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Home My WebLink About27872-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29403 Date: 04/30/03 T~IS CERTIFIES that the building ACCESSORY Location of Property: 115 HIGHLAND RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Sectlo~ 109 Block 2 CUTCHOGUE (HAMLET) Lot 16.1 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 2001 pursuant to which Building Pexl~it No. 27872-Z dated NOVEMBER 7, 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 THREE CAR GARAGE AS APPLIED FOR. · ~he certificate is issued to JANICE HANSEN of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF ~%LTH A~PROVAL ELEt'£~fCAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~mu N/A 1077080 N/A ~09/21/02 Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27872 Z Date NOVEMBER 7, 2001 Permission is hereby granted to: JANICE HANSEN 115 HIGHLAND ROAD CUTCHOGUE,NY 11579 for : CONSTRUCTION OF A THREE CAR ACCESSORY GARAGE AS APPLIED FOR at premises located at 115 HIGHLAND RD CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0002 Lot No. 016.001 pursuant to application dated OCTOBER 4, 2001 and approved by the Building Inspector. Fee $ 405.60 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 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 plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Cormnercial building, industrial building, multiple residences and sitnilar buildings and installatious, 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: I. 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. I~er~ifi&ate 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, Swimlning 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 - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: _ ~N Old or Pre-existing Building: Location of Property: tiff House Nc~. '~ - Street Owner or Owners of Property Date. ~ 3'-nO 7-- (check one) Suffolk CountyT~mMap4'4o44~00; Section - ~/-~ -- Block Subdivision _ fiq~ / ~_F_4'~o~_¢$ FiledMap. Pernfit No. ~.-t7 ~' ~'7.L DateofPermit. /~, v~'O[ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Te~nporary Certificate __ Fee Submitted: $ Fiual Certt icate: (check one) I~ BY THIS CERTIFICATE OF COMPLIANCE THE r~ NEW YORk BOARD Of FIRE UNDERWRITERS r~ BUREAU OF ELECTRICITY r~ 40 FULTON STREET ~ NEW YORk, NY 1OO38 r~ CERTIFIES THAT ~ Upon the application of upon premises owned by ~ FORK ELECTRIC ROBERT HANSEN TWIN ~ P.O. BOX 48 26905 RT 25 ~ JAMESPORT, NY 11947, CUTCHOGUE, NY 11935 ~ Located at 26905 RT 25 CUTCHOGUE, NY 11935 ] Application Number: 1077080 Certificate Number: 1077080 ~ Section: Block: Lot: Building Permit: BDC: NS11 ..-q Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Detached Garage, Outside, was inspected in accordance with the National Flectrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 21st Day of September; 2002. Name QTy Rate Rating Circuit Type Panels 1 30 2 Wiring and Devices Receptacle 4 0 General Purpose Switch 5 0 General Purpose Fixture 5 0 Incandescent Receptacle 1 0 GFCI I of 1 ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. STATE OF NEW YORK ) ) ss: ~ COUNTY OF SUFFOLK ) /, being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at That on the ~, day of 1~,3,]__ ,2001 deponent architect/engineer, licensed by the State of New York, hereby states that s/he 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# 1000- ~'e~7~ lo? ~/~ I~ 7- L,~7"i~. I street address ~ /~ ~/v--C'~)~ ~5" A //~. {/~ ngineer ' Sworn to before me this ~.~ day of /V'~l/. ,2001. I'~ary Public Notar7 Public, State of New Yo~ No. 4875563 Qualified in Suffolk County Commission Expires November 3. cc: Applicant BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: fi/ 9-/01 .DATE SUBMITTED: t~ / 'ff /01 SCTM# DISTRICT: 1,000 SECTION: !o STREET: PROJECT DESCRIPTION: ARCHITECT / ENG~E~~ BLOCK: ~.- LOT: CFFy:~ SUBDIV. NAME:~.~....~_ FAST T~CK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? t'/° NOTES: ~- LOTS 40,000SF -100-24. Lot recognitiom(CRF~TED before June 30, 1983), UNDERSIZED LOTS FROM JAN. 1997 100-25. Merger.(A nonconforming at any time after 7/1/83) ZONING DISTRICT: REQ. LOT SIZE:~°'~O REQ. FRONT /a REQ. REAR /o, --.-.-.-.-.-.-.-.-.~ WATER FRONT? PANEL ii: /et/(7"' /-~ - C.~ CONFORMING? M~ 4otO ACT. LOT SIZE:__ REQ. LOT COV. ~o ~ ACT. LOT COV. . PROP.PRop.FRONTREAR REQ SIDE/~,~/a ..a,,~? .~AC~S~E DESC~TION: FLO6D ZOO: ~ , AGENCY PERMITS REQUIRED FOR REVIEW AP~LS REQUIRED: SUFFOLK COUNTY HEALTH DEPT: YES ~rBED #): DTE: NEW YORK STATE DEC: Par-DECganS YES Ol~ SOUTHOLD TOWN TRUSTEES: YES o~ TOWN ZONING BOARD APPROVAL: YES or~ TOWN PLAN. BOARD APPROVAL: YES or~ TOWN HISTORICAL PRE (SPLIA): YES orr0 NYS ENERGY: YES OR NO : ~ / EGRESS (18 H min.? 4 sq total) / wS~q-~Q. FT.x 4 %) BUll,DING PERMITS OPEN/EXPIRED: 'BP -Z / C/0 Z- HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: / / PERMIT #:RI 0- LIGHT (SQ. FT. x 8%) FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: ~/~- SF SECOND FLR: _.f.~.o SF TOTAL: /3'.r',~ SF SF)- ( ~" SF)= ~-~.~- SF X $. :~ INIT OTHER TOTAL FEE FEE FEE +$ 765-XS02 BUILDING DEPT. INSPECTION [ ] FOUN~i~tST [. ~iDATION 2ND [ ~ FRAMING [ ] ROUGH PLBG. [ . ]~N [ /,~ FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ FO~~UNDATION 1ST [ ] ROUGHPLBG. [ ] FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: INSULATION FINAL DATE INSPECTOR ~.~D 'I-HSPgCTION. FOUHDAT~OH rwSUI, ATXOH PER N. ¥. CODE TOWN OF SOUTHOLD BUILDING DEPARTMI~,NT TOWN HALL SOUTHOLD, NY 11971 TEL: 7~-1802 D/~pproved z/c ,2o BUILDING PERMIT APPLICATION CHEC~.I,~T . lq'.¥.$.D..~¢ .... Contact: APPLICATION FOR BUH,1HNG PERMIT. INSTRUCTIONS a. This spplic~fion MU~T bo completdy fill~ in by typewrit= or in ink and ~amitted to th~ Building Inspector with sots ofpl~% accurat= plot ph~ to scale. Fee aocordiug to schedule, . b. P10t plan shew'lag location of lot and ofbutl4{-~ on pr~nises, reistlonship to adjoi-~%~ ~s or public strec~ or areas, and waterways. ~ c. Thc work cowred by this applioatical may not be °°mm~0ed before issuanoe ofBuildi"$ P~mlt. d. Upon approval of t~i~ applioafion, the Bu/Mi~ Inspector will issue a Building Perm/t to the ~lAicant. Such a p,~ ~h~;1 be kept on the pre~se~ available for imp~don ttn~uShout the work. . ' e. No buildi~E shall bc occ~ied or used in whole or in part for any purpose what.so.ewr until a Cextificate of Occopancy is issued by the Building Inspector. APPLICATION L~ tt.v. KEB¥ MADE to the Bufldi~ Depart.for the issuance ~f a Building .permit pummnt to the B~,.ai~ Zone Ora~.~ce of the Town of Southold. Suffolk County, N~w York. ~a otl~r applicable Laws, Orai,~no~s or Regulations, for th~.consmiction of buildings, ~_aa. itions, or alterations or for r~moval or d~molition as ~ describ~L Th~ ordlmnc~ building code, housmg ~ixtg, and regulations, and to applicant agr~-s to comply with all applicabl? laws,, State whether applicant is own=, l~ssee, ag~t, architect, ~nginecr, g~al.__contractor, elec=idan, plumber or builder Name of owner of premises (as onthe tax roll or ht~t deed) If applicant is a corpo,~alon, signature of duly authorized officer (Nme and title of corporate office) Build~s License No. Plumbers License No. Ele~Ui~ans License Other Trade's License Location of land on which proposed work will be do,n?: House Number Street County Tax Map No. 1000 Sec'don Subdivision Hsmlet ~' Block '2- ' Lot Filed Map No. '! gl / b. lntended use and occupancy _~ e.a~' L Nature ofwork (checkwhlch applicable): New Building Repak Removal Demolition 5. If dwelling, number of dwe11ing lmits If garage, number of cars 42 Addition Oth~ Work Alteration (Description) (to be paid on ~ling this application) Number of dwelling traits on each floor Ifbnsiness, commei'cial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ,~ ff.'S" Rear .~, $' Number of Stories Height Dimensions of same structure with alterations or additions: Front Depth Height Number of Storiet~ 8. Dimensions of e~tlre new constmcedon: Front .g ? ' Height /gz', Number of Stod~s . 9. Sizeoflot:Front tq/' + · Rear '2-07' 10. Date Name of Former Owner Will excess flu be removed ~ premises: YES NO . Address ' ~'~fc.~ouo ~e . PhoneNo. Address Address ~Z_, k ~o ~/~// 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be to-graded ftc-- ~,..,.~,.~ 14. Names of Owner of~i.~es ~; ~_~ NameofArchitect r...h~/~ Tg~'~x Name of Contractor ~ri/~ ~ ,'_~- 15. Is th~propertYwithl, 100 feet ofatidal wetland? *YES NO X · m YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE RBQUIRED 16. PrOvide survey, to scale, with a~an'ate foundation plan and distances to pmpezl-y lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NI~W YORK) SS: COUNTY OF . emg clnly sworn; deposes and says that (s)hc ts th~ applicant (Name of individual si~i-g co.~kact) above ~amect, '(Contractor, Ag~at, Corpor~ Officer, of said owner or owners, and is duly authmdzed to pa'form or have lXa-formed the saidwork and to mak~ a~a file this application; that all statem~ts contained in this application are tree to the best of his knowledge and,beli¢~ and that tl~ work will be performed ia the manner set forth in the application filed ther.with. HELENE O. HORNE Notaw PubliC. State of Ne~ ~ No, 4961364 Qualified in Suffolk CoUld. ~.. Commission F-.~ires May 2/, ~_ 62~d~ ~ BO~° NOTE I=MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK Of:' SUFFOLK COUNTY ON AJAR. 26, 1977RS FILE NO. 65}7'. SUFFOLK COUNTY TAX MAP DIS1' IOoo SECI'~ gl BLOCK.--[--LOT II/~, SURVEY FOR HOWARD ROSENSTONE LOT I, "MAP OF HIGHLAND ESTATES" AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE MAY ~'O, ~980 80' ;~91 GUARANTEED TO: THE TITLE GUARANTEE CO HOWARD ROSENSTONE l[YOUNG a YOUNG ALDEN W YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYORNYS LICENSE NOI2845 HOWARO W YOUNG, LAND SURVEYOR N.¥S LICENSE NO 4~89~,