HomeMy WebLinkAbout40536-Z zeFP044o Town of Southold 3/30/2016
041- Gia; P.O.Box 1179
' 53095 Main Rd
ss*y p���') Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38186 Date: 3/30/2016
THIS CERTIFIES that the building OTHER
Location of Property: 1125 Windward Rd, Orient
SCTM#: 473889 Sec/Block/Lot: 14.-2-30.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/11/2016 pursuant to which Building Permit No. 40536 dated 3/17/2016
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"OUTDOOR SHOWER STALL ATTACHED TO A ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to O'Hagan,James
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Autho ?fig ture 1
guffD(,•
�; TOWN OF SOUTHOLD
�O Gyp BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 40536 Date: 3/17/2016
Permission is hereby granted to:
O'Hagan, James
1125 Windward Rd
Orient, NY 11957
To: construct outdoor shower as applied for.
At premises located at:
1125 Windward Rd, Orient
SCTM # 473889
Sec/Block/Lot# 14.-2-30.1
Pursuant to application dated 3/11/2016 and approved by the Building Inspector.
To expire on 9/16/2017.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $200.00
CO -ADDITION TO DWELLING $50.00
Total: $250.00
111
Bu :' - pector
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. 4/ l,, Z
New Construction: Old or Pre-existing Building:
(check one)
Location of Property: 1 2j bU(oDvJcc.2j
j� I Oc OR(e(A77
House No. Street Hamlet
V1_ce O'1-4--cla_Owner or Owners of Property �1� '((Vi'Gs � V-)
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision �/� Filed Map. Lot:
l
Permit No. IV5cO Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final'Certificate: (check one)
Oo
Fee Submitted: $�o
uMe
Applican Signat re
1 405.3
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] RO H PLUMBING
[ ] FOUNDATION 2ND [ ] SOLATION
[ ] FRAMING /STRAPPING [1 FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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DATE 3 �/ /. INSPECTOR - • gl
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FIELD Ir sPEcQN IMPORT D . . �. ' .,L COTS . '
P omA. 'SON(1ST) ,. i . . , M
; . sFOUNDAI`ION(2ND) -__--
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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 Survey
SoutholdTown.NorthFork.net PERMIT NO. ���6 -Check cD 4----5D
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined41____<-3 20 ( /42 Single&Separate
Storm-Water Assessment Form
Contact:
Approved 3 ) --/
,20 J le Mail to:
Disapproved a/c
47,
Phone:
Expiration l l (R ,20 1 Y A tri* 3I i1
to
A(19
r2EZEVEi' n Ins or 4 �'" v (
p tl'
- - D PLICATION "OR BUILDING PERMIT
NEAR ' 1 2016 lolevitu//I
/�,
D , 20 /&/
TTppB�ppDING��DE�pP�Tn.��,,nn INSTRUCTIONS
a. This app�icr�a oGi� ff911 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.
1. 4,e . /Que.-if-ea/ O ate.,
(Signature of applicantr name,if a c rporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 01 k mckn T -eA
(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 pro oswork will be done:
,e.ip
House Number Street ,-',;::' .Hamlet
2
County Tax Map No. 1000 Section 1 Block " Lot Jo
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy )
b. Intended use and occupancy 6 _S
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. Dimensions of existing structures, if any: Front - Rear Depth
Height Number of Stories
Dimensions of'same structure with alterations or additions: Front
Depth Height Number of iS'to�-ies P 4 "{1 < �.�i, �', ± r-_
A 8. Dimensions of entire new construction: Front Rear,`�� ; Depth /I;
Height Number of Stories " ai'M I i RAM `' L,
9. Size of lot: Front Rear - Depth
41r,4i"t'-i-I'.7F.1.3ti.t z.,i h'.n V Cy•'.
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 Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. :s this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO x
F 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,
(S)He is the
(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 th'
1 t-$i day of _ii
DDI la DONNIE
D. of BUNCH
ork
(� ,� p �otary tdo.01 B Suffolk 0 0 J
��' ` Qualified in Suffolk County -e'
Notary Public Commission Expires April 14,2D le Signat re f Applicant
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PLUMBER CERTIFICATION I 4.4
ON LEAD CONTENT BEFC3:7 1
CERTIFICATE OF OCCUPAN.:;Y I
SOLDER USED IN ET_ f O
WATER
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SUPPLY SYSTEM G/I ,'10T 1
EXCEED 2/10 OF 1% LE'D. W I
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AP
9� ��a+ p� o I o
�G" ROVED �e7 NOTED c.J N
DATE: ': �IN o -
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�.P.# ___ 1)�� - AL'L LUMBING WASTE , M , M
FEE: ' -8 WAT RtINES NEED -,,,li
NOTIFY ® � Y: __.__-.. I.�/-. .- TESiN3FOR�COVERIN I
BUILDING DEPARTPrI• ,1 j '" ': N I Z
� ,Lo7
M «Q� 6Z.9 =I S
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS: 3d1d
1. FOUNDATION - TWU REQUIRED ,9 L'9 8Z ,I►0"0£ " oNno3
FOR POURED CONCRETE 310HN`�":7E1 I
°Ri1 -co
2. ROUGH - FRAMING & PLUMBING 3dld I 1 W1 x0 O
°Nno.4 W1x0I
3. INSULATION :11 I M
4. FINAL - CONSTRUCTION MUST I
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BE COMPLETE FOR C.O. 1!') "9e NI i
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ALL CONSTRUCTI)N SHALL MEET THE 1 I
REQUIREMENTS OF THE CODES OF NEW M. . e� oft`
YORK STATE. NOT RESPONSIBLE FOR 4 °,�oa °�
DESIGN OR CONSTRUCTION ERRORS. aq�tio. 0 o
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COMPLY WITH ALL a DES-OF .L V � b y,,d .�� ��5 °N`��, a I E-4 cew
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NEW YORK STATE TOWN CODES ys •°a' 7 �s A` , '`'� : S000a '
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AS REQUIRED AND C1 (TIONS O'" �` )00°�� �s P4 rzi
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PURSUANT TO CHAPTER 236
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