HomeMy WebLinkAbout37268-Z 'oOFO, Town of Southold Annex 06 5/1/2013
3 y P.O.Box 1179
co 54375 Main Road
oy � � Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36218 Date: 5/1/2013
THIS CERTIFIES that the building ACCESSORY
Location of Property: 625 Dean Dr, Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 116.-5-7
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/1/2012 pursuant to which Building Permit No. 37268 dated 6/1/2012
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:
accessory pergola as applied for.
The certificate is issued to Sullivan,Brian&Adams,Marjorie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
//A,6tVonzpd Sign ure
yam" TOWN OF SOUTHOLD
�O�g11FF0(,YCo .
BUILDING DEPARTMENT
y a TOWN CLERK'S OFFICE
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#: 37268 Date: 6/1/2012
Permission is hereby granted to:
Sullivan, Brian & Adams, Marjorie
253 W 73rd St
New York, NY 10023
To: construct an accessory pergola as applied for
At premises located at:
625 Dean Dr
SCTM # 473889
Sec/Block/Lot# 116.-5-7
Pursuant to application dated 6/1/2012 and approved by the Building Inspector.
To expire on 12/1/2013.
Fees:
ALTERATION OF ACCESSORY BUILDINGS $220.00
CO -ACCESSORY BUILDING $50.00
Total: $270.00
Building Inspector
Form No.6
TOWN OF SOUTHOLD.
BUILDING DEPARTMENT
TOWN HALL
765-1.802
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, 19$7) 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$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- $100.00
3. Copy of Certificate of.Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate o€Occupancy -Residential $1..00,Commercial$15.00
Date.
New Construction: Old or Pre-existing Building:' (check one)
Location of Property: ({, 2 5 h EA 624 U 0- t>TG ff Gry
House No. Street , Hamlet
Owner or Owners of Property: 1�' S r L L r lL M !Az �n"1 i s ill-A4 S
Suffolk County Tax Map No 1000, Section Block 5 Lot -7
Subdivision rj Filed Map. Lot:
Permit No. ) r!D Date of Permit. Z Applicant: rT i F lD�e t o A_)
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted: $ J`�Q .C72ya/
Applicant Signature
'3 7;_
O�t�OF SO(/T�°l
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION -— -
I FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REM
DATE4 �
INSPECTOR
SOUry�lo '
TOWN OF-SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION ,
[ ] FOUNDATION 1ST [ ] ROUG LBG.
[ ] FOUNDATION .2ND [ ] 1 ULATION
[ ] FRAMING/STRAPPING [ ; FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE �� INSPECTOR
FIELD lNSPEE."1'�ON REPORT DATE COMMENTS
la � Q^ _
FOUNDATION(1ST) �
- -------------------------------
FOUNDATION(ZND)
Ok
ROUGH FRAIMING& y
PLUMBING
• C
INSULATION PER N.Y.
H
STATE ENERGY CODE
FINAL
5l
ADD ITI AL COMMEN S IAPC
cOL
p
Z o
• . z
� m
• D
LA
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
www. northfork.net/Southold/ PERMIT NO. D eg Check
Septic Form
N.Y.S.D.E.C.
(( Trustees
Examined (p ,20 Contact:
Approved Co I,20J Mail to:
Disapproved a/c
Phone:
Expiration 20L-� nn
Building Inspector
0 V E
PLICATION FOR BUILDING PERMIT
M AY 2 3 2012 Date N►f}�t l`j , 20 1 Z,
INSTRUCTIONS
BLDG.DEPT.
a.This appUpatiW 'MT letely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of p ans, 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. rr
� 1
(Signature of applicant or name,Yf a corporation)
16,5 E ll$`er,%4 , NJ u`( I&c>I Z
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
A e644 11'LLT
Name of owner of premises 5 94 A.&) S u L L-t u ts ti, 6 R.I e Rd C- AtD A-µ S
(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. I- S A
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
( ?15 "DEAN AR,IV& e-0Te,40 0E
House Number Street Hamlet b
Y,C�..ydMRp9fdRiwrynfi..Y!':-✓:.a:Sv+ +.iu}�Fn:e�OVvaW6i��lGNL l:�.v'
County Tax Map No. 1000 Section l I CO Block b Ci ;ot "b
�c,t: •,:
Subdivision Filed Map N
(Name) 4nw 3 IN:�4q 1,;
`� _ _ uS71r`�A.1 f!C°I�:i'.i:lliT},):'•�;f, )S`
.r::.:Lg:;::t.,�wc!�y`-"�''.G4'"tr�i�a�'G'-'�°�°r�,dc'r.�✓,i�'ae;ra-t'... -�
f
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S t N[.t_ 1'A m i!t -j s ">c Nc,
b. Intended use and occupancy k N GUe i P M i t,y pfS e.tog
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work 12ERGoL4 AT swiwr+�Ny'Pooc.
(Description)
4. Estimated Cost !F;, ch!po 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 Z
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front G Z ` Rear 2 7 Depth t,
Height iA Number of Stories I
Dimensions of same structure with alterations or additions: Front 6,Z Rear Z 7
Depth k Height i Number of Stories l
t
8. Dimensions of entire new construction: Front I Z Rear l 7,; - Depth Z5
Height Is f Number of Stories ouc pc�Goc►4 = FCcc'E srr�Na�.v c,
9. Size of lot: Front Rear l L o ,Depth Z I Z
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_X_
13. Will lot be re-graded? YES NOLLWill excess fill be removed from premises? YES NO tC
ro Suu.tvow 25� W 'IS ST. V'$G
14. Names of Owner of premnises MP Wing Ab"S Address N`f Pt IL ; Phone No. 917-h41- 9 un
Name of Architect Guz►a-VAVR TH,&mMcN Address �D$N "� sT
.t �� ���� Phone No °h7-84-9-i5k1
Name of Contractor 4 4 y,"a� C,o N�T2 , I to c,asrs�ee au�
I Address �1nMy, �T_Phone No.
04 6T�1 •Z98-023 3.
ll°I5?i
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 OFAL��e7Lj �rn,Qs�'7^ being duly sworn, deposes.and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is theAf-?e Y16-C A,4le- ,
(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.
Swornj before me this
-da af- 20g
Notari Public Signature o pplicant
AMA .. PJ� QM;
NotAry.p"Wic-fit 'of,Nlw,Yost
Oum1 8A+(n IYr�IYork C:
My:Comii-soon EicPICQ�
PowY
I
1
SUR VEY OF
-� LOT 6
N "DO WNSVIEW"
FILED OCT. 11, 19 70 FILE NO. 5509
Oak AT CUTCHOGUE
TO WN OF SOU THOLD
GMT SUFFOLK COUNTY, N. Y,
O �� gg• Ut��o e O 1000--116--05--07
-11 30 0 30 60 90
Ni1j" „A ,0_I ;U t .�< ors•:_
.• �` Xb
P y \ —- LA !! !
o., ---- � Scale 1 — 3 0
��
198
N- -7a•2g'0 E. f 1 ��� o �- APRlL I? 2�0l0gprp. pool)
/0/��
25
tz
PP r
�� �, a� �. `r ",•�;ty CERTIFIED TO=
ETNEL ENGELS
2�1' \\ COMMONWEALTH LAND TITLE
0 26 INSURANCE COMPANY.
PECONIC ABSTRACT, INC.
a ��.%+ �• -JA♦� .. "may rW ji;�?.,�_
N:'-Y.S .;LIE .,,NO. 49618
,ANY ALTERATION OR ADDI FIO�I "C THIS SUR'/FY IS �� VIOLATION � ECONIC SURVEYORS,"' PX.
OF SECTION 7209 O. THE NF;'% YORK STATE EDUCATION LAW, (516) 765 - 5020
> EX,�FPT AS PER SECTIOb: 7209—SUBDIVISION 2. ALL CERTIFICATIONS
AREA = 34,�32 sq. ��. P. o. BOX 909
HEREON ARE VALID FOR THIS ri,a r AND CO"IF_S THEREOF• ONLY I� I�:n Tnn ii> R P c r��- -T
r-
/''7 [�,W✓,Y� � /� f/, 1h' IL,I€,+1� �� `�J 1''7 �jL;- --.f� �.tr��r(�•� ,f�rA _ [+�1.t�,�.�-l��
r .+'\v,d' i f W Ir���.�h. �4+ �'V' �11p�1'^'"-1--f V'� l',i�\K V r I!- �/���CJr� 1 4+Y' 1 Grp� I,,.W F.�1.'-]✓�✓
WI M PI
fyp �oofi p� To 6�, e;>" Pt4,
A)gs
A PROVED AS NOTED
_� X ►
BY
j•1�,F� BUILDING D PARTMENT AT
-- - - - -- - - _ - - - - - I 7b5 187 8 AM TO 4 PM FOR THE
t I Gr�L.IVA5 `t cu o)WING INSPECTIONS: '..i
i A\\/kA i = -T-IeUNDATION-TWO REQUIRED
1Y Of f+.1R POURED CONCRETE
I — ROUGH-FRAMING,PLUMBING, °.
! I
STRAPPING,ELECTRICAL 8 CAULKING
R TION
A. FINAL-CONSTRUCTION 8 ELECTRICAL
MUST BE COMPLETE FOR C-0.
! J — F7001 ALL CONSTRUCTION SHALL MEET THE
' t REQUIREMENTS OF THE CODES OF NEW
YQRK STATE. NOT RESPONSIBLE FOR
u D.,.A ORrOM3TINlCTK}N ERRORS. 4
1 I �
-- - - _ OCCUPANCY OR
!JSZE IS UNLAWFUL
CCUPANC`
- � { � \`'•...,�—.:�`v a.0�=f^:
Job Date
�► Elizabeth Thompson ,Architect uT4 �l o 4U� , I-]`f
250 Mercer St. Suite B 806 Title Scale
New York, NY
10012 212-614-7180
f
2 x rU
ti
Y
0
M OTC t
PE-F m NouSE
ZxI`G
_ "—���
a
I
lO
Job 6t 5l D�4j PP'lVE date
Elizabeth Thompson . Architect 15)1 � '
Lurk-l-olu 6 � �I�
j 11
165 East 1181h St. Suite 7A Title scale
New York, NY
r 10035 917-848-1541
I