HomeMy WebLinkAbout30519-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30637 Date: 12/14/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 7945 M3~IN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 2 Lot 28
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 19, 2004 pursuant to which
Building Permit No. 30519-Z dated JULY 28, 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 ACCESSORY NON-HABITABLE UNHEATED GAP~AGE IN THE REQUIRED REAR
YARD AS APPLIED FOR.
The certificate is issued to RAYMOND & JUDITH JACOBS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~EALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
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 UI~TIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30519 Z Date JULY 28, 2004
Permission is hereby granted to:
RAYMOND JACOBS & WF
PO BOX 255
EAST MARION,NY 11939
for :
CONSTRUCTION OF AN ACCESSORY, NON HABITABLE, UNHEATED GARAGE IN
THE REQUIRED REAR YARD AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 031
pursuant to application dated JULY
Building Inspector to expire on JANU/LRY
7945 MAIN RD EAST MARION
Block 0002 Lot No. 028
19, 2004 and approved by the
28, 2006.
Fee $ 979.80
/ Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUP_an'NCY
This application must be filled in by typexwiter 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 Ulmsual 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 amhitect 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, Alterat ons 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
New Construction:
Location of Property:
~ Old or Pre-existing Building:
House No. Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Date.
(check one)
Hamlet
Block ~9 Lot
Filed Map. Lot:
Permit No. ?~')~'/~
Health Dept. Approval:
Planning Board Approval: /L/.~-/
Request for: Temporaw Certificate
Fee Submitted: $ olg,.Dr~',, t~ ~
'7-.110- o './ Applicant: /'~-4~t~oa3t'D /-
Underwriters Approval: /L/.,,~t
Date of Permit.
Final Certificate:
p'~" (checkone)
) ~pplicant Signt~tr~'
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT, N.Y. 11944
(631) 477-1652
November 29, 2004
Michael J. Verity, Department Head
Southold Town Building Deparment
Main Road
Southold, NY 11971
Re: Residence
Raymond Jacobs
7945 Main Road
East Marion, NY 11939
Barn
Permit No. 30519 ~
To Whom It May Concern:
I have inspected the strapping of the above
mentioned project on October 20, 2004, and found
that all the strapping had been installed in
accordance with the New Yrok State Building Code
and the Southold Town Building Code.
Sincerely, /~~/~
~~ce M~. Tuthill, P.E.
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P,O. BOX 162
GREENPORT, N.Y. 11944
(631) 477-1652
AuguSt 6, 2004
Mr. Michael J. Verity, Department Head
Southold Town Building Department
Main Street
Southold, NY 11971
Re: Garage
Raymond Jacobs
7945 Main Road
East Marion, NY
Permit # 30579 Z
11939
rence
To Whom It May Concern:
I have inspected the site of =~--- ~ ~ the newly
poured concrete foundation for the garage at the above
mentioned residence with respect to the removal of the
concrete form ties and the parching of these holes in
~reparation of the waterproofing of the foundation wall.
his work meets the requirements of the New York State
Building Code and the Southold Town Building Code
Sincerely,
M. Tuthill, P.E.
Applicanff
ArchitecV
SCTM//:
Distric: J.000 Section: ~ / Block. 07[- Lot °~-~
Ih'ojecl
Date
Reviewed:
Date
Submilled
Subdivision
Suffolk Comity Health'Dcpt ,~
New York State. D. E; C. ...///
row, r,,~t~ . /
Town Zonln. g Board approval: _
Town Plmmi~ Board approval: :/
Flood Plane Elevation ?~
Flood Zone:
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT, N.Y. 11944
(631) 477-1652
December 6, 2004
Mr. Micael J. Verity, Department Head
Southold Town Building Department
Main Road
Southold, NY 11971
Re:
Barn
Raymond Jacobs Residence
7945 Main Road
East Marion NY 11939
Permit No. 30519 ~
To Whom It May Concern:
I have inspected the above mentioned baRN ON
December 5, 2004 with reference to the height limitation
requirement of the Southold Town Building Code
being 18' mean height above grade base~.on_th~ average
the shingles to the soffit under the eaves 8'-7".
This gives an average of 15'~ The average heigh~f the
fill at the base of the foundation to the bottom of
the shingles is about 1'-7". The total height of the
average height is 16"-7" does not exceed the limitation
of height above grade of the Southold Town Building
Code.
Sincerely,
rence ~. guthill,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] F~J,INDATION 2ND [ ].~JLATION
[//~AMING [ ~ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS.
DATE
INSPECTOR~jh
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]IN~J~'I~iON
[ ] FRAMING [~NAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ~ ~'-~'~-~ /
I'OWN OF SOUTHOLD
BUILDIN~ DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southoid/
Examined ~f~, 20~L~
Approved ~/~200~
Disapproved
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
plnnnin~ Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Tmst~s
Contact:
Marl to:
Phone: ~-7 7 -
rz:&~ i ' B~i~g ~spector
a. ~s application ~ST be oompIetely ~flled ~ by ~e~ter or ~ ~ ~d sub~tt~ to ~e B~g ~peotor wi~ 4
sets o~ pl~, aec~te plot pl~ to sc~e. Fee ~o~g to s~hed~e.
b. Plot pl~ show~g Ioc~fion of lot ~d o~b~l~gs on pre~sos, ~l~tions~p ~ ~djo~g p~ses or pubIi~ s~s or
~e~, 8nd wste~sys.
c. ~e work ~over~ by t~s appelation may not be eommen~ed befo~ ~ssu~e of B~g P~t.
d. Upon approv~ o~s applio~fion, ~ B~g ~p~tor will issue a B~g Psat to ~ ~ppH~t. Suoh a ~'~t
shall be kept on ~e premises a~able for ~tion ~ou~out the work.
e. No b~ld~g s~ be occupied or ~ed ~ whole or ~ p~ for ~y p~ose w~t so ev~ ~ ~e B~g ~po~tor
issues a Ce~ifi~te of O~eup~cy.
f. Ew~ buil~g pe~t s~I exp~e ff ~ work au~o~ ~ not com men~ ~h~ 12 mon~ ~er
issu~ce or ~s not ~en completed w~t~ 1 ~ mon~ ~om such ~te. ~no zo~g ~;~ or o~ ~tiom
prepay ~ave been enacted ~ ~e ~te~, ~e B~l~g ~spo~tor ~y au~ofize, ~ w~t~g, ~e e~o~ion of
addkion six mon~s. There~er, a new p~t s~ ~ ~qu~ed.
~PLICATION IS ~BY ~E ~o ~e B~l~g D~t for ~e iss~ce ora Bufl~g Pe~t p~t to
Bmld~g Zone Ord~ce of the To~ of Sou~old, Suffo~ Go~, New Yor~ ~d o~ ~pp~cable Laws, ~oes or
Re~lafions, ~or the con.orion ofbufl~gs, ~tio~, or aItemfio~ or for ~mov~ or d~o~fion
applie~t a~es to comply wi~ all app~abIe laws, o~i~ces, buil~g ~ode, hous~g o~, ~d ~io~, ~d to
authored ~spectors on p~ses ~d ~ b~l~g ~or neoess~ ~p~fio~.
' (~ Of ep~t~ ~,~f a co~o~oa)
,2o _q_
(Maili~$ ~ddress of applicant) ~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
· / (As on thcg/tax roll or lates~eed)
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:
7¢V5'
House Nuthber Street
Hamlet
Cqunty Tax Map No. 1000
Subdivision
(Name)
Section (~.7)
Block ca~'
Filed Map No.
2. State existing use and occupancy of premises allld inlended use, ttad occupancy o f proposed constmctiort:
a~ Existing useandoceupancy ..~fg~ ~
b Intended ~ '" / ~
3. Nature of work (check which applicable): New Building ~ Addition Alteration
Repair Removal Demolition Other Work
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(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 Number of Stories
8. Dimensions of entire new construction: Front 'St_~r Rear
Height /~'¢~ Number of Stories .,~
Rear
9. Size of lot: Front Rear
10. Date of Purchase /~ ~ .,*' 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-graded? YES NO t//Will excess fill be removed from premises? YES
14. Names of Owner of premises~ ~eAddress~.~~hone No.
Name of Architect ~ ' C/ Address Phone No
Name of Contractor Address Phone No.
Depth
15 a. Is this property within 100 feet of a tidal wetland or a freshwater xvetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE ~QUIRED.
b. Is this property withln 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 )
being duly 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.
Swo~n to before me this
of,
Not. Public
NO.
fluallfiafl In Suffolk Oou~ ~.