HomeMy WebLinkAbout43106-Z SFFO[,�C Town of Southold
10/18/2018
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39982 Date: 10/18/2018
THIS CERTIFIES that the building ALTERATION
Location of Property: 1000 Beachwood Ln.,Southold
SCTM#: 473889 Sec/Block/Lot: 70.40-59
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/5/2018 pursuant to which Building Permit No. 43106 dated 10/5/2018
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:
SCREENED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Farrell,Almira
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Signature
o�°SU.F K�OG TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
of . SOUTHOLD, NY
Cpl � Sao
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#: 43106 Date: 10/5/2018
Permission is hereby granted to:
Farrell, Almira
PO BOX 167
Southold, NY 11971
To: CONSTRUCT PORCH ADDITION
Replaces BP# 13203
At premises located at:
1000 Beachwood Ln.,Southold
SCTM # 473889
Sec/Block/Lot# 70.-10-59
Pursuant to application dated 10/5/2018 and approved by the Building Inspector.
To expire on 4/5/2020.
Fees:
PERMIT RENEWAL $85.10
$85.10
Building 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
j 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
111 e
Date.
�V Old or Pre-existing New Construction: Building: (check one)����`�
Location of Property: A ��� �; '�r/`��7� �"'e-,
Street Hamlet
House No. �,r�r l/
y Owner or Owners of Property: 17/!�1/Zw / `��
l Suffolk County Tax Map No 1000, Section 03 d Block /L/ Lot J )
Subdivision
Filed Map. Lot:
d O1
i
Permit No. ll e of Permit. Applicant:
i Health Dept.Approval: Underwriters Approval:
a Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ qr3
Applicant Signature
SOUTyO
TOWN OF SOUTHOLD BUILDING DEPT.
u 765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I SULAT �N�
[ ] FRAMING /STRAPPING [ FINAL 0
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
oFc�a Pb U e&4
DATE 0 Y INSPECTOR
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STAFE COPISTRUCTI0 Fti'^IlY
CODES NOT RESPONSIDI' FOR
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SUFFOLK CO HEALTH DEPT.APPROVAL h
H.S NO.
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J MAP OF pa<) E07TY STATEMENT OF INTENT
6;J �/J •. (� SU(2V@��p F02 THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
AT SUFFOLK CO DEPT.OF HEALTH SERVICES.
s7 C`rS6p r SQ(JT(-{QLQ (S) APPLICANT
�= -ff C'IJfJ MYSUFFOLK COUNTY DEPT. OF HEALTH
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SERVICES - FOR APPROVAL OF
CONSTR UCTION ONLY
T DATE-
{ N H.S.REF NO.tD
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SUFFOLK CO TAX MAP DEStGNATION:
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q•,fi; 1000 OTO 010 59
l a=monutnerr+ OWNERS ADDRESS:
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a N�N � ` ElevaY,iorrs refer-fo tneorn sea level.
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/ No+e:Lof numbers shown refer do (LO+ f9) •+uuTHOxlzs)AE-e:Ano,oe Ac�Inon
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O S / RODERjl!5 K VAN TUYL,P.C. 5h
LICENSED LAND StJRlEYORS
GREENPORT NEW YORK
0 1780
SUFFOLK CO HEALTH DEPT APPROVAL n
H S NO
v0
STATEMENT OF INTENT
c'3 ( SUt2VcYE.7 F072 THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
j• ����L�L� CONFORM TO THE STANDARDS OF THE
a s AT
SUFFOLK CO DEPT OF HEALTH SERVICES
c1,`960 SCUTHOLO (S) APPLICANT
ho. \` �•O e \� ��'-Z�K CcJnJTY)NY SUFFOLK COUNTY DEPT OF HEALTH
1--�--• o\ "'o \� SERVICES - FOR APPROVAL OF
N CONSTRUCTION ONLY
DATE
Ji E N
H.S REF.NO (l' $O' 8 9
LAPPROVED
`rgJ tankL a m (!!B-/ SUFFOLK CO.TAX MAP DESIGNATION:
Scale : 50'=!" DIST. SECT. BLOCK PCL.
N ! s�sE (hoJse�
�� Area=24,750= f lOQO OTO 010 59
�[\`( monurri-errf OWNERS ADDRESS
out t I
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ElevmHores refer 4o mean sea level.
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p j j/ PrerfiJt; ors in F/ooh-Zo�re 4-4 (eICv.6� DEED.L.698$ P.l88
1;
u} TEST HOLE STAMP
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Nate'Lof numbers shown r-!o (Lof 19 TO THIS SURVEY IS A VIO"AT C,0,
� yp.p
�e 1E /- SECTION 7209 OF THE NEW YON STATE
`T-> /' "Moi o f SocrffTVvcwf'fried Jn Sr otic EDUCATION LAW
(erL's o�7"- ce as M, lW 21-41 hl c Trus 6„ COPIES OF THIS SURVET MAR NOT L[.-
A C6LNTY HEALTH DnPARTWLNT ME"ANOSU[VEYORSIMEOSEAL OR
_ E, A V. p EwouED SUL STEAL Nor a CO.e:lgeEo
Ng�e w M „� �� /�\ l}�'
DATS. C �9O? -- / SD IO Y A VALID TRUE C09T.
` '• y GUARANTEES INDICATED HEREON SHALL RON
loam ONLY TO ME 9ERSON FOR WHOM THE We"
-- r , IS 9RE9ARED,AND ON HIS EINAI7 TO THE
�� �� O•• 'f T::s 5,.. - - c-„nbesr, TEwcwO Hlsrrur O RNME u AGEKVf A'
g __ '_ TO ME A,,,Q ES OF ME(ENDING WE.
Inez; ')� . ,-_. •-d _'ound MTION.GUARANTEES ANOT iRwEW[A
p/cw'9 h
to Z3 __ _ac G - ,.. OR culLN
i 3� 'O ADDITIONAL RE w7Tmnin
/ Chief cf ^^e^^1 E7gineerin6 SEAL
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S !_ RODERICK VAN TUYL,P.C.
wa-her, Sjz
LICENSED LAND SUR46EYORS
1 /
GREENPORT NEW YORK
IY017ED