HomeMy WebLinkAbout34776-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34083
Date: 11/18/09
THIS CERTIFIES that the building WINDOWS
Location of Property: 2775 BRAY AVE LAUREL
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 126 Block 9 Lot 13.4
Subdivision Filed Map NO. __ Lot No. __
conforms substantially to the Application for Buiiding Permit heretofore
filed in this office dated JUNE 3, 2009 purs,,a-t to which
Building Permit NO. 34776-Z dated JUNE 15, 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 FIRST FLOOR WINDOW REPLACEMENT IN AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to CHRISTOPHER P WRIGHT
(OWNER)
of the aforesaid building.
S~P~)I~( C~3I~%~YDEPAR~1~T OF }~aJ~THAPPRO~-~J~
ET~t"rKIC~%L C]~RTIFIC~%TE NO.
PL~ C~TIFIC3~TION Dkr~u3
N/A
N/A
N/A
Rev. 1/81
TOWN OF $OUTItOLD ~-~'~ /
TOWN HALL .~ ~ :~: ~.~,
- 765-1802
1. F . survey of property wflh aCCurate location Of all buildings, property lines, streets, and unusu
· topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S.9 form).
3. Approval o f electrical installation from Board o f F'~re Underwriters.
4. Swgm statement from plumber certifying that the Solder used in system contains less than 2/10 of 1% lead.
5. Commemial 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. F~r eais~ng bui~di?ags (pri~r t~ Apri~ 9~ ~957) n~n-c~nf~rming uses~ ~r bt~Ymgs and "pre-e~Asting~ ~and uses:
t. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic ·
2. A properly completed application and consent to inspect signed by the applicant, ff 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. Tempotar3, Certificate of Occupancy - Residential $15.00, Commercial $15.00
'LOCation ofpr°perty: ~7~"'~-~/2~ ~__~4(X¢~ ff~'~Jr/~/
· . . Ho'use'l~o. ~'~ / ~ Street ~- - -- '
SuffolkCountyTaxMapN°iooo, section I~ .' Block ~. tgi) ' Lot (~t~ '667
Subdivision
PcrmitNo. 3~ ~'~ ~DateofPermit.
· Health Dept. Approval:
Planning Board Approval:
.Request for: Temporary Certificate
'Filed Map.
Applicant:
Underwriters Approval:
Final Certifi, 'te:
(checkone)
Applicant Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUIDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 34776 Z
Date JUNE 15, 2009
Permission is hereby granted to:
CHRISTOPHER P WRIGHT
33 ROPE LANE
HEMPSTEAD,NY 11756
for :
REPLACE WINDOWS ON FRIST FLOOR OF EXISTING SFD PER APPROVED PLANS
AS APPLIED FOR.
at premises located at 2775 BRAY AVE
County Tax Map No. 473889 Section 126
pursuant to application dated JUNE
Building Inspector to expire on DECEMBER
LAUREL
Block 0009 Lot No. 013.004
3, 2009 and approved by the
15, 2010.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
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
F]F, LD INSPECTION REPORT [ DATE [ ' COM1V~NTS ~.)
FOUNDATION (1ST)
FOUNDATION (2ND) ~-~
ROUGH FRANHNG &
PLUMBING '.~
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL / /
ADDITIONAL COMMENTS
TOWN OF'SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined / Q ,20
Approved ~ ~//,/ ~"7 20_ (~''/
Disapproved a/c
Expiration
PERMIT NO.
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
C°ntact:Mailto: /~.]~/ F'~.~ ;~
Phone: 7 ~q{- 4/dO_}''-'
JUN 3 2OO9
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date ,20
I~LDG. DEPT. INSTRUCTIONS
TOWN OF SOUTHO[O
a. ~pplication 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 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 ! 8 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 constmction 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 r~egulations, and to admit
authorized inspectors on premises and in building for necessary inspections. /7~ ~//.
a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent~ engl~n,
general contractor, electrician, plumber or builder
Name of owner of premises Q, ~-/~ [ ,f '~/~/~7)~-/~- I/[f~ [ ~ /'4 .r
/
(As on the tax roll or latest deed)
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.
Location of land on which proposed work will be done:
7.775 A. /¢rff
House Ndn~ber [ Streei ~
Hamlet
County Tax Map No. 1000 Section /oQ(4~ Block ? Lot /'--~, c7/
Subdivision Filed Map No. Lot
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy -J-'/4J ~'(.~" Jc-/q/'~'/[C ~ /~ ~/~-.f
b. Intended use and occupancy &4/O'q ~..
3.
Nature of work (check which applicable): New Building Additioj.La_-4~ Alterati. o_n
Repair Removal Demolition r~q25{~C6~rkr~r F-~-,~-~rztM)~,~.~t V~//tdz3o'~' _C ~
(' I~/l~'.r7 fi-t. ~v,q- ~n,, c V (Description) .)
4. Estimated Cost Fee ~ &
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
If business, commer..qial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear Depth
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
Size of lot: Front -~'~
ix. ear / Depth
Real:
10. Date of Purchase
Name of Former Owner
1 1. Zone or use district in which premises are situated /r~ 4 0
1 2. Does proposed construction violate any zoning law, ordinance or regulation? YES NOZ
1 3. 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
Address
Address
Phone No. ~'/~ ~ $'- ? fl '- 3' 7fv
Phone No 7~7 tf, ~-/,/
Phone No.
9* 5(/
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/DREQUIRED.
9*
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.
18. Are there any covenants and restrictions with respect to this property? * YES __ NO X
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
C O~/~Y~/t/ ._~(~/~ V~-- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(Contractor, Xgdnt, Corporate i2)ffic~r, etd.)
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 ail 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.
Swom to before me this r'r'-, ~ ~ '~ / /
,.'~ dayof ~.~J_~ 2009 ./5 ,,//.~ ~//7/ ~
-. 'rIG T H
Nota~ Public 0,~,m~g~a,i~h,t, Si~ature of Applicant
~_TOWN OF SOUTHOLD PROPERTY RECORD CARD
~WNER ~ STREET ~._'~ '~..~)-" VILLAGE DIST, SUB. LOT
~ ~ ACR. '
S~S. VL. FARM CO~. CB. MICS. Mkt. Value
~N D · IMP. TOTAL- gATE RE~RKS
AGE BUILDING CONDITION
N~ NORMAL BELOW ABOVE
~FARM Acre Value Per Value
Ac re [q.
Tillable FRO~TAG[ O~'~ ,'ER
Wo~land FRONTAGE ON ROAD
Meadowlond DEPTH
House Plot BULKH~D
~ ~ ~ ~ DOCK
Total
M. Bldg.
Exteneion
Extension
Extension
Porch
Porch
Breezeway'
Garage
patio
O*
Total
COLOR
Foundation
Basement
Ext. Walls
Fire Place
Type Roof
Recreation Room
D~Tr
Bath
Floors
Interior Finish
Heat (~ t ~,~
Rooms 1st Floor
Rooms 2nd Floor
Driveway
Dinette
I
EDR.
!BR.
FIN. B
TRIM
EXISTING 1ST. FLOOR PLAN
SCALE: 1/8" = 1'-0'
FEE:Cr'.,~--~--- '~ '- :': .... " ' .....
NOTIFY BJiLOlt: -r ~..~_,'~T AT
c7,':',N STOBM WATER BUNOFF'65q$o2 8;,,,,! ~'~ ,,~ r.,r, TXE
,,, ,~,~, T TO CHAPTE~ 236 FOULOWiN~ .~ .....
i. FOUNDATIO;~ - T,hO ~EQUI~ED
FO~ POUGED
- Fr~,,~,~ & PLUMB',NG
2. ROUGH "
3. iNSULATION
4. FINAL - MUST
BE COMPLE1
ALL CO ,, S~,~ L_ET THE
REQUIREMENTS 3F THE CODES OF NEW
)T RuSwOdS~BLE FOR
~UCTION ERRORS.
:F THE TOWN CODE.
PROPOSED 1ST. FLOOR
REVISIONS:
f
TYPICAL ~NDOW OPENING
TYPICAL DOOR OPENING
I/'...... i/ I[]/' Ir/ ~ I/, i !l ~i'l,: 'Il
(/ ,,~ ,!/ l,
WIND LOAD PATH CONNECTION AND
CONSTRUCTION DETAIL DRAWINGS
' mm
WIND-BORNE DEBRIS PROTECTION FOR WOOD STRUCTURAL PANEL
A~ PER TABLE 1609.1.4, N.Y.S. RES. CODE: ALTERNATIVE FOR OPENING PROTECTION (IF NOT USING IMPACT GLAZING)
AND MAX]MUM PANEL SPAN 0~8 FEET ,~'IALL BE F~RM~ FOR O~[N],G PROTECT[CN IN ONE- AND TWO-b-I-ORY I~I,LD[NGS. PANELS SH eALLm cB~m~~
~ PAN~L~ MUST' CUT TO S'Z' AN~ READY TO USE ~N ANY NEW '~ ,DOV~l~~~'~[N~/~R~
REVISIONS:
A-2