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HomeMy WebLinkAbout32701-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33636 Date: 04/07/09 THIS u~KTIFIES that the building ADDITIONS Location of Property: 175 KOKE DR (HOUSE NO.) County Tax Map No. 473889 Section 78 Subdivision Filed Map No. __ SOUTHOLD (STREET) (HAMLET) Block 7 Lot 47 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 5, 2007 pursuant to which Building Permit NO. 32701-Z dated FEBRUARY 6, 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 FIRST AMD SECOND FLOOR DECK ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JEFFREY L & KATHRYN CHAGNON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPART~T OF HF~J~T~ APPRO%L~L ~LECTRICAL CE£TIFICATH NO. pLiERS CKKTIFICATION DATED N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD * BUILDING DEPARTMENT TOWN HALL ~ APPLICATION FOR CERTIFICATE OF OCCUPAN This application m23t b21~ ~Y typewriter or ink and submitted t° the BuildingDe A. For new build' g o : I'"--.~.,.~'~t~n,n. 1. Final survey of property with accumte location of all buildings, property hnes, s~ 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. 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 masons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Ahcrations 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: House No. Owner or Owners of Property: ~J,~-~'~F'~?~'~ Suffolk County Tax Map No 1000, Section / o 00 Subdivision Pennit No. ~,'~)~--~ \ Old or Pre-existing Building: 17.5' ~/(O /(E- ,D tq , Date of Permit. Street L. ~0 Date. (check one) q Hamlet Block t5 7 Lot 0 ~7 Filed Map. Lot: Applicant: -,J Eff'('tq~ ~ t · Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 2 g'"o O O Final Certificate: (check one) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 32701 Z Date FEBRUARY 6, 2007 Permission is hereby granted to: JEFFREY L CHAGNON 175 KOKE DR SOUTHOLD,NY 11971 for : CONSTRUCTION OF FIRST & SECOND FLOOR DECK ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (REPLACES BP #28398-Z) at premises located at 175 KOKE DR County Tax Map No. 473889 Section 078 Block pursuant to application dated FEBRUARY 5, Building Inspector to expire on AUGUST SOUTHOLD 0007 Lot NO. 047 2007 and approved by the 6, 2008. Fee $ 150.00 ~horizel% Signature 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. Date MAY 16, 2002 Permission is hereby granted to: JEFFREY CHAGNON 175 KOKE DRIVE SOUTHOLD,NY 11004 for : CONSTRUCTION OF FIRST AND SECOND FLOOR DECK ADDITIONS AS APPLIED FOR at premises located at 175 KOKE DR SOUTHOLD County Tax Map No. 473889 Section 078 Block 0007 Lot No. 047 pursuant to application dated MAY 16, 2002 and approved by the Building Inspector to expire on NOVEMBER 16, 2003. Fee $ 150.00 AuthoX~_5~e~~ Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING ~FINAL /~ ,' [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE '/~--/~ '- 0 ~' 7651802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. - [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] INSULATION [~"'FI NAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN.~.).TION [ j..j.,f'l NAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR FO~DATION (1ST) FO~ATION (2~) PL~G ~S~A~ON PER N. Y. STATE E~RGY CODE TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-11102 FAX: (631~ 765-9502 ///d ,2o._.7~~ Examined Approved Disapproved a/c Expiration //'//~ / 6~;)- ",'i BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health --~3 sets of Building Plans Planning Board approval PER_MIT NO~~~ --.8urvey.Check Septic Form N.Y.S.D.E.C.  Trustees e: dY/ '7 r 6077 B~g Inspector' ~ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This apphcation. MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector w/th 5 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and ofbuildin~ 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 Bu/Iding Permit to the applicant. Such a permit shall be kept on the prem/ses available for inspection throughout thc 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 fi.om 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. Thareat~er, a new pea'mit 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 ofbaildln~ additions, or alterations or for removal or demolition as herein deschbed. 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. (S~gnaffu'e o~applicant or name,?f a corporation) 0V/ailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~'f~t~Ey L'- A/VI5 ~AT'l'h~[/~' (As on the tax roll or lat' est deed) If applicant is a corporation, signature of duly authorized officer ame o,oo or' 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 Namber Street County Tax Map No. 1000 Section Subdivision 07~?. oo Block 0 7~0 0 : Lot Filed Map No. Lot ------_=. State existing use and occupancy of premises and intended use and occupancy of proposed constmctiofi: a. Existing use and occupancy .~-iL)~to 7' I/ar~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost ,~ ~6vOO, O O If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work ~At~ (Description) Foe (To be paid on filing tlfis 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 Stodes Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories $. Dimensions of entire ne~v construction: Front Rear Depth Height Number of Stories 9. Size oflot: Front /20. OO ! Rear /Z0. OO/ Depth 10. Date ofPurchase ~ _JR/~r, ~O~-NameofFormerOvcner ~/~N'~T-i~r,..~'~""/""¢~"'"~"~'~,,,-, .,,-.- t 1. 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 ~f/Will excess fill be removed fi-om premises? YES NO ~ 14. Names of Owner ofpremises ~Ht~#~al Address ff-~,' r~t~ -- PhoneNo. ~;~d-~-( - tOT~ Name of Architect ~l'r'Le'~,Jt~t?Oo~t 'T ~i~' AddressP°~q ~tw~'t~0"l PhoneNo ~1 ~2} ~5'0 Name of Contractor ,.g'gT,~' Address ~ '- t Phone No. 15 a. Is this property within 100 feet ofatidal wetland or a freshwater wffdand? *YES NO ~ * 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. 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) COUNTY OF ..~.,~,~S: <~¢K/q ~')/ /- ¢~4~'X/¢A/ being dul~ sworn, deposes and says that (s)he is the applicam (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or o~mers, 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 l~lief; and that the work will be performed in the maturer set forth in the application filed therewith. Sworn to/before me tl:fis /~ ^. /(d daytpf /~,~.. /- 200'L' WIMJAM E L£WlS Notaqf .P, ublic, State of New Yo~ No, 01LE499,5882 ~ Qualified in Suffolk County ~omrnission Expires May 4, 20~t~ RES* ~.~/~ [/~ LAND SEAS. TOTAL IMP. FARM DATE PROPERTY RECORD CARD VI LLAGE E 'DIST. SUB. LOT ACR. TYPE OF BUILDING COMM. CB. MICS. Mkt. Value REMARKS AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE -FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland ¢ FRONTAGE ON ROAD DEPTH BULKHEAD DOCK Meadowland House Plot Total 78-7-47 11/01 tension , Breezeway (qorage Patio Total TRIM Foundation Basement Ext. Walls iFire Place !Type Roof !Recreation Room i~,~. , Bath I~"'1~ L.. L.. Floors Interior Finish Heat Rooms 1st Floor .~ Rooms 2nd Floor I Driveway ~-- 72~ !Dinettel LOT ~ = 1.5,000 ¢---~.FT. / / / / I=XI~TII~ TH~ E~TOI~i~ / / / / / / / , / / / SITE PLAN SITE PLAN C, HA~NON RE~II3~NC, F 60RE'r' CREEK ROAI~ (KOKE 13:~1~) ~A'I'VIIEH, N.'f'. ~.C,.T.H.# 0100-075-01-04-'/ C, OUNT~ OF: .5~UFFOLK-, TOHN OF .F:x2UTHOLI]> JEFFREY T. BUTLER, P.E. P.O. t~,OX c---~HO~HAM, NEH TEL.: 6~1.8~21.~8>50 FAX: ~, TYPICAL ~IL 6EGTION ~ , PROPOSED FOOTINO PLAN ' ';i , ~ -- ~ J / ~; m ~ J The Amscan ]nstmtute of ~hite~ Candgions shall apply [ I , .~.00' '~ I ~0 all work pe,o~ed On ~i' p~oje~.OCCUPANCY OR , ' ", , J dis=epancies taus' be brought to the aa--t'on of the Engineer USE IS UN~WFUL I ' '~"~' "~ ' ' I re~onsiblefor~.e~onsnmr~odedoncehehasst.dedwom WITHOUT CERTIFICATE m , I ex~l'orhiddenjobc~d'"ons' 0F0CCUPANCY · I I ~ i J 3. Con,nor shaft guarantee to the Owner that ell remodels and [~ ~ H~TEm J J ~11 be of go~ quelity, free from faults and defe~ for a pedod UNDERWRITERS CERTIFI~TE _ , / I J °f °ne Y~r E°m the date Df the final Cedifi~te °f O~uPan~  - ~ ~ ~ ~ meth~s, te~niques, sequences or proc~ums, er for ~e ~ ~.m.c. m : / J shell not be resp~sibte for Ihe ~n~ctom failure to ca~ out ' : ' ' r ' ' ' I I : .,, J U II H H ~ Insurance ~vemge including ~lauto~ p~l~es (WoAer NOT~BUILDIN~ DEPARTMENT L j/ Compmnsatmon. otc,) and general li.~l,,~ ,n an m~., nm MATERIAL NOTES: ~ FOL~WING IN~PE~ON~: i j : a nam~ insure~ on any a~d all polities 2x8 CCA deck J~ts, sPaCing as noted 6, OMI~ED ~2x8 OCA gi~er FORPOUREOCONCR~ ~ J J j B~OOH '2 ~, ~1 wood in con,ct with ~n~ete dr mas~ to be WoJman~zed 6"x6" CCA sup~ ~ls, anchor [o con~ele ~ ROUGH - FRAMING & RLUM~IN~ or pressure ~eosoted. Provided 2x4 CCA cross bracing under u~er deck ~ ~ 8. OMI~ED Provide rail, see detail ~ I ~ 90MI~ED Provide maim per code 10OMI~ED ALL CONSTRUCTION SHALL MEET ~ ~ b L regulations o[the N.Y BF.U and a N.Y.BF.U. ae~flcate I ~ I 1o be presen[ed to the ~ner at ~e completion of ~e job 2 All ~mem am sohd STATE CONSTRUCTION & ENERGY J ~ J ~ 1 3 Do not s~le drawings Use figure dimensions only. 45 PmvideD°Uble jois~ JJ JJ II ~1 j II II ~j 14.18. OMl~EDThese dryings and sp~lfi~fians are ins~me~ts of sewice and 7 Whom jois~ am n~ed SECOND FLOO~ DECK PLAN I . ~ on any other project except by wdEen .uthodzmlon of the Engineer 9. All beams and gi~ers shall have 2" beadng min.