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Home My WebLink About27311-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28477 Date: p5/30/02 TI{IS c~a('rIFIES that the building ACCESSORY Location of Property: 6850 ALDRICH LA (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 120 Block 3 MATTITUCK (HAMLET) Lot 8.2 Sut)d±vision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29, 2001 pursua~lt to which Building Peru~t No. 27311-Z dated MAY 14, 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to THOMAS A DICKERSON & WF. ( OWNER ) of the aforesaid building. SUFFOLK COUIqTY DEPARTMENT OF HEALTH APPROVAL BLEt-£~ICAL CERTIFICATE NO. PLUMBERS C~TIFICATION DA'r~ N/A N/A N/A 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. 27311 Z Date M_AY 14, 2001 Permission is hereby granted to: THOMAS A & WF DICKERSON PO BOX 268 MATTITUCK,NY 11952 for : NEW 12' X 14' ACCESSORY SHED IN REAR YARD AS APPLIED FOR. at premises located at 6850 ALDRICH LA MATTITUCK County Tax Map No. 473889 Section 120 Block 0003 Lot No. 008.002 pursuant to application dated APRIL 29, 2001 and approved by the Building Inspector. Fee $ 35.00 Authorized Signature Rev. 2/19/98 COPY. For~ 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 submitte~ 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 Complianoe 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 applicantl 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 Buildin~ - $100.00 3. Copy of Certificate'of Occupancy - ~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .... .. ~. ,.~.( .0~.. New' Construction ......... .. Old Or Pre-existing Building ...... Location of Property. [ ~- .......... House No. Street Hamle~ Onwer or Owners of Property .......... ~. ~ ~/~ ~ AJ County Tax Map No 1000, Section ............. Block ................ Lot.. 00~. ~)0~ Subdivision .................................... Filed Map ............ Lot ...................... ~'~"~[[ "~'~' (i~ ~'[ ''Applicant'~?~'d'?-~., r ~..~ Permit No ................ Date Of Permit.. ! ~/~ Health Dept. Approval .......................... Underwriters Approval .................. ....... Planning Board Approval ................... ..... Request for: Temporary Certificate ........... Final Certicate .......... ~ee Submitted: oc_ ..... .... ......... to the 6diidf~-' BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: 5/14/01 APPLICANT NAME: DICKERSON DATE SUBMITTED: 4/29/01 SCTM#--- DISTRICT: 1,000 SECTION: 120BLOCK: 3 LOT: PROJECT LOCATION AND TYPE OF PROPOSED WORK: PROJECT DESCRIPTION: ADD,ALT~ OR N/D: 8.002 /2- ~(/4 STREET: 6850 ALDRICH LANE CITY: MATTITUCK SUBDIV. NAME: FAST TRACK: YES ~ ARCHITECT / ENGINEER: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/1/83 ZONING: PERMIT ESTIMATE AMOUNT:_$ ~ .00 PERMIT USE: EXISTING: fl ~--~ INTENDED: 5'~/~ ZONING DISTRICT: R40, R80, AC, CONFORMING: YES OR NO REQUIRED LOT SIZE: .SQFT. WHERE ACTUAL LOT SIZE FROM?TaX CaRD REQUIRED REQUIRED. 1sr FOUND: FRONT: ' PROPOSED: ?.,fi~ t, SIDE YD:_YO ' '/__ 2NI) FOUND: FRONT: ' ACTUAL: ' SIDE YD: '/ LOT COVE~g~: ALLOWED: % EXISTING: sf % NEW: s£ CORNER~r YES.OR NO WAT ER i~RONT? YES ~R~ bESCRIPTION:. FLOOD C~M4~IANCE ZONE: PRE-FIRM 3/18/80 PANEL #: FLOOD ZONE: ACTUAL LOT SIZE: SQFT. ' PROPOSED:~/g}? REAR: ' PROPOSED:/32 [ ' ACTUAL: '/ ' REAR:--' ' % ACTUAL: % TOTAL: sf PERMIT #:R10- AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPLI~TION TOWN SPETIC PERMIT: YES orMO SUFFOLK COUNTY HEALTH DEPT: YES or)~, (BED #):__ DTE:__/__/__ APPROVALS REQUIRED: NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES or,~'- TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES or NYS ENERGY: YES OR.~5"7: EGRESS: VENT: LIGHT: BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 , BP -Z / C/0 , FEESTRUCTURE: FOUNDATION: SF FIRST FLOOR : /~r- SF SECOND FLR : SF TOTAL: /d ~ SF T( SF)- ( SF)= SF X $ =$ 1NIT OTHER TOTAL FEE FEE FEE +$ +$ = $ B INSPECTION RgPORT - DATg FOIINDATION (]ST) I ROUGH FRAI4E & PLIJI~BING INSIILATIONI~R N. Y. STATE ENER~ CODE II # II II II : II 11 II II COI~ENTS ADDITIONtL C~S: [ BLDG. DEPT. J L, TOW~q OF SOUTHOLD j FOI~INO. I TO~/N OF SOU~flOLD BUILDING DEPAETt~NT TO%IN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 Di~o~ed a/c .................................. CH~C~ ......................... SEPTIC FORM ................... DEC ........................... TRUSTEES ...................... NOT IFY: CALL .................. ~IAIL TO: ................... (Building Trt~l~ctor ) APPLICATION FOR BUILDING PERHIT 'Date ............ ' .... ,~0... INSTRUCTIONS a. This applieatim ,,m~ .be 'c~letel~' filled in by typem'iter or in i~ ""a :n_~h,itted to the Building Inspector 3 sets o£. pl~-% accura ,~e plot:plan ~o ~cale, Fee according to schedule. :l , . ' ,[ b. 'Plot plan ~,~ng i0e~tion of lot;~ of lmildin~s on premises, relaticamhip to adjoining pr~r~ises or public s~reers or ~-% ~a giving a deradled description of layerof p~op~~,~t''be:dr~ l~ ' ~diagr~ which is .,~ o: this ~pplication. c. The turk co. red by this application my not be cu~,,onced before issua~e of Building Permit. d. U~ ~o.al of this application, the Building Inspector ~ill issue a Building Pe~mlt to the applic~t. Sud pemit ~all be,kept on the praises a.ailable for inspection throughout the ~ork. . e. No building shall be occupied or used in ~hole or in part for any purpose ~ahatever until a Certificate of At~hlOa'IC[~ I~ tsa~mi ~ t~ the Building Depa~.t for the iss~ce of a Building Permit pursnnt to Building Zo~ Ordinance of the To~n of Soutlaold, Suffolk County,' New York, and other ~pplicable La~s, Ordinanaes' or 'Regulatiorm, for tho construction of imildlngs, ~itions or alteratioas~ or for' removal or a~alition, as herein described. The mo~li¢~nt a~-ees to tv,,.2ly with all 'appliCable ~,i~m, ordin~s, buildi~de., housing code, and ,regulations, ~aco ~t~it ~,thoriz~l inspectors' premises ~n~ (Igailing . res~ of applic~t) State ~her_her ~lic~-t is owner, lesseeS, arch:tect, engineer, ~eral contractor, electrlelall, plunber or ............................ ............. ......... ? ..... ' ........................... ....... .......... ~.~ o, ~.~ of ~...~.~t~i .... D..;c.&~ox2. ........ : ................................................ (as on t~e ~ roi1 or late~t deed) If am,Ii, cant i~ a corporation, ~ignature of &aly ~athori~d officer. (Nam ~ title of co~p~rate officer) Other Tr"a~'s License No ..................... I. I~cation of l~ tm ~txid~ proposed ~ ~11 ~ ~ .... ~ ..... ~ .................................................. ..... .................. : J.omc .... .......................... ................. .. ~ ~ St~t ~et ~ ,~ ~. ,~ ~i~ .,~- ........ ~ .~..~,..: .... :. ~t~?~. ........... ~ivisi~ ...................................... Fil~ ~ ~. ~t .., ............ 2. State mst;~ ~ ~~ 0f ~ims ~ ~t~ ~ ~ ~ of ~ mt=ti~: a. ~ti~ m ~ ~ ................................... :':~:V..'; .................................. ~ir ............ ~l ............. ~liti~ ............ Oar ~ ~~..~[ .......... '. ~~~ (~ipti~) 4. Es~i~m~ ~s~ . . (to ~ ~id ~ fili~ '~is a~li~ti~) 5. If ~lli~, ~r of ~lli~ ~its ............ ~r of ~lling ~its ~ e~ ~r ................ If ~e, ~r of ~rs ...................................... 5. If ~i~ss, ~..,~rcial or ~ ~, ~i~ ~ ~ ~tent of e~ ~ of ~. ~, ............ 7. Di~nsi~s of ~isti~ st~m~s, if ~: ........ ~ ..... ~ ' th t~i~t ......................... ~r o[ Stories .,.' ................... D~z~ o~ ~ st~e ~th alterati~ or ~iti~: ~t .............. ~ar ............... ~Pth .................... ~i~t .................... ~r of Stories ............... 8. Di~nsi~ of ~ti~ ~ ~t~tim: ~t ................ ~ar ............... ~p~ .............. ~i~t ......................... ~r of Stories P- Si~ of lot: ~,t .................... ~ ........... ;; ....... ~p~ ............... . ..... IO. ~te of ~d~ ..................... ~ of Four ~r ........................................ I I. ~ or ~ district in ~i~ p~,t~s a~ si~ ............................................................... 12. ~s ~ ~tim violate ~ ~i~ 1~, o~i~ or ~lati~: ........................ 13. ~ilL lot ~ o, ................. ~ o~ ~,~,~ ~ '.~.~M~ ......... ~ ,,, ~.71..[~a$~.: .......... ~ ~. ~~. 15. Is this p~o~ ~in ~ f~t o~ a till ~tl~? * ~ .......... ~ .~. ~OT DIAG~ ~ate cl~ly ~,'~- ~r~ li~s. Gi~ 's~t ~ bl~ ~r ~ ~ripti~ ~i~ to ~cd, ~ ~ st~t ~s ~ i~i~te ~r interior or ~ lot. (Contractor, a~t, corporate officer, etc ) l' f said o~ser or o~mers, and is duly authorized to perfozm or have performed the said ~ork a~l to make ar~ file this pplication; that all statet~,~t, ts Co~tained in this aPblicatlon are true to tbe best of his lmo~ledge and b~liefi and hat the ~rk viii be pervorned in, tim maturer set forth in the application filed therewith. ~rn to before ne this ......... uunt~ iN ,~"FOi. K ~ AVENUE _ SINGLEJrAI~IILY DWI:lUNG O~Y OATE~EC 0 9 1987.s ~ NO ~? · The sewaKe disposal and water ~pply faciliti~ for location have been ins~cted by th~ Depa~ent a~/~ ,~a. H ~ , ch~f~f Bureau of Wastewa~r Mana~m~t HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT I,I~AR~ST WiT1ER ~AIN-,.,_ld_l_-4, #SOURCE OF WATER, ~ ~dlrtr CO. TAXMAP MT K3~X7 SECTION I-eO K,OCK..Q~_. LOT I~TMEIIE R HO DWELLINtS WITHIN I00 FEET OF TI41S AROPERTY OTHER THAN THOSE S#OV~J HEREON. N THE WATER SUPIR.Y AMD $1EMI4~E DISPOSAL SYSTEM FOR THIS NSIDEMC~ ~1~ ~ ~ T~ STAM~ OF TH~ S~K LOFTY DEPARTMENT ~ ~LTH ~LI~T, NOTE~ B=MONUMENT A-'STAKE \ SURVEY FOR THOMAS A..plCKERSON & CATHERINE M. OlCKER$ON FEB. S~I987 DEC. 16~ 1986 JUNE 8,1986 AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK N LI~a, UTHOR1ZED ALTERATION OR ADOITION TO THIS $UmVEy B A VIOLATION OF ~CTtON ?ZO9 ~ THE ~W YO~K STATE E~CATION LAW SUNVE~R'~ I~EO S~L OR ~MBOSSEO ~AL SHALL NOT IE CON~IOE~D TO ~ A VALIO TRUE COPY ~ ~R~ ~R WHOM ~E SU~T IS AND ~ HIS BE~F ~ THE TITLE C~, MENTAL AGENCY A~ LEMOING INSTITUTION INSTITUTI~. GUARANTEES a~E ~T ~ERABLE ~ A~ITI~AL INSTITUTI~S OR SUBSEQUENT O~ERS NOISTANCES S~M HEREON FROM ~[RTY UN~S ~XISTIN~ ST~UC~RES AR~FOR P~POS~ AMD AK HOT TO B~ USED ~ ESTABLISH P~P~RTY UN[S OR ~R THE ER~CTIOfl ~ FENCES DATE: SCALE: I"= 60' NO. 86. 468 UARANTEF $OUTH~K YOUNG YOUNG ALDEN W. YOUNG~ PROFESSIONAl.. ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO, 12045 HOWARO W. YOUNG, LAND SURVEYOR N.Y,S. LICENSE N0.4589~ 400 OSTRANOER AVENUE RIVERHEAO~ NEW YORK