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Home My WebLink About36812-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 9/11/2012 No: 35940 Date: 9/11/2012 THIS CERTIFIES that the building RESIDENTIAL REPAIRS Location of Property: 155 Woodcliff Dr, Mattituck, SCTM #: 473889 Subdivision: Sec/Block/Lot: 107.-7-27 Filed Map No. conlbrms substantially to the Application for Building Permit heretofore Lot No. filed in this ofliced dated pursuant to which Building Permit No. 36812 dated 11/14/2011 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: roof damage repair as applied for. The certificate is issued to Burke, Michael & Burke, Linda (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 #: 36812 Permission is hereby granted to: Burke, Michael & Burke, Linda 155 Woodcliff Dr Mattituck, NY 11952 To: Repair roof damage as applied for Date: 11/14/2011 At premises located at: 155 Woodcliff Dr, Mattituck SCTM # 473889 Sec/Block/Lot # 107.-7-27 Pursuant to application dated To expire on 5/15/2013. Fees: 11/1/2011 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLiNG $200.00 $50.00 Total: $250.00 Building Inspector Focm No. 6 TOWN OF SOLrFHOLD. 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 w!th 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 D0pt. of water supply and sewerage-disposal (8-9 form). 3. Approval of electrical installation fi.om Board 6fFire Underwritem. 4. 'Sw.om statement from plumber certifying that the solder used in system eontaiea less than 2/10 of 1°,4 lead. 5. Commercial building, industrial building, m01tiple residences and similar buildings and installations, a certificate of Code ComplianceTrom architect or engineer respensible for the building, .6. Submit planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) fi`on-conforming us~s, or buildings and "pre-existing" land uses~ 1. Accurate survey of property showing all property line~, streets, building and. unusuM natural or topographic features. 2. A properly ¢gmpleted app}ication 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. New Construction: Location of Property: C. Fees 1. C, ertifica!e 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 Date.. tC/O V ! ,,-zO tl Old or Pre-existing Building: /(check one) House No. Street --' Hamlet O, ror Ow.era omoperty: / . S. oikCo?.tyT.,d .p oi000. S ion r-7 Bioo .r7 Subdivision Filed Map. PermitNo. ~ff_~ /~- DateofPermit. //-./~t- ]./ Applicant. H~dth Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ Lot Underwriter~ Approval: FinalCertificate: ~/~ (checkone) ' (- App~cant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY INSPECTION [ ] ROU~/H-PLBG. [ ] IN,,,f4]LATION [~'/~NAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH)_ [ ] ELECTRICAL (FINAL) REMARKS: ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net -~.F xam i ned Disapproved a/c ........... Expiration ~[~,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIS 1' Do you have or aced the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Survey Septic Form N.Y.S.D.E.C. -- Trustees ,0V-" [~/ Sin~le~ &Separate ' [ { Storm-Water Assessment Form TOWN OF SOUIHOLD ] Mail to: Phone: %uilding Inspector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date/~//~V, I .20 II a. Tiffs application MUST be completely filled in by typewriter or in ink and subnlitted 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, alld waterways. c. The work covered by this application may not be comntenced be[bre issuauce of Building Permit. d. Upon approval of this applicatiom tile Building htspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available Ibr 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 issoes a Certificate of Occupancy. f. Every buildiug permit shall expire if the work authorized has not commenced withiu 12 months after the date of issuance or has not been completed within 18 mouths from such date. If no zoning amendments or other regulations affecting tile property have been enacted itl the interim, the Building Inspector may amhorize, iu writing, the extension of the permit fbr an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Buildiug Department fer tile issuance of a Building Permit pursuant to the Building Zone Ordinance oftbe Towu of Southold. Sufl'olk County, New York, and other applicable Laws, Ordinances or Regulatious, for the coustruction of buildings, additions, or alterations or for removal or demolition as berein described. The applicant agrees to comply with all applicable laws, ordinaaces, building code, housiug code, and regulations, and to admit authorized inspectors on premises and in buildiug for necessaO iuspections. /' ~ [ '-"-"(Signature of appfi~ff~t~-r"n"~n~e, ifa corporation) / rs'- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder r"> w APPROVED-- NOTED "-o , Namcorownerofpremises /- '' (As on thc ' 'o - , . · . ,-,- G[Fy 8bi ~ -,~ 11' applicant is a corporation, s ~ aatu 'eol akuy, aumonzea, omcer 765-1-~02 8 ",,. (Name and title ofg~q~qfg~nr) ....... ~ gOUNDA~ m Builders L cense No. ,J ...... U{ J~.~,~k~ Plumbers License No. 'i; "7i :r iT' '~ ' I .[ectnclans Ltcense No. Other Trade s License No.U~ [~{,5[)', JW NUY 1. Location of land on which proposed work will be d(Sne: House Number Street County Tax Map No. I000 Section FOR POU: , 'F 2 ~OU,SH.F: aiding ,. 2 INSULATION 4 F~NAL - C~/vSTRqC'~l¢~k~' I'Lk~ ' FdUST BE CON Pb~ 1E Fc~ c O DESIGN OR Block ~ Lot Subdivision Hied Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy' · ~-- Nature ofwo~hich applicable): New Building Repair y Removal Demolition 4. Estimated Cost ~. ~50 n 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. It' business, commercial or mixed occupancy, specify n~ture and' extent of each type of use. 7. Dimensions of existing structures, if any: Front Hei§ht. Number of Stories Rear 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 Fom~er 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 1e-graded? YES NO Will excess fill be removed fi'om 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 * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * 1F YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, with accarate 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. 1 8. Are there any covenants and restrictions with respect to this property? * YES NO · IF YES, PROVIDE A COPY. STATE OF NEW YORK) (~ ,, SS: ~k~ ka ~ [ ~ K~' bei,,g duly sworn, deposes and says flmt (s)he is the applicant ' (Nm~6f~dividual signing contract) abov~,tlame& (S)lte is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perlbrm 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 there~ith. Sworn to before me this [ dayg_f, fix. JO '-,j 20 L~' ~ _ ~o. 01~06190696 ~ ff F , NotaryOtb c ' ~O0m~p¢~l~i~.~ufPl~?~n~.Z ~ - - Sg,attredfApp~a,t- ,0 .x ~es~mv 8 20LW ) Town of Southold ~ ~ Erosion, Sedimentation & Storm-Water Run.off ASSESSMENT FORM STORM-WATER~ 6RADIN(~ DRAINA6. 8~PEO~WO~ * PRO~8~ ~N~-raOc'~ON ~ / WO~~ ~~~~) ~a~~m~? .- ~~) 4 ~1 n~ ~u~ ~e ~lng ~ ~ ~ Cubic Yar~ of Mate~M ~n~y 6 is ~ a Natural Wat~ Site? ~ ~ ~ ~P R~u~n~: or ~in One Hu~ (10~ ~ ~ a WeS~d m~' -- am ~ ~a ~ ~n ~1~ u~l~ ~e ~ ~o~ whl~ ~c~ Fi~een (15) ~t of V~I Rise to ~ ~c ~ ~ ~ a s~s ~ ~ ~ ~ ~ ~ d~ O~ Hu~ (10~) of H~ Dis~? ~ -- 1.~~~s~.~ in~ a~ ~e ~ir~aT~ ~~ ~ -- CO~ O~.L.~..~..~ ....... .............. ~ ~ ~-~ ~ ................... ~g ~ *~m de~e~ ~. ~ ~~7~} .................................. ; ......... S~ to ~ore me ~; ........ .............. ............... .......... 1~) FORM- 06/10 VICKI TOTH Notary Public, State of New York No. 0]106190696 Qua fed ill Suffolk C~9~ntv