HomeMy WebLinkAbout36398-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
6/1/2011
CERTIFICATE OF OCCUPANCY
No: 34975
Date: 6/1/2011
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
DECK
260 Longview Ln, Southold,
Sec/Block/Lot: 88.-4-55
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
5/3/2011 pursuant to which Building Permit No.
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" deck addition to an existing single family dwelling as applied for
Lot No.
filed in this ofllced dated
36398 dated 5/18/2011
The certificate is issued to
Llinas, Kenneth & Stanton, Monique
(OWNER)
of the aforesaid building.
SUFI(OLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
~ ~u~tho~~gnature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36398
Permission is hereby granted to:
Minas, Kenneth & Stanton, Monique
Date: 5/18/2011
9701 Shore Rd
Brooklyn, NY 11209
To:
"as built" deck addition to an existing single family dwelling as applied for
At premises located at:
260 Longview Ln, Southold
SCTM # 473889
Sec/Block/Lot # 88.-4-55
Pursuant to application dated
To expire on 11116/2012.
Fees:
5/3/2011
and approved by the Building Inspector.
CO - ADDITION TO DWELLING
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
Total:
$50.00
$976.00
$1,026.00
Building Inspector
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 unusual 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 Underwritem.
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.
B. 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. 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 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 Property:
House No.
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No. '~(~ ~
Heal~ Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ ...~'~. ~/~,~,
Date.
Old or Pre-existing Building: o~
Street
Date of Permit.
Applicant:
Underwritem Approval:
Block-- 61t Lot
Filed Map.
Final Certificate:
(check one)
Hamlet
(check one)
AppliCant Signature
Lot:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING / STRAPPING
[ ] ROUGH PLBG.
[ ~J'FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECllON
[ ] F~ERESlST~'rcMA'TlWCTIO.
[ ] FIRE RESISTANT PENETRATION
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
~ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ )FIRERESISTANTPENL='~ATION
REMARKS:
DATE
INSPECTOR
TX)WN.OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
PERMITNO. 3~ 3 ~
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
~ 4 sets of Building Plans
Planning Board approval
'%'"'4 Survey
Septic Form
Trustees
Flood Pe~it
Sto~-Waler Assessment Form
Lontact: ~ ~a
Phone: ~/7-
Bdilding Inspector
APPLICATION FOR BUILDING PERMIT
Date
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 montb~ from such date. If no zoning amendments or other regulations affecting tl'.e
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit Ibr an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department Ibr 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 lbr removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, bousing code, and ret, ula~ions, and to admit
authorized inspectors on pren~ises and in building for necessary inspections. /y//52~/
.,./x,, (Signatui~e of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
(As on the tax roll or latds't 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 No.
1. Location of land on which proposed work will be done: . , ,~ ia
House Number S~eet H
County Tax Map No. 1000 Section ot~,~7~ Block ~ Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intendec[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_
Repair Removal Demolition
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
Fee
(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: Front Rear
Height. Number of Stories ~'~2, .~,~- ~,/,t.~
_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
I 1. 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 r~ Will excess fill be removed from premises? YES__ NO/~
,,*. l'~amesofOwnerofpremises~_e~t,'~ [,-u~ Adclress,-,26,o~,.-~vte,~/~, PhoneNo. ¢l~-~'~'"5-~
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet cfa tidal wetland? * YES__ NO /~
* IF YES, D.E.C. PERM1TS MAY BE REQUIRED.
NO 7'-
16. Provide survey, to scale, with accurate tbundation 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 ,)~
14~__,f-,~ e,~ ~l- ~ i' ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above nmned,
CONNIE D. BUNCH
Notary Public, State of New York
(S)He is the
(Contractor, Agent, Corporate Officer, etc.) ~,_ Qua .ffled In Suffolk County
of said owner or owners, and is duly authorized to pedbrm or have performed the said work and to make and fife 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 '
,-,Q~--~ day of~ 20]/
Notary Public
· TOWn of Southold
Erosion, Sed,men~ ~ ~l~o~--Wat~r Run.off ~S$_~$SMENT FOR.'.'
PROPERTY LOCAT~N: S.C.T.M. ~
THE FOLLOWING ACTIONS MAY RE~I. UIRE THE SUBM!-_~--_'~L~.--_.OF A
STORM-WAi =~ GRADING~ DRAINAGE AND EROSION CONTROL PI_',',
C~KT!HED BY A DESIGN PROJ=ESSJONAL IN THE STATE OF NEW YO~,.
SCOPE OF WORK - PROPOSED
a. What ~ Ihe Total Ama d lhe ig'~.:~ p{~i~ls?
(Include TotM Ama d all Paff~l~ Io~1~1 wll~n
b. W~I b Um Tobd Are~ of I.~d (~
yes No
FORM - 06110
_/ //J~
OCCUPANCY OR
.USE IS UNLAWFLIL
WIT?,OL:: CEF¥[: CATE
OF OCCUPANCY
APPROVED AS NOTE[}/i~
D~TE~B.P. ~ ~ ~ ~ ~
NOTIFY BUILDING DEPARTMENT AT
76~1802 8~ TO4 PM FOR THE
FOrCiNG INSPECTIONS:
1' FOUN~TION - ~ REQUIRED
FOR POURED CONCRETE
h_goIREMENTSOFTHE'' ' ,.Jt NEW
YORKST'~TE NOTRESPON. 3LECOR
DESIGN OR CONSTRUCTION ERRORS,
RETAIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.