HomeMy WebLinkAbout36101-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34787
Rte: 01/10/11
T~IS C~TIFIES that the building ACCESSORY GARAGE
Location of Property: 820 WATERS EDGE WAY
(HOUSE NO.)
County Tax Map No. 473889 Section 88
Subdivision
SOUTHOLD
(STREET) (H~LET)
Block 4 Lot 40
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 9, 2010 pursuant to which
Building Permit No. 36101-Z dated DECEMBER 17, 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 TWO CAR GARAGE AS A~PLIED FOR.
T~e certificate is issued to HENRY P & DOROTHY FLINTER
( OWNER )
of the aforesaid building.
S~FO~ C~)~ DBPART~T OF ~nj~{ ~PRO~F~J~
~C'~RIC3~L C~RTIFIf3%~E NO.
PS~ C~TIFICATION D~£~D
Rev. 1/81
N/A
N/A
N/A
r~u~or~z d/Sig~ure
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)
PERbIIT NO. 36101 Z
Date DECEMBER 17, 2010
Permission is hereby granted to:
HENRY P & DOROTHY FLINTER
820 WATERS EDGE WAY
SOUTHOLD,NY 11971
for :
"AS BUILT" CONSTRUCTION OF AN ACCESSORY GAR_AGE AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 088
pursuant to application dated DECEMBER
Building Inspector to expire on JUNE
820 WATERS EDGE WAY
SOUTHOLD
Block 0004 Lot No. 040
9, 2010 and approved by the
17, 2012.
Fee $ 616.40
Aut henri zed Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTIfOLD
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, p.roperty lines, streets, and unusual natural or
topograpb./c 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 Pl.amfing Board Approval of completed site plan requirements.
B. For extsting 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. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees 1. Certificate of Occupancy - New dwelliug $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Switraning 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 Property:
Date. I3 ~ l0
Old or Pre-existing Building: (check one)
House No. Street
Owner or Owners °f Property:
Suffolk County Tax Map No 1000, Section ~ ~
Subdi~sion
Permit No..
Date of Permit.
Hamlet
Block /7/ Lot
Filed Map. Lot:
Applicant:
Health Dept. Approval:
'Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Underwriters Approval:
Final Certificate: ~/ (check one)
App/ffcant Signature
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I~ATION
[ ] FRAMING / STRAPPING [/~ FINAL
[ ] FIREPLACE&CHIMNEY [ ] FIRE SA,.,- ~ ,f lNSPECTION
[ I I:I~E RESISTHIT C~4STR~ I ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAP~NG
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSU..~.ATION
[ ~AL
[ ] FIRE SAFETY INSPECTION
[ ] mE RESiS'rJJIT COtA'TRUCTIOfl [ ] FmRE RESmSTAHT PENE'mATION
I*O~qI}ATION
FOUNDATION (2~)
. ROUGH ~G &
STA~ E~R~ CODE
~D~ION~ COUNTS --
"
TOWN OF SOUTHOLD
BUILDINO PERMIT APPLICATION CHECKLIST
Do y~u have or need the following, before apply/ng ?
Board of Health
N.Y.S.D~.C.
Contact:
APPLICATION FOR BUK,DING PERMIT.
INSTRUCTIONS
sets ofp~-, accurate plot plan to scala Fee accordh~.~ to schedule, relationship to adjol.;.~ premises or public streets or
b. I4ot plan show/ng location of lot and of buiJclln~ on premises,
areas, and waterways.
c. The work covered by*h~. ~plication may ~ot be ~-.~ced before issuance of B~ai%~ Permit.
d. Upon approval of ~ application, the Bui~ai~ Im~eetor will issue a Building F:.-,:~ to the applicant Such a pen~t
~h.n be kept on the pr~ml.es awO~le for inspection throughout the work. .
e. No builS~-~ shall be occupied or used in whole or in part for any purpose what. o-ever until a Certificate of Occupancy
is issued by the BVil~%v Inspector.
APPLICATION IS IiBREBY MADE to the Bui]~l~%~ Deparmaent for the issuance ~f a Building t~etmit purwant to the
Bu/3~%v Zone Ora~ne~ of the Town of Southold, Suffolk County, New York, and other applicable Laws, Or~*ne~s or
Regulations, for the construction ofb~l~; ~dO~tions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, buiJeli~ code, housing code, and reg,~a.~ons, ~a to admit
anthorized inspeeton ~n pr~mi~es and in brfila~g for necessary'inspections. / '
/ . ~ ~ of
%~ur-t(a~z~/ K/5' I Iq-'71
State whether applicant is owner, lessee, agent, architect, mgineer, general eontra~r, ekctrieian, plumber or builder
Name ofowncr ofpremi,~es E M k~/
(as onthe tax roll or latest deed)
If applicant is a coq~oration, dgnature of duly authorized officer
(Name and title of corpo.~to officer)
Builders Licons¢ No.
Plumbers License No.
EleetricJa-~ Liconse No.
Other Trade's License No.
1 .' Location of land on wl~ich proposed w ~osk?~Jl .be ,do, ne:,
House N~m~ber Street
Co,u~.y.T. ax ~ No. 1.0,00 Section
Sut,aivis,on ia/~¥
State existing use and occupancy of t~mises and intended use.and occupancy of proposed construction:
Nature of work (check which applicable): New Buflalng
Repair Removai Demolition
i. E~mated'C~st O
5. If dwelling~ number of dwelllng units
If garage, number of cars
F6'~
Addition
Other Work
Alteration'
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. ffbusiuess, commercial or mixed occupancy, specify nature md extent of each type of use.
7. Dimemsions o,f ?ffdug stzuctures, if an3c. Front.
Height I I' ~ Number of Stofles
Dimensions of Same structure with alterations or additions: Front
Depth -~-D.'~" Height
$. Dimenszous of entire new construction. Front
Height Number of Stories '
Depth
10. Date of Purchase
Depth A2' 7
·Rear
Number of Stofles [
Rear Depth
11. Zone or use district ~n which premises are situated
12. Does proposed construction violate any zoning law, ordinance or re~tlation: A//)
13. Will lot be ro-graded /~v/ O Will excess ffil be removed from premises: YES ~O~.
·,
- i4. Nam~ of Owner ofpremi.~es/~£~ ky i~ / ~-[ ~ ~//~t~v Phone No.C ~ / ?/~ ~- -~ ~L-~ c}
Name of A~chitect Address Phone No
Name of Conmmmr Address Phone No.
15. Is this prop~ty withln 100 fl~q: ora tidal wetland? *YES ·
· IF YES, SOUTHOLD TOWN TRUSTEES PER_MITS QUI~D
16. PrOvide survey, to scale, with actuate fouadetion plan and distances to property lines.
17. If elevation at any point on propexty is at 10 feet or below, must provide topogra~hicai data on survey.
STATE OF NEW YORK)
H~ ~..V . FL I y'~_~_._ being duly swom~ deposes and says that (s)hc is thc applicant
(Name ofi~divkh~! mgni~ cod~ ~'t) above ~med, .
(S)He is the
_f~ h/^/P~--
(Contractor, Agc~t, Corporate Officer, ~tc.)
of said owner or owners, and is duly authorized to perform or have p~formed the said work and to make and file this application;
that all statements contaiued in th!,~ application are tree to the b.e~., of his knowledge and belie~, and that the work will be
Performed in the ~er set forth in the applic~tion'filed therewith. ' '
Sworn to.before me this ~
/.o/ dayof t~ b/g4////~~/ 20/d .
BUILDING PERMIT EXAMINER CHECKLIST
Applicant:
~CTM#1000- ~' -
Property Address:
[~uilding Permits (Open/Expired): BP__-Z / C/0 Z- , Info: BP__-Z / C/0 Z- , Info:
3P -Z / C/O Z- , Info: BP__-Z / C/O Z- , Info: BP__-Z / C/O Z- , Info: __
~ingle & Separate Search Required? Y o~)Determination:
IBQ. LotSize: _ ~o__~ : ACr.~LotSize,~?79:~Y_,~. ~-~P~E~Q. LotCov. ;x~ ACT: Lot Cov.
IBQ. Front 3~ ACT. Front kRE_Q Side ~ AC~. Slain- lb ' REQ Rear ~r'~ PROP. Rear
Naterfront? Y o~(N9) x /
tTes, water body:~ Panel// ~ (e ~ Flood Zone: /~/ Bulkhead/BluffDistance:
*Date Submitted: / ~-~] 0 -/0 Date Reviewed:
Estimated Cost:
Subdivision: ~ ~ Zone: ~ z ~o Conforming?. ~_
Pre COs?
I.DDITIONAL APPROVALS REQUIRED
Inltolk County Health: Y o~_.~}- If yes, '~Bed#: *Date: / / *Permit#.'
- If no, certification required: Y or N Received: Y or N By:
DEC: PRE-DECg/1/75 Y orN~ Date:
;outhold Trustees: y o~- Date: __
~outhold ZBA: Y or~ 7 Date: / __
louthold Planning: Y or~- Date: __ __
['own Landmark C of A: Y o~.~DTE: /__
Town Septic: Y or N
/ Permit #:
Permit #:
Permit #:
Permit #:
/
or NJ Letter - Notes:
or NJ Letter - Notes:
- Notes:
- Notes:
*NYS CODE Compliance (page 2)~r N
totes:
~ee Structure:
:oundation: SF
~irst Floor: _~3 SF
:econd Floor: SF
)ther: SF
?omi: SF
Calculation:
3 SF X $ ,bio =$
+ Initial Fee: $
+ Addition~al Fee ( ): $
SFX$ =$
+ Initial Fee: $
+ Additional Fee ( ): $
[00 , 0 v
616,40
NEW YORK STATE CODE COMPLIANCE CHECICLIST
CLIMATIC/GEOGRAPHIC DfiSIGN CRITERIA:
.Groun/i Snow Load: ~0 Wind Speed; 120MPH. Seismic Design Category." B
Weathering: Severe .-Frost Depth: 36" __ Termite: M-H' Decay: S-M
Design Temp: 11 -Ice Shield Underlay: YES l~lood Haza/'ds:
USE/OCCUPANCY CLASSIFICATION
HEIGI:IT/FIRE AREA: . ~
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/pREscR~TiVE
FULL FP, LAMING DESIGN ELEMENTS: y/N
HEADERS: Y/N WALL STUDs: Y/N
CEILING JOISTS: YiN FLOOR JOISTS: Y/iN
LU~IBER SPECIES AND GRADE: YiN
GIRDERS: Y/N
ROOF RAFTERS:
WINDOw AND DOOR SCHEDULE!
.[M[ISSLE TEST REQUIREIV[ENTS: Y/N
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
VENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: YfN
PLUMBFNG RISER DIAGI'CAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: YfN
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
COMPLIENCE~/(9/lXl (RETURN TO
TOTAL
PAGE ONE)
'1-
.-j
E LE ',//4 Tt oD
:!
,I,
- ELECTRICAL
INSPECTION REQUIRED
L
Jr
':1009 NMOI ~HI JO
9gZ ~tlclYH90l iNVNS~/ld
~TA~N STORM WAT~ RUNOFF
PURSUANT ~0 CHAPTE~
~ ~ OF THE TOWN CODE.
~v .... '., , CA,.. & TOWN CODEs
AS REQUI~EC ANONo T[O~F
-- ~ SOUTHOLD
/
~ PPF~OVED AS NOTED
~,~ ,~ /~VT~/~ #~, /o /
h ,T~ff BUilD NG DEPARTMENT AT
7%4d02 8 AM TO 4 PM FOR THE
F u~ L,'%VlNG ~NSNSpECTIONS:
FOUNDATiO~ TWO REQUIRED
FOR POURED CONCRETE
~OUGH-FRAMING, PLUMBING,
STRAPPING ELECTRICAL & CAULKING
3 INSU~TION
4 FINAL-CONSTRUCTION&ELECTRICAL
MUST BE 60MPLE~ FOR C,O'
ALL ~ONSTRUCTION ~ALL MEET ~E
REQUIREMENTS OF THE CODES OF NEW
YORK STATE NOT ~8~NSIBLE FOR
OESIGN OR CONS~TION E~OR8