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HomeMy WebLinkAbout31286-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31159 THIS CERTIFIES that the building ADDITION Date: 09/14/05 Location of Property: 325 SUMMIT LA EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 35 Block 8 Lot 5.23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Building Permit No. 31286-Z JULY 11, 2005 pursuant to which dated JULY 15, 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 AS APPLIED FOR. The certificate is issued to ALEXANDRA JONES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED , - t /- /'-� horied Si nature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT o 1 2 2005 TOWN HALL 765-1802 —t 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 1°40 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. 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 .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 accessot}, 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 New Construction: _�� Old or Pre-existing Building: Location of Property: House Owner or Owners of Property: Date. /0 L (check one) 0 Suffolk County Tax Map No 1000, Section Block _ Lot Subdivision 1-1 U Ir m /! LEM TPS Filed Map. Lot:, Permit No. 3_t :),.f�%_ Date of Permit. ApplicantiA N>Pwtt rJ(� Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Underwriters Approval: Final Certificate: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. i:lop$M93l, (en»1:4a64 (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31286 Z Permission is hereby granted to: for ALEXANDRA JONES 36 BLACKSMITH CT Date JULY 15, 2005 HUNTINGTON STATION,NY 11746 OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 325 SUMMIT LA EAST MARION County Tax Map No. 473889 Section 035 Block 0008 Lot No. 005.023 pursuant to application dated JULY 11, 2005 and approved by the Building Inspector to expire on JANUARY 15, 2007. Fee $ 150.00 / Authorized Signature ORIGINAL Rev. 5/8/02 31.2-P (.::;, -e 765-1802 BUILDING DEPT. SPECTION IST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY[ ] FIRE SAFETY INSPECTION DATE ?/coo� INSPECTOR 3) P -g6 z 765.1802 BUILDING DEPT. INSPECTION [FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] FINAL ] FIRE SAFETY INSPECTION DATE El �� INSPECTORS TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/ STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: zv� DATE �� 3 o `� INSPECTOR '/✓ `� FIELD`INSPECTION REPORT D TE/ COMM TS f FOUNDATION (1ST) ------------------------------------ FOUNDATION (2ND) q/q - tt fi W [21 C --- - ROUGH FRAMING & PLUMBING ` L4 I "r ' m T a -JA-6 c l -- - - - - INSULATION PER N. Y. STATE ENERGY CODE -- - -- -. -- - - - FINAL c ADDITIONAL COMMENTS - -- - - -- p r m X - - - - - - p - O z 0 a 2 a 6� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined It(( / 2005 Approved 20 05 Disapproved a BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Boprd approval Survey PERMIT NO. Check 8'7 9 Septic Form N.Y.S.D.E.C. Contact: 'h Mail [o: Phone: CO3( - YTI — 37$0 Expiration 1iL ,.I Building Inspector APPLICATION FOR BUILDING PERMIT Date 20 L o 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 s,all 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 pEgttlations, and to admit authorized inspectors on premises and in building for necessary inspections. n n (Signature o,/applicarit or ffaghe, if a corporation) 36 0- (Mailingaddress of applican }�WT/N670rU J9r9TiN /r7(6C State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises _ (�EJO`1 N D r P x (As on the—tax 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 N 1. Location of land on House Number proposed work will be latest deed) County Tax Map }Np. 1000 Section Block d 0 s Y2 T"i ' • y ;L"ii, 1:, 11f61a: ��' :fR Subdivision J M (rl 1 -r:&" Filed Map No. [�04 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S r N G L- e —)o r n, �N e /'-e Q D 0 b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work G{t- (De cription) 4. Estimated Cost 'S & O If dwelling, number of dwelling units If garage, number of cars Fee (To be paid on filing 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. Dimensions of existing structures, if any: Front Rear Height Number of Stories Depth is Dimensions of same structure with alterations or additions: Front ear 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 (D /� V S rkYl e 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NOV� 13. Will lot be re -graded? YES _ NO�Will excess fill be removed from premises? YES 7_�NOX 14. Names of Owner of p misesI �,Y/j nIbGQ� �1l`Q�ess ±a7�l�Pfone No. �% 67372 /h Name of Architect oLeaT Ifi%;!rr 5 Address SD>If4pp&,e tKY_P�11oneNo -2o&? T, Name of Contractor .� c��y NEP a Z A�� Address D one No. h�3�-25— GT 15 a. Is this property 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 O ) ��)1, �emg duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above nam"ed, (S)He is the 6 W N 'PO (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. n Sworn to before me this l day of Notary Public LYNDA M BOHN NOTARY PUBLIC, 8Wa of Now York NO- 01BOB020892.8WtWk Cowry Tam Expires March 8, 20 Tl T'I\ T (--iTl V. -T7 h /f rr -I-) V, TT T -'AW 'T T"`� � J \ J � .�.�a .ti. � � Jt --J ..� • - 1 �'--� w .� .til �✓ .1, �`,��� � . App,.imt/ Date. Ownem NatiYe:... — 'Reviewed: _ Architect/ Citgitteer:. _�8_ __ Submitted: 7• I L/; "— SCTM #: l7islrict: 00 Sce0on: 131oc' ; Loi: _. _.c5 •�� Project nn �p p Subdivision location: �1 d -e- • T ..;_ �.. _ Name: Single 8-, separate Required cetttCtcation: (Yo f No) ra Rwq. 11cy. Zrunin� i�islricl ll� ro 7—(S'Nifde� Actual:((o( cuvcragc I top(,ised Rte, F� i� (From VITOI Proposed: Yard Proposcd:(RcarYard Pfoposcd• a% Project Description. A. rGENCO+Fermi REQUT ED FQEL RE, VICEW N.A. NO YES I�fumber Suf -otk County Health Dept. N6w York State. D. E- C. Town Tmstces Town Zoning Board approval:_ Town Planning Board approval: Flood.Plaae Elovation V? Flood Zone: r r�f-►�,� f 7� 3UFFOLR COUMV M7ARTWW OF N&ALTH SERVICES PERMIT 41'OR APPR©VAl,QA CONtfi F ItiJCI`iON FOR A SINGLE i1`F> ULN RESU32NCR ONLY � DAT& HS RSP, W". 00 aAPPRO Mikk INIAMIUM OF.EXPIRESThREEYEARSFRO 1p LO LOT 15 cA 1 ac % C30 IN s ��. PLOT PLAN OF u c LOT 15 %p v MAP OF SUMMIT ESTATES F SECTION No. 2 �! FILE No. 10768 FILED MAY 21, 2002 ��lo SITUATED AT Qrar EAST MARION TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-35-08-5.23 ,V4dp �4 SCALE 1"=30' DECEMBER, 23, 2004 ( (�� Y ba CQ9 • OS, AREA = 30,000.00 sq. it. 0.689 ac. A NOTES 1. REFER TO FILED MAP FOR TEST HOLE DATA. 2. MINIMUM SEPTIC TANK CAPACITIES FOR A I TO 4 BEDROOM HOUSE IS 1,000 GALLONS. 1 TANK; 8' LONG, 4'-3' WIDE, W-7' DEEP 3. MINIMUM LEACHING SYSTEM FOR A I TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 2 POOL;6' DEEP, 8' dia. } SS PROPOSED EXPANSION POOL PROPOSED LEACHING POOL PROPOSED SEPTIC TANK �t s9 O PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TRLE SURVEYS AS ESTABLISHED O•9 N O• 4 BY THE L.I.A, S. AND APPROVED AND ADOPTED ,. FOR SUCH E BY THE NEW YORK STATE LAND'' v TRLE ASS OF w y GUS co At _ o N.Y.S. LIc. No. 49668 3 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7208 OF THE NEW YORK STATE EDUCATION LAW. Jos h A. Ingegno � COPIES DF THISURV SURVEY IMP NOT BEARINGL THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT td Surveyor BE CONSIDERED TO BE A VALID TRUE COPY. ' V% C CERTIFICATIONS WDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM TIE SURVEY &) IS PREPARED, AND ON HIS 98WF TO THE TOLE COMPANY, OOVERNMENTAL AGENCY AND 1Yk Surveys - Subdivisions - Site Plans - Construction Layout INSTITUTION LISTED T GA,,s'WdEES OF THE LENDING WTITI- TUTION. CERTIFICATIONS E NOT TRANSFERABLE. PHONE (631)727-2090 Fax (631)727-1727