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HomeMy WebLinkAbout30542-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30340 Date: 08/09/04 THIS CERTIFIES that the building REPAIR Location of Property: 2386 HYATT RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473869 Section 54 Block 1 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 3, 2004 pursuant to which Building Permit No. 30542-Z dated AUGUST 4, 2004 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancv for which this certificate is issued is "AS BUILT" REPAIRS TO 2T EXISTING ACCESSORY GAZEBO AS APPLIED FOR. The certificate is issued to JANET WOCKENFUSS, TRUSTEE (OWNER) of the aforesaid building_ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Autho ized Sign ure 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. 30542 Z Date AUGUST 4 , 2004 Permission is hereby granted to : P MOORE FOR WOCKENFUSS 51020 MAIN RD SOUTHOLD,NY 11971 for "AS BUILT" REPAIR OF AN EXISTING ACCESSORY GAZEBO AS APPLIED FOR at premises located at 2386 HYATT RD SOUTHOLD County Tax Map No. 473889 Section 054 Block 0001 Lot No. 004 pursuant to application dated AUGUST 3 , 2004 and approved by the Building Inspector to expire on FEBRUARY 4 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING 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 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 I. 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. August 9, 2004 New Construction: xx Old or Pre-existing Building: (check one) Location of Property:____ 2385 Hyatt Rd Southold House No. Street Hamlet Owner or Owners of Property: Janet WockenLtiss, Trustee Suffolk County Tax Map No 1000, Section 54 Block Lot 4 Subdi-Osion Filed Map. Lot: Permit No. 30542 Date of Permit. 8/4/04 Applicant:_ Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: sx (check one) Fee Submitted: $ �s_aan tcc 30:�,O f2""S 97 Applicant Signature Applicant/ Date Owners Name:, INoc .-j,�_ . Reviewed: _ Architect/ Date Engineer. _ _ Submitted: 443 �_ SCTM #: Districc 1 000 Section: 5/ q- Block: _ Lot: Subdivision Loca(ion: dio & � Name:__ Sink& separate Required Comriication: tYes!Nol Req. Rey. /nnil)g I)islricC ([At size:/ Acwal._ I (W coverage PlVplucd Req. lFmnl Yard Proposed:�J (Side Yard Proposed: I (Rear Yard _ Pruposcd' Project Description: i AGENC=ERMITS Permit REQUIRED FOR REVIEW N.A.. N-0- 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 77? p Flood Zone.- t M • - TOWN OF SOUTHOLD PROPERTY RECORD CARD �� OWNER STREET c;2 VILLAGE DIST. SUB. LOT F�ORMED OWNER N E ACR. ,•--Jad' of )ockPY") I-(,-t 5S ^.R.,. ' I•'c.+" -�,•s,a. -M",..+°+w „a...4�. e �' I -._.5,_•� , A_ -�. S W TYPE OF BUILDING ? n R �. SEAS. VL. 1513 FARM COMM. CB, MISC, Mkt. Value LAND IMP, TOTAL DATE REMARKS Q�'"�� . !9" G"'_`.�y �l�,7 •� u./..:�--» .,�4�..ck -::.,i�" �'6•�;"� 7 ,:g+'= �e:�:F �1 6 / ��L 1134 a 7 �C�PV C7ts� �u ln� C��n�Z�sS Biu � NIL 3 /R �p,� 88� r1�ti cduJe,l E i rl . �a�c�cu.Q.�-,P�/.r✓/— AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 vVoodland 3wa.mnpland FRONTAGE ON WATER 3rushland FRONTAGE ON ROAD ` House Plot DEPTH BULKHEAD Total DOCK 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: e . o . t DATE �/� �� INSPECTOR /Y' �' TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEIFARTMENT Do you have or need the following,before applying-9 TOWN HA'L Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 ,, Survey my w.northfork.net/Southold/ PERM /�0 IT NO. _ Check Septic Form N.Y_S-D.E.C. Trustees Examined 20_ Contact: Approved Q/ ,20e99� Mail to: Disapproved a,c Phone: Expiration_ �LL 200� Building Inspector APPLICATION FOR BUILDING PERMIT 3 2€004 Date 20 D_,T a INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 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 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. (Signature of applicant or name,if 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 %�� W27 Gl� (As on he tax 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 propp`osed ork will be done: Z � / 3 (,/7 Aw House Number Street Hamlet County Talc Map No. 1000 Section S�j Block Subdivision Filed Map No. Lot.-: (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 9� — Ubu MZ 7� k / „l b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair X. Removal Demolition Other Work (Description) 4. Estimated Cost 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 3. 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 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 Will excess fill be removed from premises? YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor 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 we ithin 300 feet of a tidal wetland? * YES NO * 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) S: COUNTY OF ys J&Jt, 4� Ci �G�71-e— being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the ontractor 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 this N Lary ublic Signature of Applicant MELANIE DOROSIO NOTARY PUBLIC,State of NewWeS{ No.91D04634870 Qualified in Suffolk Coun Commission Expires September 14L— SURVEY OF PROPERTY W AT HOR T ON' S POINT TOWN OF SO UTHOLD SUFFOLK COUNTY, NE W YORK 1000-54-01 -04 , a SCALE: 1 =40 Dov. 27. 2040 LIEC. I1, 2000 ( prop. hse. 1 Mar. 13, 2001 (additions) q: May 2, 2001 (Slaked Hse. Location) ..' S(7.0 . tiV • , dv JUNE 8, 200! ( certiflcallon ) F (h`!�p /►�� �;i% T' \ SEPT. 25, 2002 (revision prop. hss) �C/TT t T"/ Hole 01 or. Loam Clay N A 2. C e��A y� o f � �, o �iQ��c � ti��` f�i�r ✓, - aro wn Al ,Q .toy CL Fine )o Coarse t Sornd SPfis' 0 ANY At_TERA TION OR ADDITION To THIS SuKe vE r IS A VIOL A Ti OPS ©o- �ti OF SECTION 7eO9 OF THE NEW YORK STATE EDUCA?ION ; 4,w " p • ' CERT, ICATI�?h„S .•' � .` MO EXCEPT AS PER SECTION 7209-3; 2. ALS y. HER£t7N ARE vALID f QR THIS MAP AND COPIES THEREOV ONLY IF � SAID mAP Q0 COPIES, BEAR THE IMPRESSED SEAL OF THE StJRVEYJR ' WtC SIGNATURE APPEARS HEREOF.' NEW yon 1 C& I am Far�;t�ar with the S i ANDARvS FOR APPROVAL �rcO JANCT '' t.rnerxQe AND CONSTRUCTION OF SuBSURFACE r � FRAIWK 11► SUSS DISPOSAL SYSTEMS FOR SINGLE ��rs_�� KE;ITE�� t S X= Loth �. + c fir',, uw^d Will 010;-de ay the `ond; ;ort_. sr o ort t1'te perrr+t to Constr UCt i FIVE _ _ l' � �� __ : •`�__ Hyt_"_= T41,� l^C.; torr c� well= and r-esspoots s ;Owr i of-eor: are CONTOUR LINES ARE�REFEF, SEI; 'r0 t n or NP t k r;)-tG r,r'a f 1-orq oth-e'- s EASTERN TOWNS TCxPUf�R�P MAPS (NGVD.) �r _ / from ie�C OSe vC� .iOP�S A yI t coA-TAL EROSION HA2ALPP L lkRa a :0QSTAr_ p ^x „ Etevat!ors are re+er_enceot to or pssurne F'ROSION MAP PHO 'j�{� u=MDNU�tEN'; • J =y O O O E ALL CONS TRUC I ION SHALL /T I MEPT THE REQUIREMENTS OF THE OCCUPANCY OR =ES'OF "YORKSTATE. USS IS UNLAWFUL WITHHQUT CERTIFICATE Q CtCUPANCY -77 3-61.0w CxIR4gE Kri 'r 7e eof / \ �1PPROV AS NOTED B.P.# f/ Z I f , By. .1• + r I I'. ING DEPARTWNr AT 1 - / `. . .. . -• . � ` AM TO f PM FOR THE t. ATION E L I INSP, CTIONS: TWO REQUIRED y / POURED CONCRETE GH • FRAMING & PLUMBING S LATlON I IN L - CONSTRUCTION MUST ! BE OMPLETE -^R C.O. ALL CINSTRUCTION SHALL MEET THE REOUI,iEMENTS OF THE CODES OF NEW — aYORK STATE. NOT RESPONSIBLE FOR / 'OWQ'OR CONSTRUCTION ERRORS. _ — YyINSit cy� gG j _ _ i � I �4,r '�� o� - --•- - ` ���� 22�3� off, O . �� rlY I193S -