Loading...
HomeMy WebLinkAbout31225-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31121 Date: 08/18/05 THIS C~I(TIFIHS that the buildin~ ALTERATION Location of Property: 81 MALLARD LANE 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 JUNE 16~ 2005 pu3csuant to which Building Pezmlt No. 31225-Z dated JUNE 24, 2005 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certifiuate is issued is ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PECONIC LANDING OF SOUTHOLD (OWNER) of the aforesaid building. SUFFOLK COUI~TY DEPARTMENT OF H]~,LTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CKI~TIFICATION DA'£~U3 N/A N/A N/~ Rev. 1/81 ~~ d/Si~nature Form ~o. b TOWN OF SOUTHOLD BUILDING DEPARTSIENT TOWN HALL APPLICATION FOR CERTIFICATE OF OCCUPANCY L ]This application must be filled in by typewriter or ink and subinitted to the Building Department u ith the following: A. For new building or new use: 1. Fir, al 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 ftmnL 3. Approval of electrical installation from Board of Fire Underwriters. 4. S~om statement from plumber certi~'ing that the solder used in system contains less than 210 of 1% lead. 5. Conm'`ercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliauce from architect or engineer responsible tbr the building. 6. Submit Plmming Board Approval of co~npleted site platt 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. " A properly' completed application and consent to inspect signed by the applicant. Ifa 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 dxvelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupaucy 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: Date. ,'~)~,-'~"O'~7" ,/~'/2~P~ Old or Pre-existing Building: ~ (check one) House No. Street ' -- ' ~I~nlet ¢ -- Owner or Owners of Property: .,,'~'~,,~:~. Suffolk Count)' Tax M[ap No I000, Section d2..~-- Block Lot Subdivisiou Permit No. Health Dept. Approval: Plmming Board Approval: Request for: ]TemporaD' Certificate Fee Submitted: $ ,~ Filed Map. Lot: I)ate o f Permit._ ~.~,~' Applicant: ~r: - -,~..'OA~',~:::2 Underwriters Approval: Final Ce~ ificate: tog ? q") FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES U~TIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31225 Z Date JUNE 24, 2005 Permission is hereby granted to: PECONIC LANDING 81 MALLA~RD LANE GREENPORT,NY 11971 for : MINOR ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1205 MAIN RD GREENPORT County Taxx Map No. 473889 Section 035 Block 0001 Lot No. 025 pursuant to application dated JUNE 16, 2005 and approved by the Building Inspector to exlDire on DECEMBER 24, 2006. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 FIELD INSPECTION REPORT ~ DATE ,~ COMI~'IENTS FOUNDATION (1ST) FO~ATION (2ND) ROUG~ F~I~G & PL~B~G ~SULATION PER N. Y. STATE ENERGY CODE ~DITION~ CObI~IENTS g 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND ] FRAMING [ ] INS/.ULATION [z/~NAL ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FO~I~I~DATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~-"/~ ~ ~ l/ / P~CON~C LAND~ " ~ _o ~o ~ ~ ~ ~ ~x=~o°°~l[lll~[ lllll I~]1111~ ~ ~ ~ IIl~llllllllllllll~lllll F/ 0~ 0 W ~ ~ I ~ ~ P~S ~ ~VATI~ ~E PROECED UI~B EDE~ CO~GHI ~W ~ ~ ~ j E ~E ~'~K ~. U~L RA. ~E RIGHT TO BUl~ ~Y ONE ~R~RE ~ ~S[ P~S ~ ~B ~CL~f [0 [HE BU~. o ~ ~'~ ~ 06/17/2005 .... ~ .... ~ ~ ~ z ~ ZO O0 © COP'~IGIi)' 2C~5 FR.~CK ~. UELLEHO~IL ~LL FLO0~ PugIS ~D ELEVAIlONS ~E PRO~ECIED UNO6~ 06/t7/2005 FRANK W. UELLEHDNtL R.k IHT RIGHT [0 BUILD ONLY ONE Sll~JCllIR[ FROI, I DIES[ PLANS IS LICENCED EXCLUSIVELY [0 TI~ BLh'ER. m HEADER HEIGHT TO MATCH EXISTING ~ SILL HEIGHT ~1 ~1 TOWN ~OF SOUTHOLD BU~LD ING DEPARTMENT TO'WN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ~vww. northfork, neffSouthold/ Examined Approved Disapproved a.'c 20 r'- PERMIT NO. BUILDiNG PERMIT APPLICATION CHECKLIS' Do you have or need the following, before applying' Board of Health 4 sets of Balldiag Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: ' Building 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 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 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 the Building Inspector issues a Certificate of Occupancy. f. 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 months fi.om such date. If no zoning amendmems or other regulations affectIng the property have been enacted in the interim, the Building Inspector may authorize, ha writing, the extension of the permit for an addition six momhs. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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 laws, ordinances, building code, housing cg~e, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,~/~////~]t..//f// (~/gn~tur~ of applicant or name, i~ a corporation) (Mailing address of ~pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises '~--~. ~4'tA.J (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. Location of land on which proposed work will be done: House Number Street ' Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block / Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~P_~'~/z~L~//~'7 c b. Intended use and occupancy 3. Nature of work (check which applicable): New Building. Addition Alteration Repair Removal Demolition Other Work Estimated Cost ~// 4 ,.~CO If dwelling, number of dwelling units If garage, number of cars (Description) Fee ~/ / ~'~ -- (To be paid on tiling this application) 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 ~--~ Rear ,5~/ Height ,~ 2.g~ Number of Stories / Dimensions of same structure with alterations or additions: Front Depth .~,~.~ t Height ".-'23 ~ 8. Dimensions of entire new construction: Front ~'2t Height ~,, 2'~' Number of Stories Number of Stories Depth ~.. J , Rear / Rear .~2 t .Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase --~t2~r ~?~r 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? YES __ NO V'/ 13. Will lot be re-graded? YES__ NO ~'/Will excess fill be removed from premises? YES__ NO 14. Names of Owner of premises/-'~ P~-' Address ,~! Z'7~//,~a~"d~-/ Phone No. ~/. 27/. Name of Architect ~'~// /4d//Z~/-t/ Address Jv~'~5 31~, .,~z:r//l~4ItPhone No ~/~,/ Name of Contractor ZIlOg" //I./dl ldO,l Address ~ 4~ t'fi~v~'a~-~ Phone No. ~:~l. 15 a. Is this propel'ty 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. STATE .OF NEW YORK) SS: COUNTY OF C~,~A~.r~' ~//~:~,~.'~J..2/~,~ dt~ff., being duly sworn, deposes and says that (s)he is the applicant (Name of individual sjLming contract) above named, (S)He is 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 ~ No[,,~Public BONNE I. DOROSKI N~,~ PubnC, store Of NewYod~ No. 0mO6095328, StJffol lm'm E~im July 7, Signature of Applicant Town Hall. 53095 Main Road P.O. Box ! 179 Southold. New York 11971-0959 Fax t631 ~ 765-9502 Telephone (631 ) 765- 1802 August 11, 2005 BUILDING DEPARTMENT TOWN OF SOUTHOLD FRANK W. UELLENDAHL P.O. BOX 316 GREENPORT, N.Y. 11944 To Whom It May Concern: We are unable to complete your Certificate of Occupancy because of the following An application for Certificate of Occupancy is not on file. (Enclosed No Electrical Certificate on file. J The Check is not on file. - $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984.) BUILDING PERMIT #31225-Z (PAGE RESIDENCE) reasons: // 413885 5oumom ' ' 35 .-1-25 P~conic Landing at Southold Ro~e~ ~ C~ Y~ Health bldg/Co-op LandAV: 64.800 1205 R~te 25 Lend S~ze.~.i~l ~e i~; TotalAV: 2.133.809 O~ner Tot~ I Talable ~alue Mi~cellaneou~ lame: Peconic Landing al Souihold C~nty: 2.022,458 Book: 11954 ~4~i: 2.022.458 Page: 591 Addl Addr: Sche~: 2.127.809 M Street: 1500 Bmcknock Road PO B~: ~hla~er ~a~ 1.~15.23~ Acol No: 17 S~= Total: 0 , ~i~ 1 ~ 1 ~ook Page SaleDa~e SaleP~e O~ne~ · p~J~ Hea~hbld~ . · ' . Hbhd ~: 0 Ut~ities: Exemption Total 10 Tam Own ~ Building: Se~ion: Total: O ~de A~oun~ Year - Pct 41121 WAR VET 25.461 O' ~1~3~ COMB~ VE~ 74.520 0 0 41141 DSAB~ VET 5.370 O- 0 ~ ~e ' .' '. U~s Pc[ Ty~ U~e Tax ~ ~ype Name Dim1 Dim2 SOFT Yr FD031 E-WPmtec6=. .00 .00 - ,':'-~ ;'. ' ' '