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HomeMy WebLinkAbout23157-Z FORM NO.3 TOWN OF SOUTHOLD �� cJ BUILDING DEPARTMEM TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NP23157 Z Date................/ .................................. Permission is hereby granted to: ..� .../ ,�c,�,......................................................... / .....fi'pioxv.....%�t.:................................. ......... ...... ............. ~...... ..... . ..4,�........... .. . ........... ........... ........... ........ . ........................................................................................................I.......... .................................................................................................................................................................. at premises located at.................... 0, l...�/� ...........:. ... . ....................:..................................................... ....................... xr ...... ........./11&1� .................. .............. County Tax Map No. 1000 Section ........ ..... Block.........1.1.............. Lot No. ........I.Q.............. 61 pursuant to application dated ...............zr/P V...q................... 19......-., and approved by the Building Inspector. Fee .......... 1!50 ............. ........... .'41ns ............................... B ding pector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT NOV 2919% TOWN HALL 765-1802 CLe ^ :. _. APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 t#* 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 Buildins - $100.00 3. Copy of Certificate of Occupancy - $20.00 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. . . . . . . . . . . . . .. . . Locationof Property.'. . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT -trisn c-clON lu-Vul T DATE COrfMLNfS �' ------------------- - ---------------- _Is � .-OUNUAT1ON ( 15.1•) n I ------ -u------------- -- ----------- --------------------- Ul OUNDATION (2ND) — ---_----u �`1 I II I----------- MUCH FRAME h -----�,— ------------ -------- -- ---- — P L U M I I N G -----II- — ------------------------- — ---- _ II _ -°_ ______________________ ____ __----•------___-- S INSULATION PLR N. Y . STATE ENERGY ---- I C CODE I I -- ----- ------ -- 1 _ n I i{ FLNAL {{ -- --------------------------------- ---_-----ADDITIONAL COMMENTS: ------------ o � 7 Y - -. . . -------- _._ _. .. . ,\c t*1 uu��t.0 ut FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . BUILDING DEPARTMENT CUL• Ch . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORtl _ . . . . . . . . . . . . . NOV 2919% SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N,DT I FY 66 CALL .— . . . . . . . . . . a� �JF Examined r` ;` �� : .: 19lJ . - MAIL T0 : Oft- 313 Approved . .1,2�� . . . . . . 19/Permit NO. �./ � . . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (B ld' In ector) APPLICATION FOR BUILDING PERMIT ��99 Date .fv,o ✓. . . . 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted 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 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 inspectiolgs. . . . . . "' ". . . . . . . . . . . . . . . . . . . . -- (Si ature of applicant, or name, if a corporation) 5­0 )Ole ve- 11135— (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ow me �`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .APPROVED AS NOTED. . . h e j� DATE: i2 S'4 B.P.# Name of owner of premises . . . . . . l .` . . . .�'. . . . . . . . . C. .� . . . . . . (as on the tax roll or latjg UILDING DEPARTMENT AT If applicant is a corporation, signature of duly authorized officer. 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED (Name and title of corporate officer) FOR POURED CONCRETE 2. ROUGH FRAMING & PLUMBING Builder's License No. 11 . . . . . . . . . . 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . ee�f DESIGNOR CONSTRUCTION ERRORS L Location of land on which proposed work will be done. . . . �a .r� . . . . . �a s�j ��• • . • • • • • • • • r C''v �"�e t la 3i House Number . . . . . . . . . . . . . . . . . . . . . . . Street . . . . . . . ." . . . . �. . . . .Hamlet . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) A 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . .rr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . �`�t/a 7' is e�1 .. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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) S. 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 . . . . . . . . . . . . . NumberofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . . . Nameof Contractor . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . , . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. (STATE OF N O ,COUNTY OF� S.S / being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) 'above named. fieisthe . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 6� V . . . .day of , 19 . . . Notary Public6&a \ . . . . . County CLAIRE L.GLEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N Public,State of New York U (Signature of applicant) No.4879505 Qualified in Suffolk County Commission Expires December 8,1916 TOWN OF SOUTHOLD PROPERTY RECORD CARD � OWNER STREET 2-50 VILLAGE DIST. SUB. LOT �oh+n i- bra .i ua v-e , ,. x FORMER OWNER N e E :' ACR. OAD S W TYPE OF BUILDING SEAS. VL. FARM COMM. CB. MICS. _ Vclue - Mkt,,, LAND IMP. TOTAL DATE REMARKS \j'v � •? i.. i `a "^ � � �/yc' /feAh d �o AeC L ..26� �Yc�k7Ct' � 01 WrIt a e� 3 0 3 8' o v /3 ", ��� i v,=3o G � .1 ��7�r�e d 7�0 ,fie crC /' .3,3 46 7 D oZ OQ A a®C7 I ) 311 4 C.�.h ► as o — ec + k k ' v '�- lob, 0.0D AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre "illable FRONTAGE ON WATER Voodland FRONTAGE ON ROAD d Q Aeadowl,and DEPTH f.f sous ot, BULKHEAD "otal DOCK *pF SO!/jyOlo Town Hall,53095 Main Road Fax(631)765-9502 P.O. Box 1179 G • Q Telephone(631)765-1802 Southold,New York 11971-0959 COUNTY, BUILDING DEPARTMENT TOWN OF SOUTHOLD January 10th, 2007 John T. Beck P.O. Box 221 Cutchogue,N.Y. 11935 RE: 1250 Pequash Avenue (alteration/living room) SCTM# 103 11 10 Dear Mr. Beck, Please be advised that your Building Permit#23157 issued December 5th, 1995 has expired. According to the Code of the Town of Southold, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit,please submit a fee of$150.00 at that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. c�3 !,5 Frame -------- 1 Ct Pt ADS 1 t f CJS dC7 X-4z (3Cc J;df snC r � ` ' ycs { Ile .41 �/ 3 s S X BCG Res-;