HomeMy WebLinkAbout32792-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32890
Date: 02/14/08
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 13920
(HOUSE NO.)
County Tax Map No. 473889 Section 54
SOUNDVIEW AVE
(STREET)
Block 3
SOUTHOLD
(HAMLET)
Lot 3
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 12, 2007 pursuant to which
Building Permit No. 32792-Z
dated
MARCH 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to PATRICK BARRY & JUDY M. SMITH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPAR'l'MENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
103938C
12/28/07
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
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This application must be filled in by typewriter or ink and submitted to the Building Department with the follow~:
'-ri
A. For new building or new use: '~,
1. Final survey of properly with accurate location of all buildings, property lines, streets, and unusualnatura19\' .
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 nses:
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,
Swinuning 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 Celtificate of Occupancy - $50.00
5. Temporary Certiticate of Occupancy - Residential $15.00, Commercial $15.00
Date.
:2.-/ / '-/ / ()?{"
{ {
(check one)
New Construction:
~
_.. Old or Pre-existing Building:
Location of Property: _139._.J....Q.
HOllse No.
'S 0 LA.. ha. V \ e.W
Street
Au e. .
So u...{.h 0 I d
Hamlet
Owner or Owners ofPropelty: _eQ....trJc.k
Suffolk County Tax Ivlap No 1000, Section
t:Jo...rry
054
5mi+b 'YJ4.dy /VI. Smrf-l,
Block 0 0 0 3 Lot 0 0 3_
SubdivisionN ov+h"'i!>_~o(_ Fs-fa....res Filed Map. _5" 7 S' Lot__ 0______
Permit No. _ ?; 2 JJ_;)... ____. Dale of Permit. 3 - I :2 - 0 7 Applicant:LCL it" ;" k. Be",... '( :5 tYl " +L
Health Dcpt. Approval: _,__
___~__...___. Underwriters Approval: __.
PlalUling Board Approval:
Request for:
'T'empormy Celiificate ___ _
final Certificate: V
(check one)
Fee Submitted: $ :L5. 0 D
P~t1~
Applica Ignature
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C DZ 398F)
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.
32792 Z
Date MARCH
12, 2007
P~rmission is hereby granted to:
PATRICK BARRY SMITH
238 GEORGE ST
WEST ISLIP,NY 11795
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP 31027.
at premises located at
13920 SOUNDVIEW AVE
SOUTHOLD
County Tax Map No. 473889 Section 054
Block 0003
Lot No. 003
pursuant to application dated MARCH
12, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 12, 2008.
Fee $
150.00
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Authorized Signature
ORIGINAL
Rev. 5/8/02
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
PERMIT NO.
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
3 :2/"ld- (~
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Date MARCH
29, 2005
Permission is hereby granted to:
PATRICK BARRY SMITH
238 GEORGE ST
WEST ISLIP,NY 11795
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
13920 SOUNDVIEW AVE
SOUTHOLD
County Tax Map No. 473889 Section 054
Block 0003
Lot No. 003
pursuant to application dated MARCH
28, 2005 and approved by the
Building Inspector to expire on SEPTEMBER 29, 2006.
Fee $
150.00
re
ORIGINAL
Rev. 5/8/02
.
3 'J-7f2-C-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING I STRAPPING [
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: W
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INSPECTOR
3')'1'1) ie.Y\
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [K"Q L"'R "L.~
[ ] FOUNDATION 2ND 0-INSULATION
~1'1f-IUI.n_ , JJtIUlrFING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: ~ r:J-
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DATE f)-I r- crs
INSPECTOR
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J /02-7&
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] F~~TION 2ND [] INSULATION
[ ~RAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
07C r
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DATE / 0 I rJ-c{:((/;- INSPECTDR
310J-7c
'3 :l; '1)' 2:;:"
765.1802
BUILDING DEPT.
INSPECTION
[~NDATION 1 ST [] ROUGH PLBG.
[ ~OUNDATION 2ND [] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
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DATE
INSPECTOR
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FIELD INSPECTION REPORT DATE COMMENTS . ~
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FOUNDATION (1ST) ----- /./ 7(/ -~~ ~
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STATE ENERGY CODE ' /-' ~ ._._----~-
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FINAL
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TOWN OF SOUTHOLD
BUILDING Dl!;PARTMENT
TOWN HALL
, . " .
SOUTHOLD, NY 11971
TEL: (631) 76S-111Q2
. 'FAX: (631) 765-9S0~'
www. northfork,ne Southoldl
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PE~IT'N~~
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
... Board ofHeaIth
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic F onn
N.Y.S.D.E.C.
Trustees
Cont~ct:'
Examined
,.-
)
,20 ~
,20 .
Approved
Disapproved ale
Mail to:
Expiration
.
. .
Phone:
,20-?
,\~f5.' '" Buildi" ector
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\,'-,' WR 2. 8 - "~PPLICATlON FOR. ~.ulL.n~NG PERMIT
WI . ~ . .
\ ..L... - rp~ ., , Date
0~ ""tQ. INSTRUCTiONS ,. '.'
a. This application JI1UST be.cfmpletely filled in by typewriter Of in ink and submitted l<l,the Building Inspector with 4
sets of plans, accurate plot pran.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 applicatiol,l; the Building Inspectorwill 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 witl;1in 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted inll\e'intehm; the-Bllilding'Insl\ector may,authorize, in wpting, the extension of the permit for an
additicrDsix'months. Thereafter, a new permit 'Jliall1.erequired, .. ,..:. .... .' , \..'
APPLICATION IS HEREBY MADE to the Building Department for the iSsWnc.e,lit:a BUildiIlg Permit pursuant to the
Building Zone Ordinance of the Town of South old, Suffolk County, New York, and<tther llppl,icai1leLaws, 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.
'.
,20_
(Signature of applicant or name, if a corporation)
-l.?J? G~e>r.g 5+. IiJesl- Is/,n NY
ailing address of applicant! t (795
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Otvner
Name of owner of premises Pa-+r i ck Aarr V . ~ i -Ih
(A~ 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.
Blectricians License No.
)ther Trade's License No.
{lIt'-
.
Location of land on which proposed work will be done:
/ '3 9 ~ tJ .5> (..tJl d I/I~W ,4VO'1 ue.
louse Number Street
SOlL_Mold
Hamlet
'unty Tax Map No. 1000 Section 5 L./
,division He>rff/l..cJt:IOQ E sf~e..s
(Name)
Block .3
Filed Map No. 5' ~ 7.5
Lot
Lot
3
to
2. State existing use and occupancy of premises and intended use and occupa~ of proposed constru~tion:
a. Existing use and occupancy '3 bt"'c1roolYl SU?Jlt> i:J;Jm.i/y dUJe.II"~
.
b. Intendeduseandoccupancy ,5a.J?'le. _-5 ht'drooln 5In.J1t>..fJm;t d4le/I/q;
V Alteration V
3. Nature of work (check which applicable): New Building
Repair Removal Demolition V
Addition
Other Work
(Description)
4. Estimated Cost~...1.7,', 07r0 ,
5. If dwelling, number of dwelling units )
If garage, number of cars 2.
Fee
(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.
II/a...
I
/ I I ljll Rear / /1 11"
7. Dimensions of existing structures, if any: Front [pCp 7 ~h 7'
Height c2~. 5 . Number of Stories I
Dimensions of same structure with alterations or a?ditions: Front &. ~ 'Cf &il\' ." ;' ~,~r i. b I 'I I'
Depth .5~'.:2" Height..2~. S Number of Stories I
Depth ...:s,f '.:z ..
8. Dimensions of entire new construction: Front /l fa....
Height ..2.2 5" ' Number of Stories /
9. Size oflot: Front I tf 5 Rear /'1'1. %'1
Rear ..:2 ~' t. "
Depth
) t. '
Depth ~ 7F. 73
10. Date ofpurchase 6/.;2J" It? 4./
Name of Former Owner &nrv Rwqen
. v
II. Zone or use district in which premises are situated rc::.:5 I dt!:.n -1-,'4.-/
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 ~
P 139UJ Sot.c.Nl"iew ~
14. Names of Owner of premises Iii-irick S. ..sn,;tM.ddress ':;'..rA.,.tI, Ny Phone No.,;.3/-(.t. 9-5351
Name of Architect L4...."')' 71L+Ai 1/ Address Phone No
Name of Contractor ~ D_~aLLJ/1er Address Phone No.
IS 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. PrQvide surv.ey,.~o scale, with a~c~~te:foun4ation plan and distances to property lines.
. ,. "', "" '....
17:.ifelevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
COUNTY o~f--
? -t--t ~ .1--, r" S'VI- ,f. L , . being duly swoni; deposes ~d sais.that (s)he is the applicant
(Name of individual signirlg contract) 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.
SW:~~~;hiS
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Notary
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Signat e of ~pplicant
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P,\TRICIA CORWIN
Nobv Public. Slat. of N.. York
No.01C05011852" .
Oual~led in Suffo~ eollntv. : . ..--
CommisSion Expl"" S'Pl13,::lt!J tJ J
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IMP.
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Tillable
Woodland
Meadowland
Hause Plot
Total
TOWN OF SOUTH OLD PROPERty ,.RECORD CARD
. ft1 -6'7'
- -;;-.'
TREET
VI LLAGE
DIST.
SUB.
LOT ~ (,
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Sou7i. 1'-
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TYPE OF BUILDING
W
VL.
FARM
COMM. CB.
MICS.
Mkt. Value
TOTAL
REMARKS
DATE
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rn IT/-; $ 4~s ,0()0
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FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
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tension If l'?r..sr . 6 '1(, /.J,.."
Extension
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Porch
Porc~"tr< /Y)(I( =.J.4.-if
Breezeway
Garage
Patio
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Bosement fu// Floors OAk'. 0j. K.
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S, Ext. Walls Wd $'/4-k Interior Finish r;.' LR.
Fire Place I' Heat 6'/ f'fl DR.
?t"O I[ype Roof Rooms 1 st Floor BR.
.
Recreation Room Rooms 2nd Floor FIN. B
Dormer Driveway
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BUFF. co, DEPT. OF Hl!.ALTH SERVICES STATEMENT 0,. INTENT
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