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Home My WebLink About33486-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32793 Date: 12/18/07 THIS CERTIFIES that the building INTERIOR ALTERATION Location of Property: 65490 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 53 GREENPORT (STREET) (HAMLET) Block ~ Lot 12.6 Subdivision Filed Map 1110. Lot 1110. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 11, 2007 pursuant to which Building Permit 1110. 33486-Z dated OCTOBER 23, 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 ALTERATIONS (INTERIOR BATHROOM ADDITION) TO AN EXISTING COTTAGE #15 AS APPLIED FOR. The certificate is issued to BREEZY SHORES COMMUNITY (OWNER) of the aforesaid building. SUFFOLK COUlIITY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE Il1O. N/A PLUMBERS CERTIFICATIOlII DATED 12/12/07 JOE WHITECAVAGE ~/;.:~'",. 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: 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 a 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, tions to dwelling $25.00 Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.0 , 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 11- D~CL,.....b,J""" ?on'"J. New Construction: Old or Pre-existing Building: R-r<-eT.'t Shor-e os \5 SA 1" !'>Iv!. House No. >< (check one) Location of Property: c.~ 54'1 0 MA"" e...J Street c.......tl!t'1'I r:>n....+ Hamlet Owner or Owners of Property: g ... r "'-0 " Suffolk County Tax Map No 1000, Section 53 Block s Lot 012. 001. Subdivision Filed Map. Lot: Permit No. 2> '3 4 8" Date of Permit. 10. Z). 0'" Applicant: t?.o. r r-n.... Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: x (check one) Fee Submitted: $ -v14A~~"-~ Applicant Signature &.v:.7"':>5'3>;) Co -t-.2>J.7Q 3 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. 33486 Z Date OCTOBER 23, 2007 permission is hereby granted to: SHORES COMMUNITY BREEZY PO BOX 546 GREENPORT,NY 11944 for : ALTERATIONS (INTERIOR BATHROOM ADDITION) TO COTTAGE #15 AS APPLIED FOR at premises located at 65490 MAIN RD GREENPORT County Tax Map No. 473889 Section 053 pursuant to application dated OCTOBER Block 0005 Lot No. 012.006 11, 2007 and approved by the Building Inspector to expire on APRIL 23, 2009. Fee $ 200.00 utho ORIGINAL Rev. 5/8/02 Town Hall, 53095 Main Road P,O. Box 1179 Southold, New York 11971-0959 Pax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: /'?'~.2.~1 Building Permit No.~ J.1-/ jTU Owne~~ez</ 0hhU' c;rhfe'S -""'-/.;(" / (Please print) -./ --- Plumber: ;:')oe 01o.'+-e..c.. 1 V~-J e (Please prin lead. I certify that the solder used in the water supply system contains less than 2/1 0 of 1% Sworn to before me this ~d dayof~ , 20~ ~~ (Plum ers Signature) ~~~~~ Notary Public, ~ County / ~~-~ ~~rlSMay~1L . '\ '\":"'1~""" .~. \L~"- " (~..;(O. '0? , \ ..: '/''':/~ ....... ~~~..- ) .'.. " ~:'~'<:~~~.Y'# ~!~.: .....;......../ ,.-.,." ",,i SC^tE_I.f(:a.l~o' , ) \ , / f~("c 2. ..,:=. 7 '. ' '\-.'-' ~ - '. ~ j .-' './ ---\, \~ON'UN D--E'QV,I" 'TO" . SIl&.P -/ . H?s,..M~hIr'~ . ~...~--_. ..,,,",vs.E'P "@" ~,,-,c.t. ". (j 'f-/--.c;,u'i'r""dt. JJ"L~. 1.7 . O' . , '--l Ce"I'TAGooC P<I"'JOIi:l.JX'" ~ . ~D ~~ <. c:rF"lo=.~ ~h4f:"'.H'~_ _ _ .s''''~~l!:>' "J._"oU,!!-"f'._.. - - -r,. ,_ _I..~~- ~ ....,..,........ ..L'f'......(TY,,) . .. I"IJ"'~.,.....~~ r2QN~":r,.....~.._~c tH3ttl@ ~]~.g~ @ , ........... '"' e-~.c:..j,f' (~........c.)... :,s ..-" a.'7. 8,~ '. '~-'<,.~~.~>/ _ _ .,..SAGe. BL~D.. - . - . ~ ~. r \ ~t._...... . . . \.. 51"! (.l. J;i'~ " iY"-"~~' ~-~~m (] If au V' \1 ....,....,*'" Et.-t..' Isr~ ' " -&=-C ...,_....... \" .' PlC.":. - -,J0 . - -llo' -- - """'\... HOUS. (,".~,~) , , LJ \..&J. -., .- ':..~-----r--;- / ~~-~.~:1;;'..~kP~/". -/ [3 I / f0 \. J. ~'I ,. ,,0 '/. 0:-' . . . ... . . - , " " - '-.- '-... .'. . -- ~c~ ,s- ~ "OUil'lO 5, , ~ 'Pf ea..>€- ettrf DtVn hqs ~ /ssuRd H scky fA)~ j1-ermff (,3/- 3;<3.., 3'i?tt k-m.p 63/- 965'-63J-9 I!.LtL --d.~."Jc ~ ) ~..~ :5 s ~~--c-- ~~~ TOWN OF SOUTHOlD BUilDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1ST [~OUGH PlBG. [ ] FOUNDATION 2ND [ ~SUlATION [J1'FAAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT ~ [ ] FIRE RESISTANT PENETRATION REMARKS: f~ cr' ~ d!c'- / /r:L"r-P ~, / L...f!-. ~-= ~ / INSPECTOR FlELD INSPECTION REPORT DATE I COMMENTS \>-.1>0 \)Jl"J FOUNDATION (1ST) -.(:.~ ~~ ------------------------------------ q:~ i- FOUNDATION (2ND) ~ I ~ 2 11/-ItJ 07 a / t-~ M-- . v::' , 0/'. 9 I I c.O Hd '7-...... ~ --,y..-./ ~. \J\ ./ r ./,:;7 ./ -C.'" ~.., ROUGH FRAMING & o ~ t'j PLUMBING .., ~. p ~-~ 1-- '> ' _.__n____ ------------- ~:= ----- ~ INSULATION PERN. Y. -- t'j .., STATE ENERGY CODE . . 0) /lA,o 07 ~~ ~ / I r // //'A ~ -~ . o. // / / ) --v-'"~ \ ..- . v / -//7 ) 6 FINAL V ~ . ADDITIONAL COMMENTS r . ~ f~ VI ? ., ~ -t'j o ~ ~~ 6::l ...1)0 z I> ;J ~ = ~I:l t'j >0 ~ .. .. APPLICATION FOR BUILDING PERMIT Date ~ l'f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SoutholdJ PERMIT NO. Examined Approved Disapproved ale ,20--7- ,20_ Expiration ,20_ -" r"\ ~~l~~~~~JW\ L; b 0 , DE?"" J L, ....0.'1 to ""If' "c: -.., ,THO_--,-__ T,~....;..~,_~_'-.' '....--' .---- BUILDING PERMIT APPLICATION CHECKLIST Do you have or n,eed the following, before applying? Board of Health 4 sets of Building Plans ./ Planning Board approval 3"5 '1 g--{ G ~:; ./ Septic Form N.YS"DEC Trustees Contact: Mail to: Phone: 5'~ ~ 5 ,;1~- ~~ r;3f - 77-d},tJ 75 INSTRUCTIONS ,20~ 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 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 sbilll 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, and to admit authorized inspectors on premises and in building for necessary inspections. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 6wl'1e.V" Nameofownerofpremises -g,rt',<'."Z,,~l..8n9'" (I.0V17r'Ylw:-,,~ Trr.c. c.,~ "'It:- j~ I~" (As on the tax r Ii or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Dan Fi;' vier 7i: ,;? 'i? 'I :Sk. If L Plumbers License No. J1:VYl.G'if"e.-,., rtllmlhiflj Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: ~D~/ :If I i{' 5~BI vJ . House Number Street County Tax Map No. 1000 Section Subdivision 53 (Name) Gree-n ee v-+ Hamlet Block 5 Filed Map No. Lot ,~ l, Lot 2. State existing use and occupancy of premises and intel1ded use and occupancy of proposed construction: a. Existing use and occupancy {J he- - -Fzvn.r, j Ij ~;? !> n1a I e.t> ~... b. Intended use and occupancy s~~ 3. Nature of work (check which applicable): New Building Repair X Removal Demolition "' Addition ~ Alteration X OtherWork!tvl1fl'/( if sifl.K. bW1XP~ (Description) . 4. Estimated Cost # '3 ,iJ7YtJ ,q7; 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 1;Z , Height I B I Number of Stories Rear Jl1e I? I Depth 36" Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rejlr , , 8. Dimensions of entire new construction: Front Height Number of Stories Depth Rear 9. Size oflot: Front Rear Depth 10. Date ofPurchaseJ.ek. mr( Name of Former Owner ~"J Esl-e..k 11. Zone or use district in which premises are situated f.-- t/ 0 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO 1 , 13. Will lot be re-graded? YES_NOAWill excess fill be removed from premises? YES_NOX- 14. Names of Owner of premises P~y $rn;c., kdl.ddress Phone No. Name of Architect~/, Pl. 't....-r11 i \ \ Address :rKlet ~. ~one No '117-/ (, S':;l Name of Contractor Address' Phone No. 15 a. Is this property within 100 feet ofa 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. 18. Are there any covenants and restrictions with respect to this property? * YES_NO L * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF~ j. ~l'{ 8 <trV7Y\ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the owner (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 ~re me t . ~daYOf Notary Public 2~ \ BARBARA ANN RUDDER Notary Public, Slale 01 New York Ilo.4855805 Qualiiied ill Sollolk County..., ^"l 0 Commiaslon Expires Apr\l14~ ~