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HomeMy WebLinkAbout35353-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34218 Date: 03/09/10 T}{IS ~KTIFIES that the building REPAIRS Location of Property: 27835 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 102 Subdivision Filed Map No. CUTCHOGUE (STREET) (HAMLET) Block 1 Lot 18.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 22, 2010 purs,,~-t to which Building Permit No. 35353-Z dated FEBRUARY 23, 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 REPAIRS TO AN EXISTING FOUNDATION (PARISH HALL) AS APPLIED FOR. The certificate is issued to RC CHURCH OF SACRED HEART ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTM~qT OF HEALTH API~ROVAL ELECTRICAL c~KTIFICATH NO. PL{~4BERS C~u(TIFICATION DA'r~u3 131677C 11/24/09 Authorized 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 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 tmusual 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 amhitect or engineer responsible for the building. 6. Submit Planning 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 unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees t. 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 -©) -~ -lc: Date. i New Construction: Old or Pre-existing Building: (check one) Location of Property: f"~ Y?)D t%~"~ ~ dG~Of~,~il~~ House No. Street .~ - H~let Owner or Owners oferope~y: ( ,~. , ('~vX(~ ~C~( Suffolk Co~ty Tax map No lOOO, S~tion [C~ Block I Lot ~. ] Subdivision Date of Permit.-~' ~3 - I 0 Permit No. ~¢).5 ~ ~ Health Dept. Approval: Filed Map. Lot: Applicant: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ I f,L ~ ( (- ,g I - Final Certificate: (check one) Applicant Signature DEC-11-8009 09:56A FROM:LADEMANN ELECTRIC IN 6317347286 T0:7345861 Pol~I Issue Date 11/24/2009 Electrical Inspection Certificate Eisctrlcal Inspection Service, Inc. Application Number $75 Ounton Avenue 131877C East Patohogue. NewYofl~ 11772 Issued To: Street: Village: Section: Sacred Heart Parish Recreation Center Rt 25 Main Road Cutchogue Zip: 11935 Block: Lot: Town: Southold Contractor: Lademann Electric Inc. (L) Lic. # 4141-E Was examines and found to Da In compliance with the National EleGtricel Code. ~ Commercial [] NVDetecte [] Pool [] tetFIoor [] Indoor O Basement ~ HotTub [] Residential I'~ DeL Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Recepteeles Fixtures 10 Dishwasher Washer/Amp,, Dryer/Amps Furnace 011 Gas CIrculatom Mater Amps Phase UG/OH Jacuzzi / Bldg. Permit: Other Equipment GFI Heatem A/C Fans 2 Oven Range/Amps Microwaves Smoke Detector Bell Transformer Television CO DeteGtor Hugo S. $urdl President This M/tlficate must not be mitered in any manner. Inspectors may be Identlfiecl by t~elr crecle,tisis. 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: 'h(-~ --~--~%~'~ / INSPECTOR FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35353 Z Date FEBRUARY 23, 2010 Permission is hereby granted to: CHURCH OF SACRED HEART RC PO BOX 7775 GARDEN CITY,NY 11530 for : REPAIRS TO Ai~ EXISTING FOUNDATION(P~RISH HALL) AS APPLIED FOR. at premises located at County Tax Map NO. 473889 Section 102 pursuant to application dated JANUARY Building Inspector to expire on AUGUST 27835 MAIN RD CUTCHOGUE Block 0001 Lot No. 018.001 22, 2010 and approved by the 23, 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 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 }'/.,~5 , 20 ,/o Expiration ,20 JAN 22 2010 BLDG, DEP[ PERMIT NO. g5555 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 Contact: Mail to: Phone: ?~pector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 Cc/ a. Tlfl~%t3rt~t~[t'l~ MUST b~ completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 se~s 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 'ad'd~e6s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If plicant is a corp, pratioj~, sig~, ature o~tuly authorized officer (l~e and title of co~(orate officer) Builders License No. Plumbers License No. Electricians License No. t~ l c~ [ ~'--" Other Trade's License No. Location of land on which prop. osed wor!q, xwi[1 be done: House Number Street County Tax Map No. 1000 Section I D ~)~ Block Subdivision Hamlet I Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy ofpropose~t construction: a. Existing useandoccupancy /7,]~r~?,~ ~/~' b. Intended use and occupancy ,_~, ~/~'rlq[, ~ FL ff-~[ 3 ~T A/ G ~F-~ d~ ~x~i-~o/V/ 3. Nature of work. (check which applicable): New Building_ Repair '.~/' Removal Demolition 4. Estimated Cost ~ol ~ ,o Fee 5. If dwelling, number of dwelling units If garage, number of cars f9 Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor O 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 ! 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 J 13. Will lot be re-graded? YES NO '/Will excess fill be removed from premises? YES__ NO ff/~ 14. Names of Owner of premises Address Name of Architect <~'-~a~¢~. -'Oece_k~,[i Address Name of Contractor 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. Phone No. Phone No ~o vt.go ,~,~. Phone No. NO f 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. STATE OF NEW YORK) SS: COUNTY OF ) (Name of individual signing contract) above named, (S)He is the ~t~. 0_ t0a~4a_c~-a-~ /-- '~q~$u~¢,~L ~'~ b (Contractor, Agent, Corporate Officer, etc.) NO CONNIE D. BUNCH Notary Public.State of New No. 01BU6185050 Oualified 'n Suffolk Co~m) Commission Expires A~ril ~ ~(~t being duly sworn, deposes and says that (s)he is the applicant 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. Swom to before me this ~h3~r~ c{ day, o f ~--~ ,~,w, O,w~ 20!O Notary Public / STgnatu3~ of~pplicant