HomeMy WebLinkAbout18215-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219071 Date MAY 22, 1990
THIS CERTIFIES that the building DECK
Location of Property 472 LINDEN AVE. CUTCHOGUE
Houee No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 03 Lot 2.41
Subdivision COUNTRY CLUB EST. Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 9, 1989 pursuant to which
Building Permit No. 182152 dated JUNE 15, 1989
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 CONSTRUCT A DECK AS APPLIED FOR.
The certificate is issued to LINDA B. WARREN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
C
Building Inspector
Rev. 1/81
goaae< xa 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° 8 ~ 1 rJ Z DateC//~~.~!/..r.?.'1~.~.........~.~..........., 19.17...
Permission is hereby granted to: ~f,~~
to
of premises located at ..........~..j .1.. 1....p5.......~r^~..~.r.~~.......
..........................................................~1...~...3.5................................................................................
County Tox Map No. 1000 Section Block .....Q~......~jLot No....cz'..:..G~I...
pursuant to application doted ..Ci~~~,.111.!!la..~............G~ 19.C1..~ond approved by the
Buildfng Inspector.
Fee S.•~d..
Buildfng Inspector
Rev. 6/30/80
Form No. 6 ~ ~ ~ ~ n ~ ~ (j
TOWN OF SOUTHOLD ~j
BUILDING DEPARTMENT ~ 3 Q YfMf u
TOWN HALL
765-1802
TOWP1O SOEUTldOLD
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 - ResidentiaQl $15.00, Commercial $15.00
Date ../.1~r:t.~':...~~~.~.~9.~~.......
New Constructions" . Old Or Pre-//existing Buildin/g
Location of Property.. ~ .........4. ! ~:f; !'J.... /:'t ~ ~ cf d;c W~.
House No. Street Ham~Yet
Onwer or Owners of Property...~.l.h~+n.....f~3 f,. ~(a'„j`;Y.;I~yy~'A
County Tax Map No 1000, Sectio~n...~.-Q/--I......Block....Q.J.........Lot...k'~.:.7./............
Subdivision.C4u C~:~. ~1. i.; ~ . G. ~'-.l. .....Filed Map............Lot .
Permit No.~~.c~f.~-,,,°'--,,,Date Of Permit.~~kh.~.1~?~~:~.Applicant
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporrary Certificate........... Final Certicate...~......
Fee Submitted: $.,tY;y,~,U;~,,,,,,,,,,,,,,,,,,
S/zz/~io ~
C U Z ~ 967 APPLICANT ' .
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765.1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSU TION
[ ]FRAMING [ INAL
REMARKS: - C~
e
DATE ~ I l~ INSPECTOR
. ~
765-1802
BUILDING DEPT.
1 NS~PECTION
[ FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ~ FINAL
REMARK~SQ~:,,~~,~! ~ G~~~~~
e
` , ` 'V
DATE 9 INSPECTORS
~ ~ T65-1862
BUILDING DEPT.
INSPECTION
[ ] FO DATION 1ST ( ] ROUGH PLBG.
( FOUNDATION 2ND ( ]INSULATION
[~RAMING [ ]FINAL
REMARKS: --~~r
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6
DATE INSPECTOR -
r
B0.\RD OF HE.ILTH
FORM NO. 1 3 SETS OF PL.1NS , , , , , , .
SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FoRCt .
TOWN HALL
SOUTHOLD, N. Y. 11rJ71 NOTIFY
TEL.:765~1802 CALL
L•xamincd 19... PiAIL T0:
Approve/~.fi.~1~C....~ 19~L Permit No..I.~ ~L~~ .
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
- Date h...l~.,....., 15W.f'~
INSTRUCTIONS
a. Tltis 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 tftis 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 shalt be occupied or used in whole or in par[ for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Bui]ding Department for the issuance of a Building Permit pursuant to the
3uilding 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.
Tite applicant agrees to comply with all applicable laws, ordinances, buildinc code, housin; code, and regulations, and to
~dmit authorized inspectors on premises and in building for necessary inspectio s.
. l~ ~i ~ ~ _
(Signature of applicant,/~or name, if a corporation)
• • • • • • ailing addre~f applicant) ~ •
State whe~tAh[,er,,a'p^pl~ic~a/n~/t ~isno~w"ne~r, l'e''sse~e,
agent, architect, engineer, general contractor, electrician, plumber or builder.
Vame of owner of premises J~ ,...l~V ~CJL?,P~~~._
(as on the tax roll or latest deed)
IC applicant is a corporation, sign~~tur~ejof duly authorized officer.
(Name and title of corporate o//f//fi~c/er),[~ "
Builder's License No. .....~3Q .7. •
Plumber's Liccnsc No . .
Electrician's License No . .
OtherTradc's License No .
Lojc~ation of land on which proposed work will be done.
douse Number • • • •
trccf Hamlet
County Tax ~\tap No. 1000 Section ~ Block , , , Q 3
~~((J~~ p Lot . /J )
Subdivision .~O.4t.n~f: (~h~L,Gi ,,.~,5~~-~... Filed ~fap No. ' , t J .
(Name) Lot.
• State existing use and occupancy of prCmmises and in [ended use and occupanoy of proposed construction:
a. Existing use and occupancy ~iWJ"~,
b.tn[ended use and occupancy
i
1`aturc of wort, check w•ntch
3 ~ . • • : ( R`rnpplicable): Ncw [3uilding , , , , Addition ~i~11Cfah0n
Repair oval . • .
_ Demolition .Other 1Vork .
4. Estimated Cost ...~..,~w--Q-. ~'v „ • • , . • , . • , . • . . V ~ , . • • • • • , (Description) .
.Fee "
tto be paid on filing this application)
f dtveihn°, number of dwcllin
° ° • . • g units N[tmber of dwelling units on each floor , ,
If ~ara~c, number of cars d occupancy, spccil'y nature and extent of cacti type of use , .
7: Hob l `s ons of emstm^]strurctur~cs, if any: Front , , ' '
° Rear Depth .
.Number of Stories.
Dimensions of same structure with alterations or additions: Front ~ ~ • ~ • ~ ~ ' '
Depth.. .Height. Rear..................
8. Dimensions oC entire new const~ructia ' ' ' ' ' ' ' ' ' ' • ' • • • • • Number o(Storics
n: Front , Rcar , .Depth
Heigl[t Nu~nbcr of Stories
- 9. Sizcoflot:Front Rcar.•~•~~~~~~~~~~~~•••••~•~•~••~•••"'•'
10. Date of Purchase Depth
1 1. Zone or use districts
in~ivhicl[~ 1 ' ' ' ' ' ' ' ' ' • • • • Name of Former Owner . . • . 1 ~ ~ ~ • ~ ~ ~ •
pr~miscs are situated . ' '
12. Does proposed cons ruction vio4ate any zoning law, ordinance or regulation: • , ' ~ '
l3. Will lot be regraded ~(r , .Will excess Fll be removed from premises: Ycs
14. Name of Owner of prcmises.,~, Address
Name of Architect • • • • • • • • • • • Phone No..,~l,3C/
Name of Contractor . Address ........Phony, No...
' ' " ` .`.T"" ` •a u^`,~,,`d'~ .Address . , , ,phone No. 7,,~ ~
.~of~rr~~ .
15.Is this property loca'~ted within 300 feet of a tidal wetland? *YES....NO....
*If yes, Southold Town TrusCees 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. i
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.
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'TATL• OF 1EW YORK,
'OUNTY OF , S•~
(:~amc of individual sip d ' ' ' ' ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant
°nin• contract)
~ovc named.
cisthc
I! (Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ • • ~
said owner or owners, and is duly a'utl[orizcd to perform or have performed tttc said work and to make and file this
plication; that all statements contain4d in this application arc true to the best oC his knowledge and belief; and that the
rrk will be pertotmcd in the manner sus forth in the application filed thcrowith.
nom to before mcgcthis Gq
.........`....C.. .day of. ~)l~p........ , j~Q,/ '
tary• Public, • •N.~.vY•`-..
County / "-l.
HELEN R DE VOE , ,.G~~\
~~b~4701876 S~it9(olkCounty~ • • • . • . • , • • • •
Term Expires March tiU, ls--•W (Si-nature of applicant)
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TITLE N0. T-12-84745
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' Lot 26
SURVEY FOR
LINDA B WARREN
• PART OF LOT N0.32, ~~COUNTRY CLUB ESTATES II
AT CUTCHOGUE DATE APR. 17, 1986
s
TOWN OF SOUTHOLD SCALE I" = 50'
SUFFOLK COUNTY, NEW YORK NO. 86- 310
N UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED T0~
SURVEY R A VIOLATION OF SECTION 7209 OF THE LINDA B. W
NEW YORK STATE EDUCATION LAW y~~,,,
K COPIES OF THIS SURVEY NOT fEARWG TNF lANO CHICAGO 'A^" CO.
SUR VEY0114 INKED SEAL OR ENDOSSED SEAL SMALL
NOT DE CONSIDERED TO DEAVALID TRUE COPY CITIB b O TA W YO`¢
MGU ARANTEES INDIUTED HEREON SMALL RUN DNLY N
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SUINEY IS PREPARED ~j> ~
AMD OI XIS DEHALF TO THE 7171E COMPMY, GOVFIIN- ^ •~~I# 0 s
K NEAREST WATER MAIN NI. I KSOURCE Of' WATER PRI WITE _PUDLIC_ MENTAL AGENCY AMD LENDING INSiITU TI ON LISTED "~=r,4,. .p, w
R suFF CO. TAx MAP piT~_QQ SECTION 109 DLOCK ~'.L LOT Pa z.D HEREON, AND TD THE ASSIGNEES OF 7ME LENDING B +.e „ -
NTNLRE ARE NO OWELL11Nf WITHIN 100 FEET OF THIS PROPERTY " ~tt'1~~"~~'°I~'~b~ a+
INSTITUTION. GUARANTEES ARE NOT TRM SFER4 DLE z m : q'ya4ra ~d ~ ; D
OTHER TMAM iNOSE SHOWN HEREON TO ADOI TIONAL INS TITVTIq/5 OR SUBSEQUENT. o
M THE WATER SUPPLY AND SEWAiC DI SFOf AI SYSTEM FOR TNIf RRIDE NCE OWNERS ~ ~ ~
WILL CONFORM TO TM[ STANOMOf OF THE SUFFOLK COUNTY DfPMTN[MT N DISTANCES SHOWN HEREON FROM PROPERTY LINES ~ ~.n t'O
OF MEAL TN fGtV ICLf. TO ExISTING STRUCTURES ARE FOR A SPECIFIC F' ® f
APPLICMT~ PVR POSE AND ARE NOT TO DE USED TO ES TADLISN ~~O o• 1213/" 1.~Q%
PROPERTY LINES OR FOR THE ERECTION Of fEMCE6 EKSISEEA f
~~i1~
ADDRESS ~
YOUNG a YOUNG 4000sTRnNDERAVENUE
RIVERHEAD, NEW YORK
NOTES r" MONUMENT STAKE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF 9UFF0 LK AIDEN W. YOUNG, PROFESSIONAL ENGINEER
COUNTY ON OCT. I7,ID7D AS FILE No.sT3s. ANO LAND SURVEYOR N.Y.S.UCENSE N0.12845
RE, PARCEL NO. I, MIN OR SUBDIVISION PLAN PREPgRED FOR
"COUNTRY CLUB ESTATES" HOWARD W YOUNG, LAND SURVEYOR
N THE LOGTKW DF WELL(W SEPTIC TANN(fT)D CESXOOLS(C?) (MOWN HEREON N.Y. S. LICENSE N0.45693
ME FIIOM FIELD OpERMATIpIS AND OR ~TA O1 TNM[D FIYOM OTHERS
D RAN UIS & SONS INC. 1046