HomeMy WebLinkAbout22670-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23902
Date SEPTEMBER 20, 1995
THIS CERTIFIES that the building ADDITION
Location of Property 2745 PINE TREE ROAD
House No. Street
County Tax Map No. 1000 Section 104 Block 3
Subdivision Filed Map No.
CUTCHO~UE, N.Y.
Hamlet
Lot 6
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCE 17, 1995 ~ursuant to which
Building Permit No. 22670-Z dated APRIL 12, 1995
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 SCREEN PORCH ADDITION TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
ROBERT SCRIPPS
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-353861 - JUNE 2, 1995
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FORM
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
22670 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date .............. ~ .......................................
Permission Is hereby granted to:
~.~....~~ ........................
.~.~....~.....~....~ .................
to.....~~.~....~ ....... ~~ ...... ~ ....... ~-'J,.~.'.~<~ .....
~ ....... ~...~~......~~ ......... ~,~......~..~~
CountyJax Map No. 1000 sectlon..Z.~...,.~,,., ........ Block ...... ~,,, ........... LotNo ........ ~..~.. ...........
pursuan, to application dated ......... ?/...,....2 .................................. 19~..~'b~d approved bythe
Building Inspector.
Fee $.....~.~...:..~...
Rev, 6/30/80
form Mo. 6
· r0~vN 0v SOUTIIOLD
BUILDING DEPARTHENT
TOWN HALL
765-!802
APPI, ICATION 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:
Final survey of property with eccurate location of all buildings, property lines,
streets, and u,usual natural or topographic features.
2. Final Approval from Health Dept. of water snpply and sewerage-disposal(S-? form).
3. Approval of electrical installation from Board of Fire Underwriters.
S~orn statement from plumber certifying that the solder used in system contains
less then 2/~0 of 1% lead.
5. Commercial building, industrial building, multiple residences end similar buildings
and installa'tions, a certificate.of Code Compliance from architect or engineer.
responsible for the building.
6. Submit Planning Board Approvel of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
l. 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 tbs applicant.
If e Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
i. Certificate of Occupancy - New dwelling $25.00, Additions to d~elling S25.00,
Alterations to d~elling $25.00, Swimming pool $25.O0, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existin~ Buildin~ - StO0.O0
3. Copy of Certificate of Occupancy - $20.00
Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residentj~-~$15.00, Commercial $15.00
.................
~e~ Construction ........... Old~O-r Pre-exi-~.~ng Ik~l~ing .... ~..~. ........
oeation Pro,erty. i ........ .... ...........................
-~ous.e No.~ ~ ~ ~ ~?~ Str~t tla,,let
Dower or O~,ers of Property..~.~{~{~ ........................................
/
gubdivision ................................... IFilc~ H~j~. ........... Lot ......................
Health Dept. Approval .......................... Underwriters Approval .....................
'lan.lng 8oard Approval ........................
2equest for: Temporary Certificate .......... Fi.al Certical:e ...........
Fee Submitted:~ $ , ~ ~
e~c. %~qk ...... ......................
¢~10~ ':.. ' .................
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYo,,k 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 7, 1995 '
Mr. Robert Scripps
2745 Pine Tree Road
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
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 # 22670-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
ROUGH FRAFdg &
PLUI4BING
[I
II
II
It
INSULATION PER N. Y.
STALE ENERGY II
CODE
~DITIONAL C~HS:
New York State Department of Environmental Conservation
Building ~40---- S .U.U.U~.tS_to~.Y..Brook, New York 11790-2366
· ~ Uti
Based on the information
Thomas C. Jodlng
pate: '?/ :,,,'-', /j / Commissioner
-¢3
you have submitted, the New York State
Department of Environmental Conservation has determined that:
Therefore, in accordance with the current Tidal Wetlands Land Use
Regulations (6NYCRR Part 661) no permit is required under the Tidal
Wetlands Act Please be advised, however, that no construction,
sedimentation, or disturbance of any kind may take place seaward of
the tidal wetlands jurisdictional boundary, as indicated above,
without a permit. It is your responsibility to ensure that all
necessary precautions are taken to prevent any sedimentation or
other alteration or disturbance to the ground surface or vegetation
within Tidal Wetlands jurisdiction which may result from your
project, such precautions may include maintaining adequate work
area between the tidal wetland jurisdictional boundary and your
project (i.e. a 15' to 20' wide construction area) or erecting a
temporary fence, barrier, or hay bale berm.
Please be further advised that this letter does not relieve you of
the responsibility of obtaining any necessary p'ermits or approvals
from other agencies.
CC: -
Very truly yours,
Deputy Regional Permit Administrator
Albert $. Kmpski, President
John Holzapfel, Vice President
William G. AIbertson
Martin H. Garrell
Peter Wenczel
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall
53095 Maio Road
P.O. Box 1179
Southold, New York 11971
Telephooe (516) 765-1892
Fax (516) 765-1823
October 28, 1994
Robert Scripps
2745 Pine Tree Road
Cutchogue, NY 11935
Re: SCTM ~104-3-6
Dear Mr. Scripps,
After an on site inspection of your property, the Southold Town
Trustees found that the proposed construction of a 15' X 15'
porch is non-jurisdiction as per survey dated September 8, 1994.
The Trustees recommend that a row of hay bales be placed to
prevent any runoff into Little Creek, and that any activity
associated with construction of this porch that is within 75' of
the designated wetlands would be in our jurisdiction and would
require a letter of waiver or permit.
If you have any questions, please call our office.
Yours truly,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK/djh
cc. Bldg. Dept.
ZBA
CAC
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ]~ULATION
[/] FINAL /'~
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [,~"~NAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~ /~///~~
DATE
INSPECTOR
')0
THE NEW YORK BOARD OF FIRE UNDERWRITERS RAos 1
'i(~.~71 BUREAU OF ELECTRICITY
[~- ~., , · 815 JOHN STREET. NEW YORK. NEW YORK 10038
~!~.~,~.., JUNF. 02,1995 ~ ~p~i~,,;o, No. o,y;~ ~7247995/95 N 353861
THIS CE~IFIES THAT
o~y the electrtc~ ~ulpment ~ ~sc~b~ be~w a~ int~oc~ by t~ ap~icang ~med on t~e a~e application number in t~ prem~es of
ROBERT SCRIPPS, 2745 PI~ TR~ RO~, CUTCH~U~, N.Y.
~ms exa,nined on ~Y 30,1995 and found to be in compliance with the NaMonaI Elect~cal Code.
FIXTURE
OUTLETS
DRYERS
FIXTURES RANGES COOKINGDECKS OVENS DISH WASHERS EXHAUST FANS,
MULTI-OUTLET
SYST~S
NO, OF FEET
R - V I - -C- E-
A W G. NO. OF HI.LEG A. W, G. NO OF NEUTRALS A.W.G.
PER ~ OF CC. COND. OF HI-LEG OF NEUTRAL
OTHER APPARATUS:
G.F.C.I,-1
G & S CONTRACTOR
BOX 215
SOUTHOLD, NY, 11971
LIC.#578E
GENrdAL MANAGER
This certificate must not be altered in any manner; return to the office of the Bo0rd if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPART~J~ENT. THIS COPY OF CEfiTIFICA, TE MUST NOT BE ALTERED mN ANY MANNER.
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .......... , 19
Approved .... .-., 19?CPcrmit No .~f.~..~.~. ?.
Disapproved a/c . ..
BOARD OF HEALTH . .
SEPTIC FORH
...........
CALL ....................
MAIL TO:
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building lflspector, with
sets df 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 l~yout of property must be drawn on the diagram which is part of this app//-
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.
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 Southotd, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for i:emoval or demolition, as herein described.
Tile applicant agrees to comply with all applicable laws ~-d: ...........
....... , w manvca, o~UUam~ code, uOUSlng c e, and regulations, and to
aamlra~ltllorlzeamspectox~onpremisesandin building for necessary i~sp~ctions
....
· . ( i~nature o~ applica~t~, ~l~o'r~n')' ' '
........... (Maili;¢ ,~c}dre~s ;~' applicon) ...........
State whether applicant essee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(as on the tax roil ;, i~te,t .........
[~applJc~nt is a corporation, signature of duly authorized officer.
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ................ ~ .....
1. Location of land on which proposed work will be done;
il N b St ........
ouse um er reet, .... · ..........
c ,yT M lOOOS /o.*/: ·
OUn ax ap No,ection ............ Block . /;/
Subdivision , .
Riled Map No ·
(Name)
~ State existing
" nsc and occupancy of premises and intended use ~ud Occupancy of proposed construction: ' -- ~'
a. Existing use and occupancy
................................. :1~ ,~00~.1 lltJ~lOIt
b Intended ~.~ ~ ~.~ ~l~b~ '¥JiATO~ .................
use and occupancy ...............................~11~1~ ~1~%~.,~1 .................
J. Nature of work (check which applic able): New Building .......... Addition .5.~. tMtcration ...........
Repair .............. Rbmoval .............. Demolition .., ............ 8wlmmlng poet ............
Tennis Court ........ Accessory Building .......... Fence ' ...... Other Work ...........
4. Estimated Cost, ..~...~.r ..... ~ ....................... ee ....................................
, (to be paid on filing this application}
$. It' dwelling, number of dwelling uniis ............... Nnmber of dwelling units on each floor ............... .
If garage number of cars
6. If business, commercial or mixed oc~cupan~y, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, i[any: Front.., ............ Rear ............... Depth ...............
Height ............... Numbe~of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ............. Rear .......
Depth ...................... }Ieight ..................... . Number of Stories ....................
8. Dimensions of entire new construction: Front ............... Rear .............. . Depth .............
Hei,.'ht Number~ of Stories
9 Size of lot: Front ' Rear Depth
10. Date of Purchase .......... ~ ................ Name of Former Owner ...........................
11 Zone or use district in which premises are situated
12. Does proposed construction violate! any zoning law, ordinance or regulation: ................................ .
13. Will lot be regraded .; ......... ,I- .............. .. W/Il excess fill be removed from premises: . Yes .... No.
14 Name of Owner of premises [ ' Address Phone No ......
Nme'of Architect ' Address Phone No
Name of Contractor ' ' Address Phone No '
15.Is this property locate'd within ! 00 feet of a tidal wetland? ~¥ES .... NO ....
~][f yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all b~dldings, whether existing or proposed, and. indicate ail set-back dimensions from
property Hnes. Give street and block nu tuber or description according to deed, and show street names and indicate whether
interior or comer
STATE OF NEW Yg~Rm-
COUNTY,OF ','" ~t,.,~[.~.[¥.... S.iS
· (Name of individual signin contract)
above named. ,
He is the .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this
application: that all statements contais!ed in this application are true to the best of his knoxvledge and belief; and that the
Work wilt be performed in the manner ~ct forth in the application filed there~vith.
Sworn to betore me tins //~ i " ,,
r,a~a,a~ ~ ~,v', (Signature of applicant)