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Home My WebLink About28919-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30581 Date: 11/23/04 THIS CERTIFIES that the building ADDITION Location of Property: 665 JASMINE LA SOUTH/PEC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 69 Block 3 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 13, 2002 pursuant to which Building Permit No. 28919-Z dated NOVEMBER 18, 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 ADDITION & AN UNHEATED TWO CAR GARAGE ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWARD & DONNA DUNNE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1175810 10/22/04 PLUMBERS CERTIFICATION DATED 11/19/04 EDWARD DUNNE c thor' ed 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 NO. 28919 Z Date NOVEMBER 18, 2002 Permission is hereby granted to : EDWARD & DONNA DUNNE 665 JASMINE LANE SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ADDITION & UNHEATED 2 CAR GARAGE ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 665 JASMINE LA SOUTH/PEC County Tax Map No. 473889 Section 069 Block 0003 Lot No. 014 pursuant to application dated NOVEMBER 13 , 2002 and approved by the Building Inspector to expire on MAY 18, 2004 . Fee $ 264 . 60 ` - - Lei%►^-moi+-_ Authorized Signature ORIGINAL Rev. 5/8/02 3,�V 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 1. 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. W I O y New Construction: Old or Pre-existing Building: (check one) Location of Property: (p 6S— 5-Ls yn 1 ti ,CA. 50 044701d House No. Street Hamlet Owner or Owners of Property: �c1(,��c DO n nc. D,.,nrw E Suffolk County Tax Map No 1000, Section Block Lot Subdivision50 LVHn 3 1& �[ t�S Filed Map. Lot: Permit No. 2?� 1 Cl' Z Date of Permit. Applicant: ,E.. 07Kyw% Du nr.t Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ 2 Applicant Signature . 33/ ca-. 365V o�o$�FFo�,�oo CA Z Town Hall,53095 Main Road O Fax(631)765-9502 P.O..Box 1179 y�fjol �aO� Telephone(631) 765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Building Permit No. 1 / 2— Owner: �� ..c� F �vxvnc- DUVL n (Please print) Plumber: CC/L.,�.1 D ^.% e;=� (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. LarcD�� U4 (Plumbers Signature) Sworn to before me this day of IW7 Yr ab,,- 20 b Notary Public,�l-Lr� County ft:"M wA URI C.� I.I� L�G�Ln C I� Cn C.I� r c�P rrJ?P cJ'�r.J� cic�lrJ�R3 IN SBY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 TERS S 5 S BTOFNEECTRICITY 40 FULTON STREET ` S YORK, NY 10038 5 CERTIFIES THAT S 5 5 5 Upon the application of upon premises owned by 5 5 5 EDWARD DUNNE EDWARD DUNNE S5 665 JASMINE LN 665 JASMINE LN �5 SOUTHHOLD, NY 11971 SOUTHOLD, NY 11971 S S 5 5 Located at 665 JASMINE LN SOUTHOLD, NY 11971 5 Application Number: 1175810 Certificate Number: 1175810 S 5 5 SSection: Block: Lot: Building Permit: BDC: NS11 c5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 C electrical devices and 5 wiring, described below, located in/on the premises at: 5 5 First Floor,Attached Garage,Outside,Attic, SCj A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 22nd Day of October,2004. 5 5 Name OTY Rate Ratine Circuit Twe 5 5 Appliances and Accessories 5 Dish Washer 1 0 1.2 KW Panels C S5 1 50 7 S Wiring and Devices SOutlet 15 0 Fixture SFixture 15 0 Incandescent S 5 Outlet 24 0 General Purpose 5 Receptacle 14 0 General Purpose S Switch 10 0 General Purpose 5 Receptacle 1 0 20 amp Laundry S SReceptacle 1 0 30 amp Dryer 5 Receptacle 4 0 GFCI 5 5 5 S 5 seal 5 S I of 1 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. c 5 S o �� o ;1 X7171 LDL I��i Z I�I��f T'T TJ TJ T TT `�V IJ-4 W1 L rC—LIQr- Applicant/ � Date. Owners Name: iF,`2 — Reviewed: Architect/ Date �-- Engineer: Submitted: SCTM #: �, District: 1 000 Section" 131oc Lot:l Project Subdivisioi Location: ��s ("1 -�� - — Name: - �XJuto r Sin&le& separate Required eerttfication (Yes/No Rcy ^f 11..__ Req, QQ 'Zoning District: l I,ot s' c _ Actual: �U l (Lot cuvcragq�_ Niscd 4,-)'t ep l Req. t t t Req. Req, IFront Yard �5{{Proposed: `/�yj (Side Yard ly Proposed/2 I (Rear Yard SS Proposed l Project Description: ��-- AGENCI{"aBERMITS Permit REQUIRED FOR REVIEW N.A. ISO YES Number Suffolk County Health Dept. C/ New York State D. E. C. .� Town Trustees Town Zoning Board approval: r/ Town Planning Board approval: Flood Plane Elevation??? Flood Zone: ...... Notes: M-1802 BUILDING DEPT. NSPECTION FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS• � �D-a-r y DATE � � �� INSP 765-1802 BUILDING DEPT. INSPECTION [ ] F NDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: � G1 DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUND ION IST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLA CHIMNEY REMARKS: Za- 407 DATE � � IN8P -._. BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 64c DATE �� INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ok G�"� o DATE �� " � INSPECTOR2?� v"� FOUNDATION(IST) •.►moi! i �� _ _'�'�` FMR, 1 • 1 �W 27- ROUGH FRAMING1 PLUMB]ING ill of on-1 m- WWA INSULATION STATE ENERGY CODE j ADDITIONAL COMMENTS -----------.-- �• `� - 0 i r� .r r TOWN 04 SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. '� FYI? Check Septic Form N.Y.S.D.E.C. Trustees Examined 20 0 Contact: Approved !t 120 0>- Mad to: Disapproved a/c Phone: Expiration 200 4L �..-- building Inspector s 3 '(V: APPLICATION FOR BUILDING PERMIT Date . 2002— INSTRUCTIONS 200ZINSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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) 665 Jcsm ane �� So�+L•a(c.� (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder �t�.TnC Name of owner of premises LIJ s11-J Anc- IVA- v n r E (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: ('n 7 fC yh [ ne- le. so toa I House Number Street Hammet County Tax MILA4-A& No. 1000 Section�O� Block Lot_A I� Subdivision V`%k1 c,3 Filed Map No. 9,0-3'7 Lot 3 (Name) rz 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy qr%,n,c�� (-&S'1k nc ` b. Intended use and occupancy 5t°nmerr 3. Nature of work(check which applicable):New Building Addition ✓ Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost gy,*000 Fee /5-0 (To be paid on filing this application) 5. If dwelling,number of dwelling units N A 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. /L/�4 7. Dimensions of existing structures,if any: Front yd- Rear 63— Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front 79 Rear '79 Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front-151, I—1Rear Z6 o Depth 80 10. Date of Purchase c-. #'i 17 7 yName of Former OwnerRGA(C LU 6,4 :e—~ 11. Zone or use district in which premises are situated (� W 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 � � i 14.Names of Owner of premises 1YO�^� IJ`"' -ddress6& -jJk"'K/So yhone No. &S 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 ) dwc.Y-mac r� being duly sworn,deposes and says that (s)he is the applicant (Name of individual signing contract)above named, (S)He is the d lj rv- (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 day of 20 0 L 1�. L 10 14 N Public Signature of Applicant JOYCE M.WII.KINS Notary Public,State of New York No.4952246,Suffolk County Term Expires June 12, 01.0 03 rvcl n l c,e� 0u-, .: 4 L. z S,pp. -- Ll , 3 yk� /•P' , 24.3. 40, b V , o Z CVA 0 V a Aftj 9FNY AL TERA TION p/� ADDITOV TO THS SURVEY IS A VIOLATION C - `��A Tov SECTION 7209 OF THE NEW YORK STATE EDLCA TION LAW. EXCEPT AS PER SECTION 7009 - SL*VMSION Z. ALL CERTAF TIONS hE•REON ARE VALD FOR TM MAP AAV COPES TIEREOF OAL y F SAD MAP OR COPES BEAR 7W&OWSSED SEAL OF THE SURVEYOR WHOSE SIGMA TURF APPEARS)C MON. ADDITIONALL Y TO COAVL Y WITH SAID LAW TERM ' AL TERED BY ' MUST BE USED BY ANY AAV ALL SURVEYORS UTALIZM A COPY OF ANOTHER SUPVEYOMS W TERMS SUCH '&$PECTED 'AMD BROUGHT - TO - DATE 'ARE NOT AN COWL= WITH THE LAW. CERTIFIED TOO EDWARD A. DUNNE DOWAUIM THE L OW ISLAW SAVkWS SAW Fee SURVEY OF SUPERIOR ABSTRACT CORPORATION LOT 3 TRW-S-543938-3 'WAP OF SOUTM W MAS" MED"W 4 IMMAP NO 9297 A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COLOVTY, NL Y The water su ply and sewage dlsposo/ 1000 — 69 — 03 — 14 system for his res/dence wJll conform to the standards of The Suffolk County Scale: iii= 30, Department o1 Health Services. Mwd? IX 1992 AX Y 14 w2 f faur&tion) The locations o1 wells and cesspools shown hereon are from field OC>f 24 M2 observations and or from data obtained from others. fj NEW yp CIA' I MEr2,�� SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES AREA = 14,202 sq! ft. -40 ,, FOR APPROVAL OF CONSTRUCTION ONLY �,. .Y. L . NO. 49618 92 SO 40 DATE_ WS. REF. N0. PECOtWC V O�S'� C. 09 � 11 765 - 1797 cont. founder lon 01/24/03 P. O. B 90 D S correction 2/2/96 12. TRA.V-_ ET APPROVED - revise lax number 12/08/92 SOUTHOLD, N.Y. 1197/ 93 - 103 { 4 d 0 i _ 0 � c T 0 U• $ w g a r Y S r � LU J v p a I _ , Afz4stc r.rJ.ni I[ ti ` �� II ---_ =- F = -= l ----- _ -WO Y�-v>rr f tJ 17) 1 —7- t -- I I n If copper tubing is used PROVIDE SMOKE-DETECTING'-- 2m for water distributing ALARM DEVICES system; piping shall be - I AS TO PART. 721.1 '-I- — --- - - " .--- — -- -- ----of type.9 K or L only__ DAT • ' �. — — APPROVED-AS NOTED — N.v.$ BUILDING CODE. -". UNDERWRITERS CERTIFICATE ti}{Eley a84 L4 _ RE UIRED B'R# , WW1 BY- NOTIFY BUILDING DEPARTMENT T /� < iF NE4y y09� IIF, j +`1 765-1802 9 AM'T FOR T E FOLLOWING�p�g6P� -- - � ' PLUMBING ?� 9. FOUNDATICIN • TWO REQUIR D -�'�:y ( `� w PROVIDE OPENING$ FOR ALL PLUMBING WASTE 'i ` I �" _ FOR POURED CONCRETE -r;�: /€M1 &WATER LINES NEED 2 ROUGH • FRAMING & PLUMBING sF uaxxsai 4? BERG€NCY ESCAPE AS TESTING BEFORE COVERING pLq� gER CERTIFICATION & INSULATION Oy F�' REQUIRED BY PART. 714 0 4 FINAL • CONSTRUCTION MUST A0FES510h Y, STATE BUILDING CODE ON LEADCONTF', ,_ ^EFORE BE COMPLETE FOR C.O. PROVIDE ANTI-SCALDAND,'OR CEp,TIFICA TE OF ;pANCY ALL THE CONSTRUCTION EMENTS SHALL THE NY THERMAL SHOCK PREVENTING SOLDER USED .r;'' '- !,TER STATE CONSTRUCTION & ENERGY t + - DEVICES AS TO PART. 902.6(K) CODES. NOT RESPONSIBLE FOR DO NOT PROCEED WITH OCCUPANC'u ' N.Y. STATE BUILDING CODE. SUPXILV SYSTEa.,' /OT . DESIGN OR CONSTRUCTION ERRORS FRAMING UNTIL �UR`!EY USE IS UNLA`AUL u EX(, 2/10 of i - -. 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