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Home My WebLink About33522-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~d~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33678 Date: 04/28/09 THIS CERTIFIES that the building ADDITION Location of Property: 275 BACK LA (HOUSE NO.) County Tax Map No. 473889 Section 17 Subdivision Filed Map No. ORIENT (STREET) (HAMLET) Block 4 Lot 26 LOt No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 14, 2007 pursuant to which Building Permit No. 33522-Z dated NOVEMBER 14, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ·"ne certificate is issued to MARTIN A & APUL D SARANDIA & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HE~J~TH APPROVAL ELEt-£KIC3%L CERTIFICATE NO. PLIERS CERTIFICATION DAT~U N/A N/A N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT -- 765-1802 APPLICATION 'FOR CERTIFICATE OF OCCIJ~ ---- ~s ~pli~tion m~ ~ fill~ ~ by ~ewfiter or ~ ~d ~b~ed to ~ Buil~~~; . ~ WN 0F SOUTH0tD For new buUdlng or new use. 1. F~ ~cy ofpm~y wi~ a~tc l~fion of ~1 ~l~gs, pm~y 1~, s~ts, ~d ~us~t to~p~c f~. 2. F~I Appm~l ~m H~ ~t. of wat~ supply ~d ~cmgc~sposal (S-9 fo~). 3. Appm~ of cl~t~c~ ~lafion ~m Bo~ of F~ Undc~t~. 4. Sworn s~cnt ~m plm~ ~g ~at ~c mld~ m~ ~ s~tcm con~ l~s ~ ~0 of 1% l~d. 5. Commemi~ b~l&ng, ~d~ buil~g m~fiplc ~idcn~ ~d s~l~ buildings ~d ~la~ons, a ~ificatc of~dc Compli~cc ~m ~c~t~t or en~ ~iblc for ~c buil~g. 6. Submit planning Bo~d Appm~l of ~mplct~ site pl~ ~mcnts- B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud uses: I Accurate survey of property showing all property lines, streetS, building and,unusual natural or topographic features. 2. A properly ccmpleted application and ccnsent 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. 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelllng $25.00, Alterations tu 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 Ce~ificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Location of Property: Old or Pre-existing Building: (check one) House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~"~ 9~ ~'~. Date of Permit. Health Dept. Approval: Street Hamlet Filed Map. Lot: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Z-'e-). ~)0 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. 33522 Z Date NOVEMBER 14, 2007 Permission is hereby granted to: MARY M NELSON PO BOX 374 ORIENT,NY 11957 for : NEW CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. REPLACES BP # 27283 at premises located at 275 BACK LA County Tax Map No. 473889 Section 017 pursuant to application dated NOVEMBER Building Inspector to expire on MAY ORIENT Block 0004 Lot No. 026 14, 2007 a/Id approved by the 14, 2009. Fee $ 75.00 ! Authorized 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. 27283 Z Date MAY 2, 2001 Permission is hereby granted to: MARY M NELSON BOX 374 ORIENT,NY 11957 for : NEW CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 275 County Tax Map No. 473889 Section 017 pursuant to application dated FEBRUARY Building Inspector. BACK LA ORIENT Block 0004 Lot No. 026 22, 2001 and approved by the Fee $ 75.00 ORIGINAL Rev. 2/19/98 -FORIt NO. I TOIOt OF SOUTHOLD BUILDING DF. PART,lENT TOI~I HALL SOUTHOLU, lt. Y. I ] 9 7 I TEL: 765-1802 ~vroned ................ , ~.~.~.. ~t No..2.?..2..~.2...~. .... Disapproved a/c .. · (Building InSpector) BOARD OF HEAl/H! ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALL .................. ~n, TO:~..~..~ ?~ .......... ..... APPLICATION FOR BUILDING PERHI'r IIISTRUCTIONS a. 'Ibis application nn~t be ¢oapletely filled in by type~iter or in ink and sul~itted to the Ik~ihling Insl~ctor ~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan a'~ing location of lot and of lmildings on premises, relationship ro adjoining premiss or r~blic streets or areas, and giving a detailed description of layont of property wrist be drama on the diagran ~Atich is part of this application. c. The ~ork covered by this application may nor be cemented before issuance of Ikfilding Permit. d. Ulxm ~,o~al of this application, the Building Inspector trill issue a Building Pemit to the appl icaat. Such permit shall be lmpt on the' pre~isee n~ailable f~r inspection thx~x~3aont the ~rk. e. Nobuilding shall be oncupied or used in~holeor inpart for mr] lattrpose~hatever tmtil a Certificate of Occupancy shall have ~ granted by t/m Building Inslmctor. APPLICATHlt IS ~ 1~I~ to the Building at for the issuance of a Building Permi~ purs~an; to ~he Building Zone Ordlnanee of tim To~n of Sonthold, Suffolk C¢~mty~ Be~ York, and other applicable Laws, Ordb~nces or Regulations~ for the eoastruetian of Daildlngs~ a~lltious or alterations, or for removal or cler~li~ion, as ~erein described, lhe applicant agrees to ~pl~ ~rith all al~licable lm~s, ordinances, building code, h~sing code, and regulations, an~ to admit authori~l inspectors on p~dses and in Dailding for necessary inspections. ............... (Signat'~e of al~plicant, or nane, if a corpara[ion) (l"lailing address of appl ican[) Stare ~bether applicant is(r~ner'~ le~ee~ ag~t~ architect, engin~r, g~r~ral contractor, elec[rician, plt~t'~r or b~i]d (as an the tax roll or latest deed) If applicant is a corporation, sig~atora of duly authorized officer. (Nme and title of corporate officer) Builders License No .................. ~ ....... Plt~ers License No .......................... Electricians Liee~e No ...................... Other Trade's Li~-~.se No ..................... I. l~cation of land on ~aich proposed ~rk ~rill be done .............................................................. ..... ........ ........................... .............................. lk~se Ncni~r Street Bamlet Camry Tax ~ No. 1000 Section . .~.~ ........... Block ~'] Lot ..... ~.~.. Sulxtivision ...................................... Filed ~ No ................ l~r ............... (~e) 2. State existing use and occupancy of pt~dses and intended use and occupancy of proposed construcCiot~: ¢. - a. Existing use and occta~aey l~.~. ....................................................... b. Intended use and oncopasey ............................................................................. 3. N:Jture of ~ork (ct~ck Milch applicable): Nea Building .......... ~iti~ .......... ~teration ..~ ..... I~f~ir ............ ~ripti~) 4. Esti,,nt~l C~st: ...~.~..: ......... f~ .............................................. (to ~ ~id ~ fili~ this a~li~ti~) If garage, t~l~r of cars ...................................... ,.,,~,,~,~ ~,~ ~,~,,~ ~,~. i~ ~,; ~....~'.O~ ..... ~ .~.~ ...... ~,,, ..~L~'t' ........ It, i~,t ..... ~ ................. ~r of Stories ..... ~<A: .......... [)inensit~m of ~m st'n~re ~ith alterati~s or ~itions: ~t ............... ~ar ............... ~pth .................... ~i~t .................... ~r of Stories ............... ~.,i.~.~i~,,~ ,,, ,,~,~ ~ ~ion: ~ ... 3 ........ ~,r ....~.a... ~ .B.O ....... ~i~,~ ...... [~ ............... ~t oe Sto~i~ ..... ~ .............. 9. Siz~ of lot: Frt~t .................... ~ar .................... ~pth .................... ] I. 7~ or u~ district in ~id~ p~i~s a~ si~t~ .............................................................. 12. ~s propel c~st~ti~ violate any ~i~ 1~ o~i~e ~ ~lati~: ...... ~ ............. ~3. ~ill lot I~ r~r~ ........ ~.~ ....... ~ill · ~ of Ard~it~t .................................... ~ .............................. ~ ~ ............... ~ of C~tr~tor ................................... ~ress ............................... ~ ~ ............... 15. ls this p~rty within ~ f~t of a till ~tl~? * ~ .......... ~ .~ ...... PI.ifF DI^GRAH locate clearly and distinctly all buildings, ~i~elzher existing or propov~l, and indicate all set-back dimensions properly li~es. Give street and block nuni~r or description according to deed, and sho~ street nares ar~l indicate ~4~ether in[eril)r or corr~r lot. (Cxmtractor, agent, corporate officer, etc.) of .~aid t~er or (.'~n~ors, m~l iS duJy ~thoriz~ Lo ~r[o~ or h~e ~r[o~ fl~ mid ~ ~ Lo m~ ~ file OHs a~licati~; thaL all statomnts c~Lai~ in this a~]icati~ are t~ to ~ ~8t of his ~l~ m~ ~[ief~ a~ that the ~rk ~ill I~ t~rfon~l in tim mm~r ~t forth in ~e a~Iimtim fil~ ~. ~m Lo ~fore n~ this ~ OOSEPH L. TOWNSEND J~. (Si~of ~ti~) ~ N~aW Public, StYe ~ ~ York Qua/, Suffo& County ~. ~3~35 Comm~sion Expires Feb. 28, 20 O I TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION INSPECTOR DATE BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] RO~.PLBG. [[]] ~ORAUMNiD~A~ION2ND [[ ] ~iNALLATION [ ]FIREPLA~CHIMNEY REMARKS: ~~----~ 765.1802 BUILDING DEPT. INSPECTION FO~ION 1ST [ ] ROUGH PLBG. i ]~FORAUMNiDNA(~ION 2ND i i IF~NSAU~ATION / FIREPLAC~:~'~HIMNEY/! DATE 765-1802 BUILDING DEPT. ! N [ [] 1ST [ ] ROUGH PLBG. [ -'OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP~A~HIMNEY REMARKS. ~ ~ DATE 765-t802 BUILDING DEPT. , o~u~oSPECTION N 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS INSULATION I~R N. ¥. STATE ENERGY CODE OF $OUTHOLD PROPERTY RECORD CARD OWNER STREET ~__ 7 ~-.)-- VILLAGE DIST SUB. LOT 'FOR~v~ER~OWNER N ~C;I,42d !~.*~,,~,, E ACR. S W TYPE OF BUILDING / RES.~ O 0 SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAN D IMP. TOTAL DATE REMARKS I / ~' ~ AGE BUILDING CONDITION N~ NORMAL BELOW ABOVE FARM Acre V=lue Per V~lue Acre Tillable 1 Tilbble 2 Tilloble 3 Woodlond Swampland FRONTAGE ON WATER BrusMond FRONTAGE ON ROAD House Plot DEPTH BULKH~D Fotol DOCK M. Bldg. Extension Extension Extension Porch Porch Breezeway Garage Patio Total COLOR TRIM Foundation Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Driveway Bath Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Dinette LR. DR. GEORGE M. AGNEW 39 ASHLEY CIRCLE COMMACK, NEW YORK 11725 November 7, 2007 Building Department Town of Southold PO Box 1179 Southold, NY 11971-0959 Re: Building Permit # 27283 Enclosed please find check in the amount of $75.00 for the renewal of the referenced building permit. I will call to arrange for an appointment for the final inspection. Sincerely, George M. Agnew Enclosed: letter of 3/5/07 DATE; ~, FEE: NOTIFY BUILDING DEPARTMENT AT 766-1802 9 A~ TO ~ P~ FO~ THE ~OLLOWlNG INSPECTIONS: ~ FOUNDATION - ~O ~EOUIRED--~, FOR POURED CONCR~E ~-~ - 2 ROUGH - FRAMli';S & PLUMBING Y: !~ULATiON ~. ~ NAL - CONS'rRUCTION MUST El: COMPLETE FOR C,O, ALL CONSTRUCTION SHALL MEET THE REOU',RC~ENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES NO'F RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS , 0CCUPN~,,C¥ OR USE IS UNLAWFUL ~'J1THOUT CERTIFICATE · v~uUVANU~ · ~1/~. ~ n?erh~ 883° / NOTE~: · IHONUNIENT AREA = 2,f;,,~-/3' 5F OR 0.61 AORE5 ®P..APHIC, SCALE II'= 40' LO'nc/~ ~Clr~Om~, (Dr ~ COc~. ~erl// Lo~r~nc~ F~ ~ t5.17' I; ~¢mQrt~£°rmerlu · HOmLo~ 0 oLL O~ N SUt~.~I~¥ OF: PROPEP-..T"'r' SITUATE: ORIENT TOP, IN, fX2UTHOI2 SUFFOLK C, OUNT'r', NY .~UR~D 12-OI-q~ 5,UPPOLK. OOUNt~ TAX I000- I~- 4- 26 TO: HART 1'4. NEL.eON COHHON!NEALTH LAND TITLE INSURANC, I= GOHPAN'K JOHN C. EHI~ERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERItEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-TIGERXPROSX99-294 "t .....R A A h A-A ] Il ,x' % ............... 7-I" .............. 1- ~ cos-- z~.-z Ralph Appelbaum Associates Incorporated iV-- . .7¸ R A A / / / / / / / / Date ,/Scale Drawn //Checked Ralph Appelbaum Associates Incorporated Planning and Design 1o3 Spnng Street NewYork NewYork 10012 _1~ o~48-00 Fax 212 33462l-4 Drawing