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HomeMy WebLinkAbout31283-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31234 Date: 10/24/05 THIS CERTIFIES that the building ADDITION & ALTERATIONS Location of Property: 895 LEETON DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 59 Block 1 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 2005 pursuant to which Building Permit No. 31283-Z 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED The certificate is issued to ANITA of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 (OWNER) 2074035 10/04/05 , u-'-Zrizedl Signature �dC.�To: D�t 0 T O D ,p -HALL 765-1$U2` APPLICATION FOR CERTIFICATE O_F71cc PIT, SIS -71 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 % 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 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 New Construction: Location of Property: No. Owner or Owners of Property: Date.�1 /, J Q� Old or Pre-exit' Building: ✓ (check one) L%aill LVA ! ✓E SDc1Q� g Street Hamlet iiT� dl uIAJn! Suffolk County Tax Map No 1000, Section �0 Block Subdivision Permit No. 3 )a b 3 Z. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ j S, 601 6Z11r. - ( 113 7 Co-?, 31a3`( Lot Filed Map. ' Lot: Applicant: —r / /),L fy r3Sii�ll� Underwriters Approval: Final Certificate: (check one) BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by TOM KRAUS P.O. BOX 336 GREENPORT, NY 11944 Located at 895 LEETON DR. SOUTHOLD, NY 11971 Application Number: 2074035 Section: Block: Lot: ANITA QUINN 895 LEETON DR. SOUTHOLD, NY 11971 Certificate Number: 2074035 Building Permit: BDC: nsll Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, stair well -addition, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 4th Day of October, 2005. Name OTY Rate Ratin Circuit Tyne Miscellaneous as built -1990 Wiring and Devices Outlet 2 0 Fixture Fixture 2 0 Incandescent Outlet 2 0 General Purpose Switch 1 0 General Purpose Dimmers 1 0 An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 1 of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 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. 31283 Z Permission is hereby granted to: ANITA QUINN 249 HICKOK RD NEW CANAAN,CT 06840 for : Date JULY 15, 2 CONSTRUCT AN ADDITION AND ALTERATIONS TO AN EXISTING DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 18967. at premises located at 895 LEETON DR SOUTHOLD County Tax Map No. 473889 Section 059 Block 0001 Lot No. 011 pursuant to application dated JULY 15, 2005 and approved by the Building Inspector to expire on JANUARY 15, 2007. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. a 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) 18967 z Date ....... ............................................ 19. Zip Permission is hereby granted to: , q —5�' f �1?997- 7 ............. � ............... okiz,l ... vn to A ....... ....... ~ ......... .... ...... ... .......... .. . ... ......... 44� .... .. . atpreilses located at .......... ........... . .................................................. ............................................... ................................................................................... . County Tax Map No. 1000 Section ...... ;2 ...... pursuant to application dated 75 ................ Building Inspector. Fee Rev. 6/30/80 0 Block ........../........ Lot No . ........ el .... .................. I 1q./.0, and approved by the ........ ....... . ............. Bull g Inspector Jrx&.p IIVSFCCTIO14 - IIDAT5 II Com'af urs FOUNDATION (1st) FOUNDATION (2nd) A H � a 2. ROUGH FRAME & •PLUMBING 0 �z 3. INSULATION PER N. Y. STATE ENERGY CODE Cn ^j m m y .. I 4. FINAL •. 7 H x o AD I011AL COMMENTS: � b H f. r � H rry 1 H0 O� i m a to m -a a 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND[ ] IN CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY[ ] FIRE SAFETY INSPECTION r" DATE INSPECTOR 802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1ST [ ) ROU H PLBG. l FOUNDATION 2ND [ INSULATION ( J FRAMING [ ) FINAL REMARKS: &L t . DATE b,,2-) 2U INSPECTOR 44- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ J ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [t,I/FRAMING [ ] FINAL REMARKS: DATE 0 INSPECTOR M-1802 BUILDING DEPT. INSPECTION ( ] FOUNDATION IST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ =TION r% DATE J INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 2 f INSPECTOR � ..:pfd �14$2iCul ..iu.1. Yim t N�p� � _ lrRc__,.v--.__. < � _ _•'Y 'moi _ �-a'«' qofW —'Y wnr.S F+ar"°` 3" #x' 'L i I - x�,�``,tY s h • f {I - • �Z. E tt OF NE VL iia PRO il v. RT•�,+ ,3LR�'EY`EO FCR I A7- ij- / v`• I• < -z, is aus cav I CC53 Q�9 b l r q nssi Sher n h _. w^'sun qi wt.-,mhe _ n c.� s one unh i us rzi "iL i e M �rsut-�114Ce o��� surV��ed I - _t �:.�►� 8,F moo* .p /lfoverno�i, /9 /. • lY ! ./'"CA4— R/ K.- i'� ,fj-1 (/�-14" 4'., Reo er�c#�(// I��n/7U'G{/, -� R - _s � t F Y AKe4Mdoa+4"Ch. C. �,etf r�.t /vew r . ow BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY .......... jPMP I % j TOWN OFSOUTHOLD CHECK •......... tr[ BUILDING DEPARTMENT SEPTIC FORM TOWN HALL uf�UFF''Y !.11.t`� SOUTHOLD, N.Y. 11971 NOTIFY CALL ............... w •' TEL.: 765n1802 MAIL TO: �po7C IIII Examined ... ......... 19 Approved ...? / ....... 19Permit No. Disapproved a/c ..................................... ................................. ....... .. . (B dding Spector) APPLICATION FOR BUILDING PERMIT t p Date .. `; `.��........... 199.q 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 inspec oM�o�u��........� ............................................ /� (Signature of applicant, or name, if a corporation) ...... ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................. ............................................... Name of owner of premises ..... --rt-to .. .I A 5 .1'i • Q N .o -.......... (as on the tax roll or latest deed) If applicant is a corporati n, ature of duauthorized officer. (Name and title of corporate of icer) ALL CONTRACTOR'S MUST BE SgFFOLK COUNTY LICENSED Builder's License No. . IN R 51A . T , ... , .. . Plumber's License No . ........ ............. . Electrician's License No . ...... ............. . Other Trade's License No . .... .............. . 1. Location of land on which proposed work will be done. I iL v c3 4.O u Y t 40.:: House Number Street Hamlet County Tax Map No. 1000 Section .... 5F Q ....... Block ...... I........... Lot ... .............. . Subdivision ..................................... Filed Map No. .............. Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....I. �'M I `� .......................................................... b. Intended use and occupancy ......... SA -..,.r .................................................. 3. Nature of work (check which applicable): New Building .......... Addition .. ✓ ...... Alteration Repair .............. Removal .............. Demolition .............. Other Work ..... 4. Estimated Cost ......... `{' `TD . .................. Fee .................... . (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ...... Number of dwelling units on each floor . If garage, number of cars ..................................................... _ ... .... . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ...3.9 - P...+ ... Rear .....4 "' ...... Depth Height . 1 T.. 2 ..... Number of Stories ...... _7 ............................... ...... . Dimensions of same structure with alterations or additions: Front ... 7 7.*' ........ Rear . Depth ..... T'.. "'...— ........ Height ...7 T: ........ Number of Stories .... ? . .............. . 8. Dimensions of entire new construction: Front ... .... Rear .... ?"'.''. * ... Depth . 3 Q''� .. ... Height .. 7�°"!..!..... Number of Stories .......... .................................. • . ....... . 9. Size of lot: Front .... X4.-.4.......... Rear .... l w 7:? .......... Depth . � 4L?- v ........... . 10. Date of Purchase ............................. 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: .. � 9 ........ 13. Will lot be regraded ..... 0.0 ..................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premisesF' M4" . Q9. t'?rt ... Address Phone No -T (-5.' .`?` :'?' , Name of Architect - Address ... Phone No ................ Name of Contractor LTA ..1+t Ir" J' .! ?.�'�'..... Address -'k,"! ! .. ' ! � �... Phone No. l 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No n... *If yes, Southold Town Trustees PermitPLOmay be required. Locate clearly and distinctly all buildings, whether existing or proposed, andindicate all set -back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether '.nterior or corner lot. STATE OF NEW YORK, S.S -OUNTY OF ................. .......................... I ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ieis the......................................................................................... (Contractor, agent, corporate officer, etc.) :)f 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 .vork will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............... ./.7......day of. << .... .......... 19 !.4 Jotary Public, ...... ... County NOMNOM PUMA �eVOEof New York Na 4707878, S#M 7Mm b0ft N wh 30, ta_y /V ..................................... ... ...... (Signature of applicant) I • 1T '& R. ©J Coo ^J 1"AmYtJ4'i r. � C7 -X A7te s . ri I • 1T '& R. • OCCUPANCY OR USE IS UNLAWFUL aV!JTHOUT CERTIFIG i, a 3 , OF OCCUPANCY 4'I'F R A;2 At tail_ � .. 3iav, - A!!D AS NOTED DATE: B.P. # 0 FEE: gy; NOTI BUI G DEPA E 765-1802 9 AM TO 4 Pf4 R THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. g ALL CONSTRUCTION SHALL MEET A fE THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR • DESIGN OR CONSTRUCTION ERRORS ©J Coo ^J 1"AmYtJ4'i C7 -X A7te ri • OCCUPANCY OR USE IS UNLAWFUL aV!JTHOUT CERTIFIG i, a 3 , OF OCCUPANCY 4'I'F R A;2 At tail_ � .. 3iav, - A!!D AS NOTED DATE: B.P. # 0 FEE: gy; NOTI BUI G DEPA E 765-1802 9 AM TO 4 Pf4 R THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. g ALL CONSTRUCTION SHALL MEET A fE THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR • DESIGN OR CONSTRUCTION ERRORS