HomeMy WebLinkAbout30478-ZFOPd~ NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30352 Date: 08/11/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 605 SEAWOOD DR
(HOUSE NO_) (STREET)
Colu~ty Tax Map No. 473889 Section 79 Block 7
SL~odivislon
Filed Map No. -- Lot No. --
SOUTHOLD
Lot 66
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~3LY 12, 2004 pursuant to which
Building Permit No. 30478-Z dated JULY 13, 2004
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 ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR "AS BUILT".
The certificate is issued to DAVID G & MARY ANN FEAVEL
(OW~mR)
of the aforesaid building.
SUFFOLK COUN~f DEPARTMENT OF }~ALTH APPRO%L~L
ELECTRICAL CERTIFICATE NO.
pLI~MBERS CERTIFICATION DA'£~U
~Z/A
N/A
Authorized 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 FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30478 Z Date JULY 13, 2004
Permission is hereby granted to:
DAVID G & MARY AAIN FEAVEL
PO BOX 1659
SOUTHOLD,NY 11971
for :
AS BUILT ACCESSORY SHED IN THE REQUIRED REAR YARD AS APPLIED FOR
BUILT PRIOR TO 2003
at premises located at
County T~ Map No. 473889 Section 079
pursuant to application dated JTJLY
Building Inspector to expire on J~LNTJARY
605 SEAWOOD DR SOUTHOLD
Block 0007 Lot No. 066
12, 2004 and approved bythe
13, 2006.
Fee $ 150.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOVGN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN IL~LL
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:
i. Final sm'vey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Fitml Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation fron~ 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 histallationa, a certificate
of Code Compliance fi.om arckitect 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:
i. Accurate survey o£property showing ail property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to hispect 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, .Mterations to dwelling $2~d90,
Swirnming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. CertificateofOcanpancyonPre-existingBuilding- $1r00 00
3. Copy of Certificate of Occupancy- $.25
4 Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $ f 5.00, Commercial $15.00
New Construction:
Location of Property:
House No.
Owner or Owners of Property:
SuffoLk County Tax Map No 1000, Section
Date.
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Old or Pre-existing Building: )~
Street
Block
Date of Permit.
I
Request for: Temporary Certificate
Fee Submitted: $
Filed Map.
. Applicant:
Underwriters Approval:
(check one)
Hmnlet
07 Lot
Lot:
Final Certificate:
(check one)
,kpplicant Slgna(-m e
Applicanff .: '"
Architect/
Engineer:
SCTM/~:
Dislricl: 1,00.0 Section: , Block
'Reviev,,ed: ~
Submitted:
Projecl ' ' '
t.oca,ion: ,~o g"'
Single & ~eparale Required
(-erhficadon: (Yes / No)
/~
Project Description:
Subdivision '
Name:
AGENC~,JPERI~ITS
REQUIRED FOR REVIEW
Suffolk Cotmty Health' Dept.
New York State D. E: C.
Town Trust.s ·
Town Zoning Board approval:
Town Plinning Board approval:
Flood Plane Elevation ???
Flood Zone:
.j
Permit .
NO YES Number
NOtes:
Southold, :q '
3
i
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTtFICA';,.r-
OF O¢_,CUPANCY
UNDERWR~RS OER~FIOA"~
RE~II:ED
9×4 ~" '-' ¢-~m~ i 600
7111 sheathing
i 2x8 too, ra~ters
~ asphalt ~,,.
2-2~!0 hesdsm ~hova doors
APPROVEDASNO~D
~0
REQUIRED
FOR ~URED CONCRETE
Z ROUGH - FRAMING & PLUMBING
3, INSU~ON
4. FINAL - CONSTRdCTION MUST
BE COMPLETE FOR C.O.
~L CONSTRUCTION SHALL ME~ THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE ~R
DESIGN OR ~NSTRUCTION ~RORS.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~"~1NAL
[]FIREPLACE&CHIMNEY[
REMARKS:
] FIRE SAFETY INSPECTION
TOWN OF SOUTHOL,~ ~: ?-~..~" ." ' .'
BUILDING DEPARTMI3~
TO*WN HALL ;: "' I~ '!
,,_. ..- I 2 2004,
SOUTItOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502 ~----~-£:~ .... ..
w*~mr, northfork.net/Southold] PER311T NO.
Examined 7/~/~ ,20--o/
Approved ~3 ,20 o~/
Disapproved a/c
Expkafion ' //~ ,20Z2~_'
BUILDING PERMIT APPLICATION~CriECKLIST
Do you have or need the following, befor%applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey_
Check
Septic Form
N.Y.S.D.E.C.
Tmstees
Mailto: ~30 ~Olt
Ik;,Jd,
Phone: 7 ti 7
! Bulldfiag Inspector
APPLICATION FOR BUII~DING PERMIT
Date
INSTRUCTIONS
,2005/.
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets ofplarm, acenrate plot plan to scale. Fee according to schedule.
b. Plot plan showing location oflot and of buildings on promises, 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 premises 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 xvithin 12 months after the date of
tssusnce or has not been completed witkin 18 months fi.om 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, mad regulations,)~td to admit
auth°rized inspect°rs °n premises and in building f°r neeessaw inspecti°ns' //j~)~
(Sxguature o a'~pplicant or n~me, ifa corporation)
(/Via/ling address of applicant)
State whether applicant is owner, lessee, agent, axchitect, engineer, general contractor, electrician, plumber or builder
Na.meofownerofpremises bsivld, h,,~d J~v'., ~q .F'~tvg/
(A(s 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 LicenseNo.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed ~vork will be done:
House Number Street
Hamlet
County Tax Map No_ 1000 Section
:~S.ubdi,dsion
(Name)
Block tO 7 Lot
Filed Map No. Lot
State ~.-x~sting use and occupancy of premises and intended use and occupancy ofpr0posed con~tmction:
.~i. Existinguseandoccupancy q~,^~l~ ~'~,!~t ~I~t..]],.~ :,
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building. Addition
Repair Removal Demolition Other Work
Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
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
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear
Height Number of Stories
9_ Size of lot: From /&2' Rear ]~0 1 Depth
Depth
Rear
10. Date of Purchase
Name of Former Ox~mer
11_ Zone or use district in which premises are situated ~ t~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO/~
13. Will lot be re-graded? YES__
14. Names of Owner of premises
Name of Architect
Name of Contractor
NO )~ Will excess fill be removed from premises? YES
t~.ta~ ~-~q~tt ~,l Address ~o..~ 5*,~{h'-
~ ~Phone No.
Ad&~s Phone No
Address Phone No.
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 X
* 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:
COUNIY OF )
btt~,,~_ & ~'~ ~'_ ] being duly sworrk deposes and says that (s)he is the applicant
CName of individual signing contract) above named,
(S)He is the ~)ed ~4-r
(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 l'fis knowledge and belief; and that the work,~dll be
performed in the mariner set forth in the application fried therewith.
Sworn to before me tiffs
/,~-T~ clay of ,k~/-'h 200~
~' JOYCE M. WILKINS
Notary Public. State of New York
No. 4952246, Suffolk County
Term ExDires June 12.(:~%