HomeMy WebLinkAbout30333-Z FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUI NG ERMIT
(THIS PERMIT MUST BE KEP ON THE PR MISES IL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30333 Z ate Y 9, 2004
Permission is hereby gran ed to:
R BERT A WF RTIN
1 BAYSID DRIVjE
M�NHASSET,NY 11 30
for
ADDITIONS AND ALT TIONS TO AN E ISTING DWELLING AS APPLIED FOR.
THIS PERMIT REPLACE PERM :T #10275 ADD IONAL CERTIFICATION WILL BE REQUIRED.
at premises located at 6512 INDIAN NECK LA PECONIC
County Tax Map No. 4738 ection 098 Block 0006 Lot No. 001
pursuant to application d t d MAY 17, 2004 and approved by the
Building Inspector to expir on NOVEMBER 19, 2005 .
Fee $ 150 . 00
Author ze Signature
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COPY
Rev. 5/8/02
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FORK NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ............. 519... , Application No. . .d.....7 ^.........
Approved ............ . .......�,5 19. Permit No. . ...a7�.r. .z.
Disapproveda/c . .. .................... ...............................................................
.�. ...... ..
.. ... ....... ... ...... ................... ........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date !^may. t?............... .. 197.1...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 property must be drawn on the diagram which is part of this application.
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 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
shalt 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 buildings for necessary inspections.
..........0: ....... . ........ .. ...................................................
(Signature of applicant, or name, if a corporation)
................... .... 1. .. ..
(Adss of aPPlican
.'..........................
State whether applicant is owner, lessee agent, architect, engineer, general contractor, electrician, plumber or builder.
.:.............................................................................................................................
Nameof owner of premises .....0-6-t/.l#'.....�h.. ............................................................................................
If applicant is a corporate, signature of duly authorized officer.
........................................................................................
(Name and title of corporate officer)
Builder's License No. ....I'j. ...L..14..1.........................
Plumber's License No. ......-yk.A................... .........
Electrician's License No. .....jZ7..................
Other Trade's License No. .............................................. 1__ LiJ.-
d �a���1. Location of land on which proposed work will be do Map W YY`... 1............ . of N . ........................
Street and Number .....0 �.. �?.. ................( c.. 1... ......................pall...........
go
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ...... .............................................. .............................
b. Intended use and occupancy .... ........
3. Nature of work (check which applicable): New Building. .................. Addition ....X.......... Alteration .................
Repair .................. Removal .................. Demolition................... Other Work ................................................ ....
(Description)
4. Estimated Cost ...........�5..!!v...................................Fee ......Ari.w...................... .................:...............:...............
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..........................Number of dwelling units on each floor ............................
Ifgarage, number of cars ..............................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
r
7. Dimensions of existing structures, if any: Front iS..o............... Rear ....3..Q.r..................... Depth .o.............
Height ...... Number of Stories
Dimensions of same structure with alterations or additions: Front .....�:.°........................ Rear Z.0.....................
Depth ...... .................... Height ......I_E................Number of Stories ....... 2-12..................
8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................
Height .................... Number of Stories ...........................................................................................�2 0..............
q 1 �
9. Size of lot: Front ................1....................................... Rear ...... ................................... Depth �.�J .............J`.........
10. Date of Purchase .C . .L.............................Name of Former Owner ..11.. .. ... -......
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 ........... ........i. Will excess fill be removed from premises: ( ) Yes ( ) No
Q. -<^I' M 4w �^
14. dame of Owner of premises ... ......... .... ... ......................... Address ...CA:u!�^:::`:..�..`.�.... Phone No. ........:.............
Name of Architect .............................................................. Address ................................ Phone No. ......................
Name of Contractor ... ... ..�•..�.................... Address .alf',... ......1.�. Phone
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 lot.
e l
� a
f ,, A
STATE OF NEW RK, S:S
COUNTY OF Aa.'-44
{ .being duly sworn, deposes and says that he is the applicani
.................... ... . .. . ....... : .. .. . . .. . .......
ame of mdrvidual signing contract')
above named.
Heis 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 perfoy62y in the manner set forth in the application filed therewith.
Sworn to before me this
........ day of .. ................................,
Notary Public. ........ . ....... .. .............. ............ County ...... .... ....... ..... ....aure
. ...................... ....................
(Signof applicant)
,GGc� �Q6�L
Mc-le
O. Y PLT * 0.1'tOY
B.IC, of 4ow York
BABETTE C. C
Suffolk County No, a_;,iJZS00
Commission Expires March 30, 11
OF SO(/jyol
Town Hall Annex ~ Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,New York 11971-0959
CQU
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 5`', 2009 1st NOTICE
6512 Indian Neck Lane, LLC
78 Chelsea Road
Garden City, N.Y. 11530
RE' 6512 Indian Neck La. (Additions/Alterations)
SCTM: #98.-6-1
To Whom it May Concern:
Please be advised that your Building Permit#30333 issued May 19'Vh, 2004 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued before the use of the structure.
To renew your Building Permit, please submit a fee of$150.00; at time we can
schedule an inspection by one of our Building Inspector's
If you have any questions, please call us at 765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT
8 PROFESSIONAL ENGINEER
1725 HOBART ROAD I PO Box 616, SOUTHOLD, NEW YORK 11971
{ TEL 631.7652954 • FAX 631.6143516 • e-mail: joseph@fischetti.com
Date: May 3, 2006
Reference: 6512 Indian Neck Road
Southold Building Dept
PO Box 1179
Southold, NY 11971
Dear Sir,
I certify that the 18 foot by 12 foot bedroom addition as shown on the as constructed plans used for the
Building Permit# 10275—ref#30333 was constructed to the New York State building codes in effect at the time of
construction. Qap
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OFESStO'�P�
Joseph Fischetti, P.E.
) o Y/
Form No.6
n TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
j 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
Date. 2 a J
New Construction: Old or Pre-existing Building: V (c ck one)
Location of Property: �/ /V e-C AL
House o. treet Hamlet
Owner or Owners of Property: ,t
Suffolk County Tax Map No 1000, Section Block Lot Q
Subdivision Filed Map. Lot:
Pennit No.JO 3 3 Date of Permit. / Q Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ ,
td
pplicant S gnature
7654802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND ( ] I ULATION
[ ] FRAMING [ FINAL
[ ]
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE INSPECTOR "�
Of so
3333 z �
TOWN OF SOUTFIOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIO
[ ] FRAMING / STRAPPING � FINAL �- "`�
[ ] FIREPLACE & CHIMNEY [ ] FIRE SA SPECTION �
REMARKS:
Com- O
� o
DATE S 3 � -INSPECTOR-
THE NEW YORK BOARD OF FIRE UNDERWRITERS
gr BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date August 14, 1979 Application No...file 0 30 760 N 44:5389 4 5 3 8 9
THIS CERTIFIES THAT L,�
only the elect�a¢!equipmePt�tts;ril d below nd introdu b the applicant named on a above plication number in the premises of
D �'Ti dRa I , �, l�ndian t ea�C La. , 10�U e/o RoMpson La., Peoordc,NY
in the following location; ❑ Basement ® 1st Fl. ❑ 2nd Fl. Section Block Lot
was examined on August 9, 1979 and found to be in compliance with the requirements of this Board.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT yAPpR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
5 1 ;
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER EQUIP. X 2W 1 JF 3W 3 0 3W 3 X 4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A•W.G. �•�NEUTRALS A.W.G.
EQUIP• PER AV OF CC.COND. OF HI-LEG OF NEUTRAL
OTHER APPARATUS:
Ru2and Electric Co.
P'„O, Box 143
Mattituok, INY, 11952 Lic.242L Amau NA�R
r
Per
This certificate must not be altered in any manner;return to the office of the Board if incorrect.',Inspectors may be identified by t it Vedentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAN
o��g�fFO��-cQG
co
Town Hall,53095 Main Road 1 Fax(631)765-9502
P.O. Box 1179 Gy Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 20,2003
Mr.&Mrs.Robert A.Martin
15 Bayside Drive
Manhasset,N.Y. 11030
Re:Premises @ 6512 Indian Neck La.,Peconic,N.Y.
Suff.Co.Tax Map#1000-98.-6-1
Dear Mr. &Mrs.Martin:
It has been brought to the attention of the Building Department that a deck addition has been constructed to
your dwelling without first obtaining a building permit.
Also be advised that there is an expired building permit#10275-Z issued June 1979 for an addition to the
dwelling,and a Certificate of Occupancy has never been issued.
According to the Code of the Town of Southold,A Building Permit is required before any construction can
be undertaken,and a Certificate of Occupancy Issued. You are in violation of the Southold Town Code.
Please contact this office as soon as possible so this matter can be resolved.
I thank you for your anticipated cooperation.
Respectfully,
SOU OLD TOWN BUILDING DEPT.
Gary J. ish,
Building Inspector
(Cert.Mail)