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Home My WebLink About32855-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33423 Date: 12/09/08 THIS CERTIFIES that the building FOUNDATION REPAIR Location of Pr~erty: 1600 WATERVIEW DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 78 Block 7 Lot 33 Sul)division Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 26, 2007 pursuant to which Building Penuit No. 32855-Z dated MJ~RCH 28, 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 FOUNDATION REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LINDA S CARLSON ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPAR~)U~NT OF HE~J~TH ~PROVAL ELEc-i'RICAL CERTIFICATE NO. PL~ CERTIFICATION DA'r~D N/A N/A N/A Authorized Signature Rev. 1/81 Form No. 6 , ..~ so ca ~ 11 ~ I"< t '~,; BUILD~G DEP~TMENT t ~g~[ ~- ~¢ APPLICATION I~OR CERTIFICATE O1~ OG~U_~¢g p ' T :; .... This application must be filled in by typewriter or ink and suN~tted to the Building Department with the following: A. For new building or new use: l. Final survey of property with accurate location of all buildings, propel%, lines, streets, and unnsual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sexverage-disposal (S-9 form). 3. Approval of electhcal installation fi-om Board of Fire UndemqSters d. Sworn statement fi-om plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Co~mnercial building, industrial building, multiple residences and similar buildings and installations, a ceriificate of Code Compliance from architect or engineer responsible fbr the building 6 Submit Planmng Board Approval ofcompleled si~e [)lan requirements For existing buildiags (prior to April 9, 1957) nou-confo~ming uses, or buildings and "pre~existing" land uses: I Accurate sum;ey ofpropel~y showing all p~operty lines, st~ceis, building and unusual natmal o~ topographic fkatures. 2. A properly completed application and consent to inspect signed by lilt :q)plicallt Ifa Certificate of Occupaacy is denied, thc Building lnspecto~ shall state thc ~easons the~cf~t in xx nling lo tim applic;~nl C. Fees I. Certific:~leofOccupancy-Newcwe lf,.$25/l[./',dditio~; ocwc: ~[,.~2q &ltci:~t~c, ns to cwclling $25.00, Switmning pool .$25.00, Accessoo' building ~25 0()..&dclitmns 1,~ a. ocs.,o~ ,, Imildinj, $25 00. Businesses $50.00 3 Copy of Cetlificate of Occupancy- $25 4 Updated CertitSc;l~c ef Occupal~cy $50 New Construction: __ Old o~ ~m-existmg Building: House No Sired Hamlet' Snbdivisi<m I:iled Health Dept Approval: Plamfing Board Approval: Request for: Temporary Certificate Fee Submitted: 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. 32855 Z Date MARCH 28, 2007 Permission is hereby granted to: LINDA S CARLSON 1600 WATERVIEW DRIVE SOUTHOLD,NY 11971 for : REPAIR A FOUNDATION ON AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 1600 WATERVIEW DR County Tax Map No. 473889 Section 078 Block pursuant to application dated MARCH 26, 2007 SOUTHOLD 0007 Lot No. 033 and approved by the Building Inspector to ex/Dire on SEPTEMBER 28, Fee $ 2008. 00.oo Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~FOUNDATION 1ST [ ] ROUGH PLBG. ~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [~X~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: DATE FO~A~ON (1ST) ~-)~ 0 ~ -- ROUGH ~G & PL~G / / ~SULATION PER N.Y. ~]/,/1. STATE E~RGY CODE F~ ~D~ION~ COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 !/~R 2 6 ? TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ PERMIT NO. Examined ~,~~?. , 20~=}~__ Approved ,20~/ Disapproved a/c / Expiration J/~ ,20 ~ 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: ~ Mail to:. Butld~ng In~pe APPLICATION FOR BUILDING PERMIT Date5~ (c:> INSTRUCTIONS ,20 Or) 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 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. 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 regulati93s,~and to admit authorized inspectors on premises and in building for necessary inspections...~ /~ /~/~,/( Sigfi.aturC¢~j//c'arff °r~e' ~rP °rati°n) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ , b,.._ (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. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which, proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision Hamlet Block ~ Lot Filed Map N,o. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ;~ ~ b. Intended use and occupancy ~ ~ 3. Nature of wedlock (check which applicable): New Building Repair ~ Removal Demolition 4. Estimated Cost ~C')O. (~ 5. If dwelling, number of dwelling units ~ If garage, number of cars Fee Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor I 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear .Depth Height. Number of Stories Dimensions of same structure with alterations or additions: Front ~/'/lt'' Rear Depth. Height Number of Stories 8. Dimensions of entire new construction: Front ~ X~ Height Number of Stories Rear .Depth 9. Sizeoflot: 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 __ 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES__ 14. Names ofOwnerofpremises~]/~J& ~---F~.r/5OP-'Addressff~/D(9'' ~-/zJ~'rtJ,'C '.D,&,, Name of Architect Address Name of Contractor Address 15 a. Is this property within 100 feet of a tidal wetland or a tYeshwater wetland? *YES * 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. NO NO '~_ ~Phone No. Phone No ~ / ~ ~5-1500 Phone No. 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 ///~1~ 5 .~£ //~J)~'.~'~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual 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 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. Swo[n,~ before me thi~l \ [O ~ dayof Notal~ublic 20 63 ~/Si~ture of ~pplicant ME~z~,NIE DOROSKI NOTARY PUBLIG, State o~ No, 01D04634870 Qualified in Sufl01k Cou~ Co~sion ~ir~ September 30,~ 0 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. APP, ROyED AS NOTED OATE:~'~/__.~__ ~ p # ~iEoET: F~y B~UiLDiNG i~i:'F ~ ~M ENT A'~T 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR USEIS UNLAWFUL WITHOUT CERTIFICA- OF OCCUPANCY JOSI:PM I-1~5(JHE~-I ~, ¢~ PROFESSIONAL ENGINEER 1725 HOBART RD/PO BOX 616 SOUTHOLD, NY 11971 631-765-2954