HomeMy WebLinkAbout35078-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34241
Date: 03/25/10
THIS u~KTIFIES that the building ALTERATIONS
Location of Property: 780 YEWNECOTT DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 6 Lot 6
Subdivision Filed Map NO. Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 15, 2009 purs~ant to which
Building Permit No. 35078-Z dated OCTOBER 19, 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 KITCHEN ALTERATION IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ROBERT GUIRY
of the aforesaid building.
(OWNER)
SUFFOLK COUN~"f DEPARTMENT OF HEALTH APPROVAL
ELRC~rKICAL U~UiTIFICATH NO.
PLUMBERS c~aTIFICATION DA'r~u 03/22/10
~/A
131535C 02/26/10
MATTITUCK PLUMBING & HEAT
Rev. 1/81
II ~fl]~ BUILDING DEPARTMENT
!
765-1802
IOWN OF SOUTHOIO ,~PPLICATION FOR CERTIFICATE OF OCC~CY
This applicat/:on 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 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 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 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
New Construction:
Location of Property: '7 ~)
House No.
Owner or Owners of Property: '~O~2~T' ~ Ck_i ff~
Suffolk County Tax Map No 1000, Section (0~
Old or Pre-existing Building: / (check one)
~ Street Hamlet
Subdivision
Permit No. ~ ~g) -]
Health Dept. Approval:
Date of Permit. }O}lq]Oq
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~'. tr~
Block 0 190 ~p Lot
Filed Map. Lot:
Applicant: r/~OD f~' ~Z~ ~'/~l,~lS
Underwriters Approval: ~
Final Certificate: ~// (check one)
~ture
Issue Date
2/2612010
Electrical Inspection Certificate
Electrical Inspection Service, Inc. Application Number
375 Dunton Avenue 131535C
East Patchogue, New York 11772
(631) 286-6642
Issued To: Guiry Residence
Street: 780 Yennecott Ddve
Village: Southhold Zip: 11971
Section: Block: Lot:
Town: Southhold
Contractor: Complete Quality Electric
Was examined and found to be in compliance with the Nafionat Electrical Code.
Lic. # 34161-ME
[] Commercial [] NV Defects [] Pool [] 1st Floor [] Indoor [] Basement [] Hot Tub
~] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey
Switches Receptacles Fixtures GFI Heaters A/C Fans
8 9 9 3
Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves
I I 40 1
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi Television CO Detector
/
Bldg. Permit: 35078
Other Equipment
K~chen
Hugo S. Surdi
President
11/18/2009
I InspeclJon: 02/24/2010
John Mc Mahon Ill
This certificate must rmt be altered in any manner. Inspectors may be identified by their credentials.
~,;,,r' HaH, 53095 Main Road
PO Box 1179
BUILDING'DEPARTMENT
TOWN OF SOUTHOLD
Fax (631) 765
Telephone (631
CERTIFICATION
[~ad
I certify that the solder used in the water supply system contains less than 2/10 o£ I%
S~orn to before me this
day oi' ~ , 20 /o
;xolar), Public; ,~~__Counly
Signature)
DENISE KING
Notar? Pul)lie, State of New York
Registration #01Kl6041757
Qualitied in Suffolk County
My Commission Expires May 15,
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. 35078 Z
Date OCTOBER 19, 2009
Permission is hereby granted to:
for :
INTERIOR ALTER3ITIONS
ROBERT GUIRY
PO BOX 1152
SOUTHOLD,NY 11971
(KITCHEN) TO EXISTING SFD AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 055
pursuant to application dated OCTOBER
Building Inspector to expire on APRIL
780 YENNECOTT DR SOUTHOLD
Block 0006 Lot No. 006
15, 2009 and approved by the
19, 2011.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING
FIREPLACE & CHIMNEY
fiRE ~ES~'T~IT CO~mUOT~I
]~IGH PLBG.
,,~INSULATION
FINAL
fiRE SAFETY INSFECTWN
RRE IIESlSTANT PENETRATION
MORIZZO,I
Kitchens &Baths,
Complete Kitchen & Bath Remodeling
SHOWROOM: North Road Commons, Unit 19
22355 Route 48, Cutchogue, New York 11935
· DESIGN · SALES · INSTALLATION
P.O. Box 789 · Southold, New York 11971
Phone: 631-765-5772 · Fax: 631-765-6196
October 16, 2009
To: Building Department
From: Ron Morizzo
In reference to the Guiry job:
1. Replace two Kitchens windows (same size) with new Andersen insulated windows.
2. Remodel Kitchen: new Kitchens cabinets and tops.
3. New Lighting.
If you have any further questions, please do not hesitate to call.
,.~ .....r~ I a~S C~-r~ ~ ir ~,~ i L
REQUIRED
nt
CER'f 5:~CATION OF
NAILING 8' CONNECTIONS
,, , .¢~cc~I ;iRED.
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF '[HE 'f0WN CODE.
NOTIFY
765.1802
FEgLD INSpeCTION REPORT I DATE I COMMENTS
FOUNDATION (1ST)
FoLrNDATION (~ND)
PL~G
~DITION~ COUNTS
TOWN OF SOUTHOLD
BU1LDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined
Approved
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
Contact:
Mail to: ~--/~/~ [~(1~.~.0
Phone: 7C,"5- 5-t"7
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. This application 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 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 ofpremises ~',O]2~0 (7"' ~.~L/.t 1~
CAs on the tax roll or latest deed)
If al~cant is,a corporation, signaturetqf duly authorized officer
~ (Nam~ and title of corporate oYf~ce{)--
Builders License No.
Plumbers License No. ~ 9, lc, -t-~
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:
-7,fo
HOuse Number Street
Hamlet
County Tax Map No. 1000 Section ~'"-~ Block ~
Subdivision Filed Map No.
rot 6
Lot
2. State existing use and occupancy of premises ?d intended use and
a. Existing use and occupancy ~F~-i ~1.
b. Intended use and occupancy ] ~v~-~
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost ~"~'10't70' Fee
5. If dwelling, number of dwetling units
If garage, number of cars
o~f proposed construction:
Addition
Other Work
Alteration .~
(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. Sizeoflot: 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 '~'~OV~
Soo ,,ot o
15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES
* IF YES, SOUTHOLD TOVv~N TRUSTEES & D.E.C. PERMITS MAY I~E/REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO~_
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
Address Phone No.
Address Phone No
Address~.O ~o~ 7~q PhoneNo."7~:5'-O~'Tq 2--
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 _~
/
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
CO~'~'NI£ O. ~ONCH
~otary Public, State of New ¥o~
No, 01[1U6155050
, Qualified in Suffolk Count
t-.ommissior~ Expires April 14 ~ ,J ~._
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing,,qontract) above 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 tree 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 before me this ~ ~
\~--~ dayof [-~c~ 20 ~)5
Notary Public
/~icant
TOWN
OF SOUTHOLD
OWNER
FORMER OWNER
,TRE~r
N
S
PROPERTY RECORD CARD
V l LLAGE
E
w
DIST. SUB. LOT
TYPE OF BUILDING
RES~/,~i O SEAS. VL. FARM COMJ~. CB. MICS. Mkt. Value
LAND IMP. TOTAL
DATE
/~/ ~ / ~
REMARKS
Value Per Vclue
Ac re
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowla~d DEPTH
BULKHEAD
House Plot
Total
DOCK
COLOR
TRIM
M. Bldg.
Exter~sion
Extension
Porch
Breezeway
Garage/' ¢o~9
Patio
o B.
Total
Foundation
Basement
Ext. Walls
· Fire Place
Type Roof
Recreation Room
Dormer
D/c Both
F oars
· }nterior Finish
Heat
Rooms 1st Floor
Rooms 2nd Floor
Driveway
I Dinette I
LR.
BR.
FIN. B
APPLICANT:
'CO TT
5O
V3,~98 '