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HomeMy WebLinkAbout31196-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA/{TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30981 Date: 06/15/05 THIS CERTIFIES that the building FLOOR REPAIRS Location of Property: 95 NAVY STREET ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 26 Block 1 Lot 12.2 Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 9, 2005 pursuant to which Building Permit No. 31196-Z dated JUNE 13, 2005 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 FLOOR REPAIRS TO EXISTING SEASONAL DWELLING AS APPLIED FOR & AS PER CERTIFICATION OF LAWRENCE TUTHILL, P.E. DATED 6/9/05. The certificate is issued to JERILYN B & JOHN WOODHOUSE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'r~u3 N/A N/A N/A Rev. 1/81 Form No. 6 TOX~qN 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: For new building or new use: 1. Final surcey 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 resideuces and similar buildings and installations, a certificate of Code Compliance from amhitect or engineer responsible for the building. 6. Subtmt Plamfing Board Approval of completed site plan requirements. 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 stale the reasons therefor in writing to the applicant. 1. Certificate of Occupancy - Ne'&, dwelling $25.00, Additious to dwelling $25.00, Alterations to dwelling $25.00, Swinmm~g 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, Conunercial $15.00 New Construction: Location of Property: Date. ~'"~/2- )/t ~~ Old or Pre-existing Buildiug: ~ (check one) Street Ha~et Block { Lot ~ 'Z. 2-- House No. Owner or Owners of Property: 3 ~ ~7_~ ~_¥ to Suffolk County 'Fax Map No 1000, Section ~- (~ Subdivision Fded Map. Lot: Pemfit No. Date of Permit. Applicaut: Heahb Dept. Approval: Underwriters Approval: Plamfing Board Approval: Request for: TemporaD' Certificate Fee Submitted: $ Final Certiticate: / (checkone) 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. 31196 Z Date JUNE 13, 2005 Permission is hereby granted to: JERILYN B & JOHN WOODHOUSE PO BOX 360 ORIENT,NY 11957 for : FLOOR REPAIRS TO AN EXISTING SEASONAL DWELLING AS APPLIED FOR & AS PER CERTIFICATION OF P.E. at premises located at 95 NAVY STREET County Tax Map No. 473889 Section 026 Block 0001 pursuant to application dated JUNE 9, 2005 Building Inspector to expire on DECEMBER Fee $ 150.00 ORIENT Lot No. 012~a- and approved by the ORIGINAL Rev. 5/8/02 r i ] , w ~ ,-,4 ~'- Z Z q~ U ~ 0 0 o~ o~o ~ U ~: ~- ~ ~ ~ z ~ > 0 z 0 ~ ~ o , 0 LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER P.O. BOX 162 GREENPORT, N.Y. 11944 (631) 477-1652 June 9, 2005 Mr. Michael J. Verity, Department Head Southold Town Building Department Main Road Southold, NY 11971 Re: Residence John Woodhouse Navy Street Orient, NY To Whom It May Concern: I have inspected the above mentioned residence as to the floors in the kitchen and the living room being spongy and found that the deficiency has been corrected by the installation a 6"x6" timber girder along side of the existing 4"x6" girder as shown on the attached plan. Sincerely, Lawrence M. Tuthill, P.E. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 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 ~'. northfork.net/Southold/ PERMIT NO. r/~[ \q~ ..~ Check ~ Septic Form I ./' fl N.Y.S.D.E.C. Examined ~.,/.~.j 20__ {:~ ~ t ~{~1~ Contact: Approved .20~' /71 I I ~ ~[ Nlailto:~f; ~0¢~0~ Disapprovedac ~ ' ~ } ~ Q0 ~ ~&O OCd~ ~ m one: Expkation[ ,20.. -m~ingI~ ~ ~~_pt ~-c~ ~ .. ~ ~,'. '-- i, ~ ~PPLIC ~TION FOR BUILDING PE~'IIT ~/ ~ / ~STRUCTIONS ' -- ~~T be completely tdled m by typewriter or m t~ and submitted to the Bmldmg ~spector wtth 4 sets of >lans,~accurate plot plan to scale. Fee according to schedule. b. Plot pl~ showing location of lo~ and of buildings on premises, relationship to adjoining premises or public streets or areas, and watem'ays. c. The work covered by this application ma3 not be commenced before issuance of Building Pe~it. d. Upon approx al of t~s application, the Building ~spcctor will issue a Building Pe~it to the applicant. Such a pe~it shall be kept on the premises available for inspection t~oughont the work. e. No building shall be occupied or used in whole or in pan for any pu¢ose what so ever until the Building ~spector i~su~s a Cegificate of Occup~cy. , f. Ex'e~' building pe~it shall expire if the work authodzed has not commenced withn 12 months a~er the date of .tssuance or has not been completed within 18 months from such date. If no zmfing amendments or other regulations affect~g the property have been enacted in the intehm, the Building ~spector may autho~zc, in writing, the extension of the pe~it for an addition six months. Therea~er, a new permit shall be required. ,~PLICATION IS HE,BY M:~E to the Building Department ~or the issuance ora Building Pe~it p~suant to the Building Zone Ordinance of the Town of Southold. Suffolk Count},, New York, and other applicable Laws, Ordin~ces or Re~lations, tbr the const~ction of buildings, additions, or alterations or for removal or demolition as herein deschbed. The applicam a~ees to comply with ~1 applicable laws, ordinances, building code. hous~g code, ~d regulations, and to admit authodzed inspectors on premises and in building for necess~' inspections. (~gnamre of applicant or name. if a co~oration) (MatiNg address of ap~cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~'"~]'~; C V'/-~ ~ bLJ,~OOt-'/OO./~ (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 LicenseNo. E, ob Soqe ~ ~,~ Plumbers License No. Electricians License No. Other Trade's License No. 1~O- z ~x-k ~O'v~', \ ~ Location of land on which proposed work will be done: q 5- sf House Number Street Hamlet County Tax Map No. 1000 Subdivision (Name) Section 2 6:, Block I .~ Filed Map No. Lot I~- ' '2-~ Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 5, }q ~ ~ _('~ ~,,, t~\. b. Intended use and occupancy ~, ~,, ¢ Ix X'7~ ~ ~ ', l~ \ 3. Nature of work (check which applicable): New Building Repair / Removal Demolition 4. Estimated Cost 5. If dwelling, nulnber of dwelling units If garage, number of cars Addition Alteration Other Work Fee (Description} ITc be paid on filing this application t 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 Real- Depth Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Size of lot: Front Real- Depth 10. Date o f Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zotfing law, ordinance or regulation'? YES NO 13. Will lot be re-gaded? YES NO Will excess fill be remo~ ed from premises? YES NO 14. NamesofOwnerofpremises4e~,¼r~ bO0,,dho~,-Address,)3q IJ:bC~fiCtO0~ PhoneNo. ~2,~-~ )0 ~ Name of Architect t_o._~ v,,\ '~or v, I I I Address Phone No NameofContractor I~o,O So,-~,3,n Address PhoneNo. 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOX,VN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet cfa tidal wetland? * YES NOJ,____ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. i7. If elevation at any point on property is at I 0 feet or beloxx, nmst provide topographical data on survcx. STATE OF NEW YORK) (' , SS: COUNTY OF~r.~4~c ) -)~ ¢ ~ ~V ~ ~ L,d O ~ d k o ,~ ~ ~ being duly sx~ om. deposes and says that I s' he is the applicant (Name of indix idual si~fing contract) above named, ~s the (Contractor, Agent. Corporate Officer. etc. ) of said owner or owners, and is duly authorized to perfom~ 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 m the manner set forth in the application filed therewith. Sworn to before me this MELANIE DOROSKI NOTARY PUBLIC. State 01 flew Yod~ No. 01D0463.4870 Oualified in Suffolk County --,^ t~L {~ommis~on Expires SeptemBer 30,_/.,,i2 ~' /' ~' Si=m~ature of Applicant LL!