HomeMy WebLinkAbout26738-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31946 Date: 10/23/06
THIS CERTIFIES that the building ADDITION
Location of Property: 415 SOUTHERN CROSS RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 110 Block 5 Lot 30
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 17, 2000 pursuant to which
Building Permit No. 26738-Z dated AUGUST 24, 2000
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 & RAMP ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to ROBIN SADOWSKI-SYNNOTT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
""-L /- x-4
hor zed Signature
Rev. 1/81
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 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:
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
Date. / O /0
T—
New Construction: Old or Pre-existing Building:
� (check ons)
Location of Property: q1 � �� �""�R- CL�cr J & (/�t.��
House No. �1 Street H let
Owner or Owners of Property: J�C �� w 'Sur) F I
Suffolk County Tai Map
��No.1000, Section Block Lot
f I.X
Subdivision .ez A ,'#'1` Filed Map. Lot:
Permit No. a ( 13&-2 Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: , (check one)
Fee Submitted: $
/010
aQr Applicant Signature
cD ;u3)g9�O
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. 26738 8 Date AUGUST 24, 2000
Permission is hereby granted to:
SUSAN WOLBER
415 S CROSS RD
CUTCHOGUE,NY 11935
for
NEW CONSTRUCTION OF NEW DECK ADDITION TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 415 SOUTHERN CROSS RD CUTCHOGUE
County Tax Map No. 473889 Section 110 Block 0005 Lot No. 030
pursuant to application dated JULY 17, 2000 and approved by the
Building Inspector.
Fee $ 75 . 00
Authoriied Signature
ORIGINAL
Rev. 2/19/98
765-1602
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: co
DATE INSPECTOR
765-1602
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] F NDATION 2ND [ ] INSU ION
[ FRAMING [ INAL
[ ] FIREPLACE A CHIMNEY
c
REMARKS: o
60
DATE OV INSPECTOR
L
mu) INSPEI:CION REPORT— DACE COMMENTS
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Plormer �s�
ZOO 0 . , _, TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET !7/ 5 VILLAGE DIST. SUB. LOT
I117"f1t„ Jer,r/i od d O✓ 74c /i u e /2
FORMER OWNER N! ,yE ACR.
>Od7�/jEhn l orJ 4
4 Y r��
P S W TYPE OF BUILDING
1N, /47y 4WD, vN7`— s; DuSoN
RES.4�0 SEAS. VL FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS A
d e r #1
i
/o G3 �Y /o% 14h, v2nu ,,'4 e�M7 and
a o mo S . _ VNe-Plato r. �Gs41T
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
I
FARM Acre Value Per Value
Acre
i
Tillable I
Tillable 2
Tillable 3
Woodland °t
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House Plot DEPTH a
$rdiif FfG4p Pd
Total DOCK
BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 13 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT HECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971 DEC ..... . . ... .. .. .. . .. .. . . . . . .
TEL: 765-1802 TRUSTEES . . . . ... .. .. . .. .. . . . . . .
Examined... l.1�........, 20.PP. MAIL T0: . . . . . . . . . . . . . . . . . . . .
Approved...BJ.�........., Baa. Permit No. .. 3.�
...................................
Disapproveda/c .................................. ...................................
17
(Building Inspector)
; Y
APPLICATION FOR BUILDING PERMIT
.011re of SiWT7 OLD Date. . JjOy. .7.tJZ . . . , , 20.0.0. .
INSTRUCTIONS
a, 'this application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
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 mist be drawn on the diagram which is part of
this application.
c. The work covered by this application may not be careened before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection througtwut the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of
Occnpaouy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MAIE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zane Ordinance of the Tum 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. Tbe applicant agrees to comply with all applicable laws, ordinances, build' housing code, and
regulations, and to admit authorized inspectors on premises andZi �, neves a ctions......................�........
ure of applicant, or name, if a corporation)
PO Box 1026 - Southold NY 11971
...................................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber-10'r builder
„_„__,__General Contractor
..... ...............................................................................:..........
Name of owner of premises ... JN/ -
. ........................................................
(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. 21-536_HI
................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of land on which proposed work will be done..............................................................
415 Southern Cross Cutchogue
................................................................ ... ...........................
House Number Street Hamlet
County Tmn Map No. 1000 section ........ Block .....5........ Lot ...3 d........
Subdivision No u/2 Filed No. Lit
iii. .............. Map ...............
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... One, family house
b. intended use and occupancy ......Ssme.................................................................
Eb %' 4381G.ott
Jt;vem eollq,Z cot^T
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair ............ Mammal ............. Demlition ... ......... Other Work Deck,6 Ramp ....................
(Description)
4. Estimated Cost $19:000:00 fee
(to be paid on filing this application)
5. IE dwelling, number of dwelling units ... ue...... Umber of dwelling units on each floor ...one,,,,,.....
Ifgarage, tanber of cars ..one................................
6. IE business, commercial or mimed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
Height ......................... Number of Stories ..-Q-................
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... Height .................... htmher of Stories -0-....h.... I
.. -��Dee''�ph
8. Dimensions of entire new construction: Front ..49... ......... Rear ..36.........! LU,........
height ......................... Umber of Stories .....0_.............
9. Size of lot: Front ...90............... Rear ..90................ Depth .200...............
10. Date of Purchase ..................... Name of Former Owner ........................................
H. Tore or use district in which premises are situated ....xesldentaal............................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ......io...............
13. Will lot be regraded ......?44........... Will excess fill be removed from premises: YES ND
14. Names of Owner of premises As.Sus>:R.VPjb€F........ Address .$puthern,Cross phone No 734,5209,,,,
Nameof Architect .................................... Address .............................. Phone No. ............
Name of Contractor .Juhn.S..Chrlstie.............. Address W.ARYF.1R26.,..59.gtb914.?A.Pho a No 765-1532,
15. Is this property within 300 feet of a tidal wetland? * YES .......... NO .No,,,,,,
*IF YES, SOfMM WM TRIMMS PERMTT MAY BE REAM.
PLOT DIAGRAM
Locate clearly and aiatinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give stet and block rubber or description according to deed, and show street names and indicate
whether interior or corner lot.
PROPERTY LINE LOCATIONS
' 1
1 .31 FT Sum L:Drr Q z�FT
i
2ea,•.. Lhr.m{
srnir•.
Or NU YORK,
�tp\ SS
QAINIY OF ............... c�
............... � '... +!......NC.%4.1 Q.......being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above mmanhed,
lieis the .... ......... .:....... ! t .e....................................................
(Contracto agent, corporate officer, etc.)
of said owner or rs, and is duly authorized to perform or have performed the said work and to make and file this
application; that all stateients contained in this application are true to the best of his knowledge and belief.; and
that the work will be performed in the never set forth in the application filed therewith.
ywom to before me this
fKx
........t...........day of .. .. �(R..
Notary Public ...... . .............. .. ... ...
.... .. ..... .. .............
ROBERT I.SCOTT,JR. (Signature of Applicant)
aery Publie,Stats of Y
Qualified in Suffolk
No 01
Term vxpirss May 31
,
a
D+M4 d�1 OO ILR'9
FEE: IIIA
NOTIFY Mame OOMM1 wr AT
786-19a 9 AM 7O 4 !M ICOR INE
FOLLOWING MIBPEC110Nlk
1 FOUNDATION - TWO REGUIRED
FOR POURED CONCRETE
2 ROUGH - FRAMING & PLUMBING
3 INSULATION
4 FINAL - CONSTRUCTION MUST n�i cs ns57 eo. ,Oy "»k
i3� COMPLETE FOR C.O. /i ys 16C 60n- .3c
Qn3G
AL1_ ._::),*1 "' '.'JCTION SHALL MEET
= t _-MENTS OF THE N.
')N & ENERGY
40
� PLUMBING m GRADE
II
ALL PLUMBING WASTE I I
&WATER LINES NEED I I I I
TESTING BEFORE COVERING
r;Lt,I I I I I
L_j fFj,.r7 F�Lr'I
J PROVIDE
®�/CU®®NCY ®iI 11ts 1'6" X 1'6" X 1 O" D. POURED
(% =FN WPPW tuti Is uW CONCRETE FOOTINGS
USE IS UNLAWFUL for vvww dftbftfflng REAR ELEVATIOCrYP. ALL)N OMP. FILL FIRM
system: piping shah be
WITHOUT CERTIFICATE
OF OCCUPANCY REQUIRED
UNDERWMTEK MITIRPATE
REQUIRED
,T--r PLUMBER CERT/F/CAT/ON FR Mi
ON LEAD CONTENT BEFORE OF FOUNDATION LOCATION
CERTIFICATE CF OCCUPANCY HAS BEEN APPROvM
SOLDER USED /N WATER suszE wor sEx
EXCEED 2110 of 1% LEAD.
EXISTING HOUSE
TO REMAIN
a
�� gaLr ?O E7�/S7.s-rG
57nueTueP_
a a .
p I
� "L J 8/2200 Jour Cq rimer'\
LL ✓c w a,rt.-y ST�GO
DOUBLE 2"X 8" GIRDER
II x (CCA TYP. ALL) t4II Ca-n..o�r W ITN
t
t1
lr a, r- — _
L '-
J L
� 6"X 1--6- P. CONC.
II LL
a^ a II FOOTING (TYP. ALL)
7'_1'x.. II mo mm Xm
Xm x
N lV® N r 1
if r J71
Q..
72.
L J r, L r — "1 LlI— J I
- - :±7
.. L,
L _
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J L J L
5'-11 " II 7'-8" 7'-4" 7'-4" 7'-81
71
LTJ L_ 3 L — J L- J L
Y - 2"X8" CCA RIM JOIST
8' 8' 8' Be 8'
FOUNDATION PIAN
TO REMAIN /,r4utri,5UN rVVUt3o68H
PROVIDE DOUBLE 2" X 6"
FLUSH HEADER ABOVE
i
/ PROPOSED DECK
1 / 13'0" X 35'0"
5'-$„ 18,
12-1°
DQ
4'-1" 5'-11"
PROPOSED HA DICAP RAMP 4'-10"
12
1 PITCH
36'
FLOOR PLAN
ISSUED: JOB TITLE:
6/30/00 ISSUED TO CLIENT FOR REVIEW.
PROPOSED ELEVATION & PROPOSED ALTERATION TO EXISTING RESIDENCE -
FLOOR PLANS CUTCHOGUE NEW YORK
SCALE: 1/4"
BUILDING PERMIT REVIEW CHECK LIST
Applicant/ Date
Owners Name: SSI s�� Reviewed.-
Architect/ Date
Engineer: Submitted:
SCTM #: , \
District: 1,000 Section: �b Block: Lot: �y
Project L.� y�� ,� p Subdivision
Location: `) .5 Q) fZ,(1 �.fDSS 4DAM _ Name:
Single& separate Required Cr`
certification: (Yes/No)
Req. Req. dd
Zoning District: [Lot size: Actual: [Lot coverage Proposed.—I
Req - I Req. �t , Req. / 4
[Front Yard Proposed: �(s ] [Side Yard � Proposed: '' [Rear Yard Proposed:—j0 J
Project Description: �.(It
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation??? `
Flood Zone:
Notes.: J
1 Lu c-4_ S /r0 C 0 u sc- W C C e-C ll /9 N
rel "_ / GC[C