HomeMy WebLinkAbout28618-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29590 Date: 07/24/03
T~IS CERTIFIES that the building ADDITION
Location of Property: 1705 ACKERLY PD LA SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 69 Block 5 Lot 6
Subdivision Filed Map No. -- Lot No, --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~JLY 23, 2002 pursuant to which
Building Permit No. 28618-Z dated AUGUST 1, 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 TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
~e certificate is issued to CH3LRLES W WRIGHT
( OWNER )
of the aforesaid building.
SUFFOLK COU~FrY DEPARTMENT OF ~IEALT~ APPROVAL
ELEt-r~ICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION D~r~u
N/A
N/A
N/A
Rev, 1/81
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES %INTIL PULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28618 Z Date AUGUST 1, 2002
Permission is hereby granted to:
CHARLES W WRIGHT
1705 ACKERLY POND LANE
SOUTHOLD,NY 11971
for :
CONSTRUCTION OF A DECK ADDITION TO Al{ EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at 1705 ACKERLY PD LA SOUTH/PEC
County Tax Map No. 473889 Section 069 Block 0005 Lot No. 006
pursuant to application dated JULY 23, 2002 and approved by the
Building Inspector to expire on FEBRUARY 1, 2004.
Fee $ 150.00
COPY
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
,~ ?~: · TOWN HALL
765-1802
APPLICATION EOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department 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 of Fire Undelwvriters.
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.
Bo
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.
Co
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinm6ng 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. q I Q//'~/0 ~
Hou)e"~NN~0.. 5
Owner or Owners of Property:_~
Suffolk County Tax Map No 1000, Section
New Construction:
Location of Property:
Old or Pre-existing Building: __ ~./ (check one)
Subdivision
Permit No. ~)~:9 { ~
Health Dept. Approval:
Planning Board Approval:
Filed Map.
Date of Permit. Applicant:
Underwriters Approval:
Final Certificate:
Temporary Certificate
Request for:
Fee Submitted:
Hamlet
Lot
Lot:
(check one)
M E
I~ Y L
a r C h
K R A M
i t e c t
E R
Mr. Gary Fish
Southold Town Building Dept.
Southold Town Hall
PO Box 1179
Southold, NY 11971
June 24,2003
RE: Wright Residence
Open Permit # 28618Z
Dear Gary,
As per your request, I am certifying that I inspected the footings and framing of the deck of the above
mentioned project during construction and that they comply with the drawings and.t~e NYS Residential
Building Code. The owner has installed a new handrail and guardrail, and J~1~epa~l~ the driveway, thus making
the risers uniform height in accordance with the NYS Residential Building Code.
Cc: Na.~cy~l~L~arlie Wright
· ,: :,3 AR(
124 BROAD STREET G R EEN PORT, NY 11944 G 3 1- 4 7 7 -8 ? 3 6 631-477-8936 FAX
Projecl Description: 2.~.~. ~,a4~_..i~__'
Suffolk County Health'Dept.
New York 8tale D. E. C.
Town ZonSng Board. approval:
Town Plamfing Board approval:
Flood Plane Elevation ???
Flood Zone:
765-1802
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION 1ST 'Z' [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] IN/SULATION
[ ~FRAMING '~ [ ~INAL
[ ] FIREPLACE & CHIMNEY
REMARKS: /~ ~.~,~ ~
.,, ,, , '" //.b J,
DATE
INSPECTOR
co~
ROUGH ~r,,A.iVII~ G &
pILUlVlBING
INSULA.TION PER N. Y,
,~I)DITION,~L COiV/IYIEN'I'S
TOWN OF SOU~HOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
Examined
.Approved
Disapproved a/c
7/.Me, 20
k. xpiration 2~ / ,200~a_
PERMIT NO.
BUILDING PERMIT APPLICATION CI51ECKLIST
Do you have or need the following, betbre 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:
Building Inspector
~!",, 57 !7 i ' 'i_ !APPLICATION FOR BUILDING PERMIT
f,,~ ' 5' ': Date "//i ~1/ O '~--" , 20
I INSTRUCTIONS
a. T~is a~[icati0n MUSTq~cgm.%~Jetely fined in by t~ewfiter or in ink ~d sub~tted to the Building Inspector with
sets of pi~umte'pFot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on pre~ses, relationship to adjo~g pre~ses or public streets or
areas, and wate~vays.
c. The work covered by this application may not be cm~nenced befbrc issu~ce ofBuil~g Pe~it.
d. Upon approval of this application, the Building Nspector will issue a Building Pe~t to ~e applicant. Such a pe~fit
shall be k~t on the pre~Nscs available for inspection t~oughout the work.
e. No building shall be occupied or t~sed in whole or in paa for any pu~ose what so ever ~til the Building Inspector
~ssues a Certificate of Occupancy.
f. Eve~ building permit shall expire if thc work authorized has not con~cnccd wi~ 12 months akcr thc date of
~ssuance or has not been completed within I g months from such date. lfno zoning amendments or o~er regulations affecting the
prope~y have been enacted in the imerim, the Building Nspector may authorize, in writing, ~e extension of thc pen~t fbr an
addition s~ months. Thereafter, a new permit shall be required.
~PL~CATION IS HE.BY M~E to the Building Dep~tment for the issuance cfa Bufl&g Pe~t pursuant to thc
Building ~ne Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Rc~latio~, for the const~c6on of buildings, additions, or alterations or for removal or d~olition as herein described. The
applic~t a~ecs to comply with all applicable laws, ordinances, building code, housing code, ~d rc~lations, and to admit
authoNzed inspectors on premises and m building for necessa~ inspections.
' ~ ~amre ofapplic~t or nme, ifa co~oration)
(M~l~g ~ess of applicant)
State whe~er applicant is owner, lessee, agent, ~chitect, engineer, general con.actor, elec~ci~, plumber or builder
Nam¢ofownerofpmmises b,~,~,k~O'-{ 4- ~.~/k~{..~ ~NJl~-,,\~'Pf'i-
(As on the tax roll or latest deed)
I f applicant is a corporation, sigmature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location o__f land on~hich proposg._d work wilJ b,¢ done:
_ {q-05 AoF. PoNB 00TtiOLb
House Number Street Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Block 0%
Filed~Map No.
Lot ~:~
Lot
9
State existing use and occupancy of premises and intended use and occupancy of proposed_.~constructi0n:
a. Existing use and occupancy J~'l ~f~L-F~. ~/~IL,¥ ~.~.e~klf_~'~
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
5. IFdwelling. number ofdwelling units
If garage, number of cars
Addition "-~" Alteration
Other Work
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of usc.
7. Dimensions of'existing structures, if any: Front
4q' Rear 4
Height [ ~O' Number of Stories
Dimensions of_.sarge structure with alterations or additions: Front 4q~
Depth ~ Height [(~9' Number of Stories
8. Dimensions of entire new construction: Front ~ '- (zT" Rear Depth
Height Number of Stories
Size oflot: Front i tq '51 , '
Rear /%iO l' Depth I ?) O
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated /~k- ~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
Rear 4q~
.'2-
NO J
13. Will lot be re-graded? YES l,,,~O Will excess t511 be removed from premises? YES ~ NO__
14. Nantes of Owner of premises .Vk/~lo(~' Address i'Df051/k/.,~ D~ho~nne No.
Nan~eofArcbitectB, K~M~',,~ Address kg~ g~.Ofi~D PhoneNo
Name of Contractor ~A. ~.L}~d-..} _Address ' ' Phone No, '~2[--bO
15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet cfa tidal wetland?* YES__ NO ~
* 1F YES. D.E.C. PERMITS MAY BE REQUIRED.
NO
16. Proxide 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.
ST,VFE OF NEW YORK)
C()Li NTY O~
~l~--; [~Y ~' -- K~{,~ being duly sworn, deposes aad says that (s)he is the applic~t
(Name of individual sing contract) above named,
(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 mariner set forth in the application filed therewith.
Sworn to befbre me this ,'~ ,,
c~'2~ ctav of ~ 20(3
C/Notary Public
LYNDA M. BOHN
NOTARY PUBLIC, State of New York
No. 01 BO6020932
Qualified in Suffolk County
Term Expires fdarch 8, 20_~_~
~_.~nature of Applicant
P,.EGP,^DE A5
~QUI~D FOR
NEW DECK
LAYOUT
VATION
GARAGE
CONDEN~
NEW WOOD DECK,
~ +3'- I 0 31E,"
EXIST. ?0ST TO ~
RcEMAIN
LINE OF E
NEW P.E. TIE
PLANTER.
0.00
5TONE
¢ R.I5 ER.5
UP
R.L=FAINING WALL
TO DE
R~EMOVED
4EW 5TONE
PATIO
NEW RR. TIE
R~I'AINING WALL
PLAN
APPROVED AS NOTED r
~IOTIF¥ gUILDING OEPAR?~E#? &? I'~qu~/ I
765-1802 9 AM TO 4 PM FOR ?HI
HOP-,SE COERAL FENCE
MICHAEL ¢ PAMELA HUNT
N4Go27'OO"W
FO' ~ m~,rk~f' ;NSPECTIONS:
1, , ~ 'Cid - TWO REQUIRED
t ,, ,~11 [IONCRETE
~. [ ' "- FRAMING & PLUMBINQ
& FINAL - CON~TRUCTIO~
BE COMPLETE FOR C.O.
~LL CONSTRUCTION SNAL[ ~E~
THE REQUIREMENTS OF THE N.~
~TATE CONSTRUCTION & ENERGY
~ODES. NOT R~SPONSIBLE FOR
~SIGN OR CONSTRUCTION E~OR~
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
UND~WRITERS CERTIFICATE
131.01'
J ~- -- ~ r- -- r- T ~
5TR.INGER..TY1=.
2-2x I 0 ~TR.INGER.,TYP.
4x4 CCA POST
ON
2'-O"x2'-O"x ILO'`
PC PTG, lYF.
ACI~F, LY POND LANE
(DOWI~EY LAN~)
lt~UIRED
N
POST
FOUNDATION PLAN
51TE PLAN
L_J L_
R.R. TI~ PLANTER. '- 2xG CCA
5TR, IN GER`,TYP.
DRAWING LIST LOCATION MAP LEGEND ABBREVIATION
SYMBOL DESCP-J FTION SYMBOL DE~CPJ PTION
~ At DE~. DeFa~men~ INSUL InsJmbt~. Insulabn~. bsubbon FK Ya~r
A~Hff~U~L D~N~ 5E~ION 5~DOL ~ ' D~R NUMBEA V.C. ~C brushed ~mlJ~ g~. DTL g~ml tNT, In~nor QU~. Quahty
5E~ION NUMDE~ A.L~. ~ovchmsh~ Flor ~A. ~ gJam~r ~W
I 5~E FL., FOUNDATION PL., P~N, ~. 07~Z J 5HE~ NUMBER AIA ~n~n I~bt~ of ~chl~ DIAG. gJa~onal L ~n~th ~ ~fn~cra~r
~ PARTITION ~ ~E~ ~cn~n Jn5[]~ of Electn~l En~lnccm DIM.. DIMEN D~m~ns~On ~V.
:~ATmON 5~L ~ LUM. Alummnum D~ds) Uncar
~ECH. ~dh~t¢¢ E~C. dc~rm~l MA~L Ma~l
~T~ ~T~ ~ D~L~UM~ ~&~ ~NM ~?m~m~or 1~stm~Ma~nat ~WC ~l~rmc~a~r~r MIN M~mm~m T?~, T~l~h~n~
~ OHE~ NUMDE& KOUGH WOOD ~LOC~NG ~, ~o~rd ~ ~haust MI~. M~ellan~5 TM ~K Th~n~
5~' I ~ OG¢ 05 ~G~ IXI 5E~ION) D~, bl~k ~1~1, ~sbn~ MI L Mc~l ~ T~r21
BM, beam ~y ~Fos~ N No~h
~OOD DL~NG b.U. ~ ~[h¢~ NN. hmsh NEC Nabo~l
DOl. bOLero FL.. ff~ Flor N:MA Nabonal tl~ri~l Manufa~m?5 ~5~ I V~ Vine C~mo~m~ Tile
~ COLUMN UNE D IU. bnbsh I hcr~l Uni~ N. F~t NJ. C. Not In Cofl[~ct V~T, V~&~c~I '
~Y
POND
C~. Cablne~ FF. hrc~r~ NO Numar V,I ,~, V~n~ m
y Documen~5~s~a~e~l ~ameAWn~hA~GHT LOCATION P~N I dF~ , FINISH ~OD CEA.CLG Ccramtc~dm~ FNX'I G. ~bn~r~ :uAN'[ ~.
CFM Cubic ~ Ycr Min~ GA. Gau~c O~ ~craH D~m~nslon ~ Wl~h
~ FLOOD (~E ~ CL.. L Cen~rhne G~. Gallon U.C. Up Conic W~r ~1~
O~EE CH~ * N~ ~GHT ~ ~ E~ATION MA~ CL. CI~c~ GALV. Galvam~ OO
CLK. Clear GU General Contra~r Fur FOden5 KCr GUblC ~ ~ Wi~hn~l[
' CONC. Coacr~ HB H~ ~b~ FH.
ZONING 22,4G~ ~ ~ EQUIPME~ NUMBER ~ISTING W~ CON I. ~n~lflUOU5 H,M. ~ollow M~I FL, ~ fflasbc
GUV'G C~m~ HU~Z, Honzon~l P~D Ylum~nq
~OE ~ M~ ~UE~NG ~ ~ ~ISlON ~L DEMOUSH WA~ ~UG] Ky] g8a~r~UblC V¢~ HW~K ~o~H°Urwa~ YL~UFNL
gU [N Cubic Inch LB. Insd¢ Um~ FOL
9UEV~K ENGINEE~NG QUEUE. ~ ~ ~N~ ~ INSULTED W~ CU ~ Cubic Yard IN. I~h ffbr Founds per
g Uc~h INCL. Inc ud~ nc udm~ Fbi Founds ~r b~uare Inch
DBL Double INFO, Info,abort ~g.