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Home My WebLink About28285-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29922 Date: 12/19/03 THIS CERTIFIES that the building ADDITION Location of Property: 910 TUTHILL RD EXT SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No_ 473889 Section 55 Block 6 Lot 15 .43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 2002 pursuant to which Building Permit No_ 28285-Z dated APRIL 17, 2002 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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID P. & JENNIFER LAFRENIERE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized Sign re 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. 28285 Z Date APRIL 17 , 2002 Permission is hereby granted to: DAVID LAFRENIERE 910 TUTHILL RD EXT SOUTHOLD,NY 11971 for CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 910 TUTHILL RD EXT SOUTHOLD County Tax Map No. 473889 Section 055 Block 0006 Lot No. 015 . 043 pursuant to application dated APRIL 16, 2002 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature COPY Rev. 2/19/98 Form No.6 // OF SOUTHOLD BUILDING DEPARTMENT 0� r^ { 1 ` (le 96 r Ch Cdf TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 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- $.25 G 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. d New Construction: p� Old or Pre-existing Building: (check one) Location of Property: / -TI47VI LL Qd- EX-t House No. Street Hamlet Owner or Owners of Property: okn d P �� /gyp �igy�Pt71Jl 6 '� Suffolk County Tax Map Ngo 1000,, Section SS 5, W 3 Block ( Lot / O Subdivision y/Gti�DI4T%IG9wW S Filed Map. Lot: Pernut No. o'-5-.7— Dale of Pemrit._Applicant: PVjAf_e U.Q Lj4TQEA1/EkL— Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: t/ (check one) Fee Submitted: $ a� ^ 1 pph a t Si e J en � �a9a2 �� rp w CU� C1✓, TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST- SUB. ACR. REMARKS s _ TYPE OF BLD. _ # a4o' -eoa bwe.l ;ni a ciq, :- � PROP. CLAS $-L LAND IMP. TOTAL DATE �SOp -?3Po26�70 - P of 15 Sa 2� o Y FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOTl� Zz TOTAL Q ~ ; ■■■■■■■■■■■■■■■■■■■■ " ■■■■■■■■■■■■■■■■■■■■I COLOR ■■■■■■!■■■■r'.J■■■11■■■■ ■■■N■Ifii ■■■11■■■■ TRIM ■■■■■nPatio ■■■■■■■■■■■■■ Foundation Bath Dinette SLAB Extension Ext. Walls Interior Finish L.R. Extension Fire Place Heat D.R. rch ■®®� ®� M I 1 Applicant/ Dale Owners Nine: A e U Reviewed: Architect/ Date Lngineer. ___ __----_— - ___--- Submitted: ____ SCM n: District: 1 .000 sec6i011: —!.r 131oct, �a LoC IJr. Project r- SubdIVIS1011 // Location: _ g/O �r~. �r--_/�CQ__—�-�1,---a-�� Name; a—Vk 4 Single &, separate Required cmiFinadon: _(Yes/Nom JU Rer{. /� OU7 �— �� licq. Yoniag Oi91nc1'�� (IAI size' Ac"",1 �� =f—I ILaI coverage p z I'ropaseJ -,lel Rconi Yard fw Reda Ist G Reg. (Proal yard /s1' Pr—/oposed.'7�� ' [Side Yard _ vProposul: __J [Rear Yard4 _.-_ proposed-' -d Project Description: At /c . AGENC=ERMITS Permit . REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C- Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: 765-1802 BUILDING DEPT. I PECTION ZI F NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIR LACE CHIMNEY REMARKS: DATE INSP M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST /IR HPLBG. ] FOUNDATION 2ND ATION FRAMING [ J FIREP C & CHIMNEY REMJ*RKS: 1 77 ATE l� INSPECTO FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (lt y at C FOUNDATION (2ND) z 0 x ROUGH FRAMING& PLUMBING i -3 n INSULATION PER N.Y. e STATE ENERGY CODE FINAL �C fiL" r ADDITIONAL COMMENTS 02 7�z? o s t� - X I b O lx r x c b y TOWN OF SOUTHOL L - BUILDING PERMIT APPLICATION CHECKLIST :;: BUILDING DEPA11TM �1PR 162002 'j Do you have or need the following,before applying? TOWN HALL C) 2-002 Board of Health SOUTHOLD, NY 11971 BLDG DEPT 3 sets of Building Plans TEL: (631)765-1802 MjLiN 0F SOUTHOLD Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. Check Septic Form MY.S.D.E.C. Trustees Examined �/J/, 20 G1_ Contact: Approved_ L�j�, 20r%y Mail to: Disapproved a,'c `� Phone: Expiration_ /o l 7 ,2003 Building4imp!V APPLICATION FOR BUILDING PERMIT Date 1 C--D, 20 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 waterways. 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 issue a Building Permit to the applicant. Such a permit shall be kept on the prem ses available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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. &gl� ofap'ockA or name-, a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises �iAyyc-) P UeQf n CAJF (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: `Tu4kdI 'Rd ;2c4k d cl House Number Street Hamlet County Tax Map No. 1000 Section Block (0 Lot 43 Subdivision �,Gtn al n-4 v..ysdmor Filed Map No. Lot l S(13 Q,me) 2. State existing use and occupancy of premises and intended use and occuponey of proposed construction: a. Existing use and occupancy WD.M i b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work ��tttt (Description) 4. Estimated Cost `� 3C001W Fee (To be paid on filing this application) 5. 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 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 b Rear 1 TO •%,, 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? YES_NO +/ 13. Will lot be re-graded? YES_NO V�Will excess fill be removed from premises?? YES_NO, 14. Names of Owner of premises Q6,�a Q I,9�tfi Address Q\D `TAl„1(Rdhone Name of Architect fkc�a nY X- w b+.f Address nw,n VtcA figm ora( .Phone No tft i _oak cT Name of Contractor 5'Z Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO e— • IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) �wAy� r W f tai being duly swom,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the CltirN r�y (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 statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me thi day of_ 220 ✓�-�/!tib otary Public ign pplicant J&MO M.WILKINS Notary Public,State of Newyork No.4952246,Suffelk County Term Expires June 12, ,A —�� G 5. / / � o , R L, 001- %,A ORS e i � A �n \ • N af�CJ �� y PO `"s vl� TCF N ; ZEE `.V"`.. �,/; iT• �� !�. ao Air c Q AS 'few, 931 o N:lf N• f , mss"0 701, ^ ��j \'��.: ' _ - •�_. .•.mow,:.- ,. .. P �yc�i�O� `rcOV ZZ 5• 169 eOaOV►a gyp. � po\5J4t•Gp SURVEY FOR OF NEIy DAVID LA FRENIERE 81 JENNIFER. LA FREN IERE W. r y��1 LOT NO.40, HIGHPOINT MEADOWS, SECTION TWO" CO AT SOUTHOLD DATE OCT. 5, 1998 R * TOWN OF SOUTHOLD SCALE I"= 40' SUFFOLK COUNTY, NEW YORK NO 98 -0595 %UNAUTHORISED ALTERATION OR ADDITION TO THIS -CERTIFIED T0= C7 /, SURVEY 6 A VIOLATION OF SECTION 7209 Or THE F 458 �V NEW YORK STATE EDUCATION LA r DAVID LA FRENIERE �l'41YV� %COPIES DI THIS SURVEY NOT LEARNO THE LAND JENNIFER LA FRENIERE �u A sURVEYON•S INKED SEAL OREMw33ED SEAL 5HALL LORRAINE �MANDEL NOT BE CONSIDERED TO SE A VALID TRUE COPY COMMONWEALTH LAND TITLE INSURANCE %GUARANTEES INDICATED HEREON SMALL RUN ONLY TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY 13 PREPARED COMPANY AND ON NIS BEHALF TO THE TITLE COMPANY,GOVERN- LAWYERS TITLE INSURANCE COMPANY % NEAREST WATER /AIN—MI _ III SOURCE OF WATER+.PIIIWITE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED- R SUFF CO. TAR MAP OST JMSECTION-0_BOCK_6_LOT IS.{3 HEREON,AND TO THE A331GN91ES OF THE LENDING MTNCRE ARE NO DWELLINGS WITHIN 100 FEET Of THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE OTHER THANATTER SUOSE SHOWN AGEHEREONDIS TO ADDITIONAL INS TITUTNRNb OR SUBBLOUCNT / N THE CONFORM f TO T AND SEWN DISMAL TO l STFTLK FOR TY RLP DEPARTMENT OWNERS WILL ALTH TO THE STANDARDS OF TOE SUFFOLK COUNTY D[►ARTM[MT N O XISTI E3 SHOWN HEREON FROM PROPERTY ONES o OF NULTN SERVICES TDE%ISTIN6 STRUCTURES NOES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TORE USED ON ESTABLISH APPLICANT- PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS TEL 400 YOUNG S YOUNG RRRHEEAAD,,NwYOR"`K'E NOTE , III=MONUMENT FOUND n' STAKE SET ALDEN W.YOUNG,PROFESSIONAL ENGINEER SUVISION MAP FILED IN THE OFFICE OF THE CLERK OF - AND LAND SURVEYOR N:Y.S.UCENSE NO 12845 SUFFOLK COUNTY ON MAR. 19,1990 AS FILE NO.8911. o HOWARD W YOUNG, THE LOCATIOIOF WELL(WI,SLPTIC TANK(STIBCESSPODLs(C►I'BMOW/WNIEREON O. M LANG SURVEYOR 9 ARE FROM FIELD OBBEWN RTMN3 AMD ONDATAOBTAIRED PRIOR OTHERS N.Y.S.LICENSE N85693 Z.B. SRANDIS A SONS INC. N%, o � o , m 1 ; � II , tl i �, —a .t i� � ;I I i t ,I I �_✓�t'.�A..t�3IrJ °'�f � :.•.,. .- r W " m it 1 V3 L cc Q'i 0 Tr - 1 { i{ 1i it i t it I I 71 14;I 'rl E~t .Ce{�Ilat{ PaFLO:�z� �`4�'��` OCCUPANCY OR AMN ;L41 Pl.i'•i.BF USE IS UNLAWFUL 1/4pc I ��; " �"ttlf�' " �� ,RWT CERTIFICATE OFQCCUPANCY , r1 d�` r=�D AS N0TEO.2 S�-- Y- FEe�A_BY: i' _ NOTIFY BUILDING D ARTMENT AT 765-0502 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: i'J, L FOUNDATION • TWO REQUIRED a FOR POURED CONCRETE ROUGH - FRAMING t PLUMBING _ INSULATION " 5! • FINAL • CONSTRUCTION MUST L� BE COMPLETE FOR C.O. U ALL CONSTRUCTION SHALL MEET yy - THE REQUIREMENTS OF THE N.Y. j STATE CONSTRUCTION 6 ENERGY 3 0 4" CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Q s a