Loading...
HomeMy WebLinkAbout35947-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34670 Date: 11/10/10 THIS c~RTIFIES that the building TENNIS COURT Location of Property: 1205 PT PLEASANT RD (HOUSE NO.) County Tax Map NO. 473889 Section 114 Subdivision MATTITUCK (STREET) (HAMLET) Block 1 Lot 4 Filed Map NO. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 2010 pursuant to which Building Permit No. 35947-z dated OCTOBER 15, 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 "AS BUILT" ACCESSORY TENNIS COURT AS APPLIED FOR. The certificate is issued to EDWARD & ADRIENNE SOLOMON (OWNER) of the aforesaid building. SUFFOLK CO[~TY DEPARTMENT OF HEALTH APPROVAL ~.RCTRICAL U~TIFICATE NO. PLU~ERS U~TIFICATION DA'r~o N/A N/A Rev. 1/81 FORM NO. ~ 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. 35947 Z Date OCTOBER 15, 2010 Permission for : "AS BUILT" is hereby granted to: ED SOLOMON CUTCHOGUE,NY 11935 INSTALLATION OF A TENNIS COURT AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 114 pursua/lt to application dated OCTOBER Building Inspector to expire on APRIL 1205 PT PLEASANT RD MATTITUCK Block 0001 Lot No. 004 4, 2010 and approved by the 15, 2012. Fee $ 200.00 Authorized Signature Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [~.~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SA,-.', 1~ INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT I~F. NETRATION REMARKS: II- ? -/° DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~O~U~ Tq~IOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ,20/° / Approved ¢rD//~ ,~'~, 20 //__0 Disapproved a/c Expiration 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 Form N.Y.S.D.E.C. Trustees .Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: APPLICATION FOR BUILDING pERMIT Date ~-~OT-. ~- INSTRUCTIONS 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 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., ,4,,,/~ ~ ,~~'~/~/~//'/ ( 'g o tppl[cant or name, if a corporation) (Mailing address o?iPPhcan() State whether applicant is owner, lessee, agent, architect, engineer, general c0ntract~,~$~0~-~or builder Nameofownerofpremises ~t~JA~,% ~M~ N '~[' EltflOl~ ngnan~E~T ~, (As on ~e tax roll or late~t, fleed) s AM TO 4 PM FOR I~[ If applicant is a corporation, signature(6 ged of r (Name and title of corporate offia~ V~"r;.~,, ~.-,,- . Builders License No. Plumbers License No. !.d Electricians License No. -" Other Tradeis License No. 1. Location of land on which proposed work will be done: House Number Street FO :'.:'iN :INSPECTIONS: 1 F, ~U~F'ATION- TWO REQUfRr ? FOR POURED CONCRETE 2 ROUGH- FRAIlINO, PLUMBING, STRAPPING~ ELEC'[ilI~AL & CAULKING 3, INSULATION 4 FINAL.CONSTRUCTION & ELECTRICAL MUST BE COII~I.ETE FOR C.G. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERR©~S Hamlet County Tax Map No. 1000 Section t.[,d¢ Block ~ I Lot Subdivision Filed Map No. Lot State existing use and occupancy of prcnuises 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 Demolition 4. 5. Repair Removal Estimated Cost J~g~Dt(Z:tg>O If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee Alteration (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. 7. Dimensions of existing structures, if any: Frontj'~!~l~.~ 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 Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 1 I. 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 ofpremises~' - - - , , .;ddress r~j~PhoneNo.~ Name of Architect Address Phone No Name of Contractor'Er~c_ ~ Cr~z~-- Address J~ga~=~l:l:L~;_.Phone No. 7q~ .=~>1~1 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 'j NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property 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. 18. Are there aug cgvenants and restrictions with respect to this property? '~ YES __ * IF YES, PRO'VIDE 'A COPY. STATE OF NEW YORK) COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of indiyidl~l~ signing contract ~ above named. (S)He is the (Contractor. Agent, Corporate Officer, etc.) of said owner or ownerg.: ~m~t is duly authorized to perform or have performed the said work and to make and file this application: that all statements ,c6~a~e~ m 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. S.,~/9/_~to before me this~ _ DENISE K NG Notary Pubt,c, State of New Yorl( Registration #01KI6041757 OuaIifi_ee~ in Suffolk County ~ ~' Signat~ of Applicant S 64'51'21" E 81.98' S BY INltER-sCIENCE RESEAI~CH A$SOC~TES ON JULY ~8, '20~0 ZONE AE (EL .... ZONE 61"$4'05" E 70.37' $ 52"0,~,~ ,, 58°23'55" E S 66°( 57. t2' 'i I