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Home My WebLink About29385-ZFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29463 Date: 05/22/03 THIS CERTIFIES that the building ADDITION Location of Property: 3300 SOUND DR GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 33 Block 1 Lot 6 Sul0division Filed Map No. __ LOt No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 2003 pursuant to which Building Permit No. 29385-Z dated MAY 16, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RALPH W GROVER & NANCY C CLEVELAND (OWNER / of the aforesaid building. SUFFOLK COUNR~f DEPARTMENT OF ~ALTH ~_PPRO~-~J~ ELECTRICAL CERTIFICATE NO. PLUq~BE~S CERTIFICATION DATED Rev. 1/81 N/A N/A N/A h~rize~ S~--g~atu~ 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) PERMIT NO. 29385 Z Date MAY 16, 2003 Permission is hereby granted to: RALPH W GROVER 3300 SOUND DRIVE GREENPORT,NY 11944 for : CONSTRUCT ADDITION TO SINGLE FAMILY DWELLING AS APPLIED FOR. REPLJkCES BP 23178. at premises located at 3300 SOUND DR GREENPORT County Tax Map No. 473889 Section 033 Block 0001 Lot No. 006 pursuant to application dated MAY 16, 2003 and approved by the Building Inspector to exq~ire on NOVEMBER 16,__2~~ COPY Rev. 5/8/02 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTO/~D) oo,,~ ..................... ~.,..¢..~./2 .............. ,9.r..~...-- Ne 23178 Z Building Inspeo,~ ~ Rev. 6/30/80 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: Ao 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. Bo 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. Co 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 New Construction: 57~Location of Property: House No. ~bJ'~)wner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision ~ Old or Pre-existing Building: Pen,(it No. t~'~3g~- ~ ! Health Dept. Approval: Planning Board Approval: (check one) Street (X:~~O"¢~ -- Hamlet __ Date of Permit. Request for: Temporary Certificate Fee Submitted: $_ c~-~' Oo Block _ Filed Map._ Applicant: Underwriters Approval: Lot ~:~ Final Certificate: -- Lot: (check one) AppliCant Si~na~,.~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ ~RAMING [ ROUGH PLBG. INSULATION FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSU~T4~N [ ] FRAMING [~_~iNAL [ ] FIREPLACE & CHIMNEY , DATE INSPECTOR 765.t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] RO~I PLBG. [. ~ULATION [/_./J FINAL ] FIREPLACE & CHIMNEY REMARKS: DATE ~/~~ c~ INSPECT! FOtlHI)ffT I Otl Al)l) I T I ()/IA [. CO[IHI~i~I'['S: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY - TEL.: 7654803 CALL Examined . . /~ , HAIL Approved..~./~ ~, ~.~.PennitNo.~Z . '-// (~ildinglnspector) A~I~ FOR BUILDING PERMIT INSTRUCTIONS BOARD OF ItEALTtt ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ TO: Date . .~'~.C,..q. ..... 19 .c:/5- a. This application must be completely filled in by Wpewriter 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 arc,is, 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 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 whatever until a Certificate of Occupancy shall 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 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 ~-emoval 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. (S~grlature ot applicant, or name, ff a corporanonY (Mailing address of applicant) , State whether applicant is, owner, lessee, agent, architect, engineer, general contractor, electrician, phimber or builder. (as on the tax roll or latest deed) I f applicff~ is a corpora~g~,a~ o f du~::2rized officer. ..... ~j~me ~ title ot corporate officer) Build~r's"~''-License No ...~..~...~.9.~ .... ~,..-~. ...... Plumber's License No. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work ~vill be done. ..33do. ........... .*.e , ............... [louse Nun] ber St,r&et Hamlet ~ ~" ' . ~ Lot...~ Count~ Tax Map No. ~000 Section .............. ~ . Block ............................. Subdivision . (Name) Filed Map No. Lot ............... 2. State existing use and occupancy of premises and intended use and ocCopancy of proposed constrnction: a' Existing use and occupancy ~ ~wx b' Intended use and occupancy .[...~ ~'17, 3. Nature of work (check which applicable): New Building ' Addition V~ Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... ~O (Description) 4. Estimate'd Cost OO, ~ · . . ~, ........................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units 1 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 .... .ha, JO .............. 7. Dimensions of existing structures, if any: Front .... &~; ........ Rear .... .~..g ....... Depth ....:~h ........ Height .... Z.~.t ....... Number of Stories ..... .~. .................... ~ ......................... Dimensions of same structure with alterations or additions: Front ....... ~..t,. ....... Rear .. ~' ' ' ' · o(-%6 ........... Depth ...... .~.. ~...t .......... Height ...... ~.~.~' ............ Number of ,Stories ...... ~ ............. 8. Dimensions of entire new construction: Front ...... ~ ........ Rear ...... ('~ ........ epth .... ~ .......... Height ..... I.O..'. ...... Number of Stories ......... l .............................................. 9. Size of lot: Front ...-ff-4~..~.o.r.v~. ~a ....... Rear ...................... Depth ...................... 10. Date o£ Purchase ............................. -- ~4, Name of Former OB, ncr .... ~ ........................ 11. Zone or use district in which premises are situated ..... ~..&~3~ .0.~..~.~.~'~(-~ ................................. 12. Does proposed constructio~Ji~?late any zoning law, ordinance or regulation: ...L~.'.. ev~ ......... fi.f,~ ......... 13. Will lot be regraded ...... :Z. ~.. ................. Will excess fill be removed~from premises: ~lq~es No 14. Nmne of Owner of premises .~O.kqk, x. ~-~rPg.~. ~r7.... Address,....~P.~..-~.¥~c.$.'~. ~'p4'e.. Phone No... ~ .'Tt.~/.'w ....... Name of Architect .......... x ................ Address ................... Phone No ................ Name of Contractor ~-(l~...~ [I.3. q~.~ .......... Address ~'.ov.~..._.1~,)9. ,X.'..... Phone No. q'7:/: .Lz.~5.-7 .... 15.Is this property located within 300 feet of a tidal wetland? *YES .... NO.:.. *If yes, Southold Town Trustees Permit may be required. 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 inter/or or comer lot. STATE OF NF~__ O 1~,__ r/~ S S COUNTY OF .,,.--,~/o6~dS/.flj~ .... ' ......... ............... being (Name of it,9tlividual signing contract) above named. duly sworn, deposes and says that he is the applicant lie is the .............................. .:~; ....................................................... ~/~gent, corporate officer, etc.) of said owner or owners, and is duly autho?iz-ockto-~fform 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 tile manner set forth in the application filed therewith. Sworn to before me this ............... .... _.,.. ..... Nota~ e u bl~ .¢.~ .~~,~ .... County /~~ No. 4879805 Qualified in Suffolk Coun~ ~ ~ (Signature of applicant) t",,d, GRC~E R 107