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Home My WebLink About37221-Z r Town of Southold Annex 6/5/2012 SUFFO(,�C P.O.Box 1179 54375 Main Road co oy Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35734 Date: 6/5/2012 THIS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 565 Stillwater Ave, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 103.4-11 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 5/11/2012 pursuant to which Building Permit No. 37221 dated 5/17/2012 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: handicap ramp for an existing one family dwelling as applied for. The certificate is issued to John&Dorothy Behr (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED A o ' ed 'gnature TOWN OF SOUTHOLD for' BUILDING DEPARTMENT y TOWN CLERK'S OFFICE oy • � , SOUTHOLD, NY ?!pl a4 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#: 37221 Date: 5/17/2012 Permission is hereby granted to: Behr, John & Behr, Dorothy 3 Lewis Rd PO BOX 1025 East Quogue, NY 11942 To: construct a Handicap Ramp at an existing single family dwelling as applied for At premises located at: 565 Stillwater Ave, Cutchogue SCTM # 473889 Sec/Block/Lot# 103.-1-11 Pursuant to application dated 5/11/2012 and approved by the Building Inspector. To expire on 11/16/2013. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ADDITION TO DWELLING $50.00 Total: $250.00 Building Inspector Z>1 so 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$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. New Construction: y Old or Pre-existing Building: (check,one) Location of Property: JrGs 7l-1 �e t= �(J i2allet House No. Street Owner or Owners of Property: Jo (/ �.,p2 O A(Y Suffolk County Tax Map No 1000, Section �C.V Block Lot Subdivision Filed Map. ,c.�� / Lot: Permit No. Date of Permit.// Applicant: /r//C�l��,�. 2vl��zSH�- Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Appli ' ature ho��OF SOpT�olo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING XIFINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) . REMARKS: . DATE INSPECTOR ' SOUryolo ,3 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION- I FOUNDATION 1ST [ ] ROU [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING/STRAPPING [ FINA [ ] FIREPLACE A CHIMNEY [ ] FIRE S INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] E ECTRICAL (FINAL) REMARKS: �-- DATE / INSPECTOR r . .i FIELD M2EON REPORT DATE COMMENTS COMMENTS, FOUNDATION(1ST) --1--- -MT- ............. FOUNDATION(2ND) (fy o U . i rA ROUGH FRAAnNr- & ._P PLUMBING s INSULATION PEIL N.Y. STATE ENERGY CODE JCc FINAL ADDITIONAL COMMENTS 70 O Afj 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 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. 63�]� Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20��, Storm-Water Assessment Form Contact: Approved 20/,,�' Mail to: Disapproved a/c Phone: —c Expiration 20,_/,3 EC il, Bui ding Inspector DAPPLICATION FOR BUILDING PERMIT MAY 10 2012 Date 120 INSTRUCTIONS at, ip on MUST b completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 setslffl, k cale.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 inspection (Signature o 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 J-641V '61-41 �orr'07`�V (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on whtc k will b roposed w re done: 7 Vv eer House Number Street Ha nlet County Tax Map No. 1000 Section 0 Block } Lot I 1 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises a�}d int nded use an occupancy of proposed construction: a. Existing use and occupancy / 7 Nl eill e/41— b. Intended use and occupancy �i WJ/L 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work /d&&e-4P Iy"m (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 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 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 Rear Depth Height Number of Stories 9. Size of lot:Front Rear Depth 10.Date of Purchase 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_NO 14.Names of Owner of premises 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 *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. 18.Are there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF being duly sworn,deposes and says that(sChg Atafflj�t,CH (Name of individual signing contract)above named, UUIIVV SUN Notary Public,State of New York (S)He is the No.01 BU6185050 (Contractor,Agent,Corporate Officer,etc.) Qualified Q�(� Commission Expires April 14,2__-_ 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 �r day of 20Q kA Notary Public Signatur icant Al Not AL GdYsir� o aiLl H � � �� Pie