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HomeMy WebLinkAbout44310-Z Qgut'fu Town of Southold 11/25/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40886 Date: 11/25/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 930 Jacobs Ln, Southold SCTM#: 473889 Sec/Block/Lot: 79.-7-35 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/17/2019 pursuant to which Building Permit No. 44310 dated 10/17/2019 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: "AS BUILT"REPLACEMENT WINDOWS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Ellinghaus,Jonathan&Joy of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED n n 4 u o ' e Signature ��o�soFFat" TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44310 Date: 10/17/2019 Permission is hereby granted to: Ellinghaus, Jonathan 620 Pelham Rd New Rochelle, NY 10805 To: to legalize "as built" alterations (replacement windows) to an existiong dwelling as appplied for. At premises located at: 930 Jacobs Ln, Southold SCTM # 473889 Sec/Block/Lot# 79.-7-35 Pursuant to application dated 10/17/2019 and approved by the Building Inspector. To expire on 4/17/2021. Fees: AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00 CO -ALTERATION TO DWELLING $50.00 Total: $450.00 Building Inspector 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 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$50.00,Additions to dwelling$50 00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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. New Construction: Old or Pre-existing Building: c (check one) t Location of Property: (V)j o CL L.© k S House No. Street Hamlet Owner or Owners of Property: Q Suffolk County Tax Map No 1000, Section �� 1 — Block Lot Subdivision ` Filed Map. Lot: Permit No. Date of Permit. Applicant. Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ Gj Applicant Signature v SOUTgOIo # -TOWN OF SOUTHOLD BUILDING DEPT. cou765-1802 INSPECTION [ ] FOUNDATION 1ST - - [ "] ROUGH PL13G. [ ] FOUNDATION 2ND- ` [ = b INSULATIOWCAULKING GV �l0"M,6d 1 [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY M [ A]--FIRE:SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]- FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS e CrJ FOUNDATION(IST) -------------------------------------- FOUNDATION (2ND) t�r1 f s H I ROUGH FRAMING& H .J PLUMBING ;7 r INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDITIONAL CO MENTS 101IL111 • 0 z m X lio Oz •x d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying9 TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey Southoldtownny.gov PERMIT NO. Lo Check Septic Form N.Y.S D.E.C. Trustees C.O.Application Flood Permit Examined 120 Single&Separate Truss Identification Form 7Storm-Water Assessment Form Contact ( : Approved ,20 III Mail to: Disapproved a/c e A r N yr Phone: v ALL d5'� - Expiration ,20 P, QE IL6 � ~'.�` . �' '- "'� ERT d d 2 "` Z mg Ins ec ' OCT 1 7 2019 3 APPLICATION FOR BUILDING PERMIT uvPAN�� Pod"091?�1-, �,, Date , 20 Ce ft! 140,, --a-, , INSTRUCTIONS � lY + A a&Vc�tion MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets* ay}s, 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 waterways. 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 a 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 what so ever until the Building Inspector- issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 inspections. AS gnature of applicant or name,if a corporation) 41 ) M:�I!�� i�T (Mailingaddress of a licant N01.FY E Utt l�.';iG_ Tt,,E� nn. �p�� t'0� State whetMi-4i")ic;ai�it is�grvvtler�;11 ssee a ent, architect, engineer, general contractor, electrician, plumber or builder F01-1.0 � 4,1 i j �d0 REOL`I tC pOUt�FU Name of own iq (pt>�einti �+`,' C fir' u1 r\ OI,IJ S 2 Ea0 Tl alt (AAn the tax roll or latest deed) { If applicant s TM of ora ionT iarrI N of dul authorized officer '.. X comPLY WITH ALL CODES OF Nam an tt;LlBf� n ' raT'e"„frc )�w►��' NEW YORK STATE & TOWN CODES ( �l d@ r�� Builders Licen UND_1`al[1�11,S; �rj, :. nr_r ilJSJIB, FOR' AS REOl11RED AI,I Plumbers Lich i 'rtNoT��TL• P� ^-.� 1t0N EBS S TOWN ZBA Electricians L�ZW9 ,R Other Trade's License No. SOUTHOLD TOWN P ING BOARD SOUT WN TRUSTEES 1. LocatiW of land on which proposed wor will be done: l D �a 1cLa. I House Number Street q Hamlet County Tax Map No. 1000 Section I Block Lot �j(!Y- Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alterati n Repair Removal Demolition Other Work ( h (Description) )C) 4. Estimated Cost 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 Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear D�epthti i � 1 Height Number of Stories 9. Size of lot: Front Rear Depth 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? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Narnes of Owner of premises Address Phone No. Name of Architect Address Phone No Naive of Contractor Address Phone No. 15 a. is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that((s1�)he is the licant (Name of individual;signingecontract),aboye named, BONNIE. Notary P!)htir'. Rtr tp of NaWY'* (S)He is the 1- -' No.01130f:,Ar'050 (C6nfracior,3Agent;Corporate Officer,etc.) C lssionExpires April 14," , of said owner or owners and is duly authorized'tb perform or have performed the said work and to make and file this application; that'all stat ments"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. Swor Xo before met nw, 1 day of ,..20 6 .... Notary Public ignatur pplicant rI�luCem� w �nAdu�s —�y� howF he+�