HomeMy WebLinkAbout31169-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31704
Date: 07/21/06
THIS CERTIFIES that the building DECK ADDITION
Location of Property: 350
(HOUSE NO.)
County Tax Map No. 473889 Section 70
MAILLER CT
(STREET)
Block 9
SOUTHOLD
(HAMLET)
Lot 38
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 20, 2005 pursuant to which
Building Pennit No. 3ll69-Z
dated
MAY 26, 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to GEORGE & VERONICA ROPPELT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
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Rev. 1/81
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Form No.6
TOWN OF 80UTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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""__.APPLlCATION 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 (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 2/1 0 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) uou-couformiug uses, or buildings and "pre-existiug" land uses:
I. 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 $15.00
Date.
(; ~J-I'{)&
11111/ t.e1?
House No. Street
Owner or Owners of Property: t:;r7':>/2CJ' E T ~ aoN/ct4
Suffolk County Tax Map No 1000, Section / 7 i)
t,/bat Old or Pre-existing Building:
~a;
New Construction:
Location of Property:
C 7-
(check one)
go ",,"TfhL 7J
Hamlet
~a-zr
9 Lot :It'
Block
Subdivision
Permit No. 3/1 t." 9 ?- Date of Permit.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
FeeSubmitted:$ h7~~
Filed Map. Lot:
Applicant: GlE1Jto/ IT ~ II",,-z.-r
Underwriters Approval:
Final Certificate:
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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.
31169 Z
Date MAY
26, 2005
Permission is hereby granted to:
GEORGE & VERONICA ROPPELT
4 BRIDLE PATH
FARMINGVILLE,NY 11738
for :
DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
at premises located at
350 MAILLER CT
SOUTHOLD
County Tax Map No. 473889 Section 070
Block 0009
Lot No. 038
pursuant to application dated MAY 20, 2005 and approved by the
Building Inspector to expire on NOVEMBER 26, 2006.
Fee $
150.00
~ (!ft
, Authorized Signature
ORIGINAL
Rev. 5/8/02
3!/(;;1C-
765.1802
BUILDING DEPT.
INSPECTION
REMARKS:
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING [ . FIN L
[ ] FIREPLACE & CHIMNEY [
co
..
DATE '?!'y"t~~ INSPECTOR
.
5//(;9 &
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUND~ ON 1 ST [] ROUGH PLBG.
[ ] FO DATION 2ND [] I~ATION
[- RAMING [.n-FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
~
DATE 7fijOJ INSPECTOR
3JIG9.&
765.1802
BUILDING DEPT.
INSPECTION
[~DATIDN 1ST [] RDUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: 4?~ 4c Iv
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DATE t, I / r;c!Or:- INSPECTOR
t
...
FIELD.S'lSPECTION REPORT
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
,
.i
DATE COMMENTS
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TOWN OF SOUTHOLD ',' !--
BUILDlNGDEPARTMENJ;I. 202005, 'I
TOWN HALL ' _'l.:1 . '-'
SOUTHOLD, NY 11971' L_-- ---- j I
TEL: (631) 765-1802 l.._ _ ')\A,I~Lg'. ..~H(1c 1.___1
FAX: (631) 765-9502 C '1/,
www.northfork.netlSouthold/ PERMIT NO. 3ll ~ [-1:/
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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:
Mail to: f~ IleA/'
1ft 2 z.;\./ b~., IC#."I
Phone: fr72- - ;;~il-c.
Examined
'5
'20tJ~D<
20
Approved
Disapproved a/ c
~. Sh..U
1\ (JL,204
Expiration
--f~~ctor
APPLICATION FOR BUILDING PERMIT
Date ~//~
,2005'"
INSTRUCTIONS
a. This application 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 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 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.
I
/h~ {?~v?
C/' (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
C O,v'712,q-c.f7J fL
Name of owner of premises (J,u:ollj?: i?o(J~ iT
(As on the tax roll or latest deed)
If app, . cant is a c~, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. FJ-2t:>911.:z:::
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location ofland on which proposed work will be done:
3S'O ,4//1d.E~ cY-r-
House Number Street
s;,u -rhdd '
Hamlet
County Tax M~ No. 1000 Section 7 v
Subdivision, 'n?' /77th!:d p'~.1/
(Name)
c::;
Block 7
Filed Map No.
;-\'Lot ~
.9'770 " Lot." .7'-'
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,
2. State existing use and occupancy of premises and intllnded use and occupancy of proposed construction:
a. Existing use and occupancy _'V ,;-/} t E ~ ,,rk>n-<- 'L...
b. Intended use and occupancy 5'~ Z-
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
~
Alteration
4. Estimated Cost
~~r02-
(Description)
Fee
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 ? t,:, Rear
Height Number of Stories I
t,t,.
Depth //?,S--
Dimensions of same structure with alterations or additions: Front ~ {,
Depth /.:? inS- Height Number of Stories
, -
Rear fi:, (p
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size oflot: Front /10 Rear 1/:.2-/.5 Depth (CJJ. L/.3
10. Date of Purchase r- 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? 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 4~A;f A,pfit.r Address 5;<'fh., ~
Name of Architect Address
Name of Contractor J/H< 4//f# Address;?uZ,v.ih,I/I.l'#
Phone No. ;:U.'J - ~"7& "
Phone No
Phone No. ?t.S- ""77
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _ NO ~
* 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.
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 OF )
J/Uf ~ / IF .,rJ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ~/,-,,~7Z-
(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.
20K
Notary P
MELANIE DOROSKI
NOTARY PUBlICbState of New 'bill
No. 010 4634870
Comm/sQualified in Suffolk County (
sian Expires September 30.~ u
Signature of Applicant
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I"lJlN1IHG ARMS, ADDII10N 10 IJUIl.QIHOS OR IH't OIHER DONSJRUanQN.
UfrWJlHDII2ED ALlEMlION OR IGDI110H 10 1HII SUR\IEY IS A WllA110N OF SEC11DN
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CERTIFIED ONLY TO:
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N.Y. L1C. No. 048992
HAROLD F. TRANCHON JR. PENN. L1C. No. 2115-E
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FILE No. SMIlHFlELO PARK
JOB No. 04-249
SURVEYED FOR
LOT NUMBER 26
MAP Of SMIlHFlELD PARK
SITUATED AT SOUTHOLD
TOWN Of SOUTHOLO, SUffOLK COUNTY, N.Y.
SCALE 1. = 30' DATE 6-15-2004
FILED MAP No. 4770
DATE 9-27-1966
TAX MAP No. (REF ONLY) 1000-70-9-38
DISK 2004
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
P.O. BOX 616
1866 WADING RIVER-MANOR RD. WADING RIVER.
NEW YORK, 11792
631-929-4695
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000 - 7 (> - 9 - 3!?'
OWNER
TOWN OF SOUTH OLD PROPERTY RECORD CARD
60
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DIST. SUB. LOT
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TYPE OF BUILDING
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COMM.
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MICS.
Mkt. Value
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y
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LAND
IMP.
TOTAL
DATE
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AGE
NEW
FARM
BUILDING CONDITION
NORMAL
Acre
BELOW ABOVE
Value Per Volue
Acre
FRONTAGE ON WATER
FRONT AGE ON ROAD II 0
DEPTH 11.3 J
BULKHEAD
DOCK
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Woodland
Meadowland
House Plot
Total
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Extension
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Fire Place I Heat DR.
. Rooms 1 st Floor BR.
Type Roof
Recreation Room Rooms 2nd Floor FIN. B
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Porch
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Garage
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CERTIFIED ONLY TO:
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N.Y. L1C. No. 048992
HAROLD F. TRANCHON JR. PENN. L1C. No. 2115-E
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FILE No. SMITHFIELD PARK
JOB No. 04-249
SURVEYED FOR
LOT NUMBER 26
MAP Of SMITHFIELD PARK
SITUATED AT SOUTHOLD
TOWN OF SQUTHOLD, SUFFOLK COUNlY, N.Y.
SCAlE 1" = 30' DATE 6-15-2004
FILED MAP No. 4770 DATE 9-27-1966
TAX MAP No. (REF ONLY) 1000-70-9-38
DISK 2004
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
P.O. BOX 616
1866 WADING RIVER-MANOR RD. WADING RIVER,
NEW YORK, 11792
631-929-4695