HomeMy WebLinkAbout16575-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17937
Date APRIL 11~ 1989
THIS CERTIFIES that the building
Location of Propert~ 305 SECOND AVE.
House No.
County Tax Map No. 1000 Section 67
Subdivision PECONIC SHORES
ONE FAMILY DWELLING
PECONIC
Street Hamlet
Block 02 Lot 22
MAP NO. 2
Filed Map No. 654 Lot No. 30
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 26~ 1987 pursuant to which
Building Permit No. 16575Z dated OCTOBER 27, 1987
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 ONE FAMILY DWELLING~ 1ST STORY ~ 2ND STORY DECKS.
The certificate is issued to
of the aforesaid building.
MARY ANN CREATO AND ANOTHER
(owner,
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
87-SO-103 ~k~ItCH 31, 1989
H007651 FEBRUi~RY 3, 1989
FRANK MEYER PLUMBING & HEATING 5/24/88
Building Inspector
~O~w NO. ~
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)
N._16575 Z
Permission is hereby granted to:
..... ~.¥~.....~.~.~ .........................
.... ....-~.~...~ .................................................
.... ~.~-~......~.:~.,..m~..~ ......... ~
,o .~~_~,.....~.b~;,~.~..,...,,,4.~.~..' .~.~ .....
~.......~~.._~...:......:.~-~.- ,, - ,.~____ ..................... ~.~ ............. :,..,~ .............. !~ .................. ~ .....
at premises located at .-.-~.~..~......~.....~ ......... ~., .,~Or..~ ............. L/-..ej-.~.. ........
............................................................................................
County Tax Map N'b. 1000 Section ....... ..~...~..~ ....... Block ...... ..O.....~:.. ....... Lot No.....~.."~, ...........
Building Inspector.
Building Inspector
Rev. 6/30/80
FOHM NO, 11
TOWN OF S0[Pi'HOLD
BUILDINO DEPARTMENT
TOWN HALL
SOUTHOLD, NY
DR%; EL0 PMENT PERM'IT
Pe~lsslon is hereby g~anted to:
County Tax Map No. 1000 Section ~$_7. Block
by the Building Inspector.
Building Permit No.
Building Inspocto-~,
4/80
STEVE G. TSONTAKIS ASSOCIATES
Consulting Engineers, P.C.
BUILDING DEPARTMENT
TO~N OF SOUTHOLD
Main Road
Southold, New York
11971
June 30, 1988
RE:
Foundation, 2nd Avenue
Peconic, New York
SCTM# 1000-067-02-22
I certify, based on the installer's Certification,
that the referenced foundation complies with the requirements
for an "A" zone flood plain foundation.
SGT/bu
Enc: Builder's Statement
Mason's Statement
Steve G. Tsont~k~s, P.E.
P.O. BOX 1180, 632 ROANOKE AVENUE, RIVERHEAD, NEW YORK 11901 (516) 727-7411
~EL~.2{)8-8950 DATE June 28 19 88
dOSEPH CRENSHAW
MASON tVORK
OFFICE- RTE. 25, P.O. BOX 1446
MATTITUCK, NEW YORK 11952
M Gene Csiesak Job
2nd Avenue: Penonte
Foundation consisting of:
2' wide x l' high footing with 2 ~5 rebar
l* wide x 4t high walls, 2500 PSI concrete
*ith S4 rebar from footing extendin~ 20"
EucsNs A. Cs~cs~u~
aox 429
MATTITUCK~ ~qEW YORK 11952
The assembly of the piers is as follows:
I wired ~4 rebar to the rebar that stuck out of the
top of the walls, then I laid the 12 x 16 concrete blocks
When the piers were level I filled them with portland
cement mix with gravel. I then installed 14" tie
down bolts in the center hole of the blocks.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
netura~ or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal)·
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable·
B. For existing buildings (prior to April 1957), Non-conformin~ uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~Oparty showing all property lines, streets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.(30, Accessory ,$]0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $100.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
NewConstruction ..... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .........
Owner or Owners of Property ......
County Tax Map No. 1000 Section ........... Block ............... Lot ...........
· · .................... Filed Map No ..... Lot No.
...... . .Applicant ................................
Permit No ..... Date
Health Oept Approval
· · .... Labor Dept Approval
...................... Planning Board Approval ...... .
Underwriters Approval · ·
Request for Temporary Certificate ..................... Final Certificate ...........
Fee Submitted $ '~..~-~.
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-7a
· -' "THE NEW YORK' BOARD OF FIRE UNDERWRITERs
8~00~4~'[ BUREAU OF EL.EGTRK.~ITY
! B5 JOHN STREET. NEW YORK. NEW yORK tO~e
~1~ CE~IFIE$ T~T
~ez.~" ,7&~lI~RY 2~1.989 andf~ndtobein~mpllon~withthe~ui~ntaofth.~rd.
~ 19 31 29
EXHAUST FANS
~ u~..~mm., S [ I! V I C E
SNORE DETKCTOR :-2
429
monner; mum to the office of
i BUILDING DEPAR?MEHT. THIS C
· THE NEW YORK BOARD OF FIRE UNDERWRITERS
8002461.
BUREAU OF EL.EC~'TRICITY
~'- ~I~NUaI~Y 26~ ]9~ JOHN STREET. NEW YORK. ,~11Y~.~/~O38
l)~t~ Application No. on
THIS GEI~i'IImlEH THAT
PAG~ 1
~.~ 2nd FI. F, eetioa Block Lot
and.found to be in compliance with the requlr~meat# o.f this Board.
SNOKI: DETECTOR :-2
F,I~IG F. tIE
I~OX 429
MATT [TUCK MYl 119B2,
'; )/.//
Ptr l/?'/-// Em
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date May 24~. lgR~
Building Permit No. 16575 Z
Owner Eugene A. Csicsak & Maryann Creato
(please print)
Plumber Frank Meyer P]~mbing & Heating
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumbe~/S signat~e)
Sworn to before me this
19 ~F
County
Notary Public
FOUNDATION ~(1st)
FOUNDATION (2nd)
2.
ROUGH FRAM&~
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADD]] COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
FRAMING ~2~Y'~NAL
REMARKS:
DATE
INSPECTOR
]65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[] FOUNDATION 2ND ~INSULATION
[]FRAMING [ '~/FIFINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION lST [ ] ~OUGH PLBG.
FOUNDATION 2ND [~ INSULATION
FRAMING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST ~'~] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
FINAL
7Gs-zso,
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND[] INSULATION
[~F~MING [] FINAL
REMARKS:
"DATE I ~'~ INSPECTO
BOARD OF HEALTH ~:.-
3 SETS OF PLANS ~-~
'FORM NO. I SURVEY ..
TOWN OF SOUTHOLD CHECK 4~..IP.~IL '.4 't~.
i i~UILDINGDEPARTMENT SEPTIC FORM .U-..' ......... :
TEL: 765-1802 CALL ................
Examined .¢~.~..O,~.~N. ih"l., 19 ~."l.
Approved t~*-,.~.0-~AM... ~.-].., 19~.~.. Permit No.l .[~ .~...~ .~..~.
Disapproved a/c ....................... ~ ..............
................................ ....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
MAIL TO: ~/
Date ................... 19..
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appi
cation.
c. The work covered by tltis application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm
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 Occupant
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Per,nit pursuant to tl
Building Zone Ordinance of the Town of Southold, Suffolk County", New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations; or for removal or demolition, as herein describe,
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
necessary inspections. -
admit authorized inspectors on premises and in building for
(Signature of applicant, or name, if a corporation)
...... .......
(Mailing address of applicant) \ \o~,~_
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
.......................................
Name of owner of premises . ty~..~., g.,l ~).... ~.~/h.~:~ .................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of co,orate officer) -
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done'. ...............................................
House N'um ber Street Hamlet
County Tax Map No. I000 Section ...... .(-~..~. ........ Block ....~. ............. Lot...~.~ ...........
(Name)
"2. State existing use and occupancy of premises and intended use aud occupancy of proposed construction:
a. Existing use and occupancy .............................................................
b. Intended use and occupancy ...¢.IN(~[.~ ~.~.l~..~q. ,~.~¢[[ ¢M¢ ............................. '
/
3. Nature of work (check which applicable): New Building · .&~'..' ..... Addition Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
: :' (Description)
Esti ated Co { e~ ,oo ea F
4 '
' (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 uo '
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use r4o. :. ................
7. Dimensions of existing structures, if any: Front .... . ........... Rear .............. Depth ...............
N ' fSt ~ ~
Height ............... umber o ories ......... '. ................. ' ......................
DimeBsionsof same structure with alterations or additions: Front ................. Rear ..................
Depth ................... '... Height ...................... Number of Stories ......................
Dimensions of entire new construction: Front .. 25' . Rear ? 5' Depth 5Z- ~
Height ....,q~..~ ......... Nu[nber of Stories .. I. ~ ..........................................................
Size of lot: Front $o' ~ Rear .5o~ · Depth / $o"
10. Date of Purchase ....~..qz. 7- 7 .~.~· .............. Name of Former Owner ,'~w~4&O.. t~'vq-.~.~..xYq.'3 .......
11. Zone or use district in which premises are situated...~..'. T ..............................................
12. Does proposed construction viblate any zoning law, ordinance or regulation: t~o. .............................
13. Will 19t be regraded ...'{.t¢:5. i .................... Will excess fill be removed from premises: Yes
15. Is this property locate~ within 300 feet of a tidal wetland? *Yes ..... No
· If yes, Southold Town Tgustees Permit maybe required.
.. , PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF ..............
~cJ&~,o~ A, C2.~A .~ being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
(Contractor, agent, corporate officer, etc.)
of said owneLor owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements cohtained 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
Notary Public ..... . ............ County
NOTARY ~IBLI~, State el Now?~n
No. 4707878, SuffolkCeumY~ (Signature of a~plicant~
Term ExL~es Marehi30, ~--~./
Application Received
19
Disapproval Issued
19
Permit #
19
FORM NO. 10
APPLICATION FOR DEVELOPMENT PERMIT
IN THE TOWN OF SOUTHOLD
1. Type o~ DeveLopment'Proposed:
Addition and/or Alteration
New Structure (lnc±udlng storage nanKs
Flood Proof Below Base Flood Elevation
Other (specify)
Elevation Data in relation to above mean sea level of:
(a) Lowest floor elevation, including basement ~_ feet
(b) In a V Zone, bottom of lowest structural men~er ____
6 inches
feet inches
3. FIRM--Flood Insurance Rate Map,
4. Owner of Premises N~f ~
5. Location of Property:
Zone designations
House # Street Hamlet
County Tax Map No., Dist· 1000, Section ~ Block '~ Lot(s)
Subdivision ~_~_~ ~5 Filed Map# ~,S~ Lot(s)
Permission to be granted: Owner as above __ New Owner
Under Contract Lessee Contractor ___/ Phone tt ~
Name if not given above Mailing address
Approval from other(s) before Permit is issued:
DEC ~/~ Wetlands (Town Board)
Health Services
Building Permit ~ Planning Board __
8. I, /_~o6g-~/~r ~. ~/C~,4;~ , the applicant, am the Owner .__, Co-Owner
New Owner
, Under Contract _~_, Lessee __, Agent __, Contractor
and agree to comply with all applicable sections of the Code of the Town
of Southold; County, and State and to admit authorized inspectors to
premises 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 my knowledge and belief and that the
work will be performed in the manner set forth in the application filed
therewith.
STATE OF NEW [ORK
COUNTY OF ~_
SWORN TO THIS
Notary Public
Applicant's mailing
address and phone #
if not given above
DAY OF ~c/5
H£LEN K. DE VOE
NOTARY PUBLIC. State of New Yo~k
No. 4707878, Suffolk County,,
Ten'n Expires Mlrch
TEST HOLE
¢ \
SAND
WATER
21'
- %
NOTE: ~LL WELLS LOCATE9 ON LOTS
8 & 19 ARE I00'+ FROM
PROPERTY L NE,
SURVEY OF
O
LOT $0
" MA'P NO. 2 OF PECONIC SHORES "
FILED SEP'E 15,1930 FILE N0.654
· AT PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
lO00 067 02 ' 22
SCALE I"= 20'
APR. 27,1987
NOV. 17,1987
APRIL 1'4~ 1988 (FINAL)
004 ¢
AREA:,= 7,500 SQ.FT.
~ndard~ for title mmm~ em e~ablished by
the L I. A, L.S. and approved and adopted
for m~cb me by The New Ymdc ,~ate Land
NO.
ENGIN EE
MAIN ROAD
SOUTHOLD ~ N.Y. 119ZI
CERTIFIED TO:
FIRST AMERICAN TITLE
COMPANY OF' NEW YORK
MARY ANN CREA~O '
~[1~ s~¢~ga dlspos~l ~nr; w'~t~r snpplv [z.c~[~5~s [or this
other agef~
' ' f Wastewa~er
I NSURAN C E
k
TEST HOLE
SAND
WATER
ALL WELL S LOCATE~ ON LOTS
i;UPFOLk COLJNEY OEPAfiTMEN)' OF HEALIH SERVICES
FOR APPR[ OF COr!STRL(CTION ONLY
E~PIRES I'W0
APPROVAL
%
SURVEY OF
LOT 30
MA'P NO. 2 OF PECONIC sHORES
FILED SEPT I511930 FILE N0.6§4
'AT PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
lO00 067 - 02 22
SCALE I"= 20'
APR. 27,1987
EXCAVATION INSPECTII)fl REQUIRED
AREA-' '7,500 Se.FT.
~N Y.S.LIC. NO. 49618
~ORS ~ ENGINEERS, P.C.
5020
P O. BOX 909__
MAIN ROAD
$OUTHOLD , N.Y
li971
FIRST AMERIC/~,N TITLE INSURANCE
COMPANY OF ~dEW YORK
MARY ANN Cf~EATO
Prepared in accordance with the
for ~uch use by,The New York State Land
87 -289
OCCUPANCY OR
USE IS UNLAWFUL
,WITHOUT CERTIFICATE
(~F OCCUPANCY
o. 614~3~ ~
-,I