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Home My WebLink About28897-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29442 Date: 05/16/03 THIS CERTIFIES that the building ADDITION Location of Property: 245 HICKORY RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 54 Block 9 Lot 5 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 2002 pursuant to which Building Permit No. 28897-Z dated NOVEMBER 7, 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 DECK ADDITION AND SUNROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to ANDREW & BETH WINEBERGER ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1109830 00/50/20 PLUMBERS CERTIFICATION DA'£~u Rev. 1/81 N/A ~thor'iz~di~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28897 Z Date NOVEMBER 7, 2002 Permission is hereby granted to: ANDREW & BETH WINEBERGER 245 HICKORY RD SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN UNHEATED SUNROOM AND DECK ADDITION AS APPLIED FOR at premises located at 245 HICKORY RD County Tax Map No. 473889 Section 054 pursuant to application dated NOVEMBER Building Inspector to expire on MAY Fee $ 150.00 SOUTHOLD Block 0009 Lot No. 005 7, 2002 and approved by the 7, 2004 . ~k-~gnat ure ORIGINAL Rev. 5/8/02 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 si~mlar buildings and installations, a certificate of Code Compliance from architect or engineer responsible tbr the building. 6. Submit Plamfing 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 l. 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 New Construction: Location of Property: Date. Old or Pre-existing Building: House No. Street Owner or Owners of Property: r~,~ ~ /'~ ~//~J~'~' Suffolk County Tax Map No 1000, Section &-'-fi" Block (check oue) Hamlet Lot ~ Subdivision Permit No. ~2a~a~/OT- ~ Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Filed Map. Lot: /~'J,~.~ 2 Applicant: ,n~---~ Underwriters Approval: __ 1~ Final Certificate: ~// (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by PAUL R. BURNS ANDREW & BETH WINEBERGER P,O. BOX 1061 245 HICKORY RD SOUTHOLD, NY 11971-0932, SOUTHOLD, NY 11971 Located at 245 HICKORY RD SOUTHOLD, NY 11971 Application Number: 1109830 Certificate Number: 1109830 Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting electrical devices and wiring, described below, located in/on the premises at: Fkst Floor, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in therewith the 2nd of May, 2003. compliance on Day Name QTY Rate Rating Circuit Type Wiring and Devices Receptacle 6 0 General Purpose Switch 3 0 General Purpose Fixture 2 0 Incandescent Paddle Fan 1 0 Receptacle 1 0 GFCI seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location intricated. 'BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: Il / ] /02 DATE SUBMITTED: i[ /~0~/02 APPLICANT: ~},Jbiffb) t_~_e~t.~hl~-3~'~_ SCTM#DISTRICT: 1,000, SECTION: ~ _,BLOCK: &, LOT: ~" STREET ADDRESS: Z~' ~ ~ _ CITY: ~ SUBDWISION: PROJECT DESC~TION: ~b~O~ ~~ ~ ~J~ ~- EST~ATEDPROJECTCOST:~~RcHI~EC;/;NG1NE;:---~/~ FAST T~CK? ~ S~GLE & SEP~TE CERT~ICATION-~QU~D? ~ NOTES: ~ ~ LOTS 40,000SF -100-24 ~t reco~ition.(CREATED beforc June 30, /983), UNDERSIZED LO I'S FROM JAN.1997 100 25 Mmger (A nonconforming at any time after 7/1/83 ZON~G DiSTraCT: /'q~ COlOr'G? ~O ~ REQ. LOT SIZE:~,~fl~ LOT S~E: ~ ~Q. LO~OV. ~ ACT. LOT COV. ~Q. FRONT / -, ~ PROP. FRONT~ ~Q~E /~/ff~ ACT. SDE ~ REQ. ~ ,~ ~ PROP. ~ / REQ. HgIGHT PROP. HEIGHT WATER FRONT? ~ DESC~TION: ~ ~ PANEL~: 1.~ FLOODZONE: ~ , -- APPROVALS REQUIRED SUFFOLK COUNTY HEALTH ~Fe~T: YES OBED #): DTE: TOWN SEPTIC RECEIPT: Y NEW YORK STATE DEC: PRZ-~)ECg/1/?5 YES SOUTHOLD TOWN TRUSTEES: YES or~_- TOWN ZONING BOARD APPROVAL: YES ol~Q~ TOWN PLAN. BOARD APPROVAL: YES o~..Q~_ TOWN HISTORICAL PRE (SPLIA): YES or O~_.Q.~) NYS ENERGY: YES Ot~: EGRESS (18 H min.? 4 sq total) T (SQ. FT. x 4%). BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: / / PERMIT #:R10- LIGHT (SQ. FT. x 8%). FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: 11 (C;~ SF)-( SF SF SF SF SF .SF)= SF X $__ =$ +$ INIT OTHER FEE FEE +$ = $ TOTAL FEE 2.( SF)-( _SF)= SF X $__=$ +$ +$ = $ BUILDING DEPT. .INSPECTION ~FOUNDATION 15T [] ROUGH PLBG. [*~FOUNDATION 2ND I] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY "' /~-.'-----..---<-,---'~w~-'~/'". , " ,, ' DATE l INSPECTOR 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] F/OUNDATION 2ND [ ] INSULATION FRAMING [ I FINAL FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ~/IINSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS. ~ .-'~"~-.-~- 765-1802 BUILDING DEPT. [ ] FOUNDATION 1ST [ ,] R/,OUGH~ PLBG. [ ] FOUNDATION 2ND [/~ INSULATION [ ] FRAMING [ ]FINAL [ ] FIREP~ CHIMNEY REMARKS~ _ INSPECTION BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] ROUGH PLBG. [ I FOUNDATION2ND [ ] I~ATION [ ] FRAMING ~ FINAL [ ] FIREPLACE & CHIMNEY FIELD INsI~CTIONI~ORT DATE COMiV[~NTS' FO~A~ON (1S~ ~0~0~ (~) /.-/ ~D~ON~ CO~TS .... TOWN O1~ SOUTHOLD BU1LOI ~NG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.ne?outhold/ PERMIT Approved____~__~__, 20~ Disapproved ~c/(~ ~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S,D.E.C. Trustees Contact: Mail to: ~ Phone: ~/-~J"- ~'~'~ ~ ' APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ~. Th~s apphcat~on MISST~h¢~coo/npletely filled ~n by typewriter or in ink and submitted to the Building Inspector with 3 sets of plsc~s, ~i~rate~16~ i~l~n 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. £ Every building pernnt 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 pemtit 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 Name of owner of premises .~f/~-~' -~ ,a~-,-'~f~'(,,~-~¢ ?.~, e~. (As on fl~e t~ roll or latest de~) If appli~t is a co¢oration, si~at~e ~duly aut~fized offic~ (N~e ~d title of co,orate officer) ~ Builders License No. 2 ~ -/~ Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block .~ Filed Map No. Lot .5- 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 \~-,..../-~--~.,- -- 3. Nature of work (check which applicable): New Building. Repair Removal Demolition 4. EStimated Cost ~ ~e-~,-~ Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ff'z ' Rear ~'?, '~ Depth Height ~- 2-.'.,/~ Number of Stories Z Dimensions of same structure with alterations or additions: Front Depth +'~ / Height. - z ~.'" Dimensions of entire new construction: Front .2.Y" '~ Height -~/~. ~' Number of Stories Rear Number of Stories Rear /3'- ~" Depth Size of lot: Front ./~,~ '~ Rear /pt> ' Depth 10. Date of Purchase ,~/'-'~-¢,~' Name of Former Owner /~,~/~- ,,~ ~'//-,-~ t-, ~/',~--/~ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~/ l 3. Will lot be re-graded? YES __ NO ,./Will excess fill be removed from premises? YES NO ~ 14. Names of Owner otpremises ::~ ~ ~'~-/-*~ ~--~¢~Address ac'~-~/~'~-x~L~'L~ Phone No. ~,"- ~'_F- -V~.¢4, Name of Architect / Address Phone No Name of Contractor ?),*.~ ~.r ~ Address~"3-- G--,~o_re (-,'e~-..d?hone No. t~e/- .~'.(--?..,~%a' 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO c// * 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) COUNTY OF,~i ~/~*q)S: /~)'<"~" J~.~ ~-~' being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the d"~,,--~.P'~a ~ ~ (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 tree 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. N CLAIRE L. GLEW otery Public, State of New York No. 01 GL4879505 Qualified n Suffolk Cou~.,~)r Commission Expires Dec. 8, ~ gnature of Applicant CONC. N 47'49'40"E FRAME N/F RYAN PINE ROAD '/.50.00' WOOD DECK UNDER CONSTR. AsAPHALT DRIVEWAY GARAGE 47.6" -35.3' 2 - S TO RY RESIDENCE WIRE FENCE MON. S 47'49'40"~ -- '-~ WOOD STEPS COVERED PORCH W/RAILING -47.2; 130.00' N/F BURK CONC* MON. 0 ~< 0 SURVEYED: 7 JANUARY 2003 SCALE I "= 20' AREA = 1.3,O00 S.F. OR 0.298 ACRES ?000-054'0§ GUARANTEED TO: ANDREW WINEBERGER BETH WINEBERGER SURVEY OF DESCRtBED PROPERTY SITUATE SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUN'P~, N.Y. SURVEYED FOR: ANDREW WlNEBERGER BETH WINEI3URGER SURVEYED BY STANLEY d. ISAKSEN, JR, P.O. BOX 294 NEW SUFFOLK. N.Y. N¥S Lic. No. 4927J O JR 1205