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Home My WebLink About43153-Z FOI,Vee, Town of Southold 12/11/2019 g P.O.Box 1179 0 v' 53095 Main Rd �4 �yO Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40916 Date: 12/11/2019 THIS CERTIFIES that the building FIREPLACE Location of Property: 38099 Route 25, Orient SCTM#: 473889 Sec/Block/Lot: 15.-2-16 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/12/2018 pursuant to which Building Permit No. 43153 dated 10/19/2018 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: GAS FIREPLACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Bancroft Jr,Martin /of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED t o ' e Signature SUFFock TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy. . 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#: 43153 Date: 10/19/2018 Permission is hereby granted to: Bancroft Jr, Martin PO BOX 483 Orient, NY 11957 To: install fireplace in existing single-family dwelling as applied for. At premises located at: 38099 Route 25, Orient SCTM # 473889 Sec/Block/Lot# 15.-2-16 Pursuant to application dated 10/12/2018 and approved by the Building Inspector. To expire on 4/19/2020. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 ding nspector 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: � (check one) Location of Property: �30 I � �1:�_ ',%–T— House No. Street Hamlet Owner or Owners of Property:MiNKY1(ti �j Suffolk County Tax Map No 1000, Section Block Lot 1 Subdivision l Filed Map. Lot: Permit No. —1 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ A vpt licant Sig to e So//1h0 # TOWN OF SOUTHOLD-BUILDING DEPT, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] -FOUNDATION 2ND [ - ] SULATIOWCAULKING [ ] FRAMING/STRAPPING '[ FINAL 6.0 i!ft pi" [= ] FIREPLACE`& CHIMNEY [ f-FIRESAFETY INSPECTION [ ---]--FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: owDATE- 11 'L q INSPECTOR r: b FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) H ------------------------------------- 'FOUNDATION (2ND) �t O 0 ROUGH FRAMING& y PLUMBING INSULATION PER N.Y: H STATE ENERGY CODE FINAL ADDITIONAL COMMENTS ao rn Z °z d b H TOWN OF SOUTHOL'D BUILDING PERMIT APPLICATION'CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 �' ' ' " ' 4 sets of-Buildin'g Plans TEL: (631) 765-1802 PlanningBoard approval FAX: (631) 765-9502 Survey Southoldtownny.gov PERMIT NO. Check- I 1,.J1: : Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20A Single&Separate ' Truss Identification Form Storm-Water Assessment Form, Contact: Approved ,20 Mail to: Disapproved a/c Phone: Expiratio 2 ® ., B Spector OCT 1.1 .201 APPLICATION FOR BUILDING PERRMIT DUH,DING DEFT. Date , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and-submitted to the-Building Inspector with 4 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 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 D'4aitmdnf for the'issuance'of a Building Permit pursuant io 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 alteratioris orTbi removal'or demolition as herein-describ'ed`�The' applicant agrees to comply with all applicable laws, ordinances,building code;housing co'de',and regulations; and to admit ' authorized inspectors on premises and in building for necessary inspections. '(Signature o#,applicant or name,if a corporation) - + its f •F (Mailing,address of applicant), State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,•plumber,or builder Name of owner of premises T �T (� (As on:the tax,>roll or lates deed) If applicant is a corporation, signature of duly authorized officer `•`•! (Name and title of-corporate,officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Locattiionn of land on X✓hi' h;ropos work will be done: �� , House Number Street Haml t County Tax Map No. 1000 Section Block C�_ Lot i Subdivision,, Filed Map No. Lot -; ,; i 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 -Alteration Repair Removal Demolition �er Rke)-ACj_� (Description) 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 carts 6. If business, commercial or i 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 Rears (__ i Depth Height Number.of Stories ' 8. Dimensions of entire new construction:,Front Rear ' '°c Depth 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 whish premises are,situated 12. Does proposed construction violate any zoning 14w,;ordinance.or regulation? YES NO 13, Will lot be re-graded? YES NO Will excess fill be removed.from premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address " ' ' Phone No Name of Contractor ' Address Phone No. 15 a. Is this pzoperty, within.1 QO-feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN,TRUSTEES &D.E.C.=PERMITS MAYBE REQUIRED. b. Is,this,property w;ithin-3QO;feet of a tidal wetland? *.YES Np * IF YES, D..EC: 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 atJ0 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(s)he is the applicant (Name of individual signing contract) above named, CONNIE D.BUNCH (S)He is the Notary hiePublic,Siete of New York Agent, Corporate Officer etc. 1 Contractor A11��al3�® g ) Qualified in i;ff k County o Commission Expires April 14,2� 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. Swprn t before me day o 201 OA� A Notary Public , ignd-flire of ApplicAt 1 l V FF w I• , - ► i ----�-� ___-.Cs_ ri .. lGc�,._. eu R. v 4131, -Olzri" t:. . 17, i - -4- 'AP ROVED AS NOTED a l DATE: s.P.# FEE: r d6 BY: NOTIFY BUILDING DEPART TAT 765.1802 8 AM .TO 4 PM FOR THE OCCUPANCY OF, 10F OND TION WING INSPECTIONS-, TWO REQUIRED USE IS UNLAWFUL FOR POURED CONCRETE T _ 2. .ROUGH - FRAMING & PLUMBING WITHOUT CERTII L)� I E 3. INSULATION• -___ _.. .... ..- .... . ...._-. _.,.......,.._..........._............__..._.._.�..._.._............._,._._......._........,._._..__._....__..w.__.�__.__..,.__..___ . OF OCCUPANCY _.. ..-, .,_. _ .... .... ..... .._.. ..,.._.._.... 4: FINAL - CONSTRUCTION MUST -- __ _.... ..,. ., _.... ._........,.w._..,_.._ _ _ _�...._ _ _ �._ v ..._................. --- r ... BE COMPLETE FOR C.O. •ALL CONSTRUCTION SHALL MEET THE f. REQUIREMENTS OF THE CODES OF NEW YORK STATE. -JOT RESPONSIBLE FOR bESIGN,OR CONSTRUCTION ERRORS. Fire separation required as per NYS Code COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUITED AND COND!'IONS OF r�D �N%.DEC-, /��I r ....�..., ...,mow_..-..-••^ � i r� �� ~ 4 S U - T E R AND S T E ARCHITECT 'U R E • , L A N DSCAPE D E S I G N t --- -*�� D7�� •yC? O YORK 11959 f ,. P.O. OX 1709 124 SSUP AW-NuUOGUE 2-�'/ iE O , NEW PHONE 631.653-3877 suterandsuter@gmail..com