Loading...
HomeMy WebLinkAbout34204-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33345 Date: 10/21/08 THIS CERTIFIES that the building REPAIR Location of Property: 650 ORCHARD ST (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 25 Block 4 Subdivision Filed Map No. Lot No. ORIENT Lot 8 ( HAMLET ) conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 7, 2008 pursuant to which Building ~emit No. 34204-Z dated OCTOBER 7, 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 PORCH REPAIR AS APPLIED FOR. The certificate is issued to SUSAN J & EUGENE MOISA (OWNER) of the aforesaid building. S~FFOLK COUI~TYDEPART~FFOF HKALTHA~PROVAL N/A ELE~-~'KICAL c~KTIFICATH NO. 1191238 01/30/04 PLU~EP.S CERTIFICATION DA'r~43 N/A /ri ze/S ign~ure Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: 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. 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-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 Bnilding - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cmmnercial $15.00 New Construction: Location of Property: Date. OcT 1'7, Old or Pre-existing Building: i-'~' (check one) House No. Street Hamlet Owner or Owners of Property: ~'U Suffolk County Tax Map No 1000, S~c~l~on$8~-/ Subdivision Permit No. -~ q/~Oq ~. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~,.~ ~, OO o,--.S Cl5, A/ Block Filed Map. Date of Permit. ~ 7 ,~OO,ff" Applicant: ooo ~4 Lot Lot: Underwriters Approval: Final Certificate: ~" (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE'~'' ~ -~ NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by Q.C. ELECTRIC INC. MR. & MRS. MOISA P.O. BOX 518 650 ORCHARD STREET LAUREL, NY 11948-0518, ORIENT, NY 11957 Located at 650 ORCHARD STREET ORIENT, NY 11957 Application Number: 1191238 Certificate Number: 1191238 Section: Block: Lot: Building Permit: BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of ,='1 electrical devices and wiring, described below, located in/on the premises at: First Floor, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 30th Day of Janua~¢, 2004. Name QTY Rate Ratin~ Circuit Twe Appliances and Accessories Oven 2 0 4.5 KW Dish Washer 1 0 1.2 KW Wiring and Devices Receptacle 11 0 General Purpose Switch 9 0 General Purpose ~ Fixture 16 0 Incandescent Dimmers 5 0 Va Receptacle 1 0 20 amp Laundry Va Receptacle 3 0 GFCI Va seat This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Va 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. 34204 Z Date OCTOBER 7, 2008 Permission is hereby granted to: SUSAN J & EUGENE MOISA 650 ORCHARD STREET ORIENT,NY 11957 for : PORCH REPAIR IN PLACE, IN KIND AS APPLIED FOR. THIS PERMIT REPLACES BP 29972. at premises located at 650 ORCHARD ST ORIENT County Tax Map NO. 473889 Section 025 Block 0004 Lot No. 008 pursuant to application dated OCTOBER 7, 2008 and approved by the Building Inspector to expire on APRIL ,.--%, '2~4~0. / ~ Fee $ 150.OS ~ ~~ / / '~r~rize~)gnature ORIGINAL Rev. 5/8/02 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. ~9~72 Z Date DECEMBER 23, 2003 Permission is hereby granted to: for : PORCH REPAIR IN PLACE, SUSAN J MOISA 650 ORCH~LRD STREET ORIENT,NY 11957 IN KIND AS APPLIED FOR at premises located at 650 ORCHARD ST County Tax Map No. 473889 Section 025 Block pursuant to application dated DECEMBER 12, 2003 Building Inspector to exq~ire on JUNE 23, ORIENT 0004 Lot No. 008 and approved by the 2005. Fee $ 150.00 ! Authori zed- Signature Rev. 5/8/02 ORIGINAL BUILDING DEPT. INSPECTION [~..']~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] Fou~u~IDATION 2ND [ [ ~]'"F~ING [ [ ] FIREPLACE & CHIMNEY REMARKS: ] INSULATION ] FINAL DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING [ ~NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PF.I~t ~.ATION REMARKS: ~~~. DATE //~O//~/~ INSPECTOR ///~/~///~ OWHER Ii TOWN OF SOUTHOLD BUILDING DEPA~. TMENT TOWN HALL SOUTHOLD,'NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: Expiration ' '~;~ Building Inspector :APeLICATION FOR BUILDING PERMIT INSTRUCTIONS Date~ 'k ]t~~ ,20 0.3 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 Pemait. 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 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~'~ignature of applicant~r naSne, if~-corporation~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ,5 C/,5,0-tl/ ~. /~ 0/$~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. c~ l C) [ ~ --' ~ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block ~t Lot ~ Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed consl~mction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work,~heck which applicable): New Building Repair ~ Removal Demolition 4. 5. Estimated Cost If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height_ Number of Stories Rear De[~, Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Size of lot: Front Rear _Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO__ 13. Will lot be re-graded? YES __ NO__Will excess fill be removed from premises? YES__ NO__ 14. NamesofOwnerofpremises ~'qSg-,~ ~ P/o/.~Address 15-$ rp/~C/¢,0~/) 5rPhoneNo. Name of Architect Address Phone No Name of Contractor ~ob~2F- J'*'lC Go/~ Address P~b/jv J~O (2~Pd~e 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 ora 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. STATE OF NEW YORK) SS: COUNTY OF ) ~(,{S~f ~ 1~) ~ ~'~<'1 being duly swom, deposes andsaysthat(s)heistheapplicant (Name of individual signing contract) above named, (S)He is the C) L&) N' ~ (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 tree 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 this /~ day of~ 20 ~,..~ ~ Not airy P~b~ic ~ Signatur~[Jof P~pplic~4~t /~oo- ~. ~/. ~ TOWN OF SOUTHOLD PROPERTY REC:ORD CARD OWNER STREET ~C) VILLAGE DIST. ' S, UB. LOT ,ES. ~"16 SEAS. VL. FARM COMM. CB. MISC. Mkt. Value ~ND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION -~- , N~ NORMAL BELOW ABOVE FA~ Acre Volue Per Volue Acre loodland wampland .. FRONTAGE ON WATER rushland ; FRONTAGE ON ROAD / ~ o ~ ~"~ ~ 7 ~ 0 louse Plo, DEPTH /~ ~ BUkKH~D M. Bldg. Extension Extension Extension Porch Porch Geroge Total Foundation Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Driveway ,z( 77 Bath Floors Interior Finish Heat Rooms ] st Floor Rooms 2nd Floor Dinette LR. DR. BR. FIN. B. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631 ) 765-9502 Telephone (631 ) 765-1802 March 26th, 2008 BUILDING DEPARTMENT TOWN OF SOUTHOLD 2Nb NOT'J:CE Susan ,7. Moisa 650 Orchard Street Orient, N.Y. 11957 RE: 650 Orchard St. 5.C.T.M. # 25.-4-8 Dear Ms. Moisa, Please be advised that your Building Permit # 29972 issued Decembe~ 23rd, 2003 and Building Permit # ?937§ issued May 14th, 2003 have expired. According to the Code of the Town of Southold, a Certificate of: Occupancy must be issued prior to use of the structure. To renew your Building Permit's, please submit o fee of $300.00; at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, 5OUTHOLD TOWN BUILDING DEPT. BP# 29972 - PORCH REPAI'R - $ 150.00 BP#29375 - ABOVE 6ROUND POOL - $ 150.00 Town Hall Annex 54375 Main Road P.O Box 1179 Southold. New York 11971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD SEPTEMBER 12th, 2008 FIN,~L NOT'~¢E Susan & Eugene Moisa 650 Orchard Street Orient, N.Y. 11957 RE: 650 Orchard St. S.C.T.M. # 25. -4-8 Dear Mr. & Mrs. Moisa, Please be advised that your Building Permit # 29972 issued December 23% 2003 and Building Permit # 29375 issued May 14th 2003 have expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit's, please submit a fee of $300.00: at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. BP# 29972-Porch Repair-$150.00 BP# 29375-Above Ground Pool - $150.00 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 18th, 2006 Susan J. Moisa 650 Orchard Street Orient, N.Y. 11957 RE: 650 Orchard St. SCTM# 025 0004 008 Dear Ms. Moisa, Please be advised that your Building Permit #29972 issued December 23rd, 2003 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit, please submit a fee of $150.00 at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. COMPLY WITH ALL CODES Of NEW YORV STATE g TOWN CODES AS RE ::IU!PES ~,NB Z ONOITIONS OF S.~ ~OL. OWN LC TOWN P~NN~NG ~A~ SO~MOLC TOWN TRUSTEES . N.¥,S. DEC ALL CONSTm~ Ic"rlON SHALL. MEET THE RE: -' :~','~ENTS OF THE CODES OF 'NEW YORK STATE, FLOOD ZONE COMPLY WITH CHAPTER "4(~" FLOOD DAMAGE PR_..~V.E~TION SOUTHOLD TOWN -CODE. UNDERWRITERS CERT1FtCA'rE APPROVED AS NOTEO REQUIREO FEE: NOTIFY BUILDiN:~ DEPARTMENT AT 765-1802 8AM TO 4:M FORTHE FOLLOWING IN.S°ECTION$: 1. FOoNDATION ' TWO REQUIRED ~ FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR ¢.O, AIL CONSTRUCTION SHALL MEET THE REGUIREMENTS OF THE CODES OF NEW YORI~ STATF_ NOT RESPONSIBLE FOR DES~N OR CONSTRUCTION ERROR~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFI(J;~TE OF OCCUPANCY f" CERTIFICATION OF NAILING & CONNECTION8 RE .(~.)RED ..... - . '/.t,;-,,,~c ..