HomeMy WebLinkAbout33124-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32427 Date: 06/25/07
THIS CERTIFIES that the building ADDITIONS
(STREET)
Block 1
CUTCHOGUE
(HAMLET)
Location of Property: 21125 CR 48
(HOUSE NO.)
County Tax Map No. 473889 Section 96
Lot 7
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 5, 2007 pursuant to which
Building Permit NO. 33124-Z
dated
JUNE 11, 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" ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to DAVID & BARBARA VERITY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
2040093
01/13/05
PLUMBERS CERTIFICATION DATED
N/A
~..~
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
19_'ll-l4t.{
\ 51(P ~
eel '-Iq ,&0
-1~Sr 'l'd-55
~ow 1~Cj~
.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be tllled 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 2/1 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 Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
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 - $ I 00.00
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
Date.
011/107
I I
(check one)
Street
v/
C{J"\(.'no~WL.-
Hamlet
\Jedty
Block
New Construction:
Old or Pre-existing Building:
Location of Property: 4L1.;l. 5
House No.
'Ie-\-<< 1-\ K
Owner or Owners of Property: ~ \ ) 't~ -\' -py~~
Suffolk County Tax Map No 1000, Section
Lot
Subdivision
Filed Map.
Lot:
Permit No.
Date of Permit.
Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
v
( check one)
Fee Submitted: $
~5. tf&
~,,/1l1(
CO"t3J5f 27
l8~a U~~
' Applicant Signature
[!)~~~~~~effi!~ [!)
~
~
~
~
~
~
~
~
~
~
~
~
~ Located at
~
~ Application Number:
I Section:
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
I
[!)~effi!~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~~[!)
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
B.J. ELEC. co.
BOX 16
STILLWATER AVENUE
CUTCHOGUE, NY 11935,
21125 RT 48 CUTCHOGUE, NY 11935
DAVID VERTIY
21125 RT 48
CUTCHOGUE, NY 11935
2040093
Certificate Number:
2040093
Block:
Lot:
Building Permit:
BDC:
ns11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Basement, Outside,
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 13th Day of January, 2005.
Name OTY Rate Rating Circuit~ ~
Service
I Phase 3W Service Rating 200 Amperes
Service Disconnect:
Meters: I
200
cb
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
3 3/ ~'f Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRIJCnON
[ ] ROUGH PLBG.
[ ] INSULATION
M. FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
REMARKS:
r~ ~,~ ok,
E~ ~~\ce,
DATE
b-if-01
INSPECTOR
~~
FIELD INSPECTION REPORT DATE I COMMENTS OJ-o
uJi"'l
FOUNDATION (1ST) ~J
W""
---------------~--------------------
~~
FOUNDATION (2ND) G~
:z
~
- q.J
--
--- '"
ROUGH FRAMING & .'t'\ ~
PLUMBING "'
~- f---- f;-
f--~- -- .L
C><:'
_._--- -
-_.._~_..._._.~- -..------ :Ii
------- ~
i"'l
INSULATION PER N. Y. "'
STATE ENERGY CODE f
0
/
~
II. -PI-- 1 ~ -j} .... . ~13k: 1=;,//- ,,'
,...",,"l <- r hu.r \.- I" :..<... ~t?./
,
u
FINAL
'---
0
ADDITIONAL COMMENTS ,[
..
f----- - 0
... t/~
!---~. m
;ll
-
-.
--
Ci"'l
;.. ?d
- ~
\
V "'
COo
:z
;J
L-~
-"'
"]);
i"'l
-0
1--- :-I
;t
G:l
~
-.
--
->.-
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.
33124 Z
Date JUNE
11, 2007
permission is hereby granted to:
D & B VERITY
3495 ALBERTSON LA.
GREENPORT,NY 11944
for
"AS BUILT" ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING
at premises located at
21125 CR 48
CUTCHOGUE
County Tax Map No. 473889 Section 096
Block 0001
Lot No. 007
pursuant to application dated JUNE 5, 2007 and approved by the
Building Inspector to expire on DECEMBER 11, 2008.
Fee $
400.00
I~~
I Authorized Signature
ORIGINAL
Rev. 5/8/02
,.-
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ...
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/SoutholdJ
PERMIT NO. J'3I,).'I&
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:
Examined
~/rl ,20tJ~
.
6 {,I ,200l-
I
Approved
Disapproved alc
r/(; _ S- 7 \?' - 7ifYVJ
Phone:
Expiration
/Y/,I ,20~
;/ !u.-J~
j Building Inspector
~ ~ . ~ ~ ~ ~ L, APPLICATION FOR BUILDING PERMIT
\\~ .'\'~:S. {\ l~l\ Date
\U INSTRUCTIONS
\ a. 1fP.iN.."~~~~ completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets dfptanif,accurate plot plan to scale. Fee accordmg 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.
rp/ :;-
(
,20~
(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
Nameofownerofpremises "l'laiJ(r! -S, \)er;+t .t- ~(ba.i'Z\ \ft"Xl-t-...J
(As 0 the tax roll or latest deed) 1
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.
I. Location of land on which proposed work will be done:
:J \ I d <, 12-k I{ R"
House Number Street
(ut~lL
Hamlet
County Tax Map No. 1000 Section
Subdivision
oqlo,oo
Block ('J / . 00
Filed Map No.
fJ"
Lot nOl, ODD
~A.1\.w.'.J
utn......o..-... .9tJEU Il~ ..
....'llAAIO cl'l
.-0.... ni lIIiIiItluC
.01 lllA-lIftqIl3l1iOo1111m>,:'
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy '("e",;- fd{<U'\.c e... ..
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition v
Other Work
Alteration 1/
(Description)
4. Estimated Cost
Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars 9e.. '3 u r Ii t. '-I
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type oAuse.
Depth
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
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 Q
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 V""
- -
13. Will lot be re-graded? YES _ NO_Will excess fill be removed from premises? YES_NO_
14. Names of Owner of premisesLn\C i,A...- (Jy,J", '" l1~dress3~qs A Ibt~~ ({,. ,
Name of Architect Address G-{<.t.~r"'"
Name of Contractor Address
Phone No. "710 s~ 'fqgo
Phone No
Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO V
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES_NO ~
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS'
COUNTY OFSrJffiR.C.) .
.BOJvtc-o.~ ...Je..YI~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing cohtract) above named,
(S)He is the
(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 t~~~fore me thi~
S day of f\..@ _ 20 0 '1
r/:J ,,.rl. P. ~~(;.f)~
Not~1iIANDOIJIH
NOTARY PUIIJC. .........
No. 01RM1_ .
<> - 'In IuIIlII ClMIIr
Q....' '~,""_Ib.J.D
~4 0M~
Signature of App cant
SURVEY OF PROPERTY
SITUATED AT
CUTCHOGUE
TOWN OF SOUTHOLO
SJFFOLK COUNTY. NEW YORK
S.C. TAX No. 1000-9&-01-07 .
8~.tE 1"-ao'
JANUARY 22. 1.19
AlIEA . ..U3.20 Ill. R.
0.214 GO.
CRJlIPJnRD m!
ICTIC, .....
_TOl'HER OE\IIHSKl
_llEYtNSKI
1!tP.4Wt
No?... IJL IlL --
II1tcT~_~.tTllI
...,JU:.
_11&.'-'1
I
..bseoh A IngesJ10
LMd s...veyor
..."""" -..... - ...... - ~lIJlIIlI
f.-
.~
;}I
"
~
ol'.r.,..
'..
.to.
t
.,~
~,
~
~
i9
I::J':
~
l'ull
'~1.
"'1). J>~
~
~
~ /
J
FRONT ELEVATION
SCALE: 1/4" = 1'-0"
,4)~
APPROVED AS NOTED
DATE:dJ;!.- B.P. # ~ ~ l~/ e
FEE: 1m ._ BY: f~
NOTIFY BUILD:.jG c'fITMENT AT
765.1802 8 AM TO 4"M FOR THE
FOLLO~f::;~G INS'E::T)(':-~S:
1. FOU:~DAT\O[-J ~ T\ -~..' REQU'RED
FOR POURED cu;~"ETE
2. ROUGH - FF,':,:. .:,G & PLUMBING
3. INSULATION
4. FINAL - COi":r".:~TION MUST
BE COMPLE,' <:::; C.O.
ALL CONSTRUCTiO:, SHALL MEET THE
REQUIREMENTS 0 TH CODES OF NEW
YORK STATE. NO R PONSIBLE FOR
DESIGN OR CON RU TION ERRORS.
OCCUPANCY 0
USE IS UNLAW U
WITHOUT CERT FI ATE
OF OCCUPANC
Ct:Rl WICAT/ON OF
A/LING & CONNECTIO
REQUIRED.
LEFT ELEVATION
SCALE: 1/4" = 1'-0"
REAR ELEVATION
SCALE: 1/4" = 1'-0"
( PRESUIL T PRIOR 2003 )
per..
5CALE
1/4" z 1'0"
JD
Jvne 04, 2001
,
b
,
'"
CLOSET
b
,
'"
+'-0"
f
6'-0"
f
b
I
...
~
EXI~
(REAR)
FLOOR PLAN
SCALE: 1/4" 1'-0'
~
EXI~
+'-3"
(FRONT)
~--------:
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
l__
L____ __I
,
,
,
,
,
,
,
~--------j
( FRESUIL T FRIOR 2003 )
~um ! :::: frO~~~~I~,~, PLAN
ft, '2Xg PT GIRDER' --
,-r--
- - ~ I
+X+ PT POST
wi 12X12X12
CONC. FTG.
(TYPICAL)
b
,
...
~ --- -----
~
EXI~
~
EXI~
FG. 2
June 04, 2001
SCALE 1/4" & 1'0"
JD
.
ASPHALT ROOF
1/2" SHEATHING
2X4 RR @lG"OC
2X4
@lG"OC
3' RAIUNG
b
I
io
2X4 ~~~~DSi6~~~
~
X 0 N
2XG OJ" @lG"OC
2Xg PT GIRDER
"
,~
"
',.
~
4X4 PT POST
..
.,
.;
,.}}.
"'''''--
b
I
'"
GRADE
'~
.'
'..
.~
12X12X12
CONC, FTG,
3'-0"
.'
.
'..
~
'.
;.:~
:;, EXI~
"
~ .~
.~
"
.;
SECTION ~~I~
SCALE: 1/4" 1 -
"
.,
.;
SECTION A-A
1/4" 1'-0"
SCALE:
( FREeUIL T FRIOR 2003) ~ 3
June 04, 2001
E I "
SeAL. 1/4" = 10
JD
.