HomeMy WebLinkAbout30116-z
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32708
Date: 10/31/07
THIS CERTIFIES that the building
ACCESSORY
Location of property: 1530 NEW
(HOUSE NO.)
COUnty Tax Map No. 473889 Section 109
SUFFOLK RD
(STREET)
Block 6
CUTCHOGUE
(HAMLET)
Lot 13
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
FEBRUARY 25, 2004 pursuant to which
Building Permit No. 30116-Z
dated
FEBRUARY 25, 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 ACCESSORY GARAGE WITH NON-HABITABLE 'SECOND FLOOR AS APPLIED FOR.
The certificate is issued to MATTHEW D TRUE
(OWNER)
of the aforesaid building.
SUFFOLK COONTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
II
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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JAN3/: 7
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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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 installatiou from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2110 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
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.
l!rO~7
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New Construction:
./
Old or Pre-existing Building:
.N~ .sv~{lt 1C12.
House No. Street
'7Vt}t4~ { 'D _ ~
[0 tt
(check one)
CJ!-~! .r-<.
'Hamlet
Location of Property:
{~]o
Owner or Owners of Property:
Suffolk County Taj{ Map No.1 000, Section
.
Block
((1
Lot
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.
Subdivision
Filed Map.
Lot:
Pennit No.
3.D I ( ~ - Z Date of Pennit
Applicant: ~ef,u,0 /) ~~
Health Dept Approval:
Planning Board Approval:
Request for: Temporary Certificate
.... .....<:>0
Fee Submitted: $ (7-"\1
Underwriters Approval:
Final Certificate:
/
(check one)
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
MATTHEW TRUE
PO BOX 358
CUTCHOGUE, NY 11935
MATTHEW TRUE
1530 NEW SUFFOLK RD.
CUTCHOGUE, NY 11935
1530 NEW SUFFOLK RD. CUTCHOGUE, NY 11935
1172854
Certificate Number:
1172854
Block:
Lot:
Building Permit: BDC: NS11
301/&-
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Second Floor, detached garage, Detached Garage, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 4th Day of October, 2007.
Name OTY Rate Ratin. Circuit ~
Appliances and Accessories
Furnace
Exhaust Fan
Water Heater
Panels
I 0
I 0
I 0
4.5
Oil
F.H.P.
KW
100
12
Wiring and Devices
Outlet
Fixture
Outlet
Receptacle
Switch
Dimmers
Receptacle
Paddle Fan
8 0
8 0
25 0
18 0
10 0
10 0
4 0
I 0
Fixture
Incandescent
General Purpose
General Purpose
General Purpose
GFCI
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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.
30116 Z
Date FEBRUARY 25, 2004
Permission is hereby granted to:
MATTHEW D TRUE
CUTCHOGUE,NY 11935
for :
CONSTRUCT A 572 SQ FT ACCESSORY GARAGE WITH NON-HABITABLE SECOND
FLOOR AS APPLIED FOR. THIS PERMIT REPLACES BP#27995.
at premises located at
1530 NEW SUFFOLK RD
CUTCHOGUE
County Tax Map No. 473889 Section 109
Block 0006
Lot No. 013
pursuant to application dated FEBRUARY 25, 2004 and approved by the
Building Inspector to expire on AUGUST 25, 2005.
Fee $
112.22
[)A1V'ON ~<;
ORIGINAL
Rev. 5/8/02
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1 ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] IN ATION
FINAL
] FIRE SAFETY INSPECTION
REMARKS:
co
DATE
Jt ~
INSPECTOR
./
30/1~-E:;
765.1802
BUILDING DEPT.
INSPECTION
[ ] ROUGH PLBG.
[ ] INSUL~
[ NAL
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DATE
INSPECTOR
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30 \ \~ {~NUv0Ce-~
~ 765.1802
"/BUILDING DEPT.
SPECTION
[ ] ROUGH PLBG.
] FOUNDATION 2ND [] INSULATION
] FRAMING [ ] FINAL
] FIREPLACE & CHIMNEY
REMARKS: ~ ;JOY- ~1r1,J~
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DATE I 0 ~ (J V INSPEC'I'OR
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DlSUU.TION PER B. Y.'
.STATE ENERGY
CODE.
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STREET IK?,C)
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RES:<1-0 SEAS. VL. FARM
LAND IMP. TOTAL DATE
100
OWNER
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FORMER OWNER
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NEW
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NORMAL
Farm
Acre
Tillable I
Tillable 2
Ti liable 3
Woodland
Swampland
Brushl~
House Plot
Total
M--5
VILLAGE
DISTRICT
SUB.
LOT
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ACREAGE
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TYPE OF BUILDING
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I Est. Mkt. Value
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COMM. I IND.
REMARKS B)J ,if, ~
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, MISC.
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51', C,J /SP";r060
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ABOVE
Value Per Acre
Value
FRONTAGE ON ROAD / () () J i, ~ 7 ,:u.) - J 0 cJ
BULKHEAD
DOCK
De t h /6""'6 f- i;
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M.. Bldg.
Extension
:xtension
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:xtension
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iorage
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100
>. B.
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Bosement
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C-- ,3. Bath
Floors
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")/w- Heat
Porch, Roof Type
Porch Rooms 1 st Floor
Rooms 2nd Floor
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TOWN OF SOUTHOLD ',i rn
BtJll,])ING DEPARTMENT
TOWN HALL '
SOUTBOLD, NY 11971 '"
TEL: 765-1802
20~
20....4.Z,..-
@JJ_JL~1 r~!, ' BUILDING PERMIT APPUCATION CHECKLIST
, ' " I Do you have or need tho fullowiDg; before applying ?
JAM _" /' i ~ r: !' Bomd ofHcallh
';'m 3 seta ofBuildiog PIaos
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ALDG D'PT OLD D2'r1q/~ =
, -, Septic P:
;:)() llCo reJlL1}I(j N.y.SD~.
Trustees
Contact:
.'
Examined
Approved
, Disapproved ale
Mail to:
([jJ. "
Builn;t1g Inspector
,Phone: Q!(,f~ r t/trz}
APPLICATION FOR BUILDING PERMIT
Date
I!~
,200;;""
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.l'lot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public ,streets or
areas, and waterways.
c. The wOIk covered by this application may not be commenced before issuance of Building Permit.
d., Upon approval of this application, the BUilding InspCctor ,will issue a Building Pennit to the applicant. Such a permit
shall be kepi on the ~ available for inspection throughout the work. '
. e~ No building shall be occupied or used in whole or in part for any pllIpose what-so-evcr until a Certificate of Oci:upanc)
is issued by the Building Jnspector. '
APPUCATION IS HEREBY MADE to the BuildiDg DeplU'tl:nent for the issuance of a B1ii1ding Pennit purswmt to the
Building Zone OrcHn"",..e of the' Town of Southold, Suffolk CoUnty, New York, and other applicable Laws, Ordin"",..es or
Regulations, for the eollStrul:tion of buildings, additions, or alterations or for removai or demolition as herein descn'bcd. The
applicant agrees to comply with all applicable laws, ordinances, building code, ho . code, lIIld to admit
authorized inspectors on prcniises lIIld in building for necessary inspections. '
(8
IsJo .vtu.,&.IefkN, j}~Ax-~ ~l-"-Jr/{jiJ
(Mailiua ~ of app1icant) "
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or. builder
fJtJ~eF
Name of owner ofpreniises
;41/~'~,~
. (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 woIf( will be donc;:~
I ~3D ' A)wJ fJlP: tU. ,(tJf-t 1M:
House Number Street
1'1 tt'11J
Hamlet
County Tax Map No. 1000 Section
Subdivision
! 0'1
Block "
Filed Map No.
,Lot /3
Lot
(Name)
,~
2. State existing use aDd,~of~ and in~~ ~e .and occupan~o~~sed COIISlraction: '
a. ExistinguseandoccUp8nCY J'ik ~ . t
I. \ ~-f '
b. Intendeduseandoccupancr. SAJ/.,. kif ~ .,kr&. ~~M JjYMfL
3. Nature of work (check which applicable): New Bui1~ /' Addition ~ Alteration
Repair Removal Demolition Other Work '
-I (Description)
/~ODD Fee
4. Estimated Cost
5. If dwelling, number of dwe1ling units
If garage, number of cars ' ~
. 6. IfbusinesS, commercial or mixed occupancy, specify nature and extent of each type of use.
(to be paid on fi1ing this application)
Number of dwelling units on each floor
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
Rear
Depth
Rear
Depth
Height
Number of stortes
I
19~ Size of101:: Front
I 1 Onate of Purchase
I
111. Zone or use district in which premises are situated
I 12. Does proposed construction violate any zoning law, ordinance or regulation: . No
I
8. Dimensions of entire new construction: Front d. t/
Height . H' I Number of Stortes
Rear
Jtj'
Depth
I
.;2,
Rear
Depth
Name of Former Owner
.
13. Will lot be ~graded ,.00
.14. Names of Owner ofpremises~X~1I.
Name.ofArchitect .
Name of Contractor
, Will excess fill be removed from premises: YES NO
Address lj3Q.JwJ ~/!L 1/
Address
Address
Phone No. b3/ 7J{ ,).1fo 'j
Phone No '
Phone No.'
i ~
I. 15. Is this property withili 100 feet of a tidal wetland? *YES . NO t'\ .
,
I · IF YES, SOUTHOLD TOWN TRUSTEES PER1vITTS MAY BE REQUIRED
116. Provide survey, to scale, with accurate foundation plan and distances to property lines.
I
17. If eleVation at anypoint on property is at 10 feet or below, must provide topographical data on survey.
I STATE OF NEW-I vK.ll..) CoNNEt7IC.,Ij-
5S:
COUNTYOF FA/,u:,)l'O).Q
I
,
/7}1} 771-fE ",) 17<. vE: being duly sworn, deposes and says that (s)he is the applicant
(Name of individual .npg con1raCt) above named,
I
! (S)He is the ~ m e' n \AI .XIL
:
(Contractor, Agent, Corporate Officer, etc.)' ,
i I of said owner or owuers, and ill duly authorized Lo perform or have performed the said work and to make and file tbiS application;
I that all statements contained in this application are true to the best ofhis knowledge and belief; and that the work will be
peiformed ill the manner set forth in the application filed therewith.
. Sworn to before me this
j, 'J... dayof ..-If-},J 200'L
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14:04 6312988133
CELrc REALTY
PAGE 01
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SURVEY OF PROPERTY
SIUJA TE: GUTGH06UE
TOHN: SOUTHOLD
SUFFOLK c.ouNTY, NY
SURv'EYED 01-2<:{-<:{"
SV;:';::OLI( C.OUNTY TAX .
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