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Home My WebLink About35829-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34571 Date: 09/22/10 THIS CERTIFIES that the building EMERGENCY REPAIR Location of Property: 680 MIDWAY RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 90 Block 2 Subdivision SOUTHOLD (HAMLET) Lot 9.1 Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 13, 2010 pursuant to which Building Permit NO. 35829-Z dated SEPTEMBER 13, 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 EMERGENCY REPAIR IN KIND IN PLACE IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PREM C & THERESA M CHATPAN ( OWNER ) of the aforesaid building. SUFFOLK COI]NTYDEPART~TOFHEALTHAPPROVA5 EL~C~rKIC3%L t~U~TIFICATH NO. PLUMBERS C~TIFICATION DA-r~4~ N/A N/A N/A A/th'i/ze~Signature Rev. 1/81 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. 35829 Z Date SEPTEMBER 13, 2010 Permission is hereby granted to: PREM & THERESA CHATPAR 6 SIMONSON COURT GLEN HEAD,NY 11545 for : EMERGENCY REPAIR 1ST FLOOR ONLY IN PLACE IN KIND AS APPLIED FOR. ADDITIONAL CERTIFICATION/INFO MAY BE REQUIRED. REPLACES EXP:33756 at premises located at 680 MIDWAY RD SOUTHOLD County Tax Map No. 473889 Section 090 Block 0002 Lot No. 009.001 pursuant to application dated SEPTEMBER 13, 2010 and approved by the Building Inspector to expire on M3tRCH 13, 2012. Fee $ 200.00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUIIJ)ING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 33756 Z Date MARCH 21, 2008 Permission is hereby granted to: PREM C & WF CHATPAR 6 SIMONSON COURT GLEN HEAD,NY 11545 for : EMERGENCY REPAIR FIRST FLOOR ONLY IN PLACE IN KIND AS APPLIED FOR. ADDITIONAL CERTIFICATION/INFORMATION MAY BE REQUIRED. at premises located at 680 MIDWAY RD SOUTHOLD County Tax Map No. 473889 Section 090 Block 0002 Lot No. 009. 001 pursuant to application dated MARCH 17, 2008 and approved by the Building Inspector to expire on SEPTEMBER 21~9~.~ oo.oo ed'SJ 'nature ORIGINAL Rev. 5/8/02 BUILDING DEPARTMENT - · t0w 0f s0u 0t0 ~ For new buildl~ or aewuse: .2. F~ ~ ~m H~ ~t. 0f wat~ supply ~d sew~g~apos~ rS-9 ~. ~p~ of el~ ~l~on-~ Bo~ of F~ Unde~tem B..For e~g.b~gs.~or ~ ~ffi 9, 195~ non~nfomi~ us~, or b~gs ~d ~p~sfl~" land us~: 2. A p~perly ~mplet~ applica~oa ~d ~usent to im~t si~ by the ~pli~t. ~a Ce~ficate of Occupancy is de~ ~a B~d~g ~sp~tor a~l s~ ~e ~om ~e~for in ~ting to the appli~t. C. F~s 1. Ce~ficate of O~p~cy - New dwel~g $25.00, Ad~tiom to dwe~g $25.00, ~temtiom to dwet~g $25.~, Sw~ pool $25.~, A~so~ bu~ng $25.~, Addi~ons to a~so~ build~g ~25.0~, B~esa~ $50.00. 2. Ce~fi~te of Oo~p~ey on P~x~ting Buil~g - $100.00 3. ' Copy ofCe~ifi~e ofO~up~cy - $.25 4. U~at~ Ce~ifi~te ofO~cy - $50.00 5. Tem~ ~ifi~te of O~up~ey. Resi&nfial $15.00, ~ercial $15.00 Health Dept. Approval: Piann~.s Board ApProval: (cheek One) ' ' .' - - Underwriters Approval:. Request for: Temporary Certificate Fee Submitted: $ ~. ~ Final Certificate: (check one) Date. t~ew Construction: -. . Old or Pm-eXisting Building: Location of Property: - House No. I. Street Hamlei Subdivision ~ ~-,-~.~,-, Tt.~, ~--.t4- ~ Filed Map. Lot: :Dateofpcrmit. ApPlicant: · fIELD LNSPECTION REPORT FOEri'SDATION (1ST) FOL~DATION (2ND) ROUGH F~G & LNSL~A~ ION PER N. STATE ENERGY CODE ~DITION~ CO~S m TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ~/2 ' 20~'/ Approved / ,20 Disapproved a/c Expiration ,20 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the fol owing, before applying? PERMIT NO. ,c~"-4r5~ Board of Health 4 sets of Building Plans Planning Board approval Survey Check ,,,~t~ .o ID Septic Form N.Y.S.D.E.C. Trustees Storm-Water Assessment Form I 7 Contact: Mail to: ~'7~gO~4a.54 4- [~ C.~4'~ g Bmm,ng I~ec APPLICATION FOR BUILDING PERMIT Date 9[ ~1 ,20 0g INSTRUCTIONS a. This application MUST be completely filled in by typewriter or i~ mk 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, r, htionship to adjoining premises or public streets or areas, and xvaterways. c. The work covered by this application may not be commenced befbre issuance of Building Pemfit. 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. (Sigha~'of applicant o~Jaame, ifa corp~ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~rg~ C. ~Na~, a~_ -(~q~-~eOa M. ~)cecOe~rcSo, si- (As on the tax roll or late~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 Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) ~O Block 2- ~ ' i Filed Map $o.~~a~,tO~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 5. If dwelling, number of dwelling units If garage, number of cars a. Existing use and occupancy b. Intended use and occupancy ¢~1~ I~q k~t~d Nature %f wor..k (c, heck which applicable): New Building Repair '~'0~ ]~'00~ Removal Demolition - Estimated Cost ~ 1.501000 Fee Addition Alteration Other Work (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. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front No c-lqa~qes / Rear Depth Height Number of Storie~ 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front ~30 ./~ Rear Rear .Depth .Depth I0. 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 14. Names of Owner of premises ~ca~ c C.~f,o~t¥ Address &ia,, uad, Ng, .S-°cK Name of Architect Address Name of Contractor gamno f4Co¢,~(~ Grpearrv Address 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. __ NO ~ Will excess fill be removed from premises? YES__ NO Phone No. S~¢~ q'13~3'2°q Phone No Phone No. ~3! 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) COUNTY OF~'}~/~/~_ S)S: -T~,.~5 ct M~ '['7~-e-~-{ e-¢-,clc4 ~ being duly sworn, deposes and says that (s)he is the applicant ~ame of individual si~ng contract) above named, ~sthe (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 .~y o% .t~ vC~,xl 2005~ Notar31;181~i~. ~ Sig~at'ure of Apl(fl~ant 'OWNER FORMER OWNER I s s. IMP. STREET LAND VL TOTAL FARM DATE VILLAGE E W DISTRICT SUB. ACREAGE TYPE OF BUILDING LOT 1 ~ COMM. I IND. CB. MISC. lEst. Mkt. Value NEW NORMAL BELOW ABOVE Value Per Acre Fa rm Ac re Va lue 'illable 1 BULKHEAD illable 2 DOCK illable 3 Foodland womplond rushland ouse Plot FRONTAGE ON WATER FRONTAGE ON ROAD Extension Breezeway Garage Foundation ~,~ Bath Basement cxo '.~ I Ext. Walls :t~r?,~l~ Porch[, [Rooms 1st Floor ~ Rooms 2nd Floor Patio J Dormer TOWN OF SOUTHOLD PROPERTY RECORD CARD TRIM Extension 90.-2-9.1 garage 11/04 TOWN OF SOUTHOLD PROPERTY RECORD CARD 'OWNER STREET / ~ P'Y' VILLAGE DIST. SUB. LOT ~ -- ' I FOYER ~NER N E ACR. - ~ S W ~PE OF~ R~. ~ j O~ S~S. VL. FARM CO~. CB. MICS. Mkt. Valu~ 4t0o ¢~oo ~ ~ ~ V' Tillabl~ FRONTAGE ON WATER J W~land FRONTAGE ON ROAD M~d~ DEPTH H~ Plot BULKH~D Total J M. Bldg. Extension Extension Extension Porch Deck Breezeway Garage Foundation Basement Ext. Walls Fire Place Bath Floors Interior Finish Heat Pool Attic Patio Rooms 1st Floor Driveway Rooms 2nd Floor OWNER TOWN OF soU~I;HOLD PROPERTY RECORD CARD /~"'~ STREE--F FORMER OWNER / IVI(c~ Wd u ~ N U ~ S VILLAGE E W RES. S~AS. LAND IMP. AGE NEW FARM Tillable Woodland Meadowland House Plot i Total D,ST. SUB. LOT -- ACR. TYPE OF BUILDING VL. j/~ FARM COMM. CB. MICS. Mkt. Value TOTAL DATE Value Per Ac re BUILDING CONDITION NORMAL BELOW ABOVE Acre Value REMARKS FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD D~K 90.-2-9.1 11/04 Foundotion J~oth Porch Basement ~ C-L Floors Por[~ ~ Y ~ ~ j~ p · ~0 ~ ~t. Walls Interior Finish UR. Breezeway Garage Total Fire Place Type Roof Heat Rooms 1st Floor Recreation Room Rooms 2nd Floor Driveway Dormer X ~NS .ARE REFERENCED N.O.V.D. 1.g29 DATUM. SPOT ELEVATIONS SHOWN THUS: CONTOUR LINES SHOWN THUS: rXISTING SEPTIC TANK :l,ooo -:XISTING SANITARY LEACHING POOL lO' ~ia. X 4' HIGH) (1'0 'R'OPOSr'D SEPTIC TANK EST HOLE LL~'V. lo.o) ; &-PROPOSED SANITARY SYSTEM NS & TEST HOLE DATA PROVIDED ~T HOLE DATA ID ZS-- 2 STORY FRAME HOUSE b . '~' TO DF 10'-4' 5uN =ROOH Po~cFkA!N TILE ri-RIG .~r ABOVE :TY~.). 5'-10 I/2" ~ ~' A.~.F. ~ F,A~REL -VAYLTFD _FOR!qAL DININD:: ~ I · -- I FIRST '-F.L_OOt~,: F~LAlq OAK GAP ,?.EAT I~2OH LOIJN~E : MAGTER OATH -' DE'DF, DOM F / ~, J 'OCCUPANCY]OR. 0 UoE IS UNLAWFUL W.tTHOUT CERTIFIOATE OF OCCUPANCY , REVlSiON~ : ~ ... DATE~ ,! .{-- 'I SF__OONF-.P FLOOP-. r"L/-:,U. -, NOTIFY BUILDING. '/65.1802 ,8 AM ,Iq 'FOLLOWING .... 1. F.O~NDATIO~ F~R POURED CbN~RETD- 2,.ROUGH - FRAMING 4. F~NAL'- CONSTRUCT~ON,M. BE COMPLETE FOR CQ. ALL CONS%RUCTION SHA~L MEET REQ'U~REMENTS OF THE ~oBES'QE I yORK STATE. NOT DESIGN, OI "- '" ; 5C,,ALE: l/.4-" = 3:_ _,,_,~_,., ,/-r = I ¢2' ' __ ....... LAV, U. c LE,6ET -. ¢ PROJE~ ~ENE~AL