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Home My WebLink About28879-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29480 Date: 05/30/03 THIS CERTIFIES that the building ADDITION Location of Property: 179 OLD HARBOR RD NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 3 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 2002 pursuant to which Building Permit No_ 28879-Z dated NOVEMBER 4, 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 DORMER ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PETER P WICKHAM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A . ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A t rized 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_ 28879 Z Date NOVEMBER 4 , 2002 Permission is hereby granted to: PETER P WICKHAM 3854 TRAILRIDGE RD S E CEDAR RAPIDS IA, 52403 for SECOND FLOOR ALTERATION AND DORMER ADDITION AS APPLIED FOR at premises located at 179 OLD HARBOR RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0003 Lot No. 001 pursuant to application dated OCTOBER 2, 2002 and approved by the Building Inspector to expire on MAY 4, 2004 . Fee $ 150 . 00 ut or' ed Si44ature COPY Rev. 5/8/02 ` - Form No.6 TOWN OF SOUTHOLD �' +✓ NJ 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 I% 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. Subm t 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 $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. XAY 3 New Construction: Old or Pre-existing Building: K(check one) Location of Property: _ 79 Q L D ffw 6ok 403M A&d Hoo. Street Hamlet Owner or Owners of Property: PQ^fr Lo vtSC e,/, G/<t-f*M Suffolk County Tax Map No 1000, Section // 7 Block 3 Lot / Subdivision _Filed Map. Lot: Permit No. 251679 -7— _Date of Permit. y 20022 Applicant: -rO/k 4VPAE VC,e Health Dept. Approval: )✓/� Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: � (check one) Fee Submitted: $ 2 S OU 6c— Applicant Signature Fax (516) 765-1823 ti = Town Hall,53095 Main Road Telephone (516) 765-1800 O P.O.Box 1179 �' p! Southold,New York 11971 viol � �a SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION TO: Southold Town Building Dept. FROM: Southold Town Landmark Pres. Comm. - Herb Adler, Jr. DATE: October 31 , 2002 RE: House owned by Peter Wickham on Old Harbor Rd. , New Suffolk - Tax Map #117-3-1 With respect to the proposed dormer, the Landmark Preservation Commission has no objection. The Landmark Preservation Commission is still investigating whether or not this building is on the SPLIA list. BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: to/ L /0 APPLICANT"E�� ,u�xr DATE SUBMITTED:jo /�/OZ SCTM#DISTRICT: 1,000, SECTION: 11, , BLOCK: I , LOT: j__ STREET ADDRESS: f C7)D �aTOgpIL CITY: qav u COLK SUBDIVISION: £sem• PROJECT DESCRIPTION: c. 0) Wl ESTIMATED PROJECT COSTI/ENGINEER: �� y.,,.,.p� FAST TRACK? N SINGLE & SEPARATE CERT KATION-REQUIRED? A/0 NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at anytime after 7/1 ZONING DISTRICT: I-f 0 CONFORMING? IVO REQ. LOT SIZE: y®, ACT. LOT SIZE: REQ. LOT COV. 1� ACT. LOT C✓ REQ. FRONT PROP. FRONT J'REQ SII}E� ACT. SIDE REQ. REAR jnD PROP. REAR REQ. H /I HT PROP. HEIGH/T WATER FRONT? vr< DESCRIPTION: �ou-i(oB PANEL #: .40 r _ FLOZ5D ZONE:, v APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or�, (BED #):_DTE:—/_/ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y or& NEW YORK STATE DEC: PRE-DEc 9/1n5 YES SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): or NO ► 6`(�' d?n NYS ENERGY: YES OR / EGRESS (18 H min.? 4 sq to al)=:/VENT(SQ. FT. x 4%) LIGHT(SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z_ HAVE PRE CO'S : Y OR N BP -Z/C/o Z- NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: 1410 SF FEE FEE FEE 1. SF)- (J SF)= SF X$ _$ +$ +$ _$ /;s:-0, 2. ( SF)- ( SF)= SF X $ _$ +$ +$ _ $ of?;�4, M-lW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROU PLBG. [ ] F DATION 2ND [ INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: - DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ ] IN TION [ ] FRAMING [ FINAL [ j FIREPLACE & CHIMNEY REMARKS: DATE � INSPECTOR � /� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 5 D3 INSPECTOR ✓" FIELD INSPECTION REPORT DATE COMMENTS ro FOUNDATION(1ST) J H C y FOUNDATION(2ND) M x O y ROUGH FRAMING& PLUMBING H INSULATION PER N.Y. H STATE ENERGY CODE 77 Ae FINAL ADDITIONAL COMMENTS O z Z m H O x m d FOW'.N l9F SUUi'HOLD 13U1LLANUFF,MI AFFLIU:AIION CHEC I BUILDING'DEPARTMENT Do you have or need the following,before apps, TOWN HALL Board of Health SO UTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. t-� / Check Septic Form N.Y.S.D.B.C. ,/ Trustees 7 4 20 Confact Approved r ,20_L"l - Mail to:, 4+EK R##11472- Disapproved 2.Disapproved a/c Phone: 73 4 - 4lNlg8 S tnlding Inspector APPLICATION FOR BUILDING PERMTF � �,-.iJiJ r` 2 2002 i Date A010 Z 0 Z 20 INSTRUCTIONS a W! W ' 'J",HOS a. s app c on a 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 ofbuildings on premises,relationship to adjoining preruises 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 a Certificate of Occupant', is issued by the Building Inspector. APPLICATION IS IiEREBY 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,I aws, Ordinances or Regulations, for the constriction 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 to admit authorized inspectors on premises and in building for necessary inspections. MAjeV tV0fC c✓�9'�nrz_ i a corporation) rol box M Cd FCh(Vd&E 1/93r (Matlmg address of applicant) State whether applicant is owner, lessee, ent atchite engineer, general contractor, electrician,plumber or.builder Name of owner of premises JZ i}T V LV/1 C IL 149 M (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 of land on which proposed work will be done: /791.x' OLO HA&Bo)C +201 410 /U" l SvFlroc Li House Number Street Hamlet County Tax Map No. 1000 Section Block 3 L'ot Subdivision Filed Map No. Lot (Name) 2. State existing use and.occupency ofpremises and intended use and occupancy of proposed construedow a. Existing we and occbpitncy S/a/6 L E &-f—/'K IGS E S l p�iy n.9z b. Intended use and oocupaacy 3. Nature of work.(check which applicable):New BuildingL Alteration_. __ Repair Removal Demolition Other Work (Description) 4. Estimated cost . 40D 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 toccupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures,if any. Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Hight Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase blame of Former Owner 11. Zone or use district in which premises are situated O 12. Does proposed construction violate any zoning law, ordinance or regulation: /U Q 13. Will lot be re-graded__f Q _WM excess fill be removed.from premises: YES NO P6TV4 *419 "01.6 3654 TJeArr-.Rr01lE,�sl�2tt� SE 14_ Names of owner ofyL d es wlcgH4at Address cCOAtt AAR1OSj PloneNo._3i 9 3L •6 Namc.ofArchitec. M4r¢It f6�f/.�.ir_r- Addresses OLX 933 Phone No 734 - 4/Pl Name of Contractor w AyyQE JAt�f[- Address Ps daX 3 4 9 Phone No:_73 4 -.�'7.3 u. Tty»4� 15. Is this property within:100 feet of a tidal wedand? *YES >< NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at anypoint on property is at 10 feet or below,must provide topographical data on survey. iTATE OF NEW YORK) SS: "-OUNTY OF �y J Tt "— ' -` '-v T big duly s'OTn deposes and says that(s)he is the applicant (Name of individual signing corat'aot)above named S)He is the G C �. - (C Agent u Officer, etc.) 'said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; tat all statements contained in tt=application are true to the best of his knowledge and belief; and that the work will be erfoaned in the manner set forth in the application filed therewith. worn to before me this Z.VY> day of OcSF/C 20 oL NotaYy Public Signature qApphli uNDAJ.COOPER Notary PuWle,State of New Yak No.4822563,Suffolk County Teruo Expires December 31, —i ......... Ila Wig I�.�� _ -1- PrzowosEn ng. hrtii;�,! 21" D0124j61C 2A.1 n y \ 1 f F �i s>z.:- !.,d'.�'r, :e- �f, a..�,. . � .Leri 4�`t{r'-I.a.Cv� ._- ., "�✓'1 .r' � -_ •�`.,!t.� ., ,U, :1 M c s aawriaL drss�it+Lcr.. - \ � Gny}9iru.ur \\ Va?rt 44 ' �`CA,m.�Ly cwrN A�Cc N��sBc' q✓� %awJ✓ coDr� `QCENTIM1IC:ITE .- At— I'� "(f.C1Rgt -- '.fir - kEUIUIREU APPR ED AS NOTED '---' -- BA 2 B.P.I. FiiO11IpE OPENINGS FOR 765.1 FOLLOLDING WING TO INSPECMENT AT TIONS: ry t. S'"GEf�CY ESCAPERS 785.1802 9 AM TO 4 PM FOR THE F �^'�'^ELS A't fART. 714 OF ---- -� i. FOUNDATION TO 'I: =iJE Oa?LDING CODE. - - _ � FOR POURED CON"" T 2 ROUGH - FRAMIf - u .: _ - -- �' 2. INSULATION - �I n U I I 4 FINAL - CONSTRUCTION MUL, II „ ( BE COMPLETE FOR C.O. I'J o _ ALL CONSTRUCTION SHALL MEET - o 'Li THE REOVI^- mmNTS OF THE N.Y. Ilt'~ I41, RGY CODES. NOT R SPIONS BLEEFOR - , DESIGN OR CONSTRUCTION ERRORS Sal Aj- --LU- OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE Fa S Z-o I 6aK , 140A U � 1 OF OCCUPANCY IV OrS � - Eb no I Pxw" q w scy"a MK_X � 04191" R + � N�� 11TX�