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Home My WebLink About32999-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33498 Date: 01/21/09 THIS CERTIFIES that the building ACCESSORY Location Of Propezq~y: 775 JASMINE LA (HOUSE NO.) (STREET) County Tax ~ap NO. 473889 Section 69 Block 3 Subdivision Filed Map No. Lot NO. SOUTHOLD Lot 15 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 2007 pursuant to which Building Pemit No. 32999-Z dated MAY 4, 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 ACCESSORY SHED AS APPLIED FOR. The certificate is issued to NORMAN L & SHIRLEY A WATERHOUSE (OWNER) of the aforesaid building. SO~OLKCO~I~I"/DEP;%IIT~I~TOF}~g~J~{~,~PRO~ N/A ELECTRICAL c~TIFICATH NO. 3031208 05/17/07 PLI~WBERS C~I~TIFICATION DA'r~u3 N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCU This application must be filled in by typewriter or ink and submitted to the Building BLDG. DEPT. 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, Alteratinns 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. New Construction: N~ Old or Pre-existing Building: LocationofProperty: 775' 03 emt ' House No. Street Owner or Owners of Property: /c/aRm ~J ~ Suffolk County Tax Map No 1000, Section ~t?j,~,~ Subdivision oC00 Walae.O ~ '~ Permit No. ,_¢ ~ ~77 Date of Permit. b~/t/ (check one) Block /5002 Lot Filed Map. Lot: Applicant: A~o~q ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~&~', oO Underwriters Approval: Final Certificate: ~ (check one) icant Signature Hamlet 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 NORMAN WATERHOUSE PO BOX 1215 SOUTHOLD, NY 11971 NORMAN WATERHOUSE PO BOX 1215 SOUTHOLD, NY 11971 Located at 775 JASMINE LANE SOUTHOLD, NY 11971 Application Number: 3031208 Certificate Number: 3031208 Section: Block: Lot: Building Permit:22376 BDC: ns11 qclq Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: utility building, Detached Garage, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 17th Day of May, 2007. Name QTY Rate Rating Circuit Type Panels 1 50 3 Wiring and Devices Receptacle 13 0 General Purpose Switch 4 0 General Purpose Fixture 1 0 Incandescent Defects previously reported, as items of non-compliance, have been corrected. A visual inspection made of the exposed electrical equipment in the premises indicated found no obvious unsatisfactory condition. seal 1 of 1 This ce~ificatemay not be altered in any way and is validated only by the presence of a raised seal atthe location indicated. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERi'IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32999 Z Date MAY 4, 2007 Permission is hereby granted to: NORMAN L WATERHOUSE PO BOX 1215 SOUTHOLD,NY 11971 for : CONSTRUCT AN ACCESSORY STORAGE BLDG. TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP # 22376 at premises located at 775 County Tax Map No. 473889 Section 069 pursuant to application dated MAY Building Inspector to expire on NOVEMBER JASMINE LA SOUTH/PEC Block 0003 Lot No. 015 3, 2007 and approved by the 4, 2008. Fee $ 35.00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT $OUTHOLD, N.Y. 223?6 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE VvORK AUTHORIZED) ~,e ...... ~.....~.Z. ........................ ,~.Z.,Z... Z atpr~r,~s,~ot~at ........ .'Z...Z..~.... ............. ~...~....~ ........... ~ .......................................... ................................................. .~.~'..~.~..o../~.. ............ ~.~ .. ?:.... ................................... ~oun~TaxMap.a. ~000 s~otion ........ 4.? ....... ~,o~ ......... ~ ............. ~ot.o.....Z;.~~' pursuant to application dated .............................. ~.~...~.7z ~...~. ................ 1 ~..~....~......., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] I/N~L/At~ [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE~A-FETY INSPECTION REMARKS: ] FIRE RESISTANT CONSTRUCTION ] FIRE RESISTANT PENETRATION DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION REMARKS: (/?./~.-- [ ] ROUGH PLBG. [ ] IN_./SULATION [~3"~INAL [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT PENETRATION DATE ~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND I ]INSULATION [ ] FRAMING [ ~FINAL [ ] FIREPLACE & CHIMNEY · ~ ,~/ /~ REMARKS_J, ~~ ~-~ ~-~)/~/ DATE INSPECTORl ~~---~ 765-1~02 BUILDING DEPT. INSPECTION [ ION 1ST [ ] ROUGH PLBG. [/,~ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE INSPECTOR BUILDING DEPT. INSPECTION ULATIO~! PER'~. Y. STATE ENERGY CODE COM~UYS :. ~ FI;;AL ~DDITIO~IA'L TOWN OF $OLm.IOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... //. (Building Inspector) ZLICATION FOR BUILDING PERMIT URVEY ...... ~ .... ' EPTIC FORH ....... C^LL . 7~5:.L~. ...... MAIL TO: Date .................. , 19... INSTRUCTIONS 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 giving a detailed description of layout of properW must be drawn on the diagram which is part of this appli- cation. ' 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 issued a 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 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 i.~ec.~ .C~..~.~ .......... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... 0~o .o..~...~ ................................................................ Nameofownerofpremises ...~..O.~..t~..~..~..../_...~k..?.~'~.(~..~.~/. ~ [b/~qT~ )~tS/fjL~ ~ ,(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder s License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1.Location of land on which proposed work will be done .................................................. .7. 7...67. ..................... ......... o. ................... House Number Street Hamlet County Tax Map No. I000 Section ....... ~.(~ ........ Block ... ,~ ............. Lot... ].-~. ............. Sobdivision..O~.q ?. ~ ./~.q ?..O .... ~./..A./r. ~.~'. ..........Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~ a. Existing use and occupancy . .F~.( .1(.~.'~.~... Fq.t~...~.. ............................................. ,~ b. Intended use and occupancy ~"T~O ~q~'~' '~" 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... i . ...... (Description) 4. Estimated Cost ..................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars .... ~ ............. . .... 6. If business, commercial or mixed occupancy, specify nature and extent of each ty. pe of use ............ ~ ....... 7. Dimensions of existing structures, if any: Front .~&..~ff.. f ...... Rear . ~,~..'.. ....... Depth ...a~...~ ...... Height ............... Number of Stories /. ~ ................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ......... .. ............ Number of Stories ................. 8. . "! ! ........................... p .. .~. ......... Dimensions of entire n~w construction Front ,/.~ Rear {(~ De th ~ ..... Height .... i~.. ~ .... .Number of Stories .... /. ...................................... ~ .- ........... 9. Size of lot: Front .... 7.~....~.. ~ ........ Rear 7,5~..' Denth /~ O ' 10. Date of Purchase ....... [.~[.0:.([.~...2.,:.... ......... 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 regraded .... ~/-QA ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . ~.P~O.Z,. i C~ .~.-C ...... Address '2.7..~...~-.a!. I .q .~./~ Phone No. ~: ($ .7.~ .... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No .... ' ............ 15. Is this property within 300 feet of a tidal wetland? ~Yes ........ No..~. ..... *If yes, Southold Town Trustees Perm±t may be requJ, red. 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 Int. STATE OF NEW YORK.._ S S COUNTY OF .... .~.~ ~.~ .~.~-... ' ......... b,io~t~,~,,~M ...~7'.;..k/~... ~..A~...~..~...~.:~.... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .......................... . .~..~hte<. ....................................................... (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 manner set forth in the application filed therewith. Sworn to before me this RY PUBLIC, Stat~' -z.,~-,---','~-,q .~. p.z.: .,f~/(..t~-:~'.... AREA .= 12,000 Prepered In eccordonce wllh Ihe minimum slondords for lille surveys es estoflllshed by Ihe L.I.A.L.S. end approved end odopfed lot such use by The New York $1ele Lend Tllle Assoclollon. The weler supply end sewege dlsposol syslems Ior lhls residence will conform Io Ihe slendords of The Suffolk Counly Oeperlmenl of Heallh Services, The locations el wells and cesspools shown hereon ore from field ohservofions end or from dole obfalned from olhers. SUFFOLK COtJHTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE HS. REF. NO, ArPROV£D SURVEY OF LOT 4 "MAP OF SOUTHOLD VILLAS" FILED MAP NO. A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 70 - 01 - PlO 06 Sca/e: I"= 30' March 11, 1992 ~YORS, P.C. ~0 N.Y. 11971 ~j~FY B[ULDING-DEP~AT 7~5-~802 9 AM TO ~ ~ FOR THE c{~[I OWP~G INS~CTIONS: ,':'~ mH),~Ok' ~R%~O REQUIRED T~E REQUIREMENTS OF THE N,Y. ~TATE CONSTRUCTION & ENERGY CODES NOT RESPONSlB~ FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 1 Doo~ ] J _ i. ]. ]] I ! , II I 'l ' I ]i ...... [! .... T_L E[ .... I1 .......... Z.L ............ [11