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Home My WebLink About29078-ZFORM NO. 4 TOW/~ OF SOUTHOLD BUILDING DEP~-~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29592 Date: 07/23/03 THIS CERTIFIES that the building ALTERATIONS Location of Property: 790 VANSTON RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 12 Lot 10.3 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 31, 2002 pursuant to which Building Permit No. 29078-Z dated JANUARY 7, 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 ALTER3~TIONS & SHOWER ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RONALD & JANE CHAPMAN ( OWNER ) of the aforesaid building. SUFI~DLI(COI~DEP~/~I~ OFHF~%LTHAPPRO~-AL ELEC~RIC~J~ CERTIFIC3%~ NO. PL~/~S CERTIFICATION DA'r~u3 07/01/03 N/A 72808C 06/04/03 MATTITUCK PLUMB.&HEATING Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UI~TIL FULL PERMIT NO. 29078 Z Date JANUARY 7, 2003 Permission is hereby granted to: MARILYN E HEINS PO BOX 1359 CUTCHOGUE,NY 11935 for : ALTERATIONS ~ SHOWER ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 790 VANSTON RD County Tax Map No. 473889 Section 104 Block pursuant to application dated DECEMBER 31, 2002 Building Inspector to expire on JULY CUTCHOGUE 0012 Lot No. 010.003 and approved by the 7, 2004 . Fee $ 314.10 COPY 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 subnfitted 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 plmnber 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 Plmming 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, Swi~rmaing 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 Ccrtificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: ~, Location of Property: 7~/9 House No. Owner or Owners ofProperty: ~O~],,q'L/9 /~'~d/~ ~ C/"~o,,~'~t) Suffolk County Tax Map No 1000, Section Block Old or Pre-existing Building: Street Date. 0 7/~- ~-/0..~ (check one) Hamlet Lot Subdivision Permit No. ~_~qO 7~~>~ Health Dept. Approval: Plarming Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~.~ Filed Map. Lot: Underwriters Approval: Date of Permit. Final Certificate: (check one) Tuwn Hnll. §.30~.~ M~slll Ro~d P. (.). l~ox 117g ~mdhul~f. Hew Yo~k ~ 1~71 I ,~ (516) 7qS.~B?3 r.l.phone (51r~) 7~,?,.10o; OFFICI= OF TI-II= BUILDING INSPECTOR TOWN OF $OUl'l IOLD ~ 'L' I 0 H (p ease print) /'(p-len se print) x.~ ~ I certify that the solder u,~ed In the w~ter supply contains 109~ than 2/1~, of ~% lead. ( r'l inld>e r~ ~fqnaknre ) ' Sworn to before me i_~_ ~ o~ _~~ ........ ~.~~ Ouai~tled in Suf[oLk Co ~ct? Electrical Inspection Certificate EIt~:irba! InNa~tton 94wI., Inc. Apl~ll~,atlon Number 37~ D~nton Avenu. 72606C EIIIt PltohoguI. New york 11772 (6~11 zt~1-l~42 luued To; Marilyn Chapmar~ 8treat: 790 Venston Road Village: Culchogue ~ectlon: Block: Contractor: L.demann Electric Inc, Zip: 11935 Town: Southold Lot; LIc. it 4141-E :'} CommerG~.l 22' NVOefe~ts , ! Pool i~. 'lltFFoor ~g' Indoor I:! Bslsml~t r'~J Ho~Tub ~ RiIFdlnflll ~2: O~t. GiIrlgs I.l &fflc ,Xl 2nd Floor .'i Outdom' BUILDING PERMIT EXAMINER CHECK LIST SCTM# DISTRICT: 1,000, SECTION: I~ , BLOCK:c~ , LOT: /o, 3 DATE REVIEWED: ~/// ~/Q.~ DATE SUBMITTED:/o7/~,/ /02 STREET ADDRESS: "P/qO \/'°':~-~,->,*,'~b. CITY: · PROJECT DESCRIPTION: ~ / ESTIMATED PROJECT COST: ~ ,~T/ENGINEER: ~c~,.,,'~r~F-.~' FASTTRACK?~O_L. SINGLE & SEPA1LATE CERTIFICATION-REQUIRED? ,'k/o NOTES: LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED l DTS FROM JAN.1997 100-25, Merger (A nonconforming at any time after 7/1/8: SUBDIVISION: ZONING DISTRICT: /fi- q0 CONFORMING? ,$q'0 REQ. LOT SIZE: (4o?oo ACT. LOT SIZE:~t~,~qiqREQ. LOT COV. c>QOt~o ACT. LOT COV. ,/ REQ. FRONT - PROP. FRONT _ REQ SIDE ACT. SIDE . REQ. REAR ~ PROP. REAR REQ. HEIGHT PROP. HEIGHT WATER FRONT? ,vo DESCRIPTION: PANEL #: _ FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or~)(BED #): TOWN SEPTIC RECEIPT: Y ~ NEW YORK STATE DEC: PRE-~EC 9/1/7S YES't~' o°ri~ SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES . NYS ENERGY: YESO1~O tv /]/~ EGRESS (18 H min.? 4 sq total) __ VENT (SQ. FT. x 4%) BUILDING PERMITS OPEN/EXPIRED: BP HAVE PRE CO'S: Y ORN BP NOTES: DTE: / / PERMIT #:RI0- -Z / C/0 Z- LIGHT (SQ. FT. x 8%) -Z / C/0 Z- ,. FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF TOTAL: / ~c/-:?- SF sF)-( ~-O SF)= 4-'/7 .SF X $ .30 =$ (5 .9' tS INIT FEE OTHER FEE +$ TOTAL FEE =s .Y/7-/c) 2. ( SF)- ( SF)= SF X $__=$ +$ +$ = $ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [~ROUGH ] F/OUNDATION 2ND [ FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: PLBG. ] INSULATION ] FINAL DATE INSPECTO~?~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~LATION [ ] FRAMING [ ,~=INAL [ ] FIREPlACE&CHIMNEY F/ DATE INSPECTOR FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOI~I HALL SODTItOLD, N.Y. 11971 TEL: 765- 1802 ......... /..7 ...... ?.. Pe t Di~l~Ic ............................. : .... .... 2 .~ ............................ i..~.. ...~' · :..~--.~ .... :.~. ...... APPLICATION FOR BDILDING PRRMIT BOARD OF HEALTH ............... 3 SETS OF PLANS. .............. SURVEY ........................ CHECK ......................... SEPTIC FOR~ ................... DEC ........................... TRUSTEES ...................... NOTIFY: CALL .................. 14AIL TO: .................... INSTRUCTIONS a. This applicaiion ~ completely filled in by type~iter or in ie.k asd sul~itted to ~ hiildi~ IndOor 3 .~ts.of pl~, ~ate plot pl~ to ~le. F~ ~i~ to ~le. b. ~ot pl~ ~ l~tim of lot ~ of ~ildi~s ~ ~S, ~lati~ip to Mjoini~ pr~s or ~lic struts or ~e~, ~ gi~ a ~tail~ ~riMi~ of l~t of ~ ~t ~ dr~'~ ~e di~ ~i~ is ~t of als ~liatim. c. ~ ~ ~ ~ ~is a~li~ti~ ~ ~t ~ ~ ~fo~ isle of ~ildi~ ~t. d. ~ ~,~1 of als ~li~tim, ~ ~ildi~ I~ctor ~11 i~ a ~ildi~ Pe~t to the ~liat. ~t ~1 ~ ~ ~ ~ ~=M~s ~il~le for i~tim ~$t ~ ~rk. e. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in ~le ~ in ~ for ~ ~ ~at~r mtil a ~rtificate of ~ ~11 ~ ~ ~'~,t~ ~ ~ ~ildi~ ~t~. ~I~ I~ ~ ~ m t~ ~ildi~ ~nt for ~ is~ of a ~ilding Pe~t ~t to ~ldi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~r ~li~le ~s, ~i~es or ~ati~, f~ ~ mmtim of ~ildi~, ~itims or alterati~, or for ~al or ~litia, ~ ~rein ~ri~. ~ ~limt ~s to ~ly ~ all ~li~le 1~, o~i~s, ~ildi~, ~ing ~latims, a ,o ~it m~ri~ i~tors m ~ms ~ in M~ f~s~m. (si~e ~1~, or ~, i~ a ce~ra~i~) State ~nether applic~at is ~er, lessee, agent, architect, engineer, g~r~ral contractor, electricim~, plumber or huilde~ (as on the tax roll or latest deed) If applic~t is a corporation, signature of duly authorized officer. (Nane and title of corporate officer) Builders License No .......................... Ph~nbers License No .......................... Electriciass License No. . . Other Trede's Licesme No ..................... I. I~cation of land on ~ahich proposed ~rk will be done .............................................. ............................................................. .c..u..T:..Q...H~....o...u~.. ............................... Uouae Number Street Hamlet c~,=~p ~. ,~ ~tion .... [.¢...+.. .... B~ ..... t..z. ....... bt ...~..o.....~.. .... aivision . Filed Map No ............. (~) 2. State existing use ~ occupancy of premises and intended use ami oceuparmy of proposed construction: a. Existing use and ~ ...... l ................... ~- ........ ..................................... ~,. n,t.-.~l ~ ~,l ~ .....................,?.&..,:~...~. .......................................... 3. N~ure of ~ork (check which applicable): Ne~ Building .......... ~iti~ .......... ~er~ti~ .... ~i~ ..... , . ~al ............. ~liti~ ............ Otlmr ~ .................................. ~ ~iptim) 4. ~ti,~t~ ~s~.'.~ff~. ~.~ ....... f~ .............................................. [ (to ~ ~id ~ fili~ this a~li~ti~) S. If ~lli~, ~r of ~lli~ ~mits ............ ~r of ~lli~ ~its ~ e~ fl~r ................ If ~r~e~ ~r of ~rs ...................................... 6. If ~i~$fi~ ~memlal or ~M <~ ~i~ mture ~ ~tent of eM~ ~ of ~ ...................... 7. Di~si~s of ~sti~ statures, if ~: ~t...~-'~-- .~- ~ ~.~- ...... ~Pth ................. t~i~t ......................... ~r of Stories ...................... D~i~ of ~ st~e ~th alterati~ or ~iti~s: ~t ............... ~ar ............... ~pth .................... ~i~t .................... ~r of Stories ............... 8. Di~nsi~ of entire ~ mt~ti~: ~t ...~ .... ~ar .... ~ .............. [~i~t ......................... ~r of Stories ..................... 9. Si~ of lot: ~t .................... ~ .................... ~Pth .................... lO. Mte of ~dm~ ..................... ~ of Fomr ~r ........................................ I I. ~ or ~ district in ~i~ pr~i~s am si~t~ ~ ~ ~ · 12. ~s ~ ~t~ti~ violate ~ ~i~ lin, oMi~e or ~lati~: ...... ~.~ ............ 13. ~ill lot ~ ~ ....... ~.~ ........ ~ill ~ss fill ~ ~.~,o~o~ .~.,,:.,,..:.,......~. ..... ~,~ .............................. ~m ..... : ..... ~ o~ ~o,~ ~.~ ~.. ~g.~ g~ ~.. ~,~, .............................. ~ ~- -~ ~:.~/~ ~ of ~tr~tor ~[~ ..................... .~ s ............................... 15. Is fids p~r~ ~thin ~ f~t of a till ~tl~ * ~ .......... ~ .......... PLOT DIAGRAH locate clearly and distinctly all buildings, ~dnethar existing or proposed, and indicate all set-hack dimensions fr~ property lines. Give street and block ~u~ber or deacription according to deed, and shae street nares and indicate ~hether interior or corner lot. jNam of individual signing contract) duly sx~rn, deposes and saTs that he is the applicant le is the ............................................................................................ ~ (Co~tractor (~n~,)~orperate officer, etc. ) ~f said miner or o~ers, and is duly aothorized to perf6m or have performed tim said ~rk ~ to mak~ and file this ~pplication; that all ~tat~ents c0~t~ir~l i~ rJ~is 0pplication are true to the best of his kon~ledge and beliefi and hat the ~rk will be performed in tie monet sat forth in the application filed there~th. }~rn to before me this ....'7.&~.~. .....~d " ~o ::...:.. :. :.~,~. :':::- Notary Public. ~~'/ ..~ROBERT I. SCO~T. j,. /~/. Notary Public,~tat~'o~ Qualified in Suffolk County No. 01SC472508~ __ Term Expirns May 31, (Slgnamre of Applicant) .ff:,UI~VIEY' OF= Iok ICi-/. ~ P/O LOT ICi6 AlvlEN~tE~ HAP A OF NAOOAU POINT C, LUE~ PI:~OPtEI~,TItEO, INC. t=ILE~ AUnT 16, ICt22 /kS FILE No. 15~ 51TUATE; l"IA55AD POINT TOP'IN, ~OI'TOLt~ C, OONTY, NY .~U~VEYED 0g;-2t-02 SUFFOLK-. COUNTT' TAX ~; 1000-104-12-10.~ N RUS~:u i. CHAPMAN IANE C~-IAPMAN I~IlORENT MORTGAGE CO., INC COMMONW~TH LAND ~NSURANCE INSURANCE COMPAN~ NOTEE~: · 0 IMONUM~=NT FOUND pI~F: FOUNE) AREA = 26,6-10 5.F. ~P.J~PHI C 5GALE 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\~Ip server~d~PROS\02-252.pro