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29537-Z
FORM Nb. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30286 Date: 07/02/06 THIS CERTIFIES that the building ACCESSORY Location of Property: 425 STILLWATER AVE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 1 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DUNE 30, 2003 pursuant to which Building Permit No. 29537-Z dated JULY 1, 2003 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 ACCESSORY GARAGE IN THE REQUIRED REAR AS APPLIED FOR. The certificate is issued to CHRISTA HILDEBRAND (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2008334 06/21/04 PLUMBERS CERTIFICATION DATED N/A C ti on ed Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30285 Date: 07/02/06 THIS CERTIFIES that the building ALTERATION Location of Property: 425 STILLWATER AVE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 1 Lot 10 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 2003 pursuant to which Building Permit No. 29537-Z dated JULY 1, 2003 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 PORCH ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHRISTA HILDEBRAND (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2008334 06/21/04 PLUMBERS CERTIFICATION DATED N/A c ,-".14 IsA&4( ///Alth ized Signature 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. 29537 Z Date JULY 1, 2003 Permission is hereby granted to : CHRISTA HILDEBRAND 425 STILLWATER AVE CUTCHOGUE,NY 11935 for PORCH ALTERATIONS TO AN EXISTING DWELLING AND CONSTRUCTION OF AN ACCY GARAGE IN THE REQUIRED REAR AS APPLIED FOR. TWO COS REQUIRED SIMULTANIOUSL at premises located at 425 STILLWATER AVE CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0001 Lot No. 010 pursuant to application dated JUNE 30, 2003 and approved by the Building Inspector to expire on JANUARY 1, 20 Fee $ 225 . 00 utho ' zed Sig ure i ORIGINAL Rev. 5/8/02 Form No.6 L TOWN OF SOUTHOLD BUILDING DEPARTMENT !1!I1 200PITOWN HALL 765-1802 TcAP�IiICATION'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. 1 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- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. /60 New Construction: Old or Pre-existing Building: (chec one) Location of Property: / c l l . C`. House No. treet H et Owner or Owners of Property: 6 �5�, /1 Suffolk County Tax Map No 1000, Section Block Lot el O Subdivision Filed Map. Lot: Permit No. Date of Permit. 7 / Applicant._ ' Health Dept.Approval: Underwriters Approval: Q �f 3 Planning Board Approval: F Request for: Temporary Certificate Final Certificate: I/ (check one) Fee Submitted: $ O A�plicant Signature 5 BY THIS CERTIFICATE OF COMPLIANCE. THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET NEW YORK, NY 10038 c� SCERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 5 GLENS ELECTRIC OF L.I. INC JEFF ABRAMS C P.O. BOX 1304 425 STILLWATER AVE c5 5 JAMESPORT, NY 11947, CUTCHOGUE, NY 11935 c S 5 5 Located at 425 STILLWATER AVE CUTCHOGUE, NY 11935 S 5 5 Application Number: 2008334 Certificate Number: 2008334 PP 5 5 nsl1 Section: Block: Lot: Building Permit: BDC: S 5 5 5 Described as a occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 jFirst Floor,Detached Garage,Outside, c5 5 5 le system, limited to electrical devices and wiring to the extent detailed 5 A visual inspection of the premises electrical y g 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the 21s©ay of June,2004. 5 5 Name QTY Rate Rating Circuit Type 5 Wiring and Devices 5 Cj Outlet 1 0 50 amp Special/twist lock 5 5 Fixture 4 0 Incandescent 5 5 Outlet 4 0 General Purpose 5 5 Receptacle 1 0 General Purpose 5 Switch • 4 0 General Purpose S5 5 Receptacle 1 0 GFCI C5� Receptacle 0 0 5 S 5 5 5 5 5 5 S 5 5 5 S seal 5 5 5 l of 1 cS SThis certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. c 5 o �Lmpn����������������������������������������������������������� o TOWN OF SOUTHOLDPOOPERTY RECORD CAR® OWNER STREET ;�' el _� VILLAGE DISTRICT SUB. LOT a 7 Lt�, v C L)e. FORMER OWNER K'aelt`n N -� E' f 'ACREAGE C) ,Y L id'ry � (u 5 T. Y o/mac a n--5(A v ft1 ci2 ! r) * Kne-C' n S W , TYPE OF BUILDING RES. SEAS. VL. FARM comm. I IND. CB. i MISC. LAND IMP. TOTAL DATE REMARKS 17-31,2 V D s � v�jF f �cl,r e � �°d L+P a^'�C cY•!d /�,d.:L �� � r i/ 3Z 7,f .D, 7� -�� S K5 e S 7.S Zg- L I (OO V DS^ ec, -r /o Ir r Ie- /0 e1/ / Z1 0 o 3 5 0 �1 9'e�0 _:I s. 9 1 �- i� rn� a ir-, 11C . � �t'� ABOVE t Farm Acre Value Per Acre Value D � a6 Tillable 1 zz, .b6' Tillable 2 Tillable. 3 f i ryi /� d �' u`� Woodland Swampland " Brushland House Plot Total j 71 jL 10 ■i■ill■■■■■t■■SrJ■I■I■■ C[00 _. _ _. _ . ■■■�11i■��iii�ii�i--Rum inn 7i- i■■s'i�fr►`I■■ - . _r-°.�-_.. ■■■■■■■■■■■■fib Bldg. 77 - � .. :. 1 xtensionExtension Basement Floors- - , Exte Fire Place -. ypsio 742 Porch Attic ® Porch Roo Floor Garage Driveway ' ? r .• • f �. �r M. Bldg. au Foundation G Both n Extension ,l y �' 6 Basement FLY/l Floors Gv,� Extension k v,(� Ext. Walls Interior FinishS$ Fire Place Heart C X Cl Porch ? Attic S-0 L/X d Porch �.. Rooms 1st Floor Breezeway Patio .`% Rooms,2nd Floor Garage Driveway f✓ ate/�sscss VAIvL �/ice- S.rCf�✓.'/�'�V/3�(��Z —,�.200 • P 1 Pr TOWN OF SOUTHOLD MkOPERTY RECORD CAR® OWNER STREET "I —) }" VILLAGE DISTRICT SUB. LOT �-1'11W a 71tO Ve C q ve- FORMER OWNER S + Qaejt`r1 N E-'- 'f ( ACREAGE arm . : vyn,e- 4 r''rv' os -Talslep laaln'f ( 14 V i do.975 Cis- '�n W4 1<o,e- S W, l �t Mtn TYPE OF BUILDING RES. SEAS. VL. FARM comm. IND. I CB. 1 MISC. LAND IMP. TOTAL DATE REMARKS -26 ® 6��--die C`a LPN7rd 7� /1 V/;� �;wo" 13 Q� � O ;`C' it r�;�• .-,r,: :�; 9 2' 049 / �° ��- �1C7�QQ 5(7Jc' c Y Yl@s / y d o 3"5 o 9 � I.. 3" 9 ?— rn� �� l r ABOVE - ` r Farm Acre Value Per Acre Value lAglo 0 ` %/V S GC>��"evi� ov 67 Tillable 1 Tillable 2 Tillable, 3 i+ ;i .• :r Woodland / Swampland Brushland 1. House PlotM Total 1BUILDING PERMIT EXAMINER CHECKLIST DATE REVIEWED: 7 /_,�J03 APPLICANT: Cwlt�5 �. c p ,� DATE SUBMITTED: 6' 1moo /03 SCTM#DISTRICT: 1,000, SECTION: /Q� ,BLOCK: / , LOT: /c7 SUBDIVISION: DE34. ADDRESS: �/ s S�:�I �� 4o, CITY: ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE C : Y OR N BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED Y0 NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time aftei 7/1/82 REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV.,,;,� l* ACT. LOT COV. REQ. FRONT PROP. FRONT REQ SIDE S_'I a�ACT. SIDE REQ. REAR_ 'SU DROP. RE REQ. HEIGHT PROP. HEIGHT a� �D uorl 01 PROJECTESCRIPTION: 4 �P� bav( D_ Qi ESTIMATED PROJECT COST. ARCHITEC _ WATER FRONT? �s/ ;�, D SCR PTION: PANEL # FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D T: YES NO BED #): DTE: / / PERMIT#: TOWN SEPTIC RECEIPT: Y r NEW YORK STATE DEC: PRE- C 9/1/7s YES DTE: _/_/ PERMIT#: SOUTHOLD TOWN TRUSTEES: YES NO DTE _/ / PERMIT#: TOWN ZONING BOARD APPROVAL: YES o O DTE: PERMIT#: TOWN PLAN. BOARD APPROVAL: YES o DTE__/ / PERMIT#: TOWN HISTORICAL PRE (SPLIA):' YES o NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): Y r NO NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: .2 6 SF PIO&Cry OTHER: SF a ' INIT OTHER TOTAL TOTAL: SF FEE FEE FEE I. - SF)- NSF)= SF X $"— =$ +$ +$ . =$ 2. SF)- ( '�' SF)= ®� SF X$ ® _$ �. +$ +$ �= $ 3. ( SF)- (SF)= SF X $ =$ +$ FINAL TOTA!L''N�_X SO NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Wind Speed: 120MPH Seismic Design Category:B Weathering: Severe Frost Depth:36" Termite:M-H Decay: S-M Design Temp: 11 Ice Shield Underlay:YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: m DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y/N hEADERS: Y/N WALL STUDS:Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS:Y/N ROOF RAFTERS:Y/N LUMBER SPECIES AND GRADE:Y/N DESIGN LOAD CALCULATIONS: Y/N LIVE:Y/N DEAD:Y/N SNOW:Y/N SEISMIC:Y/N WIND:Y/N WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) ��5 C a L�����MPL�MpL���L������LPL�����L�L���LPr������JPL��@ IE MPLLPC�����LPLPLPLPL�J co 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 S 5 5 BUREAU OF ELECTRICITY S 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 5 SUpon the application of upon premises owned by 5 C5 5 GLEN'S ELECTRIC OF L.I. INC JEFF ABRAMSP.O. BOX 1304 425 c5 5 ER AVE AMESPORT, NY 11947, CUTCHO UET Y 11 35 5 5 5 5 Located at 425 STILLWATER AVE CUTCHOGUE, NY 11935 5 5 5 SApplication Number: 2008334 Certificate Number: 2008334 5 5 5 Section: Block: - Lot: Building Permit: BDC: 5 ,- ns11 Described as a occupancy, wherein the premises electrical system consisting of Cj 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 5 First Floor,Detached Garage,Outside, 5 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 21 st June,2004. 5 Name OTY Rate Rating Circuit Type 5 5 Wiring and Devices C 5 Outlet 1 0 50 amp Special/twist lock 5 SFixture 4 0 Incandescent 5 5 Outlet 4 0 General Purpose 5 5 Receptacle 1 0 General_Purpose 5 5 Switch 4 0 General Purpose 5 5 Receptacle 1 0 GFCI 5 SReceptacle 0 0 5 5 5 S 5 5 5 5 seal 5 5 5 1 of 1 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 o I ��E�MLP�������UpLr&H 'fl ��QP�LPL�LPLPEP� o ,65.1802 BUILDING DEFT. ,INSPECTION IV, FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE !E CHIMNEY REMARKS: C DATE � a 1 �3 INSPECTOR ass.,$02 BUILDING DEFT. INSPECTION [ ] FOUNDATION 7ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE � INSPECTOR L y FIELD-INSPECTION REPORT D TE CONBmffS FOUNDATION(1ST) . FOUNDATION(ZND) S ROUGH FRAMING& PLUMBING INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDITIONAL COMMENTS • r O Cam- z. m 1 o . z W 2. State existitg use and occupancy of premisgs and intended uV and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy / 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cos 20 000 Fee (To be paid on filing this application) 5. If in , number of dwelling units Number of dwelling units on each floor If garage, mber of cars Z, 6. usiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories P � Z � Dimensions of entire new construction: Front q G Rear Height 6Number of Stories 2 Depth Z C9./ Size of lot: Front l5 Rear / �-• 4-6 Depth CO- Date of Purchase ,L? eU Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES V NO 14.Names of Owner of remises Address¢72< j/:U P hone No. :� 2-1425 Name of Architect idress,Phone No Name of Contractor address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. 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) SS: COUNTY OF_� CEbeing duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor,Agent, 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 0 day of 20_0 3 Not Public Si ture of Applicant UNDA J.COOPER Notary P61AW,State of New York No.4822563,Smffolk County.E8QQ 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 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 �q,5�� � Survey www. nGrthfork.net/Southold/ PERMIT NO. f Check Septic Form N.Y.S.D.E.C. Examined 20 3 Trustees Contact: Approved 21, 1 20_ Mail to: Disapproved a/c Phone: Expiration ( 20 B Inspector L SUN 3 ZQQQ .,J PPLICATION FOR BUILDING PERMIT Date , 20 T y-IN 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 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 be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing,,the extension of tke permit for an addition six months. Thereafter, a new permit shall be required. 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. (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 Name of owner of premises � . (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ��j Plumbers License No. Electricians License No. Other Trade's License No. 1. Loc tion o land on which-proposed work will be done: House Number Street Hamlet 3 County Tax Map No 1000 Section Block Subdi�nsion / Lot Filed.Map; Lot t .. .,Mi,.�': .:uya+. :'•p Y�Ery 1�x ,1 to ,1'1 4.3 - --- - .-__-.Y�• `Vim. _It�.�-�.._- � f t•e'.•_ - _:C a so fc C' 3rgp � FF Cs W. 1 1 71 ! ;• J. _ .��wR¢1'e¢ r 4e� L )iii f ,ill "x t� S v ii _� ,�tv '`� T ,.t♦1 it J. -wil- 'k.' .G'•.i� i,lF�6�. vaS,.r.'�-...:'1�jf �� ./ _.i' , - .. .. 15. • 1 `.. - : .. _ i.•�1• -,�f�jy-��p_ ..tom-`�'ek✓cs'. t N.�•'" G MA y . V i ,' - - .. �. :. �•�:,-. .-'�`,'..;FJ �-.':,+,HIg Wit.. - cr - , In vz� . .—.,; ,,.. i , i l , ----...------ .. �- -::. . . '' 4'-ii:.,�'-.�- . .. .I... .. . . . % - LASE t� Cam-J - ' .. fit 4CF5T F.; I �� s r -- .. (?I ( + f'w_' i r'� i- `I rs �' . , ,. " -- . c�1 _ .— M__ Y.•. r ti I 1 • 1 _ . .. - ._ :. :. 3w W. � - y . r {`•1' v .� ' - ' - 1 - Z� i a `• — c ; '' - — — I c ti �' 1. I - ; . . ; .. - , - -- - ", - - :. z .'-I . . . t - -- - -- --- - - i 7' �j t ;ice." c� r} '`�( �f' `,�' • . f ,� YIW. .�-�J + :f -rii r ( lS .c - ,ELAC t._ _. :4: r, ,,. r�. I. - - - - _ t_ r{ w r • . _._ Tom. A�„ T ;, ._. . J _ r, ` n.. i� - ...._ A oi . ,' . . . . . :; i r 07 4 x - ,I�.1 t.7�....�bit•`,!1 - :i' t.�A r: .,..0 1 .. ......J ... ll''.. _ . ./� - _ .. ,/ _ - . . .. .. : - - - •.- .. --.� .. .. - .. , - , G�. ,ri-,-.. ., - . . .. .. . J(. 4 fir..' «4..-.. `- -"i•-'� _p.. 1.� _-. ._ ._. I•}". _- � � ' - -- — ---' '_- n `�-:� :- .. --� �.'' .- _. __ : ' "• 1` a + --- ..•_._, Q i s _7 f� ti.L y l l %�` ;— - ,` : •ram: �, 'll 1 1 pAR 'L .. .- _ ...-"ter-- __- ��•.`_ g,�7.�• �. �,,�y.''�``9r � y r � � _ .. - .. X6W _ _ _ �—_— .. '- -S•c��1�`-r j� ,ter; •,.. a `fig y � _ /, 1 - y' 'N� !2'-bF$2.GGT d(y ./r - yy�� •�L• AO— N. 4 ' f�-t•.•'I'r`tT^'J F�t^fl?3"a!.'r•aB.°W+;� � `� � u =.- 4 _ _ .� — - .. •+-_`r _r ,;`'•rf,- - Ca?-iM G:`Lc`lt.'•OCRRTY�' .r'mem, ry_ - �•`'i _l; .jr'`.'� i`''.. r- - .- .. reed ru..r-Y 3t r tM tz':eta :a 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 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 `���7 Survey www. no,rthfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Z Trustees Examined '20 / Contact: Approved ) ,20� Mail to: `i Disapproved a/c Phone: Expiration l 20 J B Inspector JUN 3 0 2003 PPLICATION FOR BUILDING PERMIT � ��f;t�ii�Lo Date , 20 Tour►�� " 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 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 be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector 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 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. (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 Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. �/ a Plumbers License No. Electricians License No. Other Trade's License No. i 1. Loc,tion o ,land on which roposed work will be done: House Number Street Hamlet County Tax Map No. 1:000 Section tl Block / Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises d intep-ed,,fie and occupancy of proposed construction: a. Existing use and occupancy _o b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration (/ Repair Re oval Demolition Other Work (Description) 4. Estimated Cost p-p 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Nurqber of Stori s Dimensions of s,, ne t uclure wA alterations or`addilions: Front g Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories .9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Fonner Owner 11. Zone or use district in which premises are situated _Q 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO 'Will excess fill be removed from premises? YES NO 14.Names of Owner of premises 1_111,06]6k4IUD Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO t/ * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. 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) SS: COUNTY OF ) ` F /,1- 13,Q 1-N 5 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, 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 Q day of 20 d"'O'J/P /TTotary Public Si " iure of Applicant LINDA J., OOOPER rotary ftblie,State of New York Igo.4t;2256563,5uffcllR C;oun Term Expires Dece;n5er I, 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 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www.northfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 120 Mail to: Disapproved a/c Phone: Expiration ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date 520 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 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 be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property.have been enacted in the interim,the Building Inspector 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 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. (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 Name of owner of premises � / (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 0 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location f land on which -Proposed work ill ,e doge: House Number Street Hamlet County Tax Map No. 1000 Section 103 Block Lot /(� Subdivision Filed Map No. Lot' (Name) r• 2. State existing use and occupancy of preml=and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4.. Estimated Cos/2 Q P 600 Fee (To be paid on filing this application) 5Clfgarage, in , number of dwelling units Number of dwelling units on each floor mber of cars6iness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories (8� Dimensions of entire new construction: Front G Rear 2 Depth Z Height �/ Number of Stories C9./ Size of lot: Front Rear / -7• ¢'6 Depth; C . Date of Purchase �..P� w Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES V NO 14. Names of Owner of remises/ Fif ��Addressl Zs.sT C L�fl4/ hone No. Name of Architect dress Phone No Name of Contractor I Nadress Phone No. / 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO v * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. 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) SS: COUNTY OF ) ,.� PFF AD M N 5 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent, 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 C7 day of 20 0 3 N�c ,c�� a Public Sigifture of Applicant LlhIDAJ.CC)C)PER Notts Public,State of New Vbrk No.4222563,Suffolk Ceunty, Q� Term Ea^ lms�o�Yaber 31,.���0 r ALL CONSTRUCTION SHALL EET THE REQUIREMENTS OF THE z z CODES OF NEW YORK STATE. a APPROVED AS NOTED e DATE: B.P. # r r ' ) FEE: B z cov NOTIFY BUILDING DEPARTMENT AT DO NOT ^°(`CEED WITH z RIDGE VENT w 765-1802 8 AM TO 4 P'M ::-0R THE FRAMIN t',TIL SURVEY - - - - - - - T - fn - — - — - - — — � FOLLOWING INSPECTIOINS: OF FOUN'`.��' IJN LOCATION 12 ASPHALT ROOF 1. FOUNDATION • TWO REQUIRED HAS BEEN APPROVED. SILL GASKET x 15# FELT UNDERLAYM�tTPOURED CONCIRETE & Z RID 2" CDX SHEATHN(ROUGH = FRAMING !& PLUMBING 0 � 2x4 HANG 3. INSULATION ., � TERMITE SHIELD � W @16' OC 4. FINAL . CONSTRUdflION MUST 2x10 C J@16" OC, I BE COMPLETE FOR C.O. DBL. SILL PLATES - W z W >- ALL CONSTRUCTION SHALL MEET TI(�l£0 OVERLAP JOINTS) - IY W > Z REQUIREMENTS OF THEE CODES OF NEW W C) LLj YORK STATE. NOT RE:SPONSIBLE FOR fY - - ° DESIGN OR CONSTRUICTION ERRORS. FOOTING 0 - C� Elf Q O CEDAR SIDING ° _ 15# FELT � co 1/�pg I j Tj�IAIV_L CODES OF 0 Q 21 I A E & TOWN C l" PLATES TO FOUNDATION ANC HORING = 00 c~n C)TYPICAL GARAGE FLOOR AS REQ IRED AND CONDITIO"�� i Q Q 4" CONCRETE SLAB c/w cp!_F'r"�1p A L6A FIBRE MESH REINFORCEMENT (2 2 T T ILL I �, �{ TOWN PLANNING BOARD p — 6 mil POLY VAPOR BARRIER o _ lo OMPACTED GRANULAR FILL SIL S SOUTH(OLD TOWN TRUSTEES ANCHOR BOLT CONNECTION C MONOLITHIC CONCRETE FOOTING ;ova N.Y.S.DEC ANCHOR BOLT CONNECTION FOUNDATION 5l8"DIA.ANCHOR BOLT o SUPPORTING MAXIMUM SPACING co 1- — 12" BELOW GRADE °'`' Y � (2) #4 REB AR SILL PLATE TO FOUNDATION 1 STORY 72"OC ao CRAWL SPACE OR FOOUNDATION CROSS SEC TI O N SILL PLATE TO FOUNDATION N 2 STORIES 36"OC r CRAWL SPACE OR FOUNDATIONQ r co)M CO OCCUPANCY OR WALL BOTTOM PLATE TO FOUNDATION 1-2 STORIES 57"OC XQ (SLAB-ON-GRADE WITH 3x3 SQUARE WASHERS LL USE IS UNLAWFUL USE(USP LB PS58 OR B P583) o WITHOUT CERTIFICATE 0 >- m OF OCCUPANCY Z co 0 cV FLOOD ZONE I I • COMPLY WITH CHAP EER"46" FLOdb DAMAGE PREWENTION ; SOUTHOLD TOWN CODDE. I I CERTIFICATION OF: NAILING & CONNECTIONS REQUIRED. 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