HomeMy WebLinkAbout41311-Z Q�1g�FF�l,i-�pG. Town of Southold 1/24/2017
P.O.Box 1179
53095 Main Rd
oyay�l 0� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38790 Date: 1/24/2017
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 7990 Oregon Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 95.4-6.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
12/29/2016 pursuant to which Building Permit No. 41311 dated 1/24/2017
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"replacement windows and rear stoop with steps on existing one family dwelling as applied for.
The certificate is issued to Ficner, Stacia
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
o ' Signature
got, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Q TOWN CLERK'S OFFICE
y, s o�en
SOUTHOLD, NY
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#: 41311 Date: 1/24/2017
Permission is hereby granted to:
Ficner, Stacia
7990 Oregon Rd
Cutchogue, NY 11935
To: legalize "as-built" replacement of windows and rear stoop with steps on existing
single-family dwelling as applied for. Additional certification may be required.
At premises located at:
7990 Oregon Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 95.4-6.1
Pursuant to application dated 12/29/2016 and approved by the Building Inspector.
To expire on 7/26/2018.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $420.00
CO -ALTERATION TO DWELLING $50.00
Total: $470.00
ildin 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.
nderwriters: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 properly 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$15.00
De�
New Construction: Old or Pre-existing Building: / (check one)
Location ofProperty-'N 799U 0r,0pA_) x(1 ( cc�Ch
House No. Street Hamlet
Owner or Owners of Proper: ��-
Suffolk County Tax Map No 1000, Section Block o4— Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted:$
Applicant Signature
FIELD RMTLOTION REVORIr DAT= +CO S
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INSULATION PES.N,Y.
STATE ENE-ROY 04DE
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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 p
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 ,204 Mail to: �' 1kf J CW) Tei'
Disapproved a/c T
Phone: 3 I S 131 ® + /
Expiration ,20 C (n
D Bit nspe r
D
rLICATION FOR EUILDING PERMIT
DEC 2 g 2016
Date , 20
BUILDING DEPT. INSTRUCTIONS
119il39FATAMPR 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.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant) //
//10 /
State whether applican is owner essee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises Q c f,-Ar I J,e/
(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 proposed work will be done:
79.'a0 L) ed 7 CXD 00 2-
House
House Number 0 Street U Hamlet
County Tax Map No. 1000 Section 5� Block c4— T-et
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 IqS ha/./ f
/J_e cc, c� i i� o w , tri g .Q Da, er,�2 t� S 2 5
b. Intended use and occupancy
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 occupa y, 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 ;7�1,-Rear,;.-:._o ,
Depth Height Number of Sfo ries_f
8. Dimensions of entire new construction: Front Rear Depth
Height Numberof Stories
9. Size of lot: Front ear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated /GJ
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO/
13. Will lot be re-graded? YES NOD<�Will excess fill be removed from premises? YES
14. Names of Owner of premises 13A,12AA A /Address Phone No. 3Q2JP o3
Name of Architect Address Phone No6' 3�ry6 c?S/
Name of Contractor Address Phone No.
15 Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO t�
�F YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY B REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NOK
* 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-V%EOc t
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the 0w0
(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 met s
5--1+ day of [?UA 6"—201
CONNIE D.BUNCH
Notary Public Notary public,'State of New Yc Signature of Applicant
No.01 BU6185050
Qualified in Suffolk County
Commission Expires April td,2-DU-6A 0
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WIND-BORNE DEBRIS PROTECTION FOR WOOD STRUCTURAL PANEL
AS PER SEC.1609.1.2,2015 IBC:ALTERNATIVE FOR OPENING PROTECTION(IF NOT USING IMPACT GLAZING)
WINDBORNE DEBRIS PROTECTION FASTENING SCHEDULE FOR WOOD STRUCTURAL PANELS WOOD STRUCTURAL PANELS WITH A MINIMUM THICKNESS OF 7/16-
AND MAXIMUM PANEL SPAN OF 8 FEET SHALL BE PERMITTED FOR OPENING PROTECTION IN ONE-AND TWO-STORY BUILDINGS.PANELS SHALL BE PRECUT TO
COVER GLAZED OPENINGS WITH ATTACHMENT HARDWARE PROVIDED.(REFER TO SECTION 1609.1.4,1609.6.5 AND TABLE 1689.1.4 OF N.Y,S.RESIDENTIAL U
CONSTRUCTION CODE).THIS IS NOT A SUBSTITUTION FOR DESIGN-PRESSURE.ALL OPENINGS MUST HAVE DESIGN-PRESSURE UPGRADES WHERE APPLICABLE. 'z u
ALL PANELS MUST BE CUT TO SIZE AND READY TO USE ON ANY NEW WINDOWS AND DOORS.SHUTTERS MUST BE MARKED FOR WHAT OPENING IT IS TO COVER.
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