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HomeMy WebLinkAbout22943-z t FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24574 Date August 15, 1996 THIS CERTIFIES that the building alteration Location of Property 270 Rabbit Lane, East Marion House No. Street Hamlet County Tax Map No. 1000 Section 31 Block 18 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 22, 1995 pursuant to which Building Permit No. 22943—Z dated August 13, 1996 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 replace & repair existing cedar piers of existing one family seasonal dwelling as applied for. The certificate is issued to George W. Koch Jr. (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uilAding Inspector 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........... ............... ........ .. ... SIR 22943 Z Permission is hereby granted . ... .......................... .. / ,... .71..... �i... ...... ......W... o47.. 4 7 .. ........ ...G�...�?.. ..................... ............................ ....... ......... ..,............................................. at premises located at......... C.. ........ ........ .. ...... ........... � ........................ ....................... ..................... ........... ..... `` County Tax Map No. 1000 Section ........ /...... Block........./..F...... Lot No. ....(:.................... ............ .,/....... ., 2 , pursuant to application dated . ... .. .�..�.� 19... 4..... and approved by the� P Building Inspector. Fee$.../. ............ � ® r .. .... .................................... ................ .. Building Inspector Rev. 6/30/80 dd � Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR-CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector 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. 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 - .251,1 . 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15I.00, Commercial $15.00 Date . . . . /�dot . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . Location of Property. .2.70. . . . . . . . . . . . .�Ao3•/T A0,44. . . . . . . . . . . . . . .e�: : , ?_a"o?;✓. . i�.°.w/.•. . . House No. f' / (Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . -33 . . . . . . .Block. . . . . A 9 . . . . . . .Lot. . .11... . . . . . . . . . . . . . . . . . Subdivision. . . .11.��. . . . . . . . . . . . . . . . . . . . . . . . . . .{{. . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.9.49'T . . . . .Date Of Permit. .5�. fj�l./Q.,�. . . . . .Applicant. .041we. . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . X:R . . . . . . . . . . . . . . .Underwriters Approval. . . . . ��':. . . . . . . . . . . . . . . Planning Board Approval. . . . .l�. .�.. . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .�. . . Fee Submitted: $. ??'.Sx>:'. . . . . . . . . . . . . . . . . . . . . r2C , S7 7 Sr7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CD f�_2�o �� PLICANT 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS CATION [ � FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: 4fd2 L DATE INSPECTOR /� FIELD 'INSPECTION REPORT DATE COMMENTS �J NIZs t2i H FOUNDATION ( 1ST) --�I N' FOUNDATION (2ND) I� ____==___________ ROUGH FRAME 6 PLUMBING I INSULATION PER N. Y. H STATE ENERGY \ -- II CODE 77 I —II —II FINAL I ADDITIONAL COMMENTS: `a ---------------------------------------- ------------------------------------------------- r�\ x v _ t7 ro H New York State Department of Environmental Conservation Buildi%%TRyNX, 7" prop�4N6 6Y5Ork 11790=2356 Facsimile (516) 444-0373 lemma Mr- (-V.o;- �. UL) . ke(:.,)I �� �'• /�e.cc !c�J1 y9 Y e h v c, Thomas C. Jorling �S,) q t it e I c0, 11 q 71 Date: /7 0 11 ,3, / 9 y Commissioner Re: I-((1'.3v - 0 <) 9Y61dov d ,a�yr Dear ' l r k,,c--� J Based on the information you have submi-tted, the New York . State Department of Environmental Conservation has determined that: /k!- C'a oQ C O 1-7 S C r(1 c � e et J Trial f-L.a�.L�lI /�i' a � I��c� ��� �a —. �f dczz ec� cal q I (-J.e a /-? ds. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i. e. a 15f to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, �� `wavl�evWi cc: 1 NI lip Deputy Regional Permit Administrator Wpanted on recycled pager Ta C eY'iB- 1 I i 7r 70Y. •-- - ._._._. ..,. 4C.f .D�-i;%--- --�t��L..._ _./�•.r./__1jati�'_S..•_/�t.._-�-d,�....---=�"`-�'--.�...,-:�..J6.�._-.._iz.3�,D._._.:_.t��k_____:1�-T���__./__Q.___ ; . _ ..L�.')T:c.�'J ._to3-oV oi>�E-.qw-.!_.�-1.�.atr..lG•- ..,�?d,:.Fl,'D�..._..�. .. -"_I_ ...� .' °?.p,._.../.�-�e.s.�_�/�.=. ..E.`.l�/,"SY'f�4�.-_.. I __.._.,,.._-__.___,.__, _., _._____.._ ,.......----_--------- ------ I � wa:c is I � 7 -- ------- .._._._ a -� ..-_._... _._ ... • � i . I ' I - 1 u i I � : /�,c�c C - .7 ��r_F✓..._...-��-�--- C-�ia---._.�....tls_7.5--._L�?.�-ram_ r. r.•!s/� «.. .�a�.w..1�6�.?.- c l�,dvE r.=.._...._ .__._._.._ ..... O.uT',�':o 1+�f1.1.Er5._:�_._O-f:_.c_�.._G���c��:•�__._�_� p!_A6iiJ_�—..__.�.0.,.-._.. -._.?./.`�-�� - /.r^(7r.'.�._l/uG.�d.!R._:�~ j7.��. ✓G,.._. _ _-._ ......__....1.D_-.%aa.TS..R__....____��-�,t�.F- �r".�,!'✓..��_s2......_L„`z_-...��-a'_-c���S_._...____,.._..-._.__—.--•---.•-----_.__..__._..._.._ . .. Fir BOARD ' OF HEALTH . . . . . . . . ;��7 , FORM NO. 3 SETS OF PLANS f TOWN SURVEY _ _ . . . . . . . . . . � 2'� j;�,, , 0 N OF SOUTHOLD • • • • - . . Bl'1LDING DEPARTMENT CHECK . : . . . . _ . _ . . . . . . . . DLDG.i3EPT. TOWN HALL SEPTIC FORK _ . _ . . . . . . • . . TOWN OASOUTIrLQ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N aT I FyExai�iined . �� 19 CALL . . . . . . . . . : . . . . . . . (� rL MAIL TO Approved � , 19=l. • Permit No . . . . . . . . . . . . . . . . . . Disapproved,a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ._ . . . . . . . . . . . (Building Inspector) LICATION FOR BUILDING PERMIT / q Date .,3 /�Z. . . . . . . . . .. 19 n INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street or areas, and giving a detailed description of layout of property must be drawn on the'diagram which is part of this appL 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 permi 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 Occupanc-shall Have been granted t y the Building Inspector. . APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th. Building.Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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 housi g code and regulations, and tc admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) , . • • • . • • • . (Mailing address of applicant)- .uTiJ oz.a A/7,J. State; whether applicant is owner; lessee, 'agent, architect, engineer; general contractor, electrician, plumber or builder. Narne of1owrier'-fp"" -' s.`' j/e�2G. • . l✓- .�{aG . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If-applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . Plumber's License No. . . . . . . . . : . . . Electrician's License No. • . • . , , Other Trade's License No. 1. Location of land on which proposed work will be done. . . . . . . 9,7 House Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C.o"�. . . . . . . . . . . . . Street Hamlet County Tax M-ap.,.No. I OQO,Section . . . : . . . . . . . . . . . Block Lot . . . . . . . . . . . . . . . . . Subdivision • .). . . . • Filed Map'No. Lot .(Name . ... . . . .. . . . . . . . . 2.. State existing use and,occupancy of premises and intended use and occupancy of proposed construction: a. .Existinguse d occupancy :S�C se an p y . . ✓G,u� lL44e./.,--�. . . . i=N�o�✓ <—• . �c e,y!a!,�✓� .. . . . . . . . . . . . . . . . . . b. Intended use a occupancy nd occu : . �i�✓G,c.��, . �ahoic•�: . .•.�r£9���!�?-L . . . . . . . . . . . •3. Nature of work (check which applicable): New Building : . . . . . . . : Addition . . . . . . . . . . Alteration Repair X . . . . . . . . . . . Removal 2lEA�l�cls . . � . . . . . Demolition Other V kY bp . . - Ciz-bA/L 7os•T Ur�ID�� 2(Li.� eJ(.1 (Description) 4. Estimated Cost : .f�. �, ?"� f2ft�Sy t 1 � �,0od . . Fee_ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(to be paid on filing this application) S. If dwelling, number of dwelling units". .. . . . . . . . . . . . Number o dwelling units on each floor.. . . . --, , , , , , , , , If garage,number of cars — 6. If business, commercial or mixed occupancy;specify nature and extcnt of-each type of use , 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear .. Depth . j. . Height . . . , f.?.. . , , , , , Number of Stories . . . . c2. . . . . . Dimensions occfI�same structure with alterations or additions: Front , , . , , , , , , Rear . :?R . • � . Depth . . :.T.�. . Height . . . ./�.`. . . . . , , , , , , ; , : Number of Stories . . . . F. 8. Dimensions of entire new construction: Front . . . ; Rear . Depth. .�: � . . .Height . . . : . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front .7.s. . . . .'. . . .: . Rear. . .: ; . . . . . . ... . . . . . . . .Depth. , ./% . ..... . . . . . . . . . 10. Date of Purchase — w�,-, .l,y 9 . . , , . Name of Former Owner y �i�o, �* 11. Zone or use district in which premises are•situated . 12. Does proposed construction viilate any zoning law, ordinance or regulation: �. 13. Will lot be regraded iv a . Will excess fill be removed from premises: • . . .Yes . . o 14. Name of Owner of premises o,�G� . }�(. j4?SA. Address s: rZ���+�. S©�rr�q�phone No.��n S Name of Architect . . . . . . . . . . . . . . . . . . . . : . Address . . . . . . . . . . Phone No. . . . Name of Contractor . Address . . Phone No. . . . . . . . 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` from property lines. Give street and block number or description according to deed, and show street names and indicate whether �interf-o Or c0-rgef,1bf� 91 UNDERWRITERS CERTIFICATE ;�°r t 07� y i = 1 i Aye t& �; REQUIRED 2e_� �; F! �jfa tat j E� U ,> F �.�. � n APPRO E"S NOTEDa n` DATE: J y FEE. BY: NOTIFY BUILDING DEP AT +�. 765-1802 9 AM TO 4 PM FOR THE lr,_�r-+v FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE Y t 00 R� 2. ROUGH - FRAMING & PLi1MBING.. 43l.-&INSDI AT1ON --I q.,�t 4. FINAL -' CONSTRUCTION MUST r Q A. 49, ;§MPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET k THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE .FOR DESIGN OR CONSTRUCTION ERRORS ON LEAD C -N 7VVT N BEFORE I CER71FICATF OF OCCU ANCY fi75 i �aa�� ; ,LA��� D 11V AT STATE OF NEW YORK, SOLDER USE �'� COUNTY F . . . Af S.S PPI-Y S Y-S TEM CANIVOT . . . . . . . . . . . . '. . . . . . . . . . . being duly sworn, depC�an� ys�t apt 4s't4f (Name of individual signing contract) tnt above named. 'VUa-\6 I E '-ie is the . ... . . . . . . . . . . . . ./.T&:q 9 . . . . . . . . &WATER LINES NEED •TES?TING•SEFORE COUER100. . . . . . . . . . . Contractor, agent, corporate officer, etc.) )f 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.�l noowledge apo belief;an that the •vork will performed erformed in the manner set forth in the application filed therewith. t C ppell''tubing IS U iworn to before me this for Water distributing syStal m; piping shall be nr(. . . . . . . . . . .day of. '­.�. . . .. .� . . . .. . ., 19 S of types K or Leanly lotary Public, . . . . . County . . . . . . . �- . . • . . LINDAA COOPER (Signature of applicant) 'Notary Public,State of New York No.4822563,Suffolk County Term-Ettpires December31,18i..L<10 t ,. S.rJ t? l \fSa1 4 •1 t . J t , r y ,I'Jt I 1 1,.,1 �• t i Fr 9 r` - t J sir'1./' .'V! , r.�i17Q�f�' •f. vl t r• tJ '•') (' YES J' F 'kill+,Ip y. I. ' ''{ I 4 , t t t'r f I 1 y '` : !KAS j, i �t r t Isv., 1 f J. r r -O 1 t. t t r ?-.. 1 1 J. 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