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Home My WebLink About37825-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 3/18/2013 CERTIFICATE OF OCCUPANCY No: 36171 Date: 3/18/2013 THIS CERTIFIES that the building GREENHOUSE Location of Property: 620 Lake Dr, Southold, SCTM #: 473889 Sec/Block/Lot: 59.-1-22 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 2/19/2013 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: poly greenhouse addition to an existing one family dwelling as applied for. Lot No. filed in this officed dated 37825 dated 2/22/2013 The certificate is issued to Bird, Richard & Geurtze, Deborah (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Authoi4a(ed Signatu~ 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 #: 37825 Permission is hereby granted to: Bird, Richard & Geurtze, Deborah Date: 2/22/2013 620 Lake Dr Southold, NY 11971 To: construct a poly greenhouse addition to an existing dwelling as applied for; foundation location required before C.O. At premises located at: 620 Lake Dr, Southold SCTM # 473889 Sec/Block/Lot # 59.-1-22 Pursuant to application dated To expire on 8/2412014. Fees: 2/19/2013 and approved by the Building Inspector. SINGLE FAMILY DWELLING - ADDITION OR ALTERATION CO - ADDITION TO DWELLING Total: $224.00 $50.00 $274.00 Building Inspector Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OccUPgd~Icy This appli~tion must be filled in by typewriter or ink and submitted to the Building Department wi:th the following: For new building or new.use: 1. Final survey of property with aocUrate location of all buildings, property lines, streets, and unusual natural or topographic featur6s. 2. Final Approval from Health D6pt. of water supply and sewerage-disposal (S-9 form). 3.. Approval ofaloctrieal installation from Board 0fFire Underwriters. 4. 'aw.ore statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commeroial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code ComPlianceTrom 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-eonfo?ming uses, or buildings and "pre-existing" land uses: I. Aocurate survey of property showing all property lines, streets, building and tmusufil naturai or topographic features. 2. A properly qo~mpleted application and c0n~ent 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. Certificaie 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. Ce[tifieate 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 Constsuction: C~ Location of Property: 6~,. O Hous~ No. Owndr or owners of Property: ~. !. C Iff- Suffolk ~o~nty Tax Map No 1000, Section Subdivision Old or Pre-existing Building: Street Permit lqo. ,3~7'~,-~ Health Dept. Approval: Date. (check one) Hamlet Block .{ Filed Map. Date of Permit. ff ~ ~c¢ - ] ~ Applicant:. Underwriters Appwval: Lot ,20 Planning Board Approval: Request for. Temporary Certificate Fee Submi,ed: $ 5~ OO Final Certificate: 'L/ (cheek one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: "'~:~ ~ C.O~ DATE INSPECTOR,~~(~/~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved Disapproved aJc Expiration PERMIT NO. 3 '7 g~'3-5" Building 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 N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Phone: 7~5" ~/ '77 APPLICATION FOR BUILDING PERMIT Date ~,,// INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the 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, and waterways. c. The work covered by this application may not be commeuced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector xvill issue a Building Permit to the 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 ill part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every 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, itl 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 tbr the issuance ora Building Permit pursuant to tile Building Zone Ordinance of the Town of Southold, Suffolk Couuty, New York, and other applicable Laws, Ordinances m' Regulations, for the construction of buildiugs, additions, or alterations or for removal or demolition as herein described. Tile applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildiug fo.' necessar,x iuspections. ]~ ~ ~ State whether applicant is owner, lessee, agent, architect, engineer, genera~co~tra~totr, tTecrOric/ia~n, plu~bJr ~tr builder Name ofownerofpremises ~ [ ~~ (As on tine tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section ~ ~:~ Block Hamlet O ( Lot ~.'~ 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 Repair Removal Demolition 4. Estimated Cost f 70 i~ 5. If dwelling, number of dwelling units If garage, 'number of cars [Zee Addition Alteration Other Work 6-~rff~,,o~ o~aI,[ (Description) (To be paid ou 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 /(..9 9 Rear Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height_ Number of Stories 8. Dimensions ofemtire new construction: Front _~' ~ *' Rear a ' ~ '~'~*~4~ ~' a Height ~~'(~ Number of Stories t 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~-7~gT[Pexcess fill be removed from premises? YES __ 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 fi'eshwater 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. 1 7. 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__ ~ · 1F YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) (Name of individual si~ning contract) above named, (S)He is the O ~t~'A-I ~ ('Contractor, Agent, Corporate Officer, etc.) being duly sworn, deposes and says that (s)he is the applicant Jeanne Sweet Bartos NOTARY PUBLIC, State of New Yod~ No. 01BA6210083 Qualified in SuttotK Couet~ Commission Expires August of said owner or owners, and is duly authorized to perform or bare perfbrmed tile said xvork and to make and file this application; that all statements contained in this application are true to tile best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewifll. Sworn to before me thi~ I ~ day of' ~"e..bCtMjt. v'c~ 20. ~ ~ /lqotary Pub)lc S ignatnre of Applicant o o 1. LOT NUIIIBERS SHOWN THUS: ./,02" REFER TO suBDIVISION MAP k~DE FOE CONSTANTINE P. GEORGtOPOULOS FILED IN THE OFFICE Of' THE CLERK OF SUFFOLK COUNTY ON JANUARY 29, 198,5 AS FILE No. 7844 2. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. $6103CO154 G ZONE ZONE X*: ZONE X: BASE FLOOD ELEVATIONS DETERMINED AREAS OF §OO-Y,~R FLOOD; AR[AS OF 100-YF~R FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS L~SS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100-YEAR FLOOD. AREAS DETERMINED TO DF OUTSIDE $OO-YF~ FLOODPLAIN. THE EXIST[NC[ OF RIGHTS OF WAY AND/OR EASEHENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-59-01-22 SCALE: 1"=20' NOVEIdBER :5, 2000 AREA = 15,170.70 sq. ff. 0.348 ac. 0 CERTIFIED TO: RICHARD BiRD DEBORAH GEURTZE FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK HUNTINGTON MORTGAGE COMPANY '~ N.Y.S. Lk:. No. 496~ Joseph A. Ingegno Land Surveyor Title Surveys -- 5ubdivls~ons -- Site Ph3ns -- Construction Laym PHONE (631)727-2090 OFFICES LOCATED AT $.380 ROANOKE AVENUE RIVERHEAD. New York 11901 Fax (651)727-1727 144,lUNG ADDRESS P.O. Box 1931 Riverhead, New York 11901 2O lC<