Loading...
HomeMy WebLinkAbout30798-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30595 Date: 12/01/04 THIS CERTIFIES that the building ADDITION Location of Property: 295 GROVE DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 80 Block 4 Lot 12 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 23, 2004 pursuant to which Building Permit No. 30798-Z dated NOVEMBER 24, 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 & AS PER CERTIFICATION OF JAMES J.DEERKOSKI, P.E. DATED 11/29/04 . The certificate is issued to THOMAS D NOLAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized Si nature Rev. 1/81 S 3 y- /-5 Form No.6 -2,27— TOWN ,27—TOWN OF SOUTHOLD 232004 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. !7 2- New New Construction: Old or Pre-existing Building: (check one) Location of Property: &9.U1J E LAI House No. Street Hamlet Owner or Owners of Property: � �- C - I V 0 (_I l /\-) Suffolk County Tax Map No 1000, Section 0 U Block T Lot l 2 Subdivision Filed Map. Lot: Permit No. x'17 9 g Date of Permit. I 0 L./ _Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature C-0 iL_ qis Ca ��n En 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 S 5 5 BUREAU OF ELECTRICITY 5 S40 FULTON STREET - NEW YORK, NY 10038 c� 5 S THAT CERTIFIES S 5 5 5 Upon the application of upon premises owned by S 5 5 S P.O. BOX 106 MECHANICAL CORP. MARGARET450 M R EK DR. c5 5 MATTITUCK, NY 11952 SOUTHOLD, NY 11971 S 5 5 5 Located at 1450 MILLCREEK DR. SOUTHOLD, NY 11971 5 5 S 2034910 Certificate Number: 2034910 5 Application Number: S SSection: Block: Lot: Building Permit: BDC: ns11 CSS. 5 S 5 rj Described as a occupancy, wherein the premises electrical system consisting of c5 electrical devices and wiring, described below, located in/on the premises at: S SBasement,Outside, c� 5 5h extent detailed 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the e t rj Sherein, 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 5 5 authority having jurisdiction, and found to be in compliance therewith on the 2nd Day of December,2004. Name OTY Rate Rating Circuit Type 5 Appliances and Accessories 5 Cj Air Conditioner 1 0 40 Amps 5 SAir Handler 1 0 5 5 Wiring and Devices c5 5 Disconnect 1 0 60 amp Air Conditioner S S 5 5 S S 5 5 5 5 5 S S 5 5 5 5 5 seal 55 5 1 of 1 5 5 5 This certificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated. 5 5-i --L- ; 5 S 14.00" E g0.00' O O O ]BARN O N S l4°0'0" E 60.00' GARAGE 26.00 Ce LOAN 'n COCK ICGIC O \ O 22.00 �y ..................... -^ :S SCALE 30 30,3 GROVE DRIVE 3 2004 JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 To: Town of Southold Re: Deck Inspection Cathy Sherman 295 Grove Dr. Southold, NY 11791 To Whom It May Concern: An Inspection was made on the above mentioned deck, and it is deemed that the footings supporting this structure are sufficient to support the loads that will be placed upon it and is safe to its occupants. Also all construction of this deck met all building codes at the time of assembly. Any Questions feel free to call. Sincerely Jardesj. Deerkoski P.E. '4 � e t .. _ .. .ny.:S�C, �e'w fn�'ti�..Y'•`Tj,q�'ILry�i . S.tlR1lY 63//C��//0��0 E} /�� 9010 BARBAQA W` EBEQ '-, I EARN jAT .,.f s., `0000 f. 60.0 gap 30.0 �ti • UNAUTNORacD ALTERATION OR ADDIYION TO FM SURVEY IS A VIOLATION OF• t I+ SECTION 7209 Of THE NIVF YORR,STATS ' mLIG1TION LAW. • _ I C091LS OF THIS SURVEY MAP Npj NARalIfJ . .il TW LAPD SU:.VLYOR'S INR.D SEAL Oi, •• . - SAMOSUED SLAT'SHALL NQ SL CONLID9�D 1 py�T-gyp - TO A VALID qU(C::9Y. 16 J i QUARAFM:S WCICAUI)NERV. N WALL K /ff r E E'O�k V TO THL h S..'.903 1h,M INE SM"W 1 /vAbo I SYT 9R/ASTD,AJ�D U. NS iJIAU b ITN COWAHT.WVafuYALh.AL AO1NC► 06TI1 1110,4 LLSILY HL3LOIL,Aft FIX ASfiften OF ITIS Ammo MSF GUAR^kTM An NX WA1*ASM �. ... 1 C2)C) ti SEE "MAP CSF m N 5wo QQ,;8t 9 ' N FU:F—IN TH 5UFF _ CLEQK &OFF1Et AS S t; 'err �i :�L7- ). } 11 3 ;R�I�,G1iL.flQ ,L/ �. ,�• •.+' �,.�:,..:.�.�--."-yam 1 . (:j;z , T E T �TWE 1 VAt4ZN-Lt SCA L Ra 1 f INCL UDC ht..;....sScE ';.3UUFx:K t.L�'7.cvC r! r7�Eirc T t or r: Src .�8arcc' ��?�+t w°12... `� r T N OF SOUTHO LD F40PERTY RECORD , CARD /1 )WNER STREET - VILLAGE DISTRICT SUB. LOTS U /Va "ORMER OWNER N E ACREAGE G s W TYPE OF BUILDING l .S. SEAS. VL. FARM COMM. IND. CB. MISC. ' Est. Mkt. Value ' ATE REMARKS LA - TOTAL D D IMP. O L N C � 2 5 - 4 4,Wis r /d1b / vv yd•o i 9/" II S�le. - P- 6 ,pMoA--7a-- d ,9. We6Q2 O s1 Qb7 1.5 I t c)p;rev Y� IkA'xS.u_-t+�C fozvv , 9 .4 - L0&e2Q y63 -VJ (fir AGE BUILDING CONDITION o2 / S_L 1174 - 40tbe r 40/7,0 . -to /VD Gn — ,Y. C- it NEW NORMAL BELOWABOVE FRONTAGE ON WATER { Farm Acre Value Per Acre Value FRONTAGE ON ROAD liable 1 BULKHEAD liable 2 DOCK liable. 3 - oodland - iampland ushland )use Plot { ,tal OWNER STREET VILLAGE DISTRICT SUB: LOT ^ .� S ' � , FORMER OWNER N ! E ACREAGE y7 A 4 :f _ S W TYPE OF BUILDING FEES, ?jl Q SEAS. VL. FARM COMM. + IND. CB. misc. fit. Mkt. Value LAND IMP. TOTAL DATE REMARKS yv , D © p y a 3 str � 380 C 211Y 0 AG BUILDING CONDITION NE\j NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD x / Q 6 - (19_ Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot Total d I' OWNER STREET VILLAGE DISTRICT SUB. LOT �LL/G�'i�JLZ40LSI -V16 FORMER OWNER N E ACREAGE r S W TYPE OF BUILDING V of Al RES. SEAS. VL. 211 FARM COMM. IND. CB. MISC. Esj�)Mkt. Value LAND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD 040 Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot Total ! I I Y las' M. Bldg, I? ZS ►` I 3.5� O Foundation +^y.^vw. ! Both — I — I — QST �i — - — -----� --f — ----d- --� --- `d. p Bt Floors Extension Y ._ /'_[ i csemen — _- - Ext. Walls Interior Finish -Y EjgMn1L� X 2 Z Qj Z.� �Oo� — — --r c--r � r-4 --------- - Extension I Fire Place r Heot --- - - Porch Roof Type 1 Porch, I Rooms 1st Floor �patio —�`---- ') Rooms 2nd Floor Garage �'Y Y Z t� -IV C) Csd y� � Driveway O. 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 4 sets 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. Examined 1 20Contact v1 Trustees : Approved GG ,20 Mail to: Disapproved a/c Phone: Expiration O� j�,20� Building Inspector 2 3 2004 APPLICATION FOR BUILDING PERMIT Date 20(� INSTRUCTIONS —d-1 �`— 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 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 ad idon 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 inspectio Gtr, (Signature of applicant or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises (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: oV� k6 /+ N ©, f - - - -- I-Toust Number Street Hamlet County Tax Map No. 1000 SectionBlock TZ38 j�bf� Z Subdivision Filed Map No. Lot �L (Ne) tOOS 3(tt al{uA xmqx3 flQiitJAklk•7 2. State existing use a,__ occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b 4) E E#4 f( I U- (7`w L f e_-�G b. Intended use: -,.ad occupancy ks Q 1 7) –C 3. Nature of work(cher;"which applicable):New Building Addition Alteration Repair _lremoval Demolition Other Work 4. Estimated Cost1 L-)00 Fee (Description) (To be paid on filing this application) 5. If dwelling,number c f 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 existi,,g structures, if any: Front Rear Depth Height Number of Stories Dimensions of sama structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entir.: 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 I.i which premises are situated 12. Does proposed con.,uaction violate any zoning law, ordinance or regulation?YES NO 13. Will lot be re-grade:i`1 YES NO Will excess fill be removed from premises?YES NO 14. Names of Owner or emises Address Phone No. Name of Architect.__ _Address'-- Phone No Name of Contractor Address Phone No. 15 a. Is this property w ,.::in 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOL_-j TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property wt .in 300 feet of a tidal wetland? * YES NO * IF YES,D.E.C. PERT.[ITS MAY BE REQUIRED. 16. Provide survey, to sc..1e, with accurate foundation plan and distances to property lines. 17. If elevation at any pent on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK; S : COUNTY ORSE being duly sworn, deposes and says that(s)he is the applicant (Name of individual si ming contract)above named, (S)He is the L"/ti�_ (Contractor,Agent,Corporate Officer, etc.) of said owner or owners,a :d is duly authorized to perform or have performed the said work and to make and file this application; that all statements contain--d in this application are true to the best of his knowledge and belief; and that the work will be performed in the manners t forth in the application filed therewith. Sworn loWore me this A falday of ­. 11 rn e 201 OAI�_ LAA& (4,0, 44f Notary dc Signature Applicant CAROL BER Ndw NPU.O1 9 of New Vxk N�� /VElp-1 200