HomeMy WebLinkAbout38096-Z Town of Southold Annex 8/13/2013
Epp �y P.O.Box 1179
0 54375 Main Road
o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36445 Date: 8/13/2013
THIS CERTIFIES that the building WINDOWS
Location of Property: 740 Nokomis Rd, Southold,
SCTM#: 473889 See/Block/Lot: 78.-3-18
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/7/2013 pursuant to which Building Permit No. 38096 dated 6/13/2013
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 window replacement as applied for.
The certificate is issued to Hokanson,Richard
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
l
t rized 81gnature
o��uFFot,r�o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy • 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#: 38096 Date: 6/13/2013
Permission is hereby granted to:
Hokanson, Richard
1635 Nakomis Rd
Southold, NY 11971
To: As-built window replacement as applied for.
At premises located at:
740 Nokomis Rd, Southold
SCTM # 473889
Sec/Block/Lot# 78.-3-18
Pursuant to application dated 6/7/2013 and approved by the Building Inspector.
To expire on 12/13/2014.
Fees:
AS BUILT - SINGLE FAMILY ADDITION/ALTERATION $400.00
CO -ALTERATION TO DWELLING $50.00
$450.00
Buil ng 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 dlectrical 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$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 of Occupancy-Residential$15.00,Commercial$15.00
Date. 6 - 6-1?J
New Construction: Old or Pre-existing Building: (check one) ,_j.� -
Location of Property: 140 JJ6L"Ml� ��' 1 k
House No. ,^ ++Stre+ett Hamlet
C/� __
Owner or Owners of Property: 121 �c-c� TI ykP4,,�e4—
Suffolk County Tax Map No 1000, Section 16� Block Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:_ (check one)
Fee Submitted: $ IN� t ttk C'T
Applicant(SignatW
SO�Tyo�o
�o
��y00UN1`I,N�Q
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION-
I FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSU N
[ ] FRAMING /STRAPPING [ INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR
FIELD INSPEON REPORT DATE
COMI mNTS
,
FOUNDATION(1ST)
FOUNDATION(ZND) a
• z
ROUGH FRAMING& Zy
PLUAMING Cj
INSUL•ATION PEA N.Y.
1 H
STATE ENERGY CODE
J
FINAL
ADDITIONAL COMMENTS
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* 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 ��6„� Survey
SoutholdTown.NorthFork.net PERMIT NO Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined 20� Storm-Water Assessment Form
Contact:
Approved 20� Mail to: 'Van (/r
Disapproved a/c /
Phone:
�Exgiration-- o ��
Building Spector
JUN 6 2013 APPLICATION FOR BUILDING PERMIT p�
Date JU 20 13
BLDG.DEPT,
INSTRUCTIONS
TOWN 0 L 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 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
ye,Sim
Name of owner of premises qO V e/yt- aP
(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 o 11 Don which prgse�work will e don
House Nuumber Street Hamlet
County Tax Map No. 1000 Section Block 3 Lot /
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use Ad occupancy of propos d construction:
a. Existing use and occupancy �1►'t4� t-tL"I/i.1 lre 1 i11
b. Intended use and occupancy s'd Yi&1L.,
3. Nature of work(check which applicable):New Building Addition Alterationk
Repair Removal Demolition Other Work tww I ul LJ 0 to 5
(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. 5� l" &y Rear �(o I- ti Depth OAT mil' 0
Height I 7 - 41 Number of Stories
Dimensions of same structure with alterations or additions: Front �A✓VL -C-Rear
Depth Height Number of Stories
8. Dimensions of entire new construction:Front 'Q-° 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_NOX
13.Will lot be re-graded?YES NOXWill excess fill be removed from premises?YES_NOk
14.Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Z P/If Address V Z- Phone No.
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES N
*IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BQUIRED.
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`` )
0 Ar)�/{ �y P/� being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contr ct)above named, CONNIE D.13UNOH
(S)He is the Notary Public,State of New York
F ( No.01 BU5105050
(Contractor,Agent, rporate Officer,etc.) G-uaiitied in SuffOIK UOurity
Cor'trrission Expires I-,- 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 th'
r" day of UP-L 20 13
Notary Public Sign tore of Ijicant
rillr
,4� vT) 0 CC-e7l h C7(1�n G i`4
HOKENSEN RE51DENCE
COMPLY �A'ITH ALL CODES OF OCCUPANCY ORUSE IS UNLAWFUL
NEW YORK STATE AS REQUIRED A* & TOWN CODES WITHOUT CERTIFICATE
OF OCCUPANCY z p m
�-'! OARD GENERAL NOTES: O °
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�— • The Information on this set of construction documents Is to show work completed
in May 2013. Work completed, as Indicated, is within compliance of the Residential O
Code of New York State. z
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• The extent of construction Is limited to new windows only. Windows are Andersen Q LU
400 series, call-outs as shown. All windows Installed are within the rough openings
of the orlglnal windows. All headers, sllis, jack/king studs are remaining as exlsting.
Support mullions as shown. New casings, both Interior and exterior as needed.
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APPROVED AF PJOTED
LLa DATE: B.P.# P�96 2 Lp
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DEPARTMENT AT z =
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3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR (J�
\--DOUE3LE 2"X 4"SIUPPORT DESIGN OR CONSTRUCTION ERRORS.
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