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Home My WebLink About31624-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31322 Date: 12/08/05 T~IS CERTIFIES that the building ADDITION Location of Property: 3350 PINE NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Co%unty T~ Map No. 473889 Section 70 Block 12 I~t 2 Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 21, 2005 pursuant to which Building Permit No. 31624-Z dated NOVEMBER 5, 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 "AS BUILT" DECK ADDITION TO ~N EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KAREN T VAI~ADEZ (OWNER) of the aforesaid building. SUFFOLK CO%~TY DEPARII~ENT OF }IEAL~{ ~-PPROV~J~ ELECTRIC3%L CERTIFICA~ NO. PLUMBERS CERTIFICATION DA'£~U N/A N/A N/A //t~ized Signature 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: 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 ur engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo 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. ]. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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 $15.00 New Construction: Location of Property: Date. ~ Old or Pre-existing Building: ~ House No. Street } Owner or Owners of Property: ~t'~ ~{e'~6t~ [ 0~ ~/ Suffolk County Tax MapNo 1000, Section_ ~g$~/~") 0 Block 00 Subdivision Filed Map. Permit No. (check one) Health Dept. Approval: Lot Lot: Date of Permit. I ~/94/0~- Applicant: Underwriters Approval: Hamlet Planning Board Approval: Request fbr: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signature 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. 31624 Z Date NOVEMBER 5, 2005 Permission is hereby granted to: KAREN TAYLOR VALADEZ 3350 PINE NECK RD SOUTHOLD,NY 11971 for : "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 070 pursuant to application dated NOVEMBER Building Inspector to expire on MAY 3350 PINE NECK RD SOUTHOLD Block 0012 Lot No. 002 21, 2005 and approved by the 5, 2007. Fee $ 300.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] RO~,~PLBG. FOUNDATION 2ND [ ]/~ULATION FRAMING/STRAPPING [~"] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ] FIRE SAFETY INSPECTION DATE FEELI~ INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE DATE CONIMENTS ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV(Cq HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Phone: 031-765-1o [j tq'} Building Inspector ~ I "t00~ APPLICATION. FOR BUILDING PERMIT L _ ~ ~ 1 Date 111o~/ ,2005 (_ :~ '~. ,) ~ INSTRUCTIONS a. ~is application MUST be completely filled in by t~ewriter or in i~ and submitted to the Building Nspector 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 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 Buildigg 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. I/ {~n 1.4 (Signature of applicant or name, ifa corporation) (Mailing address oIapptican ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder If applicant is a corporation, signature of duly authorized officer roll or latest deed) (Name and title of corporate officer) Builders LicenseNo. Plumbers LicenseNo. Electricians License No. Other Trade's License No. Loc..ati. on of land on whichproposed work will be d9ne: House Number Street ' / / Hamlet County Tax Map No. 1000 Subdivision (Name) Section Block l~)- 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 l~r,l, tll~t~ rf.3t-~O~, b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal __ Demolition 4. Estimated Cost 31 ~ 0 0 ~ o~o Fee 5. If dwelling, number of dwelling units If garage, number of cars. Addition ~'~/a.%~ Alteration Other Work (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 Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. DateofPurchase }6~ Name ofFormer Owner 'T~trl¢~~ 11. Zone or use district in which premises are situated ~lJkq4o I~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO -/' 13. Will lot be re-graded? YES__ 14. Names of Owner ofp. remises Name of Architect Name of Contractor 15 a. Is this property within 100 feet of a 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 v-Will excess 1511 be removed from premises? YES NO ~ Address .~,'~,/~'"O ~tl(,,tqL6/~,f~Ph~neu~?. '7~-~) ~ Address Iq~q fiv3a, o~ _1~, ¢~~¢~1~5~ Address ~ ~ ~hon~o. ~ - 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) SS: COUNTY Ot~f (-0 C4c_) ~}./~0vx ~(4 10r' ~ being duly swom, deposes and says that (s)he is the applicant (Name of indivi~tual sighing cont!~ct) above named, (S)He is the Obo}/M/r/ (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 applicatkm filed therewith. Sworn tp before me this/' Not~ublic MELANIE DOROSKI NOTARY PUBLIC, State of New No. 01D04634870 0uatified in Suffolk Coun~ Commission ~ires September 30,~tJ 20 ~ Signature of Applicant