HomeMy WebLinkAbout30111-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, ~.Y.
CERTIFICATE OF DCCUPANCY
NO: Z-30087
Date: 03/16/04
TI~IS CERTIFIES that the building
ADDITIO~
Location of Property: 1435 WEST CREEK AVE
HOUSE NO.) (STREET)
County T~i~ Map NO. 473889 Section 103 Block 13
S~bdivision
Filed Map No. Lot No.
CUTCHOGUE
(HA2~LET)
Lot 32
conforms substantially uo the Application for Building Permit heretofore
filed in this office dated FEBRUARY 23, 2004 pursuant to which
Building Pe~t No. 30111-Z dated FEBRUA~RY 24, 2004
was issued, and conforms uo all of the requlremenus of the applicable
provismons of the law. The Dccupancy foz which this certificate is issued
is "AS BUILT" R3~ISED BRICK PATIO ADDITION TO 3~N EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to JOHN K & ANN M SWEENEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~ALT~ APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
oriz e~ Signature
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
COMPLETION OF THE WORK AUTHORIZED.
FULL
NO.
30111 Z Date FEBRUARY 24, 2004
Permission
lfor :
zs hereby granted no:
JOHN K & ANN M SWEENEY
W~ITESTONE,NY 11357
iCONSTRUCTION OF AN "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE
FAMILY DWELLING AS APPLIED FOR
at premises located at
1435 WEST CREEK AVE
CUTCHOGUE
county T~ Map No. 473889 Section 103
pursuant to application dated ~EBRUARY
Building Inspector to expire on AUGUST
Block 0013 Lot No. 032
23, 200% and approved by the
24, 2005.
Fee $ 300.00
Authorized Signature
Rev.
s/8/o2
ORIGINAL
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPm~%~ ( TL~ ~ ..... '~'~ 'i
~s a~cat~on must be filled ~n by t~ewnter or ~ ~d su~ed to the B~di~ D ~t .t e ~mg:~
A. For new building or new use: ~ ~,~6(~,~. ..... 1. Fi~ s~cy of pmpe~ wi~ acetate tocation of ~1 b~l~ngs, propc~y ~es, s~ee~s, ~~~
topo~ap~c feazes ~~
2. F~al A~rov~ from H~ D~t. of water supply ~d sewerage-disposal (S-9 fo~).
~p~ ofe~et~c~ ~s~tion ~ Bo~d o f Fire Und~fiters.
4. ~or~, .'~tcm&~: fiom!~l.,nbc~ c~;~; ':inv thatthesoldcrused~systemconminslcssth~2/10ofl%lcad.
5. ( 'om::w:'ch.! Imi.din,,.. i,'da~'~ ~a, Im~hli,~,. m~fiplc ~s~danecs ~d s~milar b~l~ngs ~d ~st~fio~. a cc~ficate
ofC9de ~ce ~0m ~c~tcct o~ en~ncer respo~b[e for ~e buil~ng.
6. S~ ~g Bo~d ~ova1 of complied site p~ r~u~emems.
For eXit. ting buil ~dings (prior to April 9,1957) non-conforming uses, or buildings and "pre-existing" laud uses:
1. &ecurate survey of ploperty showing all proper~f lines, s~eets, building and unusual natural or topographic
features.
A properly co .mpleted application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
den/ed, the Building Inspector shall state the reasons therefor'in writing to the applicant.
Fee8
1. Certificate of Occupancy - New dwelling $25.00, Additions ro dwelling $25.00, Alterations to dwelling $25..-~0.
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00.
2. CertlficateofOecupancyonPre-existingBuilding- $i00.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary C6xtificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building:
Location of Property:-''>~'- [ q ~_~ ~'~ ~,~2~" ~//~d:~7/¢
House No.
Owner or Owners of Property5>'- ,,~p/~/c,/
Suffolk County Tax Map No 1000, Section
Subdivision ~---~- ~
Permit No. 3 o t ( l .~
Health Dept. Approval:
Street
'/~ ~'~ Block ~3
Filed Map.
Date ofP~t. ~~ Applic~t:
~-~ Unde~riters Approve:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~ ~' ~
Final Certificate:
tcheck one)
Hamlet
Lot
Lot:
(_
Applicant/ ~ t O~
Owners Name: ,,-,
/
Architect/ ~-
Engineer:
SCTM ~:
District: I~000 Section:
Reviewed:
P,'ojec~ ~___~_ ~ Subdivision
~. . R~q.
~FronhY=d~ Fro~s~: ¢~[SideYard&/~ Propose:
Project Description: /~ ~/'"?J-~&&_]~-~d~.,fl
REOUmEn FOR R~VmW
Permit
N.A. NO YES Number
Suffolk County Health Dept.
New York State D.E. C_
Town Trustees
:'Fown Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation 777
Flood Zone:
Notes:
Town Hall. 53095 Main Road
P.O. Box 1179
Snuthold~ New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOI
November 12, 2003
John.K=& 4Lrm. M. Swee~ey
12-27 i 526u Street
Whitestone, N.Y. 11357
Re: Premises ~ 1435 West Creek Ave., Catchogue. N.Y.
Stiff. Co. Tax Map #1000-103.-13-32
Dear IVh'. &Mrs. Sweeney:
tt has been brought to the attention of the Building Depmtment that a raised deck addition has~been
constructed on the above dwelling w~thout first obtammg a building~pemut.
According to the Code of the Town of Southold. a Building Permit is required before any consumction can
be undertaken.
Please contact this office as soon as possible so this matter can be resolved
I thank you for your anticipated eooperatiom
Very tmiy yours,
SOLITHOLD TOWN BUILDING DEPT.
Bdildhtg Inspectox
(Cert. Mail/
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLB~,
[ ] FOUNDATION 2ND [ !
[ ] FRAMING [~-I~JNAL
[ ] FIREPLACEr 8: CHIMNEY [ ] FIRESAFETY INSPECTION
REMARKS: ~~~:~ //
DATE
FO~DATION (1S~
ROUG~ ~G &
PL~G
~'SL~ATION P~ N. Y.
STATE ENERGY CODE
- ww~. norflffork.n~ffS0uthold/ PERMIT NO.
Exam/ned
Approved
Disapproved aJc
Expiration
BUILDING PERMITAPPLI
Do yon have,or need ~e following~,bef6~ectpplying?
Board of ~ealtk
3 sets of Building Plans.
Planning Board approval ,, _
Snrvey
'
N.Y.S.D.E~C.
Tmst~es-
Contact:
Mail to:
APPLICATION FOR BUILDING PERMIT
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 pict 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, a~d waterways.
c. the work covered by this application may riO~ commenced before issuance of Building Permit.
~ d. Upon approval of tiffs application, the Building In~pecror will issue a Building Permit to the applicant. Such a penrdt
shplt be kept on the pren~ises 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 OccuCancy.
f. Every building pe/mit shall expire if the work authorized has not commenc:d within 12 months after the date of
issuance or has not been completed withui 18 months from iuch date. If no zoning amendments or other regul~t~ong, affec .t!ng the
property have been ermcted in tire interim, the Building Inspector may authorize, in writing, the extension of th~ permit foi~an
addition six montha. Th~reaiier, a. new permit shat[ 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 Sonthold, Suffolk:County, New York, and other applicable Laws, Ordinances or
Regtdations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees ~o comply with all applicable taws~ ordinances, building codpsq~oasin~g code, and regu~,~ ions, and to admit
authorized inspectors on premises and in building for necessary inspections.
//~- (M"U'gnature ofapp~ ' c '
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, acchitect, engine~, general contractor, electrician, plumber or builder
Name of owner of premises
(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. 1 9~/ .-?
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location 9fland o_n which proposed work~w~l! be done:
House Number Street
County Tax Map No. 1000 Section ~
Subdivision ~/
(Name)
Hamlet
Block ] ~
Filed Map No.
~2., .State-emOting use~fl occup~f~p~enuses and intended use and
, ~. Existing use marl oceupancy_
3. Nature of work (check which applicable): New Building
?~epair Remo~r/~i' Demoliffon
4. Est/mated Cost
Fee
5. If dwelling, number of dwell/ng units
If garage; .number of cars
Addition Alteration
Oth Work
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
If business, commercial or mixed occupancy, specify nature and extent of each type of pse:
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear Depth
Dimensions of same structure with alterations or additions: Front
Depth Height - Number of Stories
8. Dimensions of entire new construction: Front Rear
Height Number of Stories
Rear
Depth
9. Size of lot: Front
10. Date of Purchase
R. ear
Name af Former
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__
13. Will lot be re-graded? YES__ NO__Will excess fill be removed from premises? YES__ NO__
I4. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor ~,d/f a~t~ Ilar. .... '¢dddress ~ ~,u~Phone No.7-.~ ¢,z,~,~-~j ~ ~7
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES __NO J * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property with'm 300 feet of a tidal wetland? * YES__ NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, m 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:
K,~ ~,/_ '~ ~./h~,~-~-~_ _ being duly sworn, deposes and says that (s)he is the applicant
con
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this applkaztion;
that ali statements contained in this application are true to the bes~ 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 ~
Lg__ of OJl- _20.
Notary
PAULETTE HERNANDEZ
Notary Publio, State of New Yolli
No. Ol HE6066641
Oualified in Queens County
Commlssion Expires November 1~, 20-
00'0c_
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'NI!AI 0-,~'
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