HomeMy WebLinkAbout28021-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28491
Date: 06/06/02
THIS CERTIFIES t~at the building SINGLE FAMILY RESIDENCE
Location of Property: 760 CEDARFIELDS DR GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 40 Block 5 Lot 1.23
Subdivision Filed Map No. __ Lot No.
conforms substantially to t~e Application for Building Permit heretofore
filed in this office dated JAAUJARY 22, 2002 pursuant to which
Building Perntit No. 28021-Z dated JAAUJARY 22, 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 SECOND FLOOR ALTERATIONS TO A SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to NEIL J MACDONALD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTYDEPARTMENTOF~RALTHAPPROVAL
ELEctrICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~3 05/16/02
Rev. 1/81
N/A
1054054 05/20/02
ROBERT VAN ETTEN
Authoriz~ Si~at~e
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. 28021 Z
Date J~NUARY 22, 2002
Permission is hereby granted to:
NEIL J MACDONALD
760 CEDARFIELDS DRIVE
GREENPORT,NY 11944
for :
RENEWAL OF BUILDING PERMIT 24922-Z, TO MAKE SECOND FLOOR ADDITIONS
TO A SINGLE FAMILY DWELLING
at premises located at 760 CEDARFIELDS DR GREENPORT
County Tax Map No. 473889 Section 040 Block 0005 Lot No. 001.023
pursuant to application dated JANUARY 22, 2002 and approved by the
Building Inspector.
Fee $ 175.00
Authorized Signature
Rev. 2/19/98
COPY
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:
For new building or new use:
I. Final survey of property with accurate location of ail 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.
aJ
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 topograpliie
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
New Construction: /
Location of Property: -7/o O
House No.
Owner or Owners of Property: ]N~ 411
Suffolk County Tax Map No 1000, Section
Subdivision
PermitNo. 7<~OZ I ~'"'~
Health Dept. Approval:
Planuing Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ c~ S. o_.~a
Date of Permit.
Date.
Old or Pre-existing Building:
Street
OqO 0
Filed Map.
0{- Zd ~ Applicant:
Underwriters Approval:
Final Certificate:
(check one)
Hamlet
Lot 00[. 0 Z. -~
Lot:
(check one)
Apl~Tmant Signature
Town Halls 53095 Main Road
P.O. Box 1179
Southold, New Y6rk 11971-0959
Fax (631) 765-1823
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF 8OUTHOI,D
CERTIFICATION
Building Permit No.
Owner: .H e;~
Plumber:
'LS oZ I
(please print)
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this ,.~a
day of .,~'g.~te~..,~ , 20
(Plumbers Signatu?e)
Notary Publi~ County
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORk BOARD Of FIRE UNDERWRITERS
BUREAU OF ELECTRICITY '
40 FULTON STREET ~ NEW YORK, NY 10038
CERTifIES THAT
Upon the application of upon premises owned by
NElL J. MACDONALD
760 CEDAR FIELD DRIVE
GREENPORT N.Y.11944
NElL J. MACDONALD JR.
760 CEDARDFIELDS DRIVE
GREENPORT, VILL, NY 11944
Located at 760 CEDARDFIELDS DRIVE GREENPORT, VILL, NY 11944
Application Number: 1054054
Certificate Number: 1054054
Section: Block: Lot: Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Second Floor,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the 20th Day of May, :2002.
Name QTY Rate Rating Circuit Type
Alarm and Emergency Equipment
Sensor 2 0 Smoke
Appliances and Accessories
Exhaust Fan 1 0 F.H.P.
Wiring and Devices
Receptacle 12 0 General Purpose
Switch 7 0 General Purpose
Fixture 7 0 Incandescent
Paddle Fan 2 0
Receptacle 1 0 GFCI
seal
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [~ROUGH PLBG.
[ ] FOUNDATION 2ND
[~']'~FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] INSULATION
[ ] FINAL
765-t802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU~iPLBG.
[ ] FOUNDATION 2ND [~--~]~INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREP~A~ CHIMNEY
REMARKS. ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [
[ ] FRAMING [~I~iNAL
[ ] FIREPLA~HIMNEy
REM
DATE ~~INSPE
III,~;III.ATI()II I'F. It ti. ¥.
~'I'A T F. F. III~IIC¥
[J~
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Approved .... , 19 Permit No. ?. ?.~..2: .C?..'~-..
Disapproved a/c ................................ j ....
APPLICATION FOR BUILDING PERMIT
~..-~'] SETS OF' PLA~'I$
SURVEY
/.-CIIECK ......... 't ........
SEPTIC F 0 R,'I
CALL
HAIL TO:
INSTRUCTIONS
Date ....... : ........... 19~.(0
a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with:
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 stkeet
or areas, and giving a deta/led 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 iisued a Building Permit to the applicant. Such penni
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 0ccupancx
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 tht
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described
The applicant agrees to comply ~,*ith all applicable laws, ordinances, building code, housing code, and regulations, and tc
admit authorized inspectors on pr~mises and in building for necessary inspections. /~ . ,~ .
-- ' ... ~ .9- ~.c~C4'... '... '. ....
(Signatur~ of applicant, or name, if a corporat[o'n') ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, generaJ'contractor, electrician, plumber or builder.
C~ t.O ,"h o__. f-'-- ..... , ........ ' ............. . ....... . .............. . ................ . .... .......
Nameofownerofpremises ..~..~.'..!..3..,...~...0,.(.7..'~..o'"'o.._(,~ -JC, -
(as on tile tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.'
(Name and title of corporate officer)
Builder's License No.. N/./[.
Plumber's License No..~..~7~: ._..?....' .........
Electrician's License No.. l,t./[l ..................
Other Trade's License No.
Location of land on which proposed work will be done.
~7(~o'
.......... C ~ ,J~ ~--(-:,'~_ I J.~ .~.,.,, ': ........................ ....... : ................
............... ~.e. ' .. Coc~.¢.o.~.~:r.-p: ..... '. ;.~t.
[-louse Number Street Hamlet ........
.
Cotmty Tax Map No. 1000Section .,.' O. oo Block ~.(__.~..:00 ' Lot..O.~.( ,
.~.jt,,/'~:e.( 4,.;.O4L.(,q,f?.e Map No..(~.~...¢. Lot..
Subdivision ~ U, ~0 4;d..'.t?..;t) ,~. }..~. ~(~I .......
State existing use and occupancy of premises and intended use and occupancy of proposed constructioni
a. Existing use and occu ancy ~1-4-~; oC- L)~ ~',qlsl,,
P ...... ~ ................. .~...
b. Intended use and occupancy .~,J.C.o..o..OO.' b~.(.Jc..% ~2-~cxJr~ (-.qo..tr,:.'
-3. Nature of work (check which applicable): New Building Addition Alteration
Repair .............. Removal .............. Demolition ..... : ......... Other Work
0OO, ~ . ' (Description)
4. Estimated Cost . :~ C~ ...... : ........................ Fee
5. · (to be paid on filing th~s apphcahon)
· I~gd~;aelgI~%'unmU~e;f°TaTelhng units ............... . 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 .... : ..... :. · · . Rear
Height ............... Number of Stories . · -. ........... Depth ...............
Dimensions of shine structure with ........................................................
Depth ' alterations or additions: 'Front ................. Rear .................
Height ....... i ...' ......... ..; Number of Stories ........... 2 ·. i .......
8. Dimensions ofentire new construction: Front ..... ' Rear ........
Height Number ~ ~- ' .................. Depth .. .
9. · .............. ot ~tones ........................................
Sizeoflot: Front ............... .... ~.. Rear ............. ; .... i... Depth ..............
10. Date of Purchase ......... i .......... · ....... · · Name of Former Owner . .
11. ZOne or use district in which premises are situated .............. ............................. i ~. -
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will 10t be regraded ................................
14. ' ...... ; .................... Will excess fill be removed from premises: Yes No
Name of Owner of premises .................... Address ..: .............. Phone No ........ : .
Name of Architect ....................... ·... Address ... Phone No - ' ' ' '
Name of Contractor .......................... Address ............ ..... Phone No ..... '
t5.~ Is this property within 300 feet of a tidal wetland? *Ye~' ~ ..............
· *If yes, Southold Town Trustees Permit may be requi~ed. '" .... ~ .........
.... 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.
APPROVED AS NOTED
FEE: ~ ~J''~' ~ BY: /~' '/'~'~O/ . -
~2NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
· BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
..... ~'~('/''-~' ~{~"~~ff~.-.~ ~' being duly s,vorn, deposes and says that he is the applicant
(Name of individual signing contract) .......
(Contractor, agent, corporate officer, etc.) .
'said owner or owners, and is duly autl{orized to perform or have performed the said work and to make and file this
plication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
~rk will be performed in the manner set forth in the application filed therewith.
/om to before me thi~
Nota~ Public, State of New York.
_ 9t{alifi~d~nSuffolkCoanW ~j~ // ~ -'~b/ '(Signatureofapplicant)
commission Expires Decombor 8, 19 ~ · ~ /
SUR VE Y OF
LOT 23
SUBDIVISION OF CEDARFIELDS
FILED JUNE 27, 1990 FILE NO. 8988
A T GREENPOR T
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 40 - 05 - PlO 01
Scale 1" = 30' July 11, 1990
Sept. 28, 1990(found. loc)
March I, 1991(final)
N sa,
~4.17'
H. S. REF. NO. 90 - SO - 96
AREA = 20,124sq. ft.
Zor ~
SCENIC
l O l' .(.(.(.(~
CERTIFIED TO'
NEff- J. MAC DONALD
DALE MORTGAGE BANKER CORP. N/O/P
$ONYMA
N~W YORK
~0)' (~
P.O. BOX 909
MAIN ROAD
SOUTHOLD, N.Y. I1971