HomeMy WebLinkAbout28325-ZFORM NO. 4
TO~'~ OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
To~ Hall
Soushold, N.Y.
CERTIFICATE OF OCCUP.~NCY
No: Z-30450
Date: 09/20/04
T~IS CERTIFIES that the bni]a~ng A/DDITIO~
Location of Property: . 225 CRITTEN LA
(HOUSE NO.)
County Tax Map No. 473889 Section 70
subdivision
SOUTHOLD
(STREET) (}hAMLET)
Block 11 Lot 7
Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 11, 2002 pursuant to which
Building Pez~nit No. 28325-Z dated APRIL 25, 2002
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 EIICLOSED UI~EATED SLrA/ROOM/PORCH ~DITION TO EXISTIN~ SINGLE F~4ILY
DWELLING AS APPLIED FOR.
~e certificate is issued to JOA/q D MESCHI
of the aforesaid building.
(OWi,~R)
S~/Ft~LK COIFBFi~ DEP/~T~ OF }~T]t ~PPRO~ N/A
ELRt-i~ICAL CERTIFICATE NO. 2004467 05/26/04
PLI~4BERS CERTIFICATION DA'r~u3 N/A
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~/~iT NO, 28325 Z Date APRIL 25, 2002
Permission is hereby granted to:
JOAN D MESCHI
18 KNOLLWOOD RD
EASTCHESTER,NY 10709
for :
ENCLOSED PORCH ADDITON TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
at premises located at 225
County Tax Map No. 473889 Section 070
pursuant to application dated APRIL
Building Inspector.
CRITTEN LJt SOUTHOLD
Block 0011 Lot No. 007
11, 2002 and approved by the
Fee $ 150.00
AuLhorized Signature
ORIGINAL
Rev. 2/19/98
Form No. 6
TOX~,qN oF SOUTItOLD
BUILDING DEPAI1TMENT
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:
For new building or new use:
I. Final survey of property with accurate location of all buildings, properb' lines, streets, and unusual natural or
topo~aphic features.
2_ Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval o f electrical installation fiom Board of Fire Underwriters.
4. Sworn statement from plumber cenif54ng that the solder used in system contains less than 2/10 of 1% lead.
5. Commerc/al2building. indnstrial building, multiple residences and sirrdlar buildings and in~allatious, a certificate
of Code Compliance fi-om architect or engineer responsible for the building.
6. Submit Planning 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 SuFvey of property showing ali property lines, streets, building and unusual natural or topo~aph'tc
features.
2. A properly completed application and consent to inspect signed by the appl/cant. If a Certificate of Occupancy is
denied, the Bnilding Inspector shall state the reasons therefor in writing to the applicant.
i- Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Altemtious 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 $I5.00
Date.
New Construction:
Location of Properky:
House No.
Owner or Owners ef Property: -,J~ ~ ,~
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building: b-'" (clieck one)
Street Hamlet
Permit No. ~z~ 8~.~-.~-~' Date of Permit. //'/.2,5'//O ~
Health Dept. Approval:
Block O ~// Lot
Filed Mapl Lot:
Applicant: ~;7/~.'t~ ~/cA~'-~x
Underwriters Approval: P/
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
ca '50 5 0
Final Ce~cificate: ,v'"" (check one)
A~p~c~nt ~gnature
BY THIS CERTIFICATE OF COMPLIANCE THE
OF FIRE UNiDERWRITERS
BUREAU OF ELECTRICITY
N'IE~?~ YORK BOARD
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of upon premises owned by
JIM SAGE ELEC. INC. JOAN MESCHI
P.O; BOX 38 225 CRITFENS LA
GREENPORT, NY 11944-0038, SOUTHOLD, NY 11971
Located at 225 CRITTENS LA SOUTHOLD, NY 11971
Application Number: 2004467 Certificate Number: 2004467
Section:
Block;
Building Permit: BDC: ns11
Lot:
Described as a Resideutiat 0-599 square ft. occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, First Floor, O~side,
A
visual
inspection
of
the
premises
system, limited to electrical devices and wiring to the extent detailed
electrical
herein, was conducted in accordance with the requirements of the applicable code' and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 2drh Day of May, 2004.
Name QTY Rate Ratin~ Chcuit TYpe
Miscellaneous
service &stm room
Wiring and Devices
Outlet 12 0 General Purpose
Receptacle 8 0 General Purpose
Switch 4 0 General th.upose
Paddle Fan I 0
Outlet 5 0 Fixture
FL~ture 5 0 Incandescent
Sera,ice
1 Phase 3W Service Rating 200 .~nperes
Service Disconnect: 1 200 cb
Meters: I
.. - seal '-:..
I of l %,.- _-
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the o~atiefiSi,,5~icatbd.
;:',..'~,~.. ?o ..-//.-'7 TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
N
S
V_ILLAGE _ _
DISTRICT SUB..
,4.,.:: '
ACREAGE
TYPE OF BUILDING
LOT
RES,
LAND
NEW
Tillable 1
Tillable 2
Tillable 3
Wood[and
Swampland
Brushlond
House Plot
Total
SEAS,
IMP¸
VL,
TOTAL
FARM
DATE
COMM, iND. CB.
REMARKS
MISC.
Est. Mkt. Value
ABOVE
FRONTAGE ON WATER
?"Sc Value
FRONTAGE ON: ROAD ~// ~'"/
/F,~ ~.,..' .,'
BULKHEAD
DOCK
M. Bldg. "~ 1,~ k ~ ~ ~'
Extension /
Extension .D, )< ~ ,,' '~
Ext Walls
Breezeway
Gara¢¢
Patio
%~,-~ ~Driveway
Porch"
Porch
Bath
Floors
Interior Finish
Heat
Roo'F Type
Rooms 1st Floor
Rooms 2nd Floor
Dormer
BUILDING PERMIT EXAMINER Clq~CK LIST //~!
DATE :I~SLrED:
APPLICANT: x ¢.~ /
SCTM# DISTRICT: 1.000, SECTION:
BLOCK: /// ,LOT:
DATE REVIEWED: _~ /)~ 02
DATE'SUBMITTED: q/M 02
-,- 1
ESTnYgXTED PROJECT CO~T: ?,~OO.~ARCHITECT ,'
S~GLE & SEP,~TE CERT2ICATION-~.QU~D? NO~S:
LO~ 40~005SF -100 24. Lot reeoDdtion.~ C~ATED before June 30, [983), U~'DERS~ED LOTS FROM J_~.~997 100-25. Me.er fA nonconfonrdng st an,.,' dine a~er 71t8:
ZO G instrucT: -
~Q. LOT S~E: ~o~ ACT. LOT S~E:~?~ ~Q. LOT COV. ~O~ACT. LOT CO¥. ~'.//
~Q. FRONT 40 PROP. FRONT
~Q. ~.~ ~O PROP. ~
WATER FRO~? ~ O DESC~TION:
P~L ~: 2~ FLOODZO~: ~ ,
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH~,DEPT: ITS or/~,gED #):
TOWN SEPTIC [LECEll~T: Y
NEW YORK STATE DEC: Pmi-Inmg,'t/Ts YES ~
SOUTHOLD TOWN TRUSTEES: YES o
TO~VN ZONING BOARD APPROV:M_: YESor
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES
EGRESS (18 H rain2 4 sq"T6tal) VENT (SQ. FT. x 4%).
BUll,DING PERMITS OPEN/EXPIIR_ED: BP -Z / C/0 Z-
HAVE PRE CO'S: Y OR N BP -Z / C/0 Z-
DTE: / / PER2vIIT #:R10-
LIGHT (SQ. FT. x 8%)_
NOTES:
.- _ [ /,~ '
~ ~ ~.'~ f -/
, / r ~
FEE STRUCTL~FO~ATION: ~ ~ ~
F~ST FLOOR: &~ SF
SECO~ FLOOR: SF
OTHER: SF ~T OTHER TOT.~
TOT:~: ~ SF FEE FEE FEE
L( SF)-( SF)= SF X$__=$ +$ 1~/0---+$ =$
2.( SF)-( SE)= SF X $ =$ +$ +$ = $
765-1802
BUILDING DEPT.
INSPECTION
NDATION 1ST
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: ~~~.
] ROUGH PLBG.
] INSULATION
] FINAL
INSPECTOR
76S-1802
BUILDING DEPT.
INSPECTION
~/~__~? [ ~FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE 0~////~//~ :~'-~
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
~] F~DATIoN 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE/~_H~MN~
REMARKS:
DATE
INSPECTOR
765-11102
BUILDING DEPT.
INSPECTION
]FOUNDATION 1ST [ ] ROUGHpLBG.
[ ! FOU~H~TION2ND [ ] INSULATION
~FRAMING [ ] FINAL
] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ] ~N~ON
[ ~FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE:
INSPECTOR
TOW'N OF sOlOeD. , ~
BUILDING DE, PART3IENT
TOVVN HALL
SOUTItOLD, NY 11971
TEL: (631) 76511802
KLK: (631) 765-9502
Exannned O ~//.,~ ?0
Approved O f/.~-~ ,20
Disapproved a c
Expkafion .,20
PERMIT NO. ff-oc..35L_ff2-~
~B~ ~ng ~spector
BUILDING pERMIT _APPLICATION CHECKLIST
Do you have or need the following, before applying7
Board of Health
3 sets of Building Plans
Planning Board approval
Sm-vey
Check
Septic'Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
APPLICATION FOR BUILDING PERNHT
Date
INSTRUCTIONS
a. Th/s application MUST be completely filled in by t39ewriter or in ink and submitted to the Building Inspector with 3
sets ofplmxs, accurate plot plan to scale. Fee according to schedule.
b. Plot plan shoxving location of lot mad of buildings on premises, relationship to adjoining premises or public sn'eets or
areas, and watem-ays.
c. The work cox. ered by this apphearion ma5' 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
shah be kept on the premises available for inspection throughout the work.
e. No b~filding 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.
£ Every buildh~ permit shall expire if the work authorized has not commenced within 12 months after the date of
~ssuance 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 Buildin. g Inspector may authorize, in writing, the extension of the permit for an
addittoa six months. Thereafiei, a new permit shall be required.
APPLICATION IS HEREBY big. DE to the Building Department for the issuance ora Building Permit pm-suant to the
Building Zone Ordinance of the Town of Southold, Suflblk County, New York and other appl/cable Laws, Ordinances or
Regulations, for the construction o£ buildings,.add/tions, or alterations or for removal or demolition as herein described. The
applicant a~ees 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.
(Si_mmmre of apphcant or nm'ne,/fa corporation)
.~O 0 7 bf t~ L ~i
"~(Mai~g ad3ress of applicant)
~tate whether applicant is owner lessee, agent, architect, eng/neer, general contractor, electrician, plumber or builder
x!ameofownerofprelrfises J.~A,; /DF~gc~/! (' ~--~t4t: TR'?o~_P.~c~-
(As on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Cuilders License No.
~lumbers License No.
~lectdcians License No.
)ther Trade's License
Location of land on which proposed work will be done:
House Number. Street
Hamlet '
County Tax Map No. 1000 Section
Subdivision .~o o'r~ 1~ ~
(Name)
7O
Block i/
Filed Map No_
Lot 0.7
Lot
,State~e',x~tJ/rg~u§~ ~hd. occ ancyo rcm-uses an~ mtended use and occupancy o roposed a. Ex/stingusean,doccupancy / ~/rl//_.)/
b. Intendeduseandoccupancy / t~'~/TI/,i.'/
3. Nature of work (check which applicable): New Building_ Addition ff Alteration
Repair Removal ' Demolition Other Work
Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
Fee
(Description)
(To be paid on filing this appl/cation)
Number of dwelling units on each floor /
6. If business,'c6mmerciat'or mixed occupancy, specify.nature and extent of each type of ¢se.
7. Dimensions of existing structures, if any: Front ~/~ 'Rear
Height /¢/~ Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth .b~-2. / / Height / zTz'
8. Dimensions of entire ne;v construction: Front ,--ff,%,,~ /
Height /5/; Number of StOries /
g ¥ ' Depth
Rear
Number of Stories / ~ ~
Rear ,~,.5-; Depth
9. Size of lot: Front /gL,'_'~/' Rear [~Z g:/ '
10. Date of Purcliase ~/~/Od> Name of Former Owner
Depth If,.7., '// ,-r /~, 7.~
11. Zone or use district in wkich prem/ses are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13_ Will lot be re-graded? YES__ NO 2(' Will excess fill be removed from premises? YES NOa'~
14. Names of Owner of premises ~J'O~N ~E$ct41Address ~,~-L//E_,~-E'/'4 ~'.Y'. Phone No_~'i4- 77
Name of Architect Address Phone No
Name of Contractor afrd~qE'g>F '77', ~c/~/.rs~'~ Address ,~o7#~a-th PhoneNo.
15 a_ Is this properba' within I00 feet of a tidal wetland or a freshwater xvetland? *YES __NO __
* [F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this properBr within 300 feet of a tidal wetland? * YES NO X-
* IF YES, D.E.C_ PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
_~,~R.'T- -7~ tc~e-~-./g$g't¥ being duly swom, deposes and says that (s)he is the.applicant
(Name of individual si~m'fing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said oxxmer or owners, artd 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 [tis knowledge and belief; and that the work will be
performed in the maxmer set forth in the application filed therewith.
Sworu to before me this
.,j &y
Notary l~ublic
of Applicam
LUT NUi~r:JERS tEEF~ER TI.? '"M~P FJF S~UTN~L~OD" F~L~D ]N
THE ~?UFF~LK C~UNTY CLE~,K'S' ~FF!CE ON NOV ~4, lgSZ
AS FILE NB, B141,
S '69° ~0'00~ ~
AREA=B5, 774
i. =klEINUNEN-f
tOOO-'70-t
, SCALE: !"=80,
M~I~CH 20>,. 2002
· t56,75'