HomeMy WebLinkAbout27780-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28089 Date: 11/29/01
THIS CERTIFIES that the building ADDITION
Location of Property: 835 PEQUASH AVE CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 103 Block 7 Lot 24
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 11, 2001 pursuant to which
Building Permit No. 27780-Z dated OCTOBER 15, 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 FRONT AND SIDE WOOD STEP ADDITIONS TO AN EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to KATHERINE WINES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
A riZ d Si nature
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. 27780 Z Date OCTOBER 15, 2001
Permission is hereby granted to:
MARGERY DOLAN-KEENAN
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF FRONT AND SIDE YARD WOOD STEPS AS APPLIED FOR
at premises located at 835 PEQUASH AVE CUTCHOGUE
County Tax Map No. 473889 Section 103 Block 0007 Lot No. 024
pursuant to application dated SEPTEMBER 11, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00 1
Authorized Signature
ORIGINAL
Rev. 2/19/98
n!t� Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT g
TOWN HALL TI -7j j
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 pluirbtr certifying chat the soider used in systein wntains 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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: //� (check one)
Location of Property: 83 C,� --h
House No. Street Hamlet
Owner or Owners of Property: otic, ?it,l Ae S
Suffolk County Tax Map No 1000, Section 603 Block `7 Lot
Subdivision Filed Map. Lot:
Permit No.�-7.7 301 Date of Permit. Applicant: �44r,. �,J t KPS
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:_� (check one)
Fee Submitted: $ „ZS 0'-
zz�) 3 19 (4) f ,a-z--
L (o Applicant Signature
suu.oINa oar.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH" PL
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
-
DATE 17/,-� eINSPECTOR
�7
BATS FIECOIrIl� ws
LD INSPECTION R�lPO�tT - ..::,„,.. �'
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FOUNDATION ( 1ST) ,� 1
FOVNDQ,TION (21RD) ago-
ROUGH FRANK p a4
PLUMBING '
G
INSOLATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS: n
S
0
TOWNOFSOUMOLD BUI INGPEWAPPLLt:A7xUN CHEM
BiJIIW*GSEPARTNIE�NT Do yw�l�ro ocaoedlbel6ltavv3ag.befoac+eapp]
TOWNBALL Bardcd8a16i
SOB7MOLD,NY 1T971 .satsPlaas
TEL:76�-1802 5iuv�eq
.No, Check_,_
aed .20 Coat
App coed .20__ ,f- Mail to:
Dkqvwved a/c!
BuffftbqxotiorFoe—
` �� ' AP'PI�SCATY+ONFO�ZSTJII+DIl�TGt P9.T,
44
G t Datek6�� �( 200
t =
a.TbbSON catfcm.&=b000a**M ditby"ow&worfnt*and.mbmt#edto**Bugdiaghupedwvt
sets ofplana,apomfto tplaato scala Bee a000rtto whale
b.Plat plan&YWt g location of lot aad of builftp(nps+emises,mlati n yip to a cf*gp rcmf cs orpubft sft is
ami,and watarvvays. .
a The wank ooveaed by ibis a;plicadm may not be A m ')dCmd bef=isscaaco ofBuUfts Pccm&
qpovd of ft spp m ffie Buil ft b*pft*wM law a Bu*ftP=*to the applicant.Such*.p®
shall,bo bapt ad*a prat*m s"Mble for inspection dv oggbout tba work
a No bu ldi;g tl be oocc*d orused in whole orInVA for=Ypu=poso w3d4o-ovecuatil a CWffL=te ofOccup
is issaed by the Bgildia$Iaspeatur. • .
APPZTC�PiTTON IS HOMY MADB to the Buaft
Btdldmg Zoma O oo oftho TomeSoudWK S ��r �and of a Laws,
O t pars=or 8v
I�:ogula#iams,for the oa�tcuc�a�a o�Pb�aiT�ngs,addis,or #cora ar for removal or d as 1ua+aia.desQibed:Zb�c
mphion,4g ow to oozy with aU applicable laws,crdiaeaoes,building code,housing coda and rem and W admit.
iaspa�rs•onpi�amises sad in buiidmg for aocea��aspbotFons, •
. (S3aforasma,ifs�xpa�a�)
�b
State whcthar aPph is agent,architect,Onset. c;Sm�contractor,dooft.lidian, cr or,bm'tdm
ell
Name of ow=of prises 40e
(as,(m tho tmc roll or latest deed
If Macant is a corporation,signatme.oiddy aadiorized offoer
(Nemo and We of corpcxto Ofd=)
.Bm'ld=Li==No.�
PhmYbers License No.
Elarica�s License No.
Otbcr Trade's Licemsc No.
1. Locathoa o land an proposed workwM bo done:
Hoose Number StheatHuqW
County Tae Map No. 1000 SWdW 40 Block=� _£at
R
Subdividon Fled A No,
, i
T
• U46�OOcnpffiugbfp� � � .
matte gvse,�aayo��re�s� .
IPA
rg�,s�gvsesoda
b. .biMdednseandAAMIan�
' N Alteratiaa�.
Nature of work(&G& $pp�c bleJ:IJear Bt> --_Other
R Deanolittoa �)
. .Fee "/ SV' `� Ids applictio»l}
Cost--- . (�l» en flim
1{�. member of dwelling 14=ber of dwelling=fts on each Boor
!€garage, number of cars
cdmmac+dd ormked occu =0%sp%*ndmand a of eachtype ofvsa
�any:Fmirt Rear Depfh
Dimensions of existing sem'fiber of Stones
Height
Dimensions ofwase strucWm wilh aite>ra ona o>rnddi}ionx Front
Rear
Height Plumber of Stiorles.
DimccA=of enkireslaw v'�on.Fxont
Rear DeP�
Height Number of 5bdriQs
Sim Of lot:Rant R Danth
Dateof
pnc+d>tase• ame ofFarcae�Own�
!.Zme or we&LqftWinwhichp=*m are sued
L.Does ptoposed caatn+ctioa violate any=jug I$w,a� or rcga
3.Witllotbeso-Vrad& .WiI1�4��beiemavbdflampo ':� NO• •
-
t.Names of Oaan ar of p==iles Phaa>ve No
Name of
Nam$of • eNa
�.Is property 100 feet of a tidal wetland? *YES
NO '
• IF YES,SOUTSOLD TOWN-TRUSTEES PERUM MAYBE REQLTMW
S.provides smv+ey,W vi&a=nte folmdation-plaa and distsaces to MP3'lines.
I:N elevation at aap point on property is at 10 feet or below,mast provide toles Mbied data an survey.
TATE OF NEW YORP
SS:
OUNIY OF---�
i .
t ►�-S bei=duly swora;deposal and Sys that(S)ba is tba appHcaat
(I-U=
of mdiyiduslDA&U g coat>act)above named,
3Bais the .
.( ,A,�,�porate offiioe�eba)
VpHcadaX
'said ownor owners,and is dna'�top arli vepfdthepidwa&andtomalmandf1etbis
er
at an statements eo�ed intbis appRoadm are t knowledge aadbeU4 and dmt•*wO*will be
mod in the m==set ft&ince mon Sod tmwl&
,
oto before meft
°f 20-e/—
1--f 21 42 .
Nc,tmyPnblia Shp taa+e clfApPl
ELIZABETH A STATHIS ;
NOTARY PUBLIC,State of New.York
No.01 ST6008173,Suffolk County
Term Expires June 8,20.h z
SURVEY OF PROPERTY
S SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLD
< SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000- 103-07-24
{ �o SCALE 1 "=20'
JUNE 8, 2001
> AREA = 15,012.16 sq. ff.
�o ��ory� / S 0.345 ac.
0
O I w CONC COVER
yeti "1ti
o
GQ�4 � 0 Ic
CONC. COVER
cf
CERTIFIED T0:
KATHERINE V. WINES
LAWYERS TITLE INSURANCE COMPANY
10`5
j Fo
C do AS. Q �1`e
0 , j G Yv. ?' UNATHORIZED ALTERATION OR ADDITION
°� 0
0
1 y p4 G4 C TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
gip. Cv �° d / EMBOSSED SEAL SHALL NOT BE CONSIDERED
a(0 �9 TO BE A VAUD TRUE COPY.
o `Sp /e CERTIFICATIONS INDICATED HEREON SHALL RUN
tX
00" p' 6 2 < G� ONLY TO THE PERSON FOR WHOM THE SURVEY
�� .0- G �✓ IS PREPARED. AND ON HIS BEHALF TO THE
1�0 ? ST� e < oI �.�' TITLE COMPANY, GOVERNMENTAL AGENCY AND
p
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INS11—
cGlo TUT10N. CERTIFICATIONS ARE NOT TRANSFERABLE.
THE OFOF
AND/ORSTENCE EASEMENTSR IGHTS OF ECORD,A F
' ANY. NOT SHOWN ARE NOT GUARANTEED.
O�i G
PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDARDS FOR TITLERAS ESTABLISHED Joseph A. I n g e gn o
BY THE I.I.A.LS. AND APPROVED D ADOPTED
FOR SUCH USE BY THE NEW YOR STATE LAND
�J TITLE ASSOC IA
a ���Fs\ � �����o Land Surveyor
FI? \ ,lS . • ��c Title Surveys — Subdivisions — Site Plans — Construction Layout
dJ a \ AO o0 0� �q Q.t PHONE (631)727-2090 Fax (631)727-1727
T o
(�7OFFICES LOCATED AT MAILING ADDRESS
N.Y.S. Lic. No. 49668 1380 ROANOKE AVENUE P.O. Box 1931
a --- — — -- RIVERHEAD, New York 11901 Riverhead, New York 11901-0965
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SrLPS .7-0 Cv/J !o
a
OCCUPANCY OR
USE IS UNLAWFUL p(
WITHOUT CERT H IC
OF OCCUPA
J-K
�C
ec
APPROVED AS NOTED
4 /
DA B.P. aL
NOTIFY BUILDING DEPARTMENT AT
768.1802 9 AM TO 4 PM FOR THE _
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2 ROUGH - FRAMING & PLUMBING "
& INSULATION
4 FINAL - CONSTRUCTION MUST
BE CO LETE FOR C.O. v,
ION A EET
M&IN
N. .
STATE CONSTRUCTION & ENE
CODES. NOT RESPONSIBLE R
r