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HomeMy WebLinkAbout37779-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 2/12/2013 CERTIFICATE OF OCCUPANCY No: 36131 Date: 1/31/2013 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 340 Birch Dr, Laurel, SCTM ti: 473889 Sec/Block/Lot: 128.-1-7 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 1/23/2013 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" carport altered to garage and renovate first floor area and finish second floor bathroom in an existing one family dwelling as applied for. Corrected 2/12/13 for carport altered to garage and finishing of second floor bathroom. Lot No. filed in this officed dated 37779 dated 1/29/2013 The certificate is issued to Fox, Constance (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H 064081 4/30/99 Town of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 2/12/2013 CERTIFICATE OF OCCUPANCY No: 36131 Date: 1/31/2013 THIS CERTIFIES that the building Location of Property: 340 Birch Dr, Laurel, SCTM #: 473889 Sec/Block/Lot: Subdivision: AS BUILT ALTERATION 128.-1-7 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/23/2013 pursuant to which Building Permit No. 37779 dated 1/29/2013 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" carport altered to living space and renovate fu:st floor area in an existing one family dwelling as applied for. The certificate is issued to Fox, Constance (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED H 064081 4/30/99 ~~t~e~r 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 #: 37779 Permission is hereby granted to: Fox, Constance PO BOX 186 Date: 1/29/2013 Laurel, NY 11948 To: enclose a carport & renovate 1st floor interior space "as built" as applied for At premises located at: 340 Birch Dr, Laurel SCTM # 473889 Sec/Block/Lot # 128.-1-7 Pursuant to application dated To expire on 7/31/2014. Fees: 1/23/2013 and approved by the Building Inspector. AS BUILT - SiNGLE FAMILY ADDITION/ALTERATION CO - ALTERATION TO DWELLiNG Total: $1,128.00 $50.00 $1,178.00 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/I 0 of 1% lead. 5. Commercial building, industrial building, multiple resideaces 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: I. 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. Ifa Certificate of Occupancy is denied, the Building inspector shall slate the reasons therefor in writing to the applicant. C. Fees I. 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 Oceupancy on Pre-existing Building ~ $100.00 ~....Copy of Certificate of Occupancy - $.25 .~Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 rote. / - / -/_3 New Construction: .Location of Property: House No. Street Owner or Owners of Property: ~ 6/.~.~,/7~v SuffOlk County Tax Map No l000, Section /'59- ~ Subdivision Old or Pre-existing Building: Permit No. .5 '~7 ~ 7~ DateofPermit.[ '~o~}' (check one) Hamlet Block / Lot Filed Map. Lot: App cant: Health Dept. Appro'val: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ _ Underwriters Approval: / / Final Certificate: / (check one) Applicant Signature THE NEW YORK B'OA~D DF FIRE* UiN~ER!WiR]TERS ' PA;~, 1 8074218 BURE~%I OF .E~.EC?RiClTY F- 40 FULTON STREET, NEW ~RK, NY 10038 D~e ~R~ 30,1999 ~p~n No. ~ ~ ~7582099,/99 H 064081 THI~ ~E~TiF~ES THAT - only the e~c~ e~me.t ~ desexed be~w a~ ~uc~ by-~ ~F~t ~d o, ~ ~O.e ~ ~u~er ~ ~ the ?r~m~s of CONST~CE PETTE~EN, 34~ BIRCH DR~, ~L, w~ .x~i.ed o. ~R~ 27,1999 DRYERS FURNACE MOTORS FUT SERVICE DIS~ONNE~ I ~o. OFI PADDLE FANS-8 G.F.C.I:-5 SMOKE DETECTOR: -6 CONSTANCE PETTERSEN 340 BIRCH DRIVE P O BOX 186 LAUREL, NY, 11948 This certificate must not be o tered n any i -:GENERAL~MANAGER [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS:[ ] ELECTRICAL (R~UG ~H)~/,~ [ ] ELECTRICAL (FINAL) DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN. SUCTION [ ] FRAMING/STRAPPING [ ,~]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) / DATE INSPECTOR~~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Exa,nined If-L-q, . 20 ~ Approved Disapproved a/c Expiration BLDG. fOW~ OF SOUTHOLD Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do .xou 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. lYustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typexwiter or in ink and snbmitted to the Building Inspector with 4 sets of plans, accurate plot plan Io 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 belbre issuance of Building Permit. d. Upon approval of this application, the Bnilding Inspector will issue a Building Permit to the applicant. Such 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 pan for any porpose xxhat so ever until the Bailding Inspector issues a Ce~ificate of Occupancy. f. Eve~ bailding 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 t¥om snch date. If no zoning amendments or other regulations aftkcting the prope~ have been enacted in the interim, the Building Inspector may authorize, in xwiting, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Boilding Department for the issuance ora Boilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suftblk Coonty. 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, boilding code, housing code, and regulations, and to admit authorized inspectors on premises add in building for necessm'y inspections. ~'~ r~ a~a,ne, 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 ofprenlises C'o/')~J~otlOc_ ~_ /~ X (As on the tax roll or latest deed) If applicant is a corporation, signature of duly anthorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. l,ocation of land on which proposed work will be done: House Number Street Hamlet Tax Map No. 1000 Section ]D,~a' Block ~ '~ County Lot Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended u.se and occupancy of proposed c. onstruction: a. Existing use and occupancy [~.z~ta\}{ tq~ 1.5 'c5"r~5~ -~l~'t~x/ ~*'~['~¢5 b. Intended use and occupancy ~_o-d ~t°~_.~/jt::x,{. _'IF, ,/~5 '~F~ ~ .~oF, .- Il ~''~..q~ ct3o Alteration'~ 3. Nature oI~.work (check which applicable): New Building Additio~r Repair"~ Removal Demolition Other Work 4. Estimated Cost Fee (Description) 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 occnpancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height 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 Nanle of Former OxAqler 11. Zone or use district in which premises are situated 12. Does proposed constrnction violate any zoning la,~. ordinance or regulation'? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from 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 * 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 · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) ~X~g~ '~ )Q being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He isthe (Contractor, Agent. Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have perfm-med the said work and to make and file this applicatioa; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perlbrmed in the manner set forth in the application filed therewith. Sworn to.before me this,..w, ' ~:x~9 dayof Notary Public Signature of A'pplicant '7 TOWN C)F SOUTHO. PROPERLY' RECORD ACI~ W TYPE OF BUILDING FARM CO/IAM. CB. ~tCS. Mkt. Yalue N LAND [MD. TOTAL AGE NEW FARM NORMAL Acre BUILDING CONDITION BELOW ABOVE Vnl~e Per Value BULKHEAD DOCK OWNER STREET V~LLAGE sEAs. VL. I FARM LAND . IMP. TOTAL I DATE AGE NEW Tillable 2 Tilld~le 3 Woodland Sv,,anxoland BrusHoff'" House Plot NOP~AL Acr~ BELOW Value Per Acm ACREAGE 7~- ABOVE Value '-! I !' ~ ~ H · -'"ri-" ~.°33.~ ...... : _2. , , 7 ' I/ ) - ~ ~ -~ ~ ~ I (2) 2X10 w/1/2' ALL PLUM61N~TE .~ ~~~%.- Janua~ 26, 20Z3 & WATER UN~-~ED % ~-ESS~*~: 1' 0" TESTING BEF~E C~ERING ~, ~ ~ / -- T r / SHEET NO: ~UMBER C~FICA TION L J ON LEAD CONTENT BEFCRE CERTIRCA TE OF OCCUPANCY SOLDER USED IN WA TS ~ SUPPL Y SYSTEM CANNO T EXCEED ~10 OF 1% LEAD.