HomeMy WebLinkAbout32572-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32192
Date: 02/08/07
THIS CERTIFIES that the building
ALTERATIONS
Location of Property: 5785 VANS TON
(HOUSE NO.)
County Tax Map No. 473889 Section 118
RD
(STREET)
Block 1
CUTCHOGUE
(HAMLET)
Lot 1.4
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 27, 2006 pursuant to which
Building Permit No. 32572-Z
dated
DECEMBER 15, 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" BASEMENT ALTERATIONS TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to THOMAS & ANNE HIGGINS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
ll4408H
01/22/07
PLUMBERS CERTIFICATION DATED
02/07/07 THOMAS HIGGINS
~,.e~-
Rev. 1/81
~)'f- 7/6'B"
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
18 1 ?:},(
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 Dep!. 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 Certiticate of Occupancy is
denied, the Building Inspcctor shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - Ncw dwclling $25.00, Additions to dwelling $25.00, Alterations to dwellir", $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Busincsscs'$50.00.
2. CCl1ificate or Occupancy on Pre-existing Building - $100.00
3. Copy orCertiticate or Occupancy - $.25
4. Updated Cer1iticatc or Occupancy - $50.00
5. Temporary Certiticate ofOceupancy - Residential $15.00, Commercial $15.00
).. /7 It> 7
, ,
Date.
New Construction:
--'
___ Old or Pre-existing Building: t.-
V II"...!';;. 7<> tJ I<c Ie 'j)
Street
(check one)
.C U T C;1l~UL.....
Hamlet
Location of Property: __ <;- 711 s;-
House No.
OwnerorOwnersofPrnpcr1y:__ \t\<:>l"! f\ S' C>N-..~ 1'\ "-I"'\: \-( (C?rIct(N':::::
Suffolk County Tax Map No 1000, Section..J~ ~ 'is' '1' Block \ \ 't; , - I -l . ~ I.ot__
Subdivision
Filed Map.
t.;),. r.O:::;, '06 Applicant:
l.ot:
-.~..~._---~
Pennit No. '3:),:::; 7 :J.. Z.
Health Dep!. Approval:
Date of Permit.
.:f~~\"\I::ill ,,~U> ~~
Underwriters Approval.
Plmming Board Approval.
Request for: Temporary Certi/lcalc
Fee Submitted: $ 25 -1<ti.>______
Final Certificate:
i/
(check one)
Applicant Signature
(pc.')(~iJ5
CO f: '3:) 19 J.
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.
32572 Z
Date DECEMBER 15, 2006
permission is hereby granted to:
THOMAS & WF HIGGINS
5785 VANSTON RD
CUTCHOGUE,NY 11935
for :
AS BUILT BASEMENT ALTERATIONS AS APPLIED FOR. ADDITIONAL
CERTIFICATIONS WILL BE REQUIRED
at premises located at
5785 VANS TON RD
CUTCHOGUE
County Tax Map No. 473889 Section 118
Block 0001
Lot No. 001.004
pursuant to application dated NOVEMBER 27, 2006 and approved by the
Building Inspector to expire on JUNE
15, 2008.
Fee $
427.20
Authorized
"
ORIGINAL
Rev. 5/8/02
Electrical Inspection Certificate
Issue Date
1/22/07
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Patchogue, New York 11772
(631) 286-6642
Application Number
114408H
Issued To:
Street:
Village:
Section:
Contractor:
Mr. Tom Higgins
5785 Vanston Road
Cutchogue
Block:
Zip: 11935
Lot:
Town: Southold
Lie. #
Was examined and found to be in compliance with the National Electrical Code.
Commercial NV Defects Pool
X Residential Det. Garage Attic
Switches Receptacles Fixtures
22 47 14
Dishwasher Washer/Amps Dryer/Amps
1 1 20 1 20
Furnace Oil Gas Circulators
Meter Amps Phase UG/OH Jacuzzi
Bldg. Permit.
Other Equipment
1st Floor Indoor X Basement Hot Tub
2nd Floor Outdoor Addition X Survey
GFI Heaters AlC Fans
3 4
Oven Range/Amps
Microwaves
Smoke Detector
1
Bell Transformer
Television
CO Detector
Rough Inspection: 12/06/2006
Inspector: John Me Mahon III
Final Inspection: 01/17/2007
Inspector: John Me Mahon III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials
Town Hall, 53095 Main Road
P.O.. Box 1179
Soulhold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
~ /7 /(J 1
. I
Building Permit No. .3 ). :i 7 ;J-;Z
Owner: 11/ {In /-1 S J-/ / I C I;'" 5'
(Please print)
Plumber:
~
. ~
c.J J'1 /1 l, !II t: b I/;'S
(Please print)
I certify that the solder used in the water supply system contains less than 2/1 0 of 1%
lead.
I
/~
Sworn to before me this I
day of r.. 1)('\Cj 20~1
r~~----
-
--..-..
...., ~L"",
No. lWSullolA6140448k Co ...
QuIIiljed in u,.., \l)
Commission Expirlll January 3~()
Notary Public, S-Ai=' r--o I ~ County
?J?-57') 7-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[W-.FINAL ~',
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS: r-:~ ~
~f)k
~ftd ~ ,~1: 7
~~rwf,y
DATE ~~ 1 ~ 0 1 INSPECTOR k ~
I
JJ-S-7:J- 2--
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
rX FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
,
,4f~
DATE I~--~ ~ () 6
INSPECTOR ~.~
Boulevard Planning East, PC.
Architects. Engineers. Construction Management
www.blvdplan.com
32645 Main Road
Cutchogue, N.Y. 11935
Phone: 63 1.734.20 II
Fax: 631.734.2276
December 13,2006
Southold Building Department
Town Hall
53095 Main Road
Southold, N.Y. 11971 - 0959
Re: Higgins Residence, 5785 Vanston Road, Cutchogue, N.Y.
To Whom It May Concern,
I hereby certify to the Department of Buildings of the Town of South old that I have inspected the
above locations; and am certifying that the finished ceiling height in the cellar is 7'-9".
If you have any further questions, please feel free to call me at any time.
. l ~l(ji
\)t.c \ A ~(
FIELD INSPECTION REPORT I DATE I
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLl'MBING
INSULATION PERN. Y.
STATE ENERGY CODE
FINAL
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
PERMIT NO. 8) 51:! 6)-C.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans /'/
Planning Boa;>l approval
Survey ..-/
Check =I'- 17, f)
Septic F onn
N.Y.S.D.E.C.
Trustees
Contact:
Examined
/7 /5' ,20~
! t2f; ,20 ".....
Approved
Disapproved ale
Mail to:
Expiration
,20_
~Zoc
Phone: 7'!/1' dO ! I
NOV 2 J 20GS
APPLICATION FOR BUILDING PERMIT
Date /Vb V
27
, 20 P If
'.__.'
~-.' ......
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 of lot and of buildings on premises, relationship to adjoining premises or public streets or
area< and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval oftms 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 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, a 0 admit
,.lliorired ""_" 00 prem',,, Md m hill'''", fuc """"",, 'mp"ti"m~
(Signature of applicant or name, if a corporation)
32~#y M...m R,t
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
,4~~" f
"
Name of owner of premises Tj,t:)Ma,~ .1 An"" J.l1~.,/n.5
(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.
;,.
1. Location of land on which proposed work will be done:
S'79'5 V4U1,J,,, Ad
House Number Street
?I, f,Jp", e
Hamlet 0/
County Tax Map No. 1000 Section IJ i'
Subdivision
Block /
Filed Map No.
Lot J,4-
Lot
(Name)
2. State existing use and occupancy of premise and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..: c:..
b. Intended use and occupancy
Jt .e,~JAlI en c-t:-
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition Alteration
Other Work l~c/I"t!.
(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
Depth
Rear
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
i~
Depth
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
9. Size oflot: Front
Depth
Rear
10. Date of Purchase
Name of Former Owner
II. Zone or use district in which premises are situated
1<-1}0
.---
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~
13. Will lot be re-graded? YES_NO )<. Will excess fill be removed from premises? YES_ NO_
14. Names of Owner ofpremisesJ18_~ 1J~.,7/I" Address ~,~ V.an'/"n Phone No.
Name of Architect 8/,,';' I'uIf,u4;1 Address32.6'~ 1M""" M Phone No
Name of Contractor Address 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.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.
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 )
R o6~1' I-- t-ehn el'" I- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the /J ~ If I-
(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 ,.,f J
'1..:; day of 0
~~
20 t)Co
JOHN E. STUMPf
. NOTA~ PUBLIC. Stale 01 Now VOlt<
No.O,ST8,525/i'
Qualified In _ COunIY { t:>
()omrnlaaion E>qlir8S ~ '8, 20_
-'"""!
.7vt-y
1000 - II B' -I_I,';
OWNER
"~
TOWN OF SOUTHOLD PROPERTY RECQRP CARD
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FORMER OWNER
C ICjy
STREET;::;- ~,
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VILLAGE
DIST.
SUB.
LOT
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COMM. @ MICS.
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ACR.
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TYPE OF BUILDING
Mkt. Value
LAND IMP. TOTAL
J (10 /Poo 35o(j
'7 0/) c:c / i) C'
" 0
DATE REMARKS
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illable
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FRONTAGE ON ROAD
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food land
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DEPTH
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ouse Plot
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