HomeMy WebLinkAbout32908-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32324
Date: 05/03/07
THIS CERTIFIES that the building BASEMENT ALTERATIONS
Location of Property: 1490 SKUNK LA
CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax ~lap No. 473889 Section 97 Block 3 Lot 11.3
Filed Map No. __ Lot No. __
sh~bdivision
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 2007 pursnmnt to which
Building Permit No. 32908-Z dated APRIL 16, 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" BASEMENT ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to WAYNE J & MARY 0 MOTT
(OWNER)
of the aforesaid building.
SUFFOLK COUIqTYDEPART~ENTOFHEALTHAPPROVAL N/A
ELEL-rKICAL CERTIFICATE NO. 3029963 04/27/07
PLt~4BERS CERTIFICATION DA'r~u~ 04/02/07
CUTCHOGUE EAST PLUMBING
Authorized 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, an) ~Usual naturalor
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 existiug 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 shMl state the reasons therefor il/ writiug to tile applicant.
C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dweIliug $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 Cmtificate of Occupancy - $50.00
5, Temporary Certificate of Occupancy - Residential $15.00, Commercial $1 ZOO/ ]
New Co ~stntc lou: Old or Pm-existing Bailding: ~ (check one)
House No. Street
IIamlet
Owner or Owners of Prope,ly:
Suffolk County Tax MaI, No
Subdivision Filed Map. Lot:
Health Dept Approval: ___~/~ Undem'riters Approval: _ _
Planning Board Approval:
Request for: TempormT Certificate
Fee Submitted: $ -~'~>~'
Final Cerlificate: _ ~ (check Olle)
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDINGPERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 32908 Z Date APRIL 16, 2007
Permission is hereby granted to:
WAYNE J & MARY 0 MOTT
1490 SF3JNK LANE
CUTCHOGUE,NY 11935
for :
AS BUILT BASEMENT ALTERATIONS TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at 1490 SKUNK LA
County Tax Map No. 473889 Section 097 Block
pursuant to application dated APRIL 9, 2007
CUTCHOGUE
0003 Lot No. 011.003
and approved by the
Building Inspector to expire on OCTOBER 16, 2008~'/ ~
Fees 4OS.OS ~lt ~/
Aut o~zed Sig ature~
Rev. 5/8/02
ORIGINAL
Town Hall, 53095 Main Road
P. O. Box 1179
Soulho~, NewYol~ 11971
Fax (516) 765-1823
Telephone (516) 765-t802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION,
Building Permit No.
Owner:
(please print)
(please print)
I certl[y that the solder used in the water supply system
contains less than 2/10 of 1% lead.
r~ZStgna )
Sworn to before me this
.,//_..3~ day of L
.cary Public,
County
6UaAN J. NAQY
Notary Publlo State of New York
No, 4f~96735
Qualified in Suffolk County _
Commleslon Expires May
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD Of FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STRE~i ~ NEW YORK, NY 10038
CERTIFIES THAT
CiO BILL GERMAN
Upon the application of upon premises owned by
WAYNE MOTTS WAYNE MOTT
1490 SKUNK LANE
PO BOX 1447 CUTCHOGUE, NY 11935
MA']-I'ITUCK, Ny 11942
1490 SKUNK LANE CUTCHOGUE, NY 11935
Located at
Application Number: 3029963 Certificate Number: 3029963
Section: Block: Lot: Building Permit: BDC: ns11
Described as a occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, finnish basement,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 27th Day of April, 2007.
Name QTY Rate Ratinu Circuit Type
Miscellaneous
as built 2006
Appliances and Accessories
Exhaust Fan 1 0 F.H.P.
Wiring and Oevlces
Outlet 20 0 Fixture
Fixture 20 0 Incandescent
Outlet 28 0 General Purpose
Receptacle 22 0 General Purpose
Switch 9 0 General Purpose
Dimmers 3 0
Receptacle 1 0 GFCI
Paddle
Fan
as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to
An
be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
seal
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [/~ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRA'I1.0N
REMARKS: ~ ~/~~)
DATE
INSPECTOR
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRA.WiING &
PLUIVlBING
12'qSULATION PER N. Y.
STATE ENERGY CODE
ADDITIONAL COMMENTS
·
N/F HOOP£R
DE$CR/BED PROPERTY
CUTCHOGUE, TOWN ~c' SOUTHOLD
SUFFOLK COUNTY, N.Y.
TOWN OF SOUTHOLD
BUILDING~ DEPARTMENT
TOWN HALL
SOUI'HOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined
Approved
Disapproved a/c
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Binlding Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Bul lh/m~ng In~i~cto~'
~f'- ~ APPLICATION FOR BUILDING PE~IT
Date ~ ,20~
~STRUCTIONS
~ppScatlon MUST be completely filled in by t~ewnter or in i~ and submitted to the Building ~spector with 4
sets of plus, acc~ate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on promises, relationship to adjoining premises or public streets or
areas, and wate~ays.
c. The work covered by this application may not be commenced before issuance of Building Pe~it.
d. Upon approval of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such a pe~it
shall be kept on the premises available for inspection t~oughout the work.
e. No building shall be occupied or used in whole or in pa~ for any pu¢ose what so ever until the Building Inspector
issues a Ce~ificate of Occupancy.
f. Eveu building pe~it shall expire if the work authorized has not commenced within 12 months after ~e date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other re~lations affecting the
p~pe~y have been enacted in the intehm, the Building ~spector may authorize, in whting, the extension of the pemit for an
addition six months. Thereafter, a new pe~it shall be requked.
~PLICATION IS HE,BY M~E to the Building Depa~ment for the issu~ce of a Building Pemit pursuit to the
Buil~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces or
Re~lmions, for the construction of buildings, additions, or alterations or for removal or demolition as heroin described. The
applicant a~ees to comply with ~1 applicable laws, ordin~ces, building code, housing code, and re~lmions, ~d to admit
aut hofized inspectors ~~~~~~
on premises ~d in building for necessa~ inspections.
nt or name, ifa co~oration)
(Mailifig address of applicant) [[~
State whether applic~t is owner, lessee, agent, ~chitect, en~neer, genial con,actor, electdci~, plumber or builder
Name of owner of premises ~/~')~q~ ~ ~ ~,.(~'17'1-'
(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 worl~ .wi.~ll be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Block ~ Lot
Filed Map No. Lot
State existing use and occupancy of premises and intended rose and occupancy of proposed cons_Ltruction:
b. Intended use and occupancy '~::fi~ ~t ~/,~-'~)
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost t/~-' I ~ Fee
Addition Alteration
OtherWork [:2dh-v,-a~i~"'K)W' ,~1 k)t~.4-,
- (Description)
(To be paid on filing this application)
If dwelling, number of dwelling units ~ Number of dwelling units on each floor
If garage, number of cars ~
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existinrg structures, if any: Front ~.~ '~ Rear ~,~ Depth
Height ~' (> -- Number of Stories .~
Dimensions of same structure with alterations or additions: Front
Depth. Height Number of Stories
D imensionsofentirenewconstruction:Front /~,J/~ Rear Number of Stories
Rear
Height
Size of lot: Front //8"~' l0
Rear /, ~--\. ~ ~ Depth
.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__
13. Will lot be re-graded? YES NO ~'~ill excess fill be removed from premises? YES __
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address [{~O $1~OtOff~ g.¢ PhoneNo. (,,FI 7t,
Address ~-,3~;r.t~,~O~ Phone No
Address Phone No.
15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet cfa tidal wetland? * YES NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO f'
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 .S:,qfolk )
[,~~ ~Y, ~g:~01/l~l,r_~ J being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ~
(Cont"actor, 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 tree 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 q ~ day of
(.44otary Public
20 o~
John M. Judge
NOTARY PUBLIC, State of New York
No. 01JU6059400
{~ualified In Suffolk County
~mi~s'_~z,n._ Expir~ May I~9, 20 ~
Unf'mished Space
Exis
Suspended Ceiling Bracket ~,
1/2" SheetTock
2 x 4 ACQ witli Rll Iusulation
7'-B" LI~" / /
4mil Vapor Banier
Tile
X
Existh~g Poured Concrete Floor
Const ru_cti on Section
Scale: 1/4" = 1~ 0"
g Foundation Wall
PLUMBING
ALL PLUMBING WASTE
& WATER LINES NEBD
TESTING BEFORE OOVERI,N~.,
Poker Room
Floor Plan
21oset
Rec / Medi:a Room
Bathroom
3" 0 Roof Vent
Scale: 1/4" = 1' 0"
Wet Bar
Cedar Storage Closet
SLOPE 1/4" PER FOOT PITCH TO DRAIN
PLUMBING SCHEMATIC
Not To Scale
Septic Pump
APPP~VI~D AS NOTED
7$5-1BOB BAM TO 4PM FOR THE
FOLLOWING INSPEDTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
OCCUPANCYOR
USEIS UNLAWFUL
WITHOUT CERTIFICATE
OFOCCUPANCY
UNDERWRtTERS CERTIFICA~,
RmUaEO
PL {';dBER CERTIFICATION
ON z_~_AD CONTENT BEFORE
C[:RT,[ /L,A TE OF OCCUPANt~y ;
SO/PFc' USED IN WATER
$/,pp¢ v SYSTEM CANNOT,
~ .*.$P[ 0 2'IS OF 1% LEAD,..