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Home My WebLink About37825-Z �fF Town of Southold Annex �UFFOI,f� 3/18/2013 P.O.Box 1179 C x 54375 Main Road oy �� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36171 Date: 3/18/2013 THIS CERTIFIES that the building GREENHOUSE Location of Property: 620 Lake Dr, Southold, SCTM#: 473889 See/Block/Lot: 59.4-22 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 2/19/2013 pursuant to which Building Permit No. 37825 dated 2/22/2013 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: poly greenhouse addition to an existing one family dwelling as applied for. The certificate is issued to Bird,Richard&Geurtze,Deborah (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED i Autho ed Signatu e a�SUF��,co TOWN OF SOUTHOLD BUILDING DEPARTMENT y a 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#: 37825 Date: 2/22/2013 Permission is hereby granted to: Bird, Richard & Geurtze, Deborah 620 Lake Dr Southold, NY 11971 To: construct a poly greenhouse addition to an existing dwelling as applied for; foundation location required before C.O. At premises located at: 620 Lake Dr, Southold SCTM # 473889 Sec/Block/Lot# 59.-1-22 Pursuant to application dated 2/19/2013 and approved by the Building Inspector. To expire on 8/24/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $224.00 CO -ADDITION TO DWELLING $50.00 Total: $274.00 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. 'Swom statement from plumber certifying that the solder used in system contains less than 2110 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 s?mpleted 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.$50.00, Additions to dwelling$50.00,Alterations to dwelling S50:00, Swimming pool 150.00, Accessory building$50.00, Additions to=accessory building-$50-.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: Old or Pre-existing Building:' (check one) Location of Property: ' Q 0 � At (A �� 644 4 House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section J Block / Lot -Z- Subdivision Filed Map. Lot: Permit NO.1,�� `�f Date of Permit. 2. ,*a J �j Applicant: Health Dept.Approval: ' Underwriters Approval: Planning Board Approval: Request for: Temporary, Certificate Final Certificate: V (check one) Fee Submitted: $ T,- Dv Applicant Signature �o��OF SOpr�olo o�yCo�'Nc� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 JNSPECTION . '�-, ; [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: o DATE ®y Z INSPECTOR ' �. FIELD IIVSPECT14N REPORT DATE COMMENTS -� M FOUNDATION(IST) - --------------------............. � d FOUNDATION(2ND) ROUGH FRAMING& y PLUMBING W INSULATION PER N.Y. H STATE ENERGY CODE Y FINAL ADDITIONAL COMMENTS cl)t�f�) fat, Poo g z o 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 SoutholdTownNorthF6rk.net ,PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ��,20_9 Single&Separate Storm-Water Assessment Form y� Contact: Approved a20 �� Mail to: Disapproved a/c Phone: Expiration ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date L , A 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. ii 15d= (Signature of applicant or name, if a corporation) c aili g addre s of applicant) c� Cam/ CSp[ -V 5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder OD C-U Name of owner of premises 14 ��C� 'B"4 C.i (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 d ( Lot a% 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 b. Intended use and occupancy A$$ c S n� c) 6A, 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work G�ff,..jA w F,IE (Description) 4. Estimated Cost Fee -� (To be paid on filing this application) 1 5. If dwelling, number of dwelling units Number of dwelling units on each floor If.garage.,--iumber of cars 6. If business, coiiimercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ! y Rear ! Depth l �g Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories f le 8. Dimensions of ,I tire new construction: Front:,_ 9 Reai 1 _ G ./�a wf }1 G7 Height g. G - 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�f�A�iTl�xcess fill be removed from premises? YES 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 NQ� * 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 >c * 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 4- IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFA ) r being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, Jeanne Sweet Bartos NOTARY PUBLIC,State of New York (S)He is the WN No.O1BA6210083 ( ontractor, Agent, Corporate Officer, etc.) Qualifiedin u o oun ly Commission Expires August 10,2 - 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 tliii r�, Lf day of ' fS rU 20 1 r1Z otary Public Signature of Applicant 0-, SOUTHOLD TOWN OF SOUTHOLD yob ' h C,e stQo SUFFOLK COUNTY, NEW YORK O S.C. TAX No. 1000-59 01 —22 g O SCALE 1 "=20' NOVEMBER 3, 2000 AREA = 15,170.70 sq. ft. 0.348 ac. 1. O .0 QQo CERTIFIED TO: ' �- RICHARD BIRD DEBORAH GEURTZE FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK •-,. �N �p HUNTINGTON MORTGAGE COMPANY ♦ � �PV o Pol �s j - •S9'' - - PREPARED IN ACCORDANCE WITH THE MINIMUM O Po o -� ; 12� �OJ O yA�' \ ps �F, • STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.IALS. AND APPROVED AND ADOPTED \ ` ` �9• ��PM� g 1' %� ' F��G WON' FO AS OCUSTIONY THE NEW YORK STATE LAND o %r a SAOR �. 1 Apo �. o / T s ® 4� I - 5 /L/� 0L ° N,Y.$. LIc. No. 49661 .. A. In e- no Jose h . TOTES: : Y P . HUS: L:OT 3, REFER TO Gpec.... / , \ 1. LOT NUMBERS SHOWN T O S UNATHowZED.ALTERATION OR ADDITION Lein S(,;f't'VeyOl' SUBDIVISION MAP MADE_.FOE CONSTANTINE P. A. To THIS GEORGIOPOULOS �e�'� a Y Is SURVEY It A VIOLATION OF /.� ° SECTION 7209 OF THE NEW PORK STATE. FiLEd IN THE OFFICE 4F' THE .:CLERK 'OF SUFFOLK. COUNTY oa + �oFPP> EDUCAnoN LAW. . ON JANUARY 29, 1485 AS FILE 'No. 7844 .1, Eon COPIES OF THIS SURVEY MAR NOT BEARING:. Title.Sure s - Subdivisions -. Site Plans - Construction Layol 2. FLOOD ZONE INFORMATION TAKEN FROM:_ THE LAND SURVEYOR'S INKED E C SI y FLOOD INSURANCE RATE MAP..No. 36f03C0154 G EMBOSSED SEAL sHALL NOT BE coNs1DERED. To BE A VALID TRUE'COPY. Fox 631 727-1727 ZONE AE: BASE FLOOD ELEVATIONS DETERMINED PHONE (63:1)727-2T]90 ) ° CERTIFICATIONS INDICATED HEREON SHALL RUN MAILING ADDRESS ZONE X#: AREAS OF 500—YEAR FLOOD; AREAS OF 100—YEAR FLOOD WITH AVERAGE ONLY TO THE PERSON FOR WHOM THE SURVEY OFFICES LOCATED AT IS PREPARED, AND-ON HIS BEHALF TO THE 1380 ROANOKE AVENUE P.O. Box 1931 DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN TITLE COMPANY, GOVERNMENTAL AGENCY AND 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100—YEAR FLOOD. THE EXISTENCE OF RIGHTS OF WAY LENDING INSTf unON LISTED HEREON, AND RIVERHEAD, New York 11901. Riverhead, New York 11901 ZONE X: AREAS DETERMINED TO BE OUTSIDE 500—YEAR FLOODPLAIN. AND/OR EASEMENTS OF RECORD, IF TO THE ASSIGNEES OF THE LENDING'INSTI- ANY, NOT SHOWN ARE NOT GUARANTEED. TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. 20 ' J CIA e A r. P p E c 9 i, a,,.>,"v e FEE: _ !'' �Tl � � U ��- �:� 2 3 trs NOTIFY UIL ING 76 1802 8 qM T 4 F 9 F FOI.LOVV NG INSPE TIONS: 1. FOUN ATI N-T O R QUIRED )1 FOR POUR D CONCR ATE 2. fOUG FRAMING,fILUMB NG, TRAP DING, �LEC RICA &CAIRICAL LKIN 3. IINAL SU ION 4. --CON TRUC ION&ELEC UST B' COP LEl E FORC.O.P � ALL ONS RUCT OPT'S A L M.-ET T E p REO TIRE ENTS OF FJ CO3)' S O N> 1n' YOR.' STA E. N I Rr ,'N 3LE=FOR r DESI 3N OF CON"TRUC ,!uN Rit-lori J e IV -E- i I ' I 4 F IPQ� l