Loading...
HomeMy WebLinkAbout26958-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27468 Date: 12/13/00 THIS CERTIFIES that the building ALTERATION Location of Property: 425 STILLWATER AVE CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 1 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 4, 2000 pursuant to which Building Permit No. 26958-Z dated DECEMBER 8, 2000 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 CONVERT EXISTING ATTACHED GARAGE TO A BEDROOM WITH BATHROOM, FIREPLACE & SKYLIGHT AS APPLIED FOR "AS BUILT" . The certificate is issued to KELLY JEAN KAELIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ut ori ed Si nature Rev. 1/81 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. 26958 Z Date DECEMBER 8, 2000 Permission is hereby granted to: KELLY JEAN KAELIN 425 STILLWATER AVENUE CUTCHOGUE,NY 11935 for CONVERT EXISTING ATTACHED GARAGE TO A BEDROOM WITH BATHROOM, FIREPLACE & SKYLIGHT AS APPLIED FOR "AS BUILT" . at premises located at 425 STILLWATER AVE CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0001 Lot No. 010 pursuant to application dated DECEMBER 4 , 2000 and approved by the Building Inspector. Fee $ 75 . 00 Auth ' ed ignature ORIGINAL Rev. 2/19/98 i • : Form No. 6 TOWN OF SOUTHOLD - BUILD ING 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 buildin s streets, and unusual natural or topographic features, g Property lines, 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 1Z lead. 5. Commercial building, industrial building, multiple residencesand similar buildin 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings anc "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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling Alterations to dwelling $25.00, Swimming pool $25.00, Accessorybuilding $25. Additions to accessory building g $25.00, 2. Certificate of Occupancy on Pre-existing Building - $50.00. 3. Copy of Certificate of Occupancy _ g - $100.00 4, Updated Certificate of Occupancy _ $5.00 over 5 years - $10.00 5. Temporary Certificate of Occupancy $50.00 P y - Residential $15.00, Commercial $15.00 Date . . 'w Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . . • . • • • • • • • . • • . • • cation of Property. . .44L5; SCk-I-e-r n� �- �• . . v . . .HouseNo. Street . . . . . . . . . . . Hamlet wer or Owners of Property.:Ke( �y, : k4e-1,r1• •�. ���ort-1 uJ.•t-EL.-n Q ,•os ,jrosrE�eS . . . . . . . . • • . unty Tax Map No 1000, Section. . .. . . . . . .Block. . . . . .I . . . . . . . . .LotrCj. . . . . • . . . . . bdivision.. . . . . , . • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot . . . . . . . rmit No Q�A-q"J'?--A. . . . . ,Date Of Permit, 1!;k).000$'� J 4• • • • • • • • - . / . . . . . . . . . . . . . . . . . .Applicant.K2(C� - . . .0 alth D PP . .�jk . . . . . . . . . . . . . . ept. Approval . . ,Underwriters Approval. . . . . �, , , , , , . . • • . . . • . . . inning Board Approval. . , !J�� guest for: Temporary Certificate. . . . . , • • • . . Final Certicate. .L-�, , , , , Submitted: $. •�5.63 . . . . . . . . . . . . . . . . . . . . . . cod ;7y6g' . .Ar ' rn�T. . . . . . . . . . . . . . . . . . . . . . . . .r BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 TION [ ] FRAMING [ FINAL [ ] FIREPLACES CHIMNEY REMARKS: ,DATE INSPECTOR,,,"'-L FIELD INSPECTION REPORT__ DATE COMMENTS C------------------------------------------ ------ -� ro � II I trf if y FOUNDATION OST) FOUNDATION ( ND) - I a � - ------------------------------------ � II II ij x � >r ROUGH FRAME & li ii O tr-- PLUMBING n -------------- s II II ------------- ----------I --------II -------- -------- INSULATION PER N. Y. u e STATE ENERGY ( — CODE Ij�----I►� 11 N II II I� II II FINAL ADDITIONAL COMMENTS: r H � o' H O t=J t+y ro H BOARD OF HEALTH .. . . . . . ' 2 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY TOWN OFSOUTHOLD CHECK . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL TEL.. 765-1802 MAIL T0 : . . • • • . . • . . Examined . . . . . l Var. . . ., t: Approved . . . . . . . . ..OKA. Permit No Q Z Disapproveda/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . d' g Ins ector) . APPLICATION FOR UILDING PERMIT December 4,200019 Date . . . . . . . . . . . . . . . . . .. . . . 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 ermitshall 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. AJPPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tht Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances o, 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 tc admit authorized inspectors on premises and in building for necessary inspectio s . . . . . . . . . . . gnat re o • p • scant, o name, if a corporation) 3312 Soundview,Avnue� Mattituck�,N.Y;,11952, , , , (Mailing address of applicant) State whether applicant is-owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . .RA1.ly. XAeXiA FpgArty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . .4?5 ,Stillwater Avenue,, Cutclkogue,. N,.Y.. . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . .103. . . . . , . . . . . Block . . . . . . . .1 . . . . . . . . . Lot , , 10 . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: garage converted to bedroom with bathroom, fireplaceland skylight a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . same b. Intended use and occupancv . . . . . . . . • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , G r 3. Nature of work ('check which applicable): New Building . . . . ... . . . . Addition . . . . . . . . . . Alterations.a$.Dix4t:. Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . , . Demolition . . . Other Work . , . . . . . . . . . . . . . (Descripxion) 4. Estimated Cost. . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . Ifgarage, 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 . . . . . . . . . . . . . , . , . . . . . Depth , . . . . . , . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Fortner 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . , . . . .Phone No. . . . . . . . , . . . , . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . , , . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . , . . . . . . Nameof Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . : . . . . . . . . . . . . . . Phone No. , . . . . , . . . . . . . . . 15, Is this 'property located within 300 feet of a tidal wetland? *Yes *If yes, Southold Town Trustees Permit may be 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. see plans of Cronin and Condon dated 11/30/00 STATE OF NEW YORK, Suffoy% COUNTY OF . . . . . . . . . . . . . . . . . . Kaelin , , , being duly sworn, deposes and says that fie is the applicant (Name of individual signing contract) above named. Heis the . . . . . . .vV4e';. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . (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 statemenhets tained in this application are true to the best of his knowledge and belief;and that the work will be performed in tan r set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . . . . . .4 :day of. . December . . . . . . . . . .. Ig . . . 2000 Notary Public, . , , . Win. . . . . . County , GA Y FLAN ER OLSEN vv (Signature of applicant) Notary Public,State of New yob No 020L2959600 Qualiti@d in Suffolk Cou30,nty ' Commissign rTxP'r�Mardi J A�PROM AS NOTED oy ov OCCUPANCY OR N�oTIFY U� G DE MEN USE IS UNLAWFUL TSFOLLOVBFIZNOINM TO 6 P FON TNR WITHOUT CERTIFICATE IL FFOOUNDATION-TTWO REOUIeE% ETE OF OCCUPANCY a ROUGH - FRAMING t PLUMBING 4 FINAL • CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE NX STATE CONSTRUCTION A ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 6- Bookshe Ives s Bookshelve - . \ ` IQLpW 1N New Fireplace and Hearth It �7vG - I� _ Converted Garage to Bedroom _ with Bathroom ` `4 p191U15.L' rAd Existing Room 5111 Height = 2-8" - --- - -- ----- - Window Height = 4'-0" 24-4" New Skylight 2'-b" NO. DATE: RE\/ISION: - iLI / y^l; pN- kF. IAASU{a7IiA/ NFt11CM1OA✓ PLANS ARE PREPARED BY CRONIN AND LONDON GONSULTIN6 ENGINEERS, LLP. IT 15 A VIOLATION OF THE HEN YORK STATE EDUCATION LAW, New G Io5et 3 _l ARTICLE 145, SECTION 1209, FOR ANY PERSON 1JNLES%CTIN6 UNDER THE OR LAND NeN Bathroom 5'-4" SSURVEYOR,OTO ALTER ANDIT�N ANY WAY IFIONAL6AN ITEM BEARINS ARCHITECTTHE SEAL OF AN EN6INEER, ARCHITECT, OR LAND SURVEYOR 15 ALTERED, THE ALTERING ENGINEER, ARCHITECT, OR LAND 5URVEYOR SHALL AFFIX TO THE ITEM H15MER O SEAL AND ONE NOTATION "ALTERED BY" FOLLOWED BY HIS/HER 516NATURE O AND THE DATE OF SUGH ALTERATION, AND A SPECIFIC DESCRIPTION OF THE ALTERATION. Existing y Kitchen GhimmneCronin and Condon Consulting Engineers, L.L.P. 1755 SIGSBEE RD MATTITUCK, NEW YORK 11952 (631) 734-7250 Family Room ;'•'. ,F : , .,. , . , SHEET RE:." ''Garage Renovotion 5 j7 v 4 tow► 00 177 # v,/ PRdJ�GT: 'Kaelin/Fogarty Residence 425 5tlllwater Ave, Southold, NY SGALE - = DRANINO # h` DRAWN BYFEL 111 Renovoted Goroge, Floor Plon DATE II/ O/0o i13 m �ld� v; r„ DFC -'T p16u rj: JOB # X00-206 ; •.