HomeMy WebLinkAbout37572-Z FF O4 Town of Southold Annex 10/16/2012
=o �y P.O.Box 1179
54375 Main Road
co
o • - Southold,.New York 11971
CERTIFICATE OF OCCUPANCY
No: 36008 Date: 10/16/2012
THIS CERTIFIES that the building AS BUILT PORCH
Location of Property: 375 Corey Creek Ln, Southold,
SCTM#: 473889 Sec/Block/Lot: 78.4-27
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
10/3/2012 pursuant to which Building Permit No. 37572 dated 10/11/2012
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:
"As Built"covered porch as applied for.
The certificate is issued to VanDuzer,Jesse&Woodhull, Stacy
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A rite ignat re
T��te", TOWN OF SOUTHOLD
�goFOc/(cP� BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
"oy • � 4 SOUTHOLD, NY
0
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#: 37572 Date: 10/11/2012
Permission is hereby granted to:
VanDuzer, Jesse &Woodhull, Stacy
1730 Country Club Dr
Cutchogue, NY 11935
To: construct an "As Built" covered porch as applied for
At premises located at:
375 Corey Creek Ln, Southold
SCTM # 473889
Sec/Block/Lot# 78.-4-27
Pursuant to application dated 10/3/2012 and approved by the Building Inspector.
To expire on 4/12/2014.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $540.80
CO -ADDITION TO DWELLING $50.00
Total: $590.80
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
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. n 1�
New Construction: Old or Pre-existing Building: C (check one)
Location of Property: d t'i &0 of
House No. Stre t Haml t
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 7bBlock Lot o?
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: VO P_K
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: 4heckne)
Fee Submitted: $ ���
Appli ant tore
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH G.
[ ] FOUNDATION 2ND [ ] IN LATION
[ ] FRAMING/STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
Gr
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s
DATE /0// INSPECTOR
FIELD MSPEOTION REPORT DATE COMMENTS
FOUNDATION(1ST) _1
N�
FOUNDATION(M) Q�
ROUGH FRAMING& y
PLUN MING
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INSULATION PER N.Y. �1 '
STATE ENERGY CODE
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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?
r T#OWN 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. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined ('0 ,20 Storm-Water Assessment Form
Contact:
Approved 104 2012.1 Mail to: tf
Disapproved a/c
Phone:
Expiration 20
Building Inspector
APPLICATION FOR BUILDING PERMIT Date CO 2,20 1 j
6
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 applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner,lessee,nagent,architect,engineer,general contractor,electrician,plumber or builder
AM Ar
JName of owner of premises L7/J� � y"�
(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. Locations land on whic roposed wor ill be acne:
�15 a�e+� f c�K� LLB. �SO0h 01,0
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot
Subdivision Filed Map No. Lot
State existing use and occupancy of premises and inte de use and occupan y of proposed co}�struction:
a. Existing use and occupancy 5f✓1o.�Q. �trn I✓✓I rz SI 1 cAct, u, �ZM<-- /
b. Intended use and occupancy C, ,�t,Q_ tu/ rov- outr e,a'' f� A,5 B VL—rl'
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work Q-00F Oven-- t�CC.-
(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 I 1p Depth
Height as 1
1 Number of Stories
Dimensions of sa a structure with alterations or addition Front Rear�&
Depth I Height 3 I®�� �� Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories,
9. Size of lot:Front �Rear �2 d.g-"1 a' Depth d�9. (.71
.71
10.Date of Purchase (7 01— 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_NO,OWill excess fill be removed from premises?YES_NO \,L-
14.Names of Owner of.premises Va V\V�L 2,1� Address SOLAI
6 Phone No.
Name of Architect � V�� Address c�hone No
Name of Contractor ,dPA h p_ Address Phone No.
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES N0/'k
*IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY E/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 NOX
*IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF {�)
otn l m I w l.'f being duly sworn,deposes and says that(s)he is the applicant
(Name of 0dividual sign' g contract)above named,
(S)He is the t?Q sr
(Contractor',Agent,Ccljorate 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.
Sworn to before me this
day of 20
Notary Public Si re of Aqicant
y 7 TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER /y ' Q,� STREET 'r� : VILLAGE DIST. SUB. LOT
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RES. Q SEAS. VL. '., FARM COMM, CB. MICS. Mkt. Value .
LAND IMP. TOTAL DATE REMARKS
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
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SURVEY OF LOT # I q "�
"MAP OF GOREY CREEK ESTATES" N
FILED AJJ&. 15, Igb-7 Ar,S FILE # 4g25
T M OF S5OUTHOLLD W E
SUFFOLK COUNTY, NY
SURVEYED JUNE I, 2012
5UFFOLK GOUNTY TAX # $ o
1000 - 78 - 4 - 27 i Lot # l8
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C>ERT=TO:
MSS1E A.VAN DUZMk
STAGY 1.WOOD H[QJL LSUFFOLK
FO COUNTY M= BANK Q 58c1°40'5O"E I
IIN`SURANCIE SMkVIICIES LLC 0 266.1-7'
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NOTES:
I G ®F NE6Y
I Lot # 2O �V C,Ej�//_ �O 'u,wtharizea alteration ar dmmon!o o survey
it � _'t!`C��+ ..op beming o licensed lora wrveyar•s aem Is o
w MONUMENT FOUND Go
blaklan of sectlan,zoo.tub-awlslon�.of tt�
`O .n � New York State Edvcatlon Law.'
J V- "Only copies from[he ortgglnol of thls survey
stamped seal shoo11 eonskfe be req to be valor true
eoples•
"Lertlflcatlons Inglcaleq hereon sl9 IFy that this
HEDGE Bey was preparea m occoraa„ce nivnh the ax-
^ ISLh yf�rae5oa—tlfl-tlo-slwlllrl -ly
� Q� by tha NeweYork SW[e Assocbtbn of Wofessloal
-d on his behalf lto the IL tle I'll,
orn vey 15 prepat-ed,
Area = 242a5.25 5ct. Ft. sF�L v ogeuy and le d g mstltut on Ibtea neraon�a n
Area = 0.5577 Acres q a he aeel9 ees of the lengln9 Instltuuan. Lartlfica-
!Ions ara not transfefabld to oddiklonal Nstltutlons
ORAPHIG 5GALE 1"= 50' JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287
REF.—C:\Users\John\Dropbox\12\12-134a.pro
VAN DUZER RE51DENCE
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DOWN I 2"X 8" R.R. 765-180 8 AM TO 4 PM FOR THE LU
@ I G" O.C. (I ( FOLLOWING INSPECTIONS: J m
lu' 1. FOUNDATION-TWO REQUIRED
II CI I - FOR POURED CONCRETE
2 ROUGH•FRAMING,PLUMBING, (�
secn .oN o �° ° STRAPPING,ELECTRICAL&CAULKING U z
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MUST BE COMPLETE FOR C.O. Q z
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BACK PAGE:
ELEV. OF ^SIB` \
PORCH LAYOUT
SCALE: -Lit = I '-0" I
GENERAL NOTE: o
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• These plans and drawings reflect work performed approximately I G years ago; to ,- o O w
the best of my knowledge, all work has been completed as shown, and In accordance LU O N
with current codes. N o
CLIMATIC * GEOGRAPHIC DESIGN CRITERIA
GROUND WIND SEISMIC FROST WINTER ICESHIELD z
FLOOD z
SNOW SPEED DESIGN WEATHERING LINE TERMITE DECAY DESIGN UNDERLAYMENT HAZARDS
LOAD (MPH) CATEGORY DEPTH TEMP. REQUIRED Qom/ Q
45 LBS. I20 B SEVERE 3 FT. MODERATE SLIGHT TE I I NONE p p m
TO HEAVY MODERATE
EXISTING POURED CONCRETE
FOUNDATION WALL*
FOOTINGS TO REMAIN
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TO REMAIN LLJ
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5HEILD @ PERIMETERS *VALLEY5
PLATE HEIGHT QC
HEADER HEIGHT U
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EXISTING DECK STRUCTURE-
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TO REMAIN W
C.O.#Z7744, JUNE 1977 Q
OF IN
BUILDING SECTION "A" A �°
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