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HomeMy WebLinkAbout28394-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28838 Date: 09/03/02 THIS CERTIFIES that the building ADDITION Location of Property: 110 WEST LA EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 15 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 2002 pursuant to which Building Permit No. 28394-Z dated MAY 15, 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 SCREENED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ELLEN J SULLIVAN & ORS. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 104134 08/01/02 PLUMBERS CERTIFICATION DATED N/A 0,2w,a"', i Authorized Signat 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. 28394 Z Date MAY 15, 2002 Permission is hereby granted to: ELLEN J & ORS SULLIVAN 47 SCHUYLER AVE ROCKVILLE CENTRE,NY 11570 for . CONSTRUCTION OF A PORCH ADDITION AS APPLIED FOR at premises located at 110 WEST LA EAST MARION County Tax Map No. 473889 Section 031 Block 0015 Lot No. 007 pursuant to application dated MAY 15, 2002 and approved by the Building Inspector to expire on NOVEMBER 15, 2003 . Fee $ 150 . 00 &Authori-zed/ Signature COPY Rev. 5/8/02 q ,�?g. 57 -7 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$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 S. Temporary Certificate of Occupancy-Residential $15.00, Commercial $155.00 Date. /t1z4 s� '�— SO.�?Ov2, New Construction: Old or Pre-existing Building: yl" (check one) Location of Property: 110 1A) 5 L a/1 e� 5 ¢ Mal i 6 n House No. Street Hamlet Owner or Owners of Property: / f)Q/1 ¢' U/ 5 . ��ii�l> ✓ah Suffolk County Tax Map No 1000, Section -1 7360 7p 031 Block 0010' Lot 0©*7 Subdivision Filed Map. / LLot: J PermitNo.�39gz- DateofPermit.� J Applicant: r�CAa o22/T j i2aSYIyefi&t11 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ G 3 a' Applicalit gignature os 311�(q �- LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. Application No.: 104134 670 MIDDLE COUNTRY ROAD Permit Number: ST. JAMES, NEW YORK 11780 Block: Lot: (631) 265-3075 Fax(631)265-6057 Section Agent: Legacy Electric Owner: Ellan Sullivan Address: 83 Pine Street Address: 110 West Lane Port Jefferson NY 11776 Municipality : East Marrion NY License#: 5186E legacy OwnerPhone: Agent: No. ITEM SIZE No. ITEM SIZE No. ITEM SIZE 2 Switches: 0 SubFeeds: 0 PoolsAbvBio: 6 Receptacles: 0 Timers: 0 PoolslnGround: 1 GFCI Devices: 0 Transformers: 0 Pools Filter: 0 Dimmers: 0 ACEquipmentCentral: 0 Pools Lights: 2 MediumBaseFlxtures: 0 ACEquipmentWindow 0 CO Detectors: 0 FluroescentFixtures: 0 MotorsbyHP: 0 Disposal: 0 HID: 0 Generators: 0 Metal Halide Lamps: 0 RangeOvenCookTop: 0 WhlrlpoolHotTub: 0 RefrigUnits: 0 DryerElectric: 0 Microwave: 0 WalkinBox: 1 ExhaustFans: 0 WaterHeaterElectric: 0 ExhaustUnit: 0 CeilingFans: 0 SmokeDetectors: 0 SteamShower: 0 DW: 0 TrackLightingStrip: 0 BreadWarmers: 10 Laundry: 0 ElectricHeat: 0 GarbageDisp: 0 HeatingEquipMotors: 0 PumpMotor: 0 CentralVac: 0 ExitSigns: 0 Disconnects: 0 ChandelierLifts: 0 EmergencySigns: 0 FutureOutlets: 0 ElevatorLifts: LOCATION OF WORK: ❑Basement WFirstFloor ❑ SecondFloor k Outside ❑ Addition ❑ Survey ❑ New Const. Comments Screened Porch Wiring /Additions Wire Conductor #of OH [-] UG ❑ Amp: Phase: 1 Volts: Type: CU Size: Meters: Temporary ❑ Memberl.A.E.I. Electrical Certificate Certificate No. 104134 LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. THIS CERTIFIES THAI R L L DISTRICT Certificate Issued on: 8/1/02 INSPECTOR CONDUA I PECTION OF THE Issued to Ellan Sullivan VISIBLE PORTION OFE E TRICAL INSTALLATION DESCD EIN AND IS Address: 110 West Lane COMPLIANT WIT TH R NT NATIONAL East Marrion NY ELECTRICAL DE. Legacy Electric 83 Pine Street AEI Certified Inspector Port Jefferson NY 11776 a -AANDMI NG 910, ELL. N r t r r� LU ! -, tri 1 ,y-y ii 'rte'.__--� v ..� I ���'V_•../C ��✓��+ ..14 � k"3�(. Lij aitwrtion or edditfan J to t4 vv" py is`J VWazion of z 1{f Sectian 7:30d^.of the New Yor»Stalo •�"r"/ !ducstion taw. i Cooss of this survey map not bearing .$ the land surveyor's inked seat tz kI TA embossed seal shall not be considered to be a valid true copy. jk Guarantees indicated hereotr shall run .- . q only to the person for whom the survey _ If is prepared,and on his behaff to the . . ^'c title company,governmental agency and ()T- NE{y .. .. _. Iz-F W-SAV f Nc Cr:,:- ' lending institution listed hereon and ��'`GK .. VR r0 J 1/ � EPT l`~ , to the assignaes of the lending inti- tution.Guarantees are not transferable I*additional institutions or suteequeM + ¢O �: owners. r +.�.,;.,,.,,,, ,.�.._.__,_____. cc ,TSV Y*AP z A -A I0,',j l SBP- 115 ",'. �ti ° 4S 2bb Jia`` F� LANt) BUILDING PERMIT EXAMINER CHECK LIST DATE ISSUED: _/__/02 DATEREVIEWED: �/(S/02 APPLICANT: �J(en s,I(1„«,A DATI�-SUBMITTED: SCTM# DISTRICT: 1,000, SECTION: , BLOCK: /�, LOT: N STREET ADDRESS: 11 (KI" CITY: z SUBDIVISION: <r PROJECT DESCRIPTION: o rp" "\\, — ESTIMATED PROJECT COST-.jarARCHITEC NGINE (art ttu_ FAST TRACK? -Ca SINGLE & SEPARATE CERTIFICATION-REQUIRED? _NOTES: _ LOTS 40,000SE-100-24. Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconfonning at any time after 7/1/6 ZONING DISTRICT: � t-(o CONFORMING? A/6) REQ. LOT SIZE: _ACT. LOT SIZE: 3 REQ. LOT COV. _ACT. LOT COV. REQ. FRONT PROP. FRONT w REQ SIDE ( ACT. SIDE REQ. REAR ::�S PROP. RE WATER FRONT? 1(ld DESCRIPTION: PANEL #: /_ FLOOD ZONE:—, _ APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or �(BED #): DTE:—/ /_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y or ff-� NEW YORK STATE DEC: PRE-DEC 9/1/75 YES ori* SOUTHOLD TOWN TRUSTEES: YES ofRD TOWN ZONING BOARD APPROVAL: YES orcD TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES o O NYS ENERGY: YES ORO / EGRESS (18 H min.? 4 sq total) VENT(Sq. FT. x 4%)LIGHT(SQ. FT`. x 8%) '�`�7 BUILDING PERMITS OPEN/EXPP&D BP -Z/ C/0 Z- /,2/z w/L? HAVE PRE CO'S : Y OR N BP J�'-Z/C/o Zo`7�7, '-f f NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FE - 1. ( �� SF)- (—SF)= SF X $ _$ +$ +$_ _ $ 2. ( SF)- ( SF)= SFX $ =$ +$—+$—_ $ 765-1802 BUILDING DEPT. 1 ECTION [ ] UNDATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATENSPECTO �� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUND ION IST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION FRAMING [ l FINAL [ ] FIREPLACE HIMNEY�'�j REMARKS: DATE 7 �_INSPE M-102 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH BG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ INAL [ ] FIREPLAC CHIMNE REMARKS. �v�e e2 DATE SPE FIELD INSPECTION REPORT DATE CONMENTS a 00 FOUNDATION (IST) el ------------------------------------ FOUNDATION (2ND) P— z � 1 ROUGH FRA_MLNG&- y PLUMBING (- INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL CONEWENNTS O (IT m M 4. y O x - x d b y 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 0"s`ets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 q42Bey PERMIT NO. i fZheck S J Septic Form N.Y.S.D.E.C. Trustees Examined 6/b� ,20 a Contact: Approved 20 02 Mail to: Disapproved a/c Phone: Expiration ,20 3 # as �- �4 2ecor n P Ln � tc�l., , I Building MAY 15 2002 L - APPLICATION FOR BUILDING PERMIT gtrx= f Date -S— /� 20�� 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 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. (Si a of a t or name,if a corporation) I,P (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder /�.�•✓r/,�/�,�. CfSnfTir'i9CTOlc' ' Scf/.4�F/�, Co.JS i Name of owner of premises �� 5 . S,-k llk Jc�v\ g G- -e cS (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. /806/ e6efc y Gf/—Ecr'jG Other Trade's License No. 1. Location of land on which proposed work will be done: I k WesA-- U On t tcf Mc�rnov� 1®1 `-� House Number Street Hgo f ry County Tax Map No. 1000 Section 31 Block l 5 Lot 7 o Subdivision Filed Map No. Lot s (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy i b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition v' Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost /S eye, o O Fee (To be paid on filing this application) ,n 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 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 _ ,y)a lc( +I,ISS e (4ev-�v�e dy 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 remises? YES NO (41 Schuyler -e- lZcx k.V1(Ie Cewt-.e. (-4 .y I i�'/� 14. Names of owner of premises [Sls � M -��Address r��yrcif-i_.�,��et-;,,sN�lolyhoneNo. Name of Architect -R.,,,# LAddress hay: '\&xid Co�&Ohone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * 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 survey. STATE OF NEW YORK) SS: Z Y OF being duly sworn, deposes and says that(s)he is the applicant (Name of id4ffdual signing contract)above named, (S)He is thejn/j,P,�Cjp� (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 thi day of 20D Z__ .... . aLw"��__.. Notary Public BEUNDA BENDER �eq of���f igna a of Applicant 01 AM OR i USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY''ASMW a - FEE; NOTI BUILDING DEPARTMENT A 763.1602 B AM TO 4 PM FOR TNR 1 FOLLOWING INSPECTIONS: k 1. FOUNDATION - TWO REOUIREO -+ } FORPOUREDCONCRERE ; .T S ROUGH - FRAMING i PLUMBING B g 4 FINAL - CONSTRUCTION,;QUB}' 0 51i m BE COMPLETE FOR C.0.. - ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS O4,THE N.t I . STATE CONSTRUCTION L:ENEROM'- -- — CODES. NOT RESPONSIBLE"tATL, ,DESIGN OR CONSTRUCTION ERIIOSIL UNDERWRITERS CERTIFICATE i REQUIRED 1 f N 0 d' R z e ui m C o W o !. z z rL y I I � U i O NEW M E OSS rY7 0az254-1 4. mini �? L elf x-. II s r t' 4,; q 7'2"x'#i�l'r.VEa' } � FwHF 'rap �'� '"� � � i � II �tl ,/� " fid, i,nGr7 L�.n w �W •;�� �1�y 2 � ' 22x(a VV �} ed II j i tl � ,2I.,,+I 1 � 4,e{ ( cc 1 2xlL>itEF { dlk3(UE h!� 0 k} Y�'°Ex3l 'E TE?,. gt4pfX,2{oiiftei � S �+ v .-.7 - r ' I • I 4cjhL�.- ' if'p'�-+- � �� W o r r. 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