HomeMy WebLinkAbout28670-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29107
Date: 12/06/02
TEIS CERTIFIES that the building ADDITION
Location of Property: 2380 SOUTH HARBOR RD
(HOUSE NO.) (STREET)
County Ta~ Map No. 473889 Section 75 Block 7
SOUTH/PEC
(HAMLET)
Lot 3
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 14, 2002 pursuant to which
Building Permit No. 28670-Z dated AUGUST 19, 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 COVERED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to FRANCESCA ANDERSON
(OWNER)
of the aforesaid building.
SUFFOLK COUIFI%[ DEPi%RTMENT OF ~R;kLTI{APPRO~la_L
ELEt-i~ICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'i'~3
N/A
N/A
N/A
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. 28670 Z
Date AUGUST 19, 2002
Permission is hereby granted to:
FR3~NCESCAANDERSON
2380 SOUTH HARBOR RD
SOUTHOLD,NY 11971
for :
ADDITION AND ALTERATION TO EXISTING ENTRACNCE AREA ON THE SINGLE
FAMILY DWELLING AS APPLIED FOR.
at premises located at 2380 SOUTH HARBOR RD SOUTH/PEC
County Tax Map No. 473889 Section 075 Block 0007 Lot No. 003
pursuant to application dated AUGUST 14, 2002 and approved by the
Building Inspector to expire on FEBRUARY 19, 2004.
Fee $ 150.00
Signature
Rev. 5/8/02
COPY
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:
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 a consent to inspect signed by the applicant. Ifa Certificate of Oe~ug. an~y-3
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to ' g $ '
Swimming pool $25.00, Accessory building $25.00, Additions to accessory buil~,ing $2~i0~0i
$50.00.]
2. Certificate of Occupancy on Pre-existing Building - $100.00 .......... ', 2_.._]
3. Photocopy of Certificate of Occupancy - $ 0.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction:
Location of Property: '~ ~
House No.
Old or Pre-existing Building: ~-
Street
Owner or Owners of Property: ~'(Cl~o( ~ C (A ~ ~Og ~l&o'~
Suffolk County Tax Map No 1000, Section 0'7~' Block
(check one)
Hamlet
Lot C..)c~
Subdivision
Permit No. ~x ~> (~ ~(-Y~ Date of Permit.
Health Dept. Approval: ~ I t~
Planning Board Approval: ~ I t~''
Request for: Temporary Certificate
Filed Map. Lot:
~//ef/Oq" Applicant: ].$~¥/b/'/~o ~/v"/~r ~J3YT'~, ~A~/~-
Underwriters Approval:
Final Certificate: ~ (check one)
Fee Submittegl: $ ~'~~5~OO
445.20'
S 00°49'50" E
87.56'
,EOR~ER OWl'itE,R
LAND
AGE
NEW
Farm
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
BFushland .~
House Plot
SEAS.
IMP.
NORMAL
TOW OE SOUTHOLD PERTy RECORD CARD
VL
STREET ~ ~ VILLAGE
DISTRICT SUB. LOT
N ?,,,~, ~ ~ ACREAGE "-
S ~ TYPE OF BUILDING
FARM
TOTAL
DATE
REMARKS
BUILDING CONDITION
BELOW
Value Per Acre
ABOVE
Value
cZ-
~(~ Basement
Extension ~ ~_'~ ~ ~ ~ ~ . J __
~nsi°n /~ ~ 2 ~ ~ ~~ ~,~ ~ 7~ ~- Walls
~t~sion Fire Place He~
~ ~ ~ . ~ ~,o ~ ..... ~ ~ Porch Affic
.., ~ Porch Rooms 1st Flor
Bree~wayI Patio R~ms 2nd Flor
~r~e ~ ~ % ~ ~.= ~ ~ ./~ ~ ~ Driveway
O.B. E/+/~/ ~ ~ ~
~(I /~/ ~ '-'
FIBERGLASS/ASPHALT SHINGLES-7 ,/,2 X 8 LEDGER BOLTED TO
R~.O, FING FELT //,,'~ EXIST. HOUSE.
112 CDX PLYWD. ~J FLASHING AS REQ.
EXISTING WINDOW ~
~EIL. JOISTS
ADD NEW HIP
FEEfff'/.~)' ~ BY:,~~---'
NOTIFY BUILDING DEPARTMENT AT
76s-~8o2. AM TO 4 PM FOR THE
FOLLOW~"G ~NSPECr, O,S:
1 FOUNDATION - ~O REOUIRED
FOR POURED CONCR~E
2. ROUGH- FRAMING & PLUMBI~
3. INSU~TION
EXIIT'
,/,-
¢ "~Z~'~ X 4 Q 16' O.C. TIES / C
\L-HURRICANE CLIPS
~--'2 - 2X8 GIRDER
4 X 4 POSTS
~"-RAIL AS REQ.
~ I~ ii
/' 2 - 2X8 GIRDER
BOLTED TO 4 X 4 POSTS
TECO JOISTS TO GIRDEF
NEW ENTRY
;H
II
ANDERSON FARMHOUSE #2
NEW ENTRY PORCH
ELEVATION
1/4" = 1'0"
ENVIRONMENT EAST INC.
NEW POSTS, NEW
PORCH
5/4 DECKING
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERC'~'
CODES. NOT RESPONSIBLE] FO~
DESIGN OR CONSTRUCTION ERROr`
2 X 8 Q 16" O.C.DECK JOISTS
TECO TO GIRDER AND LEDGER
2 X 8 CCA LEDGER BOLTED TO
EXIST. HOUSE.
X 4 CCA POSTS ~ 6'0" D.C.
TO MASONRY FTGS.~
3'0" MIN. BELOW GRADE
ANDERSON FARMHOUSE # 2
NEW ENTRY PORCH
SECTION
1/4" = 1'0" 8. 13. 02
ENVIRONMENT EAST INC.
DO NOT PROCEED WITH
FRAMING UNTIL SURVEY
OF FOUNDATION LOCATION
HAS BEEN APPROVED.
I
I I
WALL OF EXIST. HOUSE
I
EXISTING ENCLOSED
PORCH
NG CONC,
& STEPS
ANDERSON FARMHOUSE ~2
NEW ENTRY PORCH
PLAN
1/4" = 1'0" 8.13.02
ENVIRONMENT EAST INC.
EXISTING PORCH & STOOP
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
ROU~,BO.
.~ISOLATION
FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
FIELD INSPECTION REPORT I DATE I COMMENTS
//,~.~ ~
FOUNDATION (1ST) / / ~
FOUNDATION (2ND)
ROUGH F~G &
PLU~G
~S~ATION PER N. Y.
STATE ENERGY CODE
/ / _~y~
F~
~D~ION~ COMMENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOI~THOLD, NY 11971
TEL: 765-1802
Examined 0~') ~
Approved t~/~f
Disapproved a/c
,2oO2
,2oO2
PERMIT NO. 2- l~-~'?t5 ~
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying ?
Board of Health
3 sets of Building Plans
Survey.
Check
S,~tic Form
Contact:
Mail to:
Z ~Build~ng'Y_nspector -
Phone:
APPLICATION FOR BUILDING PERMIT
, '~,i ~ 1~¢3\37- Date Aoo- t3 ,20 o
'~ ~ C .... : INSTRUCTIONS
; a. ~s~Hdati~ ~ST be compl~ety filled in by ~e~ter or ~ ~ ~d sub,Red to ~e B~l~ng ~spector with
sets o~} a~te plot pl~ to sc~e. Fee accor~g to sched~e.
b. Plot pl~ show~g location of lot ~d of b~l&gs on pr~ses, relatiom~p to adjo~g pre~ses or public s~eets or
~ms, ~d wat~ays.
c. ~e work cov~ed by tbs application may not be co~ced before iss~ce ofBuild~g P~t.
d. Upon approvM offs applicatio~ ~e B~l~g ~pector will issue a Buil~g P~t to the applic~t. Such a pe~t
shM1 be k~t on ~e pr~ses av~lable for ~sp~tion t~ou~out ~e work.
e. No b~l&g s~l be occupied or used in whole or ~ p~ for ~y p~ose what-so-ever ~til a Ce~ificme of Occup~cy
is issued by ~e B~l~g hspector.
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.
~t~ ¥ t R O rd S4 ~O X" ~___~ I tq C.
(Signature of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Cp r=:FOe- a,L-. P...oMto ff..
Name of owner of premises Pr>r~-,, ,.-,-~-- t
(as on the tax roll or latest deed)
If applicant.is, a corporation, signature o_f duly authorized officer
(Name and title of corp/Srate officer)
Builders License No. /-{-. t. ~ f~
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
. ,- (Name)
Hamlet;
Filed Map ~r ........r; ~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. _Ex.istin.g use and occupancy ,~t~c--t.~ W~cn~t)-~ i:>uJ~,_~_~.tO O
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost J/t) .ff0(2
5. If dwelling, number of dwelling units M,&-
If garage, number of cars
Fee
Addition Alteration
Other Work
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. /Q
7. Dimensions of existing structures, if any: Front ~,_ -/t, Rear ~¢~7 - Depth
Height 15~ Number of Stories I
o
Dimensions of same structure with alterations or additions: Front
Depth l/3~-~ Height
Dimensions of entire new construction: Front ~ ~0
Height l (~ '-~, ~' Number of Stories
9.. Size of lot: Front
Sql.RS' Rea, 4-1 .5/.
Rear
I
Number of Stodes
Rear q u-o Depth
Depth 4¢6,g 7'-
10. Date of Purchase , Name of Former Owner
11. Zone or use district in which premises are situated R~/,4~ ~t co ~To~ A~ C.
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be rergraded /q 0
14. Names of Owner ofpremmes
Name of Architect
Name of Contractor
Will excess fill be removed from premises: YES
Address .3 flSD ~.tt:~l~ ~ Phone No. -/(off--
Address Phone No
Address 'Do 130~ [~-1 PhoneNo. ~LffS~-/'ac~°C'
15. Is this property within 100 feet of a tidal wetland? *YES NO L,~
· IF YES, SOUTHOLD TOWN TRUSTEES 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)
~"~. (~) t~' ~~ being duly sworn, deposes and says that (s)he is the applicant
[ (N~ae of individual signing c~ntract) above named,
(S)He
is
the
~(~nt, 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 ali 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 fried therewith.
Sworn to before ~ .
Notary Public, State of New York
Qualified in Sl~ffolk County
NO. 01SC4725089 --
~ Expires Ma,/31, ~.