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Home My WebLink About30545-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31178 Date: 09/26/05 THIS CERTIFIES that the building ADDITION Location of Property: 725 JACOBS LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 1 Lot 1.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2, 2004 pursuant to which Building Permit No. 30545-Z dated AUGUST 5, 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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MELISSA & WILLIAM E. DONLAN III (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A %uthorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD —. BUILDING DEPARTMENT r WN TOHALL 765-1802 2 3 ?On.5 'l i� APPLICATION FOR CERTIFICATE OF OCCUPANCY" 1 � 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 propertv 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-o 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 Planning Board Approval of completed site plan requirements. 11. 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 1. 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$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 Date. 91 1 41L-)5 New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. LSI^' ► Street Hamlet Owner or Owners of Property: W t j� CA C- "Itf— � O fA(S�'r �N)�Ct.,(1 Suffolk Countv Tax Map No 1000, Section W739VI Block I Lot 1 .3 Subdivision Filed Map. Lot: Permit No. 5 t-}5"� Date of Pemut. '?I5 0" Applicant: tt 1 QM C l HeA Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: t/ (check one) Fee Submitted: $ o?S.UD ® )yj L0 Applicant Signature coITr 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. 30545 Z Date AUGUST 5, 2004 Permission is hereby granted to : WILLIAM E DOLAN III 725 JACOBS LANE SOUTHOLD,NY 11971 for CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 725 JACOBS LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0001 Lot No. 001 . 003 pursuant to application dated AUGUST 2 , 2004 and approved by the Building Inspector to expire on FEBRUARY 5 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 �ooP souryo6 os- ✓.me- 7 TOWN OF SOUTHOLD BUILDING DEPT. J 0 t1 3 7 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: �t�✓'�L -� ,< � DATE 7' os INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACENO ( HIMNEY REMARKS: ► `�� on n cc � ASa-4 NFA 1 .P0 ora Kook oA, \AAv,t t..5 wcta CrA tt r� DATE g �-1 U q INSPECTOR N3t30(Ru SufFOlk Electrical inspections, Inc. . Ce„!yr W-!.hC� l:o v Y:NA '1934 ,Ta.. r.11-873-3500• Fax 631 67, 37 a C4 Data 726, 04 Res�aeneai Ccmn_-:,i: U Scrvey 0 naw Cl AddlCcn 7 Se�i:eCnl�- .r•.aae Sei.iho.ld _--_. .. .a^ice_._.— . . .._ .. .. --- Folew ---- _aree.Acaress_ 725 ]eeo3s ane_ cross e ^ ------ t't'-%# 94 )1 42 c^ r^� oo— - - slon P _`;1C! - it .. 001-003 Sn:':HES ?i:eu•i`:i �i(�Jp a - '_ —_1ANSi 6.F.1. tltAT8 :COLS' pS� i j pool i I z t_an_S i as�x1D: Heat Pump ;lith Re Lay _ —. — _— --T--- �— ---- / Switch �;Z, E 9 __... ..'+;i'; .nc ..—_ Ovrheaa Chenae r 520 Bethel caactcica-' ConttecttnsLtd :.cares 168_MU1 Road Manotvi:le.NY 11959 19 COMMENTS OR VIOLATIONS 0 CATE -21 !.O 92 i -r a _ ��tOWN OF SOUTHOLD PROPERTY RECORD CARD — OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWN9R N v E rn C r,/wy-h I 4 DY5 . � � y�aJ i ""a S � � � W TYPE OF BUILDING MOU)n RES. 21a SEAS. FARM COiv M. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 3 no -Ion 7_164 X 3 y�z z ✓, /� r. .6L E r . d 7 d 72 �. d aZ O d 3 3/.d''/b'�+e•.J ��,r_ t-e`7�..._ �.i� d ✓fuggb �o� S /,v /� It k N ) ,Goo E v BUIL NG CONDIiI /7-�o ,`( BEL B V d ,L Q / AXA Ylr �S� • "FD mcco T�'1�l e f -7 (cco 9 z Z� 6/�i — /�t r n�/r�l/rs�. �� /c?,c.►✓ /1J0�) -TT- Tillable FRONTAGE ON WATER 4 0 -I ia0jp7,;P -111�QX U �n15• -}T� Woodland FRONTAGE ON ROAD i Meadowland DEPTH y q a P # a ass- rew &4 lin -VOID House Plot BULKHEADI _ f - Total DOCK Pg7 aq43 rxra dwe+l nt� n . faa,\ N■■n■SS■■n , ■ ■�■■■■■ri.�■■■■■■■■■ ■M■ M■■ ■■■■■■■�■■■■■■■■le!�■M■� ■■■■■ _ ■■■■■■■�MMM■■EM■■■;��■ice■■■■■■■ ■■■■■■■■■■■■■■G ■1M■�I■■■■■■■■ ■■■■■■■■■ �.� y:, ■■■■■I■�++■■NE-1-01 ■■■■■■■ M■ME vurbiaMMENJUN ON ■ h ■■■■■■Ir": ■■■■SEi■■■■■■■■■■ ,�,.,: ■■■ ■MEMO■■■■■■■■■■■■■■■■■■■■ ■■■�■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■NEMESES■■■■■■■ EMMEMEMMEMEM ME M ME EMEMMEMEME No oil No M moommommmomommmsFoundation Basement Ext. Walls � � AFire Place -oo Type Roof Rooms Ist Floor Rooms 2nd Floor -�■ FIELD INSPECTION REPORT DATE COMMENTS pv FOUNDATION(1ST) A-' 2gv+ -------------------------------------- FOUNDATION -----------------------------------FOUNDATION(2ND) .m ' 2 o,k o- J° v ROUGH FRAMING& D I,-'44 PLUMBING U r INSULATION PER N.Y. STATE ENERGY CODE (3o43-7 —� o FINAL ADDITIONAL COMMENTS C1 Q 7 Z m O = � O Z z z 0 e� b a TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HAI . Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. 30=5- Check Septic Form N.Y.S.D.E.C. Trustees Examined -i;— ,20i0� Contact: .4pproved�200 Mail to: Disapproved a/c Phone: Expiration 20 1 Low Building Inspeu`nr `0� A PLICATION FOR BUILDING PERMIT sG ,, =OLD Date7 /n o20 ' J INSTRUCTIONS a. This application MUST be completely filled in by typewriter 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 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 from 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. 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 laws, ordinances,building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) z r 3 ace 4,s t.a". s>-plat nay 1&'7I (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ' 9 �W Name of owner of premises W 1 0. Vp�, E 'Do I Cc P ! (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 land on which proposed work will be done: '72-5- —"YQC010S Lance col-yt,eul' House Number Street Hamlet County Tax Map No. 1000 Section Block Opo ( Lot o01 • 0 0 3 Subdivision -pee-v^Ae LCD AZ; Fi.ed Map No. 105-56 Lot I (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy p lea Z'i deinCce— b. Intended use and occupancy 10r i cc!) Re 5c ale,,-e- 't- A tf&cLt-eeA 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work oiffQcx,,ej l�ec�C (Description) 4. Estimated Cost 3, o 0 o Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units N f} Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, spccifv nature and extent of each type of use. �J 7. Dimensions of existing structures, if any: Front Rear d6 ��7 6/ Depth 2k/ Height ~430' Number of Stories 2- Dimensions Dimensions of same structure with alterations or additions: Front A) Rear �C Depth Alm Height AIC— Number of Stories AJC 8. Dimensions of entire new construction: Front Z s Rear 2 S Depth Height e-� ,3 / Number of Stories — 9. Size of lot: Front 15-0 Rear !$-O Depth Z-1 G 10. Date of Purchase / Name of Former Owner {'�CC4✓+� s 11. Zone or use district in which premises are situated Q $� 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO X 13. Will lot be re-graded? YES NO x Will excess fill be removed from premises? YES NO-X 14. Names of Owner of premises Z)o f 4,n Address?zf 5�bt c" Phone No. �3 l-76� Vo Z4 NameofArchitect /ea,sh� �� sbcr AddressM4h" brc-,end: Phone No 6.51- Y17 - =Yco Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO K * 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 X * 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 ) l /l! Q tt1 l at✓� 1 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing 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. Swort_l to�before e this LL d of 20 f Notary Public Signature of Applicant PA MCIA CORWIN Notary Public,State of NOW YWk No.01C05011852 OualMW in SOCAk Count ZQL12�— cammission 6mirN SaP113, SURVEY OF 4-302° LOT 1 /moo M CR MAP OF `F 0* t-* jp drq DEERFIELD FARM q�rz 1> O QF FILE No. 10596 FILED MARCH 27, 2001 7z �S SITUATED AT BAYVIEW tor� c �°k��S'' TOWN OF SOUTHOLD <fNoFP54- SUFFOLK COUNTY, NEW YORK 8z3B�o� S.C. TAX No. 1000-88-01-1 .3 SCALE 1"= 40' APRIL 10, 2001 FEBRUARY 27, 2002 REVISED PROPOSED HOUSE APRIL 14, 2003 REVISED PROPOSED HOUSE AUGUST 5, 2003 FOUNDATION LOCATION p MARCH 9, 2004 FINAL SURVEY ^4 APRIL 8,MA4 OO4R VISED SEPTIC SYS,2004 REVISED SEPTICESERIE.C .D.H.S 44 JULYJUN9.27, 22004 ADDED PR4 ADDED S OSED DPOSED ECK L0T( // ?g� AREA = 43,656.00 sq. ft. 1.002 ac. s/ CERTDIM T0: Iba' • • • / ' '. , SAFE HARBOR TITLE INSURANCE COMPANY WEBSTy J /• N '30?° � / • - / BANK WIILLIA MR DOLAN III fY '`` . O , :• MELISSA DOLAN A 71,000 DOIRMNCL OF - No. 01%AP iM G y (. FOIE f ,1fA4 Of OW-1F111 iIGM MOS a 100-1F/B i1LIA MLN AVptY,F - ..• , ! ,-y.1 . • , /` sIN�E iffi,N ATw iITA] F9�HEOIm m ID.RS TSaH Im-. floor ,�. N 9 ;�� A . �j lurt c wEAs oclwwm m E oulace m-HAx flmonAN. l'. 7 �/ h f d< 2. 7.CA FS. AW TO OU RIOIM "MI4 � �.. A a Au arms ,Nc ro rauII9ATnH IIBIUE. ZO SSP27C SYSTBY YEASD.VPIlE).1J 3 �O HBIIt 161691"A• I IIOI6v cBIBE6Y 0 SEPTIC TAHH � •, PTEAIAm N ACA:ORDN6F 96N TIIE MNMIAI �7� LEAd16H1 POOL 1 M' ]I' Si�NONeM As • A'Y LEACI«IO POOL 2 AV 3•' I>y1 //••��n1E ?9 J �,� I• IFACHM POOL 3 «• b' JSP��q�. i/ ) s N.Y.S Lc. No. .9669 UHWIIGIr?1N AIIElIH01 M NIB910M IVVM 720 rmpg= Jose A. �gegno ^• �, N6 Wa�wmYb °�aa Land Surveyor O aanFlD\ aB HBEM ]NNL�, aILT roT�ir�ial rm BI11I M SMn2Y ■PI@.11®,NIB ON NB AG TD M lB1F(r�,I�IPq6�IY��AL�NBl1�1 51/IYn•9 - 5"NlMM - STO PbI19 - COIIBI/YCWII IpxN/I TUTOY CtMTBCATORIIE MT a¢. PNONE (631)727-2090 Fas (631)727-1777 THE PWFOR OF IBMr OF HAYS OFFMS LOCATE)AT MVJAG AOOAESS Ha[ OEa H"M.AEMR[0. 372 E AVENUE p ) rOo RNE164 , Hr York 11901 Frryrhood. Ne Yar4 11901-D965 _ .. _. Applicant/ Date. Owners Name:, W Reviewed: Architect/ 7Date Engineer: _ � P Submitted: X02 SCTM #: District: 1.000 Section: W Block: Loa: 1.3 Projeca _ Subdivision t.ocalion: zS � '-- — Name: $isle separate Required certification: (Yes IN o) IJ14 Req. Req. Zoning Olslrlel: (IAl slze: Amal: 6,J ) Lot covers e , L �.—. � 1 B �1 rupuscd Req. i Req. (front Yard 3V_Proposed: ( � (Side Yard �A ro sed: Req , (� ___.� (Rear Yard Proposed Project Description: AGENCUE Permit REEQUIRED FOR REVIEW l NO CSS L�fumber Suffolk County Health-Dept. New York State. D. E.C. 7� Town Thmtees Town Zoning Board approval: L- Town Planning Board approval: / Flood Plane Elevation?v Flood Zone: No t c*!