HomeMy WebLinkAbout33381-z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32769 Date: 12/07/07
THIS CERTIFIES that the building DECK ADDITION
Location of Property: 2650
(HOUSE NO.)
County Tax Map No. 473889 Section 104
PINE TREE RD
(STREET)
Block ~
CUTCHOGUE
(HAMLET)
Lot 14
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 12, 2007 pursuant to which
Building Permit No. 33381-Z
dated SEPTEMBER 12, 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CONCETTA BETZ
(OWNER)
of the aforesaid building.
SUFFOLK Cuul.n. DEPARTMEIIIT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE Il1O.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~,.~--
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
..
This application must be filled in by typewriter or il!k and submitted to the Building Department with the following:
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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 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
I. 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
Date.
j/- I J.- -'?z00'7
New Construction: Old or Pre-existing Building:m ~/'
Location of Property: "J 6~?:J I ~L .;(J.,a tI
House No. Street
Owner or Owners of Property: {~~-~
( check one)
~9-~
/ Hamlet
Suffolk County Tax Map No 1000, Section
/6 L{
Block
o'l
Lot J 'f
Subdivision
Permit No.
Date of Permit.
Filed Map.
Applicant:
Lot:
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate: ,,/
(check one)
Fee Submitted $ . .{ oS -: ~.
Ci
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Applicant ignat e
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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.
33381 Z
Date SEPTEMBER 12, 2007
Permission is hereby granted to:
CONCETTA BETZ
55 HANRAHAN AVE
FARMINGVILLE,NY 11738
for :
CONSTRUCT A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS
APPLLIED FOR.THIS PERMIT REPLACES BP # 19213.
at premises located at
2650 PINE TREE RD
CUTCHOGUE
County Tax Map No. 473889 Section 104
Block 0002
Lot No. 014
Fee $
200.00
pursuant to application dated SEPTEMBER 12,
Building Inspector to expire on MARCH
ORIGINAL
Rev. 5/8/02
)33 g, ~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [t>(FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUC'nON [ ] RRE RESISTANT PENETRATION
REMARKS: ~ ~
LA- ok ~
C- 0,
,
tf1J e~
/7J - )-17
DATE
INSPECTOR
~P-
~lEL~ I:~S~2~:10:~
1 .
FOUNDATION (1st)
-----.-
FOUNDATION (2nd)
2.
ROUGH FRAt1E &
.PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4.
FI;IAL
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~ 'FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BLDG, DEPT. SOUTHOLD, N.Y. 11971
TOWN SOUTHOLD TEL.: 765-1802
Examined 7.:;:.;.::........., 19 .?() ~
Approved . :~~........, 19~Permit No. ;9$!(~T
Disapproved alc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.u. I 6 I!B)
71~-~ ~?
Received. ..... . . .. .,19.. .
............... ..... .......... ... .~. ..... ~~
~0r:t!:8?J. . ~.. .. .~{{h..
( ilding pector)
APPLICA ION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . . ., 19. . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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 il~,~lu:Jions.c .7. ~
,,_ ,.; C1110I ,a QJWlIttClA . . .?:;t:Y~. . . . . ..f;Q&f1J. . . . . . . . . . . . . . . . . .
~~~. .;-"". .~. ,. _ \31~.l ;.Signature o~ ap~t, or name, if a corporation)
TA~"q~ ',J -.- B~ ;1h..~...~-?.7,<'~~.Jfd...............
~ t)~'O JIlJe ,(~I m ", (Mailing address of applicant)
IH1' ~ M'l . ()T M'" e ~O'lf~'" ~ J
2~nrr~3".'" i.11.;l.l~;;(i,I,;;' c? tJ' Ie; b vII ~ . /'1'., '
State whethe~t(Mwner~,;I~~.~~I~f'J~pt' architect, engineer, general contractor, e ecmcian, plufuber or builder.
Jir31,!;')W}) '.0 ,,' """1 ")',
......... .9Mtft,..,~(l(""r~-r;;/~,... v...,............................................................
.' . - "~f.:"'M~': / :?_ L ~ ~ /) ~ /7 17---
Name of oWllfee~Sj!~;,~ .li;(;'('J,v.~."a.. .Qt.. T. . . . . . . r.. .(..be eR('(~ . . tv. (?, . . . . . . .. . . . . . . . . . . . .
0.;>". ~~'l~.I"'Ml' '.' (as on the tax roll or latest deed)
If applicant in~, ~igHafu!'e dfltJiJy.authorized officer.
.Y 1Ii-l6ii-liQu ,?''''J[,Uilll )~l!l ";'1
Yt>lBIe . MOlTJPIH".,_~ ,,) ,,',_.'"
. .. . . . . . (~.. . . . .~~~fa:t~ ~fii~~rJ'';' . . . . . . .
...i,.fJI4OtT:>Ul'll ,Z"'O~I ,Of) ,. ','
Builder's License No. .. .(r.f..!-1.~ ~~. . . . . . . . . . . .
Plumber's License No. .,......................
Electrician's License No. ......................
Other Trade's License No. -..... - . . . . . . . . . . . . . . L
1. Location ofland on which proposed work will be done. ......... J.. 0 .f . ..1.7'.. . .&;/;(I! <<. !;?/(#!.s:.
.~~.-r:L'!... .;?;;~. ~~<". .Rd...., _.-.. .(?II%A~~i1'P,............................
House Number Street / - Hamlet
County Tax Map No. 1000 Section.../ .0.. r........ Block.... cJ........... Lot.. .~. .If....
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot. . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .,..?f <1':<'. . . 1'.4":,,. ,.I. J . . Fe: P. </, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy 'jII'- yo ~ .j.1 "
. . . . . . . . . . . ',' . . . . . . . . . . . . . . 'M~;~~J'~':'.~'~ ~""';' ..,....~,..~.:. . . . . . . . .. .. . .. ... . . . ..
.__.,"
8.
3. ~~t: of work (check which applicable): New Building.... :'.,'.. . Addition .. i .'. ..l;~J\lt~~~jr.(m:;," .....
p .............. Removal .............. DemolitIon .............. Other Work . JI .....
I ~ . lQ!l iH ;Wej1Jt" 'on)
4. Estimated Cost. . . . /.,;("~ ~<. P. ~. . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . .'" . . . . . . . . . " .,.. ~ U.....
. .. ... . (to b~ paid oit filing~:ap'~~o~
5. If dwellmg, number of dwelling umts . . . . . . . . . . . . . .. Number of dwelling umts on each floor. :-.:. .;:; . . . . . . . .
If garage, number of cars ........................................................................
6. If business, commercial or mixed occupancy, specify nat1jt~and extent of ea9!l: ty~ Jf use .. . . . . . . . . . . J. . . . . . . .
7. Dimensionsofe~tingstructures,ifany: Front.. .~!}f...... Rear .~P.J.l:...... Depth. J't./,. .'/.......
Height . .~<t.. . . . . . . . . Number of Storie's. . . . . .~I.V e:-:-. .. . .. . . . 'f' . ;-. . . . . . . . . . . . . . . . . . g .t. . . . . . . .
Dimensions of same stru9ture with alterations or addiyons: Front .. :y.t1 t . . . . . . . . .. Rear.. ~t!.. . . . . . . . . . . .
Depth..... t?~...~......... Height,.. .~.~. P.......... ..NumberofStories.. .I-!~............
D. . f t' t t' . F t A:t..'t> R - D h ... 0 t
unenslOns 0 en Ire new cons ruc Ion. ron ............... ear............... ept . /. ...... . .. .. .. . .
~eigh.t .. ;7,.~.e:.. .. . .~' HlTI)er of Stories. , . . ' ., .. ~ . , , 9' 1i " , . . , , , , , . . . . .. . . . . , . , , , 'f';/. , , '.;.," , f
9. SlZeoflot: Front.. .~..(...........,... Rear.......f(,............. Depth ~./j.!:t2:!. ,/,;2.~VJ~<
10. Date ofPurch~e. ..". .1?l9.c.. <,,?~:......... :'Jame of Formg Owner A1/T.KId.~~~(!%......,.....
II. Zone or use dlstnct m w~lch ~remlses are sl~ated. . .~tf!(f'~II. .r.H,!,""~/. .~tX>N!. .. . .. . . . . . . . . . . . . ..
12. Does proposed construction Violate any zonmg law, ordmance or regulation: ................................
13. Will lot be regraded ..... /!":e..~./'. ~:J.""" ,Will excess ftll be removed fr~lI}l premises: ~ Ng.--
14. Name of Owner of premises "tf'~"I(I:-o/. . NP.f.~ . . Address~o. ;'j,i, ~ .!1!r.12, .(4Phone No..?'l.~. 'J.'.'r,....:(;>.f..
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. ... . . . . . . . . . . . .
Name of Contractor .. . . .--:-. . . .. :-:-. . . . . . .. . ., . . Address. .. . .. . .. . .. . .. . . . . Phone No. ...............
PLOT DIAGRAM
I
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
s::.e
~//P~./ ;;;?AJ~//M
,5L ~/Il~'i~, AI
DATI:~'~ U.
FEE: IY:
NOTlF't '
785-1802 . AM 10 4 PM FOR _
FOLlOWING INSPECTIONS:
1. FOUNDATION . TWO ..-_....
FOR POURED CONCRm
2. ROUGH - FRAMING . 1IWM...8
3. INSULATION
4. FINAL - CONSTRUCTION MUST
.. COMPLETE FOR e.O.
AU. ~ SHALL MElT
THE .ItEOl.lI8Si.11f. Of 1HE "Yo
$'DOl COI.1RUC1IOII . _&IV
CODES. NOr MIPDUIII... fOR
DESIOM OR ~I_JION IRMlIIS
STATE OF NEW YORK,
COUNTY OF . . . . . .. . . . . . . . . .. S.S
being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
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 ftle 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 ftled therewith.
Sworn to before me this
. . . . . . . . . . . . . . .r ~ . . . . . .day of. . . .~. . . . . . . . . . ., 197.0.
N,..., M"o. .. ~ . J< .1)". '(!<<-.. Co"'~ . cfdJ~e ..
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N.8!5-40 20 .
LO' 39
s .850 38' 20 'w.
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SURVEY FOR
EDWARD L. BETZ a CONCETTA BETZ
LOT NO. 39
.: NASSAU FARMS"
PECON I C
TOWN OF SOU
SUFF.CO., N.
SCALE: ," =
NOV-,-15. '978
DEC, 1,1978
...,.... "CII_ee.".)
Lot 38
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I>>WIIMOIIUD Al1llAnoN OR ADOn1Ofrr,l
YO nas MVET IS Ii. YIOlA1IOM OF
IfCIION 720f OF tHE .-w YOIIC STAn
IDUCAnDN LAW.
COPE OF nus SURVfY MAP NOT JE...IING
1H! lAND SURVI'OI'S NED SIAl. at
IMIOSSlD SIAL SHAU HOT If CONSIOlUD
TOIIA VAUDTIUl~.
.
GUAlANTEES tNDICATED MEllON SHALl ...... N G
ONlY 10 1m .,,- FO' WMOM 1M' '!JIm ST E R LI
as PlfPAlED. AND ON HIS IEHAU 10 JKf
mu COMPANY. GOYUHMOnAL AGiNCY Ne
UtCMNG tNSTnUTION LtsTID 1IEllOtt. AND
TO nu ASSIGNEES OJ THf LINlMNG NTJ.
MlON. GUAlANTEES ARE HOT TUHSRLUlf
TO ADDITIOHAl NTINhOIU 01 5WS!QUIHf
0........
NOTE'
o = PIPE FOUND
. = MONUMENT FOUND
MAP OF SUBDIVISION FILED IN THE OFFICE
OF THE CLERK OF SUFI". CO, ON MAR. 28, 1935
AS MAP NO. 1179,
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