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33372-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33643 Date: 04/13/09 THIS CERTIFIES that the building ACCESSORY Location of Property: 1134 BRIDGE LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax~4ap No. 473889 Section 118 Block 1 Lot 9 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this Office dated SEPTEMBER 7, 2007 purs,,ant to which Building Permit No. 33372-Z dated SEPTEMBER 7, 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 ACCESSORY GAZEBO AS APPLIED FOR. The certificate is issued to ALAN A JR & JEANNE CARDINALE ( OWNER ) of the aforesaid building. Su~,~OLX CO~I~TY DEPAIII~IIT OF HEALTN APPROVAL ELEg-rKICAL u~-rIFICATE NO. PLU~ERS c~KTIFICATION DA'£~ N/A N/A N/A Rev. 1/81 Form No. 6 TO OFSO .OLD BU~D~G DEP~TMENT APPLICATION FOR CERTIFICATE OF OCC~~ / Bt06. OEP[ rOW~ O~ SqU~ ~is application must be filled in by t~ewfit~ or i~ ~d submitted to the Building~pmment 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 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: 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 applicm~t. 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. i41' 10q New Construction: Location ofPro, perty I 1 3 q- ~'~ House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Old or Pre-existing Building: (check one) Street Date of Permit._q ['!l 0-/ Block (DO © I Lot ()(}"] Filed Map. Applicant: Underwriters Approvai: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ (check one) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33372 Z Date SEPTEMBER 7, 2007 Permission is hereby granted to: ALAiqA CARDINALE PO BOX 77 MATTITUCK,NY 11952 for : CONSTRUCTION OF AN ACCESSORY GAZEBO AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED PERMIT #16419Z at premises located at County Tax Map No. 473889 Section 118 pursuant to application dated SEPTEMBER Building Inspector to expire on M_ARCH Fee $ 100.00 1134 BRIDGE LA CUTCHOGUE Block 0001 Lot No. 009 7, 2007 and approved by the 7, 2009. Authoriz~ ' Rev. 5/8/02 ORIGINAL IPOU~ NO. ~J 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) N~- 14 ~,~¢ Z Date .....~..C~.~ ...... .~ ........ , 19~.~. Permission is hereby granted to: .... ..... .....t-~...?..~.~....~ ..................................................... .....~.~~...~....%,....i.~...~.~.~ ........ at premises located at.././..~...O. ....... ~ I~...i~ ............ ~.~.............. County Tox Map No. 1000 Section ........ ]./...~ ........ Block ........ .~)..I ....... Lot No .......~.~ ............ / Building Inspector. and approved by the Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT PENETRATION REMARKS:__ FOUNDATION {lst) FOUNDATION 2. (2nd) !1DA?E 1t ROUGH FRAME & .?LUMBING INSULATION PER N. STATE ENERGY CODE~ Ye FINAL ADDITIONAL COMMENTS BOAHD OF HEALTH '~..o 3 SETS OF PLANS ....... SURVEY .......... FORH ............. : 'FORM NO. 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL NOTIFY CALL MAIL ~.,.~ . SOUTHOLD, N.Y. 11971 ,, TEL.: 765-180:~ Examined .~, 19 Approved ~.~..~., 19~., Permit No.~'~,~..~.. Disapproved a/c ............ ......... ................................ ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT TO: INSTRUCTIONS a. Tiffs 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 availab!e 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 grante, d by the Building Inspector. '. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to ~h,': Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for remoyal 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 inspectio . (Signature~~of applicant, or name, ff a corporation) . .'~.v....'-~. :,, .7.1.. ~--h~..,..~..~.. ! M..~.z.,, (Mailing address of applicant) State whether applicant is ~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .0-~~. ]~--. ~ ................................................. (as on the tax roll or latest deed) If applicant is a corpora~tion, signature of duly authorized officer. (Name andi'title of cdrporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's Licens~ No .... ~ .............. Plumber's License No ......................... LICENSED Electrician's License No ..... ; ................. Other Trade's License No ......... ............. I. Location of land on which proposed work will be done; ................................................. .... ..... . ...... . . .,. .c . . ..... House Number Street County Tax lvlap No. 1000 Section . ] ]8 Block [ Lot ~ Subdivision ................................. . Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: E isti g d cupancy ' '.. a. x n use an DC ............................ b. Intended use and occupancy .... ,~.,'}tl~.,~.'~ ................... 3. Nature of work (check which applicable): New Building ..... ' .......-Additi°n .......... WorkAiterati°n/%' n, ~ .......... Repair .............. Removal .............. Demolition ............ Other .~.-,.~ .... (DescriP,tion) 4. Estimated Cost/~1-~.,.~.0, .~.o ............................ 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 ............... lteight ............... Number of Stories ........................................... .,; ........... Dimensions of sa~e structure with alterations or additions: Front .... !.O... ........ Rear ...[.~ ............. Depth ..... ~l 0 ............... Height ...... /. ~ ............. Number of Stories...I. .................. Dimensions of entire new construction: Front ..... /.(P..' ..... Rear .... ./.O ......... Depth .../.O. .......... Height ..... /O ....... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Dept.l~ ...................... I O. Date of Purchase ... ,/~1~.. II.'1 ..... ; ....... ~... Name of Former Owner ........................... ~ 11. Zone or use district in whit~h'premises are situated ............................. 12. Does proposed construction yiolate any zoning law, ordinance or regulation: ...~ .......................... 13. Will lot be regraded ... ~.. !~?...~ ................. Will excess fill be remov_e.d from premises: Yes No 14. Name of Owner of premises . ~. J~ i~][~ 0~L~ :. Address . Jv.O..~)(, .'1 .~./~. Phone No....2..~..~$'/..~,,, Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe re~uired. PLO'r D~AGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dLmensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~' AS NOTED OCCUPANCY OR USE IS UNLAWFUL -V?iTHOUT CERTIFICATE STATE OF NEW YORK, S.S ................... ................................................. being duly s at he is the applicant (Name of individual signing contract) above named. 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 ~his "' .......... .*'~**. / ..... :...da'y of..¢(~. ~z.~. ,~'. .... NotaryPu' 'c, .'.:~.,%& .~..'/~ ......... :.. County (Signature of applicant)