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Home My WebLink About27541-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28161 Date: 01/10/02 THIS CERTIFIES that the building ACCESSORY Location of Property: 380 HORSESHOE DR CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 95 Block 4 Lot 18.21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 11, 2001 pursuant to which Building Permit No. 27541-Z dated AUGUST 9, 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 NON-HABITABLE ACCESSORY GARAGE WITH STORAGE AS APPLIED FOR. The certificate is issued to CHARLES G & LAURA M GOY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A u orize Signature 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. 27541 Z Date AUGUST 9, 2001 Permission is hereby granted to : CHARLES G & LAURA M GOY 380 HORSESHOE ROAD CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN ACCESSORY GARAGE WITH STORAGE IN REQUIRED REAR YARD AS APPLIED FOR (NONHABITABLE) at premises located at 380 HORSESHOE DR CUTCHOGUE County Tax Map No. 473889 Section 095 Block 0004 Lot No. 018 . 021 pursuant to application dated MAY 11, 2001 and approved by the Building Inspector. Fee $ 289 . 80 Authorize Signat e ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD • BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Departm t _ owing d �I to A. For new building or new use: q ...... 1. Final survey of property with accurate location of all buildings,property lines, streets, sua natu topographic features. a 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. 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 C, Date. ! r_- New New Construction: pb Old or Pre-existing Building: (check one) Location of Property: 0. NC,(SQS�,o e >�,�¢ '�� ck-o House No. /r Street Hamlet Owner or Owners of Property: CiLe-r Suffolk County Tax Map No 1000, Section 0'75—, J O Block 0 '' - 60 Lot 0 til• 0 Z 1 Subdivision Filed Map. Lot: Permit No. y Date of Permit. Applicant: S Health Dept.Approval: Underwriters Approval: A111t Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 2 y Applicant Signature BUILDING PERMIT VIEW CHECK LIS T Applicant/ Date Owners Name: � ___ _ ([� a Reviewed: 9116101 Architect/ � �� Date Engineer: C �� -C� lu ..GP. Submitted: SCTM District: 1.000 Section: S Block: Project Subdivision Location: ______ _ Name: (/&,) Sin&le R separate Required certification: (Yes/No) cq Req. Logia 1)istrice I,ot size: Actual: ��y��J I (Loccirverage�-v• Nfoposed_j�l Req. Req. �0%C'C Req. 1 (F'0 Y d Proposed:_� (Side.Yard Proposed J (Rear Yard Proposed F3 o _J Project Description: P AGENCI+ S Rermit REQUIRED FOR REVIEW N.A., NO YES Number Suffolk County Health Dept. ✓ New'York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval. Flood Plane Elevation??? Flood Zone: • T X65-1802 BUILDING DEPT. .'NSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY ol REMARKS: ��.�. n-, l �2 - C DATED INSPECTOR � iil 76!i-1802 BUILDING DEPT. INSPECTION [ ] FOU TION iST [ ] ROUGH PLBG. [ IF NDATION 2ND [ ] INSULATION [ 4jeX FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Ovl �q�„y GcJ DATE /-2' `1 INSPE � BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PL [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL i [ ] FIREPLACE & CHIMNEY REMARKS Alo DATE � � � INSPECTOR I FIELD INSPECTION REPORT _ DATE ..: .' COMMENTS ' 1 FOUNDATION ( 1 ST) --c FOUNDATION (2ND) ------ -- c" ---- -- c" ` - r _ 10 0 ROUGH FRAME & n PLUMBING oll INSULATION PER N. Y. F,+ H� STATE ENERGY CODE FINAL a ADDITIONAL COMMENTS: 4te . �c G / H 4Wa,0F sh'llOLA ksUILVI NU 1✓bkCM11 AePLICAI ION C:HECKLIS' BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: 765-1802 /! Survey PERMIT NO. v2 757 �� Check Septic Form N.Y.S.D.E.C. Trustees Examined ate. 7 ,20 a/ Contact: L,, Approved ,20 D/ Mail to: e R%S e'oy Disapproved a/c ,,ra b7- y�� Phone: fo31-734-- 7f,-35' Building Insrector iy�hY ' j ?nol APPLICATION FOR BUILDING PERMIT 01LoDate — , 20-J11- Lo INSTRUCTIONS a. This 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what-so-ever until a Certificate of Occupan is issued 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 Reghlations, 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 inspections. D / (Signature of applicant or name,if a corporation) ,� D fi�Lra le N 11y3.s (Mailing address of applican State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder DwNe(z Name of owner of premises el&etS L�4q /n boy (don the tax roll or latest deed) If applicant is a corpora�i Pn, signature of duly authorized officer (Name and title llVV f corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: S0 lC.. t" iei✓e ye_ House Number Street HamLet County Tax Map No. 1000ection Block Lot aid Subdivision Ce- o� S S Filed Map No. Lot '*Z1 ame) Z. State existing use and occupancy of pre ises and intended use and occu ancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 61ill r l i. Nature of work (check which applicable): New Building ✓ Addition Alteration Repair Removal Demolition Other Work 1, Estimated Cost Z o, 0 t3 0 . ^ Fee (Description (to be paid on filing this application) If dwelling, number of dwelling units , > Number of dwelling units on each floor fO A If garage, number of cars 2 �. If business, commercial or mixed occupancy, specify nature and extent of each type of use. _414 o,V,,Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front l Rear Depth Height Number of Stories � r Dimensions of entire new construction: Front 2g RearZ� Depth Z HeightXe.r. M,,. 14+. Ito'(v " Number of Stories_ (Lor bA"%L i; s Size of lot: Front ( oa 1��Rear I Lk • t g Depth_ 2-7-1S• t g — c7cs ea-` ---rv'_" 0. Date of Purchase �b � % Name of Former Owner M# ' UA _ ON V 1. Zone or use district in which premises are situated kzsJ�.Vla_ 2. Does proposed construction violate any zoning law, ordinance or regulation: No 3. Will lot be re-graded I %k- Will excess fill be removed from premises: ES NO ll�S l..Q•�U 4. Names of Owner of premises Ga-1, Address go Phone No. fob t -73 7 Name of Architect _ ,� ,,,- ,ra, Address t � P+. Phone No -7 3 Lf- 2 g Name of Contractor 7'6 99-- _D9A1Lc— Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO ✓ • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: :OUNTY OF !S AA being duly sworn, deposes and says that(s)he is the applicant (Name o individual signing contras above named, 3)He is the (Contractor, Agent,Corporate Officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; gat all statements contained in this application are true to the best of his knowledge and belief, and that the work will be -rformed in the manner set forth in the application filed therewith. worn to before me this VF"IN i9L_ day of 20 Notary Public Signature of Applicant NICOLE C.THOMAa: NOTARY PUBLIC,Bto of Now lbrlc N0.OITFI6039505 �IMIktl011 E'�pi�c atdvvY I g 14L ---wa ,� s�o 'y �ti�,Thao •evago diepo �y6 v taailitiee 822a Water suppl 2 y5\0� o'f•� 1nspeatsd by this dg amine on have been � b t sprtment and round . y 0 �� Oti `oa/ cry Chief of General gagia4e+''ted. erinp. ID tE F ca 40y0 'fit G��-Y• _ Ayr Q moo. f SrQ�6 U [ �01 2698 1 .62 % �� HiQ 1 �¢ �� 4589' NO re: >t� ate, i �, ■ = MONUMENT. s s �v SUBDIVISION MAP FILED /N THE OFF/CE s i OF THE CLERK OF SUFFOLK COUNTY ON i .4' \ APRIL 4, /975 AS MAP NO. 624/. f NEAREST WATER MAIN = 4 MILES-` WATER SUPPLY = PRIVATE WELL. I ARE FROM MELD IERS. REVISIONS YOUNG & YOUNG i i THIS RESIPENCf WILL ��• 5 F AUG. 1977 400 OSTRANDER AVENUE, RiVERHEAD, NEW YORK DEPARTMENT OF HEALTH ••, 4iy ALDEN W. YOUNG HOWARD W.YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR _ C! LAND SURVEYOR. N.Y.S. LIC. NO. 12645 N.Y.S. LIC. NO. 48699 ` LINAUTHORIZEO ALTERATION OR ADDITION TO SURVEY FOR: c�'LT O THIS SURVEY I SECTION 7209 OF THE NEW YORK VIOLATION FFRANK BORN TATE EDUCATION ION `AW LO T NO. 21 , "OREGON V/EW ESTATES , COPIES OF THIS SURVEY MAP NOT BEARING r..[ .•uf. VIYVFYriY• IMKFO SEAT. OR 6C- STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) ,Z q Ld "' r; ( c � � being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at L15 el ,(enc r ren or- That That on the % day of It r I , 200 eponent pct/engineer, i licensed by the State of New York, hereby states that4lhe accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 10 0- q 5, a street address C-Uhl-}fl vc AtpoUtct/Engineer worn to before me this day of a , 200 / �' 'E� �'}o $ CE EILEEN .,SANTORA S`E'' ✓ G� NOTARY PUBLIC,State of New York 7; No. 30.4916018 Qualified in Nassau Cou ty (' Commiuion ExpiresUj __ Uj dq Notary Public ;P 032254-1 Ag�FESS 10��'� cc: Applicant I I I 3 � w opo m J _. S I OCCUPANCY OR USE IS UNLAWFUL L WITHOUT CERTIFICATE OF OCCUPANCY m fj o RFFRvVEO (!S NOTED cc q o 0 B.P. # a CLEE: C... W e AIO5A BUILDING DEPART OR HE ¢ _ "565-1 2 9 AM TO 4 PM FOR THE C7 K G I ID A / tP FOLL ING INSPECTIONS: y LL Y 1 F UNDATION - TWO REQUIRED Ix .\ _ in 0 /�• / r� �� O�� OR POURED CONCRETE 1JI ROUGH - FRAMING & PLUMB0 Y I / O . INSULATION K FINAL - CONSTRUCT -� A BE COMPLETE FOR C.OION MUST 2 // ALL CONSTRUCTION SHALL MEET 4 THE REQUIREMENTS OF THE N.V. � STATE CONSTRUCTION & ENERGY _ ��V`. CODES. NOT RESPONSIBLE FOR / r 1 _ � DESIGN OR CONSTRUCTION ERRORS SII 1_�_1 �_� - \� • - �:,,\ UNDERWRITERS CERTIFICATE I�� _--- �� \ REQUIRED -- —'-1 . ----- - Z\ DL I , I _ , s I 1 I - - - - � - - - � YHEwyy ¢ x I I I 'oPtE a T`�9,F. I I � i w I Z'�'F 1aJ22544 .�� I W FES5 pA01DT1P',, / d o� 0 9,i w O 0 7 a u N z N D m v — M -- — _---_ —_ — -- --' — -- — — --- — — -- -- —_ —_ II /gn ! �'! .Vgv-4 a 4 � W , m 213/µ"X cc uQ. 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