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HomeMy WebLinkAbout28624-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-29434 Date: 05/14/03 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property: 875 HENRY'S LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 74 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 26, 2002 pursuant to which Building Permit No. 28624-Z dated AUGUST 5, 2002 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 ADDITION & ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN M & LAURA C. HELF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1104890 04/18/03 PLUMBERS CERTIFICATION DATED N/A AJ.JwKorized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28624 Z Date AUGUST 5 , 2002 Permission is hereby granted to: JOHN M SR & LAURA C HELF 875 HENRYS LA PECONIC,NY 11958 for ALTERATIONS AND ADDITIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 875 HENRY ' S LA PECONIC County Tax Map No. 473889 Section 074 Block 0001 Lot No. 015 pursuant to application dated JULY 26 , 2002 and approved by the Building Inspector to expire on FEBRUARY 5, 2004 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD pGt I BUILDING DEPARTMENT TOWN HALL C 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This applicatit filled i by typewriter or ink and submitted to the Building Department with the following: A. For new building or new u e: 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 $25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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: y Old or Pre-existing Building: (check one) Location of Property: q� 4 �Y L-1wf Af_e"%G House No. Street Hamlet Owner or Owners of Property: Toeb/ i Suffolk County Tax Map No 1000, Section 16tW Block-)7j;�'" Lot O Subdivision Filed Map. Lot: Permit No. A2(6;-`1' --2— Date of Permit. Y�O> 2— Applicant: 1,7e—jllxj f"L�9ri— Health Dept. Approval: Underwriters Approval: altr Planning Board Approval: _ Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Zs" � Appli in Signature co � agy3y o ������� ��������������������� ss���������LPLPLPC�L��d3'r3P'L3PLrL3rL3rL3o 5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 SBUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 55 5 CERTIFIES THAT S 5 Upon the application of upon premises owned by 5 5 �5+ �5 JOHN HELS JOHN HELS �5 875 HENRY A PECONIC NY11958 PECONIC, NY 11958 CCC Located at 875 HENRY LANE PECONIC, NY 11958 Application Number: 1104890 Certificate Number: 1104890 5 c� Section: 1000 Block: 7400 Lot: 910 Building Permit::8624 Z BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of r� 5 electrical devices and wiring, described below, located in/on the premises at: �5 5 Second Floor, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 18th Day of April,2003. 5 �5J Name QTY Rate Rating Circuit Type 5 5 5 Miscellaneous �5 2nd floor addition 5 5 Alarm and Emergency Equipment 5 5 Sensor 1 0 Smoke 5 5 Wiring and Devices 5 Receptacle 14 0 General Purpose C 5 Switch 21 0 General Purpose 5 5 Fixture 8 0 Incandescent 5 L5J Paddle Fan 1 0 5 5 Lighting track 12 0 FT 5 5 5 5 5 seal 5 5 5 1 of I 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 10 ENERGY CODE CALCULATION91N 17 CHAPTER 5 SECTION 501 Detached One and Two Family Design Criteria 5750 Degree Days (For Non-Electric Heat) Zone 1113 11 // For: JO q4 //, 1 Per: Ale yhy 5 �cht i>r cohl Dated: keno-'9 "s 4 Ove �gr4fr SUBSYSTEM AREA DESIGN CODE DESIGN CODE "U" "U" UA UA Exterior Walls s 1 7 0 / a 0.14 /. G 72 - 38 d a Ceiling Roof 3 P�-fflr 0.031 Floor Over Unheated Space 3 cf 3 0, b 'Ir 0.05 / 7 /a' / 7, j Heated Slab On Grade 6.5 Unheated Slab On Grade 4.5 Basement Wall 0.1 Crawl Space Wall 0.06 NOTES: 7 7 , 01 Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage Building Envelope Systems to meet requirements of Section 501 The mechanical systems and equipment including: HVAC Equipment, HVAC Systems, Duct Systems, Ventilation Systems and Insulation of Piping Systems to meet requirements of Section 503 Service Water Heating Systems&Equipment to meet requirements of Section 504 Electrical&Lighting Systems&Equipment to meet requirements of Section 505 �e To the best of my knowledge, belief, & professional judgement, 1 e. these plans are in compliance with the code. P90Fessl " //, o 5 BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: -2 13a /L APPLICANT:�. K k DATE S[JBiv11TTED: / /Z SC11`1:r DIS 1 RIC I 1,000, SECTION. { , BLOCK: / , LUL / S - - �7 �'ccwic SIRFLI ADDRESS: R7S_ cIII : / yy,� _ SLiiflMKION: Homcs PROJECT DESCRIPTION: / aw;—.o.✓s 447222 arJo.✓S To ESTIMATED PROJECT COST: ARCHITECT/FSR: icL FAST TRACK?wo SINGLE & SEPARATE CERTIFICATION-REQUIRED? NOTES: LOTS 40,000SF-100-211crt recnpnition.(('2HA'CGD before Iunc 30. IriR l),UN DFR517_�U I_x1Tti FR(tAf ,IAN 1997i00-25.plerRer.tA nonconformine atany time after ZONING DISTRJC"1 : _ -C -_ CONFORNIING? _-o REQ. LOT SIZE:` 46cr> _ACT. LOT SIZF a3%& REQ. LOT COV. C'?o!gACT, [,OT COV. 1$%_ REQ. FROM_ -jo _ _ PROP. FRONT-- REQ SIDE--_---- I s/3'5- ACT. SIDE REQ. REAR __ PROP. REAR .rf ____REQ. HEIGHT -_ PROP. HEIGHT - WATER FRONT') - Arc DESCRIPTION: PANEL #: / FLOOD ZONE: --, - APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES oro, (BED #):_ DTE: / PERMIT 4:R10- _ TOWN SEPTIC RECEIPT: Y or© NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o _ SOUTHOLD TOWN TRUSTEES: YES of _ TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA):. YES or NYS ENERGY: & OR NO : / EGRESS (18 H min.? 4 sq total) - VENT (SQ. FT. x 4%) - LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- 4 yRl rn 1�1ae� HAVE PRE CO'S : Y OR N BPornb2i(p -Z/C/0 Z- Sly Qj�j(pT NOTES: 9 pco FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: /66SF SECOND FLOOR: 33� SF OTHER: SF LNIT OTHER TOTAL p TOTAL: �g— SF FEL FEE FEE 1. (_ - /t_SF)- ( - __ --SF)= SF a 2. (_SF)- ( SF)= SFX 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ (FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: - DATEINSPECTOR G�� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION vrFRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: - - ��-�--� . - DATE ©i 03 INSPECTOR G� /' M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING [V FINAL [ ] FIREPLACE A CHIMNEY REMARKS: o DATE 06103 INSPECTOR FIELD INSPECTION REPORT DATE coNu 2m z FOUNDATION (1ST) y ------------------------------- — FOUNDATION (2ND) I J � O/ 61, O ROUGH FRAMING& COY PLUMBING �e, e INSULATION PER N.Y I STATE ENERGY CODE FINAL ADDMONAL CO1VII1iE M 0 z m y -- zj x c TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION ClJrCCL-IST BUILDING DEPARTMENT Do you have or need the following,before applying' TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans_ TEL: (631) 765-1802 Planning Board approval _ FAX: (631) 765-9502 ��( � , Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined �' . 30 r� Contact: Approved 30�1� Mail to: —- Disapproved a/c Phone: Expiration_ L ` _ ^ 1QBuildinnspector J 1{ t' �It Stl� 2J t; ull APPLICATION FOR BUILDING PERMIT t lt• tt Date -Q ut,y /Y INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 conmuenced 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 Pemut pursuant k) 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. 7-he applicant agrees to compiv with all applicable laws, ordinances, building code, housing code, and regulations, and to �idmii authorized inspectors ou premises and in building for necessary inspections. 4& /r (S/ig�nature f applicant or name,if a coiporanon) ( ailing addr ss of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder I /r % Name of owner of premises �v/Q//,�V gf (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. b� Plumbers License No. K 1V Electricians License Other Trade's License 1. Location of land on which proposed work will be done: er�lA T House Number Street fHamlet ,>toS . County Tax Map No. 1000 Sec ion 7K- I-IS Block t ,r ` ,73WOb-f Lot �ZL 5� Subdivision �ctcrtitrC Pi��S Fjl t ap'No", Int a"Ara Lot Jerre dtc 4 ,. �_,; n ,e d�� ewoc � Z. (Name) ¢asap:^. ne�_• e- 3. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 5 b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition_ � __Alteration Repair -- Removal-Demolition-Other Work (Description) -F. Estimated Cost Fee (To be paid on filing, this application) >. If d%cclling, number of dwelling units Number of dwelling units on each floor If garage, number of cars h. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front �� Ream__ ,Depth Height /� Number of Stories / Dimensions of same structure with alterations or additions: Front S nY - ,q-s ? Rear Depth Height_ Number of Stories S. 'Dimensions of entire new construction: Front Rear Depth Height Number of Stories 0, _ 9Y 5�"q f r 0, Size of lot: Front___4 Rear /Kd- Depth 10. Date of Purchase L9r/3 Name of Former Owner 11. Zone or use district in which premises are situated 12. Docs 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 —Z 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 NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRFD. b. Is this property within 300 feet of a tidal wetland? * YES NO X * 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 OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)Heisthe /�4IyF� 7d.c ) (Contractor, Agent, Corporate Officer, etc.) of said ou ner 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. Swom to before me this 874_day of 200 Notary Public S iguatu�o f App I i can t GLENN R.YVUBICER NoWY PubNc,Stec of NOW York &j WkCaffftNa0/Wt18020878 KEYED FOR:: o�7/✓ - LOCATED AT PSCC !/G TOWN OF CCI SUFFOLK COUNTY N.Y. LOT B MAP OF PEco✓IC I-10A-7E.5 SEC. 1 CO. CLK. N0. P,131 FILED CcT SCALE I" =moo �c/ �7.5o3p E �71D 38 SUFFOLK CO. TAX MAP DATA:- DIST. 7000 SEC.07¢ 00 ry UNDERWRIEQUIREpTIFICATE BLK. O/ 00 LOT 075 000 OFi.7 � rr� b.c 43.5 52o W ;i FcETS I C,'A STxUC i�,c`. (� 3' 6 TO RELATIVE 6CUNDRY Ll"'El % piRT mT ON SURVEY, ARE FOR A �� C'AR' —5 AF — 1 SPECIFIC S` ONLY, AND Zn S 451�v-/ OR ue SHOULD NOT BE USED FOR — CONSTnUCTiCfl OF FENCES e V � OR OTutr ;TRt TURES. W o V ro m N OCCUPANCY OR USE IS UNILAWFUL � Qc �T LOMf7gNY s 47 '5a'3o [�/ 175 73 W I�FlOU� CERTIFICATE 0) OF OCCUPANCY �iJSVl7<INCE �oM,oq,v�/ } _ SURVEYED � 28� 1992 BY F oR� RAMPART SURVEYING P.C. 7'7��/ -$-ODlo3 W d \�x �, �• � �•�• c Pio BOX 377 �7 JAMESPORT, L.I., N.Y. 11947 NYS LIC. 334440 FILE NO. /3206 PAGE 2B GRIDG-40 DRAWN BY y%� UNDERWRReRsRn ~ APP OVEDASNOIEO io oA � NO MY DEPARTNUT AT 755-1807 0 AM TO 4 PM I =111{ - FOLLOWING INSPECTIONS. 1. FOUNDATION . TWO REGUNIEE FORPOUREDCONCRETU S, y P. ROUGH • FRAMING i IPMEM 111Ga INSULATION - 4 FINAL - CONSTRUCTIMN gMBE COMPLETE w ALL CONSTRUCTION i AIL OW THE REQUIREMENTS OF THE N.% STATE CONSTRUCTION i ENERGY ILK FOR DESIGN OR NOT RECOMSTRUGU0M EG E ORE,, I PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. STATE BUILDING CODE. PROVIDE SMOKE-DETECTING { ALARM DEVICES AS i0 PART. 721.1 N.Y,S BUILDING CODE.- m - II — - -- -- `4O � . r - - _ _ _ _ ._ _ —•------..—�, as IS UNLAWFUL �FJTCERT CERTIFICATE � OF _77— OCCUPANCY .'.ffi ku i CC .. r I - �1 I . r ` pop ' f�o- iaety y 1 w IAF. .. C �•� a WWWMMM .. - o FO 012154.1 - + �ADFESSISNP�'/ . i�iv ml PVT is FW, W A t HallOt M 14 J�, cc )Crl STML rL(Im"Pik otuA. ot go, Ao 'Yq I- T, bd -AIIEVj ;:4PLz 0322W If CL 110'111 1 0, w 111A P�A, 0 J111 Ya. . ,s. .:+ . n,.w . a rrnw'w.`•. - ;. -r..—r r n . 1' r rs, - v.. — z-*^aa. 'e... FlF- -„ � � � -3 . �� .; _ .,� - ,��, k"wE -,:7� ,. �.t ,;,,. .- w _x.:- lim.. x, _� <r. :..�-. , .,� .. ,k ,, .._ . , on-.. _ .r,'t✓, -.vt„-u .. r. n� .. s, _x W.... - f i 1 „4 ch tt ” lF` 14 Ic -13 001 L d l 4 } i i r a 3 1 i pI- I j� 1 yy L tc wL, i �j ;: f tldelC9n w s '., c Y 3C r" JxI,J Je na et- 1� ♦ - I" -{'rM+M T1altit /:' .y„ '•'n.,,,, t F1A'4'Ffi 5'1f<' »'y�i �' ' - T f . f _ Ir , x}: M .- ;. ' ' r- -;• ;, " : :;.. 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