HomeMy WebLinkAbout37731-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
1/28/2013
CERTIFICATE OF OCCUPANCY
No: 36124 Date: 1/28/2013
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 760 Rambler Rd, Southold,
SCTM #: 473889 Sec/Block/Lot: 88.-5-20
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
12/26/2012 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
which this certificate is issued is:
"as built" deck addition to an existing one family dwelling as applied for.
Lot No.
filed in this officed dated
37731 dated 1/7/2013
The certificate is issued to
Quane, Patrick & Quane, Laurene
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
- //~hdrized/~ignat ufr e
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 #: 37731
Permission is hereby granted to:
Quane, Patrick & Quane, Laurene
Date: 1/7/2013
35 Wellington Rd
Garden City, NY 11530
To:
"As Built" deck addition to an existing single family dwelling as applied for.
At premises located at:
760 Rambler Rd, Southold
SCTM # 473889
Sec/Block/Lot # 88.-5-20
Pursuant to application dated
To expire on 7/9/2014.
Fees:
12/26/2012 and approved bythe Building Inspector.
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
CO - ADDITION TO DWELLING
Total:
$408.00
$50.00
$458.00
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
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,
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.
New Construction: Old or Pre-existing Building:
Location of Property: 7(_,0 ]'~ ~q"Y'}
House No. Street
Owner or Owners of Property: ~:>/X,"~{, (2 ~L.
Suffolk County Tax Map No 1000, Section
Subdivision [~O~/~-IP ff'~ ~
PermitNo. ~ 77 / DateofPermit. /-- 2- /,,_~
Health Dept. Approval:
Planning Boar. d Approval:
(check one)
Hamlet
Block O5 Lot
Filed Map. ~--,Cl {2) I Lot:
Applicant:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~_ ,
Final Certificate: 5( (check one
Applicant Signature
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING / STRAPPING [~NAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: ~,~ ~"~ ~ ./~f.Z'~
:_.<~_.~. / /' .
DATE
DONALD G. FELLER .ARCHITECT
11725 Main Rd * BOX 1692 · Mattltuck, NY 11952 * 631 2985453 * Fax 298.1380
January 18,2013
Mr. Gary Fish
Southold Town Building Department
Southold Town Hall
Main Road, Southold, New York
Re:
As-Built Deck Addition at the Ouane Residence
760 Rambler Road, Southold, New York
Dear Mr. Fish:
I have investigated the depth of 4x4 supports at the above mentioned project,
and can certify that they are 36" below grade, and are in compliance with the
Residential Code of New York State.
JAN 22 2013
TOWN"OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
,/
Examined ~ ,20 { ~a~
,/
Approved ~'- .20 [~
PERMIT NO. <'~_~tt 2
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: ~0¢i/:~'9 ~ I t-qYI
Disapproved a/c
Expiration ~/~ ,20/~ ~
"~.,' ~ ~'X(~ ~ APPLICATION FOR BUILDING PERMIT
,"; ':~ ~__~ [ INSTRUCTIONS --
~ a. T~~MUST be completely filled in by ~pewriter or in ink and submitted to the Building Inspector with 4
sets ~Ms, accur- ate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings rm 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 pe~it
shall be kept on the premises available for inspection throughont the work.
e. No building shall be occupied or used in whole or in pan for any pu¢ose what so ever until the Building Inspector
issues a Ceaificate of Occupancy.
f. Eve~ 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 within 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 pemit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Depagment for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Soutbold, 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 necessaD, inspections.
(Signature of applier or name, ifa co~oration)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises '~xTle,.k£~ '--). ~ [.-k,,t.)C,.'lilx3~-. ~9,
(As on the tax roll or latest deed)
If applicant is a corporati_~on, signature of duly authorized officer
(Name and title of colporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section ~ Block (22) ~ Lot ~2.O
Subdivision ~f'x~ O~- ~-~ [/q ~ Filed Map No. q-o[ 0 1 Lot ~' *'
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~, c4~ t---E:: ~ ~ c.~ ~) ldJ4ZEl.-c4tJ~
b. Intended use and occupancy ~ C.
Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost'~ ~FoO
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 22~ Rear q-43 Depth "O tv.,
Height. 7_~ Number of Stories
Height
9. Size of lot: Front
10. Date of Purchase
Dimensions of same structure with alterations or additions: Front ~,t~ Rear
Depth. Height Number of Stories
Dimensions of entire new construction: Front ~ ~ Rear ~ ~ Depth
Number of Stories
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO X.
13. Will lot be re-graded? YES x~ NO ~ Will excess fill be removed from premises? YES NO X
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address ¢¢~0t~. I:zOt 5oq~otoPhoae No.
Address {/~c~ ot
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 'X
· IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO )~
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.
CONNIE D. BUNCH
SfATE OF NEW YORK) ~x',~,nr~ Public, State of New York
SS: No, 0~ BU6185050
COUNTY OF ) ,%~aiified in Suffolk County
Commirsion E~:pires April 14,
~NJl>q20 -4~7~E:_ } [.--~----~ being duly' sworn, deposes and sa~,s that (s)he is the applicant
(Name of individual signing contract) above named,
(S)ne is the ~'Zt5 ~1 .T't~_Jf~ '
(Contractor, Agent, Corporate 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 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
o~{z:~ day of~exu2.ccx~ 20
Notary Public
Signature of"~ 4leant
Date
To
DONALD G, FELLER *ARCHITECT
725 Main Rd * Box 1692 · Mattituck, NY 11952 · 631 2985453 * Fax 298.1380
Re
Pages to follow
For your review
--7- As requested
Please call at your convenience
Comments:
TOWN OF SOUTHOLD PROPERTY RECORD CARD
FORMER OWNER E
ES, ~ t ~ S~S. VL~ FARM COMM. CB. MICS. Mkt. Value
~ND IMP, TOTAL DATE RE~RKS
~ARM Acre Value Per V~lue
illable FRONTAGE ON WATER
/o~land FRONTAGE ON ROAD
~eadowland DEPTH
louse Plot BULKH~D
oral .- DOCK
I COLOR
Extension
Extension
Breezeway
·Garage
Total
Foundation
Basement
Ext~ Walls
Fire Place
Bath ....
Floors-
Interio~.F!ni~h.==
~ Heat
· Type Roof Rooms 1st FloOr
Recreation Room Roo~ns 2~d F oar
Dormer
Driveway
~,/...~ ~ DR.
BR: '
FIN. B
I
NOTIFY BUILDING DEPARTMENT AT ~ ~
765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
TWO
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL ~ CONSTRUCTION MUST
BE COMPLETE FOR C,O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
'//2_"