HomeMy WebLinkAbout37004-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
2/29/2012
CERTIFICATE OF OCCUPANCY
No: 35459
Date: 2/29/2012
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1250 Village Ln, Mattituck,
SCTM #: 473889 Sec/Block/Lot: 107.-11-7
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
2/14/2012 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
Lot No.
filed in this officed dated
37004 dated 2/17/2012
which this certificate is issued is:
'As Built' Alterations to a Single Family Dwelling:
Converting Covered Screen Porch to Enclosed Porch,
Windows & Patio Door, as applied for.
The certificate is issued to
Fuhring, Franklin
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
TM
ignature
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 #: 37004
Date: 2/17/2012
Permission is hereby granted to:
Fuhring, Franklin
cio Kathleen Kerzner
129 Brown St
Mineola, NY 11501
To:
'As Built' Alterations to a Single Family Dwelling;
Converting Covered Screen Porch to Enclosed Porch,
Windows & Patio Door, as applied for.
At premises located at:
1250 Village Ln, Mattituck
SCTM # 473889
Sec/Block/Lot # 107.-11-7
Pursuant to application dated
To expire on 8/18/2013.
Fees:
2/14/2012
and approved by the Building Inspector.
CO - ALTERATION TO DWELLING
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
Total:
$50.00
$534.40
$584.40
~g inspector
TOWN'OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This epplioation must be filled in by typewriter or ink and submitted to the Building Department with t~e following:
A. For new building or new use: I. 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 w. ater supply and sewemge.-disposal (S-9 form).
3. Approval ofelectrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or ongineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings attd "pre-existing" land uses:
I. Accurate survey of property showing all property lines, st~-e, ets, building and anusual natural or topographic
features.
2. A properly completed applicatlon and consant to h~speet signed by the applicant. If a Ce. rtificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to thc appli~nt.
C. Fees
I. Certificate of Occopancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swmammg pool $50.00, Accessory building $50.00, Add,bens to ac~ssot~uddmg $50.00, Busmes~s $50.00.
2. Ceaifi~te of Occupancy on Pre-existing Building- $100.00
3. Copy of C~ifieate of Occupancy - $.25
~ 4. Updat~ CertificateofOccupancy- $50.00
5. Tempora~ C~-tificate of Occupancy - Residential $15.00, Cpm mercial $15.00
New Construct/on: Old or Pre-existing Building: ~ (check one)
HouseNo. ~ St?~ 'Hamlet
SuffOlk County T~ Map No 1000, S~tion { ~ '~ Block J' i ~t ~
H~lfl] Dept. Approval: I ~ - ~O - ~ W Unde~rim~ Approval:' ~ ~ ~ ~ ~ ~
Planning Board Approval:
Final Ce~ifi~te: ~ (check one)
JKequest for: Temporary Certificate
Fee Submitted: $ ~'~-c~x/x/'
TOWN OF SOUTHOLD BUILDING DEPT.
765-t 802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING ~,.FINAL
[ ] FIREPLACE & CHIMNEY [ ) FIRE SAFETY INSPECTION
[ ) FIRE RESISTANT CONSTRUCTION ( ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELE~, fllCAL (FINAL)
REMARKS:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. Norflt Fork.net
Examir~d 20
PERMIT NO.
Building laspector
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Check
APPLICATION FOR BUILDING PEILMIT
x te
INSTRUCTIONS
a. This applJ~tion MUST ~ completely fill~ in by ty~writer or in ink and submitt~ to ~ Building Ins~tor with 4
b. Plot plan sbowing location of lot and of buildings on premises, ~lationship to adjoining premises or public steers or
c. Tbe wo~ cove~ by this application may not ~ commenced before issuance of Building Pe~it.
d. U~n app~val of this appli~fion, tbe Building Ins~tor will issue a Building Permit to the appli~nt. Such a ~rmit
shall be kept on the premiss available for in~ction th~gbeut the work.
e. No building s~ll ~ occupied or u~ in ~ole or in pa~ f~ any pu~se what so e~r until the Building lns~tor
lasts a Ce~ifi~tc of~u~ncy.
f. Eve~ building ~rmit shah expi~ i~ tim wo~ au~orized h~ not commenced wi~in 12 monlbs aRer ~e date of
issuance or has not ~n ~mpleted within 18 months fi*om such date. If no zoning amendments or other regulations a~cfing the
pm~ have ~en enacted in the interim, the Bulidlng lns~ctor may authorize, in writing, ~e extension of the ~rmit f~' an
addition six months. Th~R~, a new p~nit shaU be ~ui~.
APPLICATION 1S HEREBY MADE to the Building De~mnenl ~or thc i~uan~ ora Building Pe~it pu~um~t to the
Building ~ne Ordinance of the Town of Southold. Suffolk Count. New York. and other applic~le Laws, O~i~nces or
Reguiati~s, for the constmction of building, additions, or alterations or for ~moval or demolition as he, in described. Thc
applicant ~ to comply wi~ all applicable la~, or~i~n~s, bnilding c~e. housing ~de, and rcgulation~ and to admit
au~ori~d ins~ctoa on promises and
S~[e whether applicant is owner, lessee, agent, a~hit~t. ~llgJll~, general contractor, el~eim~, pJum~r or builder
Name of owner of promises
(As on the m~l or last d~d)
If applicant is a co,ration, signattu~ of duly authorized o~cer
~ame and title of corporate
Buildem License No.
Plum~ License No.
Electricians Li~nse No.
Other Tmde's Lice~ No.
I. Location of land on w~iqb proposed work will be done:
V llaa o Ma'11it cJa--I'u l
County Tax Map No. I000 Section. [0'-/ Block i t Lot r~
2. State existing use and occupancy of'premises ned intended use and occupancy of propased construction:
a. Existh~g use and occupancy.
b. Ih~tendeduseandoccnpancyl n 5q cd t cc-kcrm t l, t cLO $ OW $cce, e_ oL orc
3. Nature of work (check w l ch applicable): New Building Additiml AltaratioaX' eP,
Repair Removal Demolition Other Work CSLU b
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwetling units on each floor
If garage, number of cars
6. if business, cormnercial or mixed occupancy, specify nature and extant of each type of use.
7.
Dimensions of existing structures, if any: Fmat Rear Depth
Height. Number of Stories J t { ~.
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensio ~s of e]t m new con~q, ructiou: Front Re, ar Depth
Height Number of Stories I j ~
9. Size oflot: Front Rem' .Depth
lO. Dateofe,=meqliqjqg NameotFormerOwn r A-Oa.q-e
11. Zone or use disu-ict io which premises are situated ~---- ~ O
12. Does proposed construction violate any zoning law, ordinance or rt:gulation? YES__ NO
13. Will lot be re-graded? YES NO Wil~, excess fill be removed from premises? YES __ NO
14. Names of Owner of promises ~]~r~_'~J~ress Phone No.
51(o
-7t4
I
OO-/O
Name of Architect AB'dress. Phone No_
Name of Contractor Address .Phone No.
15 a. Is this property within 100 fe~ of a tidal wetland or a freshwater wetland? *YES NO ~
* IF YES, $OUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY .B.~ REQUIRED.
b. la this proparty witlfin 300 feet of a tidal wetland? * YES NO X,
* IF YES, D.E.C. PERMITS MAY BE REQUIR. ED.
16. Provide anrvey, 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 topograplfical data on survey.
18. Are there any covenantz and restrictions with respect to this property? * YES NO ~
* IF YES, PP..OVIDE A COPY.
STATE OF N.~EW YO~RK)
o q /e
~ame of individual signing ~ntracO a~ve name,
(Contactor, Agent, Coqmrate Officer, ate.)
of said owaor or owners, and is duly authori~d to ~r~rm or have ~rformed the said win4 m~d to make and file this application:
that all *mt*m~ ~nmia~ in ~is ~plleaion a~ m~ to th~ ~ of his kaowlcage and ~liefi aad tiaa ~ wo~ will ~
~orm*d in the manner set foah in the appli~fiou fil~ therewith.
Swo~t9 befor* me fla ~ __ ~
Nom~ Publi[ I~otary Public, State 0f New Yet; Si~stu~ of Applicant
[~o. 0iqO$19059g
Qur~:i;ie~i~ Suffglk C;,n<
Erosion, Sedimentation '& Siorm-Water Run-off ASSESSMENT FORM
¥ ~cc ~ ~ s.c. Tx~ THE FO~Ttfl ,1~, AGTI~ MAY nrn.!~ ~l~ n.nnt~m~ OF A
,, 3
BUILDING PERMIT EXAMINER CHECKLIST
scm#_ oo0 - o 7-/I -
Property Address: ] ~¢' ..~o
~ Date Submitted: ~TL ~l t~/ p Date Reviewed:
Estimated Cost: '
Sufdi~ision: V~~one: ~ ffOOonformmgT~
Building Permits (Open/Expired): BP -Z / C/0 Z- , Info:
BP __-Z / C/0 Z-__, Info: B?__-Z / C/0 Z- , Info:
Single & Separate Search Required? Y o~Determination
REQ. Lot Size: ACT. Lot Size:
REQ. Front ACT. Front REQ Side ACT. Side
BP -Z / C/0 Z-__, Info:
BP__-Z / CI0 Z- , Info:
~Q. ~t Cov. ~o~ ACT: ~t Cov.
~Q. Re~ PROP. Rear
REQ. Heigh'~-$ t ACT. Height R E ~, It,'rH StO~5 A ~: T__
W*aterfront? 3L6~_~/ ~ ~
If yes, water body: -- Panel# r ' Flood Zone: Bulkhead/Bluff Distance: ....
ADDITIONALAPPROVALS,,REQUIRED pkt}~/s(%) .~16w~l~ -q~L~b ~uRV~Y oR Sir[ PLAN
Suffolk County Health: Y oD- If yes, *Bed#: *Date: / / *Permit#: Town Septic: - If no, certification required: ¥ or N Received: Y or N By:
NYS DEC: PRE-DECgIllT5 Y or~- Date:
Southold Trustees: Y orb - Date: /
Southold ZBA: Y 0~(_.~- Date: l__/__
Southold Planning: Y o~ - Date: /__/
Town Landmark C of A: Y o~DTE: /_
Notes:
/ / Permit #:
/ Perinit #:
Permit #:
Permit #:
/
or NJ Letter - Notes:
or NJ Letter - Notes:
- Notes:
- Notes:
*NYS CODE Compliance (page 2): Y or N
V~/oif,&,nf~..IV~ CoMP~N$4-T/O/V
Fee Structure:
Foundation: SF
First Floor:
Second Floor: SF
Other: SF
Total: I(o~7 SF
Calculation:
+ Additional Fee ( ):
SF X $,
+ Initial Fee:
c oF o ~,,% ,~q V[LO°
AS BUILT
NEW YORK STATE CODE COMPLIANCE cHECKLIST
C.LIMATIC/GEOGRAPHIC DESIGN CRITERIA:
. Grounll Snow Load: ~0
Weathering: Severe__ -Frost Depth: 36"__
Design Temp: 11 -. · Ice Shield Underlay: YES .
USE/OCCUPANCY CLASSIFICATION:
' HEIOIZlTfFIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/pREscRIPTIVE
FULL FP, iAMING DESIGN ELEMENTS: Y/N
HEADERS: Y/lq W~LL STUDS: YfN
CEILING JOISTS: Y/N FLOOR JOISTS: YfN
LUIM[BER SPECIES AND GRADE:
Wind Speed: 120MPH__ Seismic Design Category/B .
Termite: M-H Decay:
Flood Hazards:
GIRDERS:
ROOF RAFTERS: Y/lq
W1]ffDOW AND DOOR SCHEDULE:
· MISSLE TEST ILEQUIREMENTS: Y/N
EGILESS 5.7 S.F.: YIN
LIGHT 8%: Y/N
~rENT 4%:
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/N
PLUMBING RISER D[AGILAM: Y/N
LOCATION OF FIILE PROTECTION EQUiPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: YfN
TOTAL COMPLIENCE? Y/lq (RETURN TO PAGE ONE
.I.,l~p ^~'-'I£NDED - ,,JULY lO, 1984 .....
STATEM NTOFINTENT
AI~LtCANT
SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES -- FOR APPROVAL OF
S4.JFFOLK ¢'O TAX MAi' DESIGNATION:
DIST. SCCT. ~LQ~K
A??ROVED AS NOTED
- ~ ~!JILDING DEPARTMENT AT
'~ 8 AM TO 4 PM FOR THE
~G ;NSFECT~ONS:
' ,A:~ON -TWO ~EQUIRED
P:~U:~E~ CONCRETE
~F, ,~' EUBCT~ICAL,& C~ULKING
k:jST BE COMPLETE FOR C 0
,,LL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
ELECTRICAL
INSPECTION REQUIRED
C~rv]PLY WITH ALL CODES OF
NEW,, YORK STATE & TOWN CODES
AS RiEQUIRED--- ,' i -- ..
A,J//n SOUTH ' NNING BOA~,'~
. 'Z-: . j~: .,"
This applica
A. For new
I. Final
2, Final
3. A
4.