HomeMy WebLinkAbout38612-Z
Town of Southold Annex
pySF ,t ~ 1/13/2014
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36712 Date: 1/13/2014
THIS CERTIFIES that the building AS BUILT DECK
Location of Property: 1025 Great Peconic Bay Blvd, Laurel,
SCTM 473889 Sec/Block/Lot: 129.-1-5.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/23/2013 pursuant to which Building Permit No. 38612 dated 1/6/2014
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 single family dwelling as applied for
The certificate is issued to Zilz, Linda
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
v
Au o ed ignat re
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 38612 Date: 1/6/2014
Permission is hereby granted to:
Zilz, Linda
1025 Peconic Bay Blvd
Laurel, NY 11948
To: "As built" deck addition to an existing single family dwelling as applied for.
At premises located at:
1025 Great Peconic Bay Blvd, Laurel
SCTM # 473889
Sec/Block/Lot # 129.-1-5.2
Pursuant to application dated 12/23/2013 and approved by the Building Inspector.
To expire on 7/8/2015.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $786.40
CO - ADDITION TO DWELLING $50.00
Total: $836.40
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 2/10 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
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 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: d or Pre-existing Building: (check one)
Location of Property:
House No. Street - Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (che one)
Fee Submitted: $
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND ] ROUGH P G.
] FRAMING /STRAPPING [ ] I CATION
]FIREPLACE & CHIMNEY ~ FINAL
]FIRE RESISTANT CONSTRUCTION [ ]FIRE SAFETY INSPECTION
I ] FIRE RESISTANT PENETRATION
] ELECTRICAL (ROUGH)
]ELECTRICAL (FINAL)
REMARKS:
Q
DATE
INSPECTOR ,~j~
FIELD IldSPECTxON itEPORT DATE COMMENTS
ro
FOUNDATION (1ST)
FOUNDATION (2ND)
tROUGH FRAMING &
PLUMBING y
X
W
INSULATION PER N. Y.
STATE ENERGY CODE Z,
FINAL
ADDITIONAL COMMENTS N,
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 G Planning Board approval
FAX: (631) 765-9502 Survey
So utholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined ,20 Storm-Water Assessment Form
l.~ Contact:
Approved , 20 / Mail to:
Disapproved a/c
Phone:
Expiration , 20
i Pe
DEC 1 R 2013 APPL! ATION FOR BUILDING PERMI
Date 20
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 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.
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, 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 ord lition as herein describ The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, a d regulations, and 1 admit
authorized inspectors on premises and in building for necessary inspections. %
(Si atureo pplicantorna ,,if oratiop)
(Mailing ddress of appl cant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title,gf corporate officer)
Builders License'No:
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of nd on which proposed work will be done:
~l/ ~f~i~ /c .rC~~ ~,~7dly/
House Number Street Hamlet
:-12 &1~10/-z /n
County Tax Map No. 1000 Section . ~ OZ4 -4` " Block -0 ~O 6 Lot -Q ,
Subdivision Filed Map No. Lot
2. State existing use and occupancy of pre ises and intended use and occupancy of proposed construction:
a. Existing use and occupancy rZFos
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. D' nsion of existing structures, if any: Front Rear Depth
H Numb of Stories
Dimensions structure with alt do o ddi ~7ro Rear
pth eight 'Nu ber of Stories
8. Dimensions of entire new construction: Front ear Depth
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 R 1
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES_ NOWill excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
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.
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 )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, CONME D. BUNCH
Notary Pthk, Bleb of New York
(S)He is the No. olsu61em
(Contractor, Agent, Corporate Officer, etc.) Comm010111111W in - -
kWon Entree APtB 17, 2 G
of said owner or owners, and is duly authorized to perform or have performed the said work and to mak nd file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that th ork will be
performed in the manner set forth in the application filed therewith.
Swo to before me is
day of~ L 20
Notary Public ~ , - ignature -Ap ant.
t
\ TF71 N
\ a~ SURVEY OF
\ w4 ® ti$ ~ ~ LOT 1
s MAP OF
LAURELWOOD ESTATES
a FILE No. 5595 FILED MAY 17, 1971
SITUATED AT
s\ t o el LAUREL
TOWN Of SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S. C. TAX No. 1000-129-01-5.2
V` i `C SCALE 1"=50'
MARCH 15, 2000
UECEMDER 1). 2000 REVISED PROPOSED HOUSE
FEBRtMRf 2, 2001 FOUNDATION LOCAAON
,N .r0a 40 SEPIEM6ER 27, 2001 FINAL SURVEY
AREA = 40,426.40 sq. tt.
§ O 0.926 ac.
S.C.D.H.S. No. 1410-00-0112
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SUFFOLK COUNTY OEr ARTVEyf OF
CERTIFIED TO WILLI
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UC^ 7 WORKS FOR LINDA ZILZ
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THE EXISTENCE OF RIGHT OF WAYS DFf'~(rj LOCATED AT
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MY. NOT ESHOYYIA AK NOTGGU I ANTEED. 13110 ROAWKE AVENUE P.O. B" 1931
RWERHW, New loll It90t Rher d. N. York 11901-0960
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NOTIFY BUILDING DEPARTMENT AT 765-1802 P.M TO 4PM FO
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2. ROUGH - FRAMING & PLUM ING I phone:
3. INSULATION _ (631) 298-2250
iO 4. FINAL - CONSTRUCTION MU :;T e-mail:
BE COMPLETE FOR C.O. d- _ ALL CONSTRUCTION SHALL M ET THE _ o michael@mchdesignservice .com
REQUIREMENTS OF THE CODE OF NE I
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