HomeMy WebLinkAbout38848-Z X1' ` Town of Southold Annex 5/9/2014
:4 P.O.Box 1179
1.1 '
, 54375 Main Road
"-,Ir+ • ,■ Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36906 Date: 5/9/2014
THIS CERTIFIES that the building ACCESSORY
Location of Property: 18450 CR 48, Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 96.-4-4.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
5/5/2014 pursuant to which Building Permit No. 38848 dated 5/5/2014
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" 8'X 13'shed as applied for.
The certificate is issued to Helinski,George&Helinski, Laurie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
AtAgiZedtjature
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#: 38848 Date: 5/5/2014
Permission is hereby granted to:
Helinski, George & Helinski, Laurie
PO BOX 35
Cutchogue, NY 11935
To: "as built" 8' X 13' shed as applied for
At premises located at:
18450 CR 48
SCTM # 473889
Sec/Block/Lot# 96.-4-4.2
Pursuant to application dated 5/5/2014 and approved by the Building Inspector.
To expire on 11/4/2015.
Fees:
AS BUILT -ACCESSORY $283.20
CO -ACCESSORY BUILDING $50.00
Total: $333.20
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
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
Date.
New Construction: Old or Pre-existing Building: V (check one)
Location of Property: 1(84 V Ce,qq cut-0103,u
,u
House No. �/ Street Hamlet
Owner or Owners of Property: Pe./ 1 ns K 1
Suffolk County Tax Map No 1000, Section / Block Y Lot 17// 47�
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Sig tiFfive
-18g ((- 8 f sou
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holy
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG UMBING
[ ] FOUNDATION 2ND [ ] 1 LATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
41 ' Cs?0
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DAT INSPECTOR `''
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FIELD INSPE ON REPORT DATE COMMENTS . •
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• FOUNDATION(2ND)
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PLUMBING . .
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INSULATION PER N.Y.
STATE ENERGY CODE •
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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 Planning Board approval
FAX: (631) 765-9502 Surve
Y
SoutholdTown.NorthFork.net PERMIT NO. ,?ir 8�fg' Check I ? ,� ,x.i, i?._.4
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined ,20 Storm-Water Assessment Form
Contact:
Approved ,20 Mail to: . /£�L� --, -27-0
Disapproved a/c i�� ' '.5.4,c_.Phone: L„4/.. . V— -c5—J
/,5:5
xpiration ,20
r, I 'I_`� �' l , Building Inspector
i
-- i j
�IAY — 1 2014 �i
I 'PLICATION FOR BUILDING PERMIT
_1 1 Date , 20
F-));; ;;,r . INSTRUCTIONS
TO'l t,
.pp icafion 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 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.
. ... : k.
1 � n (Signature of applicant or name,if a corporation)
(Mailing address of applicant)
Ai-'PROVED AS NOTED
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, el ctrictan, plumber or b alder
DATE' 7,'./'f B.P. # $ b
4111C1P+o BY 6Lelar
Name of owner of premises ( NOTIFY BUILDING DEPARTMENT AT
(As on the tax roll or la 765-1803 8 AM TO 4 PM FOR THE
�#t48R. aNG INSPECTIONS
If applicant is a corporation, signature of duly authorized officer 1 FC,..' ATION-TWO RECUIRE D
I r' CURED CONCRETE
(Name and title of corporate officer) 2 J ':-FRAMING,PLU C,ING,
S T bP'r-ING, ELECTRICAL &CAULKI
Builders License No. 3. IN 5=ULATION
4. FI'dAL-CONSTRUCTION &ELECTRICAL
Plumbers License No. MUST BE COMPLETE FOR C.O.
Electricians License No. ALL CONSTRUCTION SHALL MEET THE
Other Trade's License No. REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
1. Location of land on which proposed work will be done: DESIGN OR CONSTRUCTION ERRORS.
House Number Street Hamlet
County Tax Map No. 1000 Section f (0 Block 4.4 Lot . L--
Subdivision Filed Map No. Lot
r a
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 5 F—p
b. Intended use and occupancy /S-ccE cre7fa_q s 3�, (4 p
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost -4411111110111.111P Fee ,i j ?O 0.3-0_ c.Q
(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. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions o n{tire new construction: Front S Rear Depth i '3'T
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 , f 'v j 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, CONNIE D.BUNCH
Notary Public,State of New York
No.01BU6185050
(S)He is the Qualified In auk*County l
(Contractor,Agent,Corporate Officer, etc.) Commission Expires April 14,2C)/io
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 knowledge and belief;and that the work will be
performed in the manner set forth in the application filed therewith.
Sw rn to before me this
day of n 20 J 4/
0}Js( ib• 4&-t
Notary Public ignature ofApplica.'4
1000-9G 4 4.2 .
.-
1
CERTIFIED TO:
.•
ALISON O'MALLEY
CHICAGO TITLE INSURANCE SERVICES.LLC
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