HomeMy WebLinkAbout27151-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPAiNCY
No: Z-27599 Date: 03/28/01
THIS CERTIFIES that the building ACCESSARY
Location of Property: 3440 NASSAU POINT RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County T~ Map No. 473889 Section 111 Block 4 Lot 32
Subdivision
Filed Map No. __ Lot NO. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J/LNUARY 16, 2001 pursuant to which
Building Permit No. 27151-Z dated MARCH 16, 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 A/DDITION TO EXISTING ACCESSORY GARAGE AS APPLIED FOR "AS BUILT".
· ~ne certificate is issued to JAMES & ELLEN RILEY
(OWNER)
of the aforesaid building.
S[/FFOLK CO[FI~ DEpARTI~5~ OF ~TH /LPPROV/~L
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
Rev. 1/81
~~or~:~ture
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. 27151 Z Date MARCH 16, 2001
Permission is hereby granted to:
JAMES JR & ELLEN RILEY
153 OXFORD BLVD
GARDEN CITY,NY 11530
for :
DECK ADDITION TO ACCESSARY GARAGE AS APPLIED FOR " AS
BUILT "
at premises located at 3440
County Tax Map No. 473889 Section 111
pursuant to application dated JANUARY
Building Inspector.
NASSAU POINT RD CUTCHOGUE
Block 0004 Lot No. 032
4, 2001 and approved by the
Fee $ 35.00
Authori ~ Signat~e
Rev. 2/19/98
ORIGINAL
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
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 Complianoe from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-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,S25.00. Businesses $50.00.
2. Certificate of Occupancy ~ Pre-existing Buitdinm - $100.00
3. Copy of Certificate of OcCupancy - ~ -~5~
4. Updated Certificate of Ocdupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
·
Construction ........... Old
............................'"'"'"" '"
House No. Street Ha~et
Onwer or O~ers of Property....,..,.. ............................ % ..... ...........
Subdivision ..................... % ............. Filed Map .......... Lot ..............
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
6k~c. ~0 ........................
CC) ~ ~ ?~ APPLICANT
FIELD I~SPEC'I'ION P~PORT DATE
FOUNDATION (IST)
ROUGH
INSULATION PER N. Y.
STATE ENERG'Y
CODE
ADDITIONAL CO~4E~S:
!)
ROBERT H. WHELAN, P.E.
JAN
Town of Southold
Building Department
Main Road
Southold, New York 11971
PO. Box 590 * Mattitucf~ NY 11952
Tel: 651~722-5875 * Fax: 631-722-7835
January l8,2001
Att: Mr. Michael Verity
Re:
Riley Residence
Wunneweta Road
Cutchogue, New York 11935
Dear Sir:
Pursuant to our conversation, please be advised that on this date, four existing decks
associated with the above referenced residence were inspected.~ Three of the decks are
attached to the residence and theforth is attached to the garage; The purpose of the
inspection was to determine if the as-built construction could be considered structurally
sound for the issuance of a Certificate of Occupancy.
It is my professional opinion that the as-built construction is adequate to support the
intended loads and is in conformance with the general intent of the New York State
Uniform Fire Prevention and Building Code.
Thank you for your time and cooperation on this matter. If them are any questions
relative to the above please do not hesitate to call.
cc: Mr. Riley
-"~* ROBERT H. WHELAN, P.E.
CONSULTING ENGINEER
~x~2 ,/,~,,. ~,G, Bo× 590 .;
BY--'/'~ DATE.,,, , 160 BUNGALOW LANE SHEET NO. -- OF
MA~rI'iUCK, N.Y. 11952
CHKD. BY DATE. (516)298-5770 JOB NO.
FO~O~.~
t FOU..~,O.. TWO
FOR POU~ED C~CR~E
: ~ ROUGH FRAMING h PLUMBIN~
,' [ INSU~TION
,, ~ FINAL - CONSTRUCTIOB
~: ~Y/~)~I~¢5'ALL CONSTRUCTION SHALL
~ ~ N.~
& ENERGY
, FOR
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
,20 or
Approved ~(~/j~ ,20 O/
Disapproved a/c
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
~' TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
BUILDING PERMIT APPLICATION CHECKLIST:
Do you have or need the following, before applying?:
Board of Health?
3 sets of Building Plans
Survey_
Check
Septic Form
N.Y.S.D.E.C.
Trustees
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. This application MUST be completely filled in by type~witer 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 approvaI 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 premises and in building for necessary inspections.
(Signature of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~T,~ ~ .~ % ~'; / "~ "'/ ~' ~r ,
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:D ,
House Number Street Hamlet '
Block t~
Filed Map No.
County Tax Map No. 1000 Section
Subdivision
(Name)
Lot ~ ~
Lot
2. State existing use and occupancy of premises and intended use and occupancy ~fproposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition. Alteration
OtherWork '~:)~c.-~ ~
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(to be p[ id on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
8. Dimensions of entire new construction: Front '~! Rear
Height Number of Stories
9. Size oflot: Front ~O0 Rear ~) O .Depth
10. Date of Purchase Name of Former Owner ~-~
Depth
Rear
Depth
Will ~x'cess fill be removed from premises:
Address ¢-~,,~.-,~-- ~- ,+~ 11]~'30 Phone No.
Address I Phone No
Address Phone No.
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordi.nance or regulation:
13. Will lot be re-graded ~
14. Names of Owner o f premises &,~ Ri ~ '~
Name of Architect
Name of Contractor
15. Is this property within 300 feet of a tidal wetland? *YES' NO
* IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey, indicate scope of project, to scale, with distances to property lifies.
17. If elevation at any point on property is at 10 feet or below, must provide topog?phical data on survey.
STATE OF NEW YORK)
.~//I )q(~ /5'~ ~(~ /~ being duly sworn, deposes and sa
(Name of individual signing coa/ract) above named,
NO
/s that (s)he is the applicant
(S)He is the (Contractor, &~'~n~.~2orporate.Officer, etc.)
of said owner or owners, and is duly authorized to perform or have l~erformed 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 b~lief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
__.~.'~ dayof ~ ~-ht''''l. , 20OD\
Nota~ Public, State of New Yot~
No, 01GL4879505
Qualified in Suffolk Count~
Commission Expires Dec. 8,
/
(r C~' ' ~ ~]gt{a~r~ of Applicant