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HomeMy WebLinkAbout26836-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28997 Date: 10/16/02 11{IS C~TIFIES that the building ALTERATION Location of Property: 350 SKUNK LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 3 Lot 7 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 15, 2000 pursuant to which Building Permit No. 26836-Z dated OCTOBER 11, 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 BATHROOM ALTERATION IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM BAUER of the aforesaid building. (OWNER) SUFFOLK COU1TTY DEPARTMENT OF ~RALTH APPROVAL ELE~-rKICAL CERTIFICATE NO. PLUMBERS c~RTIFICATION D~£~3 Rev. 1/81 o9/~8/Ol // N/A 53447C 09/30/02 JOHN REICHERT ~or~ ze~/Signature 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. 26836 Z Date OCTOBER 11, 2000 Permission is hereby granted to: WILLIAM BAUER 350 SKUNK LA CUTCHOGUE,NY 11935 for : ALTERATION OF AN INTERIOR BATHROOM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 350 County Tax Map No. 473889 Section 097 pursuant to application dated AUGUST Building Inspector. SKUNK LA CUTCH©GUE Block 0003 Lot No. 007 15, 2000 and approved by the Fee $ 75.00 Author i zecL~S ignature Rev. 2/19/98 COPY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOm 765-1802 =~:~P?~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: 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 o{ 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. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - : .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .'- ..................................... New Construction. Old Or Pre-existing Building. .~'.~.~. Location of Property ........................................................................ House No. Street Hamlet Onwer or Owners of Property... -- .............................................. County Tax Map No 1000, Section .............. Block .............. Lot .................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No~..~..¥..~. ...... Date Of Permit. IP.~¥J.-~fi.0. .... Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Town Hall, 53095 Main Road P. O. BOx 1179 Sou~hok~, New Yo~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION BUilding Permit No. Owner: ~(3F4, /~ u ~ ~ (please print) Plumber: ~ ~- ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Signature) Sworn to before meth~s ~_ day of /~/~~.--// , EL~ A ~A~IS NOTARY PUBLIC. S~ of N~ ~. 01ST6~8173. S~olk ~un~ T~ ~ims June 8. Issue Date 09/30/2002 Electrical Inspection Certificate Applicatiq~ l~'~ber Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Issued To: Bauer Street: 350 Skunk Lane Villige: Cutchogue Zip: 11935 Town: Southold Section: Block: Lot: Introduced Core Electric Inc. Lic. # 3493-E Was examined and found to be in compliance with the National Electrical Code. [] Commercial [] NVDefects [] Pool [] lstFIoor [] Indoor [] Basement [] HotTub [] Residential [] Att. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 3 2 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector / Other Equipment BATHROOM Bldg. Permit: President Rough Inspection: Inspector: Final Inspection: 07/03/2001 Inspector: Quentin Reynolds This certificate must not be altered in any manner. Inspectors may be identified by their credentials. 16 * 7- --. ,' - OWNER STREET -~ .Z-::-/ I VILLAGE DIST. SUB. LOT W ~ ' ~PE OF BUILDING ES. Z/o LAND ~'4GE NEW"J Tillable SEAS. j Vb IMP. TOTAL N O,~J~,_~L ~1., Acre _ . fl £~0 Tillable 2 Tillable 3 FARM DATE COMM. CB. MISC. Mkt. Value BELOW ~BOW Value Per , Vglue Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD ~--~ ~- DEPTH BULKHEAD House Plot Tara I DOCK Porch Breezeway j Tota[ ~.,~/0"~' Type Roof ~'~ Recreation Roo Dormer Foundation Basement ~xt. walls Fire Place Driveway Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floo DinetteI / BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: DATE REVIEWED: /o //o/~o DATE SUBMITTED: ~'//~'/ oo PROJECT LOCATION STREET: 3~ O J'~:,-~,~ ARCHITECT / ENGINEER: CITY: SUBD1V. NAME: FAST TRACK: YES oRNO SCTM#--- DISTRICT: 1,000 SECTION: ?/2 BLOCK: ,-~ LOT: ZONING: ~, ZONING DISTRICT: R40, AC, WHERE ACTUAL LOT SIZE FROM? tt'a~ ("&~,,~ REQ. REQ. FRONT: ~t5 ' PROPOSED: ' SIDE YD: j~- '/.~ ' PROPOSED: LOT COVERAGE: ALLOWED:~ % EXISTING:__sf__ CORNER? YES OR~ WAT ER FRONT? YES OR(~ DESCRIPTION: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o~hNOTES: CONFORMING: YES c~ REQUIRED LOT SIZE: SQFT. ACTUAL LOT SIZE: ~'/e94~.SQFT. REQ. '/ ' REAR:~'O ' PROPOSED: % NEW: F_jJ sf--% TOTAL: sf % LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN. 1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION: ^DD ~ ACC OR N/D: AGENCY PERMITS REQUIRED FOR REVIEW TOWN SPETIC PERMIT: YES or~a SUFFOLK COUNTY HEALTH DEPT: YES or~_..~ (BED #):__ DTE: / / PERMIT #:RI0- NEW YORK STATE DEC: YES orqhJl~ SOUTHOLD TOWN TRUSTEES: YES o~9 TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES or ~ FLOOD COMPLIANCE ZONE: PANEL #: FLOOD ZO .NEr"~ ,-., NYS ENERGY: YES OR(~: _EGRESS: VENT: LIGHT: i,-3 ~ ~1,~....~ I/-,~ L,=..,_,, ,.,,~*,4 .-<',3~ IlL FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND FLR : SF TOTAL: SF OT( ~4 SF)- ( SF)= SF X $__ INIT OTHER TOTAL FEE FEE FEE =s +$ +$ : s ?-5 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [,~~ROUGH PLBG. [ ]~JNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL FIREPLACE & CHIMNEY REM.A~RKS.' ~/~/~'~'::~g.~'.,=~ ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [,~SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY jDATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN~JiL.ATION [ ~/j~l NAL [ ] FIREPLACE & CHIMNEY ~DATE INSPECTOR FIELD INSPECTION REPORT DATE COUNTS FOUNDATION (IST) II Jl I! II FOUNDATION (2ND) ,, ,,_ _~/'~~...~./ / II II II II II II II / -/ INSULATION PER N. Y. STATE ENERG'Y II I1 CODE II II 11 II II I1 II II II Il II II II II II 41 II ADDITIONAL COMMENTS: FORM NO. [ TOWN OF SOUTHOLD BDILDING DEPARTMgNT TOWN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 / / / Approved .... /..~.~. 1~ .... , '~.... Permit No. Disapproved a/c .................................. (Building Inspector) SURVEY ........................ CHECK ......................... SEPTIC FORM ................... ,, DEC ........................... TRUSTEES ...................... NOTIYY' MAIL TO: .................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. 'Ibis application mst be c~npletely filled in by typewriter or in ink and suhnitted to the Building Inspector w: 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b: Plot plan stx~ng 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 rmat be dram on the diagran whid~ is part of this anplication. c. 'lhe work covered by this application my not be cmnmeced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such pemit shall be lmpt on the p,t, Mses available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose tahatever until a Certificate of Occupancy shall have been granted by ~ Building Inspector. APPLICATICIq IS ~ ~ to the Building Department for the isstmnce of a Building Permit par~x~ant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for tim construction of buildiags, additions or alterations, or for r~moval or demolition, as herein described. The applicant agrees to cua~ly with all applicable laws, ordinances, building code, housing code, and regulations, m~l to a~lmit anthorlzed inspectors on premises ~ in building for necessary inspections. (Signature of applicent, or nam, if a corporation) (Mailing -'~reas of applicant) A/~, 7/~0 ~ State whether applicant is o~er, lessee, agent, architect, engineer, general contractor, electrician, plurber or lyailde ............. ~. ~. M...w...,¢.~../....~.. o. ~. ~,~. ~./w.. ~.~.. ..................................................... ~ of ~,~r of pr,~ses ...1~.. Z/Z~. ,e. m.~.W.e.. ~.~... ........................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Pltrabers License No .......................... Electricians License No ...................... Other Trade's License No ..................... ......................................... c:.,a...z'..~. ~.e. ~. ~. aS. ..... ,4Z..~.. ................................. House Number Street H~nlet County TaxMapNo. 1000 Section ....~f...-~.. ..... Block ..... 2 ........ Lot ....~.. ......... Subdivision ...................................... Filed Map No ................ I~t ............... 2. State existing use and occupancy of promises and intended use and occupancy of proposed construction: ~. ~te~ ~ and oc=p~,~y ..~..~..4ZZZ...~...~..,?~...W..O....~/.~ ~./~..../f~z~. r~.z d~ ....... (Descript ic~) estimated Cost //,~P~ .~.~...0..~...,~..~.., fee " (to be paid on filing this application) If ck~elling, ntjrt)er of d~elling ~mits .... /.. ..... tkni~er of &0elling traits on each floor ................ If garage, t~t~l~er of cars ...................................... If business, c~,,,=reial or mized oecd, specify nature and extent of each type of use ...................... Dimensions of existing structures, if any: Front ................ Rear ............... Dapth ................. lleight ......................... Nuatmr of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Dapth .................... tleight .................... 14~t)er of Stories ............... Di,ensions of entire ne~ coastruction: Front ................ Rear ............... Dept2~ .............. liei~t ......................... Ntxnber of Stories ..................... Size of lot: Front .................... Rear .................... Depth .................... Date of Purchase ..................... Hame of Forr~r O~er ........................................ Zone or use district in s,i~ich prc~alses are s~tuated .............................................................. Does proposed construction violate any zoning la~, ordinm~ce or regulation: ........................ Will lot be regraded .................... Will excess fill be removed from prc~nises: YES ~ of O~r of v,~mises . ..ff::-~+~.~.:.~. ................. a,XSre,ss .............................. ~ ~o. Z~.f.--. 7. ~.~. ti,are of Arddtect .................................... Address .............................. Pt~ne No .............. ~r~e of Cxmtractor ................................... aklress ............................... I1mne No .............. · Is this p,~t.arty within 300 feet of a tidal wetland? * YES .......... hD .......... PLOT DIAGRAM I~cate clearly and distinctly all buildings, x,imther existing or proposed, and indicate all set-back dimensions ~ property lines. Give street and block ntrd~r or description according to deed, and sho~ street nines apzl indicate ~tber interior or corner lot. (~: hEW Y(7~, SS ~1~' (J~ ....................... .... ~. g?~.d. 4~.,~'....~~.~~ .......... bei~ duly ~m, ~l~S a~ ~ys tt~t he is tl, a~l.i~nt of i.~ivid~t signing cmtract) ~, ...... ............. ................................................ (C~tractor, agent, cor~rate officer, etc.) ~id ~r or ~rs, a~ is duly mthorlz~ to ~rfom or h~e lmrfo~ O~e ~id m~ m~ to ~ a~ file this qflicati~; that alt skat~nts cmtai~ in this a~licati~ are tn~ to fl~e best of his ~1~ a~fl belieF~ mxt the turk wltl be ~rfon~l in the mm~r ~t forth in the a~ticatim fil~ tber~8~. om to ~[ore ~ this ..... ...... day ..... .... RBARA W. DELEON BA ..... .~tate of New York Notary t.'um..., ~_r.~7 .... No. 475b~ .~.~-v../ ualified in ...... GommissionQF..~pires .lan~'~rY ~[, ~' EXISTINg, KITCHEN I:)INE: ~ Il:: EXISTIN¢ t--XiS'F'IN PLAN l/4" = PLUMBING ALL PLUMBING WASTE & WATER LINES NEED TESTING BEt~ORE COVERING PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 OF 1% LEAD. INSTALL HANDICAP TOILET I. qlTH 14ALL MOUNTED ~RAID tDAI~..~ 2" · x 5&" Long EXISTIN~ K.I T,C..HEN PINEY] E - ~-" D6" x 5,D" t:~2LL-L,~ HANDICAP SHOI4E~. STALL -- INSTALL I,,IALL NIOUNTDD GRAB fDARG 2" · x D6" Long EXISTIN¢ HALL EXIST. C..LO. (.,UT E:)O!,',!N EXI5TIN~ 2"x ,9," F:L JTE, TO 2"x 6" 2-TRIPLE EX FL JT5, BELOk4 BATHROOf'4 FL P,IITH 2"x 6". D-INDTALL LEAP PAN ON ENTIF2.E FLOOR P, IITH D"- 4" Ht-~H PERINIETER. IN.'.'.'STALL TILE FLOOR. INDTALL FLOOR DI~,~.IN NEAR AR.EA OF 5HO~ER. PLAN 1/4," = I'-O" If copper tubing is used for water distributing system; piping shall be of types K or L onl~ UNDERWRITERS CERTIFICATE REQUIRED PROVIDE AIIrlI-$pA[D AND/OR ]'IIERIIA[ $110CK PREVENTIN8 DEVICES AS TO PART. 902.$[K) N.Y. STATE BUILDING CODE. OA'rE: _/Ol,,I, B FEE: ~?~.~ ._e NOTIFY BUILIHNG D 765-1 ]02 9 ~M TO FOLLI )WING II ¢SPECT 1 FCUNDATiDN - FO R POUR: ED CON 2- RC UGH - :RAMI/; 3. IN~ ~ULATIO 4. FI~AL - ;ONSTI BE COMP~ ~E FOI ALL CONSTI IUCTIOI THE REOUI~ EMEN1 STAT E CONI ;TRU~ COD 5~. N~ DESl 3N OR ~N~ UHDD z Z Al FOR THF IS: REQUIRED PLUMBING MUST MEET THE N.Y. & ENERGY IIBLE FOR I ERRORS ITERS CERTIFIC. C. TE IRED