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Home My WebLink About37636-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/11/2013 CERTIFICATE OF OCCUPANCY No: 36161 THIS CERTIFIES thatthe building CHIMNEY Location of Property: 460 Ruch Ln, Greenpo~, Date: 3/11/2013 SCTM #: 473889 Sec/Block/Lot: 52.-2-23 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 11/5/2012 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: CHIMNEY TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR Lot No. ~ed in this ofliced dated 37636 dated 11/15/2012 The certificate is issued to Massa, Maureen & Schweitzer, Alan (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 #: 37636 Permission is hereby granted to: Haas~ ~r, George PO BOX 153 Southold, NY 11971 Date: 1111512012 To: construct a chimney to an existing single family dwelling as applied for At premises located at: 460 Ruch Ln, Greenport SCTM # 473889 Sec/Block/Lot # 52.-2-23 Pursuant to application dated To expire on 511712014. Fees: 11/512012 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ALTERATION TO DWELLING Total: $200.00 $50.00 $250.00 Building Inspector Form No. 6 TOWN OF $OUTEIOLD BUILDING DEPARTMENT TOWN HALL 765q802 APPLICATION FOR CERTIFICATE OF occUPANCy This' application must be filled in by tYPewriter or ink and submitted to the Building D~partraent with the following: A. For new building or new use: 1. Final survey of property with accurate'location of all buildings, property line~, streets, and unusual naturat or topographic features. 2. Final Approval from Health D~pt. of water supply and s~werage-disposal (S-9 form)~ 3.. Approval of electrical ins, tallation from Board 0 f Fire Underwriters. 4. 'Sw. om ~tatement from PlUmier ceKifying that the aoldor treed in system contains lezs than 2/10 of 1% lead.. 5. Commemial building, indues-iai building, multiple reaideneaa and similar buildings and installations, a certificate of Code ComPliance'from architect or engineer rc~onsible for the building: 6. Submit planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) n°n-confoFming us~, or buildings and "pre-existing' land uses'.' 1. Acourate surwy of proPerty showing ali property lines, streets, building and unusufil naturai or topographic features. 2. A properly c~mpleted application and c0r~scnt to inspect signed by the applicant. If a Certificate of Occugancy 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, Swimmilig 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 - 4. Updated Certificati: of Occupancy- $50.00 ' 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: ]~/o 0 '~O House No. Owner or Owners of Property: _{'~ ~. r~ fC Suffolk County Tax Map No 1000, Section Subdivision Old or Pre~existing Building: Street Permit No. 5 7 ~ ~ ~ Date of Permit. Date· /! - /~ - . (check one) /2- Hamlet Filed Map. Lot: Applicant:. Health Dept. AppmvaE Planning Board Approval: Request for: Temporary Certificate Fee Submi,ed: $ Underwriters Appmvah . Final Certificate: / (cheek one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING/STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ]~ULATION [ ~]'FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH)~, [ ] ELECTRICAL (FINAL) REMARKS: TOW~ OF SOUTHOLD BUILDING DEPARTMENT ¥OWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SouthoidTown. NorthFork.net PERMIT NO. Exanlined 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: Approved .Jl/[~20~ Mail tO: Disapproved a/c Phone: Expiration ' ~ ~:: (~,' ~5. ?, x,,)[, ~?~'/~ 'Building Inspector INSTRUCnO S, m ThN~f~tion MUST be completely filled in by typewriter or in ink aud submitted to the Building Inspector witb 4 sets of plans, accurate plot plao to scale. Fee according to schedule. b. Plot plau sbowing location of lot aod of buildiogs on premises, relationship to adjoining premises or public streets or areas, and water~vays. 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. Sncb 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 pa~ tbr any purpose what so ever until the Building Inspector issues a Ce~ificate of Occupancy. f. Every building permit sball expire if the work authorized has uot 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 ora Building Pemit pursuant to the Building Zone Ordinance of the Town of Soutbold, Suffolk CounW, 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 autborized inspectors on premises and in buildiog for necessary inspections. (Signature of applicant or nafne, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engi ee~, general contractor, electrician, plumber or builder Name of owner of premises / (As on the tax roll or latest deed) If ap?zl~'cant isa c/q,[.poration, s',,~C~ral~ure of duly, y,y~uthorized officer / (Name and tjI4e",gt~(5orp'~""6rate of~:er) Bu41ders Licensefio// Ptmnbers Licens~ixro. ' '- .,Electricians License No. Other Trade's IScense No. 1. Locati9n of land on which proposed work will be done: }louse Number Street County Tax Map No. 1000 Section ',~c~ Block Hamlet ~ Lot C)~D Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work Estimated Cost /.~00 Y Fee If dwelling, number of dwelling units If garage, number of cars 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 Heigh'~ 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 9. Size of lot: Front Rear Depth 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 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 cfa tidal wetland or a freshwater wetland? *YES ~ NO __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES }O NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan m~d 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 ) ,_,~5";~,,'-j ~ ~/?'~-/J'~"~ being duly sworn, deposes and says tbat (s)be is tile applicaut (Name of individual signing contract) above named, .,ONNIE D. BUNCH (S)He is the .,..---------~ r,'-,Public, State of New Yotil o. 0 i BU61 /~(,_.' ~tCont~Agent, Corporate Officer, etc.) ,,,,'ii,~d in Suffolk County ~,, · '~~ ~ ~...: on iExpires April 14, 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 kuowledge aud belief; aud that the work will be performed in thc manner set forth in the application filed therewith. SworB to before me this. Notaw Public MA~A-,_SCHWEITZEK ~M~, B~LDING F~R POURE? STRAPPING INSU~TION FINAL-CON'~CT~5~ MUST BE ,3C~A~C~ ~ co. smuc~ SURVEYED FOR:- ~",,,~:a~',~ ,,~ LOT/S ,SCALE 1"-~- WILLIAM R. SIMMONS III, L.S.P.C. 1 1 MEROKE LANE