Loading...
HomeMy WebLinkAbout27988-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28172 Date: 01/15/02 THIS CERTIFIES that the building ADDITIONS Location of Property: 3080 HENRY'S LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 1 Lot 44.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 3, 2002 pursuant to which Building Permit No. 27988-Z dated JANUARY 4, 2002 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 ADDITIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT W JOHNSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A AuthorizM Signatu Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27988 Z Date JANUARY 4, 2002 Permission is hereby granted to: ROBERT W JOHNSEN 4300 SOUNDVIEW AVE SOUTHOLD,NY 11971 for CONSTRUCTION OF TWO DECK ADDITIONS TO A SINGLE FAMILY DWELLING "AS BUILT" AS APPLIED FOR at premises located at 3080 HENRY' S LA PECONIC County Tax Map No. 473889 Section 074 Block 0001 Lot No. 044 . 008 pursuant to application dated JANUARY . 3 , 2002 and approved by the Building Inspector. Fee $ 300 . 00 Authorized Signature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT i TOWN HALL ;+ 5 (?st]� 765-1802 l APPLICATION FOR CERTIFICATE OF OCCUPANC 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 I% 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 a 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$25.00,Additions to dwelling$25.00,Alterations to.dwelling$25.00, Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00,Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 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: (check one) Location of Property: 'I-4n Pec.0 R t'C House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section C7 Block p Go j Lot y 41 ,a G fj' 41 Subdivision Filed Map. Lot: Permit No. Q 7 y k? Date of Permit. — !f—O Z Applicant: ,T A k s-e,n Health Dept. Approval: - Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �Q L (P 0 Applic t Signature LAWRENCE M. TUTHILL PROFESSIONAL ENGINEER O {� � P.O. BOX 162 —AA,, GREENPORT, NY 11944 afi';5�1 5 (':.1� (631) 477-1652 n. ,f. n T. January 15, 2002 TO IkIMOM IT MAY CONCERN: Res Southold Token Building Permit No. 27988 I have reinspected the residence with a front and rear deck at .3080 henrys Lane Peconic and state that the decks are in compliance and meet the requirements of the Nev York State i'niform Fire Prevention and Building Code. Sincerely, G / Lawrence M. Tuthill, P.E. of NEW d i us tit! 032254.1 0 A90 fESS14Na�� n TJ` T7 r 4 T T �-�r T,TVT (-'t TT i ��1 — 1Z W X-1 I I Applicant/ =—/ Dale Owners Name: aka, Jphn Se - Reviewed: p� Architect/ r Date Gngir<eer: Submitted: 3 SCTM #: t District: 1.000 Section: Z! Block: _� Lot: Nroject �- — Subdivision- Location: -�C� �D 2 vu-e. Name: J Sin&le & separate Required certification: (Yes/No) ./�)o , Rey. Req, %oniog 1)istricta24 O I I of size: Vf Q _/lclual: . I (Lot coverage e-k)t Prolxised 140 . Req. / / Req. Req (I rom YardProposed: J [Side Yard 35 I Proposed:' J [Rear Yard— Proposed- _( Project Description: A-41-A- (_A& do/L—T AGEN VJPERMXTS Permit REnrirRED rLOR REVrEW N d Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board.approval: ' Town Planning Board approval: Flood Plane Elevation??? Flood Zone: Nb- es: . 4 INSP$CTION 'R3FO�tT MATE ,„:; ,� CONMENTS SPROTIOsREPORT---=-� ' s s:�� sz==a=- -.•_ -= _a_c__a�"�ctzasmaea�,x=-aaaxzxsc�a.- • as r6MATION f 1ST)' (N RMEATION. fD) c .2N__�.�__ -_=-•�-� =_�Y.�-,•__��=__--__==_-____-- -_�_=-t�-==�z��== dam. . G a KWGH VRAMIS & n ' •PLUMBING '' ' - ,a•"ms's= _ `�C INSULATION PER N. Y.- . { STATE ENERGY CODE FIAAL (c s -A�?DITIONAL CONE=S z3 • c VA TOWN OF SOUTHO BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARI �� „ �: ;� Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 1 71 3 sets of Building Plans BLDG. DEPT. TEL: 765-1802 MVIN OF S^UTHOLD Survey- PERMIT-M. urveyPERMIT . r 7 moi' Check Septic Fomn N.Y.S.D.E.C. Trustees Examined 61 1 3. )2002- Contact., Approved D Irl >20 O 2— Mail to: Disapproved a/c Phone: G 5- G S Buildings -- APPLICATION FOR BUILDING PERMIT Date 1)ec. 2 , 200 t INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 a Certificate of Occupanc3 is issued by the Building Inspector, 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 o olition as herein described. The applicant agrees to comply with all applicable laws,ordinances,building code,ho g ,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of vreturt or name,if a corporation) �l 3oG ov hoI'v 2&u Au-e - 1 &V (Mailing address of applicant) State whether applicant is.owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or.builder Name of owner of premises .611?t �7a J1 -V4 IT e V\ (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: S0 Fie . 14ehey9 1-,Vu pecc; ri 1,C House Number Street Hamlet County Tax Man No. 1000 Section_ Q 7 q Block O 1 Lot '14 9' Subdivision_ eca n ,c 161-0 11 s Filed Map No. Lot (Name) 2. State existing use aud.ocxupancy of premises and intended use and o panty of proposed construction: a. Existing use and occupancy 0 H 2 b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work k -s (Description) 4. Estimated Cost_2_' 3 ©00 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. Dimensions of existing structures,if any: Front____2 C, Rear '7® Depth 3 2 Height / g Number of Stories 1 Dimensions of same structure with alterations or additions: Front SQ' .-e- Rear Depth Height Number of Stories 8. Dimensions oentire new construction: Front Ream S Depth �.C Height ec )<, 4 ` Number of Stories 9. Size of lot: Front r" Rear �2 a Depth 03 10. Date of Purchase Name of Former Owner /0 y 11. Zone or use district in which premises are situated �e s 12. Does proposed construction violate any zoning law, ordinance or regulation: ZY . 13.Will lot be re7graded_4L Will excess fill be.removed from premises: YES r6-) 14.Names of Owner of premises .Tim T Jo ti x S A,Address Y 3� 36.Nc�►e�w Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No: 15. Is this property within 100 feet of a tidal wetland? *YES NO_ X_ • IF YES, SOUTHOLD TOWN TRUSTEES 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: COUNTY OF ) o�pB �t�n SCK being duly sworn, deposes,and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the W vi, e 0�, (Contractor,Agent, Corporate Officer, etc.) 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. Sworn to before me this day.of �')') oQL_ N Signa of Applicant' CAMILLE LUCARINI Notary Public,stateof New York Qualified in Suffolk County Commission Expires ill lip'Q1 ANY AL TERATION OR AQ rov TO TINS SMVEY It A WOCATM OF S CflgH 7209 OF TI1E AEW YQfW STATE EDtA44 TM LAN: EX TAS PER SECT OW 7109 - sumwvm /E ALL QERT i1 TIGNiIS hV ARE VALD FAR THS MAP AAD AAE Y F \ s SAID MAP OR CAPES BEAR THE 9P14ESSED SEAL 1 L 80 EYOIR s WHOSE Sl"TAME APPEARS HMOAL . SFS , AMBET�Y TBY ANY AID ALL "WYARS 7W TOW A_ BY' Fes• OF AAV SROUSHT TO DATE'ARE NOT&V COWN.MM WITH TW L \� 16 � s t5 �o c20 Q' CERTIFIED TO$ X00, `moi \ FREDERICK R. KEDENBURG LINDA VARDY - KEDENBURG !0� NORTH FORK SAW PECONIC ABSTRACT INC. SURVEY OF PROPERTY •` A T PECONIC �0° TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. VM - 74 - 01 - 44.8 SCALE r = 30' DEC. 28, 2001 ,k *�a 4 4 ..� 1'\ QF NEW p �7- 44 1. METro. O�P� ao� d �' VN.Y.S. LIC. NO. 49618 LOT NUMBER IS REFERENCED TO "MAP OF PECONIC KNOLLS" � / CONIC ORS P.C. FLEDA�V ?'W OF�E' OF -THE SUFFOLK COUNTY CLERK ON �� (631) 765 - 5020 FAX (63/ ) 765 - l 797 SEPT. 29, 1977 AS MAP NO. 6607. qE� P. 0. BOX 909 C,O AR1Ei4 a 40,015 3l ft. 1230 TRAVELER STREET SOUTHOLD, N.Y. 1/971 01 - 306 ANY AL TERA TION OR ADDITION TO TMS SURVEY IS A VIOLATION \ OF SECTION 7209 OF THE AEW YORK STATE MCA TM LAN. EXCEPT AS PER SECTION 7209 - SUBAIVOW Z. ALL CER77XATIONS hEREON ARE VALD FOR TMS MAP AAD COPIES TMWOF ONIL Y F sG SAID MAP OR COPES BEAR THE MASSED SEAL OF THE SURVEYOR WHOSE SIGNA TURF APPEARS HERE014 S�S2. E TERM 'AL MUST ANY USED BY AAAV ALL SURVEYORS 71JZM AC BY' OF ANOThER SURVEYOR'S AMP. TERMS SUCH AS �N.SFECTED'AAV Fo• 4 .1 "BROUGHT - TO - DATE'ARE NOT AV COWL/ANCE 07TH THE LAW. 'b Q' c'o BLDG. (SEPT. CERTIFIED TO* i �rtUTM 100. F FREDERICK R. KEDENBURG$ LINDA VARDY - KEDENBURG !off �` NORTH FORK BANK PECONIC ABSTRACT INC. o �h SURVEY OF PROPERTY A T PECONIC (,° , ��, �. �� TOWN OF SOUTHOLD °' tio`� SUFFOLK COUNTY, NY �,. 1000 - 74 - 01 - 44.8 SCALE 1" = 30' DEC. 28, 2001 %o, �' Jan. 3, 2002 (5 R.O.W.) �- Jan. 9, 2002 (re vision 1 4 A C of PF T. MeT�y�'P d c:)' - ��� 1`� .S. LIC. NO. 496/8 LOT NUMBER IS REFERENCED TO "MAP OF PECONIC KNOLLS' � '• c.FILEDW THE OFFICE OF THE SUFFOLK COUNTY CLERK ON FS �O (631) 765COANC 5 5020 FAX 311 765 - l797 SEPT. 29, 1977 AS MAP NO. 6607. P. 0. BOX 909 50 A A = 40,015 3 . ft 1230 TRAVELER STREET SOUTHOLD, N.Y. 1197/ 01 - 306 - Recta 0 411. N-o vs e 3 SL;d i No'. 10=g(2 _ 1 a- c.GA �/4 x CCS �e� ;•,g �'Y� �y o � CY 01 CCU _I la u USE IS UNLK,�;FUL �D WITHOUT CERTIFIC� E OF OCCUPANCY _ - APPROVED AS NOTED \0e DA o� B.P.&2=Lf -- - - FEM ) Bir. T UG NOTIFY BUILDING D PARTMEN -AT 765.1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: D n CDAC Q e7e�'•03'� G 6 �C 36 (y 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 4--4 Ac�'s 25 BGG 2 ROUGH - FRAMING & PLUMBING & INSULATION t FINAL - CONSTRUCTION MUST`•, BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET. a� � � THE REQUIREMENTS OF THE N.Y.= STATE CONSTRUCTION & ENERGY _ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS pp=l R - {G pF NEW all CE SLCL Lt us i� w 032254-1 /l 1 90FIrSS14N� ' . -jplQ0 Co f14 apo Soc�,nd �� ew_ -- Li thoed nr 4 -iiG �� Q� P __ _ 135_.4 ? L