HomeMy WebLinkAbout32283-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31813
Date: 09/14/06
THIS CERTIFIES that the building
ADDITION
Location of Property: 935 OLD
(HOUSE NO.)
County Tax Map No. 473889 Section 64
SHIPYARD RD
(STREET)
Block 5
SOUTHOLD
(HAMLET)
Lot 21
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
AUGUST 2, 2006 pursuant to which
filed in this office dated
Building Permit No. 32283-Z
dated
AUGUST 11, 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DOROTHY CRENSHAW
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
;)5'6-3)'7
14
Form No.6
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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 bnilding 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.
Location of Property:
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 Ii
Date.~&
<r (check one)
3tl CA-'fio(d
Hamlet
New ConstructIOn:
Block
C!> DO ~
Lot 0 2(
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
5 d-:J~3
Date of Permit.
'tlflloCo
Filed Map.
Applicant:
L(c;,-kr
tVCP
Lot:
~
Permit No.
Health Dept. Approval:
Planning Board Approval:
/vo
^-lo
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
~
(check one)
Fee Submitted: $
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Applicant Signature
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(o:C: ':3[813
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)
11, 2006
PERMIT NO.
32283 Z
Date AUGUST
permission is hereby granted to:
DOROTHY CRENSHAW
935 OLD SHIPYARD RD.
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at
935 OLD SHIPYARD RD
SOUTHOLD
County Tax Map No. 473889 Section 064
Block 0005
Lot No. 021
pursuant to application dated AUGUST 2, 2006 and approved by the
Building Inspector to expire on FEBRUARY 11, 2008.
Fee $
150.00
.~~
I Authorized Signature
ORIGINAL
Rev. 5/8/02
Towo Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
September 11, 2006
Dorothy Crenshaw
252 7'" Ave
New York, NY 10001
RE: 935 Old Shipyard Road, Southold
TO WHOM IT MAY CONCERN:
We are unable to complete your Certificate of Occupancy because of the following reasons:
~ An application for Certificate of Occupancy is not one file. (Enclosed)
No Electrical Underwriters Certificate on file.
~ The check is (not on file) $25.00
Final Health Department approval not on file.
No final inspection has been completed.
No Piumber Solder Certificate on file. (All permits involving plumbing issued after
4/1/84)
Certificate of Compliance from the Trustees.
Finai Planning Board Approval
BUILDING PERMIT: 32283-Z
Thank you for your cooperation.
SOUTHOLD TOWN BUILDING DEPT.
52-L~<:?-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
REMARKS:
t)
G.
[ ] FOUNDATION 1 ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING J STRAPPING [
[ ] FIREPLACE & CHIMNEY [
DATE
INSPECTOR
)yv~3t
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] I LATION
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: (~JjJ~ ~L ~11Mi&~
00 J";I1t7AS '
INSPECTOR
)vy~)1:
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[~UNDATION 1ST [
[ ] FOUNDATION 2ND [
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [
] ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
DATE 1).(/o~
!
INSPECTOR
.
FIELD INSPECTION REPORT DATE
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FOUNDATION (lSn
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FOUNDATION (2ND)
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ROUGH FRAMING &
PLUMBING
INSULATION PER N. y,
STATE ENERGY CODE
FINAL
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COMMENTS
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ADDmONAL COMMENTS
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PERMIT NO.
3..2X3.v
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 ..;j;
Septic F onn
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
9~,' ,20~
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Examined
Approved
Disapproved ale
Mail to:
J/;I ,20d-
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Phone: ;J~fj- 37(p 7
Expiration
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/ Building Inspector
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APPLICATION FOR BUILDING PERMIT
Date A l<jvd ;z..
,20~
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 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 ofthis application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shatl 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. k tJ~
(Signature of applicant or name, if a corporation)
S' I NO'f~ g~ Ave- ECls} fod NY I /<} Y I
(Mailmg address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
~f\ ,,,~4 '15 ~eYli('tI.~ cov\trtl.Ct-v~
Name of owner of premises Dc(o~ Ct'evt5~t4<J
(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. Location of land on which proposed w~)fk wiU pe done:
q3)" V/J 5h'NCl/"d UJ.
House Number Street
SCM~I!
Hamlet
""\(,'11 ~'~"<":;\ 1:"""!"I;;;'h"\~': "'r
County Tax Map No. lQPO}'~~tiott,f 0 {g Y
. . . ;' .. ""Ii .~.r", t
SubdIVISIon ~(.~ v'Tn' ~12i(i 0;. W:M ,.,i;;r
(NaIi1.re, ~ .'l:'-:Y~l
Blocli'~: 1>,' , '1"'!1l~I,1 .
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Filed Map No:,
Lot .?-I
Lot
2.
b. Intended use and occupancy C; i fj"w t ,1M<'1 ~Lj
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
..../ AJd~~~ of l]..:'X/-z..' W-
.
Addition
Other Work _()aK
Alteration
4. Estimated Cost
I>SDO[).--
(Description)
Fee
5. If dwelling, number of dwelling units
If garage, number of cars 1
(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 -:;<; /0
Rear
Depth
10. Date of Purchase
~/O
( ~ / I / D-;-
.
I
'1 ;}3 0
Depth d
To~elll
9. Size oflot: Front
Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ./
13. Wi\llotbe re-graded? YES_ NO I Wi\I excess fill be removed from premises? YES_ NO ./
14. Names of Owner of premises Do~re..~\w..; Address
Name of Architect ::JOs.eq:'~ -h" I Address
Name ofContractorClIs\1>,^ 1:-"\~ 1\-n1W'~ Address
Phone No. 7{,<;- ~>'11
Phone No m -':J9SL(
Phone No. ~3 1- ?5\i - ~ "tbf
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO J
* 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. C,C t f\~(j
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:
~ ~S~being duly sworn, deposes and says that (s)he is the applicant
ame 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
~~~'2~~~ ~.~
Notary Public . 9 ~~APPlicant
UIlllo\ S. TAGGART
........1'llbI1c. State of New 'IilIll
No. 4948506
Qualified in ~1If"l'k County I
Ccimmission Expires March 20, ~
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_ S _ 2-- TOWN OF SOUTHOLD NOPERT~ ,aSoRD CARD
C. (e V) s h CI DISTRICT SUB. LOT
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TYPE OF BUILDING
VL.
FARM
COMM.
[IND.
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I MISC.
I Est. Mkt. Value
IMP.
TOTAL
DATE
REMARKS
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AGE
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NORMAL
BUILDING CONDITION
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rillable 2
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Value Per Acre
Value
FRONTAGE ON ROAD
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DOCK
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CCUPANCY OR
SE IS UNLAWFUL
ITHOUT CERTIFICATE
F OCCUPANCY
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JOSEPH FISCHETTI, PE
PROFESSIONAL ENGINEER
1725 HOBART RD / PO BOX 616
SOUTHOLD, NY 11971
631-765-2954
APPR "VED AS NOTED
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FEE; /) . "/ BY: j/~ ~
NOTIFY BUILDING Dcp/r;TMENT AT ,
765-1802 8 AM TO 4 PM FOR THE \) .
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FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & r ,0 "iG
3. INSULATION
4. FINAL - CON,- ;, .. . "-.'J MUST
BE CO'-'PLE: c CCF C.O
All eONSTRl/ - -,~ SHf.U MeET THE
R';UIREMF'.-:'. T"E CODES OF NEW
Y("'W:ST A :E. ,,', . ESPOi\Si8LE FOR
DES:qN OR CONSTRUCTION ERRORS,
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JOSEPH FISCHETTI PE
PROFESSIONAL ENGINEER
1725 HOBART RD I PO BOX 616
SOUTHOLD, NY 11971
631~JG5-2954