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Home My WebLink About35041-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34464 ~te: 07/12/10 THIS UK4~TIFIES that the building WINDOW REPLACEMENT Location of Property: 600 OAK ST CUTCHOGUE (ROUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 136 Block 1 Lot 43 Subdivision FiledMap No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 28, 2009 pursuant to which Building Pex~t No. 35041-Z dated OCTOBER 1, 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 WINDOW REPLACEMENT, IN KIND AND IN PLACE, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PAUL M JENSEN & ANN MARIE MBNDOCHA (OWNER) of the aforesaid building. SUFFOLK COUI~I~fDEPARTF~I~TOFHE~-LTHAPPROVAL ELEt-rKICAL C~'rlFICATH NO. P~UMBERS CERTIFICATION DATED N/A N/A N/A ~zed Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC~ This application must be titled in by typewriter or ink and submitted to the Building Depart~ BLDG. DEPT. 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. Commemial 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 Plarming Board Approval of completed site plan requirements. 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 unnsual 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 i'easons 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 $ l 5.00 Date. New Construction: Old or Pm-existing Building: Location of Property: ~ t9 rD (~ c_&_~__. .~ House No. Street Owner or Owners ofPmperty: ~',~/d ~/~-3J~)OC~t /~ Suffolk County Tax Map No 1000, Section [ ~ (~ Subdivision Permit No. (check one) Ham~ '" Date of Permit. Block t Lot Filed Map. Lot: Applicant: Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: (cheek one) Fee Submitted: $ - Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII/DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35041 Z Date OCTOBER 1, 2009 Permission is hereby granted to: JENSEN/MENDOCHA 600 OAK ST CUTCHOUE,NY 11935 for : WINDOW REPLACEMENT IN PLACE IN KIND AS APPLIED FOR at premises located at 600 OAK ST CUTCHOGUE County Tax Map No. 473889 Section 136 Block 0001 Lot No. 043 pursuant to application dated SEPTEMBER 28, 2009 and approved by the Building Inspector to expire on APRIL 1, 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 [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SA~-.', ~' INSPECTION [ ] FIRE RESISTANT CONSl'RIJC'flON [ ] FIRE RESISTANT I~IETRATION REMARKS: DATE ?'"-~ ~/~ INSPECTOR'~'~ attn: Pat at Town of Southold, building department Replacement windows for 600 Oak St., Cutchogue: specs with energy factors: 11 windows 9- s6 3/4" 9 - 56 3/4" X 33 3/4" X 25 3/4" American Craftsman Series 3000 7/8" LO E2 Insulated glass with argon gas, structural rating of DP - 50 Windows will replace old windows in kind, with no changes. Ann Mendocha 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___ SEP 2 8 2009 ~LD6. DEPT. TOWN 0[ SOUTHOLD PERMIT NO. Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval SurveX Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form ¢onta O /5 f, Phone: 5[ /0 "' t.~q t~,~:2 APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS Name of owner of premises If applicant is a corporation, signature of duly authorized officer (N dtitl f rp ffi r) ' amean eo co orateo ce ., , .,.,WFU,.. Builders License No. 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 promises 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 cfa 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 aX'corporation) ~ -,~O~c ~..k,~'¢~ ~ ~,., ,t4Uailing addre~s~of applicant)~\ '~" ~" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (As on the tax roll or lates(de~x~)~T}~il]::" ' ' '7;:rL'~:lxT~ Kr '~ *t" $,%,,, ',. ;: ~ FOR THE 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 ..... r".-, ~"r'- 3. ii4SULATION ' , ~,-i :, - ,'" ~' ......... N MUST ' ' 4. FINAL ' ~.,'--' (' BE COYPLE,d "'; 30. ALL CONSTRUCTDN SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW ¥O;-1K STATE. Nt. T' p, ESPOHSIBLE FOR ~ ~~ CONSTRUOTION ERRORS. Hamlet County Tax Map No. 1000 Section l~(o Block I Lot Clb~.'.~ Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~c~_~.~.~,< ~i~._~r.~_._ b. Intendeduseandoccupancy %~_~._x~3,t~ 3. Nature of work (check which applicable): New Building Repair ~ Removal Demolition Addition Alteration Other Work 4. Estimated Cost '~ [k,OI30 po 5. If dwelling, number of dwelling units If garage, number of cars (Description) , 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 Height. Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height. Number of StorieS 8. Dimensions of entire new construction: Front Height Number of Stories Rear 9. Sizeoflot: Front Rear Depth Dep!h 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 J 13. Will lot be re-graded? YES NO ~Will excess fill be l~emoved from premises? YES__ NO ~ 14. Names of Owner of premises ~u[~'~E~'~, Address ~%k~._~'~--~xJ~ ~',~ Phone No. Name of Architect Address Phone No Name of Contractor 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 NO ~ · IF YES, PROVIDE A COPY. STATE OF N_[EW YOjkK) ./~.,~.'~ ~129,r~ ~ ~,,~6k...- being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) 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 belbre me this ,-n ~ ~} Qc[~y. of ~ ql- 202 ~ xrC- wc 'roYH 'k ~ '~(.~ I ~-'-I~MryPublic, State of New Y~rk .... , rio UIT05190696 pqotary ruonfflua~ in Suffolk ~'"" 7...- Bs~C ~ MAP OF: Pr~oPERTY' GRANITL. HALLOC K DOROTHY H. HALLOC K :t VAN