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HomeMy WebLinkAbout40756-Z �,�- ��0�'�,1S�FF���C'pG� Town of Southold - 7/6/2016 � � P.O.Box 1179 � ?'�� 53095 Main Rd ��' � o���¢'� Southold,New York 11971 ��1,�,���'� CERTIFICATE OF OCCUPANCY No: 38381 Date: 7/6/2016 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 240 Great Peconic Bay Blvd, Laurel SCTM#: 473889 SecBlock/Lot: 145.-2-1.5 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5/26/2016 pursuant to which Building Permit No. 40756 dated 6/7/2016 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"DECK ADDITION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR The certificate is issued to Diller Holler M Revoc Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFTCATE NO. PLUMBERS CERTIFICATION DATED , s Autho Signature Q�g���,co TOWN OF SOUTHOLD �� �� BUILDING DEPARTMENT y � TOWN CLERK'S OFFICE o . � SOUTHOLD, NY y�io! � ,�a�s� BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 40756 ° Date: 6/7/2016 Permission is hereby granted to: Diller Holler M Revoc Trust 26140 Hickory Blvd Unit 602 Bonita Springs, FL 34134 To: �egalize "as built" deck addition with arbor to existing accessory building as applied for. Additional certification may be required. At premises located at: , 240 Great Peconic Bay Blvd, Laurel � SCTM # 473889 Sec/Block/Lot# 145.-2-1.5 Pursuant to application dated 5/26/2016 and approved by the Building Inspector. To expire on 12/7/2017. ` Fees: � AS BUII.,T-ACCESSORY $295.20 CO -ADDITIONS TO ACCESSORY BUILDINGS $50.00 Total: $345.20 Buildin pector Forrn No 6 "l'O�'�'N OF' SOUTE{OLD BU[LD[NG DCPARTMEI�T . TOV�-`N E{ALL 765-1802 APPLICA'1CION �OR CERTIFICATE QF' OCCUPANCI' This application must be filled in by typewr�ter or t�ilc and submitted to the Building Department with the Collou�ing. A. Cor new building or aew use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograpll►c features. 2_ Final Approval from Health Dept. of water supply and sewerage-disposat(S-9 form)_ 3. Approval of electrical instal(ation from Board of Fire Underwriters_ 4. Sworn statement from plumber certifying tliat 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. 5ubmit Yianning Board Approval or completed siie plan requirements_ B. For existing buildings (prior to A.pri19, 1957) aoa-conforming uses, or buitdings and "pre-existing" [and uses: l. 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- $100.00 3. Copy of�Certificate-of Occup"ancy-�$:25� ��� � �� � � 4. Updated Certificate of Occupancy- $50_00 . S_ Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date_ �J���e �� 0� New Construction: � Old or Pre-existing Builcling: (check one) - Location of Property: �'�� ���01��G �'� �'i�D �-��E'Z" House No. Street Hamlet Owner or Owners of Property_ i�o o-�-j �� � l�''L�L � '�v�����`�S 1 Suffolk County Tax Map No 1000, Section �� Block �' Lot ( ` � Subdivision � Filed Map. Lot: Permit No. �'{��j S� Date of Permit. Applicant: Health Dept_ Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: '/ (chec one) --- �U�(?�—_—____---- --- - ---- Fee Submitted: $ � Applicant Sic. ture ` - ho��OF SOUryolo D� �� � _ . - � � � � . , � . �o o�y�0��� - � TOWN OF SOUTHOLD BUILDING DEPT. � 765-1802 I 1 NSPECTION � . � [ FOUNDATION 1 ST [ ] ROUGH PLUMBING [ ] FO NDATION 2ND [ ] IN ULATIOIeI [ FRAMING /STRAPPING [ FINAL � [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION ' � [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: - � ' O�, " C. O. � , . . DATE a� 30 �( INSPECTOR � �� • � , • � � FIELD 3N'S'�'��41�I��'0�"�S �ArS�,'� � �' ' Cd�� � • • . , . , � • , , , . �� .��� �'dUi�,�'�.'�Ori(1S'� , , . � � � , � � � , ' �' ' �� . . � . . , , � rw ���iT��wl� � �wf>M�M •Y��Y� , � ' � � � � � . � �� �'O'GT1�ID��`S4N'(2IVI)) . , ; . ��� � � . , . , ' � . 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I � TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTI30LD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 ' Planning Board approval FAX: (631) 765-9502 - . °� Survey SoutholdTown.NorthFork.net PERMIT NO. � !� Check Septic Form ' •, _ . , . � � N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20� Single&Separate , ' � Storm-Water Assessment Form Contact: Approved 20 I (/� Mail to: I� �1� ���Z�' Disapproved a/c V � mA-�-,�x.�- N� � �9 5 2 q Phone: `L`��� 5g-5� Expiration ,20 , Buil 'n ns e r D L�CCL�OML� � D APPLICATION FOR BUILDING PERMIT ��V � 6 20�� Date � �Co , 201� INSTRUCTIONS BZJII.Dd�TG DEPT. '��1ja�i§�' 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,tlie Builcling 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 pro}�erty 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 cbde, using code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ^ (Signature applicant or name, if a corporation) ���k I�9 2 i���-r;;�u�F� � I�S2 � (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ���i � `-�-�C� /, ��� �' Name of owner of premises �Ll� (Y1� Q� `-�� ���0��� �P��� (As on the tax roll or latest deed) If applicant is a corporation, sig�nature of duly authorized officer , , � , , ,, „ , . ��� �. (Name and title of,cor-porate,officer) , , . Builders License No. � ' �,' � � � - '��� � Plumbers License No. Electricians License No. � ' Other Trade's License No. - � 1. Location of land on which proposed work will be done: ��O �d �ce�rv�C �� �� ; f- � � t2��< . House Number Street � Hamlet , � � . . , , • --,9 � �ti4 e " . County Tax Map No. 1000 Section l�� Block 2 � Lot � � � 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 �[�� L� i ��- ��J�-ZC./I�C� $ Z��'c., GPv��� b. Intended use and occupancy 51�-►rYl� �n ,) 3. Nature of work (check which applicable): New Building Addition '�7�J ���'Alteration Repair Removal Demolition Other Work ��=K �' -�`���n (Description) 4. Estimated Cost Fee � • (To be paid on filing this application) 5. If dwelling, number of dwelling units f' 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. r' 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front ,,..�.e,a� .--.� ,-�--� Depth Height � � Number of_S,t�r'�es���r;,.�+��"`�'' � °"� � ..�, .��; ? � � 1 �a,..� ',��»,.��.: , .',.__� � _- , � it + f 1 ? °7 i 8. Dimensions of entire new construction: Front'� �-'� ` � Rear • �; ! ! Depth � -G���`; f Height �"-I�o�� (i.r�� Number of Stories �-- ``�"3 �F��" t°', 'k ���a;� u� '" 9. Size of lot: Front �� � Rear ��-�J � � Depth `�`2�7 � ..�,,,..�,�,�¢�,��• -FT �,:i ..:y�r. K: fd�:�n..P..�sva... 2 [ �J ( ._l o N N -fl l %'4�.�.'�-4=?'"�'�i� �s'�:�'�:�'� 10. Date of Purchase l / � Name of Former Owner �- y •^rs;. 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�f 11 be removed from premises? YES NO �� 25o F�or�;�,f�i I°1w",� 14. Names of Owner of premises {� � �[LLf� �� � Address 1--�v2�� Phone No. �`Y� - �2 t d Name of ArcHitect 1`�ONY�� r�� �-�tn—� Ad'dr`ess ►"n��-i+v� Phone No 2� �S�l-S`'� Name of Contractor ' Address �� ' Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ' NO X * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES x 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 YORIC) . SS: COUNTY OF ) LJC�i�1�`� � L—� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, ' � . � CONNiE D. BUNlCH ' idotery Public,State of New York (S)He is the �ctl�TEC�'� �t���' No.01BU6185050 (Contractor,Agent, Corporate Officer, etc.) Commisslon �xpires April 14,2__,, � 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 worlc will be performed in the manner set forth in the application filed therewith. Sworn to before me thi�s n , � day of i ' �' 20/ � � . - ".'';, �� � ����1� Notary Public Signature of Applicant � � � ---� 7'O�A/�N ' �� SOU'THOLD PRO�E�TY RECORD CARD �.., ,�. �� ; - �� 7,5� . -� � ;� �� �'�- ��:v•r - � �5- � - 1.� OWNER STREET 2 ��� VILLAGE DIST. SUB. 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'.'�.�'t-""fi-{s y 'Z1 � �'''i`'�;��-a:iX�'.��"sr'r.w—.:`�-M1�.' -';�:;?a�;, f .f. ��.s 4 r�k =�>rt r��:�'.�'�-.��: a,':-�•�'� � ir K�4` j� �.�+'„Y�Sr.:. �/� �� � ~F>+J�' �`r /� �.Q e�/ ..�� `� ej�s�5,��f yR� `� �a`1� � l�n a '� R y' , �" �ry p _ / �L' �'Y 7''O.�C ' ---=voaw s� o-.�.�e S.C.T.M. N0. DISTRICT: 1000 SECTION: 145 BLOCK: 2 LOT(S): 1.5 / c0� �•(1� , �ON. v � � �. � ��6 ��� �� �� . � o �'� � r o ��'���`'t o�6 0� " . �'°2 0� '�j�o p� eP 1155 �Ea�� �,� �\ 4 OG� . \ F' 3.9'�G� MON. � � \ F � ���P\� S�RE�GNO � . ti �� 3g.8'I `•;, P�2a . �o � ,L,�O� � , •s:� �N Z \ LAND N/F �o - �w$�y� N �" \ RICHARD EHLERS v° > . �, g�L�O MON, � 33 8 N•,. \ w COVEREO �� ...22& �`Z6 O � � � PORCH - � r \ . .i �� U.P 0 - , =`r - � 0.6'W "���� �a a. ' WOOD DECK \ ' ` - � � W/ARBOR ' � � � � - �A �E�,�E . . / . _ - r, 3 p � � � �3� . , � CA7E X ^ �p,5� �2� ° / 2�.5, � � _ WOOD 0 \ `' �- OECK �� " _ - A. � � 'pO , � �$�t � \ y ' ���• � r \?F '�ir. � �$ 0.7'W �/L XZ � ,_ �^ ��� ° A \ LAND N/F O K c� OF oy6� pp10 ,� \ EONA MCfVULTY �C� 'y g�� � �. \CATE `no 13.0'S LAND N/F n 2.8'E OF \ � • LUCY KOZER,4 r 2 ' m U.P. N , M _ __� CAo � �, ! . -- , � �v, - � . �� 5.0'W 2.8°E - WOOD PLA7FORM/STORAGE & 6' S70CKADE �Vt OWER SN t.o'w y� � � n � �����`N� Ow .' 3� ,1.8'W � W �GK 1.1'W f!� . �IO�Q � U��N�p,� �p B .NO �'� SPIKE �O��+ t - - $63 � 1 _- .. _. �� . 1 - . � � 00� eJ��N � , � �i � , �•M�� �`N� �� , - �' --� ���� " ' THE WATER SUPPLY, WELLS, �ORY�4'ELLS AND CESSPOOL ��°_�j f T� LOCA710NS SNOWN ARE FROM FIELD OBSERVAAONS _ � AND OR DATA OBTAINED FROM OTHERS. ________ ELEVATION DATU : __----- ---------- -7 c or 0.48 ACRES AREA: 20�708' / 0 `����� AND LENDING INSTITUTION RED TO BE A VAL/D TRUE COPY. GUARANTEE�yNDICATEO HEREON SHALL RUN uNAu rNORrZEO AL TERA TION OR ADDI TION TO THIS SURVEY IS A VIOLATIDN OF SEC�ON 7209 OF THE NEW YORK STATE EDUCATI�N LAW. COPIES OF THIS SU MAP NOT BEAR/NG THE LAND SUR►iEY�R S EMBOSSEDNDINGLINSTITUTIONT GUARANTEES ARE NOT TRANSFERABLE.PEClFIC PURPOSE AND USE THEREFORE THEY ARE ONL Y TO THE PERSON FOR WNOM THE SURVEY !S PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AG MENTS L/STED HEREON, AND TO THE ASSIGNEES OF THE LE THE OFFSETS OR D/MENSIONS SHOWN NEREON FROM THE PROPERTY LINES TO THE STRUCNLESS PHYSI�AL Y EVIDENT ON THE PREMISES AT THE TIME OF SURVEY NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FEN�ES, ADD/TIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EA AND/OR SUBSURFACE STRUCfiURES RECORDED OR UNRECORDED ARE NOT GUARANTEED CERTIFIED T0: LUCY KOZERA; SURVEY OF:'DESCRIBED PROPERTY FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC; MAP OF: FII.ED', • 5URVEYING� �i'1'� AT: IAUREL. 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