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HomeMy WebLinkAbout30436-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30709 Date: 01/21/05 THIS CERTIFIES that the building ADDITION Location of Property: 1695 C9 CALEB'S WAY GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 40 .1 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18, 2004 pursuant to which Building Permit No. 30436-Z dated JUNE 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 ADDITION OF BILCO ENTRY DOOR TO UNIT #C9 AS APPLIED FOR. The certificate is issued to CYRUS J & JOSEPHINE BACCHI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 01 ori ed Signature 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. 30436 Z Date JUNE 24, 2004 Permission is hereby granted to: CYRUS J BACCHI 28 PERTH PLACE EAST NORTHPORT,NY 11731 for BILCO ENTRY AS APPLIED FOR at premises located at 1695 C9 CALEB' S WAY GREENPORT County Tax Map No. 473889 Section 040 . 001 Block 0001 Lot No. 009 pursuant to application dated JUNE 18, 2004 and approved by the Building Inspector to expire on DECEMBER 24, 2005 . Fee $ 200 . 00 i Aut d Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD AN 1 9 ^ 7 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 ,T-NeDate. 0/— / -,T- New w Construction: Old or pre-existing Building: ✓ (check one) Location of Property: 9F . 1_117141 G—C/3 S �/�! 2 e-,Cit/ �a 2T House No. Street Hamlet Owner or Owners of Property:_ tet./ r LI S .4 a o S e phi Y►e C C Suffolk County Tax Map No 1000 Section d*j.. O O Block O©o Lot 009 Subdivision Filed Map. Lot: Permit No. 7Z)p�1o-7— Date of Permit. D 6-214-D1V- Applicant: uS Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: y (check one) Fee Submitted: $ 91. licant Signature G2S9/ / -• cam 36� a9 Di;�4 -- , ` - _... TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 1 60(5 VILLAGE DIST. SUB. LOT �j���S Q� ACR. REMA KS � 2 �( - � Z_1°l�� • � �� t��P�e. &5. on x•1-5 R-ib -11-12 TYPE OF BLD. �r Lt�� .sir �.391-L PROP. CLASS 2�rLwu Lo ld z i-7orb' - UY )t6t �t6 7 a 3i�o LAND IMP. 'AL DATE —L 2 �� a ewl 4, 04 4 SD© � - — --- FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL SOMERSET MA YBERRYMA BERRY SOMERSET (AE) I 00 00 (AE) ' A C- COLOR I wQ avaow► ewseo.n man,,., /Yo'xKo /to1As'o /J'oxM�o' .Y'oi/So c UVAV& tis►. "', TRIM TN a►T KOBAT4 Knrrae� nrcMf� $M 0A if Kxkmfi 1'rif i UY�6 jCODM 11v/N6 pipRppt� p�epq /9 0'r n'o' Rao.n /t0iM0 /tOi/Foy /90 if M. Bldg. Foundation Pc Bath Dinette FULL Extension 2d OIn I2?S {too Basement sloe L Floors w w Kit. Vol, Extension S X 942 Ext. Walls Interior Finish e;, L.R. v Extension Fire Place Heat %ICS D.R. Patio Woodstove BR. Porch Dormer Fin. B. Deck Attic Breezeway Rooms 1st Floor Garage Driveway Rooms 2nd Floor O.B. Pool 76S•1802 BUILDING DEPT. INSPECTION [ .�FO DATION IST [ j ROUGH PLBG. [ OUNDATION 2ND [ j INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARK DATE � �� D INSPECTOR 30�3�e� 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ =NAL ATION [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE � Q INSPECTOR � r FIELD INSPECTION7REPORTjr COMMENTS �b FOUNDATION � y tt -------------------------------------- _ �6TC FOUNDATION(2ND) �, y b n ROUGH FRAMING& PLUMBING I y 1 INSULATION PER N.Y. STATE ENERGY CODE �a -1 ff7 ,5 ,1 U 1 FINAL Ll ADDITIONAL COACM[ENTS Y-, n �-0 Z m lU � y C7 O x d 2. State existing use and occupancy of premises and i�ltended use and occu7ancy of proposed construction: a. Existing use and occupancy '51 �Cl�C – w �' �� b. Intended use and occupancy jg A W v A 3. Nature of work(check which applicable): New Building Addition Alteration V Repair Removal Demolition Other Work (Description) 4. Estimated Cost 05-d-e­o Fee (To be paid on filing this application) 5. If dwelling, number of 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 existing truc es, if any: Front3 d Rear 30 Dept Sa ' Height A. 11 Number of Stories / Dimensions of same structure with alterations or addi i ns: Front 3 0 Rear—3,o Depth --5-2 Height a' Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Dept 10. Date of Purchase amu.N2 5" gName of Former Owner f r'Q /V I5-212 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO x 13. Will lot be re-graded?YES' NO )( Will excess fill be removed from premises?YES NO 77. 30 11,E 14.Names of Owner of premises-./ C. &�Ac Address �.Gs/ Lv� C� lone No. 41 Name of Architect � 5; �IF>9 Address w d b hone No '73V-.47f'1' Name of Contractor > & 0 tel✓ Address by Phone No. Soi l o l /�97/ &1W e-5 zG(? //y 3 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 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) S: COUNTY O 11 S I ce-4 i JO. N 1 j;p- �,q�� being duly sworn,deposes and says that(s)he is the applicant (Name of individual si g 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 true 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. Sworn to be,€ore me this day o 20Q otary Public Signa of Kpplicant PATRICIA CORWIN Rotary Public,State of New York No.01C05011852 +'.ualified in Suffolk County ,icn Expku Sept.13,1.20, TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NI 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631)765-9502 Survey www.northfork.net/Southold/ PERMIT NO. A Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20± Contact: Approved ,20 Mail to: Disapproved a/c �� t 2 �� ' Phone`: J Expiration 1L 20 �V ildi s ector NTZZ 18 r APPLICATION FOR BUILDING PERMIT. l Ls p Date / 200 r,i `?` INSTRUCTIONS T y5! �1 ;)l;rr DLD 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 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.ippon 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 bas 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 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,anto admit authorized inspectors on premises and in building for necessary inspections. *V—p-e-go" - Z/6/17�.1 rt (Sig2feae of applicant or name,if a corporation) ailing address of applicant) W Por'-" R/y //7,3 / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder JIVAIdER Name of owner of premises U 5 •-' at -fid s� A 1 �9 G C �]l� (As on the tax roll of 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 pro se work will be done: G'.4 '.5 r� ery 09 � ,l 9 q House umber Street Hamleil County Tax Map No. 1000 Section 4 iCl, O l Block �� D-fl Lot &0 g� &V Subdivision Filed Map No. Lot . (Name) 'The Somerset Somerset I f� p c CP: rX ItEURUOMI 'BEDRDO 0 bSG' etlle 11.0 ix 11'.01 I BATH � I I BATH K=HEN W+D DINING AREA X,s ,nrc� Pec K i LIVING ROOM 24'4'a ZT-W FIOVED AS NOTED � DATE, B.P.N FEE.' 81. NOTI Y BUILDIP+G DEPARTMENT AT 7 765-7802 6 AM TO 4 PM FOR THE �yy FOLLOWING INSPECTIONS:REQUIRED . IjL 1. FOUNDATION - T FOR POURED )NCRETE ,_ING & PLUMBING Edi - 2. ROUGH - FRAM 3. INSULATION ALL CO ?- �F 114. FINAL - CON"TRUCTION MUST 8E COMPLETE FOR C.D. , NSTRUCTION SHALL MEET THE ; F NEW - -- - - ----- -- - ----.---� (p ,� " !h' YORKIREMENSTATET NOT TRESPONS RESPONSIBLE FOR ------------ __ _--_._--- --- -__-- DESIGN OR CONSTRUCTION ERRORS ,'. OCCUPANCY O1 2xlo USE IS UNLAWFUL ----�-- WITHOUT CERTIFICATE OF OCCUPANCY - �>L�I'-rel �� !,III-.It�.•I�I h-Ih�=t.L p�I�, �.I WI II �T _ ¢^� �n^� ALL CONSTRUCTION SHALL -- 3 k C (f I �_—, > RRW MEET THE REQUIREMENTS OF THE L _ f T CODES OF NEW YORK STATE. e_ e„uT�f(IJ� pip i • �Cjr I L.�w�.aLl_ '4�F�tA FT-FG 6 ” C7�'"'I2 - 1.11P-1 12 ° r-xTtAlrta Ft S ' r 4P y. 40 ,+ ,t \1 J 1 -Fc T! U'a TC) W,—�2T i�ILCO C - 7 a OF NEWY lscy o r t yyJ, 0. 052 �tt2 gDFESSIO�P P546/,H I 9 CQI_ Pf� Way 161lzee . wv-T- 1IY SCALE Ila" APPROVCDer DRAWN er '.GJ DRAWING NU.8ERvo