HomeMy WebLinkAbout33452-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32904 Date: 02/27/08
THIS CERTIFIES that the bui1ding STAIRS ADDITION
Location of Property: 31025 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 102
(STREET)
B10ck 2
CUTCHOGUE
(HAMLET)
Lot 23.5
Subdivision
Fi1ed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
fi1ed in this office dated SEPTEMBER 26, 2007 pursuant to which
BuHding Permit No. 33452-Z
dated
OCTOBER 5, 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 2ND FLOOR EXTERIOR STAIRS ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to SANDRA MEYER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMEI!lT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~iZ~---
Rev. 1/81
.-.---.c-:,
) ;;1 C' _ f ~ j I Form No.6
~U' , FEB 26 ' . ! !J i: BJ~~g~~~~~~i~T
I U . . [1'-/ TOWN HALL
I L, --____.J 765-1802
I b. --
f 11""\'" ''..) " ('I':)
~---- ...- ---- PLICATION FOR CERTIFICATE OF OCCUPANCY
'JYVevJ/.
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This application must be filled in by typewriter or ink and submitted to the Building Department with the following
A. For uew building or new use:
I. Final survey of property with accurate location of all buildings, properiy lines, streets, and unus1l81 natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fonn).
3. Approval ofeketrical 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 1 % 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:
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 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. Ceriificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate ofOccnpancy - $.25
4. Updated Certificate of Occupancy -- $50.00
5. Temporary Cerlificate oC Occupancy - Residential $15.00, Conunerclal $15.00
New Constl1lction:
J
Date.
Old or Pre-existing Building:
(check one)
Location ofPropeliy. j /& J-f t!(,1!j/(/ M I
House No. Street
Owner or Owners oCPropelty: ~_. __j1jf/tf,(j jf:.j"b-- _0___~~_
Suffolk County Tax Map No 1000. ScctrOlI .It) f..~ 1).,;)-1, (Block_____
HamIel
Lot
Subdivision Filed ]\'Lip_
Penn!t No _i J_tF)---, Date of pcrmiL-I;7~~~ L Applicant__
Health Depl. Approval: _______ Underwriters Approval'
L(l1
Planning Board Approval:
Request for'
Temporary Celiiflcate _
Fi1l3! Certificate (check onel
Fcc SubmlHed: $ ---..dJ. ----cu-J2___
~.'Y7~ll
co~J;J~O~
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.
33452 Z
Date OCTOBER
5, 2007
permission is hereby granted to:
SANDRA MEYER
PO BOX 1168
CUTCHOGUE,NY 11935
for :
SECOND FLOOR EXTERIOR STAIRS FOR AN EXISTING SINGLE FAMILY
DWELLING
at premises located at
31025 MAIN RD
CUTCHOGUE
County Tax Map No. 473889 Section 102
Block 0002
Lot No. 023.005
pursuant to application dated SEPTEMBER 26, 2007 and approved by the
Building Inspector to expire on APRIL
Fee $
200.00
"
Signature
ORIGINAL
Rev. 5/8/02
~- -- ---
}3i{-SrL
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING ~ FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
J,{J...,,-.... _ _ _ A
REMARKS: ~~
~
f)
C1;--
DATE
/~!i---b'6
INSPECTOR ~ ~~
,
FIELD INSPECTION REPORT DATE I COMMENTS
. ~~
FOUNDATION (1ST) ..L~
VV-l
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FOUNDATION (2ND) . ~.~
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Mkt. Value
LAND
IMP.
TOTAL
DATE
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/ 6,0
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iD J'.P'i<u!~<::z:yk .iN"" $'c'!-;r,B,w/,,<z;.--c
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M. Bldg.
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Basement
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Heat
DR.
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FIN. B.
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Rooms 1 st Floor
Rooms 2nd Floo
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
PERMIT NO. :3 3 <./').2 Z--
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:
Examined
Approved
Disapproved alc
,207
,20_
Expiration
,20_
Mail to:
Phone: 6 ~ ( 1:J 'I 6)!?
&3 I LJ7~ le:J1
I~;]! We:: ~~ APPLICATION FOR BU~DmG PERMIT
; L..c. yJ I Date
k" . I.,..
L_fr:~'O!'A;.IIJ(j~'L...l INSTRUCTIONS
~~
,20.122
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
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 ~ompleted 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.
A'~ Ilh? tff!//.u /&1" &(thlowe-
(Mailing address of applicant) / /~
tv.' /
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bt'~ r
#P'lutU';el7 /.f t)I/'u67<.
,
Name of owner of premises J',4it/IfJ/'n 0. /lITVe-/'f
(As on the tax foil or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Elumbers License No.
Electricians License No.
Other Trade's License No.
j..() 11 c( I L t1 eJ"(
H(AelJ fer
J/i~ //t(,]J
Lot 0 d--J o-O/J
-...-()O-"~~
"""'10 IIIIIll .;)IJIUCI \OM TOIII
OllllDtllAf.1 to oM
, ___If A' ;1 /./J-. L ~ .-.off", "1'".lllouO
......v'" {{;;,:, - r V'v( V-'" OS'liu~""" I"; """..",moO
I. Location of land on which proposed work will be done:
:? / tJ 7rr- JlI1/d t?-/" titil RtJiJe(B I
,
House Number Street Hamlet
County Tax Map No. 1000 Section J lJ7rO, ( (J liiock 0 cJ r;-D
Subdivision / Filed Map No.
(Name)
/
Jd /l-J ~~.
r
cJ 07J -
r""
2. State existing use and occupancy of premises and intende4 use and occupancy of proposed construction:
a. Existinguseandoccupancy .J'(p(Le M/lib(~ tJt/p'e~ ~?7//,.or;:4 '
b. Intended use and occupancy J 111(0-
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
OtherWork ~cc/< I1U4 -.JMrJeT
(Description)
)cHJ .C/O
(To be paId on filmg thIs appltcatlOn)
Number of dwelling units on each floor
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost
(
c
Fee
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
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
9. Size oflot: 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_
13. Will lot be re-graded? YES _ NO_Will excess fill be removed from premises? YES_NO_
Phone No.
Phone No
Phone No.
Address
Address
Address
14. Names of Owner of premises
Name of Architect
Name of Contractor
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_
* 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)
(J SS'
COUNTY OF JJ(ftf~) .
~ ~€ V being duly sworn, deposes and says that (s)he is the applicant
(Name of individual sIgning contract) above named,
(S)He is the
Ow rJ CfL
(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 before me t
OJ (p~dayof
Notary Public
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