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Home My WebLink About36809-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 8/27/2012 CERTIFICATE OF OCCUPANCY No: 35918 Date: 8/27/2012 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ADDITION/ALTERATION 495 JACKSON ST. NEW SUFFOLK, Sec/Block/Lot: 117.-9-4.1 Filed Map No. conforms substantially to the Application for Building Permit heretofore 10/17/2011 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: Lot No. filed in this officed dated 36809 dated 11/14/2011 front porch addition to one family dwellin~ as applied for The certificate is issued to JOHN & ANDREA SPIEGEL (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 #: 36809 Permission is hereby granted to: Spiegel, John & Spiegel, Andrea 2681 N Burlington St Chicago, IL 60614 Date: 11/14/2011 To: front porch addition to dwelling At premises located at: 495 Jackson St, New Suffolk SCTM # 473889 Sec/Block/Lot # 117.-9-4.1 Pursuant to application dated To expire on 5/15/2013. Fees: 10/17/2011 and approved by the Building Inspector. CO - ALTERATION TO DWELLING SINGLE FAMILY DWELLING - ADDITION OR ALTERATION Total: $50.00 $212.00 $262.00 Building Inspector Form No. 6 TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF occUPANcy This application must be filled in by typewriter or ink and submitted to thc 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~cts, and unusual natural or topographic features. 2. Final Approval from Health D~pt. of water supply and sewerage-disposal (S_9 form). 3. Approval of electrical installation from Board 0fFirc Underwriters. 4. Sw. orn statemant from plumber ce~fying that tho solder used in system contains less than 2/10 of 1% lead.. $. Commoroial build.g, industrial building, m61tiple residanoes 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) hen-conforming useS, or buildings and "pre-existing" land uses'.' 1. Accurate survey of property showing all property lines, stree~ts, building and unusual naturai or topographic features. 2. A properly c~mpleted 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. C. ertificaie of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, · Swimmir~g 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 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: ate. I o~ ht (check one) House No. Owner or Owners o£Property:.. 5 ~_ ~'~ Suffolk County Tax Map No 1000, Section Subdivision Permit No. -~ ~o ~' 0 Health Dept. Approval: Planning Board Approval Dat~ of Permit. //-' J 17/- Request for: Temporary Certificate Street Hamlet Block Filed Map. Lot: ] / Appneant: Underwriters Approval: Final Certificate: L~/(check one) ~ Applicant gignature Lo, q. I ' 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 [ ] FIRE RESISTANT PENETRATION ~LECTRICAL (ROUGH) [ ] ELE~ ~.iCAL (FINAL) REMARKS: DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INS~JJL-ATION [ ]FRAMING/STRAPPING [~/]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ~]~LECTRICAL (FINAL) REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-t802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH~. [ ] FOUNDATION 2ND ~ [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) .. [ ] ELECTRICAL (FINAL) REMARKS: ~~ ~ DATE ~/~Y///-~/~ INSPECTOR ~~ FOUNDATION (IST) ~ou~ATION (2~) . ROUGH FRAM~G & PLUMBIMG > mS~ON ~ N. ~. STA~ R~ CODE , ~D~ION~ COUNTS ~~ ' ~ ,, ,, ~ ,~ 0 '' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (651) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined .20 Approved Disapproved a/c PERMIT NO. 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 C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Building Inspector ~LICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 a. This application MUST be completely filled ill by typewriter or in ink and submitted to tile 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. Sucb 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 tile work at, thorized bas not commenced withio 12 montbs after the date of issuance or has not been completed within 18 months from such date. If no zoniflg arnendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, tile extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issoance ora Building Permit pursuant to tile Building Zone Ordinance of the Town of Southold. Suftblk County. New York. and other applicable Laws, Ordinances or Regulations, for tile construction of buildings, additions, or alterations or lbr remov~q~r demolition as hereiu described. Tile applicant agrees to comply with all applicable laws. ordinances, building code. ho~si~g code, and regulations, and to admit at, thorized inspectors on premises and in building for necessar3 inspeC~nat/O/._,._,,/.~o~ u~ere o~o?at~ ( 'g pp ' r name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises flE'q ~'[_ (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. q581q "'~ Plumbers License No. Electricians License No. Other Trade's License No. 1. Location o(lp. nd on which proposed work wil~!l b~e done: House Number Street Hamlet County Tax Map No. 1000 Section I~ V Block 9 Lot¢/ Subdivision Filed Map No. Lot State existing use and occupancy of .g~m~ts and intended use and occupancy of proposed construction: a. Existing use and occupancy ~; 5 ~ b. Intended use and occupancy '"-~; 5 3. Nature of work (check which applicable): New Building Repair ~ Removal Demolition Estimated Cost [ 0 ~ O (2) 4. I 5. If dwelling, number of dwelling units If garage, number of cars .~_~ /~ Fee Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height_ Number of Stories Depth Dimensions of same structure with alterations or additions: Front ~:~ ' Rear (O Depth Rear Number of Stories Rear ~ ° .Depth Depth 15 ' Height Dimensions of entire new construction: Front (O Height Number of Stories 9. Size of lot: Front Rear 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 X 14. Names of Owner of premises ~?i~;q,~"[- Address Name of Architect Address Name of Contractor i,.10~'4-1,~ C-vi' ~. uoot~l Ioo~.~ Address 15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO ,g * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Will excess fill be removed from premises? YES NO~ Phone No. Phone No PhoneNo. 6,$1 9..~ q02'~ NO 'l 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 4- STATE OF NEW YORK) SS: COUNTY OF ~ Co"~" ~'~5~,,~ being duly sworn, deposes and says that (s)he is tile applicant (Name of individual signing contract) above named, OONNIE D. BUNOH Notary Pul~, State ~ New Yo~ (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rnake and file this application; that all statements contained in this application are tree 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 t t../,,~ day of ~)~-.,~ ~-~ 20 t} Notary Public ~igna~ Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSEsSMENT FOR:.'. -- ~ ~~-~J~J~TL IN THE STA'I~ OF NEW YORK. $C0~ O1~ WORK - PROPOSED CON~IIUC'FI'ION ~~ ~~) -~;13 c~SrS~'~5 Fc0.~ ~/a X a ) ' ' a~e~ng~n~cu~cYas of Mat~ ~-a~ ~ DEC ~ ~: ~a~b~~~~ B~? ~ ~c ~ ~ ~ a ~s ~ b ~d ~ ~ CO~ O~ .................................. ~ Notl~ ~i, ~e ~ ~ Yol ~o~ ~a %~ . No. O1BU61~ ~ ~ hd~= b ~¢ ..................................... ,, ~ ~or ~p~mdve of ~e ~= or ~ ~d ~c ~ app~; ~t ~ ~ ~ ~ ~ a~~ ~ ~e m ~e ~t ~ ~o~ ~ ~i~ ~d ~ &c ~rk~ ~ ~o~ed in &c m~ ~t fo~ ~ ~c a~ff~on fil~ ~&. S~m to ~om mc ~s; ............. ................ FORM - 06/10 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 ax (631) 7 - BUILDING DEPARTMENT TOWN OF $OUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: ~1 T ~* Date: ~.~.vt,,~ ~.-. ~-Ab~* -Ct v---r..~-/OC~. !A.,'C to- tO- i! Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: Block: c~ *BRIEF DESCRIPTION OF WORK (Please Pdnt Cleady) Lot: (Please Circle All That Apply) *Is job ready for inspection: ~~-~'/'R" (O Rough In Final *Do you need a Temp Certificate: Temp. Information (Ifj3ee~ded) *Service Size: /~Pha~/3Phase 100 150 ,/~'/ 300 350 400 Other *New Service: ~und~mber of aete'"'"~ rs Change of Service Overhead Additional Information: ~.1.. ' ~ %YMENT DUE WITH APPLICATION o# MAP OF' OE$CRIBEO PROPERTY AT N£W SUFFOLK TO wN OF $OUTHOLD sUFFOLK CO, N.Y. donack associates :51:3 west moin streel riverhead ,new york 11901 I516) $69-1717 APRIL 12~ 1984 Job No. B4' 496 ~ { g m APPROVED AS NOTED ~ DATE B.P. # -- 765-1802 8 AM TO 4 PM FOLLUW NG INSPECTIONS ~,P 1 FOUNDATION TW'~ c:QUIRED :: FOR POURED E~¢ AFT~ ---- 2 ROUGH - FRAM NG PLdM~NG, STRAPP NG. ELECTR~C~ 3 CAULV'NG 4 FINAL-CONST~UC}ION&EcECT= ~L MUST BE COMPLETE -' ~ REOUIREMENTS OF THE CC~,bb F-YORK STATE .NOT RESPO~I,~iFI 'U'DESIGN OR CONSTRUCTION FP, RCiR,: ~9~5 -~-ck-Soo S+ t