HomeMy WebLinkAbout42694-Z OfFOLIA-, Town of Southold 5/25/2018
P.O.Box 1179
y 53095 Main Rd
oy O� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39665 Date: 5/25/2018
THIS CERTIFIES that the building FOUNDATION
Location of Property: 475 Youngs Ave., Southold
SCTM#: 473889 Sec/Block/Lot: 61.-4-28
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
5/17/2018 pursuant to which Building Permit No. 42694 dated 5/17/2018
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:
foundation for existing accessory building as applied for.
The certificate is issued to Horton Charles House LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
t oriz ignature
gU K� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy • 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#: 42694 Date: 5/17/2018
Permission is hereby granted to:
Horton Charles House LLC
7160 Horton's Ln
Southold, NY 11971
To: Construct foundation under existing accessory building as applied for. Additional
certification may be required. Replaces BP# 40303.
At premises located at:
475 Youngs Ave., Southold
SCTM #473889
Sec/Block/Lot# 61.-4-28
Pursuant to application dated 5/17/2018 and approved by the Building Inspector.
To expire on 11/16/2019.
Fees:
MIT RENEWAL $100.00
$100.00
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
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#: 40303 Date: 11/30/2015
Permission is hereby granted to:
Horton Charles House LLC
7160 Horton's Ln
Southold, NY 11971
To: Construct foundation under existing accessory building as applied for. Additional
certification may be required.
At premises located at:
475 Youngs Ave, Southold
SCTM # 473889
Sec/Block/Lot# 61.-4-28
Pursuant to application dated 11/20/2015 and approved by the Building Inspector.
To expire on 5/31/2017.
Fees:
FOUNDATIONS UNDER EXISTING BUILDINGS $200.00
CO -ACCESSORY BUILDING $50.00
Total: $250.00
Buildin ctor
O r
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 $15.00
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Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: ,� iS
House No. &St eet Hamlet
Owner or Owners of Property: CG' D.A Q, LL 1
Suffolk County Tax Map No 1000, Section W Block Lot
Subdivision lbtM Filed Map. ot:
Permit No. u Date of Permit. Applicant: t Lte
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (/ check one
Fee Submitted:$ �j(� �
V40TT_
A li t Signature
�� SOF SOU,y
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2NDI[ SULATION /
[ ] FRAMING /STRAPPING [ ] FINAL * ovr 4, 7j �YI/
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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C, J)
DATE INSPECTOR
r' r 1 0 • " � M 1 !�
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IMUL,ATION
STATE ENE-ROY 601M
• ai a �� r Rpt; � _
PAUMMIrm OWN-- KA
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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 11971lp 4 sets•ofBuilding Plans
TEL: (631) 765-1802 • Planning Board approval
FAX: (631) 765-9502 - "Survey'
SoutholdTown.NorthFork.net PERMIT NO. / Check
!.. ;'Septic Form
l
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 30 ,20 Single&Separate
s Storm=Water Assessment Form
Contaet: o
Approved lJ 20 `l Mail
pp l✓ '�Q-1 i p
Disapproved a/c S e�ef, I
Phone: 2 '9H ` C)I
Expiration ,20T
r -Buding I ctor.. a J
�APPLI'CA-ION FOR BUILDING PERMIT
Date ! , 20
SIN 0 � AON; I.N,S UCTIQNS--
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a. This application N I1�S�be cc npletel filled'}�.b 'typewr-iter'or'in ink and_submitted to the Building Inspector with 4
sets of plans, accurate p ot.plan to scale. Fee according t' '4L.-edule.
b, Plot plan showing-'jeckion'of-lot=and-of 15011 liiigsn 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 bi occupied'or used in w'—iri'part f'or any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized'hasnot eQmmenced within-I2'months after the date of
issuance or has not•been.completed within 1.8 months.from-such:date:If no zoning amendments or other regulations affecting the
property have.been enacted In the•iriferim,the Building Inspectot-;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 Buildipg;Aepjartment fpr.the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Tovyn;ofS,outhold;Suffolk'Cpurity;,Ne�c York;and other;applicable,Laws,$Qrdinances,or
Regulations, for the construction of buildings, additions, or alterations onior removal or demolition.as herein described.The
applicant agrees to comply with all applicable laws, ordinances,buii'dingscode„h s g code;and regulations, and to admit
authorized inspectors on premises and in building for necessary inspecti
((Nn ture o licant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premise
( t1f U�
(As'on'the tax roll or latest deed)
Iapp ica t is a corp ra 'o , signature of duly a ize officer
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(Nmn t
ae aitle of corporate of icer) '
Builders License No.
Plumbers'License No.
Electricians License No. !'
Other Trade's License No. ! �.
1. Loc ion of land on which proposedX-)
will be done: ,, ^
LA M 1�11�d
Ho se umber Stt et Hamlet
li;"tiJ�Z.i,'��.'1•i_ ..YTl;.;is e�l_1e7!)''!'Y::A 1 ULA
County Tax Map No. 1000 Section Lot
__.:__:,C,i;�i>•n!it. ,`ii-ii�!;`.il ii�,;1:;..;','".:U:.
Subdivision Filed Map No. Lot &0
2. State existing use andoccupancy of premises and int ded use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy h
3. Nature of wo (check which applicable):New Building Addition Alteration"
Repair Removal Demolition Other Work
d1Q (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 - �t-- "
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
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7. Dimensions of existing structures, if any: Front q.<-) ` Rear e20 r Depth 2-'
Height J� " Number of Stories .
P
Dimensions of same structure with alterations or additions:�Front 2__0 Rear_
Depth ( Height �6l1�r'- _ ja' Number of Stories
8. Dimensions of entire new construction:.Front-s ,,- g `� - .� Rdaf: - ,; `: Depth
Height Number of Stories
9. Size of lot: Front Rear 11, epi a th
10. Date of Purchase } f Name of Forftt,,Qwner �
11. Zone or use district in which premises dre{situdte&':`_'`.:r`, Q�
12. Does proposed construction'v�olate anytz`oning"law,'pfdinarice'or"regulation YES ;NO
13. Will lot be re-graded? YES NO •v,Will excess`fill be`remoyed fror�premises? YES NO'
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14. Names of Owner of premise 1, �dz'e'ss�- � q IQh orie 0.
Name of ArchitectAddress i „ Phone No
h
Name of Contractor
15 a. Is this property'within-100 feet of•a tidal wetland.or a4freshwaterwetlandTYES' ,NOLO
IF YES, SOUTFIOLD TOWN TRUSTEES &D.E:C':"PERIv1ITS'MAY`BE-REQUIRED.-
b. Is this prop erty'within',300'feet"of a'tidal wetland?*'YES-t;, " NO "
* IF YES, D.E.C. PERMITS MAY"BE REQUIRED.' ''•,` :`:W '
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 su vey.
18. Are there any covenants and,restrictions with respect to this property? * YES NO
IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS: LLC__C UNTY OF-SV VOV�
e
AA 1h 9A being-duly swo , de oses,and says that she is the' 'applicant
(Neamo i di i ual igning contract)abo named;
(S)He is the 2'
(Contractor,Igeht, 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 me this
day of 20 /Z
TRACEY L. D
NO I Y PUBLIC
otar Publi ,STA
Y N0.01DW6306900 ignature of Applicant
QUALIFIED IN SUFFOLK CO TY
COMMISSION EXPIRES JUNE 30,22B
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TITLE CGn'A'r,C.•1,(.,. 'AL J62UXT AND LdceflSed Land
LENDING L r:L1:..j.:.. h.AWA AM �
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APPROVED AS NOTED .-h6na ce-K-2 `ca m Aqa
DATEI 36 l .P.#,— re 1.4.1 (ice��
FEE: D�BY: COMPLY WITH ALL CODES-OF
NOTIFY BUILDING DEPARTMENT AT NEW YORK STATE & TOWN CODES,
802 s AM TO 4 PMFOR THE
FOLVgr`WIN
AS REQUIRED AND CONDITIONS OF
_
FOLLOWING INSPECTIONS: '
1. FOUNDATION - TWO REQUIRED how _
FOR POURED CONCRETE
a ! _ 2. ROUGH - FRAMING 8t PLUMBING
3. INSULATION "R
-'- 4. FINAL - CONSTRUCTION MUST Quo I me
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MIEET THE
P' f REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR OCCUPANCY OR
DESIGN OR CONSTRUCTION ERRORS. USE IS UNLAWFUL
WITHOUT CERTIF
WIT ICATE
-�- OF OCCUPANCY .
i - 6 e 6 jh ''ems G RETAIN STORM VIIATER RUNOFF
-- PURSUANT TO ChAPTER 236
OF TFIE TOVVN CODE.
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