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Home My WebLink About30628-ZFORM NO. 4 TOW~[ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, CERTIFICATE OF OCCUPAi,IC¥ NO: Z-30601 Date: 12/01/04 THIS CERTIFIES that the building ALTERATION Location of Property: 3105 PECONIC LA {HOUSE NO.) ~STREET) County Tax Map No. 47B889 Section 74 Block 4 Subdivision Filed Map No. Lot No. PECONIC /HAI4LET) Lot 16.1 conferms substantiall5- uo the Application for Building Permit heretofore filed in this office dated SEPTEMBER 10, 2004 pursuant to which Building Permit No. 30628-Z dated SEPTEMBER 10, 2004 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancv for which this certificase is issued is ALTERATIONS TO EXISTING PORCH ADDITION OF EXISTING SINGLE FA24ILY DWELLIMG AS APPLIED FOR. The certificate is issued to JULIA DAY LEO of 5he aforesaid building. SUFFOLK COUNTY DEPARTMi~qT OF ~]L~LTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~D N/'A 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) PERMIT NO. 30628 Z Date SEPTEMBER 10, 2004 Permission is hereby granted 5o: JULIA DAY LEO PO BOX 299 PECONIC,NY 11958 for : CONSTRUCT ALTERTAIONS TO EXISTING PORCH ADDITION OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#17354. at premises located at 3105 PECONIC LA PECONIC County Tax Map No. 473889 Section 074 Block 0004 Lot No. 016.001 pursuant to application dated SEPTEMBER 10, 2004 and approved by the Building Inspector to expire on MARCH 10, 2006. Fee $ 150.00 ~ z/e/~~e~· ORIGINAL Rev. 5/8/02 · 0~ NO. ~ TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017354 Z Permission is hereby granted to: x'~....m.......~ ........................... .~./..~.~...,.~~~...~..~ ....... County Tax Map No. 1000 Section .......... ...~...~...... Block ........~ ....... Lot No ........ .~....~'... ....... pursuant to application doted ............ ~./.../....~-.... ............................ , 19.~ end opprov~ by the Building Inspector. Fee $... ~..~ ............... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTM[ENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP.~NCY This application inust be filled in by typewriter or ink and subnfitted to the Building Department with the following: ho 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 pinmber certifying that the solder used in system contaius less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and sitnilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Subnfit 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: I. 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. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therelbr in writing to the applicant. 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 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. ~/[~/D y New Construction: Old or Pre. existing Building: ~ Location of Property: .~/~' tt~:'ffn~>,'Qt 'C~ ~,~2'~ House No. Street OwnerorOw rsofPruperty: Suffolk County Tax Map No 1000, Section '~ ~( Block (check one) P- con , 'C Hamlet Subdivision Filed Map. PermitNo. .~:~2.)~'~.~ DateofPermit. ~ ~[Q~O~ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (checkone) Fee Submi~ed: $ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS:~ ~* ~' DATE ~' 7,,~c// ]: FOUNDATION ( Is[ FOU~IDATION { 2nd 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI~IAL ADDITIOIIAL COMME~ITS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... · CHECK ...................... SEPTIC FORM ................ TEL.: 765-1802 CALL . :..~f~ ....... Examined. . .~X/..~...~Q.. ..... ., 19 ... ~''~ ~O~o"~ ~ ~ ,MAIL ./T0" .~' [--/ . Approved . ~ ' 19 ggPc~it ,NO. (.7~ ..... z ~ ............. d~ J4 4 Disapproved a/c ..................................... ) ::.: ??-: " :.-:: .......... .... / 6./' :/":/" APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Ttus application mfist .b~e complet~}~ filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurqte=plot plan, to seale: Fee*acCdri~Ing to schedule. b. Plot plan showing loca~tj6p~o, fjl~t"~id of~buildings on premises, relationship to adjoining premises or public streets or areas, and giving' a~deta~led description of layout of property must be drawn on the diagram which is part of tkis apph- c. The-work covered by t~s application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit ~o the applicant. Such permit shall be kept on the premises available for inspection throu-Juout the work. e. No building shall be occupied or used in whole or :n part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depm-tment for the issuance of a Building Permit pursuant to the Bu:lding~°NZ~',~c& ~A~ T~ of So~thola. Surfo:~ County, ~e,v ¥or:, ~d other applicable laws, Ordnances or P, egulati~n~ .J{oi-lt~,~jl~iu, cyiorj ~J~uildin~s, additions or alterat OhS or for removal or demo ition, as herein described he apph'~'a~f~l{g~s to c~)~p~ly wtt~all apphcable laws, ordinances, building code, housin~ code, and regulations, and to · .... CERTIFIC/ TE o, appl'cant, or.ame, i:.,corpo a:,on)''' State whether applicant :s owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. ~ ~ ,~ APP~[D AS N~D ~ . · N~-~I~ING DE~R~ENT AT 765-1~M ~ 4 PM FOR THE .............................................. FO~OWI~G IN~PEC~ONS: (Name a~d title o~co~orate o~ce~) 1. FOUNDAT~N, . ~ REQUIRED 'FOR ~ED CONCR~E Builder's License No ..... ~ ........... 2. ROUGH ~AMING & PLUMBING PJumber's License No ......................... 4. FINAL, .. ~dNSTRUCTION MUST BE coMmiE FOR C.O. ' ~]ectrJcJan's ~Jccnse No ....................... ALL CONSTRUCTION SHALE MEET THE REQUIREMENTS OF THE N.Y. Other T[=dc's License No ...................... STATE CONSTRUCTION ~ ENERGY CODES. NOT RESPONSIBLE FOR ]. Location oF l:nd on which proposed work will bc done ................ DESIGN.QB CP. NS[RUC~ON.~B~ ...... House Number Street H~mlet ' County Tax Map No. 1000 Section .... ~.~ .......... Block ................ Lot ............... Subdivision ..................................... Filed Map No ............... Lot (Name) ............... 2. State e~isting use and occupancy of premises and intended use a,d occupancy of proposed construction: ~, Existm~ use and occupancy ........................ , ............................. 5~ ~.~ ,... .... b. Intended use and occupancy · · · ~-~k · ' ' ~ ' ' ..... interior,or comer lot. 3. Nature of work (check whigh applicable): New Building ..... ' ..... Addition .......... Alteranon ......... Repair . ~ ~...~.1~..~6. P-?~emoval .............. Demolition .............. Other Wo.r~...~ ....... ~ ~ '(~'cscnption) 4. Estimatid Cos . ~ O.O.,. ~.Q ....................... Fee .................. ". ............ : ..... (to be pa~d on filing this application)- : 5. If dwelling, number of dwelling units ..... [ ......... Number of dwelling units on cacb tloor ............... If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions ofexistin~ stn~ctures, if any: Front .... ~5¢' ........ Rear .............. Depth .... ~ ........ Height . . IQ ........... Number of Stones ....... l ................. r~ ..... l ....................... Dimensions of same structure with alterations or additions' Front 2 ~ ( ~ g J Rear .................. Depth ......... ~ .......... llei~t .... :...l~ ............ Number of Stones ... ] .................. 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 Foyer Owner ............................. 11. Zone or use district in which premises are situated ...... ~.~O~.~},~ ................................. 12. Does proposed constructim~ violate any zoning law, ordinance or regulation: ...hi.G .......................... 13. Will lot be regraded ~O ......... Will e.~cess fin be removed from premises: Yes No 14.Nme of Owner of premi}~s' ~6dt~j .o..~ ~... Address?[fOO.~.. D .J ..... Phone No.~} ~: .......... Nme of Architect ........................... Address ................... Phone No ................ N~e of Contractor .......................... Address ................... Phone No .... ..-..,..- 15.Is this property' located vithln ~00 feet of a tidal vetland? *~gS'.'."'~O~' ~If yes, Southold To~n Trustees Permit may be required. PLOT DIAG ~M Locate cle~ly ~d distNctly ~1 bufldNgs, whether existing or proposed, ~d indicate ~1 set-hack d~ensions from prope~y ~nes. Give street ~d block number or description accord~g to deed, ~d show street nines and ~dicate whether ~ ~ ~' .... ~ ~, ....,: , _ , . STATE OF S.S ............... ~ ' ' " .......... %~ ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. te is the ...................... (Contract rporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed [he said work and to make and file this :pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york w~l be perforated in the m~ner set forth in the application filed therewith. ;worn to before mc this , .............. of .... .... Ou~l~ied in Suffol~ CounW Comm~ssron Expires December 8. (Signature of applicant)