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Home My WebLink About37779-Z Town of Southold Annex �Q�g�FfOl,f�0'� 2/12/2013 P.O.Box 1179 - 54375 Main Road y � o • o h4� Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36131 Date: 1/31/2013 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 340 Birch Dr, Laurel, SCTM#: 473889 Sec/Block/Lot: 128.4-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/23/2013 pursuant to which Building Permit No. 37779 dated 1/29/2013 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: "as built"carport altered to garage and renovate first floor area and finish second floor bathroom in an existing one family dwelling as applied for. Corrected 2/12/13 for carport altered to garage and finishing of second floor bathroom. The certificate is issued to Fox, Constance (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. H 064081 4/30/99 PLUMBERS CERTIFICATION DATED oriz Si ature aSu F t,fc Town of Southold Annex 2/12/2013 P.O.Box 1179 54375 Main Road o Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36131 Date: 1/31/2013 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 340 Birch Dr, Laurel, SCTM#: 473889 See/Block/Lot: 128.-1-7 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 1/23/2013 pursuant to which Building Permit No. 37779 dated 1/29/2013 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: "as built"carport altered to living space and renovate first floor area in an existing one family dwelling as applied for. The certificate is issued to Fox,Constance (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. H 064081 4/30/99 PLUMBERS CERTIFICATION DATED � rize Signa ure o %UffoLte TOWN OF SOUTHOLD y BUILDING DEPARTMENT H z TOWN CLERK'S OFFICE o . SOUTHOLD, NY 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#: 37779 Date: 1/29/2013 Permission is hereby granted to: Fox, Constance PO BOX 186 Laurel, NY 11948 To: enclose a carport & renovate 1st floor interior space "as built" as applied for At premises located at: 340 Birch Dr, Laurel SCTM # 473889 Sec/Block/Lot# 128.-1-7 Pursuant to application dated 1/23/2013 and approved by the Building Inspector. To expire on 7/31/2014. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $1,128.00 CO -ALTERATION TO DWELLING $50.00 Total: $1,178.00 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 I. 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- $100.00 Copy of Certificate of Occupancy-$.25 Updated Certificate of Occupancy- $50.00 Temporary Certificate of Occupancy- Residential$15.00, Commercial $15.00 Date. New Construction: Old or.Pre-existing Building: (check one) Location of Property: House No. Street �- Hamlet Owner or Owners of Property: �UnJ�L- � / / Suffolk County Tax Map No 1000,Section C2 �' Block Lot Subdivision Filed Map. Lot: Permit No. •3 7� 7? Date of Permit._! -a q - J Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature THE NEW PORK B! ARb Of `FlR UlNQ i1VR�TEV, PAGE 1 8074218 t31J{tAU OF ELECfi:RICITY. •40 FULTON STREET, NEW YORK,NY- iD038 . 29. H 064Q8APRIL 30 ppltcain onDate . 1 ' THIS CERTIFIES THAT only'!he electrical equipment'as'described-beloiO ahT ntrod""idi by the applicant named on Fhe above appiteatwn numLer.is in.�tl e;pre!nrses of 1. CONSTANCE PETTERSEN., 340 .:BIRCH DRIVE ZA'tWL, Ny in the following location; ® Basement Zst Fl. .2nd FL Section Block Lot was:examiiied•on APRIL 27,1999 ; f cY ; and found to lee in'compliance with the.National Etec/rscal Code :. FIXTURE RECEPTACLES SWITCHES FIXTURES'.. RANGES 400K1NG 1i-ECKS OVENS SH WASHERS EICFidUST FANS OUTLETS INCANDESCENT FLIIfSRESCENTi AMT., .AMT.:: KW.: AMT. ' . H. 8 44 17 8a. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIdLREC`P1 TIME CLOCKS BELT UNIT HEATERS MUTT OUTCf'T -DIMMERS • SYSTEMS . AMT. K.W. OIL HSR. GAS H.P: AMT NO. ` „A W G AMT AMP AMT AMP$ TRANSf AMT N PJ. .. NO:OF:fEET AMT WATTS ,SERVICE:DISCONNECT" NO. _ 'METER NO OF CC COND A W G A W'G -.A W.G. ' •AMT. AMP. TYPE EAU1P -1 0 2W' 1 0,3*•3fl 3W :04Wj -0 >'•,.: .IOF.CC. NO.OF HII G.,.: ..OF-FiI-IEG�-c �0 0F'NEUTRALS OF NEUTRAL ' OTHER APPARATUS: j. PADDLE .:FANS=8 G.'F.C.Ii=5 SMOKE DETECTOR:-6 .. : ... r • 1 1 5 CONSTANCE ;PETTERSEN _ - .<< x '• ., r , 340 BIRCH 'DRIVE P 0 BOX' Al t` hN�Rl1l. MANAGER' LAUREL., NT, 1194J. 8 11IN I Per This Cori to must':not.tie:alft:, iri•any Tnanner,-ieturn trs the otTlce of the Board if`lnbbrteG II19pe iCrs r Qy betidE�ntified by their credentidls. y OE SO(/T�o - - /L ,moo �o �✓�-T eou TOWN OF SOLD BUILD! DEPT. 776" 5-1802 INSPtEjOTION . [ ] FOUNDATION i ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL - [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) ^ � _ REMARKS: A — t DATE �� INSPECTOR 141cf'2 OF SO(/T�o 0 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLOD. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: CQ DATE INSPECTOR n FIELD IIVSPEON REPORT DATE .-Co J FOUNDATION(1ST) � FOUNDATIOrS(ZND) . yD* O W ROUGH FRANIING& y PLUMBING v � H IMUL•ATION PEft N.Y. A STATE ENERGY CODE ,J C FINAL r .ADDITIONAL COMMENTS ca 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.NorthForlc.net P Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined_)-r-2--cl ,20_� ; -• Single& Separate I' P BLDG.DEPT. Storm-Water Assessment Form I �.-----TOWN OF SOUTHOLD --- Contact: Approved o�—�20 L" Mail to: Disapproved a/c nn Phone: Expiration 20 ? Building Inspector APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 app"licantk 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 �C G f)S Y)sz Q l d X (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 which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy J3 N b. Intended use and occupancy v 4 & mj { i 1 3. Nature of work (check which applicable): New Building Additioir Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee ' jo 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 l 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 -11�1-cn Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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) �AJ�COUNTY OF In -�. K being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the 0 11< � (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. Sworeefore me this,. day of Cc.✓1 20 --►�CKi `07" _ Notary Public� of New YorkNo.Ol't'06190696 Qualiflgd in Suffolk County Notary Public Commission Expires July 28,2 Signature of Applicant H � �� TOWN OF SOUT PROS �► OWNER STREET" V]LLAGE DISTRICT SUB. FORNLER OWNER N E _ J ACREAGE / ,e 77;w W TYPE OF BUILDING r!Y& RES° SEAS. VL. FARM COMM. I IND. I CB. I MISC. LAND IMP- TOTAL DATE REMARKS F. Soo 1 • r f J14 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE _ U Farm Acre Value Per Acre Value Tillahle 1 , Ti I fable 2 I ` / Tillable. 3 I � � � `� "'2 � Woodland I . Swampland ` B rushla n;11 House Plot Total J, Ada — - TOWN OF SOUTHOLO: PROPERTY RECORD CARD r� � OWNER STREET L40 - VILLAGE- DIST. SUB. LOT QRMER gWNER. N E ACR. W TYPE OF BUILDING vow- RES. lye SEAS. VL. FARM COMM. CB. MILS. Mkt. Value LAND IMP. TOTAL DATE REMARKS SQ r �;� � Ili a 2 o .�I.go u�4D O.sSorsa C. �iAG�o r 1,1f .a F SAre2-p L34 ,r ��^,'_.• ) Y t.' ✓ 6 r � f7 &A. eke � Z -D. 5 0 a rzp rp 1, 4,Q44rnyf n `Cy,�\i !7-�- ri1 cirri ri AGE BUILDING CONDITION NEW I NORMAL BELOW ABOVE —FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Nbodland FROKTAGE ON ROAD `J C: Mea lowland DEPTH House Plot BULKHEAD -- Total DOCK L L f'O 1VjI I R-m i r u' -T r ' i Foundation • 3 Both 1� M. Bldg, � � � `� .� � 1 � .1 Q �C�i_� �C I. u � r Extension Basement t, j Floors {� Extension Ext. Wolfs � ,� '. _.,_ �� Interior Finish �r�".-�_-�, 1=xtension 1 Fire ace Heat Porch Attic " Porch Rooms ]st Floor Breezeway Patio !Zooms 2nd Floor Garage •'� ,� y S' driveway o. B. !y o S L` S X3, .Z- M C H Design Services i i t i 0 i i V)t i BANQUETTE z 0 Q 0 KITCHEN 0 WET BAR 0ri ~ W 0 Z(t ZE � Xlo PLYWOOD FLITCH - - - - - w(�— — PLATE,ALUM.FLASH. DN GARAGE �'b APPROVE®AS NOTED 7.77 DLIVING ROOM DINING ROOM `I Vl I t- axuz�Z' '— C yUP F NEW i Ol ort V-WVLl�fi'G �C P/liCl`�1JT ; 5'�I SaZ $ ASS ib 4�M' E~O'R ' ,�fr1 ��P ,' �� MOM Zoo i;y-QJi2f,o Lfl IR ��(� i-. PLO 5.. i�7 art -fii _ '• i . 07 is- 4, MIAL=COMMMOON� � u PLUWINGL.- January 26, 2013 mwl O �:®, ALL PLUMBING 1Na$T = �� ._ `_ ALL-MMA AM".7Tw &WATERLtWgiNE�d - SCALE: 1/4" = 1'-0" TMOMMM M THE �'`�1 TASTING BEFQRB GO FEEifNG 44OR MMAU'Kk ft SHEET NO: ALtJMBEP CFRTJFlCA.TION OCCUPANCY OR �N LEAD CONTENT BEFORE RTIFIC TEOFOCCUPANCY USE IS UNLAWFUL SOLDER USED•INWATER VA ff'r—uO3 T GER T HFIC TIP SUPPLYSYSTEM'CANNOT EXCEED 211.0OF 1%LEAD. c