HomeMy WebLinkAbout35316-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Tow~ Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34191 Date: 02/12/10
THIS U~I(TIFIES that the building ACCESSORY TRELLIS
Location of Property: 290 TOWN HARBOR TERRACE SOUTROLD
(ROUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 66 Block 1 Lot 33
Subdivision Filed Map No. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 15, 2010 pursuant to which
Building Permit No. 35316-Z dated JANUARY 25, 2010
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" ACCESSORY TRELLIS AS APPLIED FOR.
The certificate is issued to JOANN WALKER
of the aforesaid building.
( OWNER )
SUFFOLK CO[~qTYDEPART~I~T OF HF2%L~APPRO~l%L N/A
~.Rt-rKICAL CERTIFICATH NO. 132648C 02/05/10
PLU[~ERS CERTIFICATION DA'£~D N/A
Rev. 1/81
8LDG. DEPT,
TOWN OF SOUTHOLD
AI~PLIC~
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
TION 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 o f eleatrical 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, thc 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.
New Construction: %/( Old or Pre-existing Building: (check one)
Location of Property: ~ 3(- ~?~, >~ //r~/~>' ~ ~'tb'~c
House No. Street
Owner or Owners of Property: ~]-~c~ /'~ ,"3 ~c/,:~. (/(, ~
Suffolk County Tax Map No 1000, Section ~ ~' Block /
Hamlet
Subdivision
PermitNo. 35~,~;~/~' DateofPermit. /- :v--l:
Filed Map.
Applicant:
Lot;
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~ ~..
Final Certificate:
(check one)
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. 35316 Z Date J~LNUARY 25, 2010
Permission is hereby granted to:
for :
"AS BUILT"
JOA/gNWALKER
730 PARK AVE - # 19C-PH
NEW YORK, NY 10021
ACCESSORY TRELLIS IN THE FRONT YARD AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 066
pursuant to application dated JANUARY
Building Inspector to expire on JULY
290 TOWN H3tRBOR TERRACE
SOUTHOLD
Block 0001 Lot No. 033
15, 2010 and approved by the
25, 2011.
Fee $ 200.00
/~ri~ze~dSignature
Rev. 5/8/02
ORIGINAL
Issue Date
2/5/2010
Electrical Inspection Certificate
Electrical Inspection Service. Inc. Application Number
375 Dunton Avenue 132648C
East Patchogue, New York 11772
(631) 286.6642
Issued To: Joann Walker
Street: 290 Town Harbor Terrace
Village: Southold Zip:
Section: Block: Lot:
Contractor: P. O. B. Electric Inc.
11971 Town: Southold
Lic.# 4473-E
was examined and found to be in compliance with the National Electrical Code.
Commercial
Residential
i NV Defects ,I Pool ~ 1st Floor [] Indoor
[~ Det. Garage [] Attic ~] 2nd Floor ~ Outdoor [] Addition
Switches Receptacles Fixtures GFI Heaters
3
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps
Furnace Oil Gas Circulators Smoke Detector
Television
Meter Amps Phase UG/OH Jacuzzi
/
Bldg. Permit: 35316Z
Other Equipment
Hugo S. Surdi
President
Trellas- 3 Well Lights
Basement ~ Hot Tub
[] Survey
A/C Fans
Microwaves
Bell Transformer
CO Detector
Rough ~spection: ~
Inspector: .~John Mc Mahon III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
~', ~:LrPIN~cTIoN REPORT I DATE]
FOUNDATION (1ST)
..... ~ ................... ~.
FO~A~ON (2~)
· ROUGH ~G &
pL~G
STATE E~R~ CODE
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork. net
Examined
Approved
Disapproved *ftc
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: ~
/ Building lnspe~otor
3)~///11 APPLICATION FOR BUILDING PERMIT
I ~ INSTRUCTIONS .........
~ Scompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4
l'g'6-Fplans, 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. Thereat~er, 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, housin,~,..oo~, an~gulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
'"Th'q'~ature 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
r', ..dFX' .
Nameofownerofprem,se~ ..]Oho u t,..-O ¢xu\(-~F~
(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.
1. Location of land on which proposed work will be done:
House Number Street Hamlet
County Tax Map No. 1000
Subdivision
Section (,~ ~ Block
Filed Map No.
Lot ~
.... Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of dwelling units
If §arage, number of cars
Addition Alteration
Other Work
Fee
(Description)
(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
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear , .Depth
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 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 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
* 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__
· IF YES, PROVIDE A COPY.
NO
STATE OF NEW YORK)
SS:
COUNTY OF
.... V(~ q,[( ~rq (- .~.~'~.~/7.~_ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above n~d,
(S)He is the
(Cohtractor, Agent, Corpor-at~Dfficer, 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.
Sworrkto before me this /
~[..~) ~4~. day of-'~J, tq ~ 20 } ~
/
/ -- '~ta~ Publid
Signature of Applicant
IG & CONNECTIOI~
REQUIRED.
1000-66-01-33
!~ DATE: 1-15-2010
WALKER RESIDENCE
~:~ ~:,~%~,~,~ o:~ AS BUILT TRELLI'S
~'. ~?/~.~;I .-,, SK 1
z-¢. ~; ~,~::~:? .~ SOUTHOLD NY -
'~': ?[t~?' '~CHORNO ASSOCIATES
,%,
% ,.9
%
?
/
TEST HOLE DATA
(T£S7 HOt£ OOG BY ~cOONA£D GEO$C~ENC£ ON SEPTEMBER 20, 2005)
%
NOTES'
SURVEY OF PROPERTY
S£TUA TE
SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-66-01-55
SCALE 1"=20'
JULY 51, 2006
SEPTEIvlBER 19, 2006 ADDED DRYWELLS & PROJECT LIMITING FENCE
OCTOBER 25, 2006 ADDED NON-DISTURBANCE BUFFER
MARCH 12, 2009 REVISED PROPOSED POOL
OCTOBER 5, 2009 FINAL SDRVEY
JANUARY 8, 2010 UPDATE FINAL SURVEY
AREA = 52,560 sq. ft.
(TO TIE LINE) ].202 ac.
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM
2, FLOOD ZONE INFORMATION TAKEN FROM:
FLOOD INSURANCE RATE MAP No. 36103C0158 G
ZONE AE: BASE FLOOD ELEVATIONS DEIERMINED
ZONE X' AREAS D~TERMINED TO BE OUTSIDE $00 YEAR FLOODPLAIN.
NYS L[c. No. 50467
Nathan Taft Corwin III
Land Surveyor
PRONE (631)727-2090 Fox (551)727-1727
26-BS~H