HomeMy WebLinkAbout32106-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: 2-31635
Date: 06/27/06
THIS CERTIFIES that the building ADDITION
Location of Property: 2275
(HOUSE NO.)
County Tax Map No. 473889 Section 102
HIGHLAND RD
(STREET)
Block 8
CUTCHOGUE
(HAMLET)
Lot 8
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 13, 2006 pursuant to which
Building Permit No. 32106-2
dated
JUNE 13, 2006
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 WITH TRELLIS ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to KENNETH G MOORE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~~
Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAN~-JLr'- -r" r I.
This application must be filled in by typewriter or ink and submitted to the Building Dep~~men~~ thlrllowing:
/"G' .:rob
A. For new building or new use:. i .. _.
I. Final survey of property with accurate location of all buildings, property lines, st~ets, jlPd unusual natur,aJ.or
topographic features. --'.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (8-9 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 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.
.
(< ,,;.. M~Q,u(>\:="
(-'5q_ {{erl
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,
Swinuning 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 $ J 5 .00, Commercial $[ 5.00
Date.
(,-R-oG
New Construction:
Location of Property:
d-d-l ~
House No.
Old or Pre-existing Building:
\-\-\ cJ( CO,,, A ld
~eet
~ r\e.. {R, mDf'Jr'-P
to"..).
( eheck one)
~+ck 1ju---R-
Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section__
Block
<x
Lot
~
Subdivision
Permit No. 3?IO<O
Health Dept. Approval:
Plarming Board Approval:
Date ofPennit.Lv{::;; -0(,
Filed Map.
Applicant:
Lot:
___,__ Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate: X
(check one)
Fee Submitted: $
';;15.00
'l ~li~gnPtr#/2
~_70lf~f
l 0 2:.'7 r 10 '7 J
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)
13, 2006
PERMIT NO.
32106 Z
Date JUNE
permission is hereby granted to:
KENNETH G MOORE
PO BOX 943
CUTCHOGUE,NY 11935
for :
CONSTRUCT A DECK ADDITION IN REAR YARD "AS BUILT" THIS PERMIT
REPLACES BP 24610.
at premises located at
CUTCHOGUE
2275 HIGHLAND RD
County Tax Map No. 473889 Section 102
Block 0008
Lot No. 008
pursuant to application dated JUNE 13, 2006 and approved by the
Building Inspector to expire on DECEMBER 13, 2007.
Fee $
150.00
Authoriz
ORIGINAL
Rev. 5/8/02
,
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD. N.Y.
BUILDING PERMIT
r2en
3;;;LIO{.,.
24610
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date .....J.?\I\lUIil.F.lY........22........................... 19..9.8....
z
Permission Is hereby granted to:
.......KENNEII:1..G..MDOFlE.............................................
...... .22.7.5..,H.I.GI:1LI.\ND.. RDI.\D....................... ...............
....... CU.T.CI:1DGUE,N~.. .1.1. 5'35.......................... ............
to .... .CONST.RUC T... .A.. .DE~CK. .ADIl1:r.10N...1 N.. REAR...V. ARIl.. ".'... A5...BW 11... T....:!.................... ......
.......................................................................................".........................................................................
..................................................................................................................................................................
..................................................................................................................................................................
..................................................................................................................................................................
at premises located at............... .227..5.....H.I.Gr.iLI.\ND.. RD................... ............. ......CU:rCHOGWE.. .......
................................................................................................................................................................
County Tax Map No. ....!l.7..3885'...... Section ...1.02............. Block ....0008......... Lot No. 008................
pursuant to appllcafton dated ...JJC.T.DBER.......2!l......................... 19......'iU...... and approved by the
Bulldlns;l Inspector.
Fee $........7..5.0.0.....
Rev. 6/30/80
~ y~ ?c;$cr78
PROFESSIONAL ENGINEER
1725 HOBART ROAO I PO Box 616, SOUTHOLO, NEW YORK 11971
TEL 631.7652954. FAX 631.6143516 . e-mail: joseph@fischetti.com
Date:
Reference:
June 8, 2006
2275 Highland Road
Southold Building Dept
PO Box 1179
Southold, NY 11971
Dear Sir,
8
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765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] ~LATION
[ ] FRAMING [pfFINAL
[ ] FIREPLACE & CHIMNEY
3> ?--I 0 , L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING lP<f FINAL }..-d-J,
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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INSPECTOR ~~
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TOTAL DATE
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REMARKS
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FRONTAGE ON ROAD
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined. '~'J .~.,...., 19 .76 ~
Approved .7; .?:~..... .., 191.!?Permit No. . . . '. . . .. . . ~
Disapproved alc ................................:....
................................. ~@:
. . (Building ~:';;:r)
APPLICATION FOR BUILDING ERMIT
Wi
~ D W ~
, /997
Wi
FORM NO.1
BOARD OF HEALTH .........
J SETS OF PL.\NS .........
SURVEY ...................
CUCCK ....... _ . . . . . . . . . . ..
SEPTIC FORN ..............
t:071 F"f:
CALL ...................
HAIL TO:
. . - . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . .
Do<, (O;/. .. .., 19?)
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, other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for re oval or dem lition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building.c de, hou . de, and regulations, and to
admit authorized inspectors on premises and in building for necess7nspec.w> . L
, .. ... "0 ............ ...
. . . . . 1.g~~fq7~ ~r1.?' .i~ ~ .c~~~~~a.t:~~).. . .
. ~1;:~~~1dN}i62t) .
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
........ f.:....... .$.TTJ!.t!.rf.i. .............. ........ ............... ..................... ..........
Nameofow'lerofpremises .G.e.f\C\::.-.. .~:.... ~M.A. .'.....A' AU.OlED.......
(" '" ili, ,,, roll "' 1."" 'oed) , on ~e
If applicant is a corporation, signature of duly authorized officer. ''"""7c- ,) I.P." ,
, . FD: ..!.,oJ .01../ IY:
. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOl'IFY BUILDING OEPA ME AT
(Name and title of corporate officer) 78&-1802 . AM TO 4 PM FOR THE
FOUOWlNG INSPEC11ONS:
1 FOUNDATION '. TWO REQUIRED
fIOR !lOURED CONCRETE
2. 'ROUGH . FMMING . PWMBING
a. INSUl.A11ON
4. FINAL. CONSTRUCTION MUST
BE COMPLETE FOR,C:O.
ALL CONSTRUCTION SHALL MEET
Other Trade's License No. ......,.............. THE REQUIREMENTS OF THE NY.
, STATE CONsfRUCTION & ENF"GY
I. Location of land on which proposed work will be done. .................... COO6S.. -NOt. QeSPON<;lf; , . . . .ri .
.. 2-.:Z. .7.:5............... .I.-+! .GJ.J.~AP1)....... ~9q.~~I.~~ ~.R. :~~~~~:'~~~t~i': :-:':':. '.S:.
House Number Street Hamlet
County Tax Map No. 1000 Section...: .1.0.~...... Block... .?'.........:... Lot... .f!:.............
Builder's License No. ' . . . . . . . . . . . . . . . . '. . . . . . . . .
Plum ber's License No. ........................
Electrician's License No. ......................
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 ............................ _ . . ~""..,:. . . . . . . . . . . . . . . ..,. . . . . . . . . . . . . . . . ...
b. Intended use and occupancy ......... .1)1;.<:; (:;. . .. ';0. f.? p.. . . /I..t;; . . .~.u. ! ~.f. .': . . . . . . . . . .. . . ..
_..J", :'.,:')
,3. Nature of work (check which applicable): New Building. . . . . . . . . . Addition. . . . . . . . .. Alteration ....;..:..
Repair .............. Removal . . . . . . . . . . . . .. Demolition ....;....... ", Other Work. . .. . . . . . . . . . . .
. (Description)
. /2-00 --- . ... "
4. Estimated Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 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 mi.xed occupancy. specify nature and extent of.each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures. if any: Front. . . . . . . . . . . . . . . Rear .............. Depth...............
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . .. .. . . .. . . . . . . . .. . . .. . .. . .. .. . .. . . .
Dimensions of same structure with alterations or additions: Front ................. Rear..................
Depth. . . . : .'. . . ... . . . . . . . . . . Height.. . .. . . , ..... . . . . . . . ,. . Number of Stories. . . . . ... . .. : . .. . .... . .
8. Dimensions of entire new construction: Front. . . . . . . . . . . . . .; Rear . . . . . . . . . . . . . . . Depth ...............
Height ............... Number of Stories. . . . .. . . .. . . . . . . .. . . . .. .. . . . . . . . . . . . . . . . .. . .. . .. . .. . . . . . .
9. Size oflot: Front. . . . . . . . . .. . . . . . . . . .. .. Rear...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
II. Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . .
12. Does proposed construction violate any zoning law. ordinance or regulation: .................................
13. Will lot be regraded .......:.................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises . . . . . . . . . . . ; . . . . . . .. Address . . . . . . . . . . . . . . . . . . . Phone No. ...... . . . . . ; . . . .
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . .'. . . .
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address 'r' . . .. .....;...... Phone No. ... . . . . . . . .. . . . .
15.' Is this property within 300 feet of a tidal wetland? y ........ No.........
'. *If yes, Southold Town Trustees Permit may be equi d. . . ,
. . PLOT DIAGRAM
. .
LOcate clearly and distinctly a1l buildings, whether existing 91" proposed. and, in . ate all set-back dimensions from
property lines. Give street and block number or description accor~g to deed. and show st et names and indicate whether
interior or corner lot. / . "",.
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J'8!l:)MOO C1ilfUO'l AO't
STATEOit'lEl'fflliWR~, 0fI11' S
COUNTY OF . . '~~lt.. U~"'I . .
........ "'::'~?:r:~~;,, "~'~'~ . !I/?~ 1.":'.,.0.... .... being duly sworn. deposes and says that he is the applicant
. (Name.of indivi4}~!.~g,jjlg contract)
abOVe named...;,;! 13;1 :>fir
He is the. . . . '.' . . .'. . .A-r;~~(.. . . . " .. .. . .. . ... . . . . . . . . . . .. . . . . .. .. ... . . . . . . . .... . . '" . . . . . .
. . "! Jrt (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 thit. , .
. ......... ...~.tf.. ... ..dayOf....<:1.0('~...19q7
01o'tary PUb~iC ..... '.L/ a.u, 4 ,.L.... \,...... County
. tf'-~I:vc,~oNS y, ",' .
Notary Public. State of N.ew 0 . . . . .. ...
No. 524618265 .
Qualified 10 SuHolk County _ CJtj .
. CommiSSIon Expires Apnl 30. 1 ~(
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(Signature of applicant) .
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DATE
APR - 5 1983
. '11. D. REF.
1t...L~3 ,
Thf'l S(l'l''''\!~'.' ,~. .,.,': .,.,,'.!"r !Iupply
(;';r:111 I. 1 '_':; f:~r to :'"' :''',IJlIVe been
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DEe. J. 1982
SURVEY FOR
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ALDEN W. YOUNG, PROFESSIONAL ENGINE ER
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HOWARO W. YOUNG, LAND SURvEYOR
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