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HomeMy WebLinkAbout23662-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24750 Date NOVEMBER 20, 1996 THIS CERTIFIES that the building REPAIR Location of Property 10420 MAIN ROAD EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 11 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 30, 1996 pursuant to which Building Permit No. 23662-Z dated SEPTEMBER 6, 1996 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 REPAIR FRONT PORCH OF EXISTING CHURCH AS APPLIED FOR. The certificate is issued to EAST MARION COMMUNITY CHURCH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B ildi g Inspector Rev. 1/81 FORE[ NO. $ 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) N° 23662 2 Date ........ .. ..... ..................... 19� Permission is hereby granted to: pf Al .., .. ..........2yw............................ ... ........ .................. to . . . . .., -Ape" ..:... .I.., . ::... . ............... ...... . .. ., �:.... . ..... . ............. .. � ........................................ at premises located at ................. b.�.!L. ......:1<..r. . ...?^........................................................... .......................................................... .. .. ... .. ........ .................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ...... . L..... Block ............&.... Lot No. ..7................ pursuant to application dated .......... ................... 19..F<, and approved by the Building Inspector. Fee .�:.��... .. ... ..................Building. or ...... .. ................... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 9 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 - .25y,%. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1 .00,,, Commercial $15.00 Date . . ./!/ . /.0 . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . .d.Or•Pre�. •ist' .g Building. . . . . . Location of Property. . . . . . • . . .l.:G '1. . . . . . . . . . . House No. C, � l Street �,l.�'+ met Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .;` .��. . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . .. !. . . . .Block. . . . . . . /. . . . . . .Lot. . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot . . . . . . . . . . . Permit No. .��. �6 .Date Of Permit. . . . . . . . . .Applicant. . . .,!. :GG ���'• . • . . . ) Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . l/ Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C 5a APPLICANT L<.:-LLQ:_; . V � C4 2 �t Town Hall, 53095 Main Road !� Fax (516) 765-1823 P. O. Box 1179 °� . Telephone (516) 765-1802 Soulhold, New York 11971 r1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 18, 1996 xzx- To Whom This ay Conce n• We are unable to complete your Certificate of Occupancy because of the following reasons : An application for Certificate of Occupancy is not on file. ( Enclosed) No Underwriters Certificate on file . The check is (not on file '��fQ, No Health Department Approval on file . No final inspection has been made . _ No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984 ) . BUILDING PERMIT Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. N I l C1.1) I r1,,1'�, Iv,UTi ItEl'Urt l- 1)ATE. SCOMME W II �d I'UI INI)A'i'i ON ( 15'I') I 71.1 _ I IOIINI)Al1ON _UNU) 1 _ uOnl:►1 rltnMr. 11I.IIHII I NG �I I � _ 11d.`i111.A'I'i(1N Pf?T2 N• Y • [*� STATE.. FINlAMY li _ COJ)I, 9/QF I NAT. �! AUI)IT'IONA1. (OMMENIS .... .... ........ .. . �i . . . . .......... . . . - .. . ... .. ....... it ( BOARD OF HEALTH . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . . . . . . . . . . . . TOWN HALL SEPTIC F0RN . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.. 765-1802 CALL Examined . . . . 199 MAIL TO : . . ' • • • . • . • . • • Approved . . . . . . ., 19%ermit No. . . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F , e 3 01996 (Building Inspector) � AUG PPLICATION FOR BUILDING PERMIT ---~`' Date . . . . . . . . . .Tn+� 19 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 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. r . 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 a cant, or name, if a corporation) (Mailing address of applicant) State whether pplicant is owner, lessee, agent, architect, engineer, general contractor, electrician,.plumber or builder. Name of owner of premises . . . . . . . . . . . . . ..� `.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corppooratio�n�s' nature ofdulyauthorized officer. (Name d title of corporate officer) ll Builder's License No. . .�� . . .. .. . . . .� . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . 0 . . . . . . . Other Trade's License No. ... . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (!:::�e" . ./ �t+ri+. . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . :. . r . . . . . . . . Block . ,l/. . . . . . . . . . .. . . . Lot . . .7 . . . . . . . . . . . . . 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 . . . . L . . �. �. b. Intended use and occupancy . . . a��• '�C%' � . . . . " . . . . . . . . . -3. Nature of work�( eck which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . �. . :c.�i. . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . If garage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business,commercial or mixed occupancy, specify nature and extent ofeach�type of use . . . . . . . . . . . . J. . , . . . . . 7. Dimensions o fxi ting structures,if any: Front . . /0 tip. . . . . . . . Rear . . . . . . . . Depth . . . .6. . . . . . . . . . Height .. . .. . . Number of Stories . . . . . . ,�(/ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . ... . . . . . . . . . . . . . Height . . . . . . ,. . . . . . . : . . Number of Stories . . . . . . . . . �, . . . . . . . 8. Dimensions pf tire new construction: Front . . .& .1 . . . . . . Rear . . .IA.r(r. . . . . . Depth . . . �. . . . . . . . . . .Height 2F . . Number of Stories . . . . ...A11A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . .... . . Rear . . . . . . . . . . . . . . . . . . . . . . De*. . . . . . . . . . . . . . . . 10. Date of Purchase . . . . .f 5... . . . . . . ... . . . . . . . , me of Forme Own C'�� // . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . � � • • . • • • : : : : : : : : : : : : : : : _12. Does proposed construction, folate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . 13. Will lot be regraded . . .C& Z . . . . . Will excess fill be removed from premises: - . Yes • No 14. Name of Owner of premises '"`." . . . . . . . .Address . . . . . . . . . . . . . . . . . .Phone No. Name of Architect . . . Address p Q Phone No. . . . . . . . Name of Contractor •1. . . . . . . .Address �7t.7��5Phone No. -7 . . 15.' Is this property within 300 feet of a tidal wetland? *Yes. . No. .1� . r• *If yes, Southold Town Trustees'Permit maybe 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 interior or corner lot. APPROVED AS NOTED . DATE: B.P.# FEE: BY: NOTIFY BUILDING DEPARTMENT AT 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. 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 THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NE Kr! - / S.S COUNTY OF ` /� v V c �,� . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant Name of individual signing contra ) . ( g s • above named. tie is the . . . . L�6ont;:r:ac:tio . . . . .. . . . . . . . . . . .t agent,corporate officer,etc.) if said owner or owners, and is duly auperform 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 vork will be performed in the manner set orth in application filed therewith. ;worn to before m his \. . . . . .day of. 19 . lotary Public, . . dthe . County CLNRE L.GLEW . . . . Notary Public.State of New York nn . . . . . . . . . . . . . . No.4879505 (Signa of applicant) Qualified in Suffolk County , ares December-8.19 commission Exp _. . . ,... - MM aGI.. ` �`"� /� . � � - 'IAM �i S � �\ - ` �•y' �� NO Jr Ise \ lb t; p Va �';�•. - '�u vii; �` , 40 Fes. Jo lz - - ��l �8 _,moo - . �S #.., b 1 � :.� - t` Zs '�`� ` - �--�J-=�-=--_• - --- _ _ _ .� � r -\ •% /ice _ �. ?� .g�-� � " •''�<� '� ' �-` � -�r _ � �` ,_ 1p - 3 0 -Z , � gees Tr ,, '' -:' 1'i @.. d Y :s,,,r •N t+ �' F 3 KTA,�Ct� � r t k } b t _ q I II �A� ,t C�. c SECTION B < 30"RAILING 5/4"T&G FIR DECKING F— 2X10 CCA JOISTS 12"O.C. V V 2X12 CCA RIM JOIST— > A 2X8 CCA RIM JOIST e. 4X4 CCA LEDGER r cr +4+: W '' Of€SS10 v EAST MARION COMMUNITY CHURCH � P SECTION DATE SCALE 8!22196 NONE 2 JOIST PLAN (SAME SIZE AS EXISTING) [-7A AUG 3O � �� �— 10'6" BLDG.fel TOWN OF SOU'f P�OL.l� B 2X10 CCA JOIST 12"O.C. 6'0" < 2X12 CCA RIM JOIST < PIERS(SEE CROSS SECTION) BELOW DN < 2X10 STRINGERS 5/4 FIR THREADS J 30"HIGH RAILING A r--- 8" POST&BASE 5"0.C. v 2X10 CCA JOIST SEC A-A v ❑ v HANDRAIL EXISTING _ 'IN n CHURCH n WALL n 2X8 CCA RIM JOIST 6X6 CCA POST 2X12 CCA RIM JOIST 5/4FIR DECKING < 8"CONCRETE PIER GRADE BASE 3' BELOW GRADE uA 2'X2'X1' <—POST FOOTING -n1ZV YO u w EAST MARION COMMUNITY CHURCH a 2 SECTION &JOIST PLAN �A'OFESSIONP� L g ,� DATE SCALE 1 B 8/22/1 NONE