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HomeMy WebLinkAbout30617-Z FORM PTO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, PT.Y. CERTIFICATE OF OCCUPANCY No: Z-30.194 Date: 10/08j 04 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 51170 MAIDS RD SOUTHOLD iHOUSE ITO. ) (STREETi (HAMLET) County Tax Map No_ 473889 Section 70 Block 2 Lot 6 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 2004 pursuant to which Building Permit No. 30617-Z dated SEPTEMBER 7, 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 GARAGE IN THE REAR YARD AS APPLIED FOR "AS BUILT" The certificate is issued to PAUL & MARGARET RADICH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL IT/A ELECTRICAL CERTIFICATE NO. II/A PLUMBERS CERTIFICATION DATED IS/A / Au o ze 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. 30617 Z Date SEPTEMBER 7 , 2004 Permission is hereby granted to : PAUL & MARGARET RADICH PO BOX 362 SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY THREE CAR GARAGE "AS BUILT" IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 51170 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0002 Lot No. 006 pursuant to application dated SEPTEMBER 3 , 2004 and approved by the Building Inspector to expire on MARCH 7, 2006 . Fee $ 321 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TONIN OF SOUTHOLD BUILDING DEPARTMENT J TOII7V HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCI This application must be filled in by typewriter or ink and submitted to the Badding Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, propel ty lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-dish( sal (S-9 Fomt). 3. Approval of electrical installation from Board of Fire Underwriters- 4. Sworn statement from plumber certifying that the solder used in systcin contains less than 2 10 of I°u lead. 5. Commercial building, industrial building, multiple residences and sim lar buildings and installations, a certificate of Code Compliance front architect or engineer responsible for the building. 6. Subtrut Plamting 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 sur ey of property showing all property lines, streets, buildir g 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 htspector shall state the reasons therefor in writin-,to the applicant_ C. Fees L 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 acce;sory 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, Conmtercia $15.00 Date. _ cl 3 CL-} New Construction: _Old or Pre-existing Building: v"' _(check one) Location of Property: Sl 170 m4in ed 50l. fhr`la House No. Street Hamlet Owner or Owners of Property: 011,9(,?_ C-T t�A DI C Suffolk County Tax Map No 1000, Section Block Lot Subdivision hr0?e i t YrCAcr r I9 N la > _Filed Map. — _Lot: Pen-nit No. Date of Permit. Applicant: C (.I Health Dept. Approval: Underwriters Approval Planning Board Approval: Request for: Temporary Certificate Final Certificate: )KI (check one) Fee Submitted: $ S,Crb / Applicant Signature Cc-r,_ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: a DATEI INSPECTOR FIELD INSPECTION REPORT DATE COMMENTS -- ----------------- FOUNDATION ------------FOUNDATION(1ST) -- ----- a a --- --------- ---------- tp FOUNDATION(2ND) — ------ ----- i� f z c ROUGH FRAMING& — rn y PLUMBING ---------- - ------ -- — ------------— ---- INSULATION PER N. Y. m STATE ENERGY CODE --- ------------- - ------------ O --- ------------ FINAL ADDITIONAL COMMENTS — --- — ,O m z ------ -- VJ k b a --- r Z _ _ a r y O 'a ToNvN Or SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUIL';)ING DEPARTMENT Do you have or need the following,before applying? TORN HALL Board of Health SOUT HOLD, NY 1197t 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAN: (631) 765-9502 Survey invA% northfork.net/Southold/ PERMIT NO. 30617 Check Septic Form_ N.Y.S.D.E.C. Trustees Examined_ _,20 0 4 Contac[: 111110 Mail to: Disapproved a c-- _ -- Phone: _ Expiration _--3 '�/�"7 , -��_ ^ / Building Inspector 3 p004 APPLICATION FOR BUILDING PERMIT 20_2' _ 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 pr-raises, 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. _\PPLIC_-kTION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordutance 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. X �oa�e� c� (S' lure of applicant or name,if a corporation) Gos 7 C)1?,S0.,L L--/jPLC Joof I�s� (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ©Lo Name of owner of premises _ l� a�Ct 0.i'E� R(a 1D I L 14 (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: 5- 1170 rnaf ,n eetj 5, +t, I House Number Street Hamlet County Tax Map No. 1000 Section l d Block Lot Subdivision IFiled Map No. — Lot (Name) . P 2_ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 3 r' p r }1'p 0-1� CL60M w�ti�c1, Wae c�vt Prc,perl� y� 4o `S - b. Intended use and occupancy / 3_ Nature of work(check which applicable)- New Building \ Addition 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 3 2 .3 Rear �2 • 3 _Depth a 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 0 Rear / /pr SSI Depth 3 2Ci. 2 i 10- Date of Purchase Tu Fn Mrl.y (7%6 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—)c 13. Will lot be re-graded? YES_NO Will excess fill be removed from premises° YES__NO-4<— / n sl�. 14_ Names of Owner of premises MAJA ref �R&I,CGt Address� Io�SAi� L"e5�p{�Phone No. 603( —765—2?72 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_',�C * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, v6th 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 ) /h ARGR��F3,0/ctr being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Q(/J.(JEX (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 ti„best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed thermith. Swotr t before me this day of 20 0 ? p Notary Mblic Signature of Applicant Not p�bliA J- C00PER lic State of Neth York r` ,N0-4922583.Suffolk Cc.uoty N SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NY 1000-70-02-06 SCALE 1'=30' H/o/F NARY J MAY 24, 2004 DIRT WC, /.�`�KI o° S7 . E & JpSEPyI P(ANz 73p•30 NE 0 C 4 ? 29.9 Sly rte 3 ?' 60.4', y K o 2 J? h ,r.s' ry J' q CP e O 2 ?4„7 �Bf A�HAtT v !� DR 2D w MEDS O (D�� I2 O N DA V/D & BpNN/E PASCoE CR� DRIVE 29.88, l y �Bf ,so, v yt'�NS.1nET2C�P•T (�O ¢ �. 4900 O' C. NO. 49618 ANY ALTERAAON OR ADDI77ON TO THIS SURVEY IS A WOLA77ON ECONIC SUR P.C. OF SEC77ON 77090E THE NEW YORK STA7E EDUCA7701V LAW. (631) 765-5020 FAX (631) 765-1797 AREA=25,828 S0. FT. EXCEPT AS PER SEC770N 7209-SUBDIVISION 2 ALL CER7IF?CA710NS P.p, 76 so9 ■ =MONUMENT HEREON ARE VALID FOR THIS MAP AND COPIES 7HEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 04-150 , - i - - i - - - W. lw - _ Tfl. .� I ie T II r 41 - . It L CONSTRUCTION SHALL _._.. . . _�, . MEET THE RER E 4 1, SO . ? ' C01)E :' F NEW YORK STAT E -,_6m _ RTIFICATIONOF ' NAILING & CONNECTIONS la: z REQUIRED. SzL � . . :...:.�'a",,,.r- m,,,T;a,�,F,t_�.,,'�&r .•s,,7.`_.�'_�... . .-.. '- ::-;._.p:.._, :, . � ,. ., ws t . `.46.�,.,.�c�K'f;l.onfSga& NE�yr� je 4 .. APPROVED AS NOTED I llib _ . r DATEi1r,G 1LB.P.p 3' , ^ 'Z p .wzzs+1 FEE: BY: G. A, i6S16M AT - - E NOTIFY BUILDING DEPARTMENT - - - 765-7602 6 AM'TO 4PM FOR TH q /) I FOLLOWING INSPEC71ONS: v ! L - 1,,FOUNDATION - TWO REQUIRED . - FOR 'OURED.CONORETE _ - 2: ROUGH FRAMING & PLUMBING - 4; BE GJL ,E E PuRTC.O.MUST INERMTERSCEATFd* " OCCUPANCY OR U`�,E 1S UNLAWFUL ALGCONBTRUGTiON $HALL;MEET THE REQ !RE EOU IEMGNTSrOFTHECObESOFNEW wa{. WITHOUT CERTIFICATE � ' � YORK TATE:' NOT RESPONSIBLE FOR :,pES,IG OR GONSTRUCTI91 XI •i'. + - s , n� n W . ' I I , a I . I -A . r 1 1 1 4(( iCFGS sFf- 7C Y?rWlk i �97x - 977 #,-•:._ --- i 41 r ' 1 � e y ry I - . . .. fEof NEW a s y i Ic IL 1 I I ,ry , V �1 4._' .' .' d : .P � r -,- - ._ . �_._ ' . _'_..._:_ __Q., �_.j.,, i v4 �� _ ^ �r9- . . _. _ 5' S _ y;� _ .., _ ,4. � .. . . �:N;• _ - 1 I r