HomeMy WebLinkAbout32377-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32024 Date: 11/22/06
THIS CERTIFIES that the building ADDITION
Location of Property: 285
(HOUSE NO.)
County Tax Map No. 473889 Section 86
RICHMOND LA
(STREET)
Block 1
PECONIC
(HAMLET)
Lot 4.3
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 14, 2006 pursuant to which
Building Permit No. 32377-Z
dated SEPTEMBER 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 THOMAS & JILL LOGAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~ ~t___
I Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
\ "1
This application must be filled in by typewriter or ink and submitted to the Building Department.with the following:
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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 2/1 0 of I % lead.
5. Comn1ercial 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 thc 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, Acccssory building $25.00, Additions to accessory building $25.00, Businesscs $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Celiiflcate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.~
New Construction: Old or Pre-existing Building: i (check one)
Location of Property: ____ _;;( ~S .~ \tb monQj 1:- CLn~___
House No. Street
Y,., c.o-n I c..
- ~_\.._----- --- ----,----
Hamlet
Owner or Owners of Property: T II Dr>'lGt S .... J \ L L
Suffolk County Tax Map No 1000, Section ~~_
l-G~o. n
Block D I . cO
LotOOl\ ()O'~
Subdivision
Filed Map.
Lot:
Permit No.
Date of Permit.
___ Applieant:_
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
_..__ Underwriters Approval: __.__
Final Certificate: L (check one)
Fee Submitted: $
J,5.00
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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.
32377 Z
Date SEPTEMBER 19, 2006
Permission is hereby granted to:
THOMAS & JILL LOGAN
285 RICHMOND LANE
PECONIC,NY 11958
for
"AS BUILT" DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR
at premises located at
285 RICHMOND LA
PECONIC
County Tax Map No. 473889 Section 086
Block 0001
Lot No. 004.003
pursuant to application dated SEPTEMBER 14, 2006 and approved by the
Building Inspector to expire on MARCH
19, 2008.
Fee $
300.00
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I Authorized Signature
ORIGINAL
Rev. 5/8/02
3;)-3 17 Z
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATI~~ 'E.~-~
[ ] FRAMING I STRAPPING [t>4FINALJ!!'-~-v ~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: . " ~
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DATE /
INSPECTOR~' ~
.
,
FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
COMMENTS
1~')-1/bfo p~ 4,/~ I ~~
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
N
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5che.:
RES. 2/0 SEAS. VL.~ FARM
.LAND. IMP. TOTAL DATE
JOG SOC)
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STREET
Tillable
Woodland
Meadowland
Hause Plot
-4. ,-
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. uY" 6'7
Total
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VILLAGE
LOT 3
. <: f.r l' < .~.( 1-4,
DIST.
SUB.
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ACR.
W
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TYPE OF BUILDING
COMM. CB. MICS. Mkt. Value
REMARKS
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
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86-1-4.3 02/03
Jcffidt ::z IJ / ;;D - IIZ[()
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Extension J, ;>:;f-5 = .'JDj I
1-iCl 'X; 11 = t/-~
-
~~~,~~;; -r- (;jx'bc:=LJ-5 >13% ~51) 1~?
')/>'. I 'Oil.ll"'''\ ) ;( =' 3?-- !J. - J:.-".o
Extension (4 :< b - ;)Ji
I 57'/ =-)/ ?Ci - /6TJ :3 ,190 :c: , , Foundation PC Bath L 1/7-- Dinette I
. ~ '-"' _.l..
P@.~ ((.- If'! 13-: ~i ( Basement PLJu..... Floors K.
i y - ~
Porch 70/' /)~ -if? :l.1,J, ,5,) /4(., Ext. Walls Interior Finish LR.
(r; V -::: li,/
Breezeway J Fire Place V{iS Heat DR.
Garage J. 3x~3 = 5),1 I Z",- (() (" I Type Roof Roams 1 st Floor BR. Lt.
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Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Dormer Driveway
Total V"; '1 ~) O,~;/i
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TRIMZ( (!~l-e
TOWN OF SOV'FHOLD
BUlLDlNG"DEP ARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
PERMIT NO.
.}').3 7 Ie
BUILDING PERMIT APPLICA nON 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:
Examined
Approved
Disapproved a/e
,204
, 20126...
Mail 10:
-ft.?, 2~ '
Phone:
Expiration
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Building Inspector
As b\i\ \ +-
I 4
APPLICATION FOR BUILDING PERMIT
-'
Date
,20_
INSTRUCTIONS
a, This 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 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 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.
APPLICA nON 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, 1
oration)
Vo D:,)(. Q7~ ~V)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Gf'oJ T ~'>1e-f.:.,R
Nameofownerofpremises=rb'^"'- }- '1'1 t\ Lo~~.M..
(As on the tax roll or tyest deed)
If applicant is a corporation, signature of duly authorized officer
150 (> 'f:r:. t1.d ( '" .J.t.(2I\-< \-of\...
(Name and title of corporate officer)
Builders License No. 7S-tf ( - II
Plumbers License No.
Electricians License No.
Other Trade's License No.
YeccrNL
So u', L", \1)
Hamlet
I. Location ofIand on which proposed work will be done:
';;Z 9) R\ <- ~'^'\." N l) 'lLD
House Number Street
Lot
Lot
4.3
County Tax Map No. 1000 Section
Subdivision
''Y;~
Block
Filed Map No.
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed consfhIcti.on:
a. Existing use and occupancy
b. Intended use and occupancy
l>e ( k
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
~>.c is::-
(Description)
4. Estimated Cost
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(J<c.
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
,tV Ac
(To be paid on filing this application)
Number of dwelling units on each floor
. 6. If business, 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 c ')
Height Number of Stories
Rear
Depth --1 L{
9. Size oflot: Front
Rear
Depth
10. Date of Purchase
Name of F OlIDer 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. Will lot be re-graded? YES_NO ~I excess fill be removed from premises? YES_NO_
~p
Address.2e,~ 'R'ck..... ",'l Phone No. '( ~'1 '23d
Address Phone No
>\ddress Phone No.
\0<0 A-J
14. Names of Owner ofpremiseslo"""-
Name of Architect
Name of Contractor
15 a. Is this property within 100 feetofa tidal wetland or a freShwaterwetl~nd? * ES_NO ~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY B QUIRED.
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. . . 14--
being duly sworn, deposes and says that (s)he is the applicant
ame of individual signing contract) above named,
~
Co,..;i- (-\+(4;J--
(Contractor, Agent, Corporate Officer, etc.)
(S)He is the
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 t .
~. /' day of .
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Notary Public
200Cc
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C~re'fA~
BARBARA ANN RUDDER
Notary Public, State of New York
No. 4855805
Qualified in Suffolk CountY;:b
Commission Expires April 14: :d2LO
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PLOT PLAN OF
LOT 3
MAP OF
RICHMOND SHORES AT PECONIC
rilE No. &873 FILED HOVEWBER 20, 1979
SITUATED AT
PECONIC
TOWN or SOUTHOLD
surrOLK COUNTY, NEW YORK
S.C. TAX No. 1000-86-01-4.3
SCALE 1 "=40'
lolAY 24. 2000
JULY 24, 2000 REVISED WATER SERVICE
J,wUARY ,1,1, 2002 REVlSEO PROPOSED HOUSE
FEBRU"" , 4, 2002 ADDED WETlAND LINE
MARCH 13. 2002 FOUNDATION LOCATION
NOVE~BER 5. 2002 FiNAL SURVEY
AREA = 23,877.56 sq. ft,
0.548 oc.
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N.Y.S we. No. .9668
PHONE (S31)727-2090
Jose h A. Ingegno
Land Surveyor
omcrs LOCA7EO ,,(T
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