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HomeMy WebLinkAbout34060-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y, CERTIFICATE OF OCCUPANCY No: Z-33516 Date: 01/28/09 THIS CERTIFIES that the building DECK ADDITION I~)cation of Pro~l~cy: 2250 WELLS AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 3 Lot 22.13 Subdivision Filed Map NO. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 2008 pursuant to which Building Permit No. 34060-Z dated JULY 15, 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 DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID E ROBINSON (OWNER) of the aforesaid building. S~FOLK CO~FI~f DEP~R11~EN~r OF HF~%L/"H APPRO~ E~Cll{IC~J~ CERTIFICATE NO. PLU~BM CERTIFICATION DATED N/A N/A N/A Rev. 1/81 JAil 27 2O09 BLDG. DEPT. TOWN OF SOUTHOtD 3 ppi Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ICATION 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 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 New Construction: Location of Property: (check one) Old or Pre-existing Building: House No. Street OwnerorOwnersoferoperty: ~t~-'\~ ~¢\'3\5(~c:''x Suffolk County Tax Map No 1000, Section C~i~ D Block ('DO0 ~ Subdivision Filed Map. Lot: mermitNo. ~ct 0~(3 fL- Dateofmermit. Applicant:~'~t~'-- Hamlet Lot ©~' 015 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signature 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. 34060 Z Date JULY 15, 2008 Permission is hereby granted to: for : DAVID E ROBINSON 56850 MAIN RD SOUTHOLD,NY 11971 CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR THIS REPLACES BP#29228 at premises located at County Tax Map No. 473889 Section 070 pursuant to application dated JULY Building Inspector to expire on JANUARY Fee $ 150.00 2250 WELLS AVE SOUTHOLD Block 0003 Lot No. 022.013 15, 2008 and approved by the 15, 2010. 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 COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29228 Z Date MARCH UNTIL FULL 20, 2003 Permission is hereby granted to: ASSOCIATES INC GENDOT PO BOX 361 WADING RIVER,NY 11792 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE F~4ILY DWELLING AS APPLIED FOR at premises located at 2250 WELLS AVE County Tax Map No. 473889 Section 070 Block pursuant to application dated MARCH 10, 2003 SOUTHOLD 0003 Lot No. 022.013 and approved by the Building Inspector to expire on SEPTEMBER 20, 2004. Fee S 150.00 ~~~~~ Autho ized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Disapproved a~c [/ Expiration ~ , 20~ PERMIT NO. ~ Z~Y~L.~ 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: APPLICATION FOR BUILDING PERMIT Dat~ , 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 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 pemfit 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. (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 (As on the tax roll or'latest deed) If applicant is a corporation, signature of duly authorized officer and htle of corporate officer) Builders License No. I:~: :~'7~ 1--[ ~ Plumbers License No. Electricians License No. Other Trade's License No. ~':~ocation of land on ;~~ will he dane' ~ ~ ~,~ House Number Street Hamlet County Tax Map No. 1000 Sect~on~ ¢~?, ',' )Block "~g~;)~ ] Subdivision J-~/&':-o--r t-lt:::~r_ _~,~-,-/',~-t6_~.~ Filed Map No. (Name) Lot t~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I .~'-A~O,T_.L_c-'[ '~>d__t~;1 ! ~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost ~l~)~::t~,°r~ 5. If dwelling, number of dwelling units ]',/~- If garage, number of cars ~ ~- Fee Addition Alteration Other Work Z~)' X ~0 ' 'I2~t' ~ (Description) (To be paid on filing this application) Number of dwelling units on each floor ],4,/1, 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~J/~ 7. Dimensions of existing structures, if any: Front ~Z ,~-~ Height ,~5' Number of Stories ~- Depth ~q. 7' Dimensions of same structure with alterations or additions: Front ~.~ Rear Depth ~, ~.~' Height /~/ff_- Number of Stories ~/C. 8. Dimensions of entire new construction: Front ~//~ Rear ,~)' Depth Height .~> ' Number of Stories I ( D~_M. 9. Size of lot: Front ~i/-~ Rear ~>'~. ~-~, Depth ~ate of Purchaselt~J~[[~[l~ 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 k~r ~[~ames of Owner of premises ~'Name of Architect "~ Address Phone No. Address Phone No Name of Contractor Address Z'O"/ff-- ~F9~O~ Phone No. '7:~:g4 -t-/Od[) 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 ~B~ 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 properly 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, (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 manner set forth in the application filed therewith. Sworn to before me tiffs [(_~ dayof ~-~ - 0qotary Public LYNDA M. BOHN NOTARY PUBLIC, State of New York No, 01 BO6020932 Qualified in Suffolk Coun~t_` Term Expires March 8, 20 ~ /'~ ' 'Sl"gnatu~Appl'i"cf ~' 7 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY ROUGH PLBG. INSULATION FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT ~CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: .~-~ ~~-~ DATE 7'- ~'-~---C ,~ INSPECTOR 76S*~.802 BUILDING DEPT. /JNSPECTION [[ ]~F~~I,~ 12SN~ [[ ]] iRNOsUuGLHAT~BNG' [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMN~E.~ DATE .O.ner's.Noms ~C~:~--~lC~k.~ ~-E_~ j~ No. Overhead Door/Ope,nin. g [nformation ~UTTER DRAIN DIREC~ON ENOWALL OVERHANG VaOTH SIDEWALL OVERHANG Vented WIDTH (c,~ o~) Non-Ve~ted Ltl ~ ~ } i i STA~E.CONSTRU~ION 1 ENER~ ~!!~ · ~ ~ : i :.?:f:.:.~ ?:.::.:.::.:.~ .::..::. :.:f:.:::; .... :: ..... ...... ~.~..~ ...... ...... ...... ~ ..... ...... ...... ...... . ........... ~ .... ..... ~:~ :~::: :~::~ :::: :::::::::::::::::::::::::::::::::::::::::: :::: :::::::::::::::::~:::~::::::: ...... ~ i ..... i ~...:..i..:.../ / i ....i.....:..~ ] : i : : : ~ .i FORM 86A 5/01 (Use Largest Scale Possible) Date: Owner's Signature: ~JTTER DRAIN DIREC]]ON ENOWALL OVERHANG ~D~-I SIDEWALL OVERHANG VifD~-I Vented ¢c.~, ~,) No~-Vented Job No. MAIN BUILDING ROOF PITCH: __/12 PORCH/LEAN-TO ROOF PITCH: __/12 EYEBROW OVERHANG ROOF PITCH __/12 FOUND^I~ON ( ) Overhead Door/Ope,nin. g Information *u. linE.ams .~[ .em~. O~e Square Equals Feet FORM 86A 5/01 (Use Lorqest Scole Possible) Date: OWTt~S Signature: LOT AREA= 57,6~-1 sq. ft ROAD L~54. 14' 70. / / j · S 2..¥25'50"E 170.00' N 25'25'50'W 12783' N 24-'11'10'~V 12501' N 30'14-'20'W 75.72' ~AP OF ~ HO~ ESl'AI~S. SEC~ 1 LOT NUMBER 1 LOT NUMBER 2 NOTE: CESSPOOL, SEPTIC TANK & WATER SERVICE LOCATIONS BY OTHERS. 8-22-2002 FINAL SURVEY 6-4-2002 LOCATED FOUDATION 4-3-2002 REVISED DWELLING JOB No. 01-617 FiLE No. PECONIC DEVEL. CORP. SURVEYED FOR DAV1D~ E. ROBINSON LOT NUMBER 15 MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD SITUATED AT SOUTHOLO TOWN OF SOUTHOLD - SUFFOLK COUNTY N.Y.