HomeMy WebLinkAbout31552-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31775
THIS CERTIFIES that the building ALTERATION
Date: 08/28/06
Location of Property: 700 MCCANN LA GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 33 Block 4 Lot 17
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 20, 2005 pursuant to which
Building Permit No. 31552-Z dated OCTOBER 25, 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 ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to BONNIE, JAMES & ROBERT SCOTT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
A iz d Signature
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:
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 2/10 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) 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
New Construction:
Location of Property:
Old or Pre-existing Building:
House No. Street
Owner or Owners of Property: l50.0 N 1 F-
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Date of Permit.
Request for: Temporary Certificate
Fee Submitted: $
0-31-C. X08 5
Co --?-3f7?
Date. y'Y(D (F,
Block
Filed Map.
Applicant:_
Underwriters Approval:
(check one)
Lot
Lot:
Final Certificate: (check one)
" !. Lr
Applicant Signature
i5[il 7u■�U�c3
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. 31552 Z Date OCTOBER 25, 2005
Permission is hereby granted to:
ROBERT I JR & ORS SCOTT
700 MCCANN LANE
GREENPORT,NY 11944
for
ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
at premises located at 700 MCCANN LA GREENPORT
County Tax Map No. 473889 Section 033 Block 0004 Lot No. 017
pursuant to application dated OCTOBER 20, 2005 and approved by the
Building Inspector to expire on
Fee $ 150.00
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND []I
NSATION
[ ] FRAMING / STRAPPING [
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: U
DATE ���� INSPECTOR '`'`�
FIELD INSPECTION REPORT
DATE
COMMENTS
(1
FOUNDATION (1ST)
----------------------------------
-------------------------------------
'e
FOUNDATION
FOUNDATION (2ND)
z
ROUGH FRAMING &
PLUMBING
0
C H
r)
----
INSULATION PER N. Y.
STATE ENERGY CODE
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FINAL
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ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD e
BUILDING DEPART_'IENR'
TOWN HALL '
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Sou,(hold
20
20
Disapproved
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO. Z C/
Do you have or need the following, before applying'?
Board of Health
i 4 sets of Building Plans
Planning Board approval
Check
Septic Form_
N.Y.S.D.E.C.
Contact:
Mail
Phone: o -2--
APPLICATION
APPLICATION FO BUILDING PERMIT
Date 120
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 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.
(Signature of applicant or name, if a corporation)
7oet YN QCAc,.I LAkc- 6att�);�rr j; J
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 3erLT .ScC'1T �AwtcSScc� C PIA �c- `T
(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 of land on which Proposed work will be done:
House Number Street
County Tax Map No. 1000 Section 7 - Block q Lot
Subdivision CAsTmn_t 5Ko 2f -S Filed Map No.
(Name)
Lot
State existing use and occupancy of premises and intended use and occupancy of
a. Existing use and occupancy FCs v btns ;-i A L
b. Intended use and occupancy We
construction:
Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated CostGou-
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(To be paid on filing this application)
Number of dwelling units on each floor J
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front
Heiaht Number of Stories
(• Z
Rear &2,
Depth
&. Iv
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 of lot: Front /'SC + Rear /_'� O Depth / /
10. Date of Purchase Name of Former Owner )�Ea3 c2 AK �U . S c. (-,I=
11. Zone or use district in which premises are situated 2a-°' I
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO v- "
13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES NO
I cic� Wa C A, -Q " 2r- `f'i
SZ it A, o..;... �.:.:)�d jWwY (.: �/-(r51-5 "1 S'v
14. Names of Owner of premises �or�ciz r S S o`tt Address 5,- 7w tv A,, 2;> zvr,w-l�'hone No. 315 -z 13�
Name of Architect LAeav°Tcw-titi „tii2,cr+ Address Phone No Y77-ovoc
Name of Contractor « PLCUA-A Address Phone No. 7 C., ; - k v z 7
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:
COUNTYOF
S c-O&I being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing 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
day of 200-57
' Notary Public
X Inti
Signature of Applicant
REBECCA A. VILARDI
NOTARY PUBLIC, STATE OF NEW YORK
QUALIFIED IN SUFFOLK COUNTY
NO: 01 WO6039106
COMMISSION EXPIRES MARCH 27,D��
APP OV I AS NOTED
DATE: j0 �� � E P 8
FEE, �� — p",NOTIFY BUILDIIk: -' �RTMCNT AT
765-1802 8 AM TO 4 F'vl FOR THE
FOLLOWING INSPECTIONS,
1. FOUNDATION - TWO REQUIRED
FOR POURED CCG,!CRETE
2. ROUGH - FRAMING , PLUMBING
3. INSULATION
4 FINAL - GOIIST UCTION MUST
BE COFIPLETE
CON"TUCTI N SHALL MEET THE
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
5OO'HOLDTOWN ZBA
SOL THOLD TOWN PLANNING BOARD
LI SOL'NOLD TOWN TRUSTEES
N.Y.S. DEC
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
ALL
RECUIRENBITS O THE CODES OF NEW
YORK STATE. NO RCS, ONSIBLE FOR
DESIGN OR CON CTION-ERRORS,- -- -`- _- - --
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