Loading...
HomeMy WebLinkAbout27388-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27779 Date: 06/28/01 THIS CERTIFIES that the building ADDITIONS Location of Property: 1080 KIMBERLY LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 13 Lot 20.14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 7, 2001 pursuant to which Building Permit No. 27388-Z dated JUNE 11, 2001 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 DECK ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HENRY & ALICE FARHEDIAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //Atho/zed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT J TOWN HALL 765-1802 P;1)G. P7T. APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 a 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 - .2510 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .LX. I .I.�.�. . . . . . . . . . . . . . . . . . . . . . . . . . . . New Constructions Old Or Pre-existing Building. . . . . . . . . . . . . . . Location of Property. . 0�Q .�1 Ak�e:Y . LQ�:�-:e.. i.� . . . . . . . . . . . . . . . . . . . . . . . . . House No. (( Jul Q _ Street Hamlet ce Onwer or Owners of Property. .v. .. .�^.^�:. `�`:`�``��. + V� .w. . . . . . . . . . . . . . . . . . . . . . . . . . . f County Tax Map Novil 1080 gsection. . . . . . . .Block. 2 . . . . . .Lot. .c..l .© >. �. . . . . . . Subdivision. . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . l . . . .Date Of Permit. .4s: .I.��. � .Q.l. . . .Applicant. .`:. . .��<<�.�A.,I.Y`�. `— Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . manning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .tell". . . . . Fee Submitted: a����. . . . . . . . . . . . . . . . . . . . v�l L�� LICANT 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. 27388 Z Date JUNE 11, 2001 Permission is hereby granted to: HENRY & ALICE FARHEDIAN 1080 KIMBERLY LANE SOUTHOLD,NY 11971 for CONSTRUCTION OF DECK ADDITIONS TO A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 1080 KIMBERLY LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0013 Lot No. 020 . 014 pursuant to application dated MAY 7, 2001 and approved by the Building Inspector. Fee $ 75 . 00 t. Autho ed Signature ORIGINAL Rev. 2/19/98 3 Fe-(�-,- X65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1SULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,DATE o2-f � INSPECTOR t0FIELD INSPECTION REPORT DATE COMMENTS v �1 N H FOUNDATION ( I STY 1 1 to FOUNDATION (2ND) II I z„� ROUGH FRAME PLUMBING O - - ____-__=---------_=_�--_______________ INSULATION PER N. T. STATE ENERGY CODE I 1 1 I 11 FINAL � y ADDITIONAL COMMENTS: p z ° N TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST: BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL — SOUTHOLD, NY 11971 3 sets of Building Plans +' �4(M)I-Survey L' Check Aw"W.C. Examined 120 Approved & /y' ,20_gL_ PERMIT NO. Disapproved a/cnn 1d�AY � Z 2 l Buiong Inspector Y - APPLICATION FOR BUILDING PERMIT Dated pn , 20 0� 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 sale.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 giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 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 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 pre a 1�i1 f, r re�sary inspections. U UNLAWFUL Signature of applicant or name,if a corporation)E IS HOUTE � � at AAJQeJf-U4 ksw d) ins I ° (Mailing address of app cant) �71 State whether applicant i e ct, engineer, general contractor, electrician,plumber or builder Name of owner of premises - (as on.the tax roll or latest deed) APPR VEDAS NOTED If applicant is a corporation, signature DATE: (o Ot B.P. pp rp gn e of duly authorized officer FEE: BY: (Name and title of corporate officer) NOTIFY BUILDING AR ENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: Builders License No. 1• FOUNDATION - TWO REQUIRED FOR POURED CONCRETE Plumbers License No. 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST Electricians License No. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET Other Trade's License No. THE REQUIREMENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DE,�Si 7QRh CONSTRUCTION ERRORS 1� 1. Location,of land on whi h proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section q ?3�' c B1ockg0 .- (3-aD. I f Lot ' Subdivision Filed Map No. Lot (Name) 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 S_Q kS 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work adA 6 ackS (Description) 4. Estimated Cost '3TDo . D a _ Fee (to be paid on filing this application) 5. If dwelling,number.of dwelling units S����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. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear 10-0 , &oL� Depth A 54 a S-gI .00 10. Date of Purchase Name of Former Owner k a I Or d u vena k S , SO Te Y�Sa- 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law,ordinance or regulation: K.,6 13. Will lot be re-graded (1w Will excess fill be removed from premises: YES NO 14. Names of Owner of premises FG,4CJjA:«AA__ Address * " l0'Phone No. Name of Architect Address Phone No Name of Contractor S e Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *YES NO t/ • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, indicate scope of project, to scale, with distances to property lines. G 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 ) 4elvi r C(/h being duly sworn,deposes and says that(s)he is the applicant (Name of ndividual 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 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. Sworn to before me thiW,43V day of o 2W-,101 Notary Public Si a of Applicant ELIZABETH A STATHIS NOTARY PUBLIC,State of New Yoik No.01 ST6008173,Suffolk County Term Expires June 8.20D2_ R OXANNE ROAD SURVEY OF m PROPERTY 15 �h A T SOUTHOLD 259.00' TO WN OF SOUTHOLD „ E _ __ ,3_C SUFFOLK COUNTY, N. Y. ? N B4• ? 20 1000 70 13 20.14 Scale 1" = 40' Z No v. 7, 1988 __' °` Sept. 29,1993 M ..oa i i J + 2 N ! Feb. 14, 1994 (foundation) Zo April 21,1994 (final) � =W@�� - �.__ — y < 17e —1"7. 4-1- �C .. 50�' tn _ v C Lv 14 .M r t! 200 _ W « SUFFOLKoLm VO ALrry DEPARTOF UCTION WIL�JCES L.� 1 Q N �► � 93 SO 52 DATE_ ►fie. REF. NO. In i 1-�-- _— -.. _ - — S 04. 22' 20" W \ APPROVED —_---- CERTIFIED TO, i 292.56' JOHN KAL OROOMAK/S i I 13 TERESA KALOROUwAKIS p LANDS OVENTURE ABSTRACT CORP ' .�i�`'�NT.MS�G•9 Z COMMONWEALTH LAND TITLE INSURANCE CO. The water supply and sewage AFsposal I* 4 systems for this residence will conform T y he locations o/ wells and cesspools y �, i to the standards of The Suffolk County shown hereon are from, field observations Department of Health Services. // NEW ELEYA Ti17wCs ARE REFERENCED TO KfiV a p and or from data obtained from others. CER TFICATIONS 5125194 / N.Y.S. LIC. NO. 49618 CER TFICATIONS 411194 Prepared In accordance Wilk the MIA/mum standards for 11/14 surveys as established pECON/C 6URVEYORS P.C. NOTE LOT NUMBERS REFER TO 'MAP OF PARADISE BY THE BAY" by the L.LA.L.S. and approved and adoptee FILED NOV. 4, 1976 FILE NO. 6463 AT THE OFFICE OF THE for :.uch use by The ew York Stale Land (5/6) 765 - 5020 Title Association. MAIN ROAD 909 SUFFOLK COUNTY CLERK. AREA c 41 8678 ft. 9 SOUTHOLD, N.Y. 11971 88 - 679 i �ec� 1 .s. t � OA Y a f _ a ` v s 2 e : t I to a.� ,R ��� CJQI;� F 1'71 a Its � 14 t r b 1. _ -__ �.._......_.. ij } i LO,-I E . Ve+5t . G�., C)71 AP s Q G