HomeMy WebLinkAbout24619-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32019 Date: 11/22/06
THIS CERTIFIES that the building ADDITIONS
Location of Property: 3175 NASSAU POINT RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 13 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 15, 1997 pursuant to which
Building Permit No. 24619-Z dated JANUARY 28, 1998
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 DECK & BRICK PATIO ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to PHYLLIS KAUFER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Autriz§A Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
MAY 2 1
TOWN HALL � �" + '
r' ,
765-1802 _ F
APPLICATION FOR CERTIFICATE OF OCCUPANCYO'��a�
A. This application must be filled in by.typewriter OR ink and submitted to the building
inspector with the following: 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 fro% 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. Copy of Certificate of Occupancy - _ .25e,.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $155.00, Commercial $15.00
` / Date' .. . . / 07/� /CJ . . . . ... . . . . . . . . . . . .
New Construction. .. . V. .... Old Or Pre-existing Building.. ./ . . . .
Location of Property..v�) 7`- n!'�sS: U .d::!..::1 . . .. .V}.�� 4tI-C.. . . . . . .. . . . . . . . .
House No. Street � Hamlet
Onwer or Owners of Property.. . . ���:5 ..�:1r . . • . . . . . . . . .. . . • • . . . . . . . . . . . . • •
41 7,3819 L,,,�
County Tax Map No 1000, Section. . •O.!. . . ....BlocO r . . . . . . . .Lot.�� . . . . . . . . . . . . . .
Subdivision.&A. .. .� . .G?�c�rT . .... .. .. .Filed Map. ./. . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . .7-ny. . .LDate Of Permit. ./ . . .Applicant. . . � /*
Health Dept. Approval. . .... . ... . .. . . .. . ... ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . .. ... . ... . .... .. . . . . .
Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. . X . . . . .
oQ �
Fee Submitted: $. . .�:5. . . . . . . . P.. .../C. -
/ 69!L�
. . . . . . .
•? f p . . . . . .APPL . . . . . . .
co 2-
3�� f
765-1802
BUILDING DEFT.
NSPECTION
[ ] FOUNDATION iST [ j ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ INAL
[ ] FIREPLACE & CHIMNEY
REM/ARKS: C-c� 7�-�_
�(�c4-cam
DATE INSPECTOR aG�,
J
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)
JANUARY 28 98
24619 Date .............................................................. 19...........
Z
Permission Is hereby granted to:
PHYLLIS KAUFER
............................ .............................................................
21 BEDFORD AVENUE
...........1.............................................................................
.
ROCKVILLE CENTER,NY 11570
..........................................................................................
CONSTRUCT A DECK AND BRICK PATIO ADDITION TO AN EXISTING
to . . ..........................................................................................................................................................
SINGLE FAMILY DWELLING AS APPLIED FOR
..................................................................................................................................................................
.................................................... ... ....................................................I.................................................
..................................................................................................................................................................
................................................................................. ......................... ...................................................
3175 NASSAU POINT RD CUTCHOGUE
atpremises located at........................................................................ . ........................................... ......
.................................................................................................................................................................
.473889 104 0013 012
County Tax Map No. .......................... Section ........................ Block .......................: Lot No. ........................
DECEMBER 15 97
pursuant to application dated .......................................................... 19............. , and approved by the
Building Inspector.
75.00
Fee$........... .............
...... ............ .... ...I.... ...............................
uilding Inspector
Rev. 6/30/80
Albert J. Krupski,President �O`�SUfFO(�COG Town Hall
John Holzapfel,Vice President 53095 Main Road
Jim King
P.O. Box 1179
Martin H. Garrell py !� Southold,New York 11971
Peter Wenzel Telephone (516)765-1892
Fax(516)765-1823
BOARD OF TOWN TRUSTEES o•_ .
TOWN OF SOUTHOLD r
December 11, 1997 row 40
Phyllis Kaufer
21 Bedford Ave. -
Rockville Center, NY 11570
RE: SCTM #104-13-12
Dear Ms. Kaufer,
The Southold Town Board of Trustees, reviewed your survey, and .
determined that your project to construct a deck. and brick
='L patio, is out of the Trustee jurisdiction under.Chapter .97 of
z=k the- wetland code.
However, this determination. is not a determination_ from any' '
other agency.
If you have any further questions, -please do not hesitate to
call.
5 Sincerely, . z L
2.
4OP
i' Albert J. Krupskr, ''tTr
+ _ President, Board of:.Trustees--
cc. Bldg. Dept.
I' I�I.II I Il�il'I:l.I I1)l1,111:1'1111 1)INT V
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-- '-----�--� __ _-.-___-_____�-_......tom-.------•--....._ +_._._ -0
��m__, a BOARD OF HEALTH .
(� `rl FORM NO. 1 3 ,SETS OF PLANS
D v - �" TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
qs; BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
DEC 15 1997 _ i$ TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N_Y_ 11971
BLDG.DEfT. TES.: 765-1802 = NOTIFY:
TOWN OF SOUTHOLD _ ? . �? j
� � >�'� CALL
/ pr C /� �f 1.
Exanined......1,./ 0...., 19 ,�1 C; MAIL TO: . . . . . . . . . . . . . . . . . -
Approved...../. . . ...., 19�(!.. Permit No. ................ ._..................- ..........
Disapproveda/c .................................. ....................................
......................................................
----
(Buil g/ns
APPLICATION F P3Ril11T
Date_ %! . . . . . . . . . . 119.?
INSTRl1C'TIONS
a. 'Ibis application must be carpletely filled in by typecariter 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 application.
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
permit shall be kept on the premises available for inspection throughout the work.
e.'v 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 MAUL. 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 Iaas, Ordinamces'or
Regulations, for the construction of buildings, additions or alterations, or For removal or demolition, as herein
described. The applicant agrees to cotiquly with all applicable laws, opingfor
uilding code, housing code, and
regulations, aril to admit authorized inspectors on premises and in lxmicessary in pections.
r .. ... ... ................
(Sipplicant, or if a corporation)
Y
. ...................................................
(Mailing address of applicant)
State whether applicarA is owner, lessee, agent, architect, engineer,.general contractor, electrician, plumber or builder.
.................... ............... ............. w Y". ......................................................
Nwx- of owner of premises ................ �.!J F�r...........................................................
(as on the tax roll or latest deed)
If applicant is a ncolrporation, signature of duly authorized officer.
.................oC:'� ................................
(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..............................................................
.........moo..... /l�SS u ........................?.�(fob-c�. ......................................
house Number Street (` Nanlet
County Tax Map N 1000Stion .....`�T---- Block ..... ....... Lot .... .......
Subdivision ...;N�.. ................ Filed Map No. ...... Lot ...............
(Name)
2. State existing use and occupancy of premi and 'i/nteended use and occupancy of proposed construction:
a. Existing use and occupancy ......... .�..►!.!1.( ..... �......... ...... ...............
b. Intended use and occupancy --._...1 S U2 ...... ... .... ep— .. R<< ... -..__......
3. Nature of work (check %Aiici applicable): New Iluilding .......... Addition ..... Al ter t'n ..........
Repa i r ............ Removal ............. Demolition ............ Other Work ............
d6' (Description),
11. Estimated Cost
6......I...0.............. fee ..............................................
(to be paid on filing this application)
5. If &,elling, mxji)er of &-elling units U-nL)er of ot-.,eelling units on each floor ...../ .......
Ifgarage, ntmi.-Peer of cars .....................
6- If business, curmercial or mixed occupancy, specify nature and extent of each, type of use
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
Height ......................... Umber of Stories ..IVIA............ s,6'e 106?,ru
Dimensions of same structure with alterations or additioris: Front ............... Rear ...............
Depth .................... 11eigilt .................... bkxiber of Stories ...............
8. Dimensions of entire new construction: Ikont ...... . . Rear ............... Depth ..............
neigilt .......................... Rmi)er of Stories ....4 .......
9. Size of lot: Pront ..... Mar r Depth ....................
10. Date of Purchase ...... ....... Naveof Former Owner ...?OR-.40-5 ..........................
11. Zone or use district: in thich premises are situated .........1.006................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: A A...............
13. Will lot be regraded .-.(V..o..... ... Will excess fill be removed from premises: YES 6C
-V -7
?/ e IV Phone No t�14. Names of Owner of sesY�.�f Y(6-"5j71RL)'CP1P---- ACkIressaf ........
/7/
N 3
Name of Ardiftect ��7JdS ......... Address�. Phone No.
None of Contracro—V .................... .......
......................Phone No.
15. Is this property within 300 feet of a tidal x-jetland? * YES .......... NO
*IF YES, S(XMKN-D IUM 'IMSM-13 Ill?XFr MAY BE MQUIRPM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
froin property lines. Give street and block nuni)er or description according to deed, and show street names and indicate
%,hether interior or corner lot.
SIME, 01-' N;W Y(A?K
MUNLY Or SS
.......
X.....- ./W&. .1. ...............litiing duly scx)tu, dejx)ses aiwl LhaL lie is Lhe applicaut
(&-xix- of indivicflial signing contract)
above rumied,
Ile is Lhe ......... ......... ......
...........(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly auLhorized to perform or have performed Lite said work aix] to make and file this
application; that all statements contained in this application are tn)e to the best of his knowledge and be'HeH aixf
that the work will be performed in the twinner set forth in the application filed therewith.
Sworn Co before me Lhis
Notary INibi a of 19.D ..
...... .... y
ic . ......... ... ...........— .. . ........ ..... ......... ......
Jgwitre f Applj�.cant)
MAUREEN ECAMBA
NOTARY PUBK State of New York
No.314361035
0omw in Nassau cow31,
Ig
Commission Expires December 3
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_ �'(� VY P4L � (`►'i — �{t t✓D ,a `'♦' Gd'L. !�I`y�� 6... Ei�� .-
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TOLERANCES . "�9, �c.,. I /�f`�
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NY
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12 CHECKED DATE / DRAWING NO
TRACED APPROVED .
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