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HomeMy WebLinkAbout30429-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30401 Date: 09/02/04 THIS CERTIFIES that the building ADDITION Location of Property: 2200 HARBOR LA CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 1 Lot 27 Subdivision Filed Map No_ Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 16, 2004 pursuant to which Building Permit No. 30429-Z dated JUNE 23, 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 "AS BUILT" DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR- , The certificate is issued to ROBERT C WHITE (OWNER) of the aforesaid building. i SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A_ PLUMBERS CERTIFICATION DATED N/A ' 7/orted 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 N0. 30429 Z Date JUNE 23 , 2004 Permission is hereby granted to : ROBERT C WHITE HARBOR LANE CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN "AS BUILT" DECK ADDITION AS APPLIED FOR. ADDITIONAL CERTIFICATION WILL BE REQUIRED at premises located at 2200 HARBOR LA CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0001 Lot No. 027 pursuant to application dated JUNE 16 , 2004 and approved by the Building Inspector to expire on DECEMBER 23 , 2005 . Fee $ 300 . 00 k' 1 y / a Autho ed gnature i t r i J i J ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTNIENT TORN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Budding 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. V 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 tens than 2;10 of I'Vo 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 Platming 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 convent 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, Swimmingpoot$25.00,Accessory building$25.00, Additions to accessory building$25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine- $100.00 3. Copy of Certificate of Occupancy-$.23 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. 57— O l-f— New Construction: Old or`Pre-existing Building: (check one) Location of Property: 2C 0 t_ 17�WO&CI E_ /V House No. '� Street Hamlet Owner or Owners of Property: C62&,C/2- Suffolk County Tax Map No 1000, Section /r� 3 Block 0 O0 / Lot G Z 7 Subdivision Filed Map.t Lott:A PenNo. 3 0 4 r5 Z Date of Permit. 7' / —O Applicant: 12615 � (.cam/t/i E Health Dept_Approval: __Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate_ Final Certificate: _t� (check one) — Flo Fee Submitted: $ Z J a Lr7C�� Applicant Sigxiature � ra 10L4DI ,y a O tt } D ! D ir ®19 .1 �- K Q A 6i1` jam'€ K ` n w 1+ v ti u H ❑ ILU 9: Wz z i O . O C6 LU` � � � LU I " LA LU o > Q Q : \ O O w '1 ■ O K _ ` LL LL m LLI v > lit O , LLI W oQ > V v O Q vi W � 3 1' O /Q 41. G N C6 -a r a. C' C C7 C 2 dI LU �9 w <b o Q m- m _m o o. ° _ z Q_' .� Q 6 O 6 O 0 m O O —� �!'� Q _ 0 m i 0 z ■■ ■■ ■ ■ ■ ■®ONE■ ■ . .° ■■■■■ ■■■ ■ ■■ ■ ■ No ■..■■....■■ ■■C.■■ ■ ■ is �i■■■■■■■ ■■ ■■■■■■■ Kart�° r;?P1 ° ■■■■�1 ■ ':�5.�■�M■�■■■■■■■ ■ I.w no Ifs . ■■■.��■ . ■■■■ ■■■■ ■ ■� rFr ra � ;9F r � �t ■■�■i1■i�__ ■I�■■■■ ■E�®■■■■■■■ w� lI FA . ■■■■!� ■■o�■■■ ■■■■■■■■■■ ■■■■■■ ■■Im ■■■■■■■■■■■■ ♦ r • Basemen_ _ •®�® • ® PlaceFire ®� • DATE RE UYVED: j�-/x:'04 APPLICANT: CAMT � _" `I_y _ DATE SUBMITTED: &,'-/ 04 SCT11I9DISTRICT 1.000; SECTION: 103 , BLOCK: , LOT: 42� SLB)NISION: ` - . -_ ADDRESS: CITY: t: uc3�O 7_ON1NG DISTRICT: __ CONFORMING^ _— , BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP----Z.1 C10 Z- INFO -Z i C/0 Z- INFO-- 13P -Z/C/0 Z- , INFO ✓/BP -Z/C/0 Z- _, INFO 1 SINGLE & SEPARATE CERTIFICATION-REQLIIRED_ NOTES:— ] LOTS a0,000SF-1002og 4.Lot reenitlon.(CREATED beforeER5 lune 30, 1983),UND17.P0 LATS FROM JAN.1997100-Z5.Nferger.(A nonronforminga[any time afle REQ. LOT SIZE —ACT. LOT SIZE: NO2-CREQ. LKCOV.s,2�ACT. LOT COQ'. REQ. FRONT_ T PROP.FRONT—R . _ e f s ACT. SIDE REQ. REAR -_1z S' PROP. REAR— -/ REQ. HEIGHT PROP- HEIGHT-- PROJECT ROP. HEIGHT _PROJECT DESCRIPTION: ESTMATED PROJECT COST: ARCHITECTdRtMZ=> WATERFRONT? Zt DESCWTION: L #, t�FLOOD ZONX APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DF T: YES or 60>ED #):_DTE:__i__! PEPAflT#: _ TO WN SEPTIC RECEIPT: Y or NEVA'YORK STATE DEC: PRr-DbC 9rtr75 YES ori _DTE: –/ PERMIT #: SOUTHOLD TOWN TRUSTEES: YFS ordM DTE. PERMIT #: TOWN ZONING BOARirs APPROVAL: YES o DTE: PERMIT#: TOWNPLSu1. BOARD'APPROVAL: YES or _–_DTE__/ _/ – 'PEnIIT #: — TOWN HISTORICAL!PRE (SPLIA): YES — NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: --- � �'' ce�n` ---- FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: _ _SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: _ °=)fes SF FEE FEE FEE 1. (—SF)- (_SF)= -_SFX 2. ( SF)- L SF)=---SFX 3. ( ---SF)- (_—_SF)= SFX $-- FINAL TOTAL: S yo 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. j [ ] FOUNDATION 2ND [ ] 1 ULATION ' [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE p. INSPECTOR /✓� �/ 1 FIELD INSPECTION REPORT - DATE COMMENTS � ro FOUNDATION(1ST) �- at -------------------- FOUNDATION(2ND) ----------FOUNDATION(2ND) . z o ROUGH FRAMING& y PLUMBING f 5 y .a r INSULATION PER N.Y. 3 STATE ENERGY CODE iQclo FINAL ADDITIONAL COMMENTS ' -O y�''o SURVEY OF PROPERTIES 5ITU,4TE: GUTGHOGUE TOWN: 50THOLD N SUFFOLK COUNTY, NY �I 5URVEYED 0-1-11-02 SUFFOLK COUNTY TAX u ` 1000-103-1-21 1000-103-1-20 GElft'TMW TO: I =m obe[4 VVhnte I li 1®9 y N N lll IJ � I Land N°�� or Fornerly of Lloyd 011vor I 140.00' 01 10 O a itamorm! O GAO a✓3 91 e O O WOCd Fence . OIUT•- ��4 A ILA roe 00 I o I 3e o 2 Story p 111 _ 1 tit I prQme O O 00 I House % O io e�imR,inaas - � a I 1 = I al Tax lot 1000 2-1 5 C. 631-126) le. (Deed 'lot L 62 o I 140_MM .W - S820010 �- �C cn� �07 G ' 14pM f �21 po z Nbz -00 1011 3 i �s, 82°p1 E I; 1 ° I I ,`.3. 103-1-20 � 11 lot 1000- 156) O I (Deed ReF- L 10310 C-P O NQ I o 0 8 Na O RC � I plonaj Ilne wood fen W- 140-W 40 � 1 �w* I va wpocd fent' pll obi 8`02 01 Land Now or Phy ` D. Zwary� - ° 1 y °F 1, ghe'da ?.nn Gh!anda I I I i NOTES: �QEy� �0 - .r. - +� MONUMENT FOUND * - p PIPE FOUND TOTAL AREA = 20,000 SF OR 0.64 AGRES - AREA TAX LOT 2-1 = 140 5 FO -_ ';,: '...... 00 FOR 0.32 AGRES 1 , - _ AREA TAX LOT 26 = 14,00 O 5F OR 0.32 AGRE5 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO. 50202 i. GRAPHIC SCALE "= 30' RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF-\\Hp server\d\PROS\02-222.pro TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING D9PARTMENT Do you have or need the following,before applying'? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sea of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631)765-9502 Survey www.northfork.net(Southold/ PERMIT NO. � Check Septic Form N.Y.S.D.E.C. y ` Trustees Examined a � ,20� Contact: Approved 20� Mail to: Disapproved a/c Phone: Expiration ,20�_ Q Buildin etet-- rl PP ICATION FOR BUILDING PERMIT \Thi��\VOieation Date 20 INSTRUCTIONS a. MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans,ac te`[ilot plan to scale. Fee according to schedule. b. Plot pl shogc�'rtg location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterwa . 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. Leo,lei khtfc- (Signature of applicant or name,if a corporation) GGl fG�ilL9C ut /Vy (Wiling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer,general contractor, electrician, plumber or builder Name of owner of premises �u r (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. 7ther Trade's License No. 1. Location of land on which proposed work will be done: Z. 3oo H19ROoZ L.Fln/E CUTCIWOGUE /t/ `/ House Number Street Hamlet County Tax Map No. 1000 Section 10 j O Block O /O D Lot ---Z:W I, 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 fis I'j(;{,L(, l NGP.Ie_-- b. Intended use and occupancy LL& h w--. " C)�Oe-)(-- cCLa� 3. Nature of work(check which applicable): New Building Addition X —Alteration-------- Repair Alteration___ __Repair 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 8. 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 within 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) SS: COUNTY OF 14 /,e0,4G( W6-1 A— being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the LZ'-k-' (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 this — / v _200& -� �SureVAlancNotary Public PATRICIA C. MOORE Notary Public,State of New York Suffolk County-No. 4861668 Commission Expires June 16,2ou ,�i-kA1>�lolvA-L C�P2�lFlcA�c�c.�S /^\ APPROVED AS NOTED ---, / DATE: !L^ B.P.# 3040�1-F-- FEE: E)w BY " �� NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE ° FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE �XISTINC� NOUS 2. ROUGH - FRAMING & PLUMBING r 3. INSULATION 1 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE _-- ------ ----------- REQUIREMENTS OF THE CODES OF NEW - - � � - - YORK STATE. NOT RESPONSIBLE FOR — — - `---------------- ------- --- - *--------- ----------------------------------------- OR CONSTRUCTION ERRORS. 1 I, DESIGN 2XB LEDGER BOLTED TO HOIJ5E a32"OC COMPLY WITH ALL CODES OF NEW YORK STATE &TOWN CODES oAS REOUI ED AND CONDITIONS OF x SOUTHOLD TOWN ZBA TrF 4X4P06Tw/ SOUTHOLD TOWN PLANNING BOARD 12"XI2" GONG. FTG. ' 3' Eaow GRADESOUTHOID TOWN TRUSTEES n_) 2Xe 1 -------------- N.Y.S.DEC -' Fw(2 GIRDER - - - a -- FE - --, 5 ------------------------------ - �O" OCCUPANCY OR USE IS UNLAWFUL 9 WITHOUT CERTIFICATE OF OCCUPANCY r I 540 5O' 5� O ' r O" ALL r^NSTRUCTION SHALL (2) 2XB MEET THE HEOUIREMENTS OFTHE FLusu GIRDERf CODES OF NEW YORK STATE. -1-Fj OAA FOUNDATION FLAN FLOOD ZONE N BUILT PRIOR TO 2003 COMPLY WITH CHAP ER"46" FLOOD DAMAGE PREVENTION SOUTHOLO TOWN CODE. 1-1! I 5/4X6 CEDAR DECKING f'A 2XBDJ alb"OC J 2X8 LEDGER 1 1(2) 2XB FLU6H GIRDER - 4X4 P05T "v bWz J1 12"XI GONG, FTG. W I \ y= f r D SECTION A-A 2J�Es, u0 DECK (BUILT PRIOR 2003) ` HARBOR LA., CUTCHOGUE, IJY P of 3 June 11, 2004 SCALE 1/4" i EX16TING y 0 s O O - N ° FLOOD' FLAN - BUILT PRIOR TO 2003 20'-O" NEJV IQ `'F ` w ( w k DECK (BUILT PRIOR 2003) HARBOR LA., CUTCHOGUE, NY Pe. 2 OF 3 June II, 2004 -E 1/4', i REAR ELEVATION _ - _ - - - _ _ _ - - - - - 1 - - - - - - - - - - - LEFT ELEVATION RICHT ELEVATION LU NrirP-^a56�1 DECK (BUILT PRIOR 2003) HARBOR LA., CUTCHOGUE, NY PG. SCALE 3 of June II, 2004 I/4"