HomeMy WebLinkAbout35016-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34121
Date: 12/09/09
THIS CERTIFIES that the building MINOR ALTERATION
Location of Prc~erty: 630 YENNECOTT DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 6 Lot 5
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 14, 2009 pursuant to which
Building Permit No. 35016-Z dated SEPTEMBER 23, 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 WINDOWS AND FRONT DOOR REPLACEMENT IN AN EXISTING ONE FAMILY DWELLING AS
AppL¥~D FOR.
The certificate is issued to PAUL F & ANNE D KRAEHLING
( OWNER )
of the aforesaid building.
SUFFOLK COUN~"f DEPARTMENT OF HEALTH APPRO~%L
BLaCk,ICA5 u~aTIFICATE NO.
pLiERS CERTIFICATION DA'r~u
N/A
N/A
N/A
orized Signature
Rev. 1/81
TOWN HALL
765-1802
APpLICATION'FOR CF.,RTI~CATE OF OCCUPA
DEC z 2909
BLDG. DEPT.
TOWN OF SODTHOLO
This appliention must b~ rifled'ia by typewriter or ink and SUbmitted to the Building Depamnent with the foil°wing:
-A. For new building or new use:
1. Fi~t survey of property with accurate location Of all buildings, pmper~y lines, streets, and unusual natural or
2. Finn! Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
-3. Approval 0 f e. lectfical installation from Board o f Fi/.e Underwriters.
4. Swgm statemem from plumbor certifying that the S°lder used in syst~a contains l~ss than 2/10 of 1% lead.
· 5. Commex~ial building, industrial building, multiple residenc~sand s/mitar buildings and installations, a certificate
·Of Code.Compliant.from amhitcet.0i- engineer respOnsible for the building.
· 6. Submit Planning Board Approval ofoomPleted site plan requirements.
"B. F~re~dst~ngbui~d[ngs(pr~rt~Apri~9~1957)nun-e~nf~rm~gnses~rbui~dingsand"pre-ex~sting~landuses:
·. 1. .features..Accurate survey, of proporty, showing:, all prop~rty lines~ streets, building and unusual natural or topOgraphic .'
.2. A pr~per~y c~mp~et~d app~icati~t~ a~d c~usent.t~ inspe~t signed bythe applicant. If a Certi~cate ~f~ccupan~y is
denied, the Building lnspoetor shall state the reaaons therefor in writing to the applicant.
· C. Fees · ·
· 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.0(~ Alterations to dwelhng $25 00,
Swimming P0ol $25~00, AccesSory building $25.00, Addition~ to accessory building $25.00, Businesses $50.00.
:. 2. Certificate of O~cupaney on Pre-existing Building - $I00.00 '
3. Copy of Certificate of Occupancy _ $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certifieate of Occupancy - Rcsidential $15.00, Commercial $15.00
Hate. Oe - a
New Const~cfion:
Old or Pre-exi~ting Building: ~ (cheek one)
Honse No. Street . Hamlet'
c
h'~ff~olk CountyTax Map No lO00, Se~tion ~5~-_ ~ ~ ,,i?' . - Block Lot
Subdivision ~ 'Filed Map. ~ Lot:
PermitNo. ~'z [(~-'7_.. DateofPermit. Applieant:(~- ~,, (~..~ ~,~e [" f~Nq
Health Dept. Approval: ~ Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ~ (check one)
?ce Submitted: $ c~ ~'- ~
Q.~ c,. ~']'-~ ] '~ ~ 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. 35016 Z
Date SEPTEMBER 23, 2009
Permission is hereby granted to:
PAUL F & Ai~NE D KRAEHLING
630 YENNECOTT DR
SOUTHOLD,NY 11971
for :
REPLACE WINDOWS AND FRONT DOOR IN EXISTING SFD AS APPLIED FOR
at premises located at 630 YENNECOTT DR
County Tax Map No. 473889 Section 055 Block
pursuant to application dated SEPTEMBER 14, 2009
Building Inspector to expire on MARCH
SOUTHOLD
0006 Lot NO. 005
and approved by the
23, 2011.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN,(
BUILD.
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined
Approved
Disapproved a/c
ct {O,~ 20C6!i
Expiration
SEP 1 4 2OO9,
BLDG. DEPT.
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
Contact:
Mail to:
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date ,20
INSTRUCTIONS
ll3qN OF SOUIH0t¢
a. lnlS application MUST b'e 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 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 ora 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,~orporation)
: ; '" .... ' 'F C/4TE ' ¢
~ .... ~ ,. } 7 (Mailing address of a plicant) x k h~ ~ ]
State whether applicant is owner, lessee, agar, arc~ct~ mgmeer, general contractor, electrician, plumber or builder
Name of owner of premises ?~oX~ ~.
If applicant is a corporation, signature of duly authorized officer
APPROVED AS NOTED
_ DATE:
(As on the°ta~: roll or ~,/t:t~:qt ¢,~0&.~,, 0~ BY: ~ ~ d
Block
Filed Map No.
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade s License No.
1. Location of land on which proposed work will be done:
House Number Street
County Tax Map No. 1000 Section ~'~,~
Subdivision
NOTIFY BUILDING DEPARTMENT AT
765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
1. FQUNDATICN - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YOR!dc. qT~T~. NOT ¢,,,~PONStBLE FOR
Hamlet
Lot 3"
Lot
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy O~,* ~a- ~- / ~ ~ ~c~.,ro
b. Intended use and occupancy ~ ~iv---o,~
Nature of work (check which applicable): New Building
Repair Removal
Estimated Cost ~t 8'09 ~. oo
Addition
Alteration
If dwelling, number of dwelling units
If garage, number of cars
Demolition OtherWorkm',a ~k~,,o ~ ~ ko.W_
tpnon)
~'~...o ~- C3o..o~ ~etoZ.Descfi~ '
Fee
(To be paid on filing this application)
Number of dwelling units on each floor
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
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth Height_ Number of Sto[ies
Dimensions of entire new construction: Front Rear
Height Number of Stories
Size of lot: Front Rear Depth
.Depth
,Rear'~"' --
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. 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 Phone No.
Address Phone No
Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES
* 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
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO v'~
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
I7. 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 __
· IF YES, PROVIDE A COPY.
NO ~"
STATE OF NEW YORK)
COUNTY O P,~ [~L
-~(¥('k~.,~ ~.~"'~-~L,k ~,~ being duly swom, deposes and says that (s)he is the applicant
(Name of individual signing contract) ablkJe named,
(S)He is 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
performed in the manner set forth in the application filed therewith.
Sworn to J~efore me th~ .~
Notary Public
Signature of Applicant /q
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3
YENNEC..DTT
B~VE
I,'IOFFAT
LOT HO'5. P. EFI: ~ TO'MAP OF' YENNECOTT PAf~._M~F! LED~.I_N_
MAP OF PI2_OPEP__TY
.SU~VEyE ~ FOI2_
PkUL .F~kNNE P. I<EAEMLING
50dTHOLD
TO¥/N OFSOUTHOLD N,Y,
GU~PJNNTEED TO THE./~'IE~IC/M~ TITLE
AND TO THE 5OUTHOLD SAVINGS B/NNV..
P..0DEI:21F. V. VAN TUYL,P.C,