HomeMy WebLinkAbout32667-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32178 Date: 02/05/07
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 12555 NEW
(HOUSE NO.)
County Tax Map No. 473889 Section 116
SUFFOLK AVE
(STREET)
Block L-
CUTCHOGUE
(HAMLET)
Lot 13
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JANUARY 24, 2007 pursuant to which
Building Permit No. 32667-Z
dated
JANUARY 24, 2007
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" ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to RICHARD B & BARBARA REILLY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
Signature
Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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FfI ~ I 20"
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This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 2/10 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:
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, comm:::l $15.00 ;l! ,/0 7
Location of Property:
/ ;XSS~
House No.
KIf. hl';.-11
//fr
Old or Pre-existing Building: ~
f1)eq)Suf.-W"l J{-ve
Street
6. f?ei//1
Block bl. "
( check one)
~t~
amlet
New Construction:
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Lot /3
Subdivision
Permit No. 32 b~7
Date ofPermit.~1 Dl
Filed Map.
Applicant: ~;(' ~l.(.
Lot:
~~~r
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ X (;I)1y.y
Final Certificate: ._______(check one)
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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.
32667 Z
Date JANUARY
24, 2007
permission is hereby granted to:
RICHARD B REILLY
PO BOX 1072
CUTCHOGUE,NY 11935
for :
AS BUILT ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
.APPLIED FOR
at premises located at
12555 NEW SUFFOLK AVE
CUTCHOGUE
County Tax Map No. 473889 Section 116
Block 0002
Lot No. 013
pursuant to application dated JANUARY
24, 2007 and approved by the
Building Inspector to expire on JULY
24, 2008.
Fee $
400.00
...---.
ORIGINAL
Rev. 5/8/02
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,
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT CONSTRUCTION
REMARKS:
~-
] ROUGH PLBG.
] INS TION
FINAL
] FIRE SAFETY INSPECTION
] RRE RESISTANT PENETRAnON
C4:J
-
DATE j.IJ/O ,7
INSPECTOR
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ITECNOLOGIES
AllCHJ'l1lCnJRll PLANNING CONS'IRUCI1ON SERVIces
I:!405M1d1l__ N...yOlk 11952
631.298.1129 fu: 631.298.1128
January 22, 2007
Southold Town Building Department
Southold. N.Y.
Re: As Built Permit
Mr. Richard Reilly
12555 New Suffolk Ave.
To Whom It May Concern:
As per our inspection of the site the following items were noted:
The construction of the as-built front porch is as follows:
1. It is an unheated enclosed porch area located within the roof of the main
house.
2. The porch sits on a continuous concrete block foundation wall.
3. Floor of the porch consists of wood joists with wood decking above.
4. Exterior walls of the porch consist of wood columns located between single
pane glass removable panels.
The construction of the as-built rear covered porch is as follows:
1. The porch sits on a continuous concrete block foundation wall.
2. Floor of the porch is bluestone slate.
3. Exterior wall construction is 2" x 4" wood studs with single pane glass
sliding windows, exterior metal frame single pane glass storm door.
4. The unheated porch walls and roof is located in line with the existing
bathroom on rear face of the house.
If you have any additional questions please feel free to call our office at 631-298-1129.
-\
JAN22
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FIELD INSPECTION REPORT DATE COMMENTS -
VJ,:
FOUNDATION (1ST) C~
S~
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FOUNDATION (2ND) t ~r.
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ROUGH FRAMING & v..r;g
PLUMBING t~
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INSULATION PER N. Y. t<l
STATE ENERGY CODE J)""
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FINAL (../
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. ADDITIONAL COMMENTS N
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FORMER OWNER
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RES, ~ / 7) SEAS,
LAND
AGE
NEW
FARM
Tillable
Woodland
Meadowland
House Plot
~ ~ . .,
Totol .....--
IMP.
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dO
.55 ~
NORMAL
Acre
TOWN OF SOUTHOLD, PROPERTY RECORD CARD
DIST. SUB.
"("1
c2
ACR.
VL.
'fY
GrlleH
CB. MICS.
Mkt. Value
TYPE OF BUILDING
/IIiJftH' aUG <c
TOTAL
M"?
LOT
i p?/
!de, M~ J. R.,// ""7("
c'- r a/I~1, "i/1'0-'
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BUILDING CONDITION
BELOW
ABOVE
Value- Per
Acre
Value
'" . . I
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
~9~ - f9()()
.....-.....
DOCK
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EX.:. "J.?on b = /'fJO s-y ,/
,
Extension
Foundation C, F. Both 2 Dinette
't>%'rtlf e - · 4 ~ {;{. - , J3asement ru II
orc JI XL v r $"a (J.J Floors 0.... ,( K.
.\p'o~h' <, · ~ nX/( = I YS y /,F6 2-/Y", pt. Walls VltoocOJ,.,., ~ Interior Finish -p, ('.c( LR.
Breezeway Fire Place ;) /lP . Heat ? DR.
Garoge/ i/( , !~ g ~- .<~ :; 7::1 f / 1--~ (j/P Type Roof C~~ /-e Rooms 1 st Floor BR.
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. DOlll)llr Driveway
Total 15S~J /
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COLC
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2 j: t. Wall
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Recreatiol
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IS
I
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Breezeway
Garage
Patio
: Z.:?F
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O. B.
55.? I
Total
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
.
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO. \.jgc;.b~
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:
C=
Examined
'12'1
Approved
Disapproved ale
,20T
,20_
Mail to:
E
Expiration
,20_
Phone:
Building Inspector
APPLICATION FOR BUILDING PERMIT
,20_
Date
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 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 ofthe 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 .dmit
authorized inspectors on premises and in building for necessary inspections. !
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
(As on e tax roll or la
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.
x
/I~
Block
Filed Map No.
, Lot
\ Lot
L3
" I County Tax Map No. 1000 Section
'f-. Subdivision
(Name)
J\
.,
,
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
.
b. Intended use and occupancy
1. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
./
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(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
Depth
9. Size oflol: Front
Rear
Depth
10. Date of Purchase
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 J
l3.x lot be re-graded? YES NO~ill c ss fill be removed from premises? YES NO .
14.N~fs~~f~L~ ~,cit~/cY'~j>f~/~~:t~~~~~
Name of Architect Ad;;:;;;' Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO ~
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REglJIRED.
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 Qf i~..Fh4Al .
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being duly sworn, deposes and says that (s)he is the applicant
amed,
(S)He is the
CJh)~~
(Contracto , ent, Corporate Officer, etc.)
i said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
at all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
erformed in the manner set forth in the application filed therewith.
Sw rn.lo before me this1(
-f!c daY~f\_ f1fl1A~20fl+- _
) .
MELANIE OOROSKI
NOTARY PUBLIC, State of New'1llrll
No. 01004634870
Qualified in Suffoik County '- 1\
Commission Expires Septembllf 30~ \ 0
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ITECNOLOGIES
.~ !WIIlINO. ~OCTIml_VICIlS
i340s...........-. -y,* 1195a
63U91.1129 IIa: 1131.2!l1.112I
January 22, 2007
Southold Town Building Department
Southold, N.Y.
Re: As Built Permit
Mr. Richard .Reilly
12555 New Suffolk Ave.
To Whom It May Concern:
As per our inspection of the site the following items were noted:
. The.cor'lStruction of theas-bui,lt front porch is as follows:
1. It is an unheated enclosed porch area located within the roof of the main
house. .
2. The porch sits on a continuous concrete block foundation wall.
3. Floor of the porch consists of wood joists with wood decking above.
4. Exterior walls of the porch consist of wood columns lOcated between single
pane glass removable panels.
The construction of the as-built rear covered porch is as follows:
1. The porch sits on a continuous concrete block foundation wall.
2. Floor of the porch is bluestone slate.
3. Exterior wall construction is 2" x 4'; wood studs with single pane glass
sliding windows, exterior metal frame single pane glass stOl'm door.
4. The, unheated porch walls and roof is located in line with the existing
bathroom on rear face of the house.
If you have any additional questions please feel free to call our office at 631-298-1129.
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