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Home My WebLink About29185-ZEORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29304 Date: 03/10/03 THIS CERTIFIES that the building ADDITION Location of Property: 835 K36 CALEB'S WAY GREENPORT (HOUSE NO.) (STREET) {HAMLET) County Tax Map No. 473889 Section 40 .1 Block 1 Lot 36 Subdivision FiledMap No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 2003 pursuant to which Building Permit No. 29185-Z dated 9LARCH 4, 2003 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 RAMP ADDITION (NON-HANDICAP) TO AN EXISTING CONDOMINIUM UNIT AS APPLIED FOR. The certificate is issued to OLGA M TOLE of the aforesaid building. {OWNER) SUFFOLK COUNT~ DEPARTMENT OF ~L~LTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DAT~ Rev. 1/81 N/A N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 29185 Z Date MARCH 4, 2003 Permission is hereby granted to: OLGA M TOLE 36 CALEB'S WAY GREENPORT,NY 11944 for : CONSTRUCTION OF A PJLMP ADDITION (NON-HANDICAP) AS APPLIED FOR at premises located at 835 K36 CALEB'S WAY County Tax Map No. 473889 Section 040.001 Block pursuant to application dated MARCH 4, 2003 GREENPORT 0001 Lot No. 036 and approved by the Building Inspector to expire on SEPTEMBER Fee $ 150.00 4, 2004. ORIGINAL Rev. 5/8/02 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 thc 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 fomg. 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 $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 - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: /// Old or Pre-existing Building: Location of Property: ,~-~ ~,~ ~t~ //(.fi4 ~ House No. Street OwnerorOwnersofProperty: /t~t~ 77-tt ~.~-t~'-~A[ /[4, '"'"'[~ ~' Suffolk County Tax Map No 1000, Section O q~, OOI Block Subdivision Permit No. oQ q./~'J"- ~ Date of Permit. Health Dept. Approval: ~t Plmming Board Approval: A~ lA Request for: Temporary Certificate Fee Submitted . b 719' 0 4 (check one) Hamlet Lot ~ Filed Map. Lot: Approval: ~ [ Pr' Underwriters Final Certificate: / (check one) Applicant Signature 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ /] INSU~.ATION [ ] FRAMING [ ~ FINAL [ ] FIREPLACE & CHIMNEY DAT ' f " F~;LD INSPECiiON REI~ORT DATE COMMENTS` ' '- F OLrNDATION (1ST) FOUNDATION (2_ND) ROUGH FI~'~NO & I'LU3~I~G ""h INSULATION PER N. Y. STATE ~GY CODE ADDITIONAL COMM1OIT$ 2~ · TOWN OF SOUT~OLD B~JILDtNG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need.the fol?6wing, before applying? Board of Health 3 sets of Building Plans planning Board approval Survey Check Septic Form Examined~' ~, 20 Approved 25/ 73 , 20 Disapproved a/c Expiration~ ~, 20 N.Y.S.D.E.C. Trustees Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and subnfitted 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 waterways. c. The work covered by this application may not be cormnenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a perrnit shall be kept on the prernises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pan 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 Penmt 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. (Sig~kature of applicant or r~amer4f.~ corporation) (Mail/rig address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name o f owner o f premises ~x,O~x,~,,q2~rx ~ ,'~'----'%-~c>[ x(5~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly author/zed officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electldcians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Ntanber Street \ Hamlet County Tax Map No. 1000 Section '~_,& Block \ Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises ~ad intended us~and OC~l~ncy of proposed construction: a. Existing use and occupancy '~cc~x(Vo.r~O~-x c~\ ((~ ov~ ?q~ ) b. lntended use and occupancy ~<3x~62~,,~o,.~. 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work 4. Estimated Cost 4 ~)~0~ Fee 5. If dwelling, number of dwelling units [ If garage, number of cars ~) 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Alteration (DeScription) (To be paid on filing this application) Number of dwelling units on each floor ~ 7. Dimensions of existing structures, if any: Front Height \~' ~ Number of Stories Rem .Dep~ Dimensions of same structure with alterations or additions: Front Rear Depth Height \-~ ~ Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 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 v/Will excess fill be removed from premises? YES 14. Names of Owner of premise ~t 0a,'-Vb~_ Address C~r'o~,_k3,>r4- Phone No. Name of Architect Address Phone No Name of Contractor ,~l~-k '"f~:a\~::a~ Address Phone No. NO 15 a. Is this property within I00 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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. 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, (S)He is the (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 tree 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 this ^~ ~! dayof ~}/l~ 20~~) 0 o a;vPublic oo ~lOUn~ u! ~aj. len0 ~860~0908 [0 'ON · oA ~eN Io eI~IS 'Ol~8Ra NHO8 '~