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Home My WebLink About28292-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29426 Date: 05/08/03 THIS CERTIFIES that the building ADDITION Location of Property: 640 SOUNDVIEW AVE PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 68 Block 4 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 17, 2002 pursuant to which Building Permit No. 28292-Z dated APRIL 18, 2002 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" FIREPLACE ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KATHRYN FARRAND (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i uth ized Signature Rev. 1/81 '( A-1 I CjaFormNo.6 SIS - i ��q _ 333/ TOWN OFSOUTHOLD BUILDING DEPARTMENT TORN HALL 765-1802 'N-\c,S5r-Qc4vc, N'y It l 5'y 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 19,0 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 Planting 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 L 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 525.00, 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 Sl 5.00, Commercial $15.00 Date. ,S /�— New Construction: (� Old or Pre-existing Building: (check one) J Location of Property: 0 U K Ll tl I CJ Pry``� - boTy� — House No. I pp A (—Street p I Hamlet Owner or Owners of Property: /(a f 1 r" 1 ( r ARF 14 ri 6 Suffolk County Tax Map No 1000, Section b Block_ Lot o� I Subdivision / Filed Map. Lot: Permit No. �( � Date of Permit.`t 4-C7,;�' Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate _Final Certificate: 1 (check one) Fee Submitted: $ 50-0 C � 3 Applicant Signature 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: q DATE � ` 6�,INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULA [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 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. 28292 Z Date APRIL 18 , 2002 Permission is hereby granted to: KATHRYN FARRAND 725 MILLER AVE UNIT 313 FREEPORT,NY 11520 for AN "AS BUILT" FIREPLACE AS APPLIED FOR at premises located at 640 SOUNDVIEW AVE PECONIC County Tax Map No. 473889 Section 068 Block 0004 Lot No. 021 pursuant to application dated APRIL 17 , 2002 and approved by the Building Inspector. Fee $ 300 . 00 Authorized Signature COPY Rev. 2/19/98 FIELD LJSPECTION REPORT DATE COMMENTS -e m FOUNDATION (IST) _ x ------------------------------------ r Ing FOUNDATION 122ND) m xs=' 2 O -i z m ROUGH FRAMING& PLUMBING f y2 7 INSULATION PER N.Y. S STATE ENERG] CODE FINAL l ADDITIONAL COMMENTS O z Z m - r O X '9 2222_ v -- O -3 C Z z _ v x v m TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802@ n survey PERMIT NO.08CgC1a-7--- Check Septic Form N.Y.SD.E.C. Trustees Examined— 11116 '20 Contact: ,-J Approved 20_ - Mailto: 10 !M 5q1 YU/etdA1Z-Q_. Disapproved a/c Y 2LC4A1 l l(q 5 Phone: -0-0(0!t Building Inspector APPLICATION FOR BUILDING PERMIT Date 7 200-/ INSTRUCTIONS a. This application MUST be completely filled in by t),pewriter 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. 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 a Certificate of Occupanc3 is issued by the Building Inspector. 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 lawb,urdinauucw,building cude,Lousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Si of a licant or name, if aporarion) (Mailing address of app 'cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises JCU "1 D } (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. 1. Location of 1 don which pro sed wor#�c will be done: (0'0 o\-k V1 cy✓ '-� House Number Street Hamlet County Tax Map No. 1000 Section Block 7 Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and.occupancy ofpre ' et�ys s aytd intended use and occupancy of proposed constructibn: a. Existing use and occupancy �Cpiic Manu f b. Intended use and occupancy d i-44 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work S'r-7&F Coy fAil, (Description) 4. Estimated Cost 'flatFee (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 structures,if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 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: 13. Will lot be regraded Will excess fill be removed from premises: YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. TATE OF NEW YORK) SS: OUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, )He is the (Contractor,Agent, Corporate Officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; it all statements contained in this application are true to the best of his knowledge and belief; and that the work will be rformed in the manner set forth in the application filed therewith. iom to before me thi pit' CPP ,el(� 20 Ol N lic fignature of Applicant a-do BEL AIR 42MC FM I's new Bel Air 42MC is custom built for the The 42MC completes the masonry look with home owner that requires the pure masonry an optional break-away pattern refractory. The hand-built brick fireplace. The 42MC is a 42" 42MC utilizes FMI's standard 10" double wall wood burning fireplace that when faced with chimney pipe system. Glass doors are available brick, marble, tile or any other non-combustible in all extruded styles of brushed brass, polished material will show a clean all-brick fireplace. brass, polished chrome and black with polished brass insert. specifications 303/4 10" DIA. Framing Dimensions Width 48 3/4" Depth 26" OCCUPANCY OE? 253/4 Height 441/2" USE IS UNLAWFUL 151/2 WITNOUT CERTIFICri OF OCCUPANCY RMASN= 5/8 481/4 N;ND B IL IN 72 9 AM FOLLOWING INSP 1. DATION OUREDC 2H - FRA 43 1/2 SATION4 - CON 4024 MPLETEA TO REMlON8TRC4W R 7 OR CON 12 �Y 42 MAGE IN 4- 15 1/2 � 495/8 III ® W ARNOCK HERSEY THE U.S.A. u.i Note: Dimensions on this sheet are for reference. Distributed By: Fireplace 0.UEN.1£D Manufacturers Incorporated .w, ) iN ME NSA 2701 South Harbor Boulevard, Santa Ana, California 92704 - (714) 549-7782 - http://www.fniionline.com FA k 3339-0400 FH 55 mo g F nn v� c �1 i Doo ti,