HomeMy WebLinkAbout33825-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33000
Date- 04/24/08
THIS CHRTIFI$S that the building ADDITION
Location of Property: 700 KOKE DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 87 Block 5 Lot 6
Subdivision
Filed Map No- Lot No-
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
Building Permit No- 33825-Z
APRIL 17, 2008 pursuant to which
dated APRIL 17, 2008
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 ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARJORIE D PETRAS
(OWNER)
of the aforesaid building.
SIIFFOLR CODNTY DHPARTMEN'P OF HEALTH APPROVAL N/A
BLSCTRICAL CERTIFICATE NO. N/A
PLDIYIDERS CERTIFICATION DATBD
°ssAUthorized Signature
Rev. 1/81
~I ~~-`33c~3
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY 2 2
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: ~'' _ ~ ,:
1. 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. Swom statement from plumber certifying that the solder used in system contains less than 2/10 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 Apri19, 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
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 ofOccupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00
Date.
New Constmction: /`I Old or Pre-existing Building:
Location of Property:
No.
Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section ''~~ Block
Subdivision
(check one)
Hamlet
Lot
Filed Map.
Permit No. `?~3~~ Date of Permit. ~ ~jb= ~ S Applicant:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
~ ~ ~3oov
Underwriters Approval:
Final Certificate: _~ (check one)
Applicant tgnature
Lot:
FORM N0. 3
TOWN OF SOUTHOLD
BUILDING DEPARTME:
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 33825 Z Date APRIL 17, 2008
Permission is hereby granted to:
MARJORIE D PETRAS
PO BOX 348
SOUTHOLD,NY 11971
for
BUILD AN ADDITION ON EXISTING DWELLING. THIS PERMIT REPLACES
BP 8219.
at premises located at 700 KOKE DR SOUTHOLD
County Tax Map No. 473889 Section 087 Block 0005 Lot No. 006
pursuant to application dated APRIL 17, 2008 and approved by the
Building Inspector to expire on OCTOBER 17, 2009.
Fee $ 200.00
Rev. 5/8/02
ORIGINAL
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Examined ...!~~~`! 1 _
Approved .............~.~.. ~....,
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y. ~ , ~ ~
~..
3`5'~`~~~/ n;,~~'
19...~:~. ~ t' Application No.
,-~-- 7~
19.5.. Permit No...':?.`?~h.,,l :.................
Disapproved a/c ............... ...........................~ ............. ...................
.......................... . r... e...........................ri...............................
APPLICATION FOR BUILDING PERMIT
a~
D
.D
~/~ .~' 7~ ................ 19............~
Date ................ ...........
INSTRUCTIONS ~
a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate 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 ofproperfy must be drown on the diagram which is part of this application. ~.
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 permit
shall be kept on the premises available for inspection througfiout the work. :~
e. No building shall be «cupied or used in whole or in port for any purpose whatever until o Certificate of Occupancy ~
shall have been granted by the Building Inspector. ~
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the C7
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 tom
admit authorized inspectors on premises and in buildings for necessa//ry~~ins~p tions. y~
........(..r~~~iC~..~. ........ ..... \
(Signature of applicant, or a co oration)
..........~. s ~ .. ~~....~.~l.~y...~..~.~~.1.~.. ~ .:.....................
" ~ " " " y(Ad pplicont)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, el ricron, umber or builder.
........11~;~:~- .............................. ................................................................................................................................
Name of owner of premises ....:..~.t~1i~,,L....~L.s~q,I,L~a~..F.:~~ ..........................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Builder's License No . ....................................................
Plumber's License No . ................................................
Electrician's License No . ............................................
Other Trade's License No ...............................................
1. L«ation of land on which proposed work will be done. Mop No.: 3 ...................................... Lot No.........................
~ Street and Number .....i{/.KF..1lle~.V.b.(.F.)4:tt.:i..QI.'.~u.N.~~ACGtls;>`...G'P..~Tg~l::.~`.'/ ...............................................
Municipality
2. State existing use and occupancy of p mises and intended use and «cupancy of proposed construction:
o. Exisiting use and «cupancy .....~.`.^...`~ ................................ .........................................................
b. Intended use and «cupancy ................................................ ..........................................
-~. ,
x r,.:: ,
,
Y •~e rn,,,, ?ttrp nee';.,
+:.•~
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~Sy~,' ~f~:X'~
3. Nature of work (check which applicable): New Building .................. Addition .!~............. Alteration ..........~.,.. ,
Repair .................. Removal .................. Demolition.................... Other Work ................................................ ....
~ .....................................(Description)
4. Estimated Cost ......~~o.~~' ....................................Fee ........,!3.:~ ...............................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor .....,......................
If garage, number of cors .............................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
n r ~ .,
7. Dimensions of existing structures, if any: Front .....'I..!!::.7 .............. Rear ...3y.. i`................. Depth .j,P....P..........
~~
Height .....~:~ ............... Number of Stories ......~........................................................................................................
Dimensions of same structure with alterotion~ or additions: Front ......~:~:..~ ..................... Rear ...j~.~ ~. •............
Depth .....y:~.~d ................. Height ........1.~................Number of Stories ...... ~........................
~, r
8. Dimensions of entire new construction: Front .......Z.tr.~.7..~ .................. Rear.....y ...'~.~............ Depth .. ~P..o..............
~ n
Height ..f..t4........... Number of Stories ........s~?.F..:.P.t~K.~..4:~,~ .....................................
...................................
i ~
9. Size of lot: Front .......~ Ci .. Rear .....l.~?.~A? ........................ Depth .r!~:~.~...............
.....
10. Date of Purchase ~:~~ .......................................Name of Former Owner .{~T/.1F.Pw.(Nt.~..I~!~,.~`.(iyy............
11. Zone or use district in which premises are situated .; ....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..../1~~ ..............................................
13. Will lot be regraded ....,E/,p .................. Will excess fill be removed from premise ( )Yes (~ No
'i~' 1 P)//RAM $1/~ t RU .
14. Name of Owner of premises~t3..tC.~R..S.Tf/!!~`?~'.s.~t/:.(..'!?~/.4.:....... Address bakir..T..t!9.!Ffy~,A:r~Y. Phone No. 4:7..!.~.3~1.1~....
Name of Architect .............................................................. Address ................................ Phone No.......................
Name of Contractor ............................................................ Address ................................ Phone No.......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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.
STATE OF NEW YORK, t
COUNTY OF .N~,~ ...............1S.S
•••••••••••••.Tf{°•!M•f}5••••N•:••~•~.~(}~!r••••••••••• ..........................being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract9
above Homed.
He is tha O W(~L~
(Contractor, agent, corporate officer, etcJ
of said owner or owners, and is duly authorized to perform or hove 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
than the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
...................... .
2S?~ day of ..............~..`..~. ~...................., 19 7J...
Nota Public . ................ (~ qsS a~J.................. County
iF. ~~t~ br~d1
~mQ~p*~I~~ ~,~ ~,197~
...........~ ........: g~..~ ..... .....
(Si nature of a p is
roses xo. i
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..............3.a..., 19..1.5.
i ~ 3 ~...., 19. ~:~.. Permit No....... L
Approved .................................... .~... .............
Disapproved a/c ......................... f...~~.....................~,..~~......
Application No.... ~~1..~..........
Inspectod
APPLICATION FOR BU
PERMIT
Date ...... yy d
...<..1...~L......
.., 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate 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 ofproperty must be drown on the diagram which is port of this application.
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 o 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 Deportment for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opplicoble Lows, 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 opplicoble laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary ~Gctions. n
......... .:611-`l.- / ~
(Signature of applicant, or nom , } a corporotion)
pplicont)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, ~triciorl! plumber or builder.
.................~,,~..L'G.'~.G~~................ ..................................... .......................................................................................
Name of owner of premises ....rt;,~~:c,~:.....~.....~GL.lG'..Z4~ ..:.............................................................................
If applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Builder's License No. ......~::1l.~ :......................
Plumber's License No . .................................
Electrician's License No.
Other Trade's License No
a -- ,
Location of land on which proposed work will be done. Map No .:..:..................~............... Lot No.................
Street and Number .KOk,~.;P.Y.IY.:f`..L6J4.h.~.aFf.4%4.~~,.I~RXE..CiR..~7:~Er.:!`.....~ ...........................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ........~~-.4~%~aG~ .. ......... ......
b. Intended use and occupancy ................~................lf~':.~~............. ..... .. .. .:......................................
3. Nature of work (check which applicable): New Building .................. Addition ti ~~N~".:'}Iteration
................ .
Repair .................. Removal .................. Demolition.........,.......... Other Work ................................................ ....
~' ~ (Description)
4. Estimated Cost .......ld°.c°..° .......................................Fee ......... /~ _ ov
. ..........................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ...--,......................
If garage, number of cors .....................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
° Z ~~' 1 ~
7. Dimensions of existing structures, if any: Front ..... ~.. 7 ............... Rear ......9....................... Depth . ~S.Q..........
Height .... ~J .............. Number of Stories ....... J.........................................................................................................
Dimensions of same structure with alterations or additions: Front ......3.x...7 .................... Rear .~..`/..~................
" /
Depth ...ll.:$.:.A .................... Height ...1.~....................Number of Stories ....r..........................
~, :~ r n
8. Dimensions of entire new construction: Front ....~:Y...:7 ....................... Rear .....?:.Y...~............. Depth .~0.. a...............
! f.
Height ..j~.?o............ Number of Stories ....~+.~~!!...~?E4[CCQk.~~ ............................................................................
' ~ i
9. Size of lot: Front ........... -~.7- ................................... Rear .....1B.O..,t911........................ Depth .~~:.°.Q.................
_i
10. Date of Purchase .......~~.~ ..Name of Former Owner x'fJ7Jr. ! i• ~¢S.C~
.................................... ........ ...:R...N..~..........................
11. Zone or use district in which premises ore situated .~ ...................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ....t!0 ................................................
13. Will lot be regraded ........................... Will excess fill be removed f 3s~ e~~e : K ~s ( ) No
p~ ~ ~ Za' X
14. Nome of Owner of premises hR.Y.I.?RF..T/tlJ.t`.+.:{.`~..~!: ~/~~/f :.... Address .L~ ~:S.T.?'r#~!F~~eY~G. Phone Nora.?~:.1.~!Q.......
Name of Architect .............................................................. Address ................................ Phone No.......................
Nome of Contractor ............................................................ Address ................................ Phone No.......................
PLOT DIAGRAM
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.
STATE OF NEW YORK,
COUNTY OF .11L!kSS~-f ..............jS.S
.................T-4~.°.>?.~...~.:.«(~ ...................bein dul sworn, d
• •••••••••••••••••••••••••• • g y eposes and says that he is the applicom
CNome of individual signing contract9
above named.
He is the ..........
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or hove 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
than the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
2 STS
....................... day of ............ ~is~PT.................., 19..
Nota Public, . /`t'f1SS'~/'~ ...... County
.......... .............g ........... .......
/~ (Si nature of ica
U 1ltCFtlU3eA. ChtfP!:$ I
'+DUF1f p+lf~t, ilMrrtWEMYwt
!-,.:w 552k775
Qualifie0 N Ki=tt9lAUl~'
Cemitisebw ~izgrv ~ryt;iP, 3Y7q
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~ ~~~~
N~ ~9 Z Dote .........................aS'Bp1t.....~..........., 19.'f.~..
Permission is hereby granted to:
SAQFI..~r.~A.~,1L ..........................................................
........... 3 51.....B3.,ua3s..83~ • • Aoad ....................
....................... ~Ilttut~.. rallpt.....1I..Y........1. ~ 560
ro ..Ai111d..,ati..additiaun..,on...existing..dlael.l~,ug ..............................................................
at premises located at .~fiaGB...QaAa~e ................................................................................................
......................................................Corey.. ~re~k...~SiAtd...~~XXt..$A..tf~........~1111.t~IDI~I..X..~.
.................................................................................................................................................................
pursuant to application dated ...................Sdyt...~+6•.••••••.••••••••..•, 19.."~.,~., and approved by the
Building Inspector.
Fee ${.Je~............
~~~~~~
..............................................................
Building Inspector
TOWN OF SOUTNOLD BUILDING DEPT.
765-1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [~ FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
REMARKS:
~r-e-n
DATE ~ `~ ~a ~ INSPECTOR ~ -'i~~%~"'-~.
FIELD INSPECTION REPORT DATE COMMENTS ~ ~
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FOUNDATION (1ST) ' '
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FOUNDATION (2ND)
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ROUGH FRANIING & ~ H
PLLrMBING
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INSL7,:~TlOi~' PER N. Y.
STATE ENERGY CODE - --
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FINAL
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ADDITIONAL COMMENTS ~
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~, ,, ~ ~ ~, _ ;; _ ~a TOWN Of SOUTHOLD PROPERTY R'ECORfl CAD ~,, ~.....--
OWNER _ STREET '-~~~`?~ VILLAGE DIS,T. SUB. LOT
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FORME OWNER N E ~ ACR.
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Ric A~ .l~gce ~~ AKeI~_ S ,~
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RES. ~ ~ ~ SEAS. 7~/~
"~' " VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
7~ ~ _..~ . c .: ;:~- ~ ice, %~ r ~ _,_,P-~.,..,~ Ir'J./~.ese~-~ - f~ r4s~a~~,, <i
i' p'v / , o ,:a a ~ ~'::; ~ ~~ 3;'G ~ f l o-w s~ ~S,A,oka ~.r~ _ o ~/'~.Ck9«i
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AGE BUILDING CONDITION 7l~ri ^ ^ !„ < f?ii
NEW NORMAL BELOW ABOVE ~~ ~~~ ~ ~~~~,~~~~~,_ 1`~P`~1~Q~ ~_~ ~~/R.S _ ~~`~,
FARM Acre Value Per
Acre Value ~ r
Ti table 1
Tillable 2
Tillable 3
Woodland I
Swampland FRONTAGE ON WATER - ! ~ i u ° ° r' ;;
shland - FRONTAGE ON ROAD / p ~ o „~~' ~~z 35~,°.'a •t ~!r'~ ~ ~- ~ 7 l
House Plot DEPTH ~ 0 ~, ~
BULKHEAD
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Interior Finish
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<tension Fire Place ` Heat ~~~til {~.2 DR.
Type Roof ~ P~+3L._\~ Rooms lst Floor a BR.
>rch ~k`~ ~,.a~ cs0 ,~.~ Recreation Room Rooms 2nd Floor FIN. B.
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FO&M NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
NOTICE OF DISAPPROVAL ~
~~~ ~~ ~
File No ..................................................................Dote ........................................................, 19.......
~.
To ............................................................ ........~
~~~r /~ J .
~.... ~. r~.~. _ ,
PLEASE TAKE NOTInCEAt~7hat yournapplicationq dated ....................1.~........................, 19f..!...
for permit to constructr~.adCtxt...~~..CtL[/.~4.ot the premises located ot .............~.....................
..................................................................... Street
Map ..................~.......... Block ............G,......................... Lot ...~........................................ is
returned herewith and disapproved on the follawing grounds ....... .C..~:.~..SvS....~~
................................................................................................................................................................
/ ~ -~~~
~A~
i
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-, i-~ ~. ,...fir
Building Inspector