HomeMy WebLinkAbout32703-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No, Z-32210
Date, 02/26/07
THIS CERTIFIES that the building
ADDITION
Location of Property' 5795 ROCKY
(HOUSE NO.)
County Tax Map No. 473889 Section 21
POINT ROAD
(STREET)
Block 1
EAST MARION
(HAMLET)
Lot 3
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
FEBRUARY 7, 2007 pursuant to which
Building Permit No. 32703-Z
dated
FEBRUARY 7, 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" ENTRY WAY ADDITION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to GRACE F RAYMOND
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~.~
, ho~zed ignature
Rev. 1/81
Form No.6
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
FE8 8 ')(J1:7
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:
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 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.
1-".
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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
/te.
Old or Pre-existing Building:
R58 8/ 2001-
New Construction:
(check one)
~~r ),-//;R/[.<-f
Hamlet
Location of Property: ~~5 ,eOCey~ Pt!?/A../T E't<WD /
House No. Street
Owner or Owners of Property: ;7t~ V/9U/:h:::E $j/ Lev
./
02./
/.2../? trn C/JO
01
Lot
003
Suffolk County Tax Map No 1000, Section
Subdivision
Block
Filed Map.
Lot:
Permit No.
Date of Permit.
Applicant: ~A./K. ueui:7..JD/1I1L
Underwriters Approval:
Health Dept. Approval:
/VA
Planning Board Approval: "u H
Request for: Temporary Certificate
Fee Submitted: $ :2-C:>, 00
(1.,...u:..- 7 I gg~
Co l:: 3J.;l.lO
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.
32703 Z
Date FEBRUARY
7, 2007
. permission is hereby granted to:
GRACE F RAYMOND
5795 ROCKY POINT RD
EAST MARION,NY 11939
for :
AS BUILT ADDITIONS AND ALTERATIONS TO AN EXISTING DWELLING AS
APPLIED FOR
EAST MARION
at premises located at
280 ROSENBURG RD
County Tax Map No. 473889 Section 021
Block 0001
Lot No. 003
pursuant to application dated FEBRUARY
7, 2007 and approved by the
Building Inspector to expire on AUGUST
7 ,/.2-0 01h.
,
\
\
Fee $
400.00
,/
Authorized
ORIGINAL
Rev. 5/8/02
Frank W. Uellendahl
PO Box 316, Greenport, NY 11944,
Architect
tel 631-477-8624, fax 631-477-2997 e-mail: fuellend@aptanline.net
February 26, 2007
FER 26?
Owners:
June Vallace and Lou Raymond
5795 Rocky Point Road
East Marion, NY 11939
Project:
As-Built - Building Permit Application
For Deck and Mud Room Addition
BUILDING PERMIT # 32703-Z
CO APPUCATlON - Final Inspection
LETTER OF CERTlACATlON
The owners of the above referenced project are requesting a Certificate of Occupancy for an existing 165 SF
wood deck and a 48 SF mud room addition on the west side of the house both of which date back to the 1960's.
In order to help expedite the issuance of the CO the owners decided to remove all electrical and plumbing work
inside and outside of the addition.
In regards to plumbing the contractor removed a stop sink and outdoor shower, and as to electrical work the
outside flood light, interior ceiling light, all electrical outlets and switches and an electrical heater were removed.
Please refer also to the attached invoice by Lademann Electric Inc and photos taken Saturday, February 24.
I hereby state that the information provided above is true to the best of my knowledge.
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Frank Uellendahl \ ~/~:'?~1f!:~6;~;~
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FEB-24-2.007 12:33P FR01:~ aECTRIC IN 6317347206
1'0:4772997
P.1
LademaDD Electric IDe.
1625 StiUWBter Avenue
Cutchogue. NY 11935
631-734-7206
Invoice
I =, 11W:~EI
In BILL TO
Frank Uellcndllhl
P.O. Box 3J6
Greenporr, NY 11944
,
J
JOB LOCAllON
June Vcllace
RDCky Point RAl8cI
East Marion, NY
TERMS
1---'1
ITEM CODE DlSCRIP110N QUANTITY PRICE EACH AMOUNT
, Removed all wiriIIg lIIld .....1. -.I fiQ!II addition walls
and ceiling on 2/14107
Labor 7.S 74.00 SS5.00T
MateriUl 15.40 15.4OT
N.Y. Stale SaJes TlIX 8.625% 49.20
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II's been a pleasure worlcing wilh youl Total $619.60
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Fronk W. Uellendohl
PO Box 316, Greenport, NY 11944,
Architect
tel 631-477.8624, fax 631-477-2997 e-mail: fuellend@optonline.net
January 7, 2007
Owners:
June Vallace and Lou Raymond
5795 Rocky Point Road
East Marion, NY 11939
Project:
As-Built - Building Permit Application
For Deck and Mud Room Addition
AS-BUILT - BUILDING PERMIT APPUCATION
LmER OF CERTIFICATION
The owners of the above referenoed project are requesting a Certificate of Occupancy for an existing 165 SF
wood deck and a 48 SF mud room addition on the west side of the house both of which date back to the 1960's.
The attached floor plan and elevation reflect the As-Built situation. The deck appears to have been repaired 10
to 15 years ago, the construction Is sturdy, the deck joist system is adequate and in compliance with the current
Building Code for the required 40 psf live load.
I hereby state that the information provided on the attached As-Built plans is true to the best of my knowledge.
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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TYPE OF BLD.
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PROP. CLA~
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LAND IMP. TOTAL DATE ( 2h 1~'1-. L I () C?"ri O~. /?IIS1'f1h/YatfC?nc h I(b if fI1 ii n ,--/ rv }e.-
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FRONTAGE ON WATER TILLABLE
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FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
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FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
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FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
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PERMIT NO.
~ ~ 7 b3
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
Septic Form
N.Y.S.D.E.C.
Trustees
Contact: .
Mail to fr-auf:: UdleudtltLd
Po. g 3~t ~!fjJ:;~$'f1
Phone: 1/3 4- _t26_-.:'
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/SouthoId/
Examined
Approved
Disapproved ale
, 20----f-
,20
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,20~
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FEe J 2C'}
APPLICATION FOR BUILDING PERMIT
Date FE/3 Ob
,20dr
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 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)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
AI2CHlrEc r
Name of owner of premises C7o~ V,z:)LC-'9Ce- 1t L.eV ~Y'hCND
(As on th 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 ofland on which proposed work will be done:
~:;-C}97 .eOc...~V PZJtt<..J[ RdrlD
House Number Street
E:hST HRR/ C/tU
Hamlet
'. "
County Tax Map No. 1000 Section
Subdivision
C? 2../
Block 0 I
Filed Map No.
Lot 003
----t,ot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of prop<,,sed construction:
a. Existing use and occupancy .l2c~/T-IE.<JT/ R L
b. Intended use and occupancy e€5IVEDP/-::;(
5. If dwelling, number of dwelling units
If garage, number of cars
Addition V' Alteration
Other Work A ~.> - ,e'.7/L T
.41 (Description)
'1f 400 . -
(To be paid on filing this application)
Number of dwelling units on each floor
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost
Fee
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
I
7. Dimensions of existing structures, if any: Front a. q
Height Number of Stories 2..
Rear
" C:}'
Depth 4'1. ~ (
Dimensions of same structure with alterations or additions: Front ?~. '9 I
Depth 4:; B I Height Number of Stories
8. Dimensions of entire new co~fr[fdi5n~~ ,k/t!?.5~~ Rear '7. 2-;;;/
Height -""1-5> 1.u~~6{d€d:~umber of Stories
/3.4 i HLlO lZt7lii-( -(
9. Size ofIot: Front / 90 <)~
/"/ c:? (
~.7
2J).? I
Depth ,;,'?2. 7~
Rear
,
I:;JZ 50
Depth
SZZ ,8:;.1
10. Date of Purchase
/g~2
Name of Former Owner
"'.PRe/ct.) K/CHF7/?o.s:Ot'C/
11. Zone or use district in which premises are situated
k!,-40
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V
- -
13. Will lot be re-graded? YES_NO vi' Will excess fill be removed from premises? YES_NO .........-
14. Names of Owner ofpremisesl?O~ V)1L1.RCG Address?;qL~ R!12,{I7,1} Phone No. 7/4. g/~. 1}3;2
Name of Architect ~~1~ LM/J.c,;/E.kllt-/ Address .;2p,B 3("6" f7Ti Phone No &51. 477. 8LY:7<r-
Name of Contractor Address V Phone No.
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.e. 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~~~~~
~4V1:" UEZt..f::::1-7'l?/lIlC being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
4v,'m<f-1=rr
(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.
Swo ttI before me this
:ty day of
2001
~
J Signature of Applicant
BO 1. DOROSKI
Notary Public. State 01 NewYolt
No.01DD6095328.Suffolk~n1y
Term Expires July 7.20....l..l-f-
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ATE:~~~~E~.:.: ~3~
I EE:i'#,t~y.~
~ OTI~ ~EPARiME~JT AT
7 5.1802 8 AM TO i 4 PM FOR THE
FPLLOWING INSPECTIONS:
1 FOUNDATION. TjVO REQUIRED
FOR POURED q9NCRETE
2 ROUGH. FRAMinG & PLUMBING
3 INSULATION
4. FINAL. CONSTRUCTION MUST
BE COMPLETE FOR CO.
A L CONSTRUCTION SHAL~MEET T~J
R QUIREMENTS OF THE CODES OF NEW
Y RK STATE. NOT RESPO
,~..
D SIGN OR CONSTFlUCTIO ERRORS.
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MUD ROOM
UNINSUlATED
48 SF
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DECK ill
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RAILING
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LlCENS D LAND JRVEYOR
-1<JYS lie No 4.273 07R1563