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HomeMy WebLinkAbout31353-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, CERTIFICATE OF OCCUPANCY No: Z-31223 Date: 10/14/05 THIS CERTIFIES that the building ADDITION Location of Property: 1615 PIKE ST (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 140 Block 2 Lot 45,1 Subdivision Filed Map No. __ Lot No. __ MATTITUCK conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 29~ 2005 pursuant to which Building Permit No. 31353-Z dated AUGUST 11, 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LAUREN J & THEODORE BRIGHAM III (OWNER) of the aforesaid building. SUFFOLK COUNT~ DEPARTMENT OF ~LTH APPRO%~%L ELECTRIC3%L CERTIFICATE NO. PLDq~BERS CERTIFICATION DA'&-~U Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTItOLD 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: 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 topograptfic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fom~). 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. Cormnercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Cmnpliance from architect or engineer respot~sible for the building. 6. Submit Pla~ming 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 featm'es. 2. A properly completed application and colkqent to iuspect 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 l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinurfing pool $25.00, Accessory building $25.00, Additions to accessoo' building $25.00, Bnsinesses $50.00. 2.Certificate of Occupancy on Pre-existing Building- $100.00 3.Copy of Certificate of Occupancy - $.25 4.Updated Certificate of Occnpancy- $50.00 5.Temporat3, Certificate of Occupancy - Residential $15.00, Commercial $15.00 ,lew Construction: /~41~Old o r Pre-existing B uilding: _( ..... (check one) House No. Street Hamlet wner or Owners ot' ex'ope, y: ~3,.Ll~re~YI X, ~_qhO~. ,ffolkCounty Tax M~qx..x. No 1000, Section_l~¢ ~ Block .~ Lot ~S', l bdJvision Filed Map. _ ............... Lot: ~lth Dept. Approval: Undem'riters Approval: .......................... ming Board Approx al: lest for: TemporaD' Certificate ',ubmitted: $ o~ ~ '~ Final Certificate: (check one) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, NoY. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31353 Z Date AUGUST 11, 2005 Permission is hereby granted to: THEODORE BRIGHAM PO BOX 24 MATTITUCK, NY 11952 for CONSTRUCTION OF A DECK ADDITION TO A/q EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1615 PIKE ST MATTITUCK County Tax Map No. 473889 Section 140 Block 0002 Lot No. 045.001 pursuant to application dated JULY 29, 2005 and approved by the Building Inspector to expire on FEBRUARY 11, 2007. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 ~O~O~XO~ST) - / -, ~~ ROUGH F~G & ~{. ~ PL~G ~S~ATION PER N.Y. ~ STATE E~RGY CODE .~D~ION~ CO~NTS ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: INSPECTOR~'.__~~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ FOUNDATION 2ND [ FRAMING / STRAPPING [ FIREPLACE & CHIMNEY [ ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [~FOUNDATION 1ST [ FOUNDATION 2ND [ FRAMING / STRAPPING [ FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS: DATE g''''~ ~ -' 03'"' INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN HALL SOUTHOLp, Nl' 11971 TEL: (031) 765-1802 FAX: (631) 765-9502 · ~v,,v. north fork.net/Southo[d/ £xamined ~/~ ,20 t)5~ Approved ~/(f .20 Disapproved a c Expiration 2~t ( . 201~_'Z ~pector BUILDING PERMIT APPLICATION CHECKLIS'[ Do you have or need the following, before applying? Board of Healtlt 4 sets of Building Plans Planning Board approval Check Septic Form N.Y.SD.E.C. Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date ,20 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 watem,ays. 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 lBr inspection throughout the work. e. No building shall be occupied or used in whole or in part for an)' purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. EyeD' 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 ntay authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new pemfit 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 Count3', New York, and other applicable Laws, Ordinances or Regulations, for the construct/on 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 author/zed inspectors on premises and in building for necessary inspections. (Signature of applicant or name, ifa corporation) (Mailing address of'applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 4ameofownerofpremises ,' }~&o 050 re_- (As on t'de tax roll ~-r latest deed) f'applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) uilders License No. umbers License No. ectricians License No. :her Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section . ,e'D Subdivision (Name) Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed conslxuction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of~vork (check which applicable): New Building Repair Removal Estimated Cost / ~ F/r0, go If dwelling, number of dwelling units If garage, number of cars Addition ~/' Alteration Demolition Other Work Fee (Description) (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. 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 Rear Height Number of Stories 9. Size oflot: Front /~ib Rear ,'~'0 Depth /,~'© 10. Date of Purchase ~7/~¥ Name of Former Owner [~&I?'TP ~-- l l. Zone or use district in which premises are situated ~ ed. d ~_ r~ ,~2 ~ Ct_! .Depth 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO ~/ 13. Will lot be re-graded? YES__ NO / Will excess fill be removed from premises? YES__ NO l~Ir~, kO~xre,~ ~F, 14. Names of Owner of premises Dr-,~h~ r?q Address ~ ~¢ Phone No. ~/- NameofArchitect /_[~rr~ V~, Address PhoneNo &dl-q77- Name of Con, actor Address Phone No. 15 a, Is this property within 100 feet of a tidal wetland or a freshwater xvetland? *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. v/ 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. l 7. 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 F~4~atJ_~ /~ .~J~ff~-AJ ~/~~ being duly sworn, deposes and says that (s)he is the applicant (~a~ne of individual sign~g contract) ab~(ve name& (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 applicatio~ tlmt all statements contained in this application are tree to the best of his knowledge and belief; and that thc work will be performed in the manner set forth in the application filed therewith. WIND LOAD PATH CO~,ECTION AND CONSTRUCTION' DETAIL DRAWINGS MAX STAIR RAILING UNDIS,TURBED SQIL C~ee.o~ APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOLff, DATION - ~0 REQUIRED FOR :OURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4. FI~AL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE R~QUIREMENTS OF ~HE CODES OF NEW YORK STATE, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCy OR USE IS UNLAWFUL WITHOUT CERTIFICATF OF OCCUPANCY REQUIRED. i~E, ~ISl'FIUCTION SHALL E REQUIREMENTS OF THE CODES OF NEW YORK STATE. RETAIN STORM WATER RUNOFF. PURSUANT TO SECTION 45-10C OF THE TOWN CODE.