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Home My WebLink About28386-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29507 Date: 06/10/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 500 MAPLE LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 64 Block 1 Lot 20 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 14, 2002 pursuant to which Building Permit No_ 28386-Z dated MAY 14, 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to DOUGLAS F & AMY C ROSE JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H 067930 05/15/00 PLUMBERS CERTIFICATION DATED N/A "'4 "�7'"-/ t iz d Si ature 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. 28386 Z Date MAY 14 , 2002 Permission is hereby granted to : DOUGLAS F JR & AMY C ROSE PO BOX 1331 SOUTHOLD,NY 11971 for CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REAR YARD AS APPLIED FOR. THIS PERMIT REPLACES BP#25380 . at premises located at 500 MAPLE LA SOUTHOLD County Tax Map No. 473889 Section 064 Block 0001 Lot No. 020 pursuant to application dated MAY 14 , 2002 and approved by the Building Inspector. Fee $ 118 . 50 Autho zed S ' nature ORIGINAL Rev. 2/19/98 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. 25380 Z Date DECEMBER 7, 1998 Permission is hereby granted to: DOUGLAS F. JR & AMY C. ROSE PO BOX 1331 SOUTHOLD,NY 11971 for . CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REAR YARD AS APPLIED. at premises located at 500 MAPLE LA SOUTHOLD County Tax Map No. 473889 Section 064 Block 0001 Lot No. 020 pursuant to application dated SEPTEMBER 24 1998 and approved by the Building Inspector. Fee $ 63 . 00 Bui ding Inspector ORIGINAL Rev. 2/19/98 Form No. 6 77 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 t APPLICATION FOR CERTIFICATE OF OCCUPAtCY ~T. � D A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 ofFire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 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 a 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 Buildine - $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. . Lr�"fq Old Or Pre-existin Buildinj ^ . . . . . . . . Location of Property. .. . . . . . . . . . . . . . . .'. . b �� . 11� .s. . . . . . .Y. '::':�1�. . . . . . . . . . . . House No. Street ^� Hamlet .f Onwer or Owners of Property. m /D-w- .2. c6ej. �.1v . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section ��' .73 P. A. Bl. ock. .OQ�).l. . . . . . .Lot. . !:P:�D . . . . . . . . . . . . Subdivision. . . . ! ref e.nl.. . . . . . . . . . ./. . . .F7ileed¢Map. . . . . . . . Lot. . . . . . . . . . ./..�. . . . . .�.[. . . C Permit No. . . P. . . . .Date Of Permit. . .[a/f//. D. . .Applicant' . /-`, . I�.QSr Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . ./. . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . �11S Fee Submitt d: $. . . . . .'. . . . . � . . X50'7 . . . . . . . . . . . . . . . . . . ( Q } APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 8078275 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date MAY .5,2000 Application No. on file 19619211n9/99 H 067"130 THIS THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of DOUGUO ROSE, 500 WLF, LANE 4OUTHOLD. NY in the following location; LJ Basement W Ist FL NY F[. GAR/OUT Section Block Lot was examined on MAY 08,2000 and found to be in compliance with the National Electrical Code.- FLXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCE FWORESCEm I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 18 13 1 14 1 12 1 6 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'Pr. TIME CLOCKS I BELL UNIT HEATERS MULTI-OUTLET SYS EMSDIMMERS AMT. K.W. OIL N.P. GAS N.P. AMT. NO. A.W.G. AMT. AMP. AMT, AMPS. TRANS, AMT. N.P. NO.OF FEET AMT. WARD SERVICE DISCONNECT IN 0 OF S E R V 1 C F. METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMf. AMP. TYPF EQUIP. I R RW 1 I ]W J 1 JW J B eW PER 0 OF CC.CON NO.OF HI-LEG OF W.LPG NO.OF NEDTRAIJ Oi NFNRAL OTHER APPARATUS: WHIRLPOOL BkTH-1 PANELSOARDS11 -6 CIR, 100 G.F.C.IL-3 SMOTE DETECTORS -1 D^LtGT ROSE LL P0BOX 1131 GENERAL MANAGER SOUTHOLD, NY, 1 97 Per This certificate must not be altered In any manner; return to the office of the Board If incorrect. Inspectors may be identified by their credentials. IN In NMI BE lm,RE IME II COPY FOR BUILDING- DEPARTMENT. THIS OPY OFF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. - 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ( ( INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING ( FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ;DATE 4ZI7101 INSPECTOR 1E-LD i7:S."EC ION JJU: :n COHMENTS m a OUNDATION — ( 1st) c 'OUNDATION ( 2nd ) C z o v'9 LOUGH FRAME & V PLUMBING N H 3. m m INSULATION PER N . Y. y STATE ENERGY CODE x a y — )r m4 .. . H 04 FINAL l x d x ADDITIONAL COMMENTS: m x H N O 2 • S a H T d ' m H BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PIANS . . . . . .. . . . . . TOWN OF SOUTHOLD SURVE BUILDING DEPARTMENT CHECKlOOJ!r' TOWN HALL SEPTIC F RM . . . . . . . . . . .. . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: q 44 CALL . . . . . . . . . . . . . . . . . . Ii / �s lJ MAIL TO: . . . . . . . . . . . . . Examuired..�...G••--....., 19.p11. Approved....JV111......... 19.18. Peradt No. .. � .................................. Disapproveda/c .................................. .................................. .......................................... .. ........ J (Building Inspector) 2 4 Im APPLICATION FOR BUILDING PERMIT L_ - Date QdPli . , 19 . BLDG. DEPT. T WN FS UTH D INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector w 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan slowing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be dram on the diagram which is part of this application. 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. Suo 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAIL' 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, Ordinancesor 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, build' ohousing code, and regulations, and to admit authorized inspectors on premises and in buiTdh for my ss ns ...... ....... . ..... . ........................ Cure o applicadt, or name, if a corporation) 84�c133J1.15M&01c ...N4..1J9"1J.......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde ....... N ..................1.n......y'.........................................j......................................... Name of owner of premises ....16 qw T.,.Rcw zf ..�.�. 1.11919..0 ...................................... (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. .................... I. Location of land on which proposed work wield�be,.danne............................................................... s1 ....M ffL PctJ� . '^.'v yr{J�^r?........................................................ House lkmber Street Street Hamlet County Tax Map No. 1000 Section ......(ay...... Block ....Q.1........ Int ... ........ Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguse and occupancy ..... ... APO .. .... ... ....... . b. Intended use and occupancy as (11C:A 3. Nature of work (check which applicable): New Building .A/ Addition ... ...... Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. ...........(Description) 4. Estimated Cost .....TBD:............ fee ....!:.�IV:.GQ. ................. (to be paid on filing this application) 5. If duelling, number of dwelling units t ..... ...... Number of dwelling units on each floor ..... .......... 7 If garage, number of cars ........ 00......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use........... ........... le 7. Dimensions of existing structures, if any* Front....'.�W'�� $Rear ...� h 7,....... Depty Q ` 0 4 sleight .... t7 7 ...T �... Number of Stories .....UYI&. Dimensions of same structure with alterations or additions: Front ...510A)e0 .... Te*f.S � .... Depth .... �......... Height .... ..... Number of Stories ..JqrV ,... v , 8. Dimensions of entire new construction: Front ....Zr 3.A.. Rear .... }leight ....... j...�......... Number of Stories ................ ... - 9. Size of lot: Front ...1Z.Q............. Rear ....1.1W ........... 10. Date of Purchase ...Tit)(vAk4ii.OqL Nam of Former Owner .......... II. Zane or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: A10 ................. 13. Will lot be regraded ....WD............ Will excess fill be removed from premises: YES 14. Names of Amer of premisesy,F&R.C ?C.J�l. Address .Zc{e-LABSA1.Sav Vvao.,.1.``.., Phone No. �6S-.gyne , Name of Arcbitect 14�nS . R� S?! K!...... Wress15Q-.17 /ev�!1 .01Ti.NY Phone No. h'Z(.....!.? Nameof Contractor ...... ............................ Address ................... ........Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ...Z. *lF YES, SWIT]" MM T[dIS1FE.S PERMIT MAY BE WFI IM. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street block number or description according to deed, and show street s and indicate nuinether interior or corner lot. 5ee. kit „i _ "� Cop y1QSF SfAIE OF NW YORK, C �+ `' SS QJIINIY or ..��.�2 �f�iS��C�........ ...T.` ..L. . ''�.. ... � ..lsr.:...........beinp, duly sworn, deposes and says that he is the appl.icanl (Name of individual signing contract) above named, Ile is the ......... Q W.r:wp . ........................................................................... (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this rpplication; that all statements contained in this application are true to the best of his knowledge and belief; and _hat the work will be performed in the manner set forth in the application filed therewith. Sworn toobe" me this ....M.l2 .. .. ......day Of ^�//.....19R%.... Notary dANINE VALEN?I .. ..••• ...... . otery Public, Stets oT New Yerk igna of A licant) No. 01VA5063668 Qualified In Nassau County R pAO 21 MA(NYS R W o mIU SNpTN 263.0 N m /O1F WARREN SURVEY OF N PROPERTY A T SOUTHOLD m rt E h a P TOWN OF SOUTHOLD N. 12'30'p0 a s P SUFFOLK COUNTY, N. Y. � ' a 1000 - 64 - 01- 20 Scale: 1 30' �. f "ell �+ � ,- - Jan. 11,' 1995 °o.st P• .. �t,. 47 ra M � o � s ns° � Z o 6to f m 2e D \� c u az•I' w, Z N \O oCERTIFIED TOO ,'A N/MJ DOUGLAS ROSE, JR. li sib .294 SE 0' W R'CpNO COR ANTHOHOME NYAMY C. O INCOTTAEVINGS OF RICA —AND s M„ s. N1p/F CONGRESSIONAL ABSTRACT CO.INC. O 4NY gqLLT£RATION OR ADDITION TO THIS SURVEY IS A WOLA TION \ )F SE nW 7209 OF THE AEW YORK STATE EDUCATA)N LAW XCE0 AS PER SECTpyv 7209-StAgOMS)ON 2. ALL CERnF7CAtmw S. LIC. NO. 49618 , IE ARE VALID FOR TMS ANAP AND COPES THEREOF QALY f pe 'AID OR COPES BEAR "E AFRESSED SEAL OF THE SURVEYOR AREA = 31,486 s f t. YHO A TLRE APPEARS rEREOAL Eco ORS, P.C. Q 15161 765 - 20 .m Y TO COMPLY WITH SAA) LAW THE TERM ;ALTERED BY' P. O. BOX 909 IUST USED BY ANY AAV ALL SURVEYORS UTLA&M A COPY IF SURVEYORS AAP. TERMS SUCH AS 'fiWECTED•AND MAIN ROAD 9R -TO-OATE'ARE NOT AV COM"UANCE WITH THE LAW. SOUTHOLD, N.Y. 11971 95 - 104 N Ird-4o'-4o"w 120•CO' t} rt1 dl o N N .R I � NSW 2 GAQ �2'fA 9.0 tie a,4 to.O ale p o v b Sa Z.P - �4.43 Sri. N — N� ADDITfOW. -. 1esC, iZ.�biRENCTc i i V3.13 710.o Ivo � N� Q S� Wq4� a P O 51/0°ori'-3o"� I?o.00' QL.n T P L. id,�J i!�cAL,,�; _;�P, 40UWI--{ TAX MAP W 1000-6a4-01-1-0 J?14- OP 00 Iii 195 P✓Oer,-� 51.1PANIC. 5uAOZY"K,?,o• a a _ RmF PEAK _ A'mIG �/Et>kT �pT'p� �1�1Th _ Z?v°I' PI'UmGIA*/ASYuA T - - - 71 XM,&La OI* - -- - -- T -- - - — — — ALUM,6LrM " d - 1J��{{ � _ G I 4 BAST Cy ,T gra -- SoviT N LF-V_ TION W"'mr- f�LEVAT--1oN_ 'klY�kl�.q�Aj/AbPv1AL.T - 1 OQ °I°z7° ahlp OoaR- J�2' �pk -k[.�V\eev ' otJ 2� RAPT�V1s� lro"oa, off IJ) SST �2 la NIP FZAF-7�) �2) 2ul2+la:A> I APPRPVEDB # -2jp ve-- Fm h NOTIFY BUILDING DERMrmw a FOL OYNNG 1802 9 AM I� I= 71E 7. FOUNDATION FOR POURED CONCRIFIE �} o2 ROUGH - FRAMING i PLUMBOUS 1 3. INSUTI S _Q �� 4. FINAAL -ON MUST _ _ BE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET M THE REQUIREMENTS OF THE N.Y. macaw - STATE CONSTRUCTION S ENERGY CODES. NOT RESPONSIBLE FOR GA�L.�C�E '//4" PLYw�o SU&f lL vyi itza ON DESIGN OR CONSTRUCTION ERRORS S _ '2vj GIG BAMS Two coall--'-fev To „ 4y6, Pp (Te- 6�A&IE.Io) d c311�v.°Klv^ NIcWaLAr� aIR.v�.Yl-- iq INL L1gTVV ?TWM—p1�1Tan.:.G,r-D�a.-) L3\ 0/4Xl6o' AlL GIG-u�c,�. -� N GILD✓ - "(T +� DIJ 4'xG" fi 5. N PRQJIpE 2'u2' Au.S55 JI;U(GFI 70 OCCUPANCY OR USE IS UNLAWFUL owes siv o WITHOUT CERTIFICATE OF OCCUPANCY 15"�6'•IIL.DIfJG PAPEv� OW Yui" G171C E"re4a4d- PI.*'wj? 5^ TNII1' oN - I � � 12°,c4,yTua�ic Ira"o:c, � I 2x4 CLA 511.1- oN UNOERWRRERS.IkRiIFICAIE d1 Aw+4 OLTeaG' e"0'1111 O REQUIRED I - W�Y�C'�xo"KWIk-5Cf 0 (rl I14�Irc M/� ✓-lead h I Ii ri d- Ma1.b�lTNIc.A�e W/ 2'-4'4 LOIJTII.TUG V,�j G, MN I ADDITIONS AND ALTERATIONS to the ROSE RESIDENCE r co PItkU ° AMY & DOUGLAS ROSE, JR. j =�P ,¢:�� MAPLE AVENUE - SOUTHOLD, SUFFOLK CO., NEW YORK THOMAS C. PIEKUTOWSKI DRAWING N0. - _. . . , . ,. _ .e., . . .sem � � n . ; ;:, ._. : . ... . _. . „ - .� ,- -, - .�- ., f=,-.,. . ,: - - -•<: OF--T F. Wt h S A'EO AR b �� 169 f°urtttnih avenue aee cliff, my. 11579 676 5742 oisat .cam Tf '�N\ DATE: SEPTEMBER 16, 1999 SCALE: AS NOTED - �