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Home My WebLink About35343-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34228 Date: 03/16/10 THIS CERTIFIES that the haildin9 ADDITIONS Location of Pr~perty: 750 LIBERTY LA (HOUSE NO.) (STREET) County Tax ~ap No. 473889 Section 79 Block 6 subdivision Filed ~ap No. __ Lot NO. __ SOUTHOLD Lot 27 ( HAMLET ) conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 9, 2010 pursuant to which Buildin9 Permit No. 35343-Z dated FEBRUARY 9, 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 DINING ROOM ADDITION, "AS BUILT" SCREENED PORCH AND DECK ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RAYMOND M & DONNA M PENNEY (OWNER) of the aforesaid building. SuFfOLK COUN~"fDEPART~ITOFHE~LTH~PPRO~ EI~-r~ICAL c~TIFICAT~ NO. PLUNBER~ CERTIFICATION DA'r~ N/A Signature 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 witl: Ao For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and m 3. 4. 5. topographic features. 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. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. 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. 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 $$0.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 $. Temporary Certificate of Occupancy - Residential $15.00, Commercial $1 $.00 New Construction: ./'/ Old or Pre-existing Building: Location of Property: 70~ /~/~5~.~/~./r L~. House No. Street Owner or Owners of Property: Suffolk County Tax Map No 1000, Section 7 ~ Block Date. (check one) Hamlet Lot o.~ ~ Subdivision Filed Map. Permit No. ~.~ 5'--~ ~,~ DateofPermit. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Subinitted: $ ~ 3- Final Certificate: ~ (check one) FROM : MarkSckwartz,AlA-ArcMtect PHON~ NO. : 6317342118 Mar. 07 2810 08:17AM PI B,CHITECT MARK SCHWARTZ & ASSOCIATES March 8, 2010 Southold Town l~ilding I)elmr~e~t Main Road Southold, New York 11971 Additions and Alterations to: Peramy House Southold, New York (SCFM# 1000-79-06-27) To Whom This May Concern: I have been to the site and reviewed the existing 12' x 16' Dining Room, the Screened Porch and the existing deck. To the best of my knowledge, the structures are built as per plans and bttilt to code at the time they were ~onstm~ed. Please call this office ff you have any questions or require additional information. Penney House '/5~ Lit] ERTY LANE SOIYI'ItOLD, RA' (~EA~) 2X4 FRAJ~ED PORCN",X/ALL $1'lJD; AT 24"O~ OYE~ EXIt"rING DECI(. 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 INSPECTOR \\ 0 ,0 ,.,,,1 0 ,! ';.'.'_ "% ',EM?D:, ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING ~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~~ -~ ~ ~ DATE '~--~"~/o iNSPECTOR___~ ~ L Q 0 q 0 .j 0 U i N ~ Q 0 22.9 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. 35343 Z Date FEBRUARY 9, 2010 Permission is hereby granted to: RAYMOND & DONNA PENNEY PO BOX 1734 SOUTHOLD,NY 11971 for : BUILD AN ADDITION ON TO AN EXISTING DWELLING. REPLACES EXPIRED BP # 7653 at premises located at County Tax Map No. 473889 Section 079 pursuant to application dated FEBRUARY Building Inspector to expire on AUGUST 750 LIBERTY LA SOUTHOLD Block 0006 Lot No. 027 9, 2010 and approved by the 9, 2011. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD EUILDING DEPARTMENT ~WN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PJ~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7653 Z Permission is hereby grantedto: .,i',Rm,~.. &. :.lM.eL.lldat'~ ............................ at premises located at ....~e~llJ~..~.~J~lJ~..JJ ...................................................................... ............................................ Jai,~e~ ....... Je~tim,~.....lt,?Z+ .......................................................... pursuant to application dated ....................... J)~ ....... ~ ............... , 19..~.., and approved by the Bulld~ng In~"tor. FOR~I NO. 1 TOWN O~ $O~TSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ..~....~ .... APPLICATION FOR BUILDING PERMIT / Date .................. ./..~.....~..~... ............ , 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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 pa rt 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 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 aJterations, 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. buildings fornecessary inspections. ' ............. .............................. State whether applicant is owner, lessee, agent, architect, engineer, generaJ contractor, electrician, plumber or builder. .................................... ...................................................................................................................................... Name of owner of premises ....s~.d~..~.Z~.. ............................................................................................................................. If applicant is a corporate, 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 ............................................... ~O.~/.~... ~t...N.~ ~ ...~.~... ~O~nOdf ~l:dm::r w.(x~p~p,,o.;~.' ..w.~.°. 'r .~..~.~n.,:.. .... .M..~: .N..:.:... ................... ~' .......................................... .... ............ . . ....... ... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy //~'~'~z'/~'"~ /~'~"( b. Intended use and occupancy ................... ~.~f'...~. ............................................................... 3. Nature of wore (check which applicable): New Building .................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Wore .................................................... ..~.....~...) . ~-- ~ (Description) 4. Estimated Cost ................ .C)...~...~.:.~..~. ............................ Fee ....Z,~....~... ....... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... L ................ Number of dwelling units on each floor ./ .............. If garage, number of cars ......... ~..~..4~...~.. ....................................... 6. If business, commercial or mixed occupancy, specify nature and extent of eac~h type of use 7. D mens ons of ex st ng structures, tony: Front ............. Rear ........ Z...7.....~.. ........... Depth ....~-....~. .......... ?/ Height ...... /. ................ Number of Stories -/ Dimensons of ame structure wth oterat OhS or add t OhS' Front .~..~'. '~:/"~ .rs .................................. Rear ............................ Depth .~.~./.~....~.../. ........... Height ........ ../...7...../. .......... Number of Stories ........... ./. ................... 8. Dimensions of entire new construction: Front .............. ./...~....~. ............ Rear .... ../~ ................. / . .... Depth ...../..~.. ............... . Height .................. Number of Stones ..................................................................................................................... / 9. Size of lot: Front ........ /..,~.-~.'..~....~. Rear /~,,~, ~...O. Depth /.~C~To/~?,~... 10. Date of Purchase ..................... ./....~..~..,/,. ..... Name of Former Owner ......./~...~.,,~.,~...~. .................................... 11. Zone or use district in which premises are situated ~'~..~..~...~.q./~.. .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .//..~.Q:. ......................... 13. Will lot be regraded ............................ Will excess fill be removed troy,premises: ( ) Yes (J~) No 14. Name of Owner of premise~G.~./~./~..~....~...~...~..~..~....~...~... Xddress?.q../?....,~..~.~..~.~.. ...... Phone No..,~.~...~....Z..Z~'~... Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exL~ting 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 corner lot. STATE OF NEW ~;;),R~', ~-/ /.~ / COUNTY ~t):~.~:?~.~ ...... )' ~"~ / /~a~di~dual ~g ~ntracf) duly sworn, deposes and says that he is the applicam above na~ed. 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 belie~; and tha~ the work will be performed in the manner set fo~h Jn the application filed therewith. ~ Sworn to before me this ~ ~ / / v . ................. .... ............................. - ~ (Sig~ ~pplicont) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20 Approved Disapproved a/c ,20 Expiration ,20 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 Fom~ N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form C °ntaet :Mail to: j~,~, .~ff_- /~C, .~" ~ff~ f ~'~ Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 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 par~ 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. I"~'t (g~'g~a~re ofl(ppl(c~nt or name,~ coJ'poration) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~'~/{/~//qO t~ DtO/{/AJ~'~ (As/on th-e 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 op which proposed work will be done: House Number ' Stree5 ,Yv o 7-'r-/vcw Hamlet County Tax Map No. 1000 Section Block Lot bdivision Filed Map No. Lot 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 garage, number of cars Addition Altera.~tion OtherWork /'f,J" ,t~(/t'6,~ 7~7"]~'' Fee (Deschpti°n)/'q/~7~ (To be paid on filing this applicatioh) ' - - 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 .Depth Height Number of Stories 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 9. Sizeoflot: Front~ Rear / Rear .Depth 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 &/t)At'l~o Address Phone No. 7~ Name of Architect _\' C ~ ta/~rr'Z T-'/~_ Address -Phone No 7ff .~-~ Name of Contractor Address Phone No. 15 a. ls this property within 100 feet ora tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY B~REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOg * IF YES, D.E.C. PERMITS MAY BE REQL~IRED. INO J(' 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 C~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) O~t{.]A/J4~-- D~rJtllJq being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing~cont"~alt'55ig(~e named, (S)He is the 0(~//~ ~/~., (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 day of 20__ Notary Public Signature of Applicant ......... ........ Appro,,ed ................ ........ .5.... ........ , ................... ................................. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. INSTRUCTIONS ~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildin~ .~ 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 ofproperty must be drawn on the diagram which is part of this application. 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 wi!l issue a Building Permit to the applicant. Such permit ~, shall be kept on the premises available for inspection throughout the work. L/ 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 o Building Permit pursuant to the,?~, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances 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 lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. / ' ~]gnature of applicant,~or nam¢if a corporation) ........ .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generaJ contractor, electrician, pJumber or builder. ................................... .................................................................................................................................... Name of owner of premises ............ ..~....-~../Z.¥'..~. ....................................................................................................................... If applicant is a corporate, 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. Mop No.: ............ ...~.o..~.~. ............... Lot No.....~..9..4.?'-.'. ......... Street and Number .................... ~..~?~:¢-.'~.d44,.....~....~d.x~.~.~.~.~.i ................... .~.,:,.~.¢.-'.-~ .............................. ~ ~'~-~ 7.~ 0 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................. ,/.... ~:2.'./...4,.(~'....../...~..~..I~..~..' ................................................................. b. Intended use and occupancy ............ ~--~,~2,'~-- ~Y~k._ 3 ure of work (check which applicable): New Building .................. Addition .................. Alteration ........... Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... (Description) 4. Estimated Cost ............. ~..~..~..o..¢...O.......o..O.. ...................... Fee (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 ...................... ,/~..O...4Z.~: ....................................................................................................... 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.........../-~..¢'¢'x//~'...................... Depth .~.d. ........... Height ......... /...~. ......... Number of Stories ................ /. .................. Dimensions of sarn~ structure with alterations or additions: Front .,./"//4/'/ Rear .... .~t'.~..~.~ ....... /.~....2. / ~/ .................................... Depth ........~...~ ...6. ....... Height ......... /.. ................ Number of Stories ......... ./. ............. / / 8. Dimensions of entire new construction: Front ..............~ .................... Rear ......... /...v-z. ............. Depth . ....................... /,2 / Height ....... ./..~ ........ Number of Stories ............../. ................................................................................... 9. Size of lot: Front ............. ./...,~...~..-.....~..~ Rear /.~..~. ?~ r~,~ ?,,Z,¢':~/,~i~"~"~/ 10. Date of Purchase ....... ./....~..~.../.. .................. Name of Former Owner ........ ../.¢..~.~..'~.¢~' ............................... 11. Zone or use district in which premises are situated ................ .~....q.¢.~. ~..,~...~..~...,~.. ........... 12. Does proposed construction violate any zoning law, ordinance or regulation: .../...~...O.../. ........................................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes (~f~o 14. Name of Owner of premises~-~..fC-~....~....¢~.//,/~.~.....~..~.~..~./~....~...~... Addres~.4.~.~W./..,¢..~....~...~... ...... Phone No....~..~.~.7.~.+./.~ Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... 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 corner lot. STATE OF NEW ,.v-~)R~ ~ tS ( COUNTY OF ...~/~C'~:.~. ...... ~' "~ / // ---.. zz~ .~,--¢ xJ-~-.. /~,~,...~.~./'~..~.C~ bein duly d~oses and soys that he is the applicon, ~ of individual sign~g~rf .... sworn, above nam~ ~ ~ , He is the ;;rpo, t omce , " ' of said owner or owners, and is duly authorized to perform or have performed the soid~ to make and file this application; that oll statements contained in this application ore true to the best offs knowledge and be ief; and that the work will be performed in the manner set foffh in the application filed therewith./ Sworn to before me this ,~ / ................ of ...... ,X x .................. ...... // - ............................. REVISIONS: (REAR) ELEVATION -- ' ' SCALE: NTS : : ' ~ --- "' "I' I , I ' ~ : ~ 1=il I $CREENED PORCH [ v. III I ~ i ~. (2)~x~ ~ I _ i_ i-_.~-.i I .......... , I~.__~. .......... k~. , , , . i , . , . . ~ . EXI~I'ING HOUSE i . .~. :....:,;~ FLOOR P~N ~' ~: PROJE~ NORTH CROSS SE~ION ~ ~111~' ~ SCTM~ 1000-79-06-27 s~ce: u*': r-o" z A5 BUILTA-1