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Home My WebLink About28062-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28198 Date: 02/04/02 THIS CERTIFIES that the building ADDITION Location of Property: 540 CEDARS RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 5 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 4, 2002 pursuant to which Building Permit No. 28062-Z dated FEBRUARY 4, 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 GAZEBO ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWARD F SCHILLER & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 01/31/02 PLUMBERS CERTIFICATION DATED N/A 44.1, ;- � //uthd'rized 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. 28062 Z Date FEBRUARY 4 , 2002 Permission is hereby granted to: EDWARD F SCHILLER & WF 540 CEDARS RD CUTCHOGUE,NY 11935 for CONSTRUCT A GAZEBO ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#20831 . at premises located at 540 CEDARS RD CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0005 Lot No. 017 pursuant to application dated FEBRUARY 4, 2002 and approved by the Building Inspector. Fee $ 150 . 00 C u or ' ed ignature ORIGINAL Rev. 2/19/98 f Form No.6 '") q TOWN OF SOUTHOLD / BUILDING DEPARTMENT TOWN HALL '--- —�—�— - ... 765-1802 (2?F� I,, n 'R 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY 5 ; This application must be filled in by typewriter or ink and submitted to the Building Depa4mei it thewfollowing: _ A. For new building or new use: _� c1i «n 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. 16 1 New Construction: ,` Old or Pre-existing Building: (check one) Location of Property: Q 6" gum House No. / Street T,o Hamlet Owner or Owners of Property: /- 1�'i� �t ✓� %,het ��1� 't`j�r Suffolk County Tax Map No 1000, Section Block Lot f Subdivision Filed Map. Lot: Permit No. C:x - Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check o ) Fee Submitted: $ v Applican, ignature M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE / I pL INSPECTOR d ?OUNDATION ( 1st) c 9 'OUNDATIO11cn Q, ( 2nd ) cr o � ;OUCH FRAME & • O -PLUMBING cn m :11SULATION PER N . Y. STATE ENERGY II CODE t e_ _. y FINAL .4 ADDITIONAL COMMENTS : x O -o H BOARD OF HEALTH . . . FORM NO. 1 3 SETS OF PL.INS �• SURVEY • •� • . • • • • TOWN OF SOUTHOLD " " " ..w-1 BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . ... . . . . . . TOWN HALL SEPTIC FORtl _ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTI FY ; :� 2J/� {� CALL /z �7 . . . . Examined . . . 14. . 19`x? h1A I L TO : . Approved .. � . j { . ., 191�-Permit No.c�k,(P—R-� -:' , . . . . . . _ . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) r.- APPLICATION FOR BUILDING PERMIT �j ' Date . . ,/F��y . .`. . . . . . ., 19 %Two- , - INSTRUCTIONS- a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 set's 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 ;hall 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 ;hall 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 3uilding 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 cod q and regulations, and to admit authorized inspectors on premises and in building for necessary inspec -6 S y . � . . . . . . . . . . . — (Signature of applicant, ur name, if a/corporation) ve. .!r/�Y . . .fir y3 . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . .Gf rlPr.-G. . .. ..r,... . ��' 'l c7� r�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . .47e&4-el/. fa47,41. . . .��f9h�7�t. . . . .�'.`?i/les- . . . . . . . . . . . . . . . . . . . ... . . . . . . (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. . . Q /I�%/'' . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . — Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Locationofland on which proposed work will be done. . . . . . . . . . . . . . . . . ...,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O. . . . . . . . . . . . Lr4�+cZ/,T. . . . . . . . . . . . . . . . . . . . .4 �/� J. . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet 7 f County Tax Map No. 1000 Section . . . . . . .f�9 . . . . . . . Block . . . . ..�5 . . . . . . . . . . . Lot . . . . .Ag . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . .. . . . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . 4�vd . . . . . . . . . . . •" . t. • • . . h.,Intended use and occupancy . . . . . .Sl4 Ao� . . . . . . Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . r Repair . . . . . . . . . . . . . . Removal . . . • • • • Alteration . . . . . . . . . . . • . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . 11� �a (Description) 4. Estimated Cost . . . . .. . .... . . . . . . . . . . . . . . . . . . . . . Fee . ,�l7/ . . . . . . . . . . . . . . . . . . . . . . . . . . 5. If dwelling (to be paid on filing this application) a,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 yy De 3, Height . . . . . . Oft. , . Number of Stories . . . . . . . . . . . .I/„�, pt Dimensions of same structure with alterations or additions: Front �i /• � �rtA CM`' Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . Rear . . . . . .E-2ff: . . . . . . 8. Dimensions of entir new construction: Front Number of,Stories . . . . . . . . . . . . �s� l•��. . Rear . Depth Height . . . . . (R7:f . . . . Numb r of Stories . 4.. . ./ . . . . /7. . . . . p . . . 12 : . . . . . 9. Size of lot: Front . . �'. � . . . Rear . . . . . .f 6.Z?T7 . . . :. . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . ./- � —. . . Depth 3fF p. 11. done • • • • • • • • • • Name of Former Owner . . . . . .!`��',tP�'.S'�-j, or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: ./7Q * * . . . 13. Will lot be regraded ,r,Iq, , Will ex5ess fill e r moved from premises: Yes 14. Name of Owner of premises � c�o.-w,!,,rc.�i, j No Name l �. . Address�P <,r. �`1W W. f�;e . . Phone No. . . 7.33/: of Architect . . . . . . . . . . . . . . . . . . . . . Address . Phone No. Name of Contractor . Address . Phone No. 15. Is this property within 300 feet of a tidal wetland? *yes.•.• - . • • • . - . . . . . *If yes, Southold Town Trustees Permit may be required. - • • " No. . . , 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. ................................... 3o - _ INV t o. � 6 0 o � o � �► i ; TATE OF 1IEW -OUNTrY OF-: ' . . .j S.S' being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) above named. Ieis the . . . . . . . . . . . . . . . . . . . ?c�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . 4 :.. .da o -.- 19�/� . . .1. . . ., . . otary Pub ' . . . . . . . . . . . . • .. . . . County CLAIRE!_ a of N Notary Public,State of New York ,1 /� • . • . No.4879505 " " ' • • • - • . . Qualified in Suffolk Dow Countlr Q�� (Signature of applicalt) Commission Expires December 8.19 L +a `a i? r, }, (sobi' Na o o' CU J 6.9 L, r• -<<� •'~fit- I ' � i / 777 9 t J� 17 �X SE IsAPPROVED AS 140-TUD PATE. ? i . ov OCCUPANCY 65-1802 w AM TO- FOLLOWIN(; . �.''s I. FOUNDATt()tr , FOR PouRED 2. ROUGH 3. INSULATIO,%, 4, FINAL } I BE COMPLETE FOR � �? ALL CONSTRUCTIONSI �yF E REQUIREMENTS OF THE. � E CONSTRUCTION & ENER,,,v NOT ,RESPONSIBLE F:Ofl DE N CONSTRUCT ON ERROPS 1 6 \�