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Home My WebLink About36645-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 9/22/2011 No: 35233 Date: 9/22/2011 THIS CERTIFIES that the building OTHER Location of Property: 2555 Youngs Ave, Southold, SCTM #: 473889 Sec/Block/Lot: 63.2-1-6 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 8/15/2011 pursuant to which Building Permit No. 36645 dated 8/22/2011 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: handicap ramp for unit 6A (condo) as applied for. The certificate is issued to Cichanowicz, Brenda (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 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 #: 36645 Permission is hereby granted to: Cichanowicz, Brenda 2555 Youngs Apt 6A Southold, NY 11971 Date: 8122/2011 To: construct a handicap ramp as applied for At premises located at: 2555 Youngs Ave, Southold SCTM # 473889 Sec/Block/Lot # 63.2-1-6 Pursuant to application dated To expire on 2/20/2013. Fees: 8/15/2011 and approved by the Building Inspector. / SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $200.00 $50.00 $250.00 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, st~ets, 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 0f Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1 °A 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 ¢0mpleted 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, Swimmilig 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 &Certificate of Occupancy- $.25 Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: ~/ Old or Pre-existing Building: House No. 0 Street Date. (check one) Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision PermitNo. _'~ ~F,- ~/.,~- DateofPermit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 2 Block/ Filed Map. -2Z, - ! / Applicant: Underwriters Approval: Final Certificate: 1/~ Lot Lot: (check one) ppllm'nx ~lgnatm e TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTI [] [] PLBG. ON [ ] FIRE SAFETY INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ]~ELECTRICAL (FINAL) REMARKS: .~~~ INSPECTOR FOUNDATION (1ST) ~OUNDAT~ON (~D) . ROUGH ~G ~ PL~G ~$~ON P~N. Y. STA~ EN~ CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SouthoidTown.NorthFork. net Examined Approved Disapproved a/c 20 /( Expiration ,4c)'O, 20 [5 PERMIT NO. " Building Inspector 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 Single & Separate Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date ~//',( ,20 ?1 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 accordiug to schedule. b. Plot plan showing location of lot and of buildiugs 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 sball be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ Ibr any purpose what so ever until the Building Inspector issues a Cegificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months a~er the date of issuance or has not been completed witbin 18 months from such date. If no zoning amendments or other regulations affecting the prope~ have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pe~it for an addition six months. Thereafter, a new permit sball be required. APPLICATION IS HEREBY MADE to the Building Depamnent 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 anthorized inspectors on ~remises and in building lbr necessary inspections. [ ~ ~ ~ (Signature of applicant or name, ifa corporation) (Mailil~g address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Co w tit,ac 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. tt~/- glo ~' lA ~' Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision Hamlet Block [ Lot b Filed Map No. Lot 2. State existing use and occupancy of premises 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_ Repair Removal Demolition 4. Estimated Cost ~"2 swJ c, 5. 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: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. 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 of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF 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. 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 any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. __NO ¢ STATE OF NEW YORK) SS: COUNTY OF being duly sworn, deposes and says that (s)he is tile applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public, ~-'tate of Now York (S)He is the NO. 01BU6186050 O~"f..~,.""J la g:',,~'~k County (Contractor, Agent, Corporate Officer, etc.) Commlelllorl Exl~lr~ April 14, P.._~J ~ 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 a )~-~v~ day of.TL~~ 20 ] ] Notary Public ~~of Applican~~t APPROVED AS NOTED NOTI~EY BUI~ DING DE~'~- 'fY:, 765-1802 FOLLOW'NG 1 FO~JN',,~.I;ON ~,, -' ~.. FOR PO~.'RE D CON, . STRAP~,NG, E. 3 IN~uLA 4 FINAL-C,_LFT~:-]CT~O MUS~ BE ALL CONSTRu( REQUiREMENtS OF ~,~ YORK S}AT5 NOT BESIGN OR CONS 11'-8" O / 2X12 ACC) DJ t'~lfi"OC CC I $/4x6 ACQ DECKING /' i ' J ,8" ELEVAT,ONI ,OR PLAN FLOOR $¢ REVISIONS: A-1