HomeMy WebLinkAbout30528-ZFORM NO. 4
TO~ OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUP~NCY
No: Z-30622 Date: 12/09/04
T/~IS CERTIFIES that the building ADDITION
Location of Property: 106 THOMPSON BLVD. GREENPORT
(HOUSE NO.) (STREET) (}LAMLET)
County Tax Map No. 473889 Section 35 Block 1 Lot 25
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J-JLY 27, 2004 pursuant to which
Building Permit No. 30528-Z dated J~JLY 29, 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 ADDITION & ALTERATION TO EXISTING DWELLING UNIT #106 AS APPLIED FOR.
The certificate is issued to PECONIC LANqDING INC.
(O~;ER)
of the aforesaid building.
SUFFOLK COUAYI"f DEPART~4ENT OF ~RALTH /%PPROVI%L N/A
ELECTI~ICAL CERTIFICATE NO. 93116C 11/04/04
PLUMBERS CERTIFICATION DA'£mu N/A
Rev. 1/81
/~/t~gnature
¢
DATE 07/29/2004
ROLL SEC TAXABLE
TOTAL RES SITE
TOTAL COM SITE
ACCT NO 17
1======== ====== ASSESSMENT DATA ===========
1 **CURRENT** RES PERCENT 1
ILAND 64,800 **TAXABLE**
ITOTAL 2,161,972 COUNTY 2,082,961
**PRIOR** TOWN 2,082,961
ILAND 64,800 SCHOOL 2,161,972
ITOTAL 2,161,198
==DIMENSIONS ===1======= SALES INFORMATION ==================================
ACRES 145.01 IBOOK 11954 SALE DATE 03/16/99 SALE PRICE 8,531,000
IPAGE 591 PR OWNER LBV PROPERTIES
=======TOTAL EXEMPTIONS 6 =============1== TOTAL SPECIAL DISTRICTS 3 =====
CODE AMOUNT PCT IN IT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE
41854 100,280 04 IFD031
41834 81,090 04 49 IWW020
41121 17,388 04 ISW011
41131 57,753 04 1
F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC
75.10- 03-050 F6=GO TO INVENTORY F9=GO TO XREF
473889 SOUTHOLD
NYSRPS ASSESSMENT INQUIRY
SCHOOL GREENPORT SCHOOL
PRCLS 642 HEALTH BLDG -CO-OP
35.-1-25
1205 MAIN RD
= OWNER & MAILING INFO
PECONIC LANDING AT
SOUTHOLD INC
1500 BRECKNOCK ROAD
GREEN PORT NY 11971
===I=MISC
IRS-SS
1 1
1 BANK
F4=PREV EXEMPT/SPEC
F10=GO TO MENU
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. 30528 Z Date JULY 29, 2004
Permission is hereby 9ranted to:
for :
LANDING AT PECONIC
1500 BRECKNOCK ROAD
GREENPORT,NY 11971
ADDITION/ALTERATION TO I/NIT #106 AS APPLIED FOR
at premises located at 1205 MAIN RD GREENPORT
County Tax Map No. 473889 Section 035 Block 0001 Lot No. 025
pursuant to application dated JULY 27, 2004 and approved by the
Building Inspector to expire on JANUARY 29.~_2~06.
Fee $ 150.00 ..
COPY
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOVCN 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:
Ao
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 aud sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Under~,riters.
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.
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.
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. .4d~g~-g~_ Or g ~_~70~--
New ~ns~ction: Old or Pre-exist~g Building: ~ . (ch~k one)
~cationofPro~: /~ ~/~ ~0 ~~~ [
Ho~e No. Strut H~
O~erorO~sofProp~y: ~ ~-~ ~~ ~ ~~dO~/C ~~
Suffo~ Co~ T~ Map No 1000, S~tion ~ Bilk ~/ ~t ~ ~ ~
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ .~, --
Filed Map.
~O~Z~:~-~---~ DateofPermit. Z/Z~/~ Applicant:
Underwriters Approval:
Final Certificate:
(check one)
c
t~/
Appliet~ignature
Issue Date
11/5/04
Electrical Inspection Certificate
Electrical Inspection Service, Inc. Application Number
375 Dunton Avenue 93116C
East Patchogue, New York 11772
(631) 286-6642
Issued To: Mr. & Mrs. Sedat
Street: 106 Thompson Blvd
Village: Greenport Zip: 11944
Section: Block: Lot:
Town: Southhold
Contractor: Shore Power Electric Contracting Lic. # 31697-ME
Was examined and found to be in compliance with the National Electrical Code.
[] Commercial [] NVDefects ~ Pool [] lstFIoor [] Indoor [] Basement E~]HotTub
[] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor ~] Addition [] Survey
Switches Receptacles Fixtures GFI Heaters A/C Fans
3 6 4
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi Television CO Detector
Bldg. Permit:
Other Equipment
Sunroom
Hugo S~Surdi
President
Rough Inspection: 10/21/2004
Inspector: John Mc Mahon III
Final Inspection: 11/04/2004
Inspector: John Mc Mahon III
This certificate must not be altered in any manner, inspectors may be identified by their credentials.
Frank W. Uellendahl Architect
PO Box m6, Greenport, NY 11944, tel: 6514T/~6:Z4 fax: 6~1.477.2997 em~ll=fuellend@optonllne.net
November 1,2004
Clients:
Ed and Dorothy Sedat
Peconic Landing
106 Thompson Boulevard
Greenport. NY 11944
I 2004
BUILDING PERMIT # 305~8-Z
Conservatory Addition to Cottage # 106 at Peconic Landing, Greenport
INSULATION INSPECTION
Al: the request of the contractor of the above referenced addition I inspected the insulation in the crawl
space (R-30), walls (R-I 9) and ceiling (A-30) and found that the work was done according to the
architect's specifications.
I hereby state that the information provided above is true to the best of my knowledge.
~Fmnk U~ll~ndahl
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] F/OUNDATION 2ND [ ] INSULATION
[ ,/] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ~ ~
DATE
INSPECTORf~ ~,~~/
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[[i ;ROAU~ID~GTION 2ND [[ ~~NALATION
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMAR~
DATE
INSPECTOR
FIELD INSPECTION REPORT I DArTE I COMMENTS
...................................... i ,l,
PL~G
~S~A~ON P~ N. Y.
STA~ ENER~ CODE
II/~ ~ ~ ~
F~
~0~ CO~S
PERMIT NO. ~t~
TOWN (~F SOIITHOLD
BU1LDIN'; DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
/
Examined 9/~ ,20
Expiration ,~//~ ? ,20
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Plamaing Board approval
Survey_
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact;
7 e, ,2oo,b
APPLICATION FOR BUILDING PERMIT
-., Date
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 adjoi~fing 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 builffmg shall be occupied or used in whole or in pap' for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every buikYmg permit shall expire if the work authorized h~}'nct commenced within 12 months after the date of
issuance or hgs not been completed within 18 months from such date. If no zon/ng amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, thc 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 Ord'mance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildmgs~ additions, or alterations or for removal o1' demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances~ building code, hou~code, and/~iegulations, and to admit
authorized inspectors on premises and in building for necessaO inspections. /~/~
~,9~nature of"a~ppli~ant or name, if a corporation)
(Mailing addr}ss of applicant)
State whether applicant is oxvner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name ofox~mer of premises ~ ~/;E~,~7",~t/~'~' ,.~'~";~..~7-
(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. d.~-~7'~:~ /4J'tO~,~t
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
Block t/' ,.
Filed Map N6:'
Lot '~-~' ~
Lot
2..State existing use and occupancy of premises and intended~ use and occupancy of proposed constru~.tior~:
a. Existing use and occupancy ,~-~:=~/g~J"~/9 (_~
b. Intended use and occupancy
3. Nature of work (check which applicable): Nexv Building
Repair Removal Demolition
4. Estimated Cost 1~ ~)~ 0"~. ~
5. If dwelling, number ofd~velling units
If garage, number of cars
Addition
Other Work
Alteration
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front ~,,~ / Rear
Height ~, ~.~¢~ # Number of StOries- -/
Dimensions of same structure with alterations or additions: Front
Depth ~'7, [ /! Height q- ~.Z~-~ ~t Number of Stories
8. Dimensions of entire new construction: Front 2~,2~ ! Rear
Height ~/~_ ~ d Number of Stories
Depth 5//!
Rear ~2/
/
Depth /~'. !;
9. Size of lot: Front
Rear Depth
10. Date of Purchase ~00~
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
,
13. Will lot be re-~aded? YES__ NO ~ Will excess fill be removed ~om premises? YES NO__
14. Names of Owner of ~mises~g~q ~Ad~ess~/¢~
Nme of Architect ~ff ~//~ / Address ~ g/~
Name of Contractor ~ ~d/~ Address ~ q~ ~a~ Phone No. ~3/. ~. 37~7
15 a. Is this prope~y within 100 feet of a tid~ wetl~d or a ~eshwater ~vetland? *YES__NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE ~QUIRED.
b. Is this prope~y wit~n 300 feet ora tidal wetland? * YES__ NO
* IF YES, D.E.C. PE~S MAY BE ~QUIRED.
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 beloxv, must provide topographical data on survey.
STATE OF NEW YORK)
· SS:
COUNTY OF~
~;~,/../~" //~/~ /.d'~'/.Z~-',,4d~t~/'~ ' being~uly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(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 tree 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.
Sxvo,qa to before me this{\
,d-?/' , dayof \L~
~ ~ Notary Public
LYNDA M. BOHN
NOTARY PUBLIC, State of New York
No, 01 B06020932
Oualified In Suffolk County
Term Expires March 8, 20 ~.~
t~f Applicant
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O<::~ DATE: 07/26/2004
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