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Home My WebLink About32222-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31719 Date: 08/03/06 THIS CERTIFIES that the building DECK ADDITION Location of Property: 315 HORTON (HOUSE NO.) County Tax Map No. 473889 Section 104 RD (STREET) Block ~ CUTCHOGUE (HAMLET) Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 17, 2006 pursuant to which Building Permit No. 32222-Z dated JULY 19, 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 ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES V JABLONSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~ize~ Rev. 1/81 " ! c C' f,\. ~Oc.r-511-8"lf()1 , ., Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 JG I 1'- '-- - ~ ~_'".""_"'_ ._--1 :'.l_rG. :-'::PT. 10.\'. ,SOUTHOLD 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: I. 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: 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 I. 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. '6'/;), b I I Old or Pre-existing Building: 110 7<?:ro N R t Street II "'\ A~Lo\'l~ /y' Suffolk County Tax Map No 1000, Section L{ 7 _~7 '?'q rO (check one) Cut-<:.. \40 ~ l: Hamlet New Construction: Location of Property: ...s /~ House No. Owner or Owners of Property: '- \ i't't'-\.<.,s Block ('loo.:2.. Lot vo :z Subdivision Permit No. 3'.:2. J 2..2 z.. Date of Permit. 7 J u Jo 10 { , Filed Map. Applicant: .,j~s Lot: VJ ~~ (~y\'5,h.' Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ c~i!'/ (JZ~.7(j70~ C o.sc 3 J 7/? 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. 32222 Z Date JULY 19, 2006 permission is hereby granted to: JAMES V JABLONSKI PO BOX 512 CUTCHOGUE,NY 11935 for "AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at CUTCHOGUE 315 HORTON RD County Tax Map No. 473889 Section 104 Block 0002 Lot No. 002 pursuant to application dated JULY 17, 2006 and approved by the Building Inspector to expire on JANUARY 19, 2008. Fee $ 300.00 I~ eit: I Authorized Signature ORIGINAL Rev. 5/8/02 ? ?--?-')- ':J.- Z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION ;~., [ ] FRAMING I STRAPPING [,M FINAL ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~~> ~ 0 .. 1-3/-0' DATE INSPECTOR ~...~ . FIELD INSPECTION REPORT DATE COMMENTS . >>'l ~~ FOUNDATION (1ST) ~~ ~;; ------------------------------------ FOUNDATION (2ND) ~ VV . . _ Z .' \r\P ROUGH FRAMING & ~i PLUMBING . ,. ~ ; ~ ~~ INSULATION PER N. Y. .::Sl STATE ENERGY CODE ~ . SO . '7/" I /., ~gjC ' -'~" ;:;, ,~ L, ')~ /y ')I , //ih /FI, 0) '-. FINAL . ADDIDONAL COMMENTS ~ ~ ~- ., 1:>0 . ~ ~~.. . ~~ i . .... "-- ~~ . -'" .... ~ 4 ~ ~ 0 Z = t<l . ~ ..., . = !/ i::j t<l .", ~ . . -.-.-....----.-.....,---. ---".'" .~ .---..--.--.--------.--...-------- --- ; ~.'-50...-- I I I I 1 J. Wheaton Jf! . NO,'fi i " Lot 5& lo", lL /I'v 1 / " / r; /VlAP (;F DROPERTY I ., I ...L-. -'-'_ N.44'Zi'OO"e. - 100.0 I - -'- A t, o j; S7 o Lot" No. <) ~~ ~ . r,.,~!; II ~ ~ I --1. "1-' "- ~ ;i 1':::+~ --Iui , I f" .... , ., 0'- 4':/ l' 0 1i ,0 I L.._._.. 4,1 190 z.~. 11)01 00. .. Lot No!: 'I~ S& i-...... N , ~, tt) g i ! ;cl:r~ :r ".1 , ' .~' . ~- .~. '" 1--; . -J.~l. ~'.,":~-I ' , , :,WZI'OO'W;- I ~ p. ::~-:.- --r- ~; .."~~.i.rN- ~.- _._~., 6J~-r:i:~~Et.~~~i~Ne". ~ .~ c.. . ',:: _....t---~.......I..."-!:~_~.....~--'" :.\-~~--;.,,.., . ~. ~~ "-~~'.-1-"_-' ..", c, '.~ ~~~:~.- -~;.~;'~-'. '~'..Ii,..'."j'.''#.'.''-' --'_~"-'''-''l".'.' - '--#.-35-.'" ..,.. .'-- --;- -..c.....",...., ..-4-'" .;. ~ .~~!If"~..+*.." 'l!r..,....~""_.""'.~~"!-~""~- . . 1$lt.:f.'-';:"!l;<-1.r- ~-~-1"'-" - . ... .- .....ij-~?t;,-t-r~."*,;..~~.-.r-). _ +'~_"'s-J:--Aj':t'~"~-;; . . - .''\9'..li~'l54 t#~',~".""'''c-II;~~:'f. . 1f.O#,:.~-~_.....,.."".p'; . ' . ..,.1''!:'~'l ~::'"!"":'="~"",*~' . . .:~If:'~. ~'~,: ':. "'-. , - ~-, , .,,"t"'J!',P r" -, -~"'f.fi.t.~..,'f,>( ~.~'!'~;..-.......~~~'" ~ " SURVEYE'O "'o~ '. {~ JAYNE THOMP:SON ..... .... " ..., EA6T A1' CUT...:HOGUE S 0:.).....0L-0. N.""'. TOWN or: SC<:f~e: 5'0'::.'" ... Lo+- n~mber5 t'ef"er -to Map of N:::'-SSQU Far,"~'" ;i1ed in SuffOl"- CC~J..;t~ Clel"i:.'~ ;~+/c.e a~ Mal-"NO-. 1179 'I' J . I. t' f " . ~-.~=:1' . ,~- ~~"f:!-"!.~ ~.'":' _~_~:.:..fl.~.-!.'-!<~70.-,'-~_-,;. . ~Jo; "~"-"~." .. _I 0 ~i ~G"~ '" I ~~~ :;'-I,"1","'r'if~l!"d .to hi+et- Ccu~4-'-j I!t!e ";tJCU'~.~ij~.y4~,.....~<>~rt';l~'~~ ~~~mpa'1j and ::1e!f>'~ou1-hold SQvin,S l3-anK d~.:.E=',.M"!<i~4:,'f%7. . , . :.! - . _..........-ta..~~.__......-.;,..... ... ~,~ . - ~,,,~"....~~.!:t!!4.....,.. '~.."~. i..~.'-."-"""~~' .::k;;:~- '. "- ~~-:~'.T:"I~m~~'- ;-'-~ ~ . - '''~ .,......." " . ..._~--~-_. .\ -;.. , .~- .'<i'- --"'0;- :,,,j:',:..-,,,,..: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlSo14hold/ .. .... . ., ,-.-. ' .' . BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, befo;;.applying? Board of Health L- 3 sets of Building Plans /' Planning Board approval Survey :3 .)...rd.;)-!: Check Septic Form N.Y.S.D.E.C. Trustees Contact: PERMIT NO. Examined Approved Disapproved alc ~J1 ,20~ ,20~ _ r 1/('1 ,20~ , Expiration h c' j ~, I -. .-) ......j '~spector . . JUL 11 [ ..~--- --1 j ~~; rG. :>Ci"lT .: \~. ~ 3iiLiTHOLD -APPLICATION FOR ButLDING PERMIT Date~ Ii ,20~ INSTRUCTIONS a. lIDs 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 waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the BuildiJlg 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 shaJ1 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 Gomply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection p~ ~ent J (UY\ e5 Name of owner of premises ,~a..bJO~5k.; (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. 1. Location ofland on which proposed work will be done: t+o f~ R. CI House Number Street · County Tax Map No.1 000 Section \ 0 ~ Subdivision (Name) Block 4..' File<t " _ . '.' . . iut " ""nel iIIIiiIlJ ", '" Lot 2- Lot .v.; 2. State existing use and occupancy of premises ~d int~. ~!e and occupancy of proposed construction: a. Existing use and occupancy !:> I n.~ II!!. I)' oJ. LU LIt,' "':l b. Intended use and occupancy ~L ~ r.h.c.IL 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 4\ lDOOC>. Fee Addition V~< Alteration Other Work (Description) 5. If dwelling, number of dwelling units. J If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commer~al or mixed occupancy, specify nature and extent of each type of use. i 7. Dimensionsofexistingstructures,ifany:Front 3S ' Rear 35' Depth 2.4-' Height Number of Stories I Dimensions of same structure with alteration;>o?a~Jffions: Front _~. ~.. R~al ~ ~' -3 II pepth LJ', " Height - Number of Stories - ... ~ ~' , I 8. Dimensions of entire new'construction: Front~ 3 " Rear ~3.' 30 I, Depth 2. S ' i .. Height _ Number of Stories 9. Size oflot: Front ~oo Rear ~oo I Depth_' 00 I 10. Date of Purchase Name of Former Owner II. Zone or use district in which premises are situated R - 4-0 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~ 13. Will lot be re-graded? YES_NO L Will excess fill be removed from premises? YES_NO ~ 14. Names of Owner ofpremiseS~Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _N 0 L * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this propeqy witb"in 300 feet of a tidal ~etland? * YES_NO 1- * IF YES, D.E.C. PERMITS MAY BE REQUIRED. ~ ~. ~ 16. Provide .5!lrvey, to sC,ale, with acourflte. foun~ation 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 oP"5v{?Ik..) C O.LJ.lfuli fY}~{~ beirlg duly sworn, deposes at'ld says that (s)he is the applicant (Name of indiVidual;r:;g contract) above named, (S)He is the ~ (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 II day of T,-,-li -r~~ r Notary Public 20.f1::,.Q , .., ~, ... Signature of Applicant