HomeMy WebLinkAbout33435-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32707
Date: 10/31/07
THIS C~KTIFIES that the buil~ug SCREEN PORCH ADDITION
Location of Property: 4695 SOUTH HARBOR RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 87 Block 1 ~ot 8
Subdivision Filed Map No. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 25, 2007 purs,,ant to which
Build{--g Permit NO. 33435-Z dated OCTOBER 2, 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" SCREEN PORCH ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to KAREN LYNNE GRANT & ORS.
( OWNER )
of the aforesaid building.
COUNTY DEPARTMenT OF }~ALTH APPROVAL
CERTIFICATE NO.
~TIFICATION DA'£~U
N/A
N/A
N/A
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD -, 7 -~ - --i ~
BUILDING DEPARTMENT '] ~ [~ [:~ ~ ~ ?., '
This application must be filled n by typewriter or i~ ~d submitted to the Building Depamnent with th~id~ing:
A. For new building or new use: 1. Final su~ey ofprope~y with accurate location of all buildings, prope~y lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerag~disposal (S-9 fora).
3. Approval ofelecthcal installation from Board ofFke Unde~fiters.
4. Sworn statement from plumber ce~ifying that the solder used in system contains less than 2/10 of 1% lead.
5. Co~evcial building, industfi'al building, multiple residences and si~lar buildings and installations, a ce~ificate
of Code Compli~ce from ardhitect or engineer r~po~ible for the building.
6. Submit Pla~ing Board Approval of completed site plan requirements.
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 haspector shall state the reasons ttterefor 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- $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Cel~ificate of Occupancy - Residential $15.00, Commercial $15.00
Date._
New Construction:
Location of Property:
Old or Pre-existing Building:
House No. Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000~ Section
Subdivision
Permit No. '~ ~ ~ ~
Health Dept Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ -.t~ ~ '"""
Date of Perm/t.
(check one)
Hamlet
Block
Filed Map.
Applicant:
Lot
Lot:
Undelxvriters Approval:
Final Certificate:
(check one)
- ~pplict/ant ~'ignature
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. 33435 Z Date OCTOBER 2, 2007
Permission is hereby granted to:
KEVIN HORNE
4695 SOUTH HARBOR LA
SOUTHOLD,NY 11971
for :
"AS BUILT" SCREEN PORCH AS APPLIED FOR
at premises located at 4695 SOUTH HARBOR RD SOUTHOLD
County Tax Map No. 473889 Section 087 Block 0001 Lot No. 008
pursuant to application dated SEPTEMBER 25, 2007 and approved by the
Building Inspector to expire on APRIL 2, 2009.
Fee $ 400.00
Autho~iked Signature
ORIGINAL
Rev. 5/8/02
0ct, 18. 2007 12:15PM No, 2429 P, 1
Boulevard Planning PC.
Cutchogue, N.Y. 11935
www.blvdplan, com
Phone:631.734.2011
Fax: 631.734.2276
Building Depazl~cnt
Town of Southold
October 17, 2007
R~: Home Residence, Permit # 33435 Z
To Whom It May Concern,
I hereby certify to the Department of Buildings of the Town of Southold that I have inspected the
above locations; I have supervised the preparation of the building pl~n~ as per State Education Laws;
and I have determined to the best of my professional knowledge and belief that the structural
elements are safe and that the fotmdation support, was installed in coaformity, with the filed building
pl~us, the New York Residential Building Code, and generally approved consmaction practices.
please feel f~ec to call mc at any time.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ].~U~ATION
[/-"]"FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE~INSPECTO~
FO~A~ON (1S~
ro~o~
ROUGH F~G &
PL~G
~S~ATION PER N. Y.
STATE E~RGY CODE
..',:~,>_ ~,?_./_ ~ TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET ff/.~:'::-~ VILLAGE DIST SUB. LOT
LES.~/~ S~S. VL FA~ COMM. CB. MISC. Mkt. Value
~ND IMP. TOTAL DATE REMARKS
AGE BUILDING CONDITION
N~ NORMAL BELOW ABOVE
FARM Acre Value Per Value
Ac re
-illable 1
'illoble 2
'illable 3
t~dland
wampl~nd FRONTAGE ON WATER
rus~land FRONTAGE ON ROAD !~ i ~ ~ ~ * ~ 2 ~
louse Plot DEPTH ~ ~ 4( ~m. ~
~ ~ ~ ~ BULKH~D
oral DOCK
Foundation ' o. ~ . Bath
AA. Bldg.
Extension
Extension
Extension
~XEL~z ~
Basement
Ext. Walls
Fire P ace
7L/~' .
Floors
Interior Finish
Heat
Type Roof Rooms 1st Floor
Porch Recreation Roon Rooms 2nd Floo~
Porch Dormer
Breezeway Driveway
Garage
Patio
O.B.
Tota I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined
Approved
Disapproved a/c
/o/), 20 07
/ 20 o7
Expi]
PERMIT NO.
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 ~
Checlc:~ It/
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
uilding Inspector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
,20 ~7
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
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 hav6 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
authorized inspectors on premises and in building for necessary inspections.~ ~/~,,~,,~'/
~/'*'~Signature of~li~a~t'~r name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~¥~VtrI
(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:
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Lot
Lot
2. State existing use and occupancy ofpremise~s and in,tended use and occupancy of proposed construction:
a. Existing use and occupancy [~ta[,~o
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building.
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
Addition Alteration
OtherWork L?;,~/I~ /rar~
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front ~ tP, f
Height ~//- //5"- Number of Stories ,Z-
Rear
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
Rear
Dimensions of entire new construction: Front
Height Number of Stories
Rear
Size oflot: Front [~0 Rear 1~-3 Depth ~3 ff'
Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated ~O_ 4
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ,)~
13. Will lot be re-graded? YES __ NO X Will excess fill be removed from premises? YES NO X
14. Names of Owner of premises ~l~rO~ Address Phone No.
NameofArchitect ~[va( ,lgj~nn/~ ,~ Address /14al/n
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 X
* 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)
cOUnTY oF /x/ks)S:
]~0 /~r'¢ /~/,e/~'r- ~ beingduly sworn, deposes and says that (s)heis the applicant
(Name of individual signing contract) above named,
(S)He is the d~'~"q' ~-
(Contractor, Agen~t, 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 ~
Notary Public ,.__/
20 o?
N
//
N/O/C' ~llx£ ~ /WA~/c °°~°oN
SURVEY OF PROPERTY
A T SOUTHOLD
TO,tN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-87-01-08
~ SCALE' 1'=30'
· ~ AUGUST 8, 2007
AUG. 13, 2007 (CERTIFICATION)
CERTIFIED TO ~
KAREN L. GRANT
ALAN I¢. HORNE
KRISTIN E. HORNE
MICHAEL J. HORNE
KEVIN J. HORNE
AREA-20,206 80. FT.
· =MONUMENT
· =PIPE
ANY ALTERATION (~ ADDITION TO THIS SURVEY IS A [40LATION
OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECt?ON 7209-SUBDIt4SION 2. ALL CERTIFICATIONS
HEREON ARE VAUD F'OR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE JWPRE,~D SEAL OF THE SURVEYOR
IltfHOSE SIGNATURE APPEARS HEREON.
07-172
FLOOR PLAN
SCALE:I/4" = I'-0"
PHOTO OF REAR ELEVATION
S ~3o20,00,,5
~5,4. 5'
/5,9.
FRAME
GAI~,GE ~>
2 STORY
FRAME
HOUSE
~XIDTrNG
PRE-MANUFACTURED
SCREEN PORCH
TO DE LEGALIZED
$IT,.E PLAN
SCALE:/ =20'
5 45° 25' 30" W
7. 05'
SITE AND ZONING DATA
ZONING REQUIREMENTS P--,-40 ~D<JISTING CONDITION5 PRLOPOSED CONBTRUCTION
AB PER 100-244
LOT AREA 20. 20G S,P. 20. 20G 5.ff.
FRONT YARD SETBACK 40.0 PT 47. I PT. 47. I FT.
REAR YARD SETBACK 50.0 PT 84. 5 ~ &5. 0 PT
sroE YARD SETBACK I 5.0 PT 22. 5 PT 22. 5 PT
TOTAL ~ BOTH SIDES 35.0 PT 57. 0 PT 57. 0 PT
MAX. GROSS FLOOR AREA 20% } 7~5. 0 B.P. &.~5% 195G. G 5.P. 9.7%
MAXIMUM [1EIGHT 35.0' PT 23 h-i- 23 PT
THERE ARE NO GRADE CHANGES, EXCAVATION, FILLING, AND/OR CLEARING DOiNE TO THIS PROPERTY
OEH~ IFtCATION OF
NAILING & cONNECTION8
REQUIRE~.
APPROVED AS NOTED
~C?ANCY 0R
~SE IS UN~WFUL
WImOUT CERTIFICATE
OCCUPANCY
~I~ERWBTER$ ¢£RT F OAh
REGUIRED
PHOTO OF NORTH ELEVATION
MA1NTA1N
ADDITIONS
& ALTERATIONS
AT THE
HORNE
RESIDENCE
SOUTH HARBOR ROAD
SOUTHOLD, NY
S.C.T.M. # 1000-87-1-08
REVISIONS:
DATE:
PLANNING
P.C.
ARCHITECTS ENGINEERS
32645 MAiN ROAD
CUTCHOGUE, N.Y. 11935
Telephone Fax
631-734-2011 631-734-2276
Intemet: www.blvdplan.com
TI[ESE PLANS AND SPECIFCATIONS ARE INSTRUMENTS OF SERVICE
AND ARE THE PROPERTY OF BOULEVARD PLANNING P.C.
INFRINGEMENTS WILL BE PROSECUTED.
DATE: 9-21-07
DR. BY: JJC, R W L
SCALE: AS NOTED
CHKD: J.S.
0702 A-1