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Home My WebLink About31113-ZFORM N0. 4 TO~4 OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31067 Date: 07/27/05 THIS CERTIFIES that the building ADDITION Location of Property: 95 THOMPSON BLVD. GREENPORT {HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 35 Block 1 Lot 25 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 2005 pursuant to which Building Permit No. 31113-Z dated MAY 5, 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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING (~IT #95) AS APPLIED FOR. The certificate is issued to PECONIC LANDING AT SOUTHOLD (OWNER) of ~he aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HIP~J~TH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~U N/A N/A N/A -/"~t~ori~ d/S i~g t ure Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMF4I~- TOWN ALL I,/,.' 765-1802 ~ '- APPLICATION FOR [_. .. .:_.~ ; This application must be filled in by typewriter or ink and subn'dtted to tbe~BuildiEg Depfirtmet~t wOh2h~ollowina: 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 featnres. 2. Final Approval fi'om Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation front Board of Fire Undervmters. 4. Sworn statement from plumber certifying that the solder used m system contains less than 2/10 of 19,, lead. 5. Conunercial building, industrial building, nmhiple residences and sinfilar buildings and installations, a certificate of Code Compliance froni 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 su~,ey of property sho;ving all property lines, streets, building and unusual nalural or topographic features. 2. A properly completed application and consent to inspect sigued 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 Occnpancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelhng $25.00, Swi~mning pool $25.00, AccessoD, building $25.00, Additions to accessop,' building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy - $.25 4' UpdatedCsrtificate°fOccupancy- $50'00 5. Temporar3 Certificate of Occupancy - Residential $15.00, Cmnmercial $15.001 Date. Old or Pre-existing Building: (check one) ,-~ House No. Street Handel ! Block ][ ot New Construction: Location of Property: Owner or Owners of Property: Suffolk Count.,,' Tax Map No 1000. Section Subdivision Health Dept. Approval: Date of Pemtit. Filed Map. Applicant: Undep, vriters Approval: Lot: Plamfing Board Approval: Request for: Temporary Cerlificate Fee Submitted: $ co--Z 3to 7 ,/ Final Certificate: t/ (check one/ / Applicant Signature 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. 31113 Z Date MAY 5, 2005 Permission is hereby granted to: PECONIC LANDING #95 1500 BRECKNOCK ROAD GREENPORT,NY 11971 for : DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR UNIT #95 at premises located at 1205 County Tax Map No. 473889 Section 035 pursuant to application dated MAY Building Inspector to expire on NOVEMBER MAIN RD GREENPORT Block 0001 Lot No. 025 3, 2005 and approved by the 5, 2006. Fee $ 150.00 Rev. 5/8/02 Authorized Signature ORIGINAL 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [~ ~ON [ ]FRAMING -[/,'~ FINAL [ I FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: (/~'~'/~~c-~ _~"~/2 DATE /? "-" INSPECTO+///~,. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F/,Q,I;INDATION 2ND [ ] INSULATION [ ~'FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION 765-1802 BUILDING DEPT. INSPECTION [ ~] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ REMARKS: INSULATION FINAL FIRE SAFETY INSPECTION 765-1802 BUILDING DEPT. //INSPECTION [~,~ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ REMARKS: /~0~9~ ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION DATE INSPECTOR FIELD INSPECT}~)N REPORT DATE COMMENTS FOUNDATION (2ND) ROUGH FRAMING & PL[rMBING I~SULATION PER N. Y. STATE ENERGY CODE FINAL ,~d)DITIONAL COMMENTS TOWN OF SOUTHOLD BUIL~)INO DEPARTMENT TOVCN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~3vw. northfork.net/Southold/ PERMIT NO. -311134 Exan,ined Approved Disapproved Expiration I IJ~ .20_O~,. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, belbre applying? Board of Health -'~'4 sets of Building Plans Plamaing Board approval Check Septic Form N.Y.S.D.E.C. co,,t et: .,'o..,e 2,;.' n 7ooa' Phone: ,evV. r Building Inspector "j to~ ; `% '~ '![ APPLICATION FOR BUILDING PERMIT a~ application MUST be completely filled in by t3pewnter or in i~ and submitted to the Building ~spector with 4 sets of plus, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on promises, relations~p to adjoining premises or public streets or areas, ~d watem'ays. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon approval of tbs application, the Building ~spector will issue a Building Pemit to the applicant. Such a pe~it shall be kept on the pre~ses available t3r inspection t~oughout the work. e. No building shall be occupied or used in whole or in pa:~ Gr any pu~ose ~ hat ~o ever uutil the Building ~spector issues a Cc~ificate of Occupancy. f. EveW building pemit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning mendments or other re~lations affecting the property have been enacted in the ~terim, the Building ~spector may authorize, in writing, the extension of the pemfit for an addition six months. Thereager, a new pe~it shall be requked. .~PLICATION IS ~BY M,~E to the Building Depanment for the issuance of a Building Pe~it pursuant to the Building Zone Ordinance of the Town of Southold. Suffolk County, New York, and other applicable Laws, Ordin~ces or Re~lations, 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, and to admit authohzed inspectors on premises and in building for necessa~' inspections. (Signature of applicant or name. if a corporation) State whether applicant is o~x.2~_.Er, lessee, agent, architect, engineer, g~,eneral contractor, electrician, plumber or builder Nameofownerofpremises .~.x5 v -7~.z. -q~o/~/[~¢~/ (As on the tax roll or latest deed) Il' appli t, ga~.~orpor~n/,~gna, tt~re of duly ¢u:[.horized officer (Nme and title of corporate officer) Builder's License No. S / t//-5""-0'~-/~/ Plumbers License No. Electricians License No. Other Trade's License No. l. Location of land on which proposed work will be done: House Number Street Count,,Tax Map No. 1000 Section Subdivision~ / ~:~ o4d-~ Hamlet Block / Filed Map No. Lot Lot 2. State existing use and occupancy of premises and ir~tended use and occupancy of proposed construction.-,_ a. Existing use and occupancy /~'-~'/23~c ~-' b. Intended use and occupancv Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cos~ ~'~ If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee Alteration (Description) (To be paid on filing this application) Number of dwelling units oil each floor 6. If business, commercial or mixed occupancy, speci[v nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear 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 10. Date of Purchase Rear .Depth Name of Former Owner /9c~C, otv,/c 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO v/ 13. Will lot be re-graded? YES__ NO v/ Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOVv2q 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. NO / 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at an.',' point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COLrNTY OF ~ 'x~-~'~/e/~J ---~/~~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~/LJT'~"~c:~aq~' (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 tree to the best of his lmowledge and belief: and that the work will be perforated in the maimer set forth in the application filed therewith. Sworn to before me t14-~ 0 3 day or' /~'/~-'~ 20/~O~ ' ',.' . ~/~ ]lq.~[l.~/l~J, / Signature of ,~pplicant