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Home My WebLink About34444-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD/~CY No: Z-33573 Rte: 02/27/09 THIS u~KTIFIES that the building ADDITION Location of Property: 2555 YOUNGS AVE APT3A SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) Cotult¥ Tax ~ap NO. 473889 Section 63 .1 Bl~k 1 Lot 11 Su]~division Filed Map No. -- Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 2009 pursuant to which Building Permit No. 34444-Z dated FEBRUARY 20, 2009 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 "AS BUILT" HANDICAP RAMP ADDITION TO AN EXISTING ONE FAMILY DWELLING (UNIT 3A) AS APPLIED FOR. The certificate is issued to HERBERT H JR & NORMA S WELLS ( OWNER ) of the aforesaid building. SuFfOLK COU1F~Y DEPARTbH~NT OF HEALTH ;%PPROVAL ELE~-rKICAL ~-£IFICATE NO. PL~ CERTIFICATION DA'£~O N/A N/A N/A 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 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 Constmction: Old or Pre-existing Building: LocationofProperty: g2, ~-_ff~5 (0cd~fl~/5 ~-r.~? ~ ~.~'~ House No. S OwnerorOwnersofProperty: -~ _ .~,~.,~:,~.~. .Cf,-~C'] ~ Suffolk County Tax Map No 1000, Section (.495. I Block (checkone) Hamlet Lot I ( Subdivision Permit No. Health Dept. Approval: Date of Permit. Filed Map. Lot: Applicant: Pg/DFFr'WA. S, ~)~/ 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 COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 34444 Z Date FEBRUARY 20, 2009 Permission is hereby granted to: NORMA S WELLS 2555 YOUNGS AVE APT3A SOUTHOLD,NY 11971 for : AS BUILT H3~NDICAP P~AMP AS APPLIED FOR. at premises located at 2555 YOUNGS AVE APT3A SOUTHOLD County Tax Map No. 473889 Section 063.001 Block 0001 Lot No. 011 pursuant to application dated FEBRUARY 20, 2009 and approved by the Building Inspector to expire on AUGUST 20, 2010. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECT [ ] FOUNDATION 1ST [ ] RO [ ] FOUNDATION 2ND [ ] [ ] FRAMING / STRAPPING FINAL PLBG. ;ULATION [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CO~UCTI~ ~] F~E.~RESISTANT PEN ETRATION REMARKS: '-'~ INSPECTOR FIELD INSPECTION REPORT FOUNDATION (1ST) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE F~ ~DITION~ CO~ENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Exami.¢d C>V/ )O ,20OC/ Approved q:~/~x)O , 20 c~ q Disapproved a/c Expiration 2/O-~(.,) ,20/~ BLDG. DEPT. TOWN OF SOUT}fOLO PERMIT NO. a-~ ~/"?/'~/x?/ 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 Flood Permit Storm-Water Assessment Form Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 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 Cerlificate 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 cfa 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. ALL CONSTRUCTION SHALL (Signature of applicant or name, ifa corporation) MEET THE REQUIREMENTS OF THE C./ CODES OF ND,'~ Y,5-4 STATE, c2¢---5'-.>-- /o~'*/,¢ ..< ,/':)o,-e, (7/2J- ,.::,0 ff-~ (Mailix{g address of ~ppliefint) State whether applicant is owner, lessee, agent, architect, eng/neer, general contractor, electrician, plumber or builder APPRO /ED AS NOTED , Y~' Name of owner orp emises 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. 1. Location of land on which proposed work will be done: · .6'-,5-6- F)-o Op¢- 3 0 House Number / Street ~ (As on the tax roll ot4{hqf~at d~ufld~)lNG DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. iNSULATION 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 s sT. ¢y5. ERRO.S. County Tax Map No. 1000 Section ~'~_~. / Block Subdivision ~Hamlet / Lot // Lot Filed Map No. 4. Estimated Cost ~J/~7/ ~. (y 5. If dwelling, number of dwelling units If garage, number of cars State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy,._~/_x~-~! b. Intended use and occupancy /¢; ._~,¢;~ ~~ ~ Nature of work (check which applicable): New Building_ Addition Repair Removal Demolition Other Work Alteration Fee (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. Dimensions of existing structures, if any: Front Rear Height Number of Stories Dimensions of same structure with alterations or additions: Front ~ , Depth. Height Number of Stories Dimensions of entire new construction: Front Rear } Height Number of Stories I, Size of lot: Front Rear Depth Depth Rear 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. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater 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 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. 18. Are there any covenants and restrictions with respect to this property? * YES__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) COUNTY OF~ ,fr~lR. S)S: /k//O tr rlq ¢. (/(J q-,/[~ 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. Sworn to before me this ~ ofit9 dayof ~/~.~ 20 Notary Public VlCKI 'lOTH otary Public, State of New Yod, No. 01T06190696 Qualified in Suffo k Coum~ Commission Ex~ires luh/2~;.,_~ / 2.-- Signature of Applicant