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HomeMy WebLinkAbout22930-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. r CERTIFICATE OF OCCUPANCY No 2-23878 Date SEPTEMBER 18, 1995 THIS CERTIFIES that the building ADDITION 740 WOODCLIFF ROAD & Location of Property 2380 WESTVIEW DRIVE MATTITUCK NY House No. Street Hamlet County Tax Map No. 1000 Section 107 Block 8 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 1995 pursuant to which Building Permit No. 22930-Z dated JULY 21, 1995 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 A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BEVERLY BOEHLE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A �R l Building In pector 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) Date........................... ................................. 19./......... SIP 22930 Z Permission is hereby granted to: .. . :: �J P...................... ���. .. . .V .......................................... . ? . ., . ....... .,� ... .�............... to .. ...` ........ �,, , ,....... ' .. .. . . ~ . . ... . .......................... .. . ....... ... ..... .... .................................................................................................................................................................. .................................................................................. . ....................:.................. at premises located at....... ....... ......... ... _.................................... ...................... .............................. � 7tr ` ......................................,. ........... County Tax Map No. 1000 Section ....../,. ...,1., Block......... ........... Lot No. ..1.4.................. pursuant to application dated ...............e ........ 19...E �, and approved by the Building Inspector. Fee$.,(. .. ............. ........................... .... Building Inspecto Rev. 6/30/80 s T0I4N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802r:;; orb�.: .. .. ... APPLICATION-.FOR CERTIFICATE OF OCCUPANCY,,. .��� , A This application:must.be hilted in 'by.,.typewri'ter ORtink and sulimittad ta the building nn inspecLo.r:-withthe 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. 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 $25.00, Additions to dwelling $25.00, . Alterations 'to dwelling $25.00, Swimming pool $25.00, Accessory building $25..00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00. over 5 years - $10.00 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. . .. . . . . . . . . . . . . . . Location of Property. .,:3. . . . . . . . . . . . . . . . rO-P. . . . . . . . . . . . . . . . J l:. .;K. House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . .. Q;'z;;l„� . , , . , , , , , , . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . County. Tax Map No 1000, Section. . . A? . .. . . . .Block... . .?. . . . . . . . . . .Lot. . !/. . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . .. . . . . � q�l . . Permit No. . . .. . 9`�7�Date Of Permit. . . ��P./�.�. . . .Applicants.11Jv!?-.P�.��;''�: i,�,�j� FG2 O ce-)a1-er . . . . . . . Health Dept. Approval. . . . '. . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . .' Planning. Board Approval. . . . : Request for: Temporary' Certificate. . . . . . . . . . -inal C r at .J�.. . , . Fee. Submitted: $. . . . . , .. . . . . . . . . . . . . . . . i o \ AL jPP�'�L'ICAN is- T( } '/p/W/^Y(tJC// C// r 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE /G' / � INSPECTOR 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � �� DATE O �/ �y'-�INSPECTOI*!!/� 53, FIELPA INSi-tOCTION REPORT DATE COMMENTS ----------------- r•OUNDATTON ( IST) II — ll II FOUNDATION (2ND)------------------ II IF Xj — — C� �✓ — I ROUGH FRAME & tr u PLUMBING ��-- j`i( �I II II -------------------------1 ====____ _____----------________-----------------------'------________ �I II INSULATION PER N_ Y. H STATE ENERGY — CODE IIII —jj II ------------------------- dk====-------____------__-----------__-----------__------ ------------------------- -------- ------ n II H II jj FINAL --u u u ---- -_----ADDITIONAL-COMMENTS: 0 z a — H� "`'?�%�-�Y_'..�. "�,'•'s�';.-i;•�wi:�•�.`•'^-:�r=+�s:�:..:-- -+r:--'„_!iw Y.,.�-` ter.�.,J..o_�.T^••-. t-.� � `' `i'-•:j:� „�f s•' �'-, ._•� .L'__ -- -_ -.: -:..+...'.•_.:.Gam'--..y"'�-^"w�`''•"-�'_s:!.a!i.�,. ..•4..ntY �.•-_.._� ,�oq _�`r=•ram+oer:i •.....�._+,,..� __•._... _ •J?= ' ?% '.' -"a.' ^a`•"• mac- -- - _•`.�~ •s•� :Jt!>.- •�7F `� •.4`. ,f. - z -. i -y--`_ ;ry,^.-^ .'_' �_ +'a•f�� _ ► ��J.tiw '-.�1 •"--A�. - - •��_.��,;�.. t _ - _ •k:, r'e .�.^-�:l••. s.•i...-•t.'- v<a�� sty _�1r-.__.•a .. �,.+ �.`.t. .�� .��t =-i'..-. a%'S - •-'..t' '' `:-i � .�'r_ � '�ar� -"�A..���; _r..- ^.v:..ac-;.-R- l o-.�t!•...�,;�.. ai.�_� r-T � �..•:�.. •' _ _ ^ica--►- -_ tea•';'- -_ �:y«L•'s:�?�_�.x. � ::C,ri;..��+,�.-s_.._. -;+,•+,.�a.•'�'.- ? _ ..yc - - :-w-" - - "-�''-• -r�.. '�+`.-' - ,-' Mkt 'ice .ems' _ 7. mCf It— ow SW • •4r�` 4.6 art ILA cs. N• N. fl ._. . .SU,RVEYED=-_ Fait= MA r-r I T'U C K TOWN -OF SoiiTZv MY 5-771 4-0 _: ... .��OG NE �K CO 0 GLtatYatie'dt'=' n''S` a - _ LS a-� d,-S Cis ' t s� '= .� •� - - - - __--..c. _ ...:..... �nC��'t '� �.� ._ .. �....- _ _ter-..•+;_.y _ __ __ - - _ _ _ . To S)< s-c 1 N C- Fr"o oTi-N G- ` n u �` v'.. `�^ !' _ c r �. TYP1CA ADEC-",,- FRAN/) tQ ol— ._ -. - • _ t BOARD OF HEALTH � N yus G' 1� �5 FORM 3 SETSPLANS l . . . . . . . . ` - TOWN OF SOUTHOLD SURVEY _ . .�J 1� .- '4 C_ f! BUILDING DEPARTMENT CiiGCh . . . . . . . . . . . l;h . TOWN HALL SEPTIC FORhi . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 ET. 9 TEL.. 765 1802 NOTI FY %1 ; J " _��c?r��I �tLt l� CALL . ��� = ��. . . . . . . . . E,Gnincd . ./ ,�al9 , , hiAIL T0 : Approved . .0 . . . . . �19 X • Permit No�� ram`. . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .?. . (Building Inspector) P LICATION FOR BUILDING PERMIT 11 _ Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. 'Such 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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 c'onstructioii' 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) State whether,,applicant ;is ownerlessee;,. agent, architect, engineer, general contractor, electrician, plumber or builder. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant�is'it°corpdii tion,!°signature'of duriy authorized officer. 9 1•��` (Name and title of corporate officer) Builder's License No. . . JCS . . . . • « • , . • • , . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . House Number Street Q Hamlet County Tax Map No. 1000 Section . . . . 1 P-7. . . . . . . . Block . . . . . .v. . . . . . . . . . Lot . . . . . . 1 . ... . . . . Subdivision . . : . . . . . . . . . . . � . . . . . . . . . . . . . Filed Map No. . . . . . Lot . . . . . . . . . . . (Name)$ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . 1� . l 3� {L . . �•l • • . . . . . . . . . . . ' . . . . . .. . . b• Intended use and occupancy . . •�-5l . Q-• .� W- /1 OC,�C , ; e•�„C�, . . . . 3: Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . .. . . . . . . . Alteration Repair . . . . . ... . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work �e —KL—+ �e(bes ptiR" 4. Estimated Cost . . . . . . . �p9.0:.Q p. . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . .,. . . ` (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . Number of dwelling units on each-floor . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . P. : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . ... . . . . . . . 6. If business, commercial or mixed occupancy, specify nature n�eexx_tte t of each type of use .. . . . . . . . . . . . ... . . . . . . . 7. Dimensions of existing structures, if any: Front . A.' X. . . . . . . . . I��r. . . . . . . . . . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front .E. .-R��Reea)( :"� . lam '•• - Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . Number of Stories . . . . . . . . . . . .om./ . .D t 8. Dimensions of entire new construction: Front f . . Rehr . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Height Numbler of Stories . . . . . b .y4�� ;.�.�. . . . . . . . . . . b 9. Size of lot: Front . . . .l2�' Rear . . . . : © . . . . . . . . . . Depth . . .•� . . . . . 10. Date of Purchase . . . .� .• . . .� �. .���- • - . . Name of Former Owner . �?.��. R-4 • �•® QkL 11. Zone or use district in which premises are situated.. . . . . . . ...P_. . . . . . . . . . • • • • • 12: Does proposed construction 00. ate any zoning law, ordinance or regulation: . . . . .�-.0 .•• • • • • • - 1:i. Will lot be regraded . . . . . . 0. . . . . . . . . . . . . Will excess ill a re Moved from premises' Yes No 14. Name of Owner of premises �?Z Bb.Q (e.. . . . . . . . Address. L .q. Phone No. . . . . . . :. . . . . . . . Name of Architect . . . . . . . Address . . . . . . . . Phone No. . . . Name of Contractor. . . .ANC: . . . . . . Address F:© ' •( O •:�bnP&on`j•-73 A` 74':e. . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . *If yes, Southold Town Trustees Permit. may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate'all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 0"TUPA, NCV V OR DATE:U E I UN LA Vv'� B. � L NOTIFY BUILDING .P MEN 765-1802 9 AM TO 4 R THE �J � ti j �a FOLLOWING INSPECWNS: 1. FOUNDATION • TWO VIEQUIRED COW P 5 F3 ny b � 2. RROOUGH POURED i FRAMING PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. , STATE CONSTR=014 t ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSIitUC110N ERRORS UNDERWRITERS CERTIFICATE FEQUIRED STATE OF NEW YORK, S.S CC YOF . . . . . . • SZ• . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . . . . . . . . . . . . . . . . . . . . . . . Co�rize . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ntractor, a nt, corporate officer, etc.) of said owner or owners, and is duly au o perform or have performed the said work and to make and file this application; that all statements contained 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, . . . . . . . . . . . . . ., 19 g r Notary Public, :,. ,/. . . . . . . . Cou. ty " JOYCE M-WILKINS• • • . . . . . . . . . . . . . . . . Notary Public,State of New York nature,ofapplicant) No.4952246,Suffolk Cou Term Expires June 12,19�� 1 .