d use for which this Certifi~ ~'~ ('~__~.~,..#2569.~Property is situated in h-Residential-Agricultural zone' with access to Fine Tree Rd. & ltorton Rd; two Town maintained roads. The Certificate is issued to Ct'l- _ail_q_ Jpan [4. GrJ. me~ (owner, of the aforesaid building. Suffolk County Department of Ilealth Approval N/A UNDERWRITERS CERTIFICATE NO. N/A NOFI~L IS IILREBY GI\EN that the ownex of the above premises HAS NOT CON~ENTED TO AN INSPECTION of the premises by the Building Inspec- tor to dctdrmine if the premises comply with all applicable codes and ordhl- ances, other than the Building Zone Code, and therefore, no such inspection bas been conducted. This Certificate, therefore, does not, and is not intended to certify tba[ the premises comply with all other applicable codes and regula- tions. Buiidin~ inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL -7~D.-1802 """' Disapproved a/c .... . ............................ ~ .... ,. ................................ ~uildin, Inspector) ~PPLICATIO~ FOB BOIkDI~G PfiBMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC fl:ORM .............. ~LL )'V'KT~. J~- ~-~7~- ( -~%~. · ....... ,a. Tlfis 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 insp~cti~. ~ j -- (Si me, if a corporation) .~?...~..~.~ ._.3. ~.~..e.~/..~.~.w'.,, ~.-/.//.e. ~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ):~ c. Name of owner of premises .~.~ ..d~..~../~..,~. ~ .~.~ .,~..c:.~.t>(....~."~.o..~.~"..~..~..~..~.4.~..~ ...................... (as on the tax roll or latest deed) APPROVED AS NOTED If applicant is a corporation, signature of duly auth~orized officer. Builder's License No. ; ........... ~.. U: E'B'U qLAWFUL Plumber's License No .......... li~i~t,~l.~r Electrician's License No...~.r ~ ~'*~. ~ .'~.~ ~. CERTIFICATE ........ O[ .OCCUPANCY ~EE: ~'~ Bv'.~.~ N~I~ BUILDING DEPA~MENT AT 765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPE~IONS: I. FOUNDATION - ~O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION FINAL CONSTRU~ION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET Location of land on which proposed work will be' done .................... .T.~.[.. ~..Op!a.i.M. [~N.Tlil..OF. .Tt:II~. N.Y... · "-' IP._& ~ -- STATE CONSTRUCTION & ENERGY .... .~.~.q.. i K*..~.~..T,&~.~. ~ ...... ..~. ~ .t 9..~.~. e ~ v: ~...c,.o...~tg'...t..~9.~...~.~ .s.~.o.~.s.~ .~.~...ma.. ttouse Number Street t~aF~t~.~ OR CONSTRUCTION ERRORS County Tax Map No. 1000 Section . .,/..~.~. .......... Block .../. ........ ;;d... Lot'.'././. .............. Subdivision: .................................... Filed Map No ............... Lot ............... (Name) State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy b. Intended use and occupancy .O.t~..~. 3. Nature of work (check which applicable): New Building Addition . .t~.. ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .~.~) e' a o o o (Description) 4. Estimated Cost ........ 2. ! ...................... Fee ...................................... ,: (to be paid on filing this application) 5. If dwelling, number of dwelling.]units ...... ,~.. ....... Number of dwelling units on each floor../. 1' ./.qt%..~(.. ..... If garage number of cars ,g/(i/,' t,l.~; 6. If business, co,mmercial or mixeq' occupancy, specify niiture and extent of each,type of use ........... ~ ......... 7. Dimensions ot ex/isting structm;es,.if a~t~n~. ~,~ ......... Rear . .~.~.. .......... Depth .~..O.. . Height ... ~.~. ......... Ntinqber of Stories. '~.$~ (.*.~f(~ ........ i ....... Dimensions of same structure :~vtth~alteratlons,or ~diti'~ns' i~,-*,* ' 3 77 ............ '~ ....;t'--3 ~ ............. 8. Dimensions of entire new construction' Front ~ ~-- ', ~ -- - ' ...... ' ...... Height ... ~.~:':'772 ...... Nun3ber of Stories..-~.~-,~.%-..... ....... ~... :~ .-. ....... ' - 9. Size of lot: Front .../.~.~./... ........... Rear../~.~..~ .............. Depth ~ t.~':~ t ....... 10. Date of Purchase ../.~.F~;...i... ·: ....... ... ... Name of Former Owner . ~. . ........................ 1 I. Zone or use district in which pr6mises are situated 12. Does proposed construction violate tiny zoning law, ordinance or regulation: .... .A(..g;I ......................... I3. Will lot be regraded .. ~.0 .... I' ..... i ..... Will excess fill be removed~fr~.~p~re~mises: Yes N~) 14. Name °fOwner °fpremises g.q'o.~.' i $iq~.d'~.'v[~.'~'.' i'Address ~.ga. .................. '~'~'~ ~* ~ne No2].~.-~.~/.4. ...... Name of Architect .....'577~.. F. ........ ' ' ' Address ................... Phone No ................ Name of Contractor - ... ;--I .... Address ................... Phone No... 15. Is this property within }00 feet of a tidal wetland? eyes ....... g'"~o~ ...... · If yes, Southold %own Trustees Permit may be required. ~ '' PLOT DIAGRAM Locate clearly and distinctly all I buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ~.umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~K-.-- . ' covey OF ...... .... k ' ..... ~ ~r..Or. ~.~.~...{,.qr.?.. ~. ~ .................. being duly sworn, deposes (Name of individual signi~}g contract) above named. and says that he is the applicant He is the J ]~- (~ t,~t4 l · (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyiauthorized 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 ~et forth in the application filed therewith· Sworn to before me this · .... of. .. 19 e.