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HomeMy WebLinkAbout30814-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30658 Date: 12/28/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 275 PRIVATE RD #8 CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 3 Lot 18.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 29, 2004 pursuant to which Building Permit No. 30814-Z dated DECEMBER 2, 2004 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 "AS BUILT" ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ANTHONY & EILEEN MASSIMO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 70 ed Si ature 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. 30814 Z Date DECEMBER 2 , 2004 Permission is hereby granted to : ANTHONY & EILEEN MASSIMO 3155 EUGENES ROAD CUTCHOGUE,NY 11935 for INSTALLATION OF AN ACCESSORY SHED "AS BUILT" IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 275 PRIVATE RD #8 CUTCHOGUE County Tax Map No. 473889 Section 097 Block 0003 Lot No. 018 . 006 pursuant to application dated NOVEMBER 29, 2004 and approved by the Building Inspector to expire on JUNE 2 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 2 r 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. 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 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 / Date. j.2 New Construction: Old or Pre-existing Building: (check one) Location of Property: 14 k S S (' �� �, g c, j t— House No. Street Hamlet Owner or Owners of Property: A'el 4z U j',, %t k /p_ _,J' 10 4's 5,"M o Suffolk County Tax Map No 1000, Section Q 9�7 Block O 4 0 3 Lot 0/f, 6 O Subdivision Filed Map. Lot: Permit No. 3oq Date of Permit.,)/off Applicant: Ay +o,j;`o - .'/o.�-n/ A✓1 Health Dept.Approval: Underwriters Approval: �� / s Lo Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ I'd, - , )i ,,,A- A-42 Applicant Signature O(D 9V 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE � //310 INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) ------------------------------------ FOUNDATION(2ND) ___ _ a 0 trJ ROUGH FRAMING& -- - � PLUMBING r INSULATION PER N.Y. — --- y STATE ENERGY CODE art FINAL ADDITIONAL COMMENTS G . U 7 0 O z m X J> � k .ti — O x r -- --- CEJ b Y - TOWN OF SOUTHO LV �r. BUILDING PERMIT APPL TIQNN CHECKLIST BUILDING DEP,AR ENT Do you have or need th, Mowing,before applying? TOWN HALL 2 9 � ; '� Board of Health SOUTHOLD,NY 11911 4 sets of Building Plans TEL: (631) 765-1802 ____. .._._.._. f Planning Board approval FAX: (631)765-9502 t �' _ ._ __ .l Survey www.northfork.net/Southold/ PERMIT NO. o F/y a Check Septic Form N.Y.S.D.E.C. Trustees Examined ! �- ,20 0 5;� Contact: Approved Z Z" ,20-ge— Mail to: Disapproved a/c Phone: Expiration ,20 Of- le Building Inspector APPLICATION FOR BUILDING PERMIT Date 20, INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 the Building Inspector issues a Certificate of Occupancy. I 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 permit shall be required. 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 Regulations, 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. (Signature of applicant or name,if a corporation) )S5 J c.r,✓2 S ailing address of applicant) A 61 e_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Lookf Name of owner of premises JQ,J 4V AJ , (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on w1hich proposed worS,,�jll be done: Aa! W, S J C U c_ House Number Street Hamlet County Tax Map No. 1000 Sectiony q :Z, Z) 0 Block 03 , d O Lot:,, d/ �, -0-6. f--- Subdivision c rsG Qe e,,v &0-A-aeat Filed Map No. Lot (Name) ,,r ,� i.•y ��• . , . 2.. State existirrg use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy F 3. Nature of work(check which applicable):New Building / Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures,if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depths Height Number of Stories t � � 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner rglf"4 c r S �R e a-Af L� - 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 /Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? * S NO .� * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE QUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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 Og NEW YORK) 9 SS: COUNTY OF /4—�q 11P n ( v fXa SS I 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 true 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 this day of 661 200�4 Notary Pughc Signature of Applicant h PENNY BEDELL Notary No.g1x6 9 317 York �7 QMMW in Suffolk Coun1Y�-,�D commi..Expues Sept. ,�L_ i ONE - SUFFOLK.CO. TN O 01 -Now tft. H.S. NO.. 10 41, t ' 00 ' STA]'EMEMT OF,INVENT THE WATER SUPPLY AND SEWAGt-*I$V0SAL j CA SYSTEMS FOR THIS R£SIQgNCE INt o54/47V45Y,E"D rats �t CONFORM TO T E STANF�11 R01I '!0 TPtE ' x ! SUFFOL PT. MEAT -WA vI i.cm, 7"`Ololl0 MA 5.51100 cs� - 7 .. RiPPr{: T I r SUFFOLK C04*T�Y o6;r. Com` i. r *•� ti raft � CONSTRUCT .:caNiL � DATE. H. S. REF. NO.: 5 `^ t tcl�lB • 17Q"= APPROVED- scald : C©. TAX aESit�lAT1t'S : ---------- f _ ! DIST. SECt BLOCK \ ;R• { R�?�R = -t. IZI A c�26.S_ OWNERS ADDOESS: tic I!5 S� . COVE R1040- L<:)7" _,O�#0- L of trcrtflhd rS rilxer to Grd+wwiw . imv mab j* ,b)l i/�tr� -4 Ole i x .3-at ettra to thio eunrey is a . �� season 7208 of the Nen York sit► ~' Education Uw. WW Wir"Yoes k*Ad"W or y -. °^�Yt`Ow PK for the r _ T � Y OKYpd.and�on � 16 the J ` ''R w t All - F$'m 1(M FROM DATE OF APPROVAL. to u� or a►8 8waytiar�acted n ! ,/ WftL am "' to adadon8l tSS11 iom o it ori.. ` - .. .q H R L :yid"] t -�� �/ _ � •��� r` r p N, 6' ,�'�'�,�f ,��, ZOO ! f ,. •� V `' q,• r'` MAY _4 1993 y•%f"� ' oo �� ROa911E 1VANJPYL.P.C.ONO * � S.C. DEPT. OFL t ANV SLNtVgYORS _ HEALTH SERVICES GMEWOOT NEW YORK LANDsFc No L 4� wrwt f+n Nrw+ sj \ i _ o - OCCUPANCY OR Lte ,-+r-4 USE IS UNL Ca r U L —T WITyf ' "ER T IFICATE 0 0 ANCY SI , AFS~:'>rED AS NOTED :ZY &19c wlra- _�_Z-ILS -ST�?iNG FEE _-. _ 2.�. _ BY. r'La N01 IF BUILD. ''SENT AT 765 ff, FOR THE FOL 'A rNG It., _G I' 1. F ^:DAT"'. REOUIRED F RL 7P) s 2. RDWGH 8 PLUMBING 3. I _c 4 F _ ?ti MUST I BE 10! , ALL S-ALL MEET THE I FtC 'l F HE CODES OF NEW 4 _cc / j YOR . "ATI= ^,T RESPONSIBLE FOR DESI ��. OR CSPUC,'jICA ERRORS. C. -- N 556 /2