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Home My WebLink About30356-ZFORM NO. 4 TOWN OF SOUTROLD BUILDING ~EPA~MENT Office of the Buildin9 Inspector Tow~Rsll Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30393 Date: 08/31/04 T~LIE CERTIFIES that the huild/n~ ADDITION Location of Property: 230 DOGWOOD LA EXT (ROUSE NO.) County Tax Map No. 473889 Section 37 Subdivision EAST MARION (STREET) (HAMLET) Block 1 Lot 6 Filed Map No. Lot No. __ conforms subst~tially to the Application for Buildin9 Permit heretofore filed in this office dated MAY 24, 2004 pursuant to which Build~n9 Per, nit No. 30356-Z date~ bL~Y 26, 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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to NANCY R OETINGER & JEAN O. HOGAN (0~ER) of the aforesaid buildin9. SUFFOI~KCOUN~IDEPARTMENT OF H]~ALTHA~PRO~-AL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/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) , pE~%{I T NO, 30356 Z Date MAY 26, 2004 Permission is hereby granted to: NANCY H OETINGER 30 HOLLYWOOD AVE LYNBROOK,NY 11563 for : CONSTRUCTION OF k DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 230 DOGWOOD LA EXT EAST MARION County Tax Map No. 473889 Section 037 Block 0001 Lot No. 006 pursuant to application dated MAY 24, 2004 and approved by the Building Inspector to expire on NOVEMBER 26, 2005. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN~Sd20F $ ~ijT?40,, -O ' ¢ Form No. 6 TOV~N OF SOUTItOLD BUILDING DEP.~RTMENT TOVCN I-L&L L 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by bq~ewriter or ink and submitted to the Building Department Mth the follox~4ng: For new building or new use: 1. Final sm'vey of property '~,ith accurate location of all buildings, property 1/nes, streets, and unus~_ml natural or topograplfic femures. 2. Final Approval fi:omllealtkDept, of water supply and sewerage4isposal (8-9 form). 3. ,Approval of electrical installation from Bom-d of Fire Undenvriters. 4. Sworn statement fi:om plumber certif34ng that the solder used/n system contgms less than 2/10 of 1% lead. 5. Commercial building, Lud~tiLal bm[ding, multiple residences and sLmJ/ar build'mgs and installations, a certificate of Code ComPLiance From amhitect or engineer responsible for the building. 6. Subml~ Plmming 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 shox~4ng all property lines, streets, braiding and tmnsual natural or topographic features. 2. A properly completed apphcafion and consent to inspect signed by the applicant. If a Certificate of Occupancy is denie& the Building Inspector shall s~te the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, .~.dditio~s to dwelling $25.00, Allerafions to dwelLhig $25.00, Swimmiug pool $25.00, Accessory bmldiug $25.00, Addifions to accessory building $25.00, Businesses $50.00. 2_ Certificate of Ocanpancy on Pm-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate ofOcanpancy - $50_00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: House No. Owner or Owners of Prope~y: Old or Pre-existing Buildiug: Suffolk County Tax Map No 1000, Section ~ 7 Subdivision Perm/tNo...~03~"'(o ~._ Date. Health Dept. Approval: Date of Permit. Street Block / , Filed Map. 6 App~c~t: Undem~ters Approval: ,/ (check one) Hamlet Lot ~0 Lot: Planning Board Approval: Request for: Temporary Certificate Fee Subrmtted: $ ,-.~2 ~ , v-'o ~ Final Certificate: (check cue) ,(~.Applleant Sigrmtttr&_~ Applicant/ Owners Nane~/t./ Archi tect/ Engineer:. '~ SCTM ~: Dislrict: ],000 Secdo.'~ I~lock' __ Sinale & separate Required cel~ficaiion: ( Yes / No Project Description: Lot: ;~ ~r'l Subdivision ~- ~ '~' " l. Name: AGENC~,tERMITS REQUIRED FOR REVIEW N.A. NO. Permit YES Number Suffolk Comity Health Dept. New York State D. E, C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation 777 Flood Zone: Notes: 765-1802 BUILDING DEPT. //INSPECTION [~/] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: /~~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ULATION [ ] FRAMING [ *,/J FINAL [ ] FIREPLACE & CHIMNEY REMARKS: INSPECTOR Examined Approved Disapproved a/c ,20 Expiration 20. t~''/ BUILDING pERMIT APPLICATION ¢HECKI}~, Board of He.a.a.a.a~ ~ '- ' 4 sets of Bu~liline Plans Planning Board approxmt Surves( . Septic, Form N2Y.S.D.E.C, Trustees Contact: Mail to: ../Buildih = Ir~pector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date Ph~)ne: a. This application MUST be completely filled inby typewriter or in ink and submitted to the Building Inspecto? with 3 . · sets of plans, accurate plot plan to scale. Fee according to schedu/e. b. Plot plan showing locanon of lot and of buildings on premises, relationship to adjdining 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, ~be Building Jnspector will issue a Building Permit to the apphcant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied dr used in whole pr in part for any purpose what so ever tmtil the Building Inspector issues a Certificate 6f Occupancy. f. Every building permit shall expire i/the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months fi:om such datek-If no zoning amendments or other regulations affecting the property have been enacte{in the interim, the Building Inspector may au~6rize, in writing, the extension of the permit for an addition s/x nion~hs. Thereafter, a new permit §hall 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 Regq~lations, for the Construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply 5vith all applicable laws, ordinanees,.buildmg code, hoUsingcode, and regulations, and to admit anthori/ed inspectors on premises and, in building for necessary inspections. (Si~n,~lure of applicant or name,;it corporation) (IV[ailing address of applicant) aeoo/G State whether applicant is owner, lessee, agent, architect, engqneer, general contractor, electrician, plumber or builder Name ofoxxmer of premises ~-E ~ ,w (5)_ ~t2/~ ~,O-~/ (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: House Number Street CountyTax Map No. 1000 Section Subdix4sion Hamlet Filed Map No.. LoC, 2. State -e~tstmg'~e~aSnifl occupancy of p~:enmses anti mtenaea use aha occupancy qx proposea'comcq0n. a_ Exj,sttng use and occupancy b. Intended use and occupancy 3. Nature of work (check whichalyplicable): New Building Addition Repair Removal Demolition Other Work 4. Estimated Cost ~ 0~, ~ Fee 5. If dwelling, number of dwelling umts If garage, number of cars O~ 6. Ifbus'ihess~' commercial or mixed occupancy, specify nature and extent of each type of use. Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor r · Rear of Stories 7_ Height [~ ~,~ NumberFr°nt Dimensions of existing structures, if any: ~3~ ~ Dimensions of same structure with alterations or additions: Front Depth ~ L Height 8. Dimensions of entire new construction: Front I q Height Number of Stories 9. Size oflot: Front 17O Il Rear qo" Rear Number of Stories Rear ) ? Depth h3 Dep l ¥6. 10. Date of Purchase Name of Former Owner 11. Zone or usc district in wh/ch premises are situated ,~ ~/JO 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~// 13. Will lot be re-graded? YES__ NO JWill excess fill be removed from premises? YES__ 14. Names of O~mer of premises :~a F~M F) 0 G ~,v Address Do/-1o k/- yu)oval/-J'v&Phone'No. ~6'//, Name of Architect Address L~/M-g R.wo~fl-~,Phone No. Name of Contractor 7 Address · t/,5'b~5 ~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 ~vithin 300 feet of a tidal wetland? * YES__ NO __ * IF Y'ES, D.E.C. PERMITS 1VL~Y BE REQUIRED. 16. Provide survey, to scale, with accura{e foundation plan and distances to property lines. 17. If elevation at any point on property STATE OF NEW YORK) SS: corn, try ovSo. c (Name ofindi'~'idual s/sning contract) (S)He is the at 10 feet or below, must provide topographical data on survey_ being duly sworn, deposes and says that (s)he is the applicant bore named. (Contractor! Agent, Corporate Officer, etc.) dl I t d of said ow'ncr or oxvners, and is u y authorized o perform or have performed the sai work and to make and file this application~ that all statements contained in tkis application are tree to the best of his laxowledge and belief; and that the work will be performed in the manner set forth in the epp~cation filed therewith. Sworn to before me this. tx ,q I ,, Notary Public LYNDA M. BOHN NOTARY PUBLIC, State of New York No. 01 BO6020932 Qualified in Suffork County..~ Term Expires March 8, 20 ~ Signature of A~P-l~/cant BE CQ~PLETE FOR C.O. ALL CONSTRUCTION SHALL MEET 'Il. IN :REQUIREMENTS OF THE CODES OF NEW ,YOFIK ~TATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. .. ,,,~. ,. cO.ST,UC'r~o. ~ OCCUPANCY OR D ,NOTED / ~ .~ NOTI~ ~I~ING DEPAR~E~ AT '~p -~" NAILING & F~OW~G ~SPECT~N8: [ ' ' "~--' 1. FOUNDA~ - ~O R~RED A~ C~TRUCTION ~NA~.~ ~R ~EO .C~C~E ME~ THE REQUifiEMEN~ OP ~N~ ., USE IS UNLAWFUL W!THOUT CERTIFICATE OF OCCUPANCY