HomeMy WebLinkAbout35111-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34667
I~te: 11/08/10
THIS c~TIFIES that the building DECK ADDITION
I~3cation of Property: 95 RIGHWOOD RD
(HOUSE NO.) (STREET)
County Ta~Map No. 473889 Section 78 Block 9
S~bdivision
Filed Map NO. __ Lot No. __
SOUTHOLD
Lot 53
(HAMLET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 23, 2009 pursuant to which
Building Permit No. 35111-Z dated OCTOBER 28, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARY E CANTWELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPAR77~ENT OF ~AL774 APPROVAL
~.R~.-i-afCAL CERTIFICATE NO.
PLIghtErS Cig(TIFICATION DA'£~d3
N/A
N/A
N/A
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. 35111 Z
Date OCTOBER 28, 2009
Permission is hereby granted to:
MERY E CANTWELL
345 E 93RD ST APT17G
NEW YORK,NY 10128
for :
CONSTRUCT DECK ADDITION TO EXISTING SFD PER APPROVED PLANS AS
APPLIED FOR
at premises located at
County T~x Map No. 473889 Section 078
pursuant to application dated OCTOBER
Building Inspector to expire on APRIL
95 HIGHWOOD RD
SOUTHOLD
Block 0009 Lot No. 053
23, 2009 and approved by the
28, 2011.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
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 locatinn of all buildings, p?operty lines, streets, and unnsual 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.
Bo
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 reasons therefor in writing to the applicant.
Co
Fees
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 erope~3}:
House No.
D t X9
Owner or Ownem of Property.'~"q
Suffolk County Tax Map No 1000, Section
Subdivision
~'"~ermit No.3 2-- / [ /
Health Dept. Approval:
Planning Board Approval:
Old or Pre-existing Building:
Street
'7I Bloc
Date of Permit.
(check one)
H~tmlet
Lot 5-_5
Filed Map. Lot:
Applicant:
Underwritem Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~ ~, C} ~
Final Certificate: (check one)
App ~!~ant Signature
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INk'ION
[ ] FRAMING / STRAPPING ~ FINAL
[ ] FIREPLACE&CHIMNEY [ ] FIRESAJ-..~'INSPECTION
[ ] FIRE RESISTANT COflSTRUCTIOfl [ ] FIRE RESISTANT PEHETRATIOfl
REMARKS:
DATE
INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
[ ] FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
INSPECTION
[ ] ROU,~,,pLBG.
[ ] IN/S1JLATION
[//]~INAL
[ ] FIRE SAFETY INSPECTION
[ ]RRERESlST4NTCONSTRUCTION [ ]FIRERESlSTANTPBIETRA'I'ION
REMARKS:
DATE
INSPECTOR
FIELD INSPECT!ON REPORT [ DATE [ COMMENTS
FO~A~ON (1S~
FO~ATION (2~)
· ROUGH ~G &
PL~G
~$~ATION PER N. Y.
STATE E~RGY CODE
~DITION~ CO~ENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. north fork. net/Southold/
Examined
^pproved /:'
Disapproved aJc
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
Contact:
Mail to: /4q~/~ ? ~'r'}
Phone: ~/7-& ~1.5- Ilqt.t
Building Inspector
~,--~--~{~ E~----E ~'~LLICATION FOR BUILDING PERMIT
1/ ,NS T,ONS
a. T~._ ?~.,,[~,.,~nT be compl/ftely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets c plans, accutfitt~1 .according to schedule.
"6TPlot 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.
fi 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 ora Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applic.able 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 inspectio~?~.
{~gnature of applicant or name, ifa corporation)
£13: aOc l LD: W'/ i Iq 71
(Mailing address 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 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
1. Location of land on which proposed work will be done:
?6" H-~/t~.)aaD l{ot4O ~ouTHot..~ ~ toy
House Number Street
Hamlet
County Tax Map No. 1000 Section 0-7 ~
Subdivision ff'Tfl ~q 7~' q-5~
(Name)
Block · Lot
Filed Map No. 5-5'q 7 Lot ~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existinguseandoccupancy -.~iO. 6t..~ Ft~tnlc/ I-~t'n~ ~.~/ 15~<
b. Intended use and occupancy fiDDITDtO~ 7-0
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost Sq, f'O 0 Fee
Addition t//
Other Work
~Oo (Description)
(To be paid on filing this application)
Number of dwelling units on each floor
5. If dwelling, number of dwelling units
If garage, number of cars ~ufi4
Alteration
If business, commercial or mixed occupancy, specify nature and extent of each type of use. /t9/,,4
Dimensions of existing structures, if any: Front /.~. 5" / Rear ]--~. ff /Depth /~. ~' ~
Height ,2 )~ · Number of Stories ! 4~ (~emlodeJ Ra,'t;,w t'le,'~*,,4 ~ %)
Dimensions of same structure with alterations or additions: Front
9.
10. Date of Purchase
Depth ,28.8 ' Height ;~
Dimensions of entire new construction: Front /5~, $' '
Height ,,2 Y~ / (+ Rea ~,~ Number of Stories /
Sizeoflot: Front [Tq t Rear [
/&/
15'. ~' ~ Rear /3. -,~ ~
Number of Stories /
Rear ~', ~' / .Depth /~9 /
.Depth
Name of Former Owner
11. Zone or use district in which premises are situated ~/il / ,~'t~) ,.q OUTd-O~t~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__
NO ~'
13. Will lot be re-graded? YES__ NO v/ Will excess fill be removed from premises? YES__ NO
14. Names of Owner of premises ~d~C~nTt~tTU~ q~-N/6#wao~ ~ b
Address ~3 ~Y IlqT[ Phone No. /7-g 3
Name of~ ~0 H~ ~n~ Address/Tr~o~g°. Phone No ~-~3~-
Name ~Contractor ~/~ Address ~/~ ~'*"°~hone No.
15 a. Is this prope~y within 100 feet of a tidal wetland or a freshwater wetl~d? *YES~NO / * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this propeay within 300 feet ora 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.
STATE OF NEW YORK)
SS:
COUNTY 0 F/[)e~"l oCI('k'
~' O~ q'~l ~'~q'"~ \ being duly sworn, 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 true 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
Iq #¼ dayof Oc.~c~zc 20 ~ c~
Notary Public
~ignature of Applicant
DESIGN OR u~'~,.,,IRu~F~ON ERRORS.
.-d¢'z::,,:,~ ,, ~'- ~ ....: ,. ,.,.' , -.-.
I ~ __~ , ~-.~ ,, RETAIN STORM WATER RUNOFF
: I ----;,~--~-z~.-- ~ b 12'
' ..... _~'.' ~'~-, = .¢ ,::o'r-/,,.'~., PURSUANT TO CHAPTER 236
¥ b ' ~ ¢t¢ "' -"N OF THE TOWN CODE.
%-- ................./t'"'+ °"' ~' ~' 127'¢ ¥~"
ubR, J...,ATION OF
NAILING & CONNECT
- '~ TOWN OF SOUTHOLD Pi,!OPERTY RECORD CARD
,a~-- ?~- ?-o'-~ ~
/kC).~IE~R~I ,~--. ("~1) nJF ~ il STREET ¢.~' VILLAGE DIST. SUB. LOT
1
,FORMER OWNER N E ACR.
SO,~~ ~ S W TYpEi OF BUILDING
~ ES~ S~S. VL FA~ CO~M. CB. ~ICS. ~kt.
~ND I~P. TOTAL DATE REd,KS
FA~ Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
W~lond FRONTAGE ON ROAD
Meadowlond DEPTH
House Plot BULKH~D
Total DOCK
TRIM
Bldg.
Extension
Extension
Extension
Porch
Breezeway
Garage
Patio
Total
Bath
Floors
I~..terior Finish
Heat
Foundation
Basement
Ext. Walls
Dormer
Fire Place
Type Eoof
Recreation Room
Rooms 1st Floor
Rooms 2nd Floor
Driveway
Dinette
~,e~ jK..
LU~" C..- BP LR~
COLOR z,/, ,,q -t- U ~ ~:~ z-,- TRIM
JOB No. 05-31 TAX I.D. No. 1000-78-09-53
,1/
~0~¢
SURVEY PURPOSE: CONVEYANCE OF PROPERTY
FILE MAP No. 5547 NOV 30, 1970
CERTIFIED ONLY TO:
MARY E. CANTWELL
JPMORGAN CHASE BANK,N.A.
COMMENWEALTH LAND TITLE INSURANCE COMPANY
By DESTIN G, GRAF NY, S. LIC NO. 50067
SURVEY OF: LOT 2
MAP OF HIGHWOOD AT BAYVlEW
BAYVlEW, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
SURVEY DATE: 12/05/06
DESTIN G. GRAF
LAND SURVEYOR
P.O. SOX 704
Roe, ky Point, New Yo~, t 1778
631..821-3442
SCALE: =I "=30'