Loading...
HomeMy WebLinkAbout30549-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30387 Date: 02/01/05 THIS CERTIFIES that the building ADDITION Location of Property: 2460 GRANDVIEW DR ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 14 Block 2 Lot 3 .8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 6, 2004 pursuant to which Building Permit No. 30549-Z dated AUGUST 6, 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 TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SUSAN R. WORTH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 94462C 12/20/04 PLUMBERS CERTIFICATION DATED N/A Authorized 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. 30549 Z Date AUGUST 6, 2004 Permission is hereby granted to: ROBERT V HUNGERFORD PO BOX 609 ORIENT,NY 11957 for CONSTRUCT AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#16283 . at premises located at 2460 GRANDVIEW DR ORIENT County Tax Map No. 473889 Section 014 Block 0002 Lot No. 003 . 008 pursuant to application dated AUGUST 6, 2004 and approved by the Building Inspector to expire on FEBRUARY 6,/2006 . Fee $ 150 . 00 Autho ze Siarlat\L ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD 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 I%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 Date. � — 7i S-_-0� New Construction: Old or Pre-existing Building: (check one) R Location of Property: House No. Street hamlet Owner or Owners of Property: �. Suffolk County Tax Map No 1000, Section_� Block '1/ Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ � Applicant S)ddature co-F, 303 s�? X2'5q q OFAkqwALqWA Electrical Inspection Certificate Issue Date Electrical Inspection Service,Inc. Application Number 12/20/2004 375 Dunton Avenue 94462C East Patchogue,New York 11772 (631)286.6642 Issued To: Ms. Susan Worth Street: 2460 Grandview Drive Village: Orient Zip: 11971 Town: Southold Section: Block: Lot: Contractor: Brite Star Electric Lic. # 3398-E Was examined and found to be in compliance with the National Electrical Code. ❑ Commercial ❑ NV Defects ❑ Pool ❑ 1st Floor ❑ Indoor ❑ Basement ❑ Hot Tub Residential X❑ Det.Garage ❑ Attic ❑ 2nd Floor ❑ Outdoor ❑X Addition [K Survey 'vS Switches Receptacles Fixtures GFI Heaters A/C Fans 5 29 13 2 t Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Ly Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector Bldg. Permit. Other Equipment p 1 a/c receptacle , Hugo S. S di President Rough Inspection: 12/02/2004 Inspector: John McMahon III Final Inspection: 12/16/2004 Inspector: John McMahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. 0TOWN . OF SOUTHOLD PROPERW RECORD CARD . . Q OWNER STREQ2 VILLAGE DIST. SUB. LOT 4411 Nan FORMER OWNER N E ACR. e.r �D 'r Nd V104+tUhjef'rW S W TYPE OF BUILDING No r,-L4`Home RES.Z Id SEAS. . VL. FARM COMM. CB. MICS. Mkt. Value r LAND IMP. TOTAL DATE AUARKS 1 Uc�° SOU` S ✓ o/ fl e. r -AivOL ys6 �9 IO !;-8 D'a f C7 S i �c,r•e,�,� cc't ® A D a t Llogs a - Yawe WU,04drr V i �0 30 0 ►4 14o o z o qe !!r - L I tSB, - u u G{d qj, lao�. 11'z Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD— b 9 > Meadowland DEPTH House Plot \ BULKHEAD Total TEL. 765-1802 �c�vFFO��o�i TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR •+ P.O. BOX 728 TOWN BALL O ® SOUTHOLD, N.Y. 11971 This is to advise you that the job under building permit no . 130602 issued to Mr. Hungerford on 5/9/84 for Addition is completed and a final inspection has ( ) has not ( x ) been done . An -Underwriters Certificate is needed In order to complete this file , it is necessary that a Certificate of Occupancy be issued . Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold . Please indicate to Whom the Certificate of Occupancy is to be mailed , and ' arrange with this office for an inspection date . Occupancy or use is unlawful without a Certificate of Occupancy . 1'lease. help its to clear up this matter so that legal action does not have to be taken . Thank you for your prompt attr. nti.on . Very truly your , Y�' Victor Lessard Executive Administrator VL : gar one f 765-19U BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. C FOUNDATION 2ND] [ ) INSULATION C ] FRAMING [ ) FINAL REMARKS: �'�,��✓�"G C SII DATE INSPECTOR -/-/ R i BUILDING ter. INSPECTION ' [ ] FOUNDATION 1ST [ ] ROtKiN PLBQ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ) FINAL REMARKS: ,--% I J DATE / �'b INSPECTOR U " suiLDiNa oar. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG: [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING INAL REMARKS: 04k"- DATE � ! C 0 INSPECTOR 7,4� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: No A-c4$ S DATE g 2° ` Y INSPECTORZ/ - ��J 3 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ J 1 SULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DIV . It AL.- DATE INSPECTOR FIELD INSP]fCTION DATE COMMENTS t� 3 /G �CGry��// aN y FOUNDATION ( 1st), 'ft> `7 � 41 13 /Ld`�� een.6 )r C4 FOUNDATION ( 2nd ) / ova /� ©•� 2 • z RI ROUGH FRAME & PLUMBING I S 3 . rn INSULATION PER N . Y. y STATE ENERGY CODE x a 4 . SCE j V FINAL N pp ADDITIONAL COMMENTS : v H H H O Z 1 •, x r� a r H x r7 m H FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . . . . . . . .. 194 . Received , 19 Approved . .> �'. ¢ • • «?/,�'., I5 '?�!. Permit No. .� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Bui ding Inspector) 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 ;ets 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 jr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- -ation. 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 issued a Building Permit to the applicant. Such permit ,hall 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 whatever until a Certificate of Occupancy ;hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 'Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ['he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tdinit authorized inspectors on premises and in building for necessary ins pections. i (Signature of applicant, or name, if a corporation) (Mailing address of applicant) VA?>,S State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .�� �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . 1Z.... . . . .F .�G'_ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If app icant is a corporation, signature }of duly authorized officer. (Name and title of corporate officer) Builder's License No. . .�Q. . . . . . . . . . . . . . . . Plumber's License No. . .(Yi., .�,©�,gy\... . . . . . . Electrician's License No. �. . V.Q►��` .�to Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. eQ . `�1 �SA�� . . . . . . . . . . . . . . . . . . . �`=-. . . . . . . . . . . . . r'c..c?.? tom . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . . SubdivisionC?—f4c)t� .V%Zklz�. ������ Filed Map No. . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: i a. Existing use and occupancy . . . . � `r� . . . . A.tl(1.1��� . . Q Y. . .t . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . qz� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition .V** . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . Q, ,.). t . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . �+3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy,specify t`u,rhe and extent of each t pe of use . . . . . . . I , . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . Rear Depth . . .c�ll . Height . . .Nk,, . . . . . . . . Number of Stories. Lfit , . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . Rear + Depth . . p •(o• . . . . . Height . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . .1.1 . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . Height . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . tQQ--. . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . Name of Former Ow r 11. Zone or use district in which premises are situated . . . . ��+.��1��. . WV)At1( 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded yit.5. . . . . . . . . . . . Will excess fill be removed from premises: Yes Ne 14. Name of Owner of pre ses L?� ���pQRZ�Address .13SE-W.\4C©d1r%%. . Phone No. . . . . . . . . . . . . . . Name of Architect . . . Address . Phone No. Name of Contractor . . . . . . . Address .�, � R. � Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 4 \ICU STATE OF NEW O S.S COU Y OF • • • • • • • •' ` "` • • • • • • • • • • • • • • . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis 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 before me this t,� �/ . . . . . . . . . . . . . . �T . . : . . .da of `''. '``�`. . 197. r � , Notary Public, �,� •/� - -�. . . . . . . . . County SYLVM K. ROUSE -MARY ►UttIC, $Ht•of New YNR ` . . . . . . . . . ho. X614306- Suffolk CwRIY� (Signature of applicant) ::o�nT,ui•n RK►i�MRnh i0, 10 0 1111s WY ol Is w vlwrla+a r ECTEAN 1'1<lf Of 111E NEW wOO STS•' rlw+LAW. cr, • ok A +A.JO r\VF C,M. �,�t'F j 2 SURVEYED F'Q2 , "� O $I v' a 1 yA+ANTEf) wC';nr�0 NE.:A+ Sf�ALL UM ((((((\\\ /(.A\� (\}�'�\y/ HOME4 1 t TO Thf -tRS h:s wM.:q MF >> ��' � i `Aw /_ `I _V [... f ►eNA.rEO. ANU MIS ii:+AL r0 11R ) y/ �_JV"�r� CCw�•Nr, r�VFRNMEfrA,tA41E�K� ANC a�/ 'C) / �Mfi .fST�rUTFJN Ldi[D MlEEaH, MO t a THE ASNIGNKS Of THE LEMM &W- 1--NAL W- -NAL allAXAPCM AI.E MOT TfApo~uf Aao111otsK Mr�Isa.Fs�. > .�•� ��, �� y� OCZ{ENT ' TDOM OF SGJT�-GLD N.Y. � ,per/ ^� �trt,L �-+ �� <.• _ � � L �• + , 00 � I 3 f -r f t w z Q !02K PI P.E 1 rl.ME NWB c 2 Z-990 C, N � �i' SUFE M AY,MAP IATA-140Q-Q1�-2.3.8 1 �$ j cv l/ C0 r A o :itl NTEED ro THE T rLE GUAf2ANTEE C A5 SUrZVEYED .SNE 1, (982 j{ N QODE21GLC ./AN TUYL.PC. t4C LAF�It�T�li�1�ElC�2 EW LS" ,AT QRENF' I _ -- � I ' ��� ' . � � i n...amm.m+w_.+_�-..n.-+ -+.0 ._._.. I ...o �- .• w.v 1 _ras, m .,, �.�. T- 4 - 'Nrthl ARV -riot, I _`�_ �•1� ` �_.. c��5 , � � � ���S� �Eti�"�;?`i;� epi,.-, i ` ' ' } r OcU � y ':OR I v ;l U Is FUL _ tel-llI��FOCAT� topper tukiin9 is used �'''� ` F Yosriewmater distributing OCCUPANCY hall be _ PiPn9syi L an y - of typei r D AS NOTED y' . DAT B.P: '#k � - ' r.L==--_ - FEE: BY: LL i �COL�- _ SQ_ Zt� - _--'-... NOT FY BUILDING DEPAR - 1 - - - 1 `Y V1`N -- _ — FOLLOWING 2 9 AM TO 4 PM FOR THE _ E1�cSlr Ls�W_L`Ap I D I - /+� - c— - FOLLOWING INSPECTIONS:, - - r -- W{U_lit �( - G - O REQUIRED - � ♦j.E�.'1�' 1.- FOUNDATION TWO � - -_-- __- - - -- CD, /CQ FOR POURED CONCRETE' ; ! 2. ROUGH - FRAMING & PLUMBING `,� �r , - - - - 3. INSULATION SJRI H D-F-V 7-jD�,t —^—_. - . 4. FINAL CONSTRUCTION , MUST - fl T�1 FV BE COMPLETE FOR C. 0. - _ ' ALL CONSTRUCTION SHALL MEET 4V S . _ - - THE REQUIREMENTS OF THE MY. STATE CONSTRUCTION & ENERGY - CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. , PF-TT'/ S PI�ivC =htA'D 'q1 . 1, ? rir3 c0i: r tl�a ti �haN a SON. INK, kV `r'r�ell< �Ar � 1- .',:..__ to f�A5 A iit�S _ Gcaet — } r h M:i.lP31 a h61I G Pubi `MMS 'N Iq,NVW'OH " - M?1: 41.. �^, ,°.'r�}a" ".. J ,,.1S i 'wo1.1 '!d ngN _ _. '�>r�����'� _aer.-,7v,•,cnc+r��°a°l "�,� � , 7,11 1 j k , I pa jI v Y p Toney %7, X�_t ,wagNiMOtFY `TaYf .. I . , � s.d'`f J',W,a;), ..--. .�,---•,_.�----..i.—y-�-_— � .'is+iii � - .!,d:*=' I -h _ I___- t,{1�{$ •� 6 . i, 1;T>Q, U, , ' I - — — � 1 t caN±M q�17, nA fix'"gt.' '_'_ t r.�o�l�dav ✓�±_ � f y