HomeMy WebLinkAbout33977-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33118
Date: 06/24/08
THIS CERTIFIES that the buil.ding ALTERATION
Location of Property: 370 SOUTH
(HOUSE NO.)
County Tax Map No. 473889 Section 13
VIEW DR
(STREET)
Bl.ock. L-
ORIENT
(HAMLET)
Lot 9.1
Subdivision
Fil.ed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
fil.ed in this office dated
JUNE 6, 2008 pursuant to which
Buil.ding Permit No. 33977-Z
dated
JUNE 12, 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 "AS BUILT" BASEMENT ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MICHAEL J & MARILYN HEALION
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPAR'l'MEHT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
06/20/08
123640C
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 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 2/10 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 bnildings 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.
~41dt'
New Construction:
Old or Pre-existing Building:
Sd tJ Hl-J//<&V m
House No. Street
Owner or Owners of Property: rn /ci1C1rf' fJ+/"rti I!-lt. &a.lJ 'f/<
Suffolk County Tax Map No 1000, Section 100 () lock I
Location of Property:
310
(check one)
&dr-1)YdI;Le!i
O-~l1ret
Lot
~-I
Subdivision
Permit No. ~?PfI12- Date of Permit. ~-Id-.<;r
Filed Map.
Applicant:
Lot:
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ .1~..-
CD -2- "?':::> l\ 8
(6L '1 Lf~~
Underwriters Approval:
Final Certificate: rKJ
(check one)
r/'r; <fhoS'
A* Signature ~
06/24/2008 11: 54 FAX 6312420988
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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.
33977 Z
permission is hereby granted to:
MICHAEL J HEALION
PO BOX 793
ORIENT,NY 11957
Date JUNE
12, 2008
for :
AS BUILT ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
370 SOUTH VIEW DR
ORIENT
County Tax Map No. 473889 Section 013
pursuant to application dated JUNE
Block 0001
Lot No. 009.001
Building Inspector to expire on DECEMBER
6, 2008 and approved by the
Fee $
400.00
ORIGINAL
Rev. 5/8/02
,
Authorize
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SURVEY OF TIn; PROPERTY
NO. 370 SODTH VIEW DRIVE
BROWN'S HILLS ESTATES, ORIENT, TOWN Of' SOUTHOLD.
COUNTY OF SUFFOLK, STATE OF NEW YORK.
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33977-e-
TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
] ROUGH PLBG.
] INS TION
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRAnON
..
DATE ~//3 lop'
/
INSPECTOR
.'
IFIELD JNS~ECTION REPORT I DATE I
I
F01JNDATION (1ST)
-----------~ --,--- --- -----------------
FOl.JNJilATION (2ND)
ROUGH FRAMING &
PLFIYLBING
INSULATION PER N. Y
STATE ENERGY CODE
FINAL
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ADDITIONAL COMMENTS
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COMMENTS
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BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Plans
Q r:::J. ~ Survey
PERMIT NO. ~ ".?1'9- - I c--- Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL .
SOUTHOLD, NY 11971
TEL: 765-1802
Examined
Approved
Disapproved ale
Mail to:
.~~.;-~---":
!<.Phone:
5/6- G3S. dSif/ I
,
ctor
6
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. \ APPLICATION FOR BUILDING PERMIT ......-
__..::.~~i Date-J (j f) t:. ~
INSTRUCTIONS
,20~
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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 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 a Certificate of Occupancy
is issued 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 inspections. fn E h '
(Signa of applicant or e, if a corporation)
('0,(' d' ~ ~:;:ecant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or. builder
.~ t- -'. maUl /l;lf7;1{j~-
rYJd~_:'lkllcM
(as on the tax roll or latest deed)
Name of owner of premises
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Other Trade's License No.
N/4
Builders License No.
Plumbers License No.
Electricians License No.
I. Lo.-$ation of land on whiyq proposed ~rk will be done:
:> 7 0 Soutt> 1/ f(..\) IJ vu...t
House Number Street
()V'~f
Hamlet
(Name)
. Lot Cf .00J
Lot
x County Tax Map No. 1000 Section
Subdivision
13
Block I
Filed Map No.
2. State existing use and occupancy of premises and inten<kd use a,njl occupancy of proposed construction:
a. Existing use and occupancy ~ We-1lJ#tf '
DwdLutc;
.
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
x
(Description)
4. Estimated Cost
--
IO,()()()
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
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:
13. Will lot be re-graded
1-4. Names of~~er ofl!t.emises fJW tm1
Nameof~ ..J ,,-=;~
Name of Contractor
Will excess fill be removed from premises: YES NO
Address :3 ')0 sv&vev Phone No.47J- 6/7 B
Address 172St#!n.~ ~ Phone NofiJ/-70(; ~Z 'IS ~
Address Phone No.
15. Is this property within 100 feet of a tidal wetland? *YES NO X
. IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE ~
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.
STATE OF NEW YORK)
ss:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
i+ 1-
(Contractor, Agent, Corporate Officer, etc.)
CONNIE D. BUNCH
Notary Public.. state of New'mrk
No.01tlU6185D50
ua In .
Commission Expires April 14. ~
:S)He is the
)f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
bat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
)erformed in the manner set forth in the application filed therewith.
5wo~re me this
day of CCLlAR 20.-l2ls
~~ '!\~LA-~~
Notary Public
I
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f 000-13- \~9.1
OWNER
J
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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VILLAGE
DIST.
SUB.
MC(I" b
. LOT
S
-,
VL.
TYPE OF BUILDING
FORMER OWNER
IU
.
MICS. Mk.. Value
IMP.
.,
2~orw \ 500....
2. 1000 10 ,
House Plot
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
11< .2550 .. ,
Tillable
Meadowland
,v
'"
Woodland
Total