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HomeMy WebLinkAbout41766-Z $4�11FFal�CD�,. Town of Southold 6/30/2017 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39035 Date: 6/28/2017 THIS CERTIFIES that the building WINDOWS Location of Property: 1040 Middleton Rd, Greenport SCTM#: 473889 Sec/Block/Lot: 40.-5-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 6/28/2017 pursuant to which Building Permit No. 41766 dated 6/28/2017 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 blt"windows in an existing one family dwelling as applied for. The certificate is issued to Neuman Joseph&Helen Irry Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED .a 60ed Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT M. TOWN CLERK'S OFFICE o • 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#: 41766 Date: 6/28/2017 Permission is hereby granted to: Neuman Jospeh Irry Trust 6 Taft Ave Bethpage, NY 11714 To: as bit" windows At premises located at: 1040 Middleton Rd, Greenport SCTM # 473889 Sec/Block/Lot# 40.-5-11 Pursuant to application dated 6/28/2017 and approved by the Building Inspector. To expire on 12/28/2018. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ADDITION TO DWELLING $50.00 $250.00 i Buil 'ing Inspector 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$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 Date. New Construction: Old or Pre-existing Building: (check one) /- Location of Property: 1 D qo M j A le—h D r4 House No. Street Namlet, Owner or Owners of Property: 7J_D6f4A Ae4MA A Suffolk County Tax Map No 1000, Section Block Lot ] Subdivision �1 Filed Map. Lot: Permit No. Li ` Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature CONSENT TO INSPECTION k0 -) I '" n ,the undersigned,do(es)hereby state: Owner(s)Name(s) That the undersigned(is) (are)the owner(s) of the premises in the Town of Southold, located at which is shown and designated on the Suffolk County Tax Map as District 1000, Section , Block_�, Lot That the undersigned(has) (have)filed, or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: �rh�o tNr That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildingsdocated thereon,to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws,ordinances,rules and regulations of the Town of Southold'. The undersigned, in consenting to such inspections,do(es)so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances,rules or regulations of the Town of Southold. Dated: e'171 IV 12$,1 ✓ C't!4 4 S� re2 ✓6 1/^ /1 (Print Name) (Signature) (Print Name) TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you'have or need the following,before applying? TOWN HALL Board of Health ! SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 1 Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate Storm-Water Assessment Form Contact: Approved ,20 Mail to: Disapproved a/c j Phone: r //ot to Expiration ,20 Building Inspector D RelEonPLICATION FOR BUILDING PERMIT JUN ? 8 2W I Date Z , 20_�_? INSTRUCTIONS a. Thi j)W be completely filled in by,typewriter or in ink and submitted to the Building Inspector with 4 sets of pla re$jr�d le. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises for 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 shal I 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 Inspctor may authorize, in writing,the extension of the permit for an addition six months. Thereafter,a new permit shall be requited. 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. 1 (Signature of applicant or name,if a corporation) cW (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises .,N GU/1�`� �a r ��r ��� ��,� )16ItA ..:-Y (As on the tax roll or latest deed) If applicant is a cor0'6rati6n;:signature of duly authorized officer (Name and title of corpoiafe officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which oposed wor will be done: Q V _J/ayA r), A'i Ic��- � ,fin p« ' House Number Street Hamlet County Tax Map No. 1000 Section 4(0 Block Lot [ i i I 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 b. Intended use and occupancy ' as b ; 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 v i 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. i 7. Dimensions of existing structures, if any: Front Rear a Depth Height Number of Stories I i Dimensions of same structure with alterations or additions: Front i Rear Depth Height Number of, les'_71°",r',°`1r'_ '"�' !ir 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 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 premises? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address i Phone No. 1 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 MAYREQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO I * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. i E 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. j STATE OF NEW YORK) SS: COUNTY OF ) ^� AA ,, CONNIE D.BUNCH /V 6V„ being duly sworn, deposes andg1at e� i4t� (Name of individual signing contract)above named, No.01SU618 QualMiad In Suffolk County (S)He is the Commission Expires April 14,2�`�� (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sad 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. 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ItaNma,l. usdrn`I Manufacturer Stipulates Hallmark certification as militated below ConstructionMoisttire " ;,', VDMNCSAI _ R-PG35:SzeTested 014x1575mm36x62m-T+ e Windows and doors may behamied byexcess consmiction moss{m Ventilate the building ch nng plastering,or cow rthe interior ofthe produd(s)with plastic 'MPELLA' Al ways matt the Pella Warranty before purehasingorinsta[tFngf'etlq*Pmditets. ���f (HALLMARK 'ERTIFICATION requires the performance of at least one product of Byinstallingthisproduet,youareacknowledgingthatthisworralityispartaf duct line to hi tested In accordance with the applicable performance standards theterrrss.ofsaie.FaituretocomplywithallPellaInstallationand maintenance = Idled by an.,ln+epsndent party The certification Indicates that the product(s) of instructionsrtlayuoldyoyrPal 4tproductwarrlMy.See Written Warrantyfor ) duct line passt i the applicable tests The certification does not apply to mulled completedetat'Isatpellacorntwarranty. - )ad Design Prt,sure (DP) Air Jr./Ex A2 •' ,• r WaterTest Pressure1-05ps1+1680/- 1680pa� WARNING rerAstm E330 6.06psfMpa ADVERTENCIA with HUD 111(Gettysb rg,Ply II ®2012 Paha Corporation Part eV984915 �„'.6f induct Appraml System(1'AS)Number FL11152 it of Insurence(TDI)EYal,rtion Report Number WIN-816 pe and thickness Anneale 2 5MM/2 5MM designed per ASTM Ell 300 Door Actual Size 27 500" ide by37 500"tali KIFRr A1119 i