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Home My WebLink About36593-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 7/31/2011 CERTIFICATE OF OCCUPANCY No: 35102 Date: 7/31/2011 THIS CERTIFIES that the building RESIDENTIAL ADDITION Location of Property: 2020 Marlene Ln, Laurel, SCTM #: 473889 Sec/Block/Lot: 144.-2-31 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore Lot No. filed in this ofllced dated 7/31/2011 pursuant to which Building Permit No. 36593 dated 7/31/2011 was issued, and conforms to all of the requirements of thc applicable provisions of thc law. Thc occupancy for which this certificate is issued is: addition on existing dwelling. The certificate is issued to Glowacki, Mildred (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~~i~nature 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 #: 36593 Date: 7/31/2011 Permission is hereby granted to: Glowacki, Mildred 2020 Marlene Ln Mattituck, NY 11952 To: build an addition on existing dwelling. Replaces BP 8799. At premises located at: 2020 Marlene Ln, Laurel SCTM # 473889 Sec/Block/Lot # 144.-2-31 Pursuant to application dated To expire on 1/29/2013. Fees: 7/31/2011 and approved by the Building Inspector. PERMIT RENEWAL CO - ADDITION TO DWELLING Total: $17.50 $50.00 $67.50 Building Inspector FOEM NO. ~ TOWN OF SOUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLE'rlON OF THE WORK AUTHORIZED) N°. 8799 Z Date ............................ ~ .......~. ........ , 19....~1~ Permission is hereby granted to: .............. ~&t,t£tl~k ........................................... pursuant to application dated ........................~1~.....1.~. ............... , 19..~., and approved by the Building Inspector. IIO~EB~ ~hoek ootbaek fTou r~oat P.L, 3~f't; mtl a~ovod. Fee $...~[ ~.t~l~ ......... Building Inspector ~orm No. 6 TOWN O~ $OUT~OLD 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 9f 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 Underwfitem. 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, mtiltiple residenoes and similar buildings and installations, a certificate of Code Comptiunee 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 us~s, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, street, building and:unusual natumi 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, Additio~ to dwelling $50.00, Alterations to dwelling $50.00, · Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.06. 2. Ceytificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificat~ of Occupancy - $50.00 · 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: . (ch~k one) ~ House No. Stree{ Hamlet SUffolk .County Tax Map No 1000, Section }L~t~ Block C2~' Lot ~/' Subdivision Filed Map. Lot: Permit No. .Date of Permit. Applicant: Health Dept. Approval: Underv~ite~ Approval:, Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ -~J~ ~ D~') Final Certificate: (check one) FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, 14. Y. ..... ....... .... _ ...... ~ ~/~~' ~ ~PermitN ~pr~ed ............. ..-.~.-...-~....., 19...,.... o .................................... ........................ .............. . ................. ....................... INSTRU~IONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 cede, housing cede, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or r~he, if o corporation) (Address of applicant) State whether applicant is owner, lessee,~chitect, engineer, general contractor, electrician, plumber or builder. ......................................... ......................................................... Name of owner of premises ..~!.L....~..~.!.'..~..~.~,.v~).~..~......i'...~..I..~.:.¥.Z%L.c.,.:.~:..: ............................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. /') ( /- '" Plumber's License No ................................................. Electrician's License No...~.~.¢~..~.;...J,?.~.9..c~.'Z~.~ ....... Other Trade's License No..~..:.9..~.~4.CL..3.!Z'i..C.~....'.~L%.;-;r Location of land on which proposed work will be done, Map No.: ........................................ Lot No ................ Street and Number ~..t.~..;~,~. ..... ¢~.f....r.?.q...c: ..... ~;,.o.~- ...... ,~v.~,...~,.~.;{;~.),M ..... ,,Z.,.,~/ ............................................ ' / Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .................g.....~).~.,..g. ............................ '~'7 ............................................................. b. Intended use and occupancy ..~......9.~'..0:, ,....; .,..¢4 ...... ................ ..................................................... _! Ncture of work (check which applicable): New Building. ................. Addition ~ Alterotion Repair .................. Removal .................. Demolitior .................... Other Work .................................................. ~--~ (Z:J~- (Description) ! 4. Estimated Cost .....:..,:~..)..~...~...c.). ................................. Fee .../.. ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. I .............. Number of dwellin9 units on each floor ....1 ...................... if garage, number of cars ........................................................................................................................................... 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 .....~.,~../...~.:.~ ........... Depth .........~ ....... Height ........................ Number of Stories ..... l....~-.~.~-).~..~/. ...................................................................... ; ........ ;; ....... Dimensions of same structure with alterations or additions: Front ..... 6.2-. ...... 2 ................. Rear ...~..,~....i~ ........... Depth ......... f.O .................... Height ............................ Number of Stories ....... /. ....................... 8. Dimensions of entire new construction: Front ..... ~..,~ ......................... Rear ....... ../.:~ ................ Depth ..../..~! ................. Height .................... Number of Stories ......... /. ......................................................................................................... 9. Size of lot: Front .......... /...c."?..o...! .................................. Rear .......... /..,O...o..../. ................... Depth ..... /.~.?.. ................. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...L.~.~..;~....c~Y.~.?.¢.M! .................................................................. 12 Does proposed construction violate any zoning law, ordinance or regulation: ../~..CR. .............................................. 13. Will lot be regraded ........ tkZ....(?. ........... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises AI~.~.I~:.cY..t.r.c,...CI.0.~...r~Lc,.~;!'.... Address ~'.l.e~.~...L-.~ ....... Phone No. ,~.~.~I~..?..Q..~. Name of Architect .............................................................. Address ................................ Phone No ....................... k,!.~?_ of Contractor .............................. Address ..... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Gi~e street and block number or description according to deed, and show street names and indicate M~ether ir terior or corner lot. J ET.,\'FE C,F NEW YODK, ~' ¢ F, COU N'F~(,.OF -..~ .~.~-.-~,./~...-~,'>,,.~. f that he is the ~Name df in~idual signing contract) a~ove named. ............ ............ .......................................................................................................................... (Contractor, agent, corporate officer, etc.) g~ soid owno~ o[ owners, and is duly authorized to D~r~orm or haw performed the said work and to make this application; t~af aJJ statements contained in t~Js apgJicafion are true to the best o~ his knowledge and that the work will be p~rfo[med in th~ manner set ~o~ in t~e application filed t~erewit~. Sworn to ~efore me this FOItM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8609 Z Permission is hereby granted to: F...~...~......( ~ 1~;~)..... ~ Mat~ Build an addition on exist at premises located at 2020 Lane tuck N pursuant to application Building Inspector. Fee $.. J..~..,...0_0. .......... 19..~.~..., and approved by the Building Inspector FO~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......................................... 19 ........ Approved ........................................ , 19 ........ Permit No ..................................... Disapproved a/c ............................................................................................ Application No ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 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 m areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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 port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town o[ Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of builc~ngs, additions or or for removal or demolition, as herein described. The applicant agrees to comply with all ~licoble l, building code, housing code, and regulations, and to admit authorized inspectors on and in buildi~ for ary inspections. , / nature of applicant, or nome, if a corporation) Ave ,~at tituck (Address of applicant) State whether applicant is general contractor, electrician, plumber or builder. Name of owner of premises If applicant is a corporate, sil of duly authorized officer. (Name and title officer) \~/ Builder's License No...~...&.~. ..................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... Location of land on which proposed work will be done. Mop No.: ..... ~ ............................ Lot No....3~1~ .................. Street and Number .... .~/~..Na~..l.,~e...]~a.ae ............... Y~a.~t,.t.~,ttek. .................................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ....~..gt'.~.~..~.~. ....................................................................................................... b. Intended use and occupancy ......... .s.~.e....,.~...~..~.~....~.~.(~.~.Q~. ........................................................................... 3. Nature of work (check which applicable): New Building. ................. Addition ...... ~ ....... Alteration ...~....~.....,.' Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) 4. Estimated Cost ............................................................ Fee .~.~......0~.. .............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... .O...~.~ ........... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 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 ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............. '1.0. .................. Rear ...... .'!.0 ................. Depth --.-'J3 ................ Height .................... Number of Stories ...... O.l~e ........................................................................................................ 9. Size of lot: Front ..'J..0...0. ................................................ Rear ....... .'J....O~.. ............................ Depth ...... .~..b¢~. .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...t~JL~J...~,.::Ls.~, ............................................................................... i2. Does proposed construction violate any zoning law, ordinance or regulation: ........... ~ ........................................ 13. Will lot be regraded . ....... I~ ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...Do..~Z~,'&C~::i. ......................Address ........... }:~.~..t,~;,. ......... Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... b-!n_me of Contractor .~...~;../~ ....... .(~.~]~e],:~ .................... Address ......... ~,.~.~.~.~.1~. Phone No ....................... PLOT DIAGRAM Locete clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW COUNTY OF ....... ............................ ~'~.edb..~_.'l ~. ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ...................... ~jl~l.~.].f,t.'~:~. ............................................................................................................. (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 ali statements contained in this application are true to the best of his knowledge and belief; and tk, at the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................... ~..~ day of .......................... J.,~..~ ........... , 19..~. Notary Public, . ................... 81~;~.O-~: ............... County (Signature of applicant)