HomeMy WebLinkAbout37268-ZTown of Southold Annex
P.O. Box 1179
54375 Main Road
Southold, New York 11971
5/1/2013
CERTIFICATE OF OCCUPANCY
No: 36218
Date: 5/1/2013
THIS CERTIFIES that the building
Location of Property:
SCTM #: 473889
Subdivision:
ACCESSORY
625 Dean Dr, Cutchogue,
Sec/Block/Lot: 116.-5-7
Filed Map No.
conforms substantially to the Application for Building Permit heretofore
6/1/2012 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:
Lot No.
fried in this officed dated
37268 dated 6/1/2012
accessory pergola as applied for.
The certificate is issued to
Sullivan, Brian & Adams, Marjorie
(ow~4~)
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 #: 37268
Permission is hereby granted to:
Sullivan, Brian & Adams, Marjorie
253 W 73rd St
New York, NY 10023
Date: 6/1/2012
To:
construct an accessory pergola as applied for
At premises located at:
625 Dean Dr
SCTM # 473889
Sec/Block/Lot # 116.-5-7
Pursuant to application dated
To expire on 12/1/2013.
Fees:
6/1/2012
and approved by the Building Inspector.
ALTERATION OF ACCESSORY BUILDINGS
CO - ACCESSORY BUILDiNG
Total:
$220.00
$50.00
$270.00
Building Inspector
Form No. 6
TOWN OF SOIJT~OLD.
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 pmpen'y 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. aw. om statement fwm plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Co--iai building, industrial building, multiple residences and similar buildings and installations, a certificate
of Cod~ 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) ~ion-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 ~c~,.mpleted 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 $15.00
New Construction:
Location of Property:
V// Old or Pre-existing Building:
House No. Street
Owner or Owners ofProperty: -'~. ~t;/_~ t/.a,?,,t o.~
Suffolk County Tax Map No 1000, Section //~
Subdivision
Permit lqo.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Foe Submitted:$ ~,
DateofPermit. (o -/-/2_.
Date. ~ -/-/-- / '~.
(check one)
Block .~ Lot
Filed Map. Lot:
Applicant: ~ ,"~MO/C4~:m~a>
Undenvritera Approval:
Hamlet
Final Certificate: v// (check one)
Applicant Signature
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
//INSPECTION
[l/] FOUNDATION 15T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND
[ ]FRAMING/STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
DATE
INSPECTOR~~~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] RO~I~PLBG.
[ ] FOUNDATION 2ND [ ]~ULATION
[ ] FRAMING/STRAPPING [//] FINAL
[ ] FIREPLACE & CHIMNEY
[ I RRE RESISTANT CONSTRUCTION
[ ] ELECTRICAL (ROUGH)
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
] ELECTRICAL (FINAL)
DATE
INSPECTOR
TOWN OF SOUTHOLD
BDILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined
Approved
Disapproved a/c
Expiration /dj t , 20(~9)
PERMIT NO. ~ 7-)~ J/
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
Contact:
Mail to:
Phone:
Building Inspector
~I ---- II / ~PLICATION FOR BUILDING PERMIT
2012 IL_.V.J I S g.'-'t tq ,20
MaY 2 3 2012 Date
L [ I INSTRUCTIONS
BLDG DEPI, J
a. This al~Ol~a~iO~Ul~ll~T be, ~nm.hlet¢ly filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets o ,lans, accurate plot plan to scale. Fee according to schedule.
b. ]?lot 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 before issuance of Building Permit.
d. Upon approval of this application, the Building 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 part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
£ Every 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
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 necessary inspections. ~x~~~
(Signature of applicant or name, If a corporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises ~ft4~ ~u~.~lU/~to, r4he.lol~l~ j~-l~-~<~
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. ~ 1~ ~
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
County Tax Map No. 1000 Section
Subdivision
(Name)
Hamlet
Block o ,~( ~;~jbta'~ '~ }
Filed Map N '.,; ~,~t....~r ~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~t~t,t.~ ~/t~t.~[ ~.I;~l>~ot.~'-
b. Intended use and occupancy ~-~o~, t~ ~avt~t.,~ l~r¢,l>~s~'
Repair Removal
4. Estimated Cost ~-'~t ~
' 5. If dwellitlg, number of dwelling units
If garage, number of cars Z-
Nature of work (check which applicable): New Building
Demolition
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 /,, Z ~ Rear Z ~/ ~ .Depth
Height I r~ ~ Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth b, 4. ~ Height ~ g~ '
8. Dimensions of entire new construction: Front ~ ~.
Height I Z. ' Number of Stories
9. Size oflot: Front 14-+' Rear l(~~
~, 7. ~ Rear
Number of Stories
Rear ~ g- Depth
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 X Will excess fill be removed from premises? YES NO
14. NamesofO,amerofpremisest4~4~e ~t>~to Address lox ~f It~ogg PhoneNo.
Name of Architect gtaDo~r~'~ ~'pr,~o~o Address u,, u-~ t~o~ Phone No 'lift-
Name of Contractor I-I-~.~.~'~ ~o~o~,-r¢., Address~~n° e~i,.r~..,e ,~ Phone No. ~,~f -
15 a. Is this property within 100 feet of a 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 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.
STATE OF NEW YORK)
SS:
CO_~tU~.YOF~ "cr t__ . ./ ~...i-.-M __
(__.a(~_..~ae¥O ' ///Or~,dO-St>O' being duly swom, deposes =d says that (s)he is me applicmt
~me of ~divid~l sing con~act) above nmed,
(S)He is the ~ o~ ~C~' '/~'
(Con,actor, Ag~t, Co,orate Officer, etc.)
of said owner or owners, and is duty 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~.~
~Taz~/~/ ~ of .~a~ 20~:~
No~ry Public
o~
AF',F_A = 54-,852 sq. ft.
E'~?Ff;1 ,*~ Pt,'" 'SL, 'L. 72g:~ r')B~21VISIO,'I 2 ,",'L ~- ~ ,~ ~,
FILED
0
~oTM ~
3O
SURVEY OF
LOT 6
"DOWNSVIEW"
OCT. 11, 1970 FILE NO. 5509
AT CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-116-05-07
0 30 60 90
Scale 1" = 50
JULY ~3~ 1998
APRIL II, 2010 (prop. pool)
CERTIFIED TO,
ETHEL ENGELS
COMMONWEALTH LAND TITLE
INSURANCE COMPANY
PECONIC ABSTRACT~ INC.
,¢,_(.,..,,,.C S' :?'~'EYOI~? O:C,
(516) 785 - 5020
?. (; BOX ~09
A P¢+~OVED M NOTED
bR~'TE' ~ B.P. #
~/ ~UILDING DEPARTMENT AT
~b~-/~ 8 ~ TO 4 PM FOR TH~
~ c~WING INSPECTIONS:
~mUNDATION - ~ REOUIRED
~: ~ R P~RED CONCRETE
ROUGH- F~, ~UUBrNG,
?RAPPING, ELECTRICAL & CAULKIN~
~NSU~TI~
;~NAL- CONSTRUCTION & ELECTRIC~
MUST BE C~PLETE ~OR C 0
~ ~TION SHALL UE~
RE~T8 OF THE CODES OF NEW
E~S.
OCCUPAN~;-Y OR
: ~c IS UN! AWF ~
..., ~uCiJPANC'~
Elizabeth Thompson .
2.50 Mercer St.
New York, NY
10012
Architect
Suite B 806
212-614-7180
oufcHo&uC, urf
Title
Dote
~/,~,/,~
Scale
I ?
Elizabeth Thompson.
165 East 118th St.
New York, NY
10035
Architect
Suite 7A
917-848-1541
6.Ol'6HC)AL~ r~ ~ HW
Title
Date
Scale
1/4%1;~"