HomeMy WebLinkAbout23077-zFOI~M NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HAU.
SOUTHOI.D, N.Y.
N?
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UN'IlL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ...........................................................
23077 Z ../..0/.....¢O
Permission Is hereby granted to;
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to ....~.~-... ........ ~ .......... ~.~ ........ ~.~..,~.~ ......... ~.....~......~,-~
~'"'~' .......... ~'"";"G ........... '~?'"'"'~"':':'~ ........ ~"~'"-~'""~ ...............................
........................ , ...................................... ~.~.~....~?. ,
~o~ox~o~o ~oo ~,,o~. ~r. ....... ~,oo~ ...~7.1.. '.i'.'."~i~'~.'".'.'.'~:.'.~.'.'.'.'.'.'.'...
pursuantto application dated ......... ~.,,..,/....].....~ ................... lg.....~..~ and approved bythe
Building Inspector.
Fee ~...P.~ ....
Rev. 6/$0/80
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
~ERTIFICATE OF OCcupANCY
No Z-24456 Date JUNE 21r 1996
THIS CERTIFIES that the buildin~ ADDITION
1725 PINE TREE ROAD &
Location of Propert~ 30 PINE TREE ROAD EXT. uuTCHOGUE NY
House No. Street Hamlet
County Tax Map No. 1000 Section 98 Block i Lot 10.1
Subdivision Filed Map No. Lot No.
confo~-ms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 11~ 1995 pursuant to which
Building Permit No. 23077-Z dated OCTOBER 20~ 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 A DECK ADDITION TO AN EXISTING ONE FAMILy DNELILNG "AS BUILT"
AND AS APPLIED FOR.
The certificate is issued to
.m,T ,T.'I~4' SCHWAB
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
(owner)
N/A
N/A
N/A
Rev. 1/81
TOWN OF SOUTNOLD
BUILDING DEPARTNENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the buildiug
inspector with the following: for uew 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 froln Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement frol, plumber certifying that the solder used in system contains
less than 2/10 of I% lead.
5. Co~nercial building, industrial buildiug, multiple residences aad similar bsildings
and installations, a certificate of Code Compliance from architect or engiseer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) nou-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 cousent 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
l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling 525.00,
Alterations to dweliiug 525.OO, Swimming pool $25.00, Accessory buildiug $25.00,
Additions to accessory building 525,OO, Businesses $50.00.
2. Certificate of Occupancy on Pre-existin~ Buildin~ - $I00.00
3. Copy of Certificate of Oncupancy - $20.00
4. Updated Certificate of Occupancy - 550.00
5. Temporary Certificate o[ Occupancy - Residential $15.OO., Commercial 5]5.00
, ............
Subdivision Filed Hap ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept, Approvsl .......................... Uuderwriters ApprowH ..........................
Planuing Board Approw~l ........................
Request for: Temporary Certificate ........... Fi~ml Certicate...~.. .....
Fee Submitted:
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 17, 1996
Ms. Antoinette P. Schwab
RR 1 1725 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
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 # 23077-Z
Please contact our office on this matter.
cooperation.
Thank you for
$OUTHOLD TOWN BUILDING DEPT.
FORM NO. 1
TOWN IIALL
~"~'li n g hlspeclor)
APPLICATION F()R BUILDING PERMIT
IONS
Date ................... f9 ,..
/
API'LICATION IS HEREBY M.;',DE to tile Building l~epattmenl for tl~e issuance of a Buildil~g Permit imrsuant to the
......... o w ........................................................... APPROVED AS NOTED
If llpplicant is a coqmlalion, signature of duly aulholized officer. NOTIFY BUILDING DEPARTMENT AT
76fi-1802 9 AM TO 4 PM FOR THE
(Nmne and title or cm porale o[ficel) FOLLOWING INSPE~ION$:
~. FOUNDATION - ~O REOUIRED
B 'ldes l.'cmlse No ........................ FOR POURED COMCRET~
'2. RO~H - FRAMING & PLUMSING
3. INSU~ON
l:[r.c 'c' ~ s License No ....................... 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR CO.
Olher'l~ade'sLiccnscNo ...................... ALL CONSTRUCTION SHALL MEET
THE RcO~iREMc~IS OF THE N,Y,
t, Loc:dion ofland on which proposed wo~k will be done ....... ~ ............... S~'C'ONSTRIJ~TION'~ ENERGY
(Name)
a, Existing use and occupancy . . [m~,.~/~C~ ..... 0.~ .........................
3. Natttre ofwo.rk (check which applicahl~): New Building. .......... Addition .~.~ff-~. · AlteratiOn ..........
Repair ........ ~ ..... Removal .............. Dmnolfiion .............. Other Wolk . . ~ ............
B~es~fiption)
5. If dwelling, mmlbet of dwelling units ............... Number of dwelling mills on each floor ................
7. t)int~asions of existing structures, if any: Front ..... q~.,~ ..... Rear .., ~].g.' ..... Depth . .~?..,~ ........
l Icight ............... Nmnber of Stories ..... ][ .................................................
Deptk . . 3.~. ~ .............. Height ...................... Numbe; of Ston=s ..... ~ ..............
8. ), else sore, *e ewco s r,c on Front .... ~,& ..... Rear ...~ ...... Depth..~.~.& .......
IluigM ............... Number of Stories ......... I. ............. ~ ................................
10. Date of Pmchase ~/~/ JS.~a .................. Name or Former Owner AC~ur, · ~.a~& ............
13. WiLl lot b~ ;egmd~ ....... ' ..................... ~ill exce~s git be ,=mo~ea ham p~emisas:
14. Nam~ of O,v,,cr of premises .AaD~o~& . E. ~h.~ . ~~ ~ ~ Phon~
Name of Architect ......................... Address ................... Phone No...~ .............
PLOT DIAGRAM
STATE OF NI.iWYOI~. ' "S
...~ {~+~...~.. ~ ~ ................ being duly s,vo~n, deposes m~d says tltat he is the al, pile;mt
I lc is the ......... ~ ~ .........................................................................
~,),'~ ' ..~.~q,~'/~ ' .. ~9.~
........ x .... ~ .... day of
Buildlr~g plans roi- decL addition to home of ! irs. Allen T.
1605 Pin~ Ti-ee Road. Cutchogue, I,le~, '~"o!'!.
Deck is to be added to the front of house and e~tend 28' in length and t 2'
in width. All construction will be with pressure-treated lumber and the
deck will be supported in part by an existing cement and brick staircase.
The deck will further be supported by ten (10) 4" X 4" supports which will
be mounted on 12" poured cement footings,
The deck will be 3'3" above grade and will have a 33" railing around the
entire exposed area. Said railing will have two planks spaced 1S" apart
The support beams will be 6"w X 1 and a half inches thick with a total of
twenty-eight (28) boards spaced 14" apart.
The top of the deck will be constructed of five and a half inch wide by 1"
thick planks, The planks will be 12' in length and will number twenty
fi~,e (25).
At the end of the deck there will be 4 stairs with a railing leading to the
yard,
l,I
STATEMENT
19 7~
Buildlt'~g K, lans for deck addltl¢,r~ to, h,:,Yne ,:,f I lrs..'~.llen T. '~,cl~w ~1.,
160~, Pine Tree Rc, a,J. Cutchogue.
Deck is to be added to the front of house and extend 28' in length and 12'
in width. All construction will be with pressure-treated lumber and the
deck will be supported in part by an existing cement and brick: staircase.
The deck will further be supported by ten (I0) 4" X 4" supports which will
be mounted on 12" poured cement footings.
The deck. will be 3'3" above grade and will have a 33" railing around the
entire exposed area. Said railing will have two planks spaced 15" apart
The support bean'is will be 6"w X 1 and a half inches thick with a total of
twenty-eight (28) boards spaced 14" apart.
The top of the deck will be constructed of five and a half inch wide by l"
thick planks. The planks will be 12' in length and will number twenty
five (25).
At the end of the deck there wlll be 4 stairs with a railing leading to the
yard.
If
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMIHG
[ ] INSULATION
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
/~'/'~ 76S-].802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ].~.qULATION
[ ] FRAMING ~ FINAL
[]FIREPLACE&CHIMNEY
DATE: I/t~-\ /0~~/ INSPECTOR
765-S802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION SST [ ] ROUGH PLBG.
[ j FOUNDATION 2ND [ ] IN~N
[ ] FRAMING [/-'~FINA~.
FORM NO. 1 ~'
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN ttALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
BOARD OF IIEALTII . .., .....
'~'~3 SETS OF PLAi1S
SURVEY
"-'"'--C 11 E C K ......... ~ ........
SEPTIC FORH
t; O"~ I FY;
CALL t ................
HAlL TO;
APPLICATION FOR BUILDING PERMIT
Date ....... ; ........... 19..
INSTRUCTIONS
a. Tiffs apPlication must be completely filled in by typewriter or in ink aud sub~nitted to the Building Inspector, with
sets of plans, accnrate plot plan to scale. Fee according to schedule.
~ b. Plot plan showing locatiou of lot and of buildings on premises, relationship to adjoining premises or public sti'ee
or areas, and giving a detailed description of layout of property nmst be drawn on the diagram which is part of this app
cFtion.
c. Tile 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 pern
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or nsed in whole or in part for any purpose wbatever.nntil a Certificate of Occupan,
shall bare been granted by the Building Inspector.
APPLICATION IS tlEREBY MADE to tile Building Department for tile issuance of a Building Pernrit pursuant to tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, m~d other applicable Laws, Ordinauces
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicaut agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatious, and
admit authorized iuspectom on premises and in building for uecessary inspectious.
(Signature of applicant, or name, if a corporation)
· .....
(IVlailing address o~applicant) ~' .
State whether apl)licant is owner, lessee, agent, architect, engineer, general contractor, electrician, pknnber or builde
....... .... ' . APPROVED
NOTED
· .....
Name orowner ori, re,nises ...g.~..
(as on the tax roll or late~ll~llri9 BUILDING DEPARTMENT AT
If applicant is a corporation, signature of duly authorized officer. 765-I802 9 AM TO 4 PM FOR THE
FOLLOWING tNSPECTIONS:
(Name and title of corporate officer)
Builder's License No ..........................
Phnnber's License No ..... ' ....................
Elech'ician's License No .......................
Other Trade's License No ......................
I, FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
I~.E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REOUI~IEMENTS OF THE N.Y,
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
Location of land on which proposed work will be done.
I};~,~i Number Street fa;,; ~'~' ...... ' .............
County Tax Map No, 1000 Section .... 'q~. ........... Block .. Lot..
Snbdivision ........ ............................. Filed Map No ............... Lot ..............
(Name) ,
State existing use and occnpailcy of premises and intended use and occupancy of proposed constrttctiou:
a. Existing use and occupancy ... ~..~!,t~')O.~v. Jg~'l d~OC.~....~....O.~-)A)~.4~ .......................
b.,,,t nd d,,se ocenp ne .... .......................
3. Nature of work (check which applicable): New Building .. Addition . . . Alterati6n ....
Repair ........ ~ ...... Removal .............. Demolition .... : ......... Other Work.. ~ ..........
. o'o ...... : ~(Description)
4. Estimated Cost ................................. Fee
(to ba paid on filing this application)
5. If dwelling, number of dwelling nnits ............... . Number or dwelling units on each floor ..............
If garage, number of cars ,
6. If business, commercial or mixed occupancy, specify nature a~d extent of.each type of use ...................
7. Dimensions of existing structures, if any: Front ..... ~¢,~ ..... Rear ... ~..g.' ..... Depth . .~7...Q. }...
lleight ............... Nmnber of Stories ..... J ...............................................
Dimensions9f shine structure with alteratious or additions: Front ................. Rear .
Depth..~.~,~.t ............. tteigbt ....... ~.,. ........... Number of Stories .... ~ '' '~ .........
8. Dimensions of entire new construction: Front ....
lleight .... Number of Stories I
9. S{ze of lot: Front . .)., .~ ................ Rear ...................... Depth ....................
10. Date of Purchase ~/~/./~.~ .................. Name of Fenner Owner ht~u~.. ~.~ ..........
i 1. Zone or use distric~ i' 'n wi%ich premises ara situated ...................................................
12. Does proposed construction violate any zoning law, ordinance or regnlation: .. ~ .........................
13. Will lot be regraded ....... ~ ................... Will excess fill be removed fr~m premises: ~es
Name of Architect ........... ~ .............. Address .................... e Phone No ............ ...
N~n,~ of Cont~,~to~. ~l~V.. ~ha ........ A~ar~ g~.Y~O.~..ff. ~o~ No ...............
15. I~ thZs proparCy w~h~n 300 fe~ of
~Zf yes, SouthoZd Town Trus~eas P~rm~ may be required. PLOT DIAG~M
Locate clearly and distinctly all 'buildings, whether existing or proposed, and, indicate all set-back dimensions rrm
property lines. Give street and block number or description accord~g to deed, and show street n~es and indicate whethc
interior or corner lot.
STATE OF NEW¥OI~,., ' o o
county o~:... Su.,~o/.K. ..... t')°'°
...~O/~...~.. ~..~ ........ ......... being duly sworn, deposes and says that he is the at, plican
above named(.Name of individnal signing contracl).~~
~ i~ th~ ......... ~ ................. · ......................................... . .............
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or bare perforated the said work and to m~e and file thi
application; that all statements contained in this application are true to the best of his knowledge and belief; and that th
: be performed in tim manner set forth in the application filed therewith.
work w,l!
Sworn to before me this
........ ~.0.~.. ' ..dayor. '~~'
~f
~ ~ (' ~" - ~T C_~ ~ <,3~- ~ · . ........ ' ..............
-- LIND~ J. COOP~ . (Signature of applicant
o~O~
'N
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