HomeMy WebLinkAbout17911-z FORM NO. 9
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218198 Date JULY k9, k989
THIS CERTIFIES that the building ADDITION
Location of Property 1310 WEST RD. CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 110 Block OS Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Buildinq Permit heretofore
filed in this office dated JAN. 3I, 1989 pursuant to which
Building Permit No, 179112 dated MARCH 13, 1984
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy fox which this certificate is
issued is DECK AUDITION TO EXISTING ONE FAMILY DWELLING. NO
ENCROACHMENT OF SIIIELINE.
The certificate is issued to JOHN FORSBERG
(owner, }
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~ ~
B ing Inspector
Rev. 1/81
BOH3t NO. ~
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~ 01791.1 Z Date ............Y..f..1.x:5../.1......./...~.......... 19.8`
Permission is hereby granted to• 1
P....... .
.
ct premises located at ~..r~/.~.4~r.~aoY'..~ ~-'-c;C,,.......... ~
ct.,
County Tox Map No 1000 Section Block .......4.s~....... Lot No...~.:?.:-... .
pursuant to application dated ...3~. 19~~ and approved by the
Building Inspector.
Fee
~ C~tM.
. . . .
But ing Inspector
Rev 6/30/80
TONN OP SOUTDOLD
BUILDING DCPART:ICNT
TONN IIALL
SOUTIIOLD, NCN YORK l197i
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPAtZCY -7
HEN CO2:STnUCTIOHNft:'~..OLD OR PRE-E%ISTI22G BUILDING../.'~...VAC.I2JT LAt2D....._..
Location of Propcrty._.._.I3/d.._._~~'a:y.._~~..._.C~:
UOUSE NO. STREET llAriLCT
Ovncr or Ovncrs of Propcrty.._iYS:.~~I.'~i~:r:~
County Taz Hap No. 1060 Section . Block ..Q'~'J.. Lot
Siibdivxeion Filed Map ,..._._.Lot_......._.
Pcrai[ ?fo. .__.......Datc of Permit .._.......Applican[
Ucalth DepC. Approval Undcrvritcrs Approval__..._._......
PLanninB IIoard Approval
Request for Temporary Certificate Final Certificate
a?.S
Fcc Subaitted:
APPLICANT.. .(~~~/C!.
~,v ~ o
'ev, 10/14188
FORM NO. 6
TOWN OP SOUTf70LD
HIIILDINC DEPARTMENT
TOWN HALL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. ~ This application must be filed in typewriter OR ink and submitted to [he Building
Inspector with the following; for nev buildings or nev use:
1. Final survey of property with accurate location of alI buildings, property lines,
streets, and unusual natural or topographic fcatures_
2. Final approval of health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Pire Underwriters. ,
4_ Sworn statement from plumber certifying that solder used in system contains less
than 2/10 of IZ lead_
5. Commercial buildings, industrial buildings, multiple residences and similar
buildings and installations, a certificate of code compliance from the 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, buildings and
unusual natural or topographic features.
2_ A properly completed application, a consent Co inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state Che
reasons therefor in writing Co the applicant,
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C_ For Vacant Land Certificate of Occupancy:
1. An application for vacant Land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, 1957 shall also accompany
[he application_ If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Duelling $25.00,
Alteration to Dwelling $25_00, Svi®ing Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $[0_00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50_00
6. Temporary Certificate of Occupancy - $f5.00 Residential
$50.00 Commercial
"v- 10/14/S8
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SURVEY FOR
p W/LL/AM F. MULLEN,?R ~ MARGUEITE P MULLFN
CUTCHOGUE
TOWN OFSOUTHOLD
SUFF. CO , N. Y. CUARANTFFD TO
` C/TY T/TLE /NSURANCf CO.
VU SCALES 40'
{\~l~ NOV. /9, J969
` ALDEN W YOUNG
PROFESSlON.AL ENG/NEER AND
LAND SURVEYOR, N.Y.S. UC N0. /2845
R/YERHEAD. N Y
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FOFM N0.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL q
To ~v.-Q.., ~aAwHn ca,n,a . ! c. ~ . 9.~"~:° 1
• . 'TYT i q N•. ~ { [ ~ ~ ~ .
PLEASE TAKE NOyrTICE that nyourrl application dated .31 t1'9_ ~'9 . .
for permit to cr ouo.Uc..°;~~~-o`r, t'.°. ~(i7Sa.~?^rw.~.4.!?`~at
Location of Property 1 3 t 4. W Fc~O:. ~d „ . _ Cam" M.~-Q • . • • . .
House No Sireei ~ ~ ~ ~ ~ Hamlet
County Tax Map No. 1000 Section ..l/ D .Block ....4. S Lot ~ 1'
Subdivision Filed Map No Lot No ..7- .
is returned herewith and disapproved on the following grounds ~ c~.C~-rr+~n.
~ ~
Building Inspector
RV 1/80
f
oSUF~atK~o
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; rn Southold Town Board oaf Appeals
~,fY ~ MAIN ROAD - STATE ROAD 25 SDUTHOLD, L.I., N.Y. 11971
~Ol TELEPHONE (516) 765 1809
APPEALS BOARD
MEMBERS
GERARD P GOEHRINGER, CHAIRMAN t~ ~ n {~(J
CHARLES GRIGONIS, JR ~ _ 11I n
SERGE DOYEN, JR March 29 1989 JIU''
JOSEPH H SAWICKI i ~ w M
JAMES DIN 1Zi0, }R j~
BLDG. DEPT.
Mr. John P. Forsberg TOWN OFSOUTHOLD
259 Lincoln Avenue
Rockville Centre, NY 11570
Re: Appl. No. 3832 - Variance for Deck Extension
Dear Mr. Forsberg:
As you may or may not be aware, Members of the Code
Committee, together with the Town Attorney's and the Office of
the Board of Appeals have been discussing an interpretation of
Article XXIV, Section 100-242 concerning extensions of buildings
with nonconforming setbacks and containing conforming uses,
including the squaring off an existing principal structure
without increasing the nonconforming setback.
The Board of Appeals has determined that applications of
this nature will not require a variance if the proposed
extension will not increase the nonconforming setback, will not
increase the lot coverage in excess of 20%, and will be in
accordance with any other regulations of the new zoning code.
The Notice of Disapproval issued by the Building Inspector
for the deck addition should therefore be withdrawn. This
variance application is therefore considered moot, and you may
request, in writing, a refund of your filing fee for the
variance.
Please return to the Building Department to reinstate your
building permit application.
Yours very truly,
GERARD P. GOEHRINGER
CHAIRMAN
lk
cc: ~Ir. Victor Lessard, Principal Building Inspector
Town Attorney's Office
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SURVEY FOR
IMAUMOAI2[D AITFIU110N OR ADDITION JOHN FORSBERG '
TO THIS SUtVEY IS A YIOIAiION Oi CUTCHOV UE
S2CilON ]SC9 OF TNF N[W YORS STATE
IDUCAiION lAW TOWN OF SOUTHOLO
COTIIi Oi THIS SVRV[Y MM NOT KARMA SUFF CD N. Y. cuARANTEEO TO - NEW YO
iXE IAND SURVIVORS INKED SFAI OR R
EMg55[D 5[At SHALL NOT R CONSIDFR[p THE T/TLE GUARA E h
10 N A VAIID TRUI CORY SCAL E ~ 40 [ 51'~
N W' Y~vry
YOUNG @ YOUNG
GUA4AME151NDI[AT[D HEREON SHALL tUN JUNE 26. /975 eY• * o
ONLY TD TXl NRSON TOR WNOM TH[ SURY[T ~~i~_ ~ a .
RS ttl2AtlD, AND ON H~5 S:MAU TO IH2 %J6//LL'(/I~Y/ -
TDLE COMFAM, (pV[[NMW1A2 AOINCY AND
LL2DIAG MK11ibT10N 2'51[0 Ntl[ON, AND ALDEN W G=
To THE AAwN2FS of TNF uNOwc tr[STN PROFESS/ONAL E i
MION GUAtAN1215 ARI Not TtAH5114A51! LAND SURVEYOR, i2 `
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ow,rusw«w! R..SirtullDNS a suAw[]u2NT R/VERNEAO, N Y, °!s o [ Tp~
'Y~OA
NO.
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~J FINAL
REMARKS: !Y~ ~ C, , 0 .
DATE ~ 3 ~ ~ INSPECTOR , C~,~
. ,
1
BOARD OF HEALTH J,.....,
3 SETS ~ PL,12SS ,
FORM1i NO.t SURVEY
TOWN OF SOUTHOLD CHECK .
BUILDING DEPARTMENT SEPTIC FOR*1
TOWN HALL
SOUTHOLD. N.Y It071 NOTIFY
TEL.: 7057802 CALL
L•xaniincd ..~.t ~ 19~~. P1AIL TO :~71'I~J~~c~twn R
v
Approved . l 3, 19$`9 PCtmi[ No. l ~.Q~ .2ti.. . i_~ ~ ~ql
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Disapproved a/c t~ 1"~ °
t`~~ JAtd 3 ! 1999
~1~~,.~~~.{~
. y l,l.'l . ,TOtNfv OF SOUTHOL~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS '
a. This application must be completely filled in by tgpewnter or in ink and submitted to the Building Inspector,
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of tot and of buildings on premises, relaGonshtp to adtommg premises or public
or arras, and giving a detailed description of layout of property must be drawn on the diagram which is part of this
cotton.
c. The work covered by ttus application may not be commenced before Issuance of Buildtno Permit.
d. Upon approval of this application, the Building Inspector will Issued a Buildlg Permit to the apphcant. Such p
shall be kept on the premtses available for inspection throughout the work.
e. No building shall be occupied or used to whole or in part for any purpose whatever until a Certificate of Occu;
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant
Butldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordman•
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein desc~
Tire applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, a,
admit authorized inspector on premises and in building for necessary inspections.
(Signature of apphcant, or name, if a corporation)
(MaIlmg address of apphcant)
State whether ap hcant is o_wnper, lessee, agent, architect, engineer, general contractor, electrician, plumber or bui
Na e o owner of premises ~.'~S. . .
a (as on the tax roll or latest deed)
If a Itc t Corp`ar~tz n;atg§rature of duly authorized officer.
k:
.ii u ern ldoflcorporateofficer)
a ~ v
uAder'sLicenseNo. a ~ %i;, a,~
-t~~ i • -
Plumber's License No . i.,.,.:'•',?~„~ ""t
, r .
Electrician's License No . M;Y y ~
Ot}ier Trade's Licensc No . .
1. Location of land on which proposed work will be done , , , , , , , , , , , , , • , . • • . , .
.
5,, f - , o
. . . .
House Number Street Hamlet
t
County Tai i\1.ip No 1000 Section . I b........... Block Lot 1.~~.-........ ,
Subdivision Filed l,lap No. Lo[ .
(Name)
2. State c~istm~• use and occup.incv oCCf premises and intended~upse~.ind occupancy of proposed constnicuon•
a. Existing use and occupancy .:~?~~m~ • • 1y'~(,- ' p,' ~ ~ ~ ,-~-i
b. Intended use and occupancy • • • • • - • !~.-r....4~~ :'Y.".~...::.`1r~. } : ! ~9l"4
3. Nature of work (check a htch appltcable). New IIutldtng Addttton ,1ltera n
Repatrcc Remo ai Demolttton Other 1York . .~1~~.....
-~'1 l Ot t'l~ ~O(L~ • . • • . • • ' • (D.acnptton) •
4. Esttmatcd Cost ............TT.. Fee .
(to be patd an FiBng the appltcauon)
S. IC dtvclltng, number of dwclltng unt[s Nttmbcr of dwclltng untts on each floor .
Ifoara_c.numbcrofcars
6. If business. commercial or mixed occupancy, specify nature and crtcnt of each type of use .
7. Dtmenstons of existing structures, tf any Frant Rear Depth .
Height NumbcrofStoncs....
• Dtmenstons of same structure with alterations or additions. Front Rear .
Depth , lictght Nuntbcr oC Stones .
8. Dtmenstons oC er
t~rlew c
~Struct~on. Front Rear Depth .
Hctgltt ...............NumbcrofS[ones.
9. Stzeoflot. Front Rear Depth
10 Dale of Purchase ................Name of Former Owner .
11. Zone or use district to svhtclt premtses are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation ..hIQ
13. \t'ill lot be regraded 7Vt11 excess (ill be removed from premtses Yes
14. Name of Owner of premtses .........Address Plronc No .
Name of Architect r~ Address .Phone No. .
Name of Contmctort-oe~~:l-Eal(t . Qt•L~~Ctt!1 .Cx.'b~ddress M~~~vli.l~ .Phone No ~rf~' ~
15.Is this property located within 300 feet of a tidal wetland? *YCS.. .HO
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and dtstmctl}• all buildings, whether existing or proposed, and indicate all set-back dimensions fro
propert}' Itnes. Give street and block number or descnptton according to deed, and show street names and indicate wheth
tntenor or corner lot.
{ - ~t`1`D2~'Sot~ tl7t 1 Dtt'lC ~1'~ lit~t/1l~ //Y i~~v~. ~~-{t2t.•~. AF~aO~.
3 ~ ~ ~ APPROVED AS NOTED
,~~/7 / ~~t ~ c DATE 3 1 B,P # 7 ~
4 ~ r tP / ~CX~ R.~(. V~J FEE BY _Y. G. .
y~ v ~ - n {~~rn^S ` NOTIFY $UILDING DF PARTMENT• ~'~1'
L-•A F-C~-C7 L>( 1/ 765 7$02 9 AM TO d °r^ FOR THE
11 FOLLOWIfJG WSPECTiONS
~~ut'~n1~6'~ 'hll~,t$ t FOUNDATION - TtNOREQUIRED
i FOR POUREO CONCRETE
7_ 2K~ _ sfs ~lS I,(JrZX~ r'N.t ( 2 ROUGH • FRAMING & PLUMBING
i 3. INSULATEON
4 FINAL - CONSTRUCTION MUST
8 BE COMPLETE FOR C.O.
Z r lO d~`s'~ 1~ ~S Sk-pS ALL CON51'RUC[ION SHALL MEET
THE REAUIREMENT3 OF THE N.Y.
{IX~ l,Q,~~~ ~A STATE CONSTRUCTIO!'t #t ENERGY
d/ COOE8. Ndt ~B~RORS
VQp~G~W
V~ DESIGN 1DR CCItiBTRUCTION
OCC tip` Cp~E
COU T10' OFE\Y 1'ORi:, . • • S.S ~
H
~~p
~p~~(r'~(
• • ~~.t C~-nUr • ~ • • • • • nG QKC bang duly sworn, deposes and says that he is the appLc-
(Name of tndn~tdual stgmng contract) V~
about named. ~L_~~_ f(-
tic is the lA7!~!'?.~tn~!~
(Con[rac.[or, agent, corporate officer, etc.)
oC said owner or owners, and is duly .tnthonzcd to perform or~havc performed the s.ttd work and to make and Cile ?
=pphcauon; that a!I statements contained tit tlus application arc true to the best of tits F,nawledgc and behcf; and that
'.pork a•tfl be performed tit the manner set forth m the apphcanon lilcd thcrcwrth
Swam to before me tats
....day of .C~.~1-r~,-........ 19
fJ
\ota • Public . • • • • • • • • • • • County ~
LINDAJ COOPER (Signature of apphc=
Notary Pubitc, State of New York \
No 4822563, Suffolk Countvw
7nr i, m,n.rpc P~^PM' ~r 9 ~ 13..11~-..