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Home My WebLink About33193-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 07/13/07 No: Z-3246l THIS CERTIFIES that the building ALTERATIONS Location of Property: 1200 GIN LA (HOUSE NO.) County Tax Map No. 473889 Section 88 (STREET) Block 3 SOUTHOLD (HAMLET) Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 2007 pursuant to which Building Permit No. 33193-Z dated JUNE 29, 2007 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" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HENRY D STRUBBE (OWNER) of the aforesaid building. N/A SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. N/A N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 JuliO 07 OI.IBp 'llo~ 3<fuD ~lS o/--..jq('-j p. I B7/18/2887 13:2S &317&53883 021 AGAWAM AL1!ER'TSCIoI PAGE 81 Jl'ona No.' TOWN Ot'SOUTHOW Btm.DING DEPARTMENT TOWllIlALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Tbls applies/Ion 1111111 b. f1Iled in hy typewriter or Inlt ond IIUbmltted to tho BuUdlng Dep.rtment with the foUowln!, It.. For a... buUdlnR or n... .se: t. Finol.urvey nf """",,,y with accurateloc.t1on of oil bldIdings. pmporty 11ll..,meets. .ad unu....1 nntunll or IllpQiIOPble features. 2. PIIIlll Approval from H..llh Depl. of water IIUpply ond .owenlge-dlapo..t (8-9 fa,,"). 3, Approval of alectrleall..tnllation fi'onl Board ofPlre UndannilOB. 4. SWll11l11Il..".ot from plUlllbor ~fYlllll!lll thuolder uocd in eystern contains I... thea 2110 of! % I..d. 5. CollllllCl'clol building, bldu.1IiaJ. bulldl.... multiple ....ldOlIO.. and aImllar bulldinB" _lid illltall.Il"",, a certi6..t. of Cod. CompUanco tmm aR:hl_ or cnamoor l'OIpontlblo for tho bullcftnc. 6, Submit Plonnintl Boon! Approval of OOlllIIllbd lite plll1 "'lulrementa. ll. Por exlllln, In''ldla.s (prior to April '.1'57) IIOIH\Onfol1lllD...... or bulldlnll" and "pre.ulotl....lod un.. 1. Aol:urat. lUl'Vey of prepcrly showio! an PlVpaty liMa, otn:ds. building and UI1IlS1I.1 natural or topo....pbl. fealuree. 2. A proporly eo:npleted ,pplJcatlon and coos..,t to IIlSpOCt slloed by tho appllcaot. If. Ccnl6cot. of Octupaacy i. d...ed.. lhe BuildinllnlPcctor shall slate tho reuons thenfor In writing t. thelppll..,nt. C. FOIl I. Certlf\cat. ofOccupaacy - New dwelling 525.00, AddIUona to cIwoI1lnll m.oo. Alt....llon. to dwe1ling 52'.00, Swlmmina pool $2.5 .00. A<:ceaaory buDding $2.5.00, AddlUOIIIIo acoeasory bulldlna $2.5.00, B".ln-.- S50.oo. 2. c.tJOe"e ofOocuponcyoo Pro-c.u.tJng IluildJna. $100.00 3. CopyofCertlfiClt.ofOctupaacy_$.2.5 4. Updated Celtifieot. ofOocuponcy - $'0.00 ,. TlIIllpOmy Certificate ofOceupanoy - aeslclcnfilll S ".00, COIIlIIIOI'Ctal 515,00 Date. 7-/,,~~t1tI7 New Comtrocllon: Old or J're...ittins BulJdin&; LocationofPruperty:. /.1.t1D '7/~ .e.."fN.# HOUle No: Sttoet Ow".rorOwn..."fpropetl)':_#oSr. ~ A".......t....A 03"""''''111 SuITnl. County Tax Map No 1000. Scdion () " Blooll; t1iJ~ ~ Lot d/,y Subdlvlalon ~1 ~Y."" FilodMap. ~.!-~~ PennitNo.~ ~l)...ofPermil. ~-.z?-t17 Applfcmt: ~ ;',.:'_~_ /,/-,-,:,:-:-:,-=_ ~ Health Dept. ApprovII: _ . _. Underwrj,... ApprnIlW.: . PlannlnsDnlrdApprovnl:__. _'_h_ Roquost lbt: Tc:nponry Certlflcl,e Floal c.tJfiea..: Fee Submitted: S ./ (chook on.) J()U;;rH"~p 11amIct ./ check ono) 6..~'J9-IIo) COt 3:2 '1 ~ , 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. 33193 Z Date JUNE 29, 2007 permission is hereby granted to: HENRY D STRUBBE 1200 GIN LANE SOUTHOLD,NY 11971 for : AS BUILT ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1200 GIN LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0003 Lot No. 014 pursuant to application dated JUNE 26, 2007 and approved by the Building Inspector to expire on DECEMBER 29, 2008. Fee $ 400.00 orized Signature ORIGINAL Rev. 5/8/02 33/93(;- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUC'nON REMARKS: [ ] ROUGH PLBG. [ ] IN~TION [t-r1INAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION DATE INSPECTOR - FIELD INSPECTION REPORT DATE I COMMENTS v... \).)'" _t'l FOUNDATION (1ST) ~~ ~"" "" -----.------------------------------ ~~ FOUNDATION (2ND) 7~ - ~Z C> ~ ROUGH FRAMING & ~ PLUMBING r"" c-- --- -- --.----------- ---------------- ~= ------- ~ INSULATION PER N. Y. -- STATE ENERGY CODE ~ . .., !to. 17 .:>.e---ffJ2CO /S4:J ( ! f Ii '/ I 1/ FINAL . ADDITIONAL COMMENTS t J~ . . - - t..>l'" --- 9:;~ ~ 0 Z ~ ~ "" = 0 t'l '" :-l ,..,.,- .~.\. :' ~. . -~,'(~.L~ -.S-Y'~$:-f - -:s -/4 TOWN OF SOUTHOLD PROPERTY RECORD CARD ~ ~L ., 1. STREET /2ct) V/LLAGE DISTRICT SUB. LOT J OWNER IrV AGE NEW 3/00 106 .3cfo{) 'fra d . 0- J N E S W RES. Z-Ib SEAS. VL. FARM COMM. IIND. LAND IMP. TOTAL DATE REMARKS ACREAGE TYPE OF BUILDING CB. J 8'&JO 00 .' .c.-~ .. ,. /... ,} , . ...z..2.00 0 -1/. GIO~'</'" _ 'f(, _ I" STc"h~ w;* - iJ "_'1 C ~ c , y' 7h S71J V../ -;PI/r! I ...-/ BUILDING CONDITION c ",./.",1O.L r;;..", II! + (?.. ~ -'To I.'vo" A- . NORMAL BELOW ABOVE c./J [lit _. .^ r: /C ,~,: c, -/ v_; Farm Acre Value Per Acre Value Tillable Tillable 2 Ti liable, 3 Woodland Swampland Brush/and -- Hous-"lor- Total ~ ~ ? f(- ?/ - ~ ~ I I I I I I V~ I,,,, """ , i I I gl 1'';'1 I , 10 . ..- rt; '-' (;I I , I- I Ij.f ~~ rr ) i .t I ~ ~ , I I., I I 10 I I I I , I . ~~ oundotion Both Basement Floors I. ~ . '!-.sS'- El(t. Walls Interior Finish Fire Place HeCllt Porch , Attic Porch Rooms 1 st Floor Patio Rooms 2nd Floor .3~ /09.7- Driveway ~ ~J'3 M. Bldg. 3[, t). ~ Extension /o.t I Extension '" /1/0 -, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL' SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SoutholdJ PERMIT NO. ? , l~ ~ -;v BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ~ 4 sets of Building Plans Planning Board approval ----.. Survey ---.... Check '-\oe:. .at) Septic Form N.Y.S.D.E.C. Trustees Contact: Examined Approved Disapproved alc ,20_ '--l- ,20_1 Mail to: ,20_ Phone: Expiration ~ APPLICATION FOR BUILDING PERMI Date 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 oflot 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. 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 ofthe 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. . / (Signa e of applicant or name, if a corporation) <!/G> JF,<t!y c/tJ'VI'-SA:/ rE,<1/>') P.O. ,8(U -Y5.2- 7'A:'qYPc)~r NY //7~f' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ,O/U..& oS-TI:?UBB,t<, a'..1: ~ecu.&c)") For- k-/. of //E;V~Y JTIi!f./ME Name of owner of premises jlE/V'/(Y f) OJTI(t/tj8,t< (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 which proposed work will be done: /.zcro q/AI ~ANE House Number Street JOUT#c'f-P ;Vy Hamlet //7 7/ County Tax Map No. 1000 Section Subdivision g/lY P/WE# (Name) {)J'? Block 03 Filed Map No. Lot 0/9 Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .;}//Vl.I-E ,h'1/J1/LY b. Intended use and occupancy J/N7~ rI9M/L y / 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration /!,J-,dt//LT ;:'F,tt;?J/T (Description) 4. Estimated Cost #/4 Fee 5. If dwelling, number of dwelling units / If garage, number of cars -e- (To be paid on filing this application) Number of dwelling units on each floor / 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 5'9. $ / Rear Height "1 ,;, Number of Stories / Dimensions of same structure with alterations or additions: Front ~ Depth Height Number of Stories 59.3/ Depth ';>'Y.1/ Rear / Depth 8. Dimensions of entire new construction: Front ~ Height Number of Stories Rear 9. Size oflot: Front /00 / Rear /06.0/ Depth /fl. fJ f/IJ/UJ,4 NO 10. Date of Purchase ";//0/7 J Name of Former Owner 11. Zone or use district in which premises are simated ,/f - 7-' (J 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_ j)t4t.F S7,e{/tJtJ~ 'I j)//;.ICIf^' j)nvE- 14. Names of Owner of premises e,x~cvto,... AddreSs/J1(/I'ff.:/IIV/L~ /lI'J Phone No. 73,;1- '7",1.-7360 Name of Architect Address 0 '5/ Phone No Name of Contractor Address Phone No. /i?f'I'?LT"1t c.;/ /l'lfiWPM tl/6c"ho,..; - J~N'7 c../6v/~/~/ 760...., &'3/- 7~f'- 33ClO. 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. 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) SS: COUNTYOF~ .0/1,,-;0 ~7RuggE being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the .E~EC.U-rO K-/ E~7. 0.1=' /(E,II/KY S7;({/glJE (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. ILENE AYf>NA scan Nofary Public - State of New York NO. 01 SC4655963 Qualified in New York M; Commlsslof) Expires ""'~~ S.C.T.M. NO. DISTRICT: 1000 SECTION: 88 BLOCK: 3 LOT(S): 14 N3B042'40"E 100.01' 0.6'N 5.1'E m '" MON. FRM ~HED 8.2' LOT 9 . t':I Ol CIi", lQu .... z '" "' "" z :J z ~ u .... " CIl '" 01 co l\:l LOT 8 . 0 01 LOT 7 tii 0 t<i x O.I'S CONe. STEPS CONe. 59.3' '" ~ ..; '" ~ 0 t-3 !P ~ lQ 19.0' 0 ~ . t\I Ul lQ ~ z t:::l ~ ~ co ... ::.:l!l ~ 507,61' STRY. FRM. DWElliNG #1200 '" ..; '" 59.3' 21.7' o~c "" -' 11i <..i z o u r-,-l . ~ . ~ " o '" u " ~ :z e VI '" " ~ en - c:.,... - ~ ... 01 I:.o:l O.4'E S37054 'I 0 "w 100.00' EDGE OF PAVEMENT GIN (50') LANE 27';' ASPHALT PAVEMENT 'lli uL#IO 'lli U.P.#9 AREA: 15,222.46 SQ.FT. or 0.35 ACRES THE WA TER SUPPL Y, IIE'LLS AND CESSPOOL LDCA nONS SHOWN ARE FROM FIELD OBSERVA nONS AND OR DATA OBTAINED FROM OTHERS. nEVA TION DA TUM: _________________________ UNAUTHORIZED ALTERAnON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCAnON LAW COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONL Y TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE nTLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDEO TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDlnONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUewRES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALL Y EVIDENT ON THE PREMISES A T THE TIME OF SURVEY SURVEY OF: LOT 8 MAP OF: BAY HAVEN FILED: JAN. 22, 1959 No,2910 SITUATED AT: SOUTHOLD TOWN OF: SOUTHOLD SUFFOLK COUNTY, NEW YORK CERTIFIED TO: HENRY D. STRUBBE; N. Y. s. Lie NO. 50227 KENNETH M. WOYCHUK L.S. Land Surveyinc and Design P.O. Box 3, Mattituck, New York, 11952 PHONE (lIS1) 2118-11588 FAX (831) 2118-11588 mainlainiol the record. or Robert J. Henne.., FILE # 27-43 SCALE: 1"=20' DATE: MAY 1, 2007 ~ /1f. t/~