The URL can be used to link to this page

Home My WebLink About30773-ZFORM NO. 4 TO~{ OF SOUTHOLD BUILDING DEP~d~TMENT Office of nhe Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30615 Date: 12/08/04 T~IS CERTIFIES that the building ADDITION Location of Property: 690 AUGUST LA GREENPORT (HOUSE NO.) ISTREET; (~AMLET) County Tax Map No. 473889 Section 53 Block 4 Lot 44.27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 12, 2004 pursuant to which Building Permit No. 30773-Z dated NOVEMBER 15, 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 DWELLI>TG AS APPLIED FOR. The certificate is issued to MICHaeL J. of the aforesaid building. & BARBARA BOULDIN-PUPINO ( OWIqE R ) SUFFOLK COUNTY DEPARTMENT OF }~ALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A rized Signa5ure Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL PERMIT NO. 30773 Z Date NOVEMBER 15, 2004 Permission is hereby granted to: BARBARA A BOULDIN-PUPINO 690 AUGUST LA GREENPORT,NY 11944 for : CONSTRUCTION OF AN AS BUILT DECK ADDITION AS APPLIED FOR. ADDITIONAL CERTIFICATION MAY BE REQUIRED. at premises located at 690 AUGUST LA GREENPORT County Tax Map No. 473889 Section 053 Block 0004 Lot No. 044.027 pursuant to application dated NOVEMBER 12, 2004 and approved by the Building Inspector to expire on MAY ~/~,_~ ~ Fee $ 300.00 /,I// ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEP.M1TMENT 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 tbllowing: For new building or new use: 1. Final survey of property with accurate location of all buildings, propetW 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 Underxwiters. 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. I~. For e~sting buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of properS' 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 v4-iting to the applicant. 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 Next, Construction: X Location of Property: Old or Pre-existing Building: House No. Owner or O~ners of Property: Suffolk County Tax Map No 1000. Section Subdivision Pea-mit No. Date of Permit. Health Dept. Approval: Date. II- IT-2.00"l (check one) Street Hamlet Block Filed Map. ~ Applicant: ~r~r& Underxwiters Approval: Planning Board Approval: Request for: Temporary. Certificate Fee Submitted: $ o':~'- 0 L3 - c-o -E-- 3 L5 Final Certificate: {check one) 3o773 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING ~J~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ -~ DATE FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAnkING & pL[~,iBENG ~S[~ATION PER N. Y. STATE ENERGY CODE F~ . TOV~N bF SQUTHOLD BUILDING DEPARTMENT TO%VN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~'. northfork.net/Southold/ Examined I ~/I 5'" ,20 4 Approved ,/~J'" ,20 4 Disapproved a~c Expiration__ ,-~/~'- 20 ,~ PERMIT NO. , -'3D~3 ~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the followin~g, before applying? Board of Health 4 sets of Building Plans Planning ~ard approval Survey · Check / Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Building Inspector I 2 2O04 APPLICATION FOR BUILDING PERMIT Date kl~t:vnl:~',~ I ~- ,2000I' INSTRUCTIONS a. This application MUST be completely ffiled 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 prenfises, relationship to adjoining premises or public streets or :(cas, and watenvays. 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 shah 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 Departmem 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 inspecilons. '~c[~o~ ~. ~C~id,~- Do{~,I~0 [~] [~/ (Signature of applicaat or name, if a corporation) (Mailing address of apphcam) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (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. Location of land on which proposed work will be done: ~u~us~ Lq ~oe._ Hamlet House Number Street Count3' Tax Ma,,p No. 1000 Section Subdivision ¢qame) ' Block t.{ Filed Map 2. State existing use and occupancy of premises and intended use and occupancy of proposed consm~ction: a. Existing use and occupancy .~_$ ka~,' ~4 /-ko c ~(_ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars Iq (' '4nrhor Addition Alteration Other Work -~% [;Z~u/~ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. I%L' 't 2-0~ 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size oflot: Front [ {~t.~t I Rear [~{q I .Depth Rear Number of Stories 10. Date of Purchase ~ - ~0 -q el Name of Former Owner --~hl2mDc,' 143m0~. .~}df , 11. Zone or use district in which premises are situated ~[~.- ~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NOX~ 13. Will lot be re-graded? YES__ 14. Names of Owner of premises Name of Architect Name of Contractor NO y Will excess fill be removed from premises? YES__ Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES__ NO__ * iF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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 --°xtf"f:~l~ (Name of individual signing (S)He is the ~f~x,l~ 0'[' (Contractor, being d~y/~worn, deposes and says that (s)he is the applicant e Officer, etc.) of said owner or owners, and is duly authorized to that all statements performed in the mariner set forth in the application day . or have performed the said work and to make and file this application; * best of his knowledge and belief; and that the work will be ~l~a ftur~e of Applic~ ~0