HomeMy WebLinkAbout34088-ZFORM NO. 4
CERTIFICATE OF OCCUPANCY
No: Z-33239
THIS CERTIFIES that the building ALTERATIONS/ADDITIONS
Location of Property: 2500 OLE JULE LA MATTIT'UCK
` (HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473689 Section 122 Block 4 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 30, 2008 pursuant to which
Building Permit No. 34088-Z dated AUGUST 6, 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
i3 EXISTING SECOND FLOOR ALTERED TO LIVING SPACE, SECOND FLOOR BALCONY AND
FIRST FLOOR DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The Certificate iS issued t0 WARREN CROON JR & ANNIE
(OWNER)
of the aforesaid building.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Date: 08/22/08
SIIFFOLR COIINT'Y DEPARTMENTP OF HEALTH APPROVAL
ELSCIT2ICAL
NO.
N/A
PLDMBSRS CERTIFICATION DATED
Au horized Signature
Rev. i/81
Form Na 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
„_ ; 2 ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department ~ith the following:' : __ _ __~~
A. For oew 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 seweragedisposal (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 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-eaistiog" land uses:
]. 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 of Occupancy - $50.00
5. Temporary Certificate of Occupancy -Residential $15.00, Commercial $15.00
Date. ~ / ` t / ~Z-t-~O `Y~
New Construction: Old or Pre-existing Building: ~ (check one)
Location of Property: 2-rJ(~~ ~~ ~UL>=. LP N~ N~~--T ~ ~ G~
House No. Street Hamlet
Owner or Owners of Property: W `-~~ $ ~ NN 1 E ~~p-~n~
Suffolk County Tax Map No 1000, Section ~ 2' 2 Block ~} Lot ~ Z
Subdivision ~ / Filed Map. Lot:
Permit No. 3 40 X53 7 Date of Permit. ~ ~ 6l Og Applicant: ~ t~+~v~(~ C~ , ~] ~~yL-_
Health Dept. Approval: ~ Underwriters Approval:
Planning Board Approval: ~
Request for: Temporary Certificate
~o
Fee Submitted: $ 25
Final Certificate: _~ (check one)
Appli t Si nature
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. 34088 Z Date AUGUST 6. 2008
Permission is hereby granted to:
WARREN JR & ANNIE CROON
2500 OLE JULE LANE
MATTITUCK.NY 11952
for
AS BUILT ~S,~+SB'ALTERATIONS TO AN EXISTING SINGLE FAMILY
AS APPLIED FOR
at premises located at 2500 OLE JULE LA MATTITUCK
County Tax Map No. 473889 Section 122 Block 0004 Lot No. 012
pursuant to application dated JULY 30, 2008 and approved by the
Building Inspector to expire on FEBRUARY 6, 2010.
Fee $
400.00
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
SOUTHOLD, NY 11971
TEL: (631) 765-1802.
FAX: (631) 765-9502
SoutholdTown.NorthFork.net PERMIT NO. ~~~~ ~
Examined , 20
Disapproved
4 sets of Building Plans
Planning Board approval
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Storm-Water Assessment Form
Contact:
20 Mpa~il_to: ~. ~~ L~L.
/ krR:J 2
I Phone: ~ L ` S~~
20
A>PLICATION FOR BUILDING PERMIT
jU~
~ Date ~~ L~ ~ , 200u
L` ' f, ,
y.--~~, _ ~ = : ~-~ t~t~ ~ INSTRUCTIONS
a.Tt s ygp~ication 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 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 the Building Inspector
issues a Certificate of Occupancy.
E 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 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 r lations, and to admit
authorized inspectors on premises and in building for necessary inspectio ~..,/~ ~n
U/l.f
i + (Signatur~applican[ or name, if a corporation)
,; 1`12, M~~ irk. tNy
(Mailing address of applicant) '
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises ~, 2 ~~.lN L
(As on the tax
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate
Builders License No._
Plumbers License No. _
Electricians License No.
Other Trade's License
1. Location of land on which proposed work will be done:
House Number Street
or latest deed)
Hamlet
County Tax Map No. 1000 Section ~ 22 Block ~- Lot_
Subdivision - Filed Map No. Lot
(Name)
12
2. State existing use and occupancy of premises and intended use and occupancy
a. Existing use and occupancy ~ 11ypf~, ~ 1 11y~
construction:
b. Intended use and occupancy S~~ ~ .
Nature of work (check which applicable): New Building Addition Alteration_
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost ~-
Fee
(To be paid on filing this application)
If dwelling, number of dwelling units - Number of dwelling units on each
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front ~ ~J Rear ~~ Depth c~-~
Height <4 Number of Stories 1 '/2
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:
Rear Depth
Height Number of Stories
9. Size of lot: Front ~ ~~ Rear ~ ~ Depth I ~ / c ,.-,
10. Date of Purchase 12 / ~~ ~ Name of Former Owner W~~EI'~ ~.iN ~I""
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO )L
13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES_ NO '~
14. Names of Owner of premises W 1^ -~ec~ Address DlX Tdl . eJ Phone No. ~ ~`~
Name of Architect P t Address f~vrf~111X%C Phone No Z~tP, - 545
Name of Contractor - Address Phone No.
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. p,~ per, oF, ~~ S
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 x
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
CO OF 5~ ~--
I~F-~ being duly sworn, deposes and says that (s)he is the applicant
ame of individua signing 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 mamier set forth in the application filed therewith.
Sworn to before me this
_~~y of C' 20~~
1
~ El
to of New York
No.3b-4741154
!]ualified in Nassau / S~ffofk Coyhtieg,:,
Commission Exuires //.~ il~
3~agg z,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING FINAL ~ `,
[ ] FIREPLACE ~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUC710N [ ] FlRE RESISTANT PENETRATION
REMARKS:
DATE ~~ ~~~ ~ ~ INSPECTOR '~~~~
3`f'oB~Z
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION 1
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [~(~FINAL
[ ]FIREPLACE 8~ CHIMNEY [/ ]FIRE SAFETY INSPECTION
[ ] FlRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATI01
REMARKS: ~ ~ -v~-~
it-wd'L2. N
fir-- 2-~ i ~'' ~ ~ u ~' , /(l ~
~- ~,-- ~ ~
DATE b ^ 7~ o g INSPECTOR ~/~`~ ''~
DONALD G. FEILER •ARCHITECT
11725 Maln Rd • Box 1692 • MaBituck, NY 11952 • 631.2985453 • Fax 2981380
July 24, 2008
Mr. Damon Rallis
Town of Southold Building Department
Town Hall, Main Road, Southold, NY
Re: Croon Residence
250D Ole Jule Lane
Mattituck, NY
Dear Mr. Rallis:
I have investigated the existing sewage disposal system at the above mentioned
project, and can verify that its capacity meets the requirements of the Suffolk
County Department of Health Services for three bedrooms at the existing single
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DAT~:.~~.. B•r
FEE~.d~L- BY: J
NOTIFY BUILDING DEPT
765-1802 8 AM TO 4 PI
FOLLOWING INSPECTIO!\
1. FOUNDATION -TWO
2, - H _ FRAMING & PU
3.
4, . CONSTRUCTION
aE FOR C.O:
ALL
w
Eu,15T1*1Ca 2NO ~~ tr.1~~ SPP~E !~
plN-s-~ ~~oR, To 1964. To ZNE: , ~
bt~T oP MY ~.tOhILEQ'aE,~}E corkST'~i~rl~-+
Cor-IFot~MS To 'THE: 1`I`~S b~I1,D~N(~
cotes. ~ EM~`1 con ~ 1~R 198~}~,_'~~
{-=--
ALL
cq
COMPLY WITH7~-Lti°°~~
AS REQUIRED ANQ COND TIONS S
gpln}IpLDTOYVNZBA
SOUTHOl.D10YVN pIgNNINGIlOAFp
SOUiHOID TOWN iRtlSiEES
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N PLUMBER CERTIFICATION .
°~"~~ ON LEAD CONSENT BED
--~ CERTIRCATE OF ~ i ~ }
$04pEA ~1SH? MI YIGi~ 1 ~ ~..J
' ~ SUP.PLY~~~ ~
,...; . T~ ,.. ,~_
_, __. __ ___ . i l
~-1__.!
ALL CONSTRUCTION SHALL
'MEET THE REQUIREMENTS OF THE'. , k ~
CODES OF NEW YORK STATE. ' '' ~ F --!
~~ ~
- i ~ ~~
OCCUPANCY ti__1
GE.c ~- ~~--t.~~.~w )
~~I.CaN'~ ' ~ OR
USE IS UNLAWFUL
---
"`J°R ~ ~j NCO ~ I ~ fi ~ y~ ~, ~ ~ ~. ~~ `•-i
~_ _ /4,,~
WITHOUT CERTIFICATE
OF OCCUPANCY
--~~-
FLOODZONE
COMPLY W1tH CHAPTER "46'
FL000 D/NNR(;E PF~NENTION
SOUTHOLD TOWN CODE.
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