HomeMy WebLinkAbout32448-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 10/30/06
No: Z-31961
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1650 HORTON
(HOUSE NO.)
County Tax Map No. 473889 Section 63
LA
(STREET)
Block 1
SOUTHOLD
(HAMLET)
Lot 14
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
OCTOBER 25, 2006 pursuant to which
Building Permit No. 32448-Z
dated
OCTOBER 25, 2006
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 AS APPLIED FOR.
The certificate is issued to JANE E WELZ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL
N/A
PLUMBERS CERTIFICATION DATED
N/A
N/A
ELECTRICAL CERTIFICATE NO.
~ ML/--
thorized Signature
Rev. 1/81
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31959
Date: 10/30/06
THIS CERTIFIES that the building ADDITION
Location of Property: 1650 HORTON
(HOUSE NO.)
County Tax Map No. 473889 Section 63
LA
(STREET)
Block L-
SOUTHOLD
(HAMLET)
Lot 14
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
OCTOBER 25, 2006 pursuant to which
Building Permit No. 32448-Z
dated
OCTOBER 25, 2006
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" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JANE E WELZ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMEIIT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~izee-
Rev. 1/81
Form No.6
TOWN OF SOUfHOLD
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:
I. 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 I % 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:
I. 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
I. 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. \ lY~o' D Co
New Construction:
: X Old or Pre-existing Building:
( check one)
-Sou.. i-R ~ J
Hamlet
Location of Property:
14o'5D
House No.
\-6(~ LA~
Street
Owner or Owners of Property:
To.. i'-l..
GI..-UMz-
lP '3 Block
Lot \ '-I
Suffolk County T"j< Map No I 000, Section
Subdivision I (-< ~ Jt-. l. 0 )
Filed Map.
Lot:
Permit No. 3 ~'-\ '-\-'f:..
Health Dept. Approval:
Planning Board Approval:
Date of Permit. \D-~S -Clc:, Applicant:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
'Yv
( check one)
Fee Submitted: $ 5 o. . DO
~Cl:&3\o,5'1 ~cJe.,
Co 2: 3/0, V I AGc.'i~ 01
)<~' f.uJ~
Applicant Signa
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.
32448 Z
Date OCTOBER
25, 2006
Permission is hereby granted to:
JANE E WELZ
42 CALEB'S WAY
GREENPORT,NY 11944
for :
DECK ADDITION AND CONSTRUCTION OF AN ACCESSORY SHED AS APPLIED FOR
THIS PERMIT REPLACES 21917Z
at premises located at
1650 HORTON LA
SOUTHOLD
County Tax Map No. 473889 Section 063
Block 0001
Lot No. 014
pursuant to application dated OCTOBER
25, 2006 and approved by the
Building Inspector to expire on APRIL
25, 2008.
Fee $
300.00
ORIGINAL
Rev. 5/8/02
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.
21917 Z
Date FEBRUARY 24, 1994
permission is hereby granted to:
WELZ, JANE E
59 WEST 90TH ST
NEW YORK,NY 10024
for :
BP#21917Z
I 0
rear of an exis
tin dwellin
5~.e.....- 3d Y'f?5
at premises loc ed at 16
TON LANE
County Tax Map No. 473889 Section 063
pursuant to application dated N/A
Block 0001
Lot No. 014
and approved by the
Building Inspector to expire on AUGUST
24, 1995.
Fee $
0.00
ORIGINAL
Rev. 5/8/02
FORM NO.3
TOWN Of SOUIIIOLD
BUILDING DEPAIlIMENI
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
'~DID ~L 3~YYf ~ 9
21917 Z Date ..............tr;/.~............................ . 19....'}!::
N~
Permission Is hereby granted to:
.....;r~.~......~..:...Y!..€:.f:.?.................................
..!.~.g?,....&J(J.Od..:.f......~:S.........t..t?...~-K.. ,f~7
.......~.~.~.~.....d.y.r......./!.r:.?/.................
to ....CJ:lfIr.:.~.0.iC...........d..........)~4......@.(R:<;9.~...........~...:r...;(~..................
Q?/......7!.!4............~~..........?JL........,,~,;~~~:>~d!.'.~~~....A.~~1.?9............
.4.~......df.!t?(:~:i:.1!.........a~..~................................................................................................
...........,.....................................................,................................................................................................
.........................................................................................44.b.6.....................................................
at premises located at.........................../.~.~...........&I!?C~.!'IC.~,F.,....~.....................
....................................................................................~lZ~.~.:>..................................................
County Tax Map No. 1000 Secflon ....6...2............. Block .........91.......... Lot No. ...I.Y................
pursuantto appllcaflon ~ated .........t.f.d........I.~........................... 19....9,Y... and approved bylhe
Building Inspector.
Fee$....Z~.r.
.4)~~......................
Rev. 6/30/80
. .
Oa..
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
815 JOHN STREET. NEW YORK. NEW YORK 10038
JUH!l 29,1994 Applica.ion No. onfil. 06065894/94
PAGE 1
1001071
I
N 318916
THIS CERTIFIES THAT
only the el.ctnc.l equipment.. daeribed IHIlouJ and introduced hy the oppliecmt named' on the.botle """iaation n..","'" in d.. prem.... oj
JANE WELLS, HOR'l'ON ROAD, (East side-1st South of 48), SOU'J.'I<<)LD, N.Y.
in ."e/olIOlOinRloco.i'JilimO _.....n. 0 h. f'I. 0 Ind Fl. OUT/AT'l'IC/SIIIlD. ,'!H.ion Block Lo.
..... e.amined on 24 , 1994 and fo_ to be in c<>mpllOnce with the National ~ectrlcol CDde.
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BOX 215
SOU'J.'I<<)LD , NY, 11971
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a.lllnAl MANAGII
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This certificate must not be attered in any manner; return to the officI of It. Board if incorred. Inspector. may be identified by their credentials.
.. .. .. . .. .. . .. .. .. . . . . . .. .. . . .. .. .. .. .. .. .. .. .. .. . . .. .. .. .. . .. . . .. .. .. .. .. .. . .. .. .. .. .. .. . . .. .. .
COPY FOR BUII.DING DEPAllllENT. THIS COPY Of CEAIII'RiATE MU8TN01'.AL~."".....
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING 0 FINAL 4- ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
~~Nf~,
F-~ ~ ~ Bf( ,
10..-30 -tJb
DATE
INSPECTOR ~ ~
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1 .
FOUUDATIO~ (1st)
------
FOUNDATION (2nd)
2.
ROUGH FRANE & ,
,PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4.
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cA... O.D.~ V. JJ
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APDI~IONAL COMMENTS:
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
. . SOUTHOLD. N. V. 11971
l TOWN UTHOLD \j0JOEL.: 765.1802
Examined... ~PY....., 19 9y ~.f 3.).ljy?
I J. tV 00.... ,)../9/ /i: .
Approved. . .,)/ '/.:7'. . . . . ., 19Z /. renmt No. . . . . . . . . . ..
Disapproved ale .....................................
00
FEB16.
~m
BOARD OF HEALTH .........
. '-..l
J SETS OF PL.\NS ..........
~SURVEY ................................................
,"""" . -#-
CIlCCK..J4-. . . . . _ .. . . . . . . . . " .
SEPTIC FOR" _.............
NOTIF)':
CALL
HAIL
. . 7:~'i".-lf:o.s:. . . . . . .
TO:
... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
... ... ... ... . ... - ... ... ... ... ... ... ... ... ... ... ... ... .
.... ........... ..... ....... ............ ...........
..A/~................
. (Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date.. ~.~....... ..., I9~'f
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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted 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
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' 'ons.. . .~ . w.~!. .................
(Si l'~re&~p~;n1 or:~ if a corporation)
..... .11a$.7).~f?-r:t:JiY. .~~)o ~.t?~f-!':.IIf.~..
(Mailing address of applicant) /19rl
State whether applicant is owner, .lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... . . .... ...9 HJ.^!~. ... . .. . ...... ............. ......... ...... .. .AP AS.N~D.......
Name of owner of premises ......... .:;r/'rN ~....~:.. W~.........!>~.''''.........!':~ .J~~.
. (as on the tax roll or lates1fte ,,10 BY: _' _ _
NOTIFY BUILDING DEPARTMENT AT
If applicant is a corporation, signature of duly authorized officer. 765-1802 9 AM 10 4 PM FOR THE
FOLLOWING INSPECTIONS:
'.' . . . . . . (N~~~ ;~d 'titie' ~f ~~~~r~t~ eooUPANCY OR 1. ~g~~:T~~~ C()N~~:EQUIRED
U'FUL 2. ROUGH. FRAMING 8< PLUMBING
Builder's License No. .......... 'USg: 'IS' UNLAvv 3. INSULATION
'- 4. FINAL - CONSTRUCTION MUST
Plumber's License No. ......... .tjlW'1"~'!-OUT CERTIFICATE BE COMPLETE FOR C.O.
\ I. ! i n ALL CONSTRUCTION SHALL MEET
Electrician's License. No. ......... .;.~.." 'j'Cl"P "N..CY ~~;TERE~~~~~~~NO~ ~:E:G~
, . . C r Ov I hi
Other Trade s LIcense No. ..................... CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
I. Location of land on which proposed work will be done. .................................................
..I.~?p.. .~r:-~^!.. ~'::!.~................................ .!?~.~~.....................
House Num her Street Hamlet
County Tax Map No. 1000 Section... .Ia. R.... ..... Block......I............. Lot... .li:............
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot...............
(Name) { .
2. State existing use and OCcupancy of premises and intertded use and occupancy of proposed constl'!Jction:
a. Existing use and occupancy .. f?1?:. <.?'. J?~!.~ '!:-:-. . . . . . . . . . . . . . . . . L. . . . . : . .. . .. . . . . . . . . . . . . . . . . .
:(>, -, 'IV\J' :;,-_,~ '; ,"".;
bid d {<.t:S/Pe?JTIAl... '~i\"'c<,',..,. .'.
. nten e use and OCCUp,mcy ...................................: ,".' '. , .. ".. .. .... .. . .. .. .. . .. . ..
~
3. Nature of~ork (check which applicable): New Building.......... Addition:P.~:'~'~- Aft~~n~.........
Repair .............. Removal. . . . . . . . . . . . " Demolition ...........;.. 'Other Work. . . . . . . . . . . . . . .
' '! ' . 'J I ((B'tription)
4. Estimated Cost. .41. .J. f.c!~:.~. . . . . . . . . . . . . . . . . . . . . . . . Fee. . . . . . . . . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . .
' (to be paid on filing~!fe_Jlcation)
5 If d 11' , f' I ' "? .r
. we 109, number 0 dwellmg units.... ... ........ NumberofdweIIing 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 D' . f" . "'5.' , h -'5'
. ImenSlOns 0 eXlstmg structures, If any: Front. . . ~ ......... Rear ............... Dept " ~. . . . . . . . . . .
Height ............... Number of Stories. . { y,7.-. . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front.~~~. . . . . . . . .. Rear..................
Depth. . ;. . . . . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . Number oCStories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front. . . . . . . . . . . .. . .. Rear . SJ!'.6~". . . . . . . Depth ...............
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . ; ; . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size oflot: Front.. I fJQ.'. . . . . . . . . . . . . .. Rear. .I.0~. ~ . . . . . . . . . . . .. " Depth . 7a ~ ... . . . . .. . . . " '"
I O. Date of Purchase ..o3.t 'J."f. . .. . .. . . . " .. . . . . . . Name of Former Owner ......... c. . .. .. .. . .. . .. .. . .. .
II. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded '" N.r). " . . . . '" " .. . . . . " . Will excess fill be removed from premises: Yes No
14. Name ofOwnerofpremises~J!.. R: .fI:I~... Address .f?o. .~S!i.r..... . Phone No. r.65.";I.~....
Name of Architect.. . .. . " . .. .. . .. . . . .. . . '" . Address. .. . . . . '" . . " .. '" Phone No. .. .. . . . " .. . . .!.
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . .. . . . . . . . . Phone No. .. . . . . . . . . . . . . .
15. Is this property within 300 feet of a tidal wetland? *yes........ No..~..... .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or deSCription according to deed, and show street names and indicate whether
' interior or corner lot.
~4~~
51)<~'~-1'1I(f~"..J.r~ ,
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STATE OF NEW YORK,
COUNTY OF . . . . . . . . . . . . . . . .. S.S
(Name of individual signing contract)
above named.
........ ..........0.. .....0 ...... ..... .... .......
being duly sworn, deposes and says that he is the applicant
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
lPplication: that all statements contained in this application are true to the best of his knowledge and belief; and that the
Nork will be performed in the manner set forth in the application filed therewith.
)wom to before me this
............. L "...... .daYof..7~. ../.. .,/91:1'
'otaryPUbliC'~" .....A...f.k.~~. bountY9 ~
' \ . 1
. ,.' " . an- .w
JOYCE M. WILKINS . . . .. .....~. t... . . . . . . . . . . . . . . . . . . . . . . . . .
NoI8ry Public, StlIte of N_YorIc (Signature of applicant)
No. 4952248. Suffolk Countr__
Term Expires June 12, 11WL "
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Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
.
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 19, 1996
Ms. Jane We1z
1650 Horton Lane
South01d, NY 11971
Re: Building Permit t21971-Z
Premises: 1650 Horton Lane, Southold
Suff. Co. Tax Map t1000-63-1-14
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
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