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HomeMy WebLinkAbout34794-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34078 Rte: 11/17/09 TI{IS ~TIFIES that the building AS-BLT DECK ADDITION Location of Property: 56863 MAIN RD (HOUSE NO.) (STREET) (HAMLET) Cotumty Tax ~ap No. 473889 Section 63 Block 3 I~)t 17.3 Subdivision Filed [4ap NO. __ Lot No. __ SOUTHOLD conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17, 2009 purs,,amt to which Building ~I~Lit NO. 34794-Z dated JUNE 17, 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" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANTHONY FORGIONE ( OWNER ) of the aforesaid building. SUFFOLK CouNtrY DEPART~gNT OF HEALT~ APPROVAL N/A EI~gt-£RICAL CERTIFICATE NO. 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 rmtural 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 suwey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A pr6perly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, t ~he?uilding Inspector shall state the reasons therefor in writing to the applicant. C. Fees t. 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 ofOecupancy - $.25 4. UpdatedCertificateofOccupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: Location of Property: ~-Uo~-~o-~'~_ ~ ~ A House No. Street Owner or Own s ofPrope y: · C)',~ C~ ~-~-~ Suffolk County Tax Map No 1000, Section ~'-~ Block ~ (check one) Hamlet Lot /?,3 Subdivision Filed Map. Permit No. ~t.~ q-eI ~4-~' Date of Permit. Applicant: Lot: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ -"~-~ Underwriters Approval: Final Certificate: 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. 34794 Z Date JUNE 17, 2009 Permission is hereby granted to: ANTHONY FORGIONE PO BOX 1118 SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN AS-BUILT DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING BLT PRIOR TO 01/01/03 AS APPLIED FOR.REPLACES EXPIRED # 29279 at premises located at 56863 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 063 Block 0003 Lot No. 017.003 pursuant to application dated JUNE 17, 2009 and approved by the Building Inspector to expire on DECEMBER 17, 2010. Fee $ 300.00 ~Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. %~/~ (THIS PERMIT NO. BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 29279 Z Date APRIL 10, 2003 Permission is hereby granted to: JOSEPH DAFFIN 249 WILSON AVE WESTBURY,NY 11590 for : CONSTRUCTION OF AN AS BUILT DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING BUILT PRIOR TO JAN. 1, 2003, AS APPLIED FOR at premises located at 56863 MAIN RD y Tax Map No. 473889 Section 063 .ant to application dated APRIL .ing Inspector to expire on OCTOBER 300.00 SOUTHOLD Block 0003 Lot No. 017.003 10, 2003 and approved by the 10, 2004 . r 1 n ture ORIGINAL is/8/o2 LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER P.O. BOX 162 GREENPORT. N.Y. 11944 (516) 477-1652 Southold Town Hall Main Road Southold, NY 11971 6/12/03 Southold Town Building Department, Upon inspection of the existing deck on the property of Joseph Daffin on Main Road in Southold I noted that the center pier as noted on plans was missing. Instead tecos were used to support the new girder to the existing girder but this does not affect the integrity of the structure. I certify that the deck was built in accordance with the New York State fire and building code and meets the Southold Town building code. Sincerely, ~ Lawrence M, Tuthill 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~] I~ATION/ [ ] FRAMING [ '~] FINAL [ ] FIREPLACe& CHIMNEY REMARKS: ~ ti DATE TOWN OF SOUTHOLD BUILDING 15EPARTMENT ]'OWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Approved ///~ ~ Disapproved a/c · ~ Expiration / , J BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ---3 sets of Building Plans Planning Board approval Survey. Check ~',~ o o, O o -/- '~o~ ~. o O Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BU1LDING PERMIT Date ,20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and sub~nitted 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 waterways. c. The work covered by this application may not be commenced before issuance of Buitding 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 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 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 building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ,,,J os ,v,o,,.t '~:~:,,~/ (As on the tax roll or latest deed) If applicant is a corporat!on, 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 la.~n.d on which proposed work will I~e done: House Number Street ti?TI County Tax Map No. 1000 Section Subdivision fi, ~, (Name) Block ~ Lot /'T, ~ Filed Map No. t,,/.,,¢. Lot ~ d. 2. State existing use and occupancy of premises and intended use and occupancy of proposed const/'uction: a. Existing use and occupancy b. lntended use and occupancy .~,,ja/~ /;-a'~'~2 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~/$4fO ~? Fee Addition Alteration Other Work ,~:,,,w~,~ (Description) If dwelling, number of dwelling units garage, number of cars ~[- (To be paid on tiling this application) Number of dwelling units on each floor ] If business, commercial or mixed occupancy, specify nature and extent of each type of usc. Dimensions of existing structures, if any: Front 6~ 6, Rear Height. A3 ~ o C,, Number of Stories / Depth r Dimensions of same structure with alterations or additions: Front 6 ~, Rear Depth ~L3. '1 ' Height l,~[ o 6, _ Number of Stories / 8. Dimensions of entire new construction: Front b/,, Rear (204.e&q~ Depth Height Number of Stories 9. Size oflot: Front /7~--,..ff Rear /a;.ff.~,? Depth ,,~7~. ~"~ 10. Date of Purchase~Ja~a.,.~ ~-oOO Name vfFormer Owner 11. Zone or use district in which premises are situated ~/~4' ,~ · ,? 12. Does proposed construction violate any zoning law, ordinance or regula, on. YES NO / 13. Will lot be re-graded? YES __ NO ,,,/Will exccsq fill be removed from premises? YES__ NO / 14. Names of Owner of premises Name of Architect ,~- Name of Contractor ~ ;.ddress Phone No. g ddress ~ Phone No ? ddress --~ Phone No. 15 a. Is this property within 100 feet of a tidal wetland c r a freshwater wetland? *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 * 1F YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation pla,, and distance.' ' : operty lines. 17. If elevation at any point on property is at 10 feet or below, must pro topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ~'*'//q ~/(7'~ I~ Al'fl ~ 0£ g ,~ ,4 ,c/ bei, ~g duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, Corp rate Officer, etc.) of said owner or owners, and is duly authorized to perfor~ ~ or have perfom~ed the said work and to make and file this application; that all statements contained in this application are true t{, the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swon~o before me this ,_..day of / N~tary Public JOYCE M. WILKINS l~-tat'y Public, State of New York NO. ~952246, Suffolk County Term Expirgs / Signature of Applicant SURVEYED FOR:- .__T~.j. LOCATED AT LOT ) ~'~ [~'~,,~-'~ MAP .0 F ~k,4,~ SCALE 1 "- SURVEYED _J--~t.3~-~¢' ¢'~i~'~(1¢~ WILLIAM R. SIMMONS III, L.SP.C. 11 MEROKE LANE EAST ISLIP, L.I., N.Y. 11730 (516) 581-1688 FILE NO 7_~'7 ~-'73 BY Fax: (516) 581-1691 PAGE GRID TOWN OF SOUTHOLD PROPERTY"RLrCORD CARD OWNER STREET ~' ~ ~ c:, ,Z VILLAGE DIST. SUB. LOT ~Z-~ S W TYPE OF BUILDING ',ES. S/~ SEAS. VL. FARM COMM. CB. MICS. Mkt. Value ~l~/~/ z/~ ~/J ~ ' ~"~ ~-~ ' J / ~ ', ~ _ ~ . "- ~'-/- ,-~, t~'~ ~ ~o ~o~ / /~Jl~JP~ ~&~-~o~ ~z-t~f(,~' ' ~ ~_~.~,~_'~.~,~ ~ , '~ ~,~ ~ ' / , .l~ ~/e~-SP~ /Zo~/- ~.,~ ;o.- ~/~s-o. illable FRONTAGE ON WATER l~land FRONTAGE ON R~ ~eodowl~d DEPTH ouse Plot BULKH~D I COLOR ~Q ~-~' TRIM Extension Extension Porch Breezeway Garage Patio Total Foundation Basement Ext. Walls Fire Place ~ Type Roof Recreation Room ~ Dormer Bath Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Dinette LR. DR. BR. FiN. B Driveway OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 765-1802 9 AM TO 4 PM FOR THE ~ FINAL . OONST~U'~TfON ~E COMPLETE FOR ALL CONS~RuCTtG,,,_~ALL THE REQUj~;~]E,~~ O~ THE N STATE CONSTRUCTioN & CODEs. NOT RESPoNSIbLE FOR DESIGN OR CONgTRUGTIQN ERfiO~S