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Home My WebLink About34863-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34136 Date: 12/14/09 THIS CERTIFIES that the building ADDITION Location of Property: 2155 JOCKEY CREEK DR (HOUSE NO.) County Tax ~ap No. 473889 Section 70 S~bdivision SOUTHOLD (STREET) (HAFfLET) Block 2 Lot 28 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 14, 2009 purs,,a-t to which Building Pez~t No. 34863-Z dated JULY 14, 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 ADDITION WITH LANDING TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to MARGARET A.TONYES (OWNER) of the aforesaid building. SuF~OI~KCOI~YDEPART~TOFHEAL~AP~O%5~L N/A ELRL-rKIC~J~ u~KTIFICA~ NO. N 829102 08/25/87 PL~ u~KTIFICATION DA'r~43 07/20/09 BURTS RELIABLE INC Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAI~ This application must be filled in by typewriter or ink and submitted to the Building Del: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, topographic features. 2. 3. 4. 5. ~rtm~nt with the following: BLDG. DEPI. IO~VN OF SOUINO[D. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 masons 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, Commemial $15.00 Date. New Construction: Old or Pre-existing Building: LocationofProperty:~'-~ ~:~Zo.~_~ &~f~.~ ~,~. House No. t~ Street Owner or Owners of Property:/~z~./~tbff/~ f ~'~'"~ ~ Suffolk County Tax Map No 1000, Section ~ ~ Block (check one) Hamlet Lot ,-~'Oc~ Subdivision Permit No. Health Dept. Approval: Date of Permit. Filed Map. Lot: Applicant: /f~Z f-~ ~.~ f Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ JApplicant Signature~ P 0.8o~ 1179 (516 OFFICE OF THE BUILDING INSPECTOR TOWN OFSOUTHOLD CERTIFICATION Building Permit No. Owner: ¥~¢'~r~/"4[.d~E)( '"~/")~ (~lea'~e print) Date; Plumber: ~"'~/'J~ ~,iiAS~ (please print) I certify that the solder used in the water supply system contain than 2/10 of 1% lead. (plumbers signatur Sworn to before me this ¢Ofkday of ,_~]l~ 200CJ Notary Public, ,~2 -~-'O\ ~ County BERNADETTE L TAPLtN NOTARY PUBLIC ~844893 State of New York ~,~di,,~ ~ guffo~k County Roy ~ 7, GFCI-3 Panels3~-8 Ci~ 100 amps Selected Load Panel 1-60 Amp Tr&~sf~r 'SWitch Paul Burns 275 Town Harbor Lane Southold New.¥orkl1971 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. 34863 Z Date JULY 14, 2009 Permission is hereby granted to: MARGARET A.TONYES 2155 JOCKEY CREEK DRIVE SOUTHOLD,NY 11971 for : CONSTRUCT AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED BP # 15647 at premises located at County Tax Map No. 473889 Section 070 pursuant to application dated JULY Building Inspector to expire on JANUARY 2155 JOCKEY CREEK DR SOUTHOLD Block 0002 Lot No. 028 14, 2009 and approved by the 14, 2011. Fee $ 50.00 Authorized Signature ORIGINAL Rev. 5/8/02 IPOU. M' NO. B TO~N O~ $OUTHOLD BUILDING D£PART~NT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15647 Z Permission is hereby granted to: ............... ~ ,u..~, /..L.I..~/ . , . .~...~..~......~......~~.~ ........................................ ~ .......................... · ~..! ......... ,,t,r,m,,o, ~o~o~ed o~ .......... .~.~..--......f,~,,,~...,..~,-~.....~.~ ....... ~ ..................... County Tax Mop No. 1000 Section ..... .~...~...?. ....... Block ....... ~.....3=. ..... Lot No ...... ..'~..,~.. ............ pursuant to application dated ......~~.......~.~ ............ , 19.~..~.., and approved by the Buildlng Insp~"tor. Fee $...~..~....'.. ~ .... Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~)~FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE ~'--~/.5"--- 0 ~ INSPECTOR '~ ~ 7GS-~.80Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~/J/FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~SULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ~.~]~OUNDATION~.~.~,~ __ 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL INSPECTO~ OUNDATION (lst) OUNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL · ADDITIONAL COMMENTS 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL MAIL Approved 19~.). Permit NO./. ~ .~.~..-~. Disapproved ................................ a/c ........................ i ............ (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS,I~t-~~ SURVEY CHECK SEPTIC FORM TO:VaS ~ Ma- Date .................. , 19 .. INSTRUCTIONS a. This application must be completely fiBed in by Wpewriter or in ink and submitted 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 properW must be drawn on the diagram which is part of this appli- cation. 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 issued 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit~ursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicab/l~"l.'~.~W~,,/'Ordinances or Regulations, for the construction of buildings, additions or alteratio, I~Tx~or removal o_~t~moli~o~r~, s heir? described. The applicant agrees to comply with all applicable laws, ordinances~.build'..n.~g code, ho0sing ~o~e~/~and ~.gu~, and to admit auth°rized inspect°rs °n premises and in building f°r necessaT...x~. ~°.ns' ~'..~.._. ~./ .... : .~... · i~i'g~ait?r name, it' arrporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O~u/UE~ ................................ N~me of owner of premises .~..&~../?.~. 4.7Z..4e../.~. ~ ......... . .'~. ~..~;..~..~'...~..../. ~-~- · .~..~ ....... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done] ................................................. House Number Street Hamlet County Tax Map No. I000 Section ..."~..~ ............ Block ..... ~. ........... Lot....~?..' .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ./~.~---..5 / ~tS-~-- ¢ ~' use .... 7-~/ / =' ~ .......... b. Intended and occupancy .. .d.~.... ~ ....................................... 3. Natureofwork(checkwhichapplicable): New Building ' .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ,,~ ~, ~ O , ~- (Description) .................................... Fee ~,%"g). ' (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 ...... ~.. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ... l (~,. ~ ........... Rear ... / ~ ............. Depth . 5.9. ................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .......... ..... Rear ............... Depth ............... Height ............... Number of Stories 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zo.ning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. 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 comer lot. STATE OF NEt/Yg,P,K; / COUNTY 0 F~ff~(4tch-~ ...... S.S .............. .~ .d)..od ( .x.?../~.. .~.O.,(-d...~.Z:...~. ...... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ~ CO/j (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 knowledl~ an ~lief~i~nd that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... . .c~. ?../'¢c/.(-~-.. ........ day of..~O~.~ ...... ,19.~ Notary Public .................. ~~. County .,~..~~~~.._ ~~~~' tlffi~ ........ V'''c~---''' ~ "ifiignature~pplican~ / / ,,, C~,¢ ss ,,, If copper tubing la used for water distributing system; piping shall be SOLDER USED IN WATER SUPPLY sYSTEM cANNOT EXCEED 2/10 of 1% LEAD. PLUMBER CERTIFICAhb:, ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY t UP C ~ LLAT~. Phone 477-O400 Main Road GREENPORT N.Y. 11944 · TeN -r Es PLAN NO ~ 5 ( F ~C.~LE ~' t h