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Home My WebLink About29857-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31311 Date: 12/02/05 THIS CERTIFIES that the building FIREPLACE ADDITION Location of Property: 1555 TUCKER LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 59 Block 10 Lot 8 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 5, 2003 pursuant to which Building Permit No. 29857-Z dated NOVEMBER 6, 2003 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 FIREPLACE ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KATHLEEN GOGGINS (OWNER) of the aforesaid building. SUFFOLK COUNT~DEPARTMENTOFH}L~LT~APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A ature Rev. 1/81 Form No. 6 ~' ~ ~:. TOWN OF SOUTHOLD ., 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 · topographic features, 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. Coramercial 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 ofco~npleted 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 applicm~t. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in wr/ting to the applicant. C. Fees 1. Certificate of Occnpancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, SWirmning pool $25.00, Access.otT building $25.00, Additions to accesso~*y 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, Co~mnercial $15.00 Date. _/~p New Construction: ~/ Old or Pre-existing Building: (check one) Location of Property: ,/.fi~,-¢-,~'- ~___dffc2&r~< _ ,~-4q~-,ff-.~ .~' Honse No. Street Hamlet Owner or Owners of Property:` .7/~_ ,./~/~.~ Suffolk County Tax Map No 1000, S~tiou ~ Block Let Subdivision Filed Map. Lot: H~lth Dept. Approval: Undemvfiters Approval: Plam~ing Board Approval: Request for: TemporaD' Certificate Final Certificate: (check one) Fee Submitted: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29857 Z Date NOVEMBER 6, 2003 Permission is hereby granted to: KATHLEEN GOGGINS 1555 TUCKERS LD2qE SOUTHOLD,NY 11971 for : CONSTRUCTION OF A FIREPLACE ADDITION AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 059 pursuant to application dated NOVEMBER Building Inspector to expire on MAY Fee $ 150.00 1555 TUCKER LA SOUTHOLD Block 0010 Lot No. 008 5, 2003 and approved by the 6, 2005. ORIGINAL Rev. 5/8/02 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD April 20, 2005 Kathleen Goggins PO Box 1219 Southold, NY 11971 RE: 1555 Tucker Lane, Southold TO WHOM THIS MAY CONCERN: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file)S25.00. 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 # 29857-Z Please contact our office on this matter. Thank you for your cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2NO FRAMING [ ] ROUGH PLBG. [ ]~JLATION [ ,~j~FINAL REMARKS: ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION DATE INSPECTOR FOUNI).~.TION (IS'r) R.OUG~ IrR&M~IC- & TOWN OF SOUTHOLD BUILDI~NG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved Expiration ,20 ,20 3 - BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Plarafing Board approval Survey Check Septic Form N.Y.S.D.E.C. Imstees Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT UNDERWRITERS CERTIFICATE REQUIRED INSTRUCTIONS Date ][/~ ,20t~ a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, aecm~te plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationsh/p 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 hxspector 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 a.ny 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 re,,~lations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the exlensiomof_~ 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, tbr 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,~r l~me, if a corporation) (Mailing addresS/of apphcant) / [ ~ ~ FOLLOWING INSPECTIONS: ~OUNDATION - TWO REQUIRED FOR POUH~U CONCRETE ame owne .o RA NG 4' FINAL CONe"RUCTION MUST c~s o~ the tax roll or latest deed) If applic~t is a ~6~fi~gn~ of duly authorized omcer ~,1 C~'!NOGtlON SF'.~L ~EET THE YORK STATE. NOT RESPONSIBLE FO Builders Licens~N OR CONSTRUCTION ERRORS. Plumb~s License No, Electricians License No. Other Trade's License No. 1. Location of land on w~hich proposed work will be done: House Number Street County Tax Map No. 1000 Section ,~ ? Subdivision (Name) Ham]et Block Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy fr ,'~,~tl,-y' r/~' ,'~&,4c a ~, b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost Fee 5. If dwelling, number of dwelling units / If garage, number of cars Addition Alteration Other Work -J2(r~,~l/-,c¢ ~z~i'~'lbr~ (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 Dimensions of entire new construction: Front Height Number of Stories Rear Depth Size of lot: Front Rear Depth Rear 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? YES NO 13. Will lot be re-graded? YES NO__ Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES__ * 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. ~' ~ NO 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) , COUNTY OF 5/4 ~f'~/~S)S: X_ '~ ~% ¢ ~[ ~ 5 being duly sworn, d¢oses and says that (s)he is the applicant (Nme of individual si~ing co~ above named, (S)He is the /'--'x. (Contractor~_ent,_t_t~orporate 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 tree 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 lto before me this Ik ~ , ¢~t-~. day of [ .'x,~}~ C_) k/ 20 ~,~ ~ Notary Public ,~ Claire k. Glew Notary Public, State of New York No. 01GL4879505 Quallfl®d in suffolk Co~ot.yo~ Commission Expires Dec. ~ ~ WOOD BURNING FIREPLACES SR36A wi Va sea e Surround SR36A SR42A .i