The URL can be used to link to this page

Home My WebLink About30759-ZFORM N0. 4 TO~ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA2~CY No: Z 30738 Date: 02/03/05 T~IS CERTIFIES that the building ALTERATION I~)cation of Property: 1080 OLD SHIPYD~RD RD (HOUSE NO.) County Tax Map No. 473889 Section 64 Subdivision SOUTHOLD (STREET) (HAMLET) Block 4 Lot 24 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 2004 pursuant to which Building Permit No. 30759-Z dated NOVEMBER 8, 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 ENCLOSE EXISTING PORCH ADDITION OF SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT"& AS PER CERTIFICATION OF A~GEL B. CHORNO, AIA DATED 11/01/04. The certificate is issued to ALI & WENDY AZMOU~ (OWNER) of the aforesaid building. SUFFOIJfCOO/q~fDEPART?4~T OF I~J%L%~{D~PPROV;kL N/A ELEC~IC~kL CERTIFICA~ NO. 2038199 12/30/04 PLL~4BERS CERTIFICATION D~r~J3 N/A Kut horized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Souuhold, N.Y. BUILDING PERMIT !THIS PERMIT MUST BE KEPT ON THE PREMISES ~.~TIL FULL COMPLETION OF THE WORK AUTHC, RIZED} PERMIT NO. 30759 Z Date NOVEMBER 8, 2004 Permission ±s hereby granted uo: ALI & WENDY AZMOUN 18 WOOD RIDGE LA SEA CLIFF,NY 11579 for : AS BUILT ENCLOSED PORCH ADDITION AS APPLIED FOR. ADDITIONAL INFO. ~2,ID CERTIFICATION MAY BE REQUIRED. at premises located at 1080 OLD SHIPYARD RD SOUTHOLD County Tax Map No. 473889 Section 064 Block 0004 Lot No. 024 pursuant to application dated NOVEMBER 8, 2004 and approved by the Building Fee $ Inspector to expire on PiAY 300.00 8, 2006. / AuUhoPi ~{~ Si~ ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANUY Tiffs application must be filled in by typewriter or mk aud submitted to the Building Department with the following: A. For new building or ney, use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topo~aphic features. 2. Final Approval fi'om Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of e[ectricaI installation from Board of Fire Underwriters. 4. Sworn statement from plumber ceftin'lng that the solder used in system contaius less than 2/10 of 1°,o lead. 5. Connnercial building, industrial building, multiple residences and-similar buildings and installatious, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plamffng 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: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application aud 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, Swimnfing pool $25.00, Accessory building $25.00, Additions to accessoD, 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: I (~/4 C9 House No. Owner or Owners of Property: /~r UA' Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-existh~g Building: &q Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Date of Permit. Date. ~ (check one) Block (~ k/ Filed Map. Applicant: Underwriters Approval: Hamlet Lot 2._ (4 Lot: Final Certificate: (check one} Applican{ Signatu~) BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by ALI & WENDY AZMOUN 425 CEDAR POINT DR. EAST SOUTHOLD, NY 11971 ALI & WENDY AZMOUN 1040 OLD SHIPYARD LN. SOUTHOLD, NY 11971 Located at 1040 OLD SHIPYARD LN. SOUTHOLD, NY 11971 Application Number: 2038199 Certificate Number: 2038199 Section: 1000-64Block: 04 Lot: 24 Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, sun room&entry, [Miscellaneous as built 1989 Wiring and Devices Outlet Receptacle S,,~. itch Paddle Fan Receptacle A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 30th Day of December, 2004. QTY Rate Rating Circuit~ Type 4 0 General Purpose 3 0 General Purpose 1 0 General Pnrpose 1 0 1 0 30 amp An as built visual inspection, of thc delineated electrical installation, determined that an obvious hazard is not present and the installation is [)eli e'.ed to be in comFormance x'~ ith the applicable reference standard tbr the e~,otimated period of construction or'the premises wiring s3 stem. I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YOrk, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by RUDOLPH BRUER, SR P.O. BOX #1466 SOUTHHOLD,NY 11971 LAURA ESTATE Of YOUNG 1040 OLD SHIPYARD LANE SOUTHOLD, NY 11971 Located at Application Number: 1059705 Section: Block: Described as a Residential 1040 OLD SHIPYARD LANE SOUTHOLD, NY 11971 Lot: Certificate Number: 1059705 Building Permit: BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 17th Day of June, 2002. Name QTY Rate Rating Circuit Type Service Service Disconnect: I 100 cb Meters: 1 No visual defects: an elctrica[ survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory condition was found. seal i of This certificate may not be altered in any way and is validated only by the presence ota raised seal at the location indicated. CHORNO ASSOCIATES ARCHITECTS * PLANNERS ° INTERIOR DESIGN 355 EDGEMONTAVENUE QUAKERTOWN, PA 18951 (215) 538-2070 FAX (215) 538-1638 November 1st, 2004 Town of Southold Building Department Southold NY Re: Azmoun Residence 1040 Old Shipyard Lane Southold NY 1000-64-04-24 By this letter, I affirm that I have inspected the enclosed porch and I found it sound and properly constructed, Sincerely, ~orno, AIA 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST[ ] ROUGH PLBG. FOUNDATION 2NDI ] INSULATION FRAMING "~1 FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR ,~' "~'~ FIELD I~SPECTION REPORT I DATE I COMMENTS FOUNDATION' (1ST) FOk~NDATION (1NqD) ROUGH F~I~G & PLUMB~G ~S~ATION PER N. Y. STATE ENERGY CODE ~D~ION~ COUNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~nv. nor thfork, net/Southold/ Examined Approved Disapproved ac Expiration BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans planning Board approval Survey_ PER3,1IT NO. '~[-9~ ~ Check Septic Form N.Y.S.D.E.C. '~ / ,20f Contact:Trustees Ill,l,20 / Ivlail to: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 or./ a. This application MUST be completely filled 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 premises, relationship to adjoining premises or public streets or areas, and watem,ays. 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 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. I~ 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 mouths fi.om 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. .~PPLICATION IS HEREBY M.M)E 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 heroin described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature oqf appl~nt or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises l/~? Fid/.! ~ /~' ~7/TtgU ~ (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. l. Location of land on which proposed work will be done: House Number tStfe~{ County Tax Map No. 1000 Subdivision (Name) Section Block ~ Filed Map No. /lq 11 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / b. Intended use and occupancy 3. Nature of work (cheek which applicable): New Building. Demolition 4. Fee 5. / Repair Removal Estimated Cost If dwelling, number of dwell/rig units If garage, number of cars Addition Alteration Other Work ~'taC2ojex/fvo~c (Description) (To be paid on filing this application Number of dwelling units on each floor 5. If business, commercial or m/xed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~/(~ ~ ' Rear t_/& Depth Height Number of Stodes 10. Date of Purchase 11. Zone or use district in which premises are situated Dimensions of same structure with alterations or additions: Front Depth. Height. Dimensions ofen traction: Front [ (~ ' ~ '~ Height Number of Stodes Size of lot: Front '~ ~ ' Rear ~ ~" Depth /~o ~ Number of Stories Rear Rear Depth Name of Former Owner ~v-0, 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~.~ 13. Will lot be re-graded? YES NO fx Will excess fill be removed from premises? YES__ NO 14. Names ofOwnerofpr.emises ~/+fl- <d74~O~,t,q Address .5o~l~/d,,v~,/tq'? t PhoneNo.& Name of Architect ~ ,,q-S.5'o--L- Address Phone No2/5' 5'3,5' 2* 7o Name of Contractor Address Phone No. l 5 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. ~TATE OF NEW YORK) /dj ~-/U D/ /Jo 2 D/0 ~ ~ berg d~y sworn, d~oses and says that (s)he is the applicam ~metof ~di~dml si~ing con.et) above ~ed, iS)He is the (Contractor, Agent, Corporate Officer, etc.) >f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; hat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ~erformed in the manner set forth in the application fried therewith. gwom to before me this Notary Public GNLL,^~EITO , . NOtS~ public, State cfi New Yom 0 0 ~ ~,~- U 12_ I,,7~-,~ ~ 0 0 0