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Home My WebLink About28269-ZFORM NO. 4 TOWN OF SO%~fHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPD/~CY No: Z-28777 Date: 08/23/02 THIS C~TIFIES that the building ADDITION Location of Property: 2130 ORCPLARD ST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 5 Lot 4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 9, 2002 pursuant to which Building Permit No. 28269-Z dated APRIL 23, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARY ELIZABETH GILLEN (OWNER) of the aforesaid building. SIIFFOLK COUN~"f DEPARTMENT OF HKALTH APPRO~rAL ELEC'TRIC~J~ c~TIFIC~%I]~ NO. PLUMBF~S CERTIFICATION DA'rmu Rev. 1/81 N/A N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIT~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28269 Z Date APRIL 15, 2002 Permission is hereby granted to: MARY ELIZABETH GILLEN PO BOX 448 ORIENT,NY 11957 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2130 County Tax Map No. 473889 Section 025 pursuant to application dated APRIL Building Inspector. ORCHARD ST ORIENT Block 0005 Lot No. 004 9, 2002 and approved by the Fee $ 150.00 Authorized Signature Rev. 2/19/98 ORIGINAL 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 submiued 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 $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. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: ~ Old or Pre-existing Building: LocationofProperty: ~/,_~O OF~--/4'~:3/~.~ Cf' House No. Street Owner or Owners of Property: /~//~.'/ /_~, &/C--/._.~"~b,,..) Sufiblk County Tax Map No 1000, Section Date. Block (check one) Hamlet Lot Subdivision Permit No. ,.2 oC>o~ ~a 7 Health Dept. Approval: Planning Board Approval: Date of Permit. Filed Map. Applicant: Underwriters Approval: Lot: Request for: Temporary Certificate Fee Submitted: $ ~ ( Final Certificate: (check one) 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [[]] ;ORAUNMiDNA~ION 2ND [[ ~,]~JFiNALI. ATION [ ]FIREPLA~~.I4~NEY REMARKS: //~ ~ FIELD INSPECTION REPORT DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined Approved Disapproved a/c 0/t2,, 200~- q-~ ,C, 20 0~--- Expiration / ,.~ B;.,'D G. D L~ P-,"'. ' J Tf,)V¢,~ (~F $O0'[I40LD PERMIT NO. oZ.~gL 6 ~' -~ BUILDING PERMIT APPLICATION-CHECKLIST Do you have or need the following, beforecpplying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date A/O/¢~/~ ~ ., 20 059_ Name of owner of premises 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 the Building Inspector isshes 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 cfa Build/ag 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, houzin~, code. and re~,dl~tti~'ffis_ and tn aami* authorized inspectors on premises and in building for necessary inspections. UNDEI~AS CERTIFICATE -- OCCUPANCY OR .£0U Rm ' (Signature ~f apl~ca~t or name, if a corporation) USE IS UNLAWFUL - WITHOUT CERTIFICATE OF OCCUPANCY "IMMEDIATELY" ENCLOSE POOL TO CODE State whether apphcant is owner, lessee, mi:FORE "WATER" ' O,,e / r,-,, k' 0Vlailing address of applicant) general contra~6r; electrician, plumber or builder (As on the tax roll or 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. ASNOTED latesti~/l~ BUILDINQ DEPARTMENT AT 76~-1802 S AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED Location of land on which proposed work will be done: House Number Street County Tax M.~p No. 1000 ~Section Subdivision /~/~-~ 6//~-A/ ~ t (Name) COD~ NOT RESPONSIBLE FOR (~~-OR CONSTRUCTION ERRORS ROUGH - FRAMING & PLUMBING INSULATION 4, FINAL . CON$TRUCTION MUST BE COMPLETE FOR C.O. ALI. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y. STATE CONSTRUCTION & ENERGY Hamlet Block dP 5 ~, ;~i '~Lot~-' Filed Map No. 70 ~¢_.U'l:::, · 'Lot State,existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ._~/~r?&9- .~ b. Intended use and occupancy ~j/~, , Repair Removal 4. Estimated Cost ,~/Ca00, 5. If dwelling, number of dwelling units / If garage, number of cars Nature of work (check which applicable): New Building Demolition Addition Other Work Fee Alteration '(Descripdofi) (To be paid on filing this application) 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 ~) Depth Height 3~) Number of Stofies _~ Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories 8. Dimensions of entire new construction: Front r'~ Rear (2~ Depth Height ~ Number of Stories Size of lot: Front ~,g)~ tt Rear ' Depth 10. Date of Purchase ~c/ 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 & , ! 3~'Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names oCOwner oCpremises 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 * 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 ~urvey. STATE OF NEW YORK) SS: COUNTY · ~ ~~ , being duly sworn, deposes and says that (s)he is the applicant ( ' -' ' ' el ' o c.n'nh~.~l~[hOV~ nnmacl ;~ ';"3 '' ~r - ~.~: {Con~ Agmt, Co~mte Officer, ~c.) of sa~d..~~s~:~d,~ ~y a~ed to peffom or have peffo~ed the said work ~d to m~e and file ths application; that all statem~ts contaM~ ~:tM~appl~aflon ~e tree to the best of Ms ~owledge ~d belief; ~d that the work will be peffo~ ~ ~I'8~'~ M ~icmion filed therewith. ~' S(}t~ ii~at~e of Applicant