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HomeMy WebLinkAbout31576-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-31577 Date: OS/24/06 THIS CERTIFIES that the building ALTERATION (STREET) Block 2 CUTCHOGUE (HAMLET) Location of Property: 25615 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 109 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 31, 2005 pursuant to which Building Permit No. 31576-Z dated NOVEMBER 2, 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 CONVERT EXISTING GARAGE INTO LIVING SPACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN E & MICHELLE OLSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2087165 03/03/06 PLUMBERS CERTIFICATION DATED N/A ~~~~ uthorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 fV\-uJ- --- 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 2/1 0 of I % 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 Date. Location of Property: <7tJ 'J( (check one) ~\\~()r\<\"S '--U(\~ C_~C~D0UZ Street 'tt\ \ ~~ \ \.Q... D \~ '" Hamlet New Construction: Old or Pre-existing Building: House No. Owner or Owners of Property: --::S-\)~'f\' < \ Suffolk County Tax Map No 1000, Section Block Lot Subdivision Permit No. ~\~l\.o 7... DateofPenllit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate _ Fee Submitted: $ :::rs, \) '\) C:..o -6- 3/Sil ~ G 1D}d-\j Filed Map. Lot: Applicant:~)\\\\ C) \'S~'() Underwriters Approval: Final Certificate: X (check one) 9~(e:: '3 I 'S i\., 1iI~~~~1iI I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ CERTIFIES THAT ~ ~ ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ PAUL R. BURNS JOHN & MICHELLE OLSEN ~ ~ P.O. BOX 1061 25615 MAIN RD. ~ ~ SOUTHOLD, NY 11971-0932, CUTCHOGUE, NY 11935 ~ ~ Located at 25615 MAIN RD. CUTCHOGUE, NY 11935 ~ ~ ~ ~ Application Number: 2087165 Certificate Number: 2087165 ~ I Section: Block: Lot: Building Permit: BDC: ns11 I ~ 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, 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 3rd Day of March, 2006. ~ ~ Name OTY Rate Rating Circuit ~ ~ ~ Alarm and Emergency Equipment ~ ~ Sensor 0 Carbon Monoxide ~ ~ Sensor 0 Smoke ~ ~~~~ ~ ~ Outlet 4 0 Fixture ~ ~ Fixture 4 0 Incandescent ~ ~ Outlet 8 0 General Purpose ~ ~ Receptacle 7 0 General Purpose ~ ~ Dimmers I 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ g~ ~ ~ ~ ~ I of I ~ 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. I i'FE!~~1iI 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. 31576 Z Date NOVEMBER 2, 2005 permission is hereby granted to: JOHN E & MICHELLE OLSEN 80 ALVAHS LA CUTCHOGUE,NY 11935 for : ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at CUTCHOGUE 25615 MAIN RD County Tax Map No. 473889 Section 109 Block 0002 Lot No. 006 pursuant to application dated OCTOBER 31, 2005 and approved by the Building Inspector to expire on MAY 2, 2007. Fee $ 150.00 Ai;;. ;. ~ {;J.L I Authorized Signature ORIGINAL Rev. 5/8/02 3/57(, :Z- TOWN OF SOUTHOlD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PlBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING p<c FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: .F~ {~/ ~ck, EhJ;~ cd, ~ "'d _ DATE --' ~ J -- 0 (0 INSPECTOR ~ ~ 3 /5-7? C TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [' INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: J2; ~ Ole tv ~/ <- . , DATE 'i i'f! d? INSPECTOR /' - -~.- 3151&c TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ [ ] ~DATION 2ND [ [ --{FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION REMARKS'~' -!. h.B~j 70 :Jfl~ ~. DATE /;i3/&? ~ I INSPECTOR 3/S7?p TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [~NDATION 1 ST [] ROUGH PLBG. [v{FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS'. ~~ - C.LfL_ . .J'J -&I' .- p ~ ~7- ~ - -,s'r- )' d- O,.e ~~., ~-,,_ DATE J,2!/t.~S- , , INSPECTOR ~~~~ . FIELD INSPECTION REPORT DATE COMMENTS \)1." W/".I'~ ..=:.4. " .,... - e ~. -i' CJf. t?~ - !"l , .:I"""~a.,- ':7.- E ~ <::: . , ~~ FOUNDATION (1ST) 7T f)~ --------------.--------------------- I .~ FOUNDATION (2ND) I\~ Z ~ P (hI 1<11 L::;. ~ r- L~ A ~. -/y~ v. ~ ,7 \J\ '" ~'" ~ ROUGH FRAMING & __1ll V\!:l ~ PLUMBING fTt 3 I-=., ~ . ::p ~ :w; <,C/ ?&'U~A " t:I;1'(./CJ ( ~ 2.- ~ ~r , / ~ :l..- -/ ~ J ~ INSULATION PER N. Y. ... '" STATE ENERGY CODE ~ t -t: '5 ~ }-t I~ -t::; . ~U .JL - ,~8n e..bcf. ;,,, J-f A O/J 1, " p . , v ~...r ' ~ '.P' ./";;T rJ a- ~ IJ" FINAL ~ <Q ADDITIONAL COMMENTS \) \A ". ~~ 0 ~i } ~ ~ " !"l ~ ~~ 'V '" . - ... 0 , ..jZ == ... ~~ t:--: ,'" ~; !"l ." :-l TOWN OF S.OUTHOLD BUILDiNG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ PERMIT NO. Cl/<:'7h b BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health .8 4 sets of Building Plans J"7i4Hplc~ Planning Board approval Survey Check I'~t) Septic Form N.Y.S.D.E.C. Trustees Contact: I Examined II/.;.. '/ Iy;:)... ,20~ ,20~ Approved Disapproved alc Mail to: Phone: Expiration S"iJ,20.f2Z- I /1::.J/~ Building Inspector _ ---:::-~'1 .,.--....... " ',' r--:--;:" \~I y,.-, \ \. \ Ic':-' \ .." I' \",~ ~ ' '~~PLICATION FOR BUILDING PERMIT \1.1\..\\.-,,; :_-::-\'~',:\~ Date ()~\Obef< \, 1\'," ',' .' INSTRUCTIONS a. Thrsap;]ication 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 oflot 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. APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South old, 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. s1" .3 \ , 20 D5 ~D '4-\,~\6lo()Q C\)~~\~ (Mailing address of applic t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder D~~R, Name of owner of premises ~\\() O\'5Q{) Of\~ '<'\\~\\e () \s.eJ'\ (As on the tax roll or latest deed) 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 No. I. Lq~~n oflan House Number hich proposed work will be done: (2- Street c County Tax Map NQ" I OQ,O Spcfi9~~:,U{~ SubdivIsIOn ",d, ",i' {N'-;'I,'),;4'1';';" "[9!r:i.",'~1 .' _ ~ '-iTM .:'~';;;.,1~Li'lf':"i1)"I~' Block d.. Filed Map No. Lot Lot ~ . , 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration )( Fee (Description) 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, 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 Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated \<PS', ~ 0.....\" 0. \ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO--K- 13. Will lot be re-graded? YES_ N02{__Will excess fill be removed from premises? YES_ N021_ 14. Names ofOwnerQ[premise;j^~",\ '\'{\\~\\d)\Stfddress')?() (\\\'&l~"la~I)\(.'lI~~~e No./64 -1605 Name of ArchitecUl'ft\l~ -.r. b.ee("~ly., '(.', AddresQl,b ~~.. ~()~p YY"CAhlll<l"J'hone No 2 q ~ - 1 II \0 Name of Contractor Address Phone No. 15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO L * 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 X- * 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 OF5Uifo{K-) ~ 0 h f\ ) (') r S e V\ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S@jsthe J ~Y\4~c~ (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. Sworn to before me this .. /" :'>1 ::;5;jJ,;rY(fe<4 Notary Public ' y9/lc1r Signature of Applicant UNOA S. TAGGART NlIllIryPublic:. Stale of New York No. 4948506"......... QuaIifild In SUtIolk """,.., c:.....w'J"",", EIlpiIIs 1IIIdl20.:..z..P 7 -~-._,,----_..._.,.- Of t.1<\..'1 fOI<~p..\'IO ill 01< 5t.1< \'10 p... if\'lO \..0\5 HARBORVIEW HOMES. INC 1706 NORTH HWY. - SUITE 2 SOUTHAMPTON, NY 11968 , ~ c -'-:t- ~9z" "'"0 ~?:> <5l-'" >0~ 'l'-~ 'Z-?:> 00.. ~ "'~ '?o .'?;, )7' 'L- )7' --s.. " \5\ , )7' -Z- .....,. ,- , o'.~O 0,85 ~, . .....H II C..,<: r:"-,, ":-' I.>" (,,' & (f.l02.91 . '._- lI2..:...Ql:_QJ,]~ 1 , ,.-, t:,;i.:::: :; .-.----.-------".---------- AREA: 22,327 S.F. - 0.512 AC. CERTIFIED TO: SURVEY OF DESCRIBED PROPERTY EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECOfiVEV ARE NOT GUARANlEEO UNLESS PHYSICALLY EVIDENT DN THE PREMISES AT THE TIME DF THE SURVEY. GUARANlEES INOICAlED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR WHDM THE SURVEY. IS PREPARED. AND ON HIS BEHALF TO THE TITLE COM- PANY, GOVERNMENTAL AGENCY AND LENOING INSTITUTIONS LISTED HEREON. AND TO THE ASSIGNEES OF THE LENOING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADOmONAL INSTITUTIONS OR SUBSEQUENT OWNERS. THE OFFSETS (OR OIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPEctRC PURPOSE ANO USE AND THERE- FORE ARE NOT INTE:NDED TO GUIDE THE ERECTION OF FENCES. RETAINING WALLS. POOLS. PA TlOS. PLANTING AREAS. ADDITIONS TO BUILDINGS AND ANY OTHER CONSTRUCTION. SITUA TE AT CUTGIOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ~~"'p -...,-.,.-:c.;.~",:.{:':. . SCALE: 1 "=40' DATE: JULY 18. 2001 S.C. T.M. DIST. 1000 SEC. 109 BLK.2 LOT6 JOB NO. F3578 REVISIONS: TEST HOLE 7/30/2001 ADJOINERS WELL/SAN. 08/23/2001 STAKE FOUNDATION '0/23/2001 UNDER CONSTRUCTION 17/09/2001 F1NAL 01/12/2002 ADD SANITARY 01/'5/2002 fNJ<tdJ ~[J?B Marc E. Charest, L.S. Successors to Paul T. Canal/za, L.S. Robert A. Kart, L.S. Good Ground Surveyors, P.C.