HomeMy WebLinkAbout28451-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28877 Date: 09/19/02
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 80 COREY CREEK LA SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 78 Block 4 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 7, 2002 pursuant to which
Building Permit No. 28451-Z dated JUNE 10, 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 KITCHEN ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to FRED & LEE YOUNG
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1073965 08/30/02
PLUMBERS CERTIFICATION DATED 09/16/02 FRED YOUNG
C )2
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. 28451 Z Date JUNE 10 , 2002
Permission is hereby granted to :
JOHN J BIRGEL
80 COREY CREEK LA
SOUTHOLD,NY 11971
for
ALTERATIONS (KITCHEN) TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at 80 COREY CREEK LA SOUTHOLD
County Tax Map No. 473889 Section 078 Block 0004 Lot No. 005
pursuant to application dated JUNE 7, 2002 and approved by the
Building Inspector to expire on DECEMBER 10, 2003 .
Fee $ 150 . 00
Autho z ature
COPY
Rev. 5/8/02
Form No.6 ��OS
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
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00
Date.. 9
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: P e->/ C'W -Z rC /,g,�c rJ 7 o z
House No. Street Hamlet
Owner or Owners of Property: /�Z t� rte` zc�,
Suffolk County Tax Map No 1000, Section ZZ-R 078 Block 000 Lot Uo S—
Subdivision Filed Map. Lot:
Permit No. Date of Permit. (p —02—Applicant: /--i2.0y 1(/00N C
Health Dept. Approval: /✓/'¢ Underwriters Approval: /0 73 9(oS
Planning Board Approval: /�IA
Request for: Temporary Certificate Final Certificate: (check one)
00
Fee Submitted: $
(54<. &aLf3 0 Appli i Lure
e .2, asrg? -7
gUF FO(,�co
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y
Town Hall;53095 Main Road u• T Fax(631)765-1823
P.O. Box 1179 Eiji O�v Telephone(631)765-18C
Southold,New York 11971-0959 ���
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: S' —/(� —o 7—
Building
Building Permit No.
Owner: f—2 r jc�v n/�z
(please print) T
Plumber: r�� v�✓�
(please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
(Plwllers Signature)
Sworn to before me this
day of 20 0 -L,
JOYCE M.WILKINS
Notary Public,State of New York
No.4952246,Suffolk County
Notary Public, County Term Expires June 12, -
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5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
SBUREAU OF ELECTRICITY S
�j 40 FULTON STREET -- NEW YORK, NY 10038 5
5 CERTIFIES THAT 5
5 5
5 Upon the application of upon premises owned by 5
5 FRED YOUNG FRED YOUNG80 e5
5 OREY CREEK HO D NY, 11971 SOUT
SOUTCOREY80 HO D, NY 11971
5 5
5 Located at 80 COREY CREEK LANE SOUTHOLD, NY 11971
5
5 Application Number: 1073965 Certificate Number: 1073965 5
5 55
Section: Block: Lot: Building Permit: BDC: NS11
Described as a Residential occupancy, wherein the premises electrical system consisting of �c
5 electrical devices and wiring,described below, located in/on the premises at:
5 First Floor, 5
5 5
5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5
5 found to be in compliance therewith on the 30th Day of August,2002. 5
5 5 Name 2 Rate Rating Circuit Tyne 5
Additional Charges 5
5 kitchen alteration 5
5 C] Wiring and Devices 5
Receptacle 1 0 General Purpose
5 GFCI Circuit Breaker 2 0 20 amp Appliance 5
5 5
5 5
5 5
5 5
5 5
5
S seal 5
55
5 1 of 1 C
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5
5 5
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO GH PLBG.
[ ] FOUNDATION 2ND ( ] SULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & C7ydo,
REMARKS:
G - �
DATE O INSPECTOR
FIELD INSPECTION REPORT DATE cobDdE '!5
ro
FOUNDATION (IST)
-------------------------
FOUNDATION (2ND) C1J
z
0
ROUGH FRAMING& y
PLUMBING
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADDMONAL CONVZEEM n
O
r Z
rn
z
O
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d
TOWN OF SOUTHOL C,I, ' .- —'` BUILDING PERMIT APPLICAT "' t"HECKLIST
BUILDING DEPART 1 T Do you have or need the following,before applying?
TOWN HALL 7 r:'��
Y g, PP Yg
SOUTHOLD, NY 11971 �' Board of Health
J� 3 sets of Building Plans
TEL: (631) 765-1802 r Planning Board approval
FAX: (631) 765-9502 }r_..,..._`_s.______ �?
Survey
PERMIT NOC28 f�(� Check
Septic Form
N.Y.S.D.E.C.
t Trustees
Examined �` 20 Z Contact:
Approved 20 P►—
Mail to:
Disapproved a/c
/ Phone: 6, 76,5--/9.1
Expiration 20-3
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 41/9 20 o Z
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.
£ 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.
W
(Signature o icant name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
O W10V /Z
Name of owner of premises r)ap
(As on the tax roll o 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. _ 4/ 4
1. Location of land on which proposed work will be done:
Bo Caet`y C/ZErie- cSOJT,�/OL D
House Number Street Hamlet
County Tax Map No. 1000 Section 78 Block_____y Lot 5'
Subdivision (20,eA V C,z.6--g-ie ESTa-7-tnr Filed Map No. Y2A,y Lot
(Name) 1
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ti.,rycr P)91"/A,,/ �okWr
b. Intended use and occupan rg,y It✓ 110,A4
3. Nature of work(check which applicable): New Building Addition Alteration _`_
Repair Removal Demolition Other Work
pe (Description)
4. Estimated Cost 14 0 0 o Fee
If (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. &Z-14
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 !o o 2, Name of Former Owner ,yZ
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will lot be re-graded? YES NO IX
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 owNr72 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:
COUNTY OF )
/ rZCyui✓S being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the O tc%/C/Z
(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.
Swo to before me thi
y of 2W Q_
t Public Si re of A plicant
JOYCE M.WILKINS
Notary Public,State of New York
,
No.4952246Suffolk County
Term Expires June 1,2,a—O U
3
VMVIu, Ck no N4S >t 6ov4.jcjs-anon $WUL4kc�_ codzv.a
Kitchen Alterations
SO Corey Creek Lane
1. Remove all old kitchen cabinets.
2. Remove section of non-load bearing wall between kitchen and family room,
approximately 6' wide and 4' from ceiling.
3. Remove linoleum floor and replace with ceramic tile.
4. Remove drop ceiling in kitchen.
5. Paint.
6. Install new kitchen cabinets per attached drawings.
7. Install Silestone countertop with under countertop sink.
UNDERWRITERS CERTIFICATE
REQUIRED
OCCUPANCY OR
APPROVED AS NOTEDUSE IS UNLAWFUL
WITHOUT CERTIFICATE
DATE- 6 Io _" B.P.#o'2845�'L OF OCCUPANCY
FEE 150 BY:c� —
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED PLUMBER CERT/F/CAT/ON
FOR POURED CONCRETE ON LEAD CONTENT BEFORE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION CERTIFICATE OF OCCUPANCY
4 FINAL - CONSTRUCTION MUST S
BE COMPLETE FOR C.O. OLDER USED /N WATER
ALL CONSTRUCTION SHALL MEET SUPPLY SYSTEM CANNOT
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY '_XCEED 2/10 Of 1% LEAD,
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
PLUMBING
ALL PLUMBING WASTE
If copper tubing is used & WATER LINES NEED
TESTING BEFORE CO\oERING
for water distributing
system; piping shall be
of types K or L only
PROVIDE ANTI-SCALD AND/OR
UNDERWRITERSREQUIRED
THERMAL SHOCK PREVENTING
DEVICES AS TO PART. 902.6(x)
N-Y. STATE BUILDING CODE.
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