The URL can be used to link to this page

Home My WebLink About29386-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29703 Date: 09/11/03 T}{IS CERTIFIES that the building ADDITION Location of Property: 185 SHORE LA PECONIC (HOUSE NO.) (STREET) (H3kMLET) County T~ Map No. 473889 Section 86 Block 1 Lot 4.18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 12, 2003 pursuant to which Building Permit No. 29386-Z dated MAY 16, 2003 was issued, and conforms to all of the recfairements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARC & LAURA WAHL ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~ALT~ A~PROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATI°N N/A N/A N/A Signature Rev. 1/81 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) PEP24IT NO. 29386 Z Date MAY 16, 2003 Permission is hereby granted to: MARC & LAURA WAHL 185 SHORE LANE PECONIC,NY for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 185 SHORE LA PECONIC County Tax Map No. 473889 Section 086 Block 0001 Lot No. 004.018 pursuant to application dated MAY 12, 2003 and approved by the Building Inspector to expire on NOVEMBER 16, 2004. Fee $ 150.00 Authorized Signature COPY Rev. 5/8/02 Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY , This application must be filled in by typewriter or iuk and submitted to the Building Department with the following: For new building or new use: l. Final survey of property with accurate location of all buildings, property lines, strects, 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. Connnercial buildiog, industrial building, multiple residences and sinfilar 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 reqnirements. For existing buildings (prior to April 9, 1957) non-conforming nses, or buildings and "pre-existing" land uses: 1. Accurate smwey ofprope~y showing all property lines, ~treets, building and dnusua[ uatural or topographic featorcs. 2 A l}rOl~erly completed applicalion and COllSeut to inspecl signed by (he applicanl. If a Cci'litigate of Occupancy is denied, lbo Building Inspector shall state file 1 caSOllS tbcrcfi>r in willing lo the applicant. C. Fees I Cc~tificate of Occupaucy - New dwelling $25.00, Additions to dwclling $25.00, Alterations to dwelling $25.00, Swmmfing pool $25.00, Accessoly building $25.00, Additions to accessory btlilding $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buihling $100.00 3. CopyofCertificate of Occupancy- $.25 4. Updated Cc~ificale of Occupancy - $50.00 5. l'empoial3 CertificateofOccupancy Residenlial $15 00. Commelcial$15.00 Dale. ~/O /03> vx ' ' ~/ ~ £~ Old or Pre-existing Building: Ne ' Construction: (check one) Location ofProperty:Houselg5 No.~ho('( ~3. m~__ Street ?~COF") I( P,~(] Owne,-orOwnerso ropcr,y: COah/ Suffolk County Tax Map No 1000, Section Subdivision eerrmtNo' ~c'~.:~<~ ~ DateofPermit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Blo k Filed Map. '~/10 /0 ~ Applicant: Underwriters Approval: Final Certificate: CO Hamlet 00'4, Lot: (check one) Applicant Signature Applicanff Owners Nmne: Architecff_ SCTM fl: District: 1,000 Seclion: _~ Block: Projecl Single & separat~ Required ccmfication {Yes/No) Date Reviewed: Date Submilled: Subdivision · Nagl¢: Project Description: AGENC~..~ERMITS REQUIRED FOR REVIEW Permit .N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: ,// Town Plmming Board approval: __ ~_ Flood Plane Elevation .9?? Flood Zone: No les: SURVEY OF LOT 18 MAP OF RICHMOND SHORES AT PECONIC PECONIC TOWN OF SOUTHOLD WIND I~EE~I~,TANT CON~TI~UCTION C, ONNECTO~ NAIl.lNG ~CHEDULE FLOOR FRAMING: DECKNOTES: CLIMATIC & GEOGRAPHIC DESIGN CRITERIA 765-1~0Z BUILDING DEPT. )SPECTION [ ] FRAMING [ ] FINAL (] FIRE/~A~ & CHIMNEY REMAR~ DATE~INSPE~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] Fo?U. NDATION 2ND [ ~""FRAMING [ ] INSULATION DATE INSPECTOR~~~I~ TOWN OF SOU. THOLD BUILDING DEPARTMENT TOW1~. HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c ~, 200.2~ Expiration ~Z, 20~ PERMIT NO. ' ]2uilding Inspector BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the f*-Ilowip_?, belbre applvin~?. ~ Board of Health i 3 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter 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 areas, and waterways. c. The work covered by this application may not be cornmenced before issuance of Building Perrmt. 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 buildkng permit shall expire if the work authorized has not corrunenced within i2 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 Comity, 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. Thc applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit anthorized inspectors on premises and in building for necessary inspections.%ak) ~ C~~(]~_~ (Signature of applicant or name, ifa corporation) (Mailing addres~s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~k('~ O~_ ~ (As on the tax roll or latest deed) If applicant )¥a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No.~~('~q~ -- Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet CountyTax Map No. 1000 Section Subdivision ~%~r~c~c~ ~ ~.oce (Nmne) Block [ Lot Filed Map No. Lot State emst~ng use and occupancy of premises and ~ntenderd, use and occupancy of proposed construction: a. Ex~stmg use and occupancy ~ ~ c,. oc,, ~ ' b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost ~ ~:~/,tS?O ~ 0..9---- 5. If dwelling, number of dwelling units If garage, number of cars Ar/d- / Addition Alteration Other Work (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor /w/q- 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Depth .5</' / 6, '~ Height J'4--v¢~ 8. Dimensions of entire ne~ construction: Front ~,</ Height ~/¢~¢~ ~ F Number of Stories 9. Size of lot: ~Front 10. Date of Purchase Rear ~-~ ~ Rear ~' Depth t %(3~ Name of Former Owner ,~ Zone or use district in which prethises -7~ ~ cO" Rear Number of Stories ~,1-~-, ~ _D pth /¢ are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO r~Wi}l excess fill be removed from premises? YES NO 14. Names of Owner of premises ¥Sgctv~ C-,5o-~k Address ~- Name of Architect Address Name of Contractor ~-~t ~r-7-o~/~ /r/. ~-~q~d~es~-' - 13,~/~,?c 15 a. Is this property within 100 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 xvithin 300 feet of a tidal wetland? * YES__ NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Phone No. '~ % Phone No Phone No. 7,~ 5 NO 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. ! 7. 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 ~v4g.,t'~ t lc~ CX_~C~ M~:~,-~v,~ 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 at~plication; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work ~vill be performed in the manner set forth in ihe application filed therewith. Sworn to before me this / '-/ day of t Notary Ptfb'][ic 200,3 HELEN ROONEY Notary Public, State of New Ymk No. 4758734 Qualified in Nassau Cou111¥_ Term Expire* ~ ~ 0 e/ ~ ~. Signature of Applicant EXISTIN FOUNDATION ALL MEET THE REQUIRE~F THE CODES OF NEW YORK STATE. EXI. TIN NOIJSE OCCUPANCY OR USEIS UNLAWFUL WITHOUT CERTIFI( OFOCCUPANCY APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FORTHE FOLLOWING INSPECTIONS: I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET ' REQUIREMENTS OF THE CODES OF YORK STATE. NOT RESPONSIBLE DESIGN OR CON~'I'RUCTION ':3'=0" I0'-0" 5'=0" f~E~f~ ELEV',~TION 0~055 5EC, TION I~'~'r~ ~"~ ~ / ! W,~t--tL f~ESIIDENC. E ! PECONIC, NT F~A~E