HomeMy WebLinkAbout29111-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29830 Date: 11/13/03
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1615 FLEETWOOD RD CUTCHOGUE
(HOUSE NO.) (STREET) (PiAMLET)
County Tax Map No. 473889 Section 137 Block 4 Lot 35
Subdivision Filed ~4ap No. __ LOt No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 6, 2002 pursuant to which
Building Permit No. 29111-Z dated JANUARY 17, 2003
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 IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to FR3kNK SCAVONE
of the aforesaid building.
(OWNER)
SI~FFOLK COI~qTYDEPART~NT OF ~{F~JSTH;kPPROVAL N/A
ELEC'~RICJ%L CERTIFIC3%~]~ NO. 3864 10/16/03
PLUMBERS CERTIFICATION DAT~U N/A
'/~/~gnatur 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. 29111 Z
Date JANUARY 17, 2003
Permission is hereby granted to:
FP3~NK SCAVONE
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF AN ACCESSORY SHED AS APPLIED FOR
at premises located at 1615 FLEETWOOD RD
County Tax Map No. 473889 Section 137 Block
pursuant to application dated AUGUST 6, 2002
CUTCHOGUE
0004 Lot No. 035
and approved by the
Building Inspector to expire on JULY 17, ~
Fees 75.00 ~~
/ k~,/~Yr i zed Signature
COPY
Rev. 5/8/02
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. Coiranercial 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 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,
Swinnrfing 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
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction: /~
Location of Property: / 6 t ~
House No.
Owner or Owners of Property: _
Suffolk County Tax Map No 1000, Section
Date.
Old or Pre-existing Building: __ (check one)
Street
/--~-~a~ ~
/~ ~ Block 0 G Lot
Subdivision
Permit No. offal II I '2--
Health Dept. Approval:
Planning Board Approval:
Filed Map.
DateofPermit. j/%-, t'~ O~3 _Applicant:
C~ ff-/q__ Underwriters Approval:
Lot:
Hamlet
Request for: Temporary Certificate
Fee Submitted: $ ¢:~ ~
Final Certificate: / (check one)
Applicant Signature
Town Hall, 53095 Main Road
P.O. Box 1179
$outl~old, New York 11971-0~59
Pax (631) 765-9502
T*l*phono (631) 76S-180g
BUILDING DEPARTMENT
TOWN OF 8OUTHOLD
January 17, 2003
Frank Scavone
1615 Fleetwood Road
Cutchogue, NY 11935
To Whom It May Concern,
Upon review of your permit apphcatkm for an accessory shed, it has come ta our
attention that you have an expired building permit. Building permit # 24107Z, for
additions and alterations to a single family dwelling at 1615 Fleetwood Road, Cutchogue,
NY, was issued in 1997. Although you were ~sued a permit, you never had a final
inspection and you do not have a certificate of occupancy, which means you are in
violation of Southold Town Law.
We have issued you a permit for your proposed accessory shed, however we will not
issue a certificate of occupancy until you rectify the above referenced issue.
It is your obligation to rectify this matter as soon ss possible and remit all of the fees
associated with this action. In order to get a certificate of occupancy for the expired
permit, the permit must be renewed for a fee of $568.20 and a final inspection must be
scheduled. Once you p~s final inspection, you will be asked to submit any
documentation necessary for a certificate of occupancy, include all fees and applications
required.
If you have any questions, you can contact me at (631) 765-1802 between the hours of
8:00 a.m. and 4:00 p.m.
Building Permits L~xanmaer
CC: File
Nassau Suffolk Electrical Inspections,
5A Canal Street * Center Moriches, New York 11934 * Tel: 631-878~3500 * Fax: 631-878-3764
Application: 3864 Date:
Issued to: Scavone
Address:· 1615 Fleetwood Rd
Village:
10/16/03
Cutchogue Introduced By: Klein Electric
Lic#:4423-E
was examined and approved up to the above date and was in compliance with the NEC
l lll
Switches Receptacles Fixtures G .F.I. Sub Panel Whirlpool
4 15 6 60A
Oven Carbon
Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide
Smoke Bell
Furnace 0il Gas Heat Zones
Detectors Transformers
Meter Amps Phase Motors
Other Equipment: Wood Shop
Dock Power-1 sw,2 recepticles,1 fixture,1 GFCI
Out,Res
Permit:
29111-Z'
This certificate must not be altered
in any manner
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765~9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 17, 2003
Frank Scavone
1615 Fleetwood Road
Cutchogue, NY 11935
To Whom It May Concern,
Upon review of your permit application for an accessory shed, it has come to our
attention that you have an expired building permit. Building permit # 24107Z, for
additions and alterations to a single family dwelling at 1615 Fleetwood Road, Cutchogue,
NY, was issued in 1997. Although you were issued a permit, you never had a final
inspection and you do not have a certificate of occupancy, which means you are in
violation of Southold Town Law.
We have issued you a permit for your proposed accessory shed, however we will not
issue a certificate of occupancy until you rectify the above referenced issue.
It is your obligation to rectify this matter as soon as possible and remit all of the fees
associated with this action. In order to get a certificate of occupancy for the expired
permit, the permit must be renewed for a fee of $568.20 and a final inspection must be
scheduled. Once you pass final inspection, you will be asked to submit any
documentation necessary for a certificate of occupancy, include all fees and applications
required.
If you have any questions, you can contact me at (631) 765-1802 between the hours of
8:00 a.m. and 4:00 p.m.
Building Permits Examiner
CC: File
765-1802
BUILDING DEPT.
INSPECTION
[~/~ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMAR~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] F~NDATION 2ND
[~/] FRAMING
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
REMARKS:
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[. ~Ii~TION
[ ~/] FINAL
DATE
· OWN OF SOUTllOLD
BU1LDINO DEPARTMENT
TOWN. HALL
SOUTIIOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfor/cnet/Southold/
Disapproved aJc~2~t
Expkafion
AUG I $ 200
BUILDING PERMrr APPLICATJO~
Do you have or need the following, b~
Board of Health
3 sets of Building PI,ms
Planning Board approval
Survey
Check
Septic Form
N.¥.S.D.E.C.
Trustees
Contact:
Mail to:
--
FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20.
a. This application MUST be completely filled in by typewriter or in ink and submitted to the BuilcFmg 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 o£Bnilding Permit.
d. Upon approval of this application, the Bni/ding Inspector will issue a Building Permit to the applicant. Such a peri'nit
shall be kept on the premises available for inspection throughout the work.
e. No binlding shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new penn/t shall be requ/red.
APPLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Perm/t pursuant to the
Building Zone Ordinance of the Town of Southold, Suftblk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
ipplicant agrees to comply with all applicable laws, ordinances, building ¢ode, housin..g~code~t regulations, and to adm/t
tuthorized inspectors on premises and in building for necessary inspections.
~r~ e of applicant or name, if a corporation)
(Mail/ng address of applicant)
ite whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
ne of owner of premises
(As on the tax roll or latest deed)
~plicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
iers License No.
tbers License No.
ricians License No,
· Trade's License No.
)cation of land on which proposed work will be done:
rose Number Street
tmty Tax Map No. 1000 Section
)division
Hamlet
I~:~.,,'~ /~i,l-'
"'
Block c. ,~
Filed Map No ~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction,
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost ,ge t W t>o ~
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
(Description)
Fee
(To be paid on filing this application)
t'Vr-Number of dwelling units on each floor
If business, commercial or mixed occupancy, specify nature and extent of each type of use. rt///~
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear .Depth
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stodes
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear .Depth
9. Size of lot: Front Rear _Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated '¢-~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES /~ NO
13. Will lot be re-graded? YES NO .)<f Will excess fill be removed from premises? YES
14. Names of Owner of premises 4-. 3't~--~-4 r
Name of Architect
Name of Contractor
Address / ~,r~'- ~(v3tn,-oo,~ PhoneNo.
Address Phone No
Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ~/~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE/REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO '~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
COUNTY OF~~S:
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me tl')~
[ (^ ,. day of~l~~ ~ 2009
(J Notary Public
LYNDA M. BOHN
NOTARY PUBLIC, ~tate of New York
No. 01 BO6020932
Qualified in Suffolk Courtt~
Term Expires March 8, 20~,
/S ign~-~e o f Applicant
EAST C I'~"' E EK
(Eugene s Creek)
N 5°31'40" W
50.00'
· ~ o
0
[..- Z ,..' ,~' t~~
<
0
FLEETWOOD
SENT BY: ;
631 734 6272;
JAN-lO-03
2:35PM;
PAGE 2/3