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HomeMy WebLinkAbout27725-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28010 Date: 10/11/01 THIS CERTIFIES that the building ACCESSORY SHED Location of Property: 33195 MAIN RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 19 Block 1 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 5, 2001 pursuant to which Building Permit No. 27725-Z dated SEPTEMBER 25, 2001 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 9111" X 1312" SHED The certificate is issued to EUGENE H & WF MOISA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorize Signat e Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27725 Z Date SEPTEMBER 25, 2001 Permission is hereby granted to: EUGENE H & WF MOISA 32305 MAIN RD ORIENT,NY 11957 f or' CONSTRUCTION OF A SHED 9111" X 1312" IN THE REAR YARD. at premises located at 33195 MAIN RD ORIENT County Tax Map No. 473889 Section 019 Block 0001 Lot No. 013 pursuant to application dated SEPTEMBER 5, 2001 and approved by the Building Inspector. Fee $ 75 . 00 Aut orized Signature ORIGINAL Rev. 2/19/98 Form No. 6 (1`�•. TOWN OF SOUTHOLD BUILDING DEPARTMENT +�j TOWN HALL 765-1802 n APPLICATION FOR.CERTIFICATE OF OCCUPAN Y fPT C ,_Sni�t�tp 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 - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . .��. . . v��d�. . . . . . . . . . . . .. . . . . . . . . New Construction. . ..Y43. . . Old Or Pre-existing Building. . . . . . . . . . . . . . . Location of Property. . . . . �.�5. . . .. .. . ... f�1:/. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . W&.6/VA. . .��: . .9� . fr:!F. . . .l'�°j.5�: . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . F. . . . . .Block. . . . .6 ?1 . . . . . .Lot. . . . . . . . . . . . . . . . Subdivision. . . . . ... . . -. . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . .Lot. . . . .. . . . . . . . . . . . . . . . . Permit No. . . P?.7.7.Q . Date Of Permit. S.-WoX..7s . 9?C'r'lApplicant. . .0.4P.N.-CP , . . . . , . . . . . . Health Dept. Approval. . . . . . . . . .:-. . . . . . . . . .. . .Underwriters Approval. . . .. . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . .:.. . . . Final Certicate. . .yf�s. . . 00 Fee Submitted: $. . . . o? ... .. .. . . . . . . . . . . . . . . . . . . . . . . . . . ... . 1.. . . . . . . . . . . . . . . . . 4 G d1 as APPLICANT O�OS�FF01,�coG y� C4 Town Hall,53095 Main Road Fax(631)765-1823 P.O.Box 1179 �fi �� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD OCTORBER 4T",2001 EUGENE H MOISA 32305 MAIN RD ORIENT NY 11957 RE : 33195 MAIN RD, ORIENT TO WHOM THIS MAY CONCERN: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) NO Underwriters Certificate on file. XX The check is (not in file)$25.00 No Health Department Approval on file. No final inspection has been made. _ No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT #27725-Z Please contact our office on this matter. Thank you for cooperation SOUTHOLD TOWN BUILDING DEPT. 7c) 5- BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND1[ TION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKSZ; DATE /D � � ( INSPECTO FIM INSPECTION RIPORT DATE CONMSNTS �- ��•�==a=aae=�.��-�=a== -=saw e=aa=mx=ae=a=aa�asa=spa=Eaaaaa=Sa.-sas��--aaess �i FOONDATION ( 1 STY FObNDATION (2ND) t'. ROUGH F AIME PLUMBING s INSOLATION PER N. T. STATS ENERGY a CODE FINAL ADDITIONAL COUNTS: ` TOWNOFSOUTIOLU - BMDINO'MW GHBCKJ BiTII�D1NGDEPARTII�NT . . Doyonlanroosaeod�si4a11a�.befo�co+gipl TOWN HALL "' SOUTSOLD,NY 11971 .sotsafBoiidP TEL:765-18029 TY�bees zoo caaa Appa�av�ed 9,1 .__,20^1- ,4 Mailto:.f agENt D3sgvwved a/a ZIL AP`LIOATxONFMBVILDINGPBRlI r. '• Dato,�v_�T � ,ZQ? IIMN'STTtIICiTONS a.This applioxdon MUST be o tllodia•by gpeov&w or is ink and sabmditd to tba g hupedwvg sets ofplaus,aaaaratie plot plea to scala Fee aocordingto schedti e b.Plotplan sbowiaglooatlou ofk*and dbuilftp mpteadsos,:alationship to a4ofairgp=mf=orpublicstmt areas,and wsrvway& a Thaweakcovetedbythis mayeatbedo==oedbd=#ss = ofBWWfagPamit d,Upcm a�Pa+o'val ofd applivation,thaBu �wiII 3$sae aBuixdi�Pma�tto tbo�Iioaat.Saoh apcm slisll b¢kept oaithe available for ftoq&uttbo wank a Nob Wfvs 11 be 000upkd orusod in whete or iagmt for xw pine whaweo-everUMM a Cie of OCCUP visU=cdbytho BWWft hVeota. NIS SBRBBYXADBto&*Bodldiathoissaaaco daBWMWgPe=Jtp=oanttoth BuadiagZama Ord antro offe.T(wnofSouthold,&2aCommty;NowYom and odwmobleLaws;Oboes or R,eguisdoms,forthe of WMA cot,Or* dt=WwiorforramovalordpomolidwasIwaia.desc be&7ba appHofflt 8$row to MI&SUapplicable laws, , oode► coda,amd tagabdmsy aad m admit. waftdwd iaspect=•onWod=and iabuilldiag forbq*odm. of crasaie►I s oogmxd=) 3?3�� 1wy gn ©rQlFw? /qy . State whether applicant is ow=,lessee,agent,=Ht=4 CASM004 g.M=d M e!Vdd dna,Pier or idea Name of ow=ofp= sear}- (as.onfe twc ro.0or latest deed) 7f applicamot is a coVorxdon,4ptm.of duly su&odzed offeGr (Name and Wo of omporato offf=) Bupddm Liceusc No. Ptumb=IaccnwNo. ElochiCIM.4 License No. Offiw Trade's LicGoso No. 1. Location of lead on which proposed work wM bo-doaa: 3 .?3 0 Z 1J/li gy .0llYf7 House Number street . Hamlet ComfyTaxMapNO. 1000 Seth U-21 ,_Bloati Subdivisiaa Piled 0,;'„ ` f =#.� • (Now) , a ' J . atid,� dvseandofxupa>s�►bfp�: . rvseandoo�maY !3 LCA S�� . b .h�tian,declvseswdoccapanc�' ^ • AdW Natwe of work(chedkWHOM*Naw $.- -.— on g, Dmnolition 1VoskRepair or �} 'Cost "3 S"D _Fee ��1�bpaidoa filings applic�fiosY) . naunber of dwelling tsmfts_ l'Titmbex of dwelling=its on each 1100r if garage, number of tears Nbnsij�oaf or mixed oa=panCYt Voc*ngt=and e d,M of each tgpe of w& ensigns of existing if e0r. ROffi D Dsm Number of Stories Height ' ' Rear Dimensions of same structure alter torte or addt�onx Front Depth - Height . Plumber of Sbofiee pqyth Dimendosss of entireww om*ucdm Fxont R eat Height Number of sbotifs .Size Of lot Frosrt �- D4° }Date ofpmrhase• , Name ofFOwn [.Zone or we&swa in vddeh PWASW axe _ iAX, > Does gvposed c wswwdon violato my zoning law,'wdinmw,or regal8dow s.Will lotbeso-Va Wd ' • ,�110 Will ea�Qees$Tlbetemovbd$+omp •� � . �GE�vEI�./'1a/�� 3.z3dS- /'� �',e,'__._pbona�To. 3 3 k Names of Owmar ofpremises D l JET' PhoneN6 Name of A N A Name of AA&twPhoneNo. >.Is p�perE�rwit>rin 100 feet of alidal wetland? *YES NO • IF YES,SO=OLD T'OWN•TRUSTEES PE tUM MAYBE REQUIRED j.promde smveY,to scale,with awe fotmdadon-plan,and distances to FOPeatY lines• r:�f desva don at any point on pr atty is at 10 feet or below,must pro tde topogcaPhical data,an sprv+ep. LATE OF NEW YORE} SS XN'TY OF.S&j=,,) , u c cN F ) being MY swwxn deposas and WP tit(s}lm k the gVfictant (Nam of individwd Simaing cosdra*t)above named, )ffbistbe �w •(Ca*actcr,Agar,Coq ote OffiW4 eta.) said owner or owners,and is a1y raMadzedtopedo=crbvepad=2edtlw;ddwakandtDmWwmdMetbisqvhmd= at an comtAined inibb a 7pliagm are tine to the best of Ids kaowledge=db and dw$ie wom'k wM be tfouned in.tbo in, ad in&egVhc2 t6n'$ledt =9wiILVIOMto ' 209A _ ` Notary Ssgnua�` ROg 1.SCOTT.JR. Stats of New In Suffolk County N 1N ,01 SC472508� Tom Expires May r . e L�o " t / .� � ld ,sfA �� Cu.sel,o, 33 ev APPROVED AS NOTED DATE: 9 � B.P.# FEE: NOTIFY BUILDING DEPARTMENT AT ?C 766-1802 9 AM TO 4 PM FOR THF FOLLOWING INSPECTIONS: �3 aft I. FOUNDATION - TWO REQ IRE-F) FOR POURED CONCRETk 2. ROUGH - FRAMING & OL MSS t9° � `'I ' 3. INSULATION IS UNLAWFUL 4. FINAL - CONSTRU BE COMPLETE FOR C. . .: IN CERTI IC TE ALL CONSTRUCTION S LL MFF _ !Cy THE REQUIREMENTS TP! ' "-' w..+,� ;i f► STATE CONSTRUCTION & FN `' CODES. NOT RESPO W, DESIGN OR CONSTRU c� 'y y . a� 14-5 mac` f3jq 1awT J '7"'4roQ Z- ArRiCA 414Z A- f ti 'fir•,,,,, l '�96►Q It 47 I =r r r i I ALTERATION Ole T THIS SURVEY LS A VIOLATION OF (_► ION 7209 OF THE NEW TORK STAT ATION LAW. PIES OF THIS SURVEY,MAP NOT BEARI T E LAND SURVEYOR'S INKED SEAL OR BOSSED SEAL SHALL BE CONSIDERiD BEA VALID'SUE COPY.LAND INDICATED HEREON SHALL RUO ar -p LY TO THF JE=:SON FOR WHOM THE SUN K I PREFARED, AND ON HIS BEHALF TO THE LE COMPANY,GOVER14AW AL AGENCY, WING INSTITUTION LISTZO KREON,AND ` THE ASS!GNEfS OF THE LENDWG NiiT1'. ION.GUARANTEES ARE NOT AI)DITIONAL diS[RUTIONS OR 7 rcg G61jRAtv7-ro CopmPAmY S`urveycjQ Cc �bctr 29,/5 75' �t f cry sed crud e, Qrs 1 rrf p rt u Mie rr v" �''�; .BUILDING.PERMIT.REVIEW hHECK.LIS-T DATE REVIEWED: S IS /01 DATE SUBMITTED: 9 /s /01 APPLICANT NAME: Ao/s q SCTM#--- DISTRICT: 1,000 SECTION: /9 BLOCK: / LOT: _ STREET: 3230$ x, �Pa� CITY: SUBDIV. NAME: PROJECT DESCRIPTION: ADD.ALT c R N/D: ARCHITECT/ENGINEER: 6/, FAST TRACk: YES o O SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1 ZONING: PERMIT ESTIMATE AMOUNT:_$ 3 .00 PERMIT USE: EXISTING: INTENDED:SrQ,9kC ZONING DISTRICT: R40 8 AC CONFORMING: YES00 REQUIRED LOT SIZE: R04 SQFT WHERE ACTUAL LOT SIZE FROM? c ACTUAL LOT SIZE: 4 2605 SQF1 REQUIRED UIRED REQUIRED 1n FOUND:FRONT: 'PROPOSED: SIDE YD:/c) '/ PROPOSED.= '/ /ted REAR /d 'PROPOSED: 1m FOUND:FRONT: ' ACTUAL: SIDE YD: '/ ' ACTUAL: '/ REAR: ' ACTUAL: ' LOT COVERAGE: A T T OWED:26!% EXISTING: sf_% NEW: sf % TOTAL: sf s % CORNER? YES o O WAT ER FRONT? YES ORO DESCRIPTION: FLOOD COMP L ZONE: PRE-FIRM 3/18/80 PANEL #: 6' FLOOD ZONE: X , AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPLIC TION TOWN SPETIC PERMIT: YES or N SUFFOLK COUNTY HEALTH DEPT: YES or>116,�(BED#): DTE: / /_ PERMIT#:R10- APPROVALS REOUIRED: NEW YORK STATE,DEC: PRE-DEC 9/1175 YES or DK:f SOUTHOLD TOWN TRUSTEES: YES or 10. TOWN ZONING BOARD APPROVAL: YES or 1eS TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES or I NYS ENERGY: YES OR N EGRESS: VENT: LIGHT: BUILDING PERMITS OPPEkVEXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y O �) BP -Z/C/o Z- , NOTES: 44 FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND.FLR : SF INIT OTHER TOTAL TOTAL: /30 SF FEE FEE FEE SF)- ASF)= SFX$ _$ +$ +$ _$