HomeMy WebLinkAbout37572-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
10/16/2012
CERTIFICATE OF OCCUPANCY
No: 36008
Date: 10/16/2012
THIS CERTIFIES that the building AS BUILT PORCH
Location of Property: 375 Corey Creek Ln, Southold,
SCTM #: 473889 Sec/Block/Lot: 78.-4-27
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
10/3/2012 pursuant to which Building Permit No.
Lot No.
filed in this officed dated
37572 dated 10/11/2012
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:
"As Built" covered porch as applied for.
The certificate is issued to
VanDuzer, Jesse & Woodhull, Stacy
(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 #: 37572
Permission is hereby granted to:
VanDuzer, Jesse & Woodhull, Stacy
1730 Country Club Dr
Date: 10/11/2012
Cutchogue, NY 11935
To:
construct an "As Built" covered porch as applied for
At premises located at:
375 Corey Creek Ln, Southold
SCTM # 473889
Sec/Block/Lot # 78.-4-27
Pursuant to application dated
To expire on 4/12/2014.
Fees:
10/312012 and approved by the Building Inspector.
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
CO - ADDITION TO DWELLING
Total:
$540.80
$50.00
$590.80
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, 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 Underwriters.
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, 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 completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
derfied, the Building Inspector shall state the masons 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,
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
New Construction:
Location of Property:
Old or Pre-existing Building: ~ (check one)
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Block Cp Lot
Filed Map. Lot:
Applicant: ~ .'~ ~Dx/{g ~.
Underwriters Approval:
Permit No. ~"] ~"~ ~
Health Dept. Approval:
Date
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ -~0' 6ffD/~'~'d
Final Certificate:
Appli~t ff~antm~
TOWN OF soUTNOLD BUILDING DEPT.
765-1802
iNSPECTION
[ ] FOUNDATION 1ST
~ ROUG~_BG'
[ 1 i~LATION
FOUNDATION 2ND
FRAMING ! STRAPPING [//I'FINAL
- · ~ FIRE SAFETY iNSPECTION
iREPLACE & CHIMNEY t
F ..... '""'ION [ ~ FIRE RESISTANT pENETRATION
~ FIRE RESISTANT ~l~l
...... r ~ ELECTRICAL {FINAL}
] ELECTRICAL {RO~.U~ii" !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
T~OWN HALL
SOUTHOLD, NY 11971
TEL: (6:31) 765-1802
FAX: (631) 765-9502
SoutholdTown.Nor thFork.n et
Examined {'0/{!// ,20 /~
Approved tO/~ t , 20/]~'
Disapproved a/c
Expiration 4[ ~, 20~
PERMIT NO.
Braiding 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
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submit/ed to the Building Inspector with 4
sets uf 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. Thc work covered by this application may not be conmaenced before issuance uf Building Permit.
d. Upon approval uf this application, the Building Inspector will issue a Building Permit to thc applicant. Such a permit
shall be kept on the premises available for inspection throughout thc 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. Eve~ building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the 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 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
authorized inspectors on premises and in building for necessaly inspections.
(Signature of applicant or name, if a 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 J e,~S'~..,u 71~k'~
(As on the tax roll or latest deed)
If applicant is a corporation, signatuze of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location o~.f land on whicl~roposed worli,,will be dpne:
,%'15 c oce (See
House Number Street ~ Hamlet
County Tax Map No. 1000 Section ~ Block t./ Lot
Subdivision Filed Map No. Lot
Nature of work (check which applicable): New Building
Repair Removal Demolition
. 3. State existing use and occupancy of premises and intellded use and occupanqy ofpropose~d cor~struction:
· a. Existing use and occupancy ~t~lt-4(a~nl~ rlf::,.l'~6EL.
, , , ,,
b. lntendeduseandoecupancy ~vI~.f~ ta~/ r,od t:>d~l( O~C~ l~5 B~
3. Addition Alteration X
(Description)
4. Estimated Cost Fee
If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extetu of each type of use.
7. Dimensions of existing structures, if any: Front Rear j ~ I Depth
Height ~;;~ ti Number of Stories
9. Size of lot: Frotu
10. Date of Purchase o~Ol~~--
Dimensions of same structure with alterations or addition~: Front
Depth J l/ Height I'lL JOt' '//- Number of Stories
Dimensions of entire new construction: Front Rear
Height Number of Stories
_Depth
Rear
I!0' irreg. Rear
Name of Former Owner
I I. Zone or use district in which premises are sitvated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO Z
13. Will lot be re-graded? YES NO~_Will excess fill be removed from premises? YES NO ~
14. Names of Owner of premises ~]/~-~ ~1~/4, f.. ~- Address ~OtJ~O ~ Phone No.
Name of Architect ~ Address ~a .n~, 'hJf, lc-Phone No
Name of Contractor (...~$0[ r'I%t ~ Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland. YES N9~
* 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY ~E~REQUIRED.
b. Is this property within 300 feet of a 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 NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
~%.~Ok~/~64d~ ~ q.,~' being duly sworn, deposes ~d says that (s)he is the applicant
~e of ~hdual si~g con~act) above n~,
(S)Ue is the ~ g 51~
(Con,actor, Ag~t, C~omte 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 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.
Swom to before me this k ~'~ ~
day of 20 __
Notary Public Sig~re of A~icant ,6/ '
Iaaa-~-Y-,Z? TOWN OF SOUTHOLD PROPERTY RECORD CARD ,A//-.~.
OWNER STREET t VILLAGE DIST. SUB. LOT
J;~ r~m/~ / WOk~/~Wi-S W ~PE OF BUILDING
RES ~/- S~S. VL.~:' ' ~ FARM CO~. CB. MICS. Mkt. Value
~ND IMP. TOTAL DATE RE~RKS
I
AGE BUILDING CONDITION
N~ NOR~L BELOW ABOVE
FA~ Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Wo~land FRONTAGE ON ROAD
Meadowl~d DEPTH
House Plot BULKH~D
Total DOCK
M. Bldg.
Exten,sion
Extension
Extension
Porch
Breezeway
Garage
Patio
O, Bo
Total
/IX/~ -- /?;
COLOR TRIM
Foundotion
Basement
Ext. Tails 7ZZ~
Fire Place
Type Roof
RecreatiOh Room
Bath
Floors
Interio~ Finish
Heat
Rooms ]st Floor
Rooms 2nd Floor
Driveway
/ ~,~_ 'Dineffe
FIN.
~¥EO JU~ I, 2012
9JF~:OLt~ 60UNTT TAX ~
I000 - '~8 - 4 - 2-/
$BS~B A. VA~ Db~m~
~TACY L WOODHULL
SUI~O{.~ COUNTY NATIONAL BAN~
PIDI~I~I'Y NATIONAL
]NSURAN~ S]~IV~CBS LLC
NOTES,
· HONUHENT t=OUNO
PIPE FOUND
Area = 242~5.2~ Sq. Ft.
Are,a O.~7~ Acre5
®~APHIC SCALE I"= 30'
Lo~ ~ 18
SSq °40'D0"5
S85°21'20';V~"
N
Lo~ ~ 20
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STRI~.I~T N.Y.S. LIC. NO. 50202
RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287
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~ GENERAL NOTE:
· The~e plan5 and drawln~J5 reflect work FerFormed ap?roxlmaedy I G y~r~ a~o; eo
~he be5~ of my knowledge, all work ha5 been compl~ as shown, and m accordance
CUMATIC ~ GEOG~HIC DESIGN C~[TE~IA
~ TO reMAIN
P~ME P~N
iLO',
~ CONTINUOUS AROUND
VAN DUZER, R, ESIDENCE
AS-15U I LT DRAWl NG5
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PAGE:
~ GENERAL NOTE:
These ?lans an~l drawm~3s reflecl; work ?erforme~ approximately I
CLIMATIC ~ GEOG~PHIC D~51GN CRITerIA
~ TO ~MAIN
HEADER HEIGHT I ~
BUILDING SECTION 'IA"