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HomeMy WebLinkAbout28282-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30597 Date: 12/01/04 THIS CERTIFIES that the building ALTERATIONS Location of Property: 8985 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 3 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 2002 pursuant to which Building Permit No. 28282-Z dated APRIL 16, 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 ALTERATION TO EXISTING SINGLE FAMILY DWELLING (BED & BREAKFAST) AS APPLIED FOR. The certificate is issued to SYLVIA M DALEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1046662 04/18/02 PLUMBERS CERTIFICATION DATED 11/30/04 GREENPORT PLUMB.&HEATING ///tho ized tignature 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. 28282 Z Date APRIL 16, 2002 Permission is hereby granted to: SYLVIA M DALEY 175 EASTERN PARKWAY BROOKLYN,NY 11238 for ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING (BED & BREAKFAST) AS APPLIED FOR at premises located at 8985 MAIN RD EAST MARION County Tax Map No. 473889 Section 031 Block 0003 Lot No. 017 pursuant to application dated MARCH 5, 2002 and approved by the Building Inspector. Fee $ 187 . 20 Authorize Signatu ORIGINAL Rev. 2/19/98 7 Form No.6 113 q TOWN OF SOUTHOLD BUILDING DEPARTMENT Q TOWN HALL 765-1802 APPLICA ION 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. New Construction: Old or Pre-existing Building: (check one) ,( Location of Property: House o. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No41V0! ejtion d 3( Block 00C) 3, Lot l " Subdivision Filed Map. Lot: ,2LO—k7 Permit No. Date of Permit. Applicant: 4 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature S BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 SBUREAU OF ELECTRICITY 40 FULTON STREET -- NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 S DALEY SYLVIA DALEY 5 rj PO BOX 574 8985 MAIN ROAD E MARION NY 11939 EAST MARION, NY 11939 5 5 Located at 8985 MAIN ROAD EAST MARION, NY 11939 5 5 Application Number: 1046662 Certificate Number: 1046662 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 Described as a Residential occupancy,wherein the premises electrical system consisting of 5 electrical devices and wiring,described below, located in/on the premises at: 5 First Floor, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5 found to be in compliance therewith on the 18th Day of April,2002. 5 C] Name OTY Rate Rating Circuit Twe 5 Appliances and Accessories 5 Exhaust Fan 1 5 Exhaust Fan 1 5 Wiring and Devices 5 Outlet 5 Fixture L5'J Receptacle 8 General Purpose 5 Switch 2 General Purpose 5 Fixture 5 Incandescent 5 Receptacle 1 GFCI 5 Dimmers 1 600 5 5 5 seal S1 of 1 55 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 0 �UFFO(� Town Hall,53095 Main Road P Fax(631)765-9502 P.O.Box 1179 a� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: I r f 3 0 © y Building Permit No. C b ; 2— Owner: V' l Iq CIO (Please print) Plumber: r&E�162o rT (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbe ignature) Sworn to before me this day of� 20_�-L IL Notary Public, Sf"rr' k. County MMry �A is � B UILDING PERMIT EXAMINER CHECK LIST DATE ISSUED: —/—/02 /02� DAT VMITTED: 3 I�S/02 uc DATSUB Kn IA APPLICANT: jyLu/A �' E BLOCK: _LOT: _ N SCTM#DISTRICT: 1.000, SECTION: _____ A�Ioµ SUBDIVISION: A CITY STREET ADDRESS: r..l PROJECT DESCRIPTION: ZIQ Al HNGINE ER u�AR FAST TRACK.? ✓� b ITECT ESTIMATED PROJECT COST: � f D� o NOTES: LE & SEPARATE CERTIFICATION-REQUIRE --�-- SING ition CREATED be tore.lune 30,QUI UNDERSIZED LOTS FROM JAN-1997 100-25.Merger.(A nonconforming at any time after 7/1/83, 1983), LOTS 40,000SF-100-24.Lot recogn � CONFORMING? ACT. LOT COV- Ala ZONING DISTRICT: cl LOT COV. ��'a SIDE , /�� ACT. SIDE REQ. LOT SIZE: �o► .-ACT•PLFRONTEREQ EQ REQ.FRONT_= PACT, PROP- REAR '- REQ• REAR - �ttL /Al N o CNA- _DESCRIPTION: Av WATERFRONT'? — PANEL #: 6 FLOOD ZONE:.. APPROVALS REQUIRED TY HEALTH T: YES orUO(BED#): DTE: / /_ PERMIT #:R10-�- SUFFOLK COUN TOWN SEPTIC RECEIPT: Y orP ES NEW YORK STATE DEC: pU-D�"'YES or SOUTHOLD TOWN TRUSTEES:pVAL: YES or TOWN ZONING BOARD or O TOWN HISTORICAL PREAPPROVAL:(SPL YES r NO N C49*41 9 TOWN HIST NYS ENERGY: YES O'a ' VENT (SQ.FT. x 4%)-.!!!/ LIGHT (SQ.FT.x 8%) - EGRESS (18 H min.? 4 sq total) 6 6 -Z/ C/0 Z- ITS OPEN/E D: BPS -Z/C/o Z -' BUILDING PERM HAVE PRE CO'S : Y OR N BP----- r NOTES: SF FEE STRUCTURE: FOUN)ATION: SF FIRST FLOOR: SFpTHER TOTAL SECOND FLOOR: SF INIT FEE OTHER: F FEE FEE � TOTAL: - � S +$—_ $ �. 20 COO SF)=�-SFX$�=$J�+$� cF)= -SF X$—=$ og�FFO1�-coG o� y1 Fax (516)765-1823 ti Z Town Hall,53095 Main Road Telephone(516)765-1800 O P.O.Box 1179 Southold,New York 11971 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION TO: Southold Town Building Department FROM: Southold Town Landmark Preservation Comm. —John Greene DATE: March 20, 2002 RE: 8985 Main Road/Route 25, East Marion SPLIA#: EM-20 Tax Map#: 31-3-17 The Landmark Preservation Commission has reviewed the submitted plans for the renovation of the above mentioned property. The Commission approves the application. Thank you. ' �Rt { b u P?_DC. DE'T. ",'N' F CQUTiQLQ M-1so2 BUILDING oar. INSPECTIO" [ ] FOUNDATION IST [ ROUOR PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ �j FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: /JGc3' r Zr.Yp drlL� DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND M INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: L;�� � e lov DATE INSPECTOR�_ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: 94 lep- AL LIZ 12 DATE 141, L—IN SPECTO FIELD INSPEeTION REPORT DATE COMMENTS . �d FOUNDATION(1ST) y ------------------------------------ FOUNDATION(2ND) �t z �l ,aLv o ROUGH FRAMING& PLUMBING r '� d � ez - �► ,,1 x INSULATION PER N.Y. H STATE ENERGY CODE `I FINAL ADDITIONAL COMMENTS A Cis - o X c � b G y O z x x d b TOWN OF 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 BWd approval FAX: (631) 765-9502 �Qn �n � Survey ,/ PERMIT NO. V d Check Septic Form N.Y.S.D.E.C. y Examined /� 20� Trustees Contact: Approved" f 201 Mail to: Disapproved a/c Phone:� � Expiration /o a ,205 Building Inspector �jI APPLICATION FOR BUILDING PERMIT Rt-nG. MPT. Date p O,� dL , 20 Tr,-,-,,N ,F S UTHOLD INSTRUCTIONS 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 Ordivance 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, re ations,and to admit authorized inspectors on premises and in building for necessary inspections. igna a of apphc t or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, ent, archite , engineer, general contractor, electrician,plumber or builder Name of owner of premises Lu 14 A Ploklr (As on th 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 Hamlet County Tax Map No. 1000 Section 3 1 Block 03 Lot 1 7 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of pr ises tended use and occu c of proposed con ction: a. Existing use and occupancy Lko ( b. Intended use and occupancy S'/9f+?,E ky7 �,, 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 ori each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. S 7. Dimensions of existing structures,if any: Front Y Rear Dtf 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 Lqe) 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 6fir'MAX I VA/ 14. Names of Owner of premises SVS v14 0.41,Q Address Ad OUX 574- Phone No. e-4-'�' Name of Architect AWKL Sf/wAr-KT7�Address 141,60A 9,?3 Phone No 7.�Q— P� ✓ Name of Contractor Address G(17C#V641' 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 Z q4" 2Z being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is theT- ( ontractor,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 tz)o tet. 20 Got, otary Public LINDA J.COOPER Signature of pplicant Notary Public,State of Now York No.4e22563,Suffolk County Teras Meas Deceak;t;r S`s, oS C» east' Marron �-r'r•�' t�isf I Ic�J d Yr J�f,l14L��, 11� 7,7 ' ' '" /�+O 6 �'�/. ,..•r.d",ru..%fen,•' ANA ,n lldrto "Q F, ' Niuiultatlilla own" , 'w , 'u tis\,►w is tts���i',S •-�� y» r rl f h VV MAP OF P12OPERI-Y 411 su9 v9 YfD FOR � r .� d, C� / 46 pwo ar tvv Pow i Sufolk Co 7AW 6W } 1pa �a� -r\�-_ c,! 0 coo,sw*03t, EUL g, Pcf 17. ION I i d I 1 �� os sufcf .Jdtnd f `, 199`4 VAN' YL, :aG. °� � t ► � � .p, t, N. 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