HomeMy WebLinkAbout28000-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28188 Date: 01/29/02
THIS CERTIFIES that the building ACCESSORY
Location of Property: 225 HORSESHOE DR CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 95 Block 4 Lot 18.25
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 10, 2002 pursuant to which
Building Permit No. 28000-Z dated JANUARY 11, 2002
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 SHED IN REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to SUK YOON PARK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ut rizvd Signature
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. 28000 Z Date JANUARY 11, 2002
Permission is hereby granted to:
SUK YOON & WF PARK
225 HORSESHOE DR
CUTCHOGUE,NY 11935
for
CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD AS
APPLIED FOR (THIS RENEWS PMT. 19410) [5hej g)
at premises located at 225 HORSESHOE DR CUTCHOGUE
County Tax Map No. 473889 Section 095 Block 0004 Lot No. 018 . 025
pursuant to application dated JANUARY 10, 2002 and approved by the
Building Inspector.
Fee $ 75 . 00
i Authorized Signature
ORIGINAL
Rev. 2/19/98
FORM NM 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF nTHE WORK AUTHORIZED)
N° Z Date .... .. .. ...................................
Permission is hereby granted
.... .. .... .. ................
........ .. ... . . ..........
..........� . ..,..... �
r
tod4olpo4 .. .... .. ...... ...... . ........G.. ........
.. ....... . ,� ......... -... ....... ...........................................................
ofpremises locatedat ... ... sRL...... i...............................................
.........................................0^G. ......... . .. ... .......................................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ......... ... Block ............. .. Lot No. .....
(.R../.:,r.?.4�
pursuant to application dated .......
��.. ./.,?.`.....................................1 19.70, and approved by the
Building Inspector.
D�
Fee05
ng I
rB1 hi � r
Rev. 6/30/80
Form No.6
TOWN OF SOUTHOLD
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:
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 a 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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: r �S
M, A�&�
House No. // 4,zlv Street Hamlet
Owner or Owners of Property: EQ!\
Suffolk County Tax Map No 1000, Section ��� Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: Yve,44"
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Gag 9 6 *Applic-antSignature
.2i)ou
�P&oo
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
P
DATE /�S O� INSPECTOR '�j
FIELD INSPECTION REPORT DATE COMMENTS
b
FOUNDATION(1ST) - - ---- - ---- - - - - -- 3
------------------------------------ - ---- - -- -- -- - - - -- - -
FOUNDATION(2ND) - _. - — ---- -- -- - -- — --- - -
Z
O
ROUGH FRAMING& -- -- -- -- — - — -
PLUMBING
r
INSULATION PER N.Y.
STATE ENERGY CODE
� d
FINAL
QJ
ADDITIONAL COMMENTS
7t'
0
m
a
ro
- - -
- ----- --------- - - - - -- -----
y
d
b
BOARD OF HEALTH .�,
S j FORM NO. 1 3 SETS OF PLANS P�K., , , . . . . .
1 41� � � SURVEY . . !'J. . . . . . . . . .
a
j, TOWN OF SOUTHOLD CHECK ,f,o 3
BLDG. _ Lir BUILDING DEPARTMENT SEPTIC •FORM . . .. ,Q, K ,
aC�;_.T,,�y
. . . . . . .
OWN TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
o� TEL.: 765.1802 CALL
Examined �. /.: , . . . . . . ., 19�. . ?wn� MAIL TO . . . . . . . . . . . . . . . . . . .
Approved . .�� . . . . . ., 19U Permit No. . �.� . . . �"- . . . . . .
Disapproved a/c . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Buil
in In/,LD,NG
or)
APPLICATION FOR B PERIV11T 1 p,
Date
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 o Inspector will issued a Building Permit tthe 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 inspect* ns.
(Signatur t applicant, or�name
*, if—a-corporation)
(Mailing address of applicanty �
State whether applicant is owner, less e, agent, architect, a ineer, -eneral contractor, electrician, plumber or builder.
Name of owner of premises . . . . . . . . . . . L.(, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
_y(
. . . . . . . . . . .
as on the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer.
• . . • (Name and title of corporate officer)
Builder's License No. ... . . . . . . . . . . . . . . . . . . . . . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No.
1. Location of land on which proposed work will be done;
House Number Sttree.L HamleV'4�
. . '
County Tax Map No. 1000 Section . . . . .` . . . . . Block . . . . . , ,;/ , � . • .
Lot .
Subdivision &.Z � .�7;L.. . . Filed Map No. . .
(Name) . . . . . . . Lot . . . . . . . . . . . . . . .
State existing use and occupancy of premises and intended use and occupant
Y of proposed construction:
A. Existing use and occupancy. .i: . . . ' . . . .
B. Intended use and occupancy. . . . ..5 . . .. . , . `, ��GS�, , . . , . . . , • . .
r
3. Nature of work (check which applicable): New Building . . .: . . . . . . Addition . . . . . . . . , • Alteration . . . . . . . . . '. .
Repair . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . .Stai:nciin;+ pool . . . .. . . . . . . .
Tennis Court . . . . . . . . . Accessory Building. . . . . . . . . .Fence . . . . . . .Other Work . . . . . . . . . . .
1 ag
4. Estimated Cost . . . o . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
S. If dwelling.,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor. .
Ifgarage,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 . . . . . . . . . . . . . . . . . . .
Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . E . . . . . . . . . . Number of Stories . . . . . . . . . I. . , , , , , , , , .
g, Dimensions of entire new constriction: Front , . . .C� . . . . . Rear . . . .��?. . . . . . . . . Depth . . i. . . . . . . . . . .
Hei- . . . .I . . . . . . . Number of Stories t . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . o. . . . . . . . . . . . Rear . . . . . . . .. . . . . . . . . . . . . . Depth . . 1.0f P. . . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. 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 . . . . .Will excess fill be removed from premises: Yes .. . No.. .
14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . ...
Nameof Architect . . . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . t
Name of Contractor . . . . . . . . . . . . . . . . . : • •
. . . . . . .Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . .
15.Is this property located within 300 feet ofa tidal wetland? *YES. . . .NO
*If yes , Southold Town Trustees Permit may he 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.
STATE OF NEW YORK, S.S
COUNTY OF . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Heistile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .
(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 Ellis
. . . . . . . . . . . . . . /. . .. . . . . .day of. . . . . r. . . . . . . . . ., 19 .nto
Notary Public, . . . . . ./:r` �-':`� . County
HELEN K OE VOE . . . .
NOTARY NBLK Sade at New Yult . . . .
Zfili 4 Orj* (Signature of applicant)
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•=MONUMENT
i ,BUBO/V/S/ONA/APF/LED INTHEOFF/CE
OF THECLERKOFSUFFOLK COUNTY ON
U7 APRIL 4,/975 AS FILE N0.SZ41
THE LOCATION OF WELLS AND CESSPOOLS
SN0/0, !:'.' ;I f7tIE FR0M FIELD OBSERVATIONS
'I AND/OR FROM DATA OBTAINED FROM
REVISIONS YOUNG & YOUNG
ALG 7,/975 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
sEpr 2,/975 ALDEN W. YOUNG o` HOWARD W.YOUNG
'. "• PROFESSIONAL ENGINEER AND � - - LAND BURVEY0R •'
LAND SURVEYOR, N.Y.S. LIC. NO.12040 1 N. 43093
SURVEY FOR: 5� y
JNAUTHORRED ALTERATION OR ADDITION TO tv O.
THIS SURVEY IS A VIOLATION OF SECTION LOUIS HODOR Rv jj. rf,
,7AW. OF THE NEW YORK STATE EDUCATION L OT NO. 25, "OREGON VIEW ESTA '�° ��
COPIES OF THIS SURVEY MAP NOT BEARING' 1
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SMALL NOT BE CONSIDERED
TO BE A VALID TRUE COPi AT CUTCHOGUE GUARA EE TQ:
LCV
H -10, �•YY� 4589
GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE TOWN OF . e4 4s 'L
SJRVEY IS PREPARED,AND ON HIS BEHALF f�IAND SU19N Da
TO THE TITLE COMPANY,GOVERNMENTAL
AGENCY AND LENDING INSTITUTION LISTED SUFFOLK CO., N.Y. BY�J__ �j
HEREON,AND 70 THE ASSIGNEES OF THE �` n
LENDING INSTITUTION. GUARANTEES ARE '
NOT TRANSFERABLE TO ADDITIONAL SCALE- /�F _ �/1F DATE: AUG /. <974 "��74 - 539
INSTITUTIONS OR SUBSEQUENT OWNERS; �/
ptRF_19 RIR• R.�� •nau•
-a%0 AM 0,
225 Horseshoe Dr. �'
Cutchogue, NY 11935 ►�.
r 1
0 ,
T9
Framing:
roof and walls:
2x4 16oc Shed B
ti
Sheathing:
5/8" Tex 111
Flooring:
APPROVED AS HUED
1/2 plywood6112- ,# � side elevation
ZD
_ n
Foundation: pEpA TMEI 74
none M • " TO 4 OR
No MCI
1 TNNI • TWO REGUiRED
COIMI
•IM M & PLUMBING
l FINAL • %AAWW'1l1'ICTM MUST
7'9 BE COM'l I PON CA
ALL CONSTRUCTION SHALL MlET
THt REQUIREMENTS OF THE NX
STATM CONSTRUCTION i ENERGY USE IS UN-1
COOED. NOT RESPONSIBLE FOR WITHOUT CERTiFfCn:E
sum OR CONSTRUCTION
OF OCCUPANCY
MENEM
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Applicant/ Date
"Owners Name: �n ooh �'�- Reviewed:
Architect/ Date.
Engineer: Submitted:Submitted: / O Az
SCTM #: Cj
Oistrict: 1,000 Section: ! 5 Block: _ Lot:
Project Subdivision
location: ��t _ Name:
Sin&le &, separate Required q
certification: (Yes J Nol _
(��iReq. Rey. T
%rniing.t)is(ricci Il o(sizc: OAMOL Acuial;.4oC®/oa- ' l (IAl covcragc I'rulxised Tl
Req, /pIrt Rcq• / Req.
(f=romYard : J (Side Yard ^ Proposed: J (Rear Yard /D Proposed l'
Project Description:
AGENC'Set1 ?ERMITS Permit
REGULRED UOR REVIEW N e stn v>�r
Suffolk County Health.Dept. f
New York State D. E. C. f.
Town Trustees
Town Zoning Board,approval:
Town Planning Board approval:
Flood Plane Elevation???
Flood Zone:
Notes,