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Home My WebLink About27447-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-29599 Date: 07/25/03 THIS CERTIFIES that the building ALTERATION Location of Property: 46975 MAIN RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 69 Block 5 Lot 18.1 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 12, 2001 pursuant to which Building Permit No. 27447-Z dated JULY 5, 2001 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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to REYNOLD F BLUM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 1117695 04/14/03 PLUMBERS CERTIFICATION DATED12/09 02 REYNOLD BLUM Authorized Vgnature 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. 27447 Z Date JULY 5, 2001 Permission is hereby granted to: BIJAN SHAOULPOUR 5 EAGLE POINT DRIVE GREAT NECK,NY 11024 for ALTERATION OF A WOOD DECK AND ENTRANCE WAY TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at MAIN RD SOUTH/PEC County Tax Map No. 473889 Section 069 Block 0005 Lot No. 018 . 001 pursuant to application dated FEBRUARY 12 , 2001 and approved by the Building Inspector. Fee $ 75 . 00 Aut orized Signature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD �t�,�y C ✓�� 1 S � BUILDING DEPARTMENT TOWN HALL 765-1802 4 ?(oq APPLICATION FOR CERTIFICATE OF OCCUPANCY �) This application must be filled in by typewriter or ink and submitted to the Building bZp'arfient 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 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 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 I. 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. 7 /2-3 -::13 New Construction: Old or Pre-existing Building: (check one) Location of Property: MA/7J Ind K]0 -Jae,7f/d,C,23 House No. Street Hamlet Owner or Owners of Property: JC j'"J o e-/3 Tj L a,/V, Suffolk County Tax Map No 1000, Section Block Lot - Subdivision Filed Map. _Lot: Permit No. 7,74Y7 Jff Date of Permit. S /, Applicant: /t�E y C� BL4Jtr� Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: � (check one) Fee Submitted: $ 7— Appy ant Signature � l Town Hall, 53095 Main Road Q Fax(631) 765-9502 P.O. Box 1179 �� p�' Telephone(631) 765-1802 Southold, New York 11971-0959 1 �` BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: �fer.y p1[,Q r/ Zao Building Permit No. L7 e7 Owner: 3& Y�� `� 3& (Please print) Plumber: �Fr�Js O bt, y� (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. OJ ( umbers Signature) Sworn to before me this day of 20 20,0 e, —�- 04f- Notary Public,State of Now York Notary Public, County O �l ar�rJ�rJ�rP�P�I acnrJ�rPr�rJ�rJ�rr�nrJ��l ar l ar�rJ�rJ�cnrJ�rJ3lr�cPrJ�cfcnrJ:1l a�nc nrJ��l a�Pl al an�J-L3pLlJapL��nnJ��nnnJr �Lr P� 3PP Ieo 5 S BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY S c�5 40 FULTON STREET — NEW YORK, NY 10038 tj P7 CERTIFIES THAT Upon the application of upon premises owned by 5 5 RAY BLUM RAY BLUM P.O BOX 151 785 LOWER RD PECONIC N.Y 11958 SOUTHOLD, NY 11971 5 5555 Located at 785 LOWER RD SOUTHOLD, NY 11971 5 Application Number: 1117695 Certificate Number: 11176955 5 Section: Block: Lot: Building Permit: BDC: NS11 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 55 5 Basement, First Floor, Second Floor, Outside, 7 5 55 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 14th Day of April, 2003. 5 5 5 Name OTY Rate Ratin Circuit Type Alarm and Emergency Equipment 5 5 Sensor 1 0 Carbon Monoxide 5 Sensor 3 0 Smoke Appliances and Accessories 5 tj Furnace 1 0 Gas 5 5 Water Heater 1 0 4.5 KW 5 5 Wiring and Devices Receptacle 26 0 General Purpose 5 5 Switch 14 0 General Purpose 5 5 Fixture 9 0 Incandescent 5 5 Lighting track 3 0 FT 5 5 Receptacle 1 0 50 amp Range 5 5 Receptacle 1 0 20 amp Laundry �5 5 Receptacle 5 0 GFCI 5 5 5 5 seal 55L �5 5 1 of 1 5 5 This certificate may not be altered in any way and is validated only by the presence or a raised seal at;he location indicated. L5j 5 5 cPrJ�tPrPrPcPrPcPc!acPcPrscPrsr�cPrJ�cP�P�P�Pu�cP�PcPcPrPr�cPrPcPcPcPrPrncPcPcPrPcPr PrPrPcPcPcPcfcP�PcPcPcPrJ��rPcPcPrnrJ�rJ��P�Pr P L, 42 PO Box 151 Peconic, NY 11958 ph. 631 765-6861 January 2, 2003 Southold Town Building Department Main Road Southold, NY 11971 RE: Building Permit #27447Z 46975 main Road Southold, NY 11971 Tax # 1000-69-5-18.1 Please extend the above mentioned building permit as work is still in progress. Sincerely, Reynold Blum 2Qp2 1 BUILDING PERMIT REVIEW CHECK LIST �, DATE REVIEWED: ! / /f/C APPLICANT NAME: is 4- �/ BIZ ij DATE SUBMITTED:2–/ /z/, SCTM#--- DISTRICT: 1,000 SECTION: 69 BLOCK: S LOT: �8• / PROJECT LOCATION STREET: fu,,� ec.v,j CITY: SUBDIV. NAME: ARCHITECT/ ENGINEER: FAST TRACK: YES oye SINGLE & SEPARATE CERTIFICATION-RE/QUIRED: YES NO OTES: ZONING: PERMIT ESTIMATE A T:_% �J.� —.00 ZONING DISTRICT: R40. R80 AC CONFORMING: YES o N REQUIRED LOT SIZE: mit SQ: WHERE ACTUAL LOT SIZE FRON .T,4 CAACTUAL LOT SIZE: .2P-, d SQ REQUIRED fe/ REQUIRED REQUIRED FRONT:./-' PROPOSED kr ' SIDE YD: 2c '/4' PROPOSED: iE '/ REAR:7.!' PROPOSEDeSE? LOT COVERAGE: ALLOWED: w % EXISTING: ., sf % NEW: 'sf % TOTAL:_g�'/sf CORNER? YES o O WAT ER FRONT? LYES4N DESCRIPTION: LOTS 40,OOOSF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.199t7� 100-25. Mergg9r. Al nonconforming at any time after July 1, 1983.) Eft wl b e' A /' PROJECT DESCRIPTION: AD AL ACC OR N/D: �rTI�. AGENCY PERMITS REQUIRED FOR REVIEW NEjj1DEQ TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES o N (BED #):_ DTE:_/ /_ PERMIT #:RI O- /4/o/ 14 d. S��i.+ L.sr NEW YORK STATE DEC: PRE-DEC 9/1/75 YESor SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES o TOWN PLAN. BOARD APPROVAL: YES o FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: /62 FLOOD ZONE:_( _, NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: — NOTES: / 1/•�.�s <.� ie� d o, z- w c a I FEE STRUCTURE: E p8t 61i- ttr8 --SF FIRST FLOOR DC7 SF SECOND FLR --- SF INIT OTHER TOTAL TOTAL: 15!8 SF FEE FEE FEE TOT /ITSf-SF)- ( SF)= SFX All -- M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY i REMARKS. TV DATE �` w INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST e, ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE HIMNEY REMARKS: DATE INSPECT p7V 7 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [GINTION [ ] FRAMING [ ] FINAL [ ] FIRE7P & CHIMMEY REMARK DATE < IN8PECT0 7L 70-11W2 B ING DEPT. SPECTION ] OUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ( ] FRAMING [ ] FINAL [ ] FIREPLACE CHIM V� REMARKS: DATE kb INSPE 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ INAL [ ] FIREPLACE S CHIM Y REM K5: DATE d INSPECTO FIELD INS SCTION REPORT DATE COMMENTS i -- - H FOUNDATION ( IST) a tA FOUNDATION (2ND)__ r-411 e4t� x ROUGH FRAME a �- PLUMBING dh �. 9GcPaS— INSULATION PER N. Y. it-y STATE ENERGY CODE vp H� FINAL ry ADDITIONAL COMMENTS: H H . Ci O y� v yr auUlnvi.L tSU1LDINUYI:KM11 AePLIGA1lUN (hECKL1S -: DING DEPARTMENT FEB ' 2 Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 _ 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. 22 Check Septic Form N.Y.S.D,E.C. Trustees Examined 200/ Contact: Approved 200// Mail to: Disapproved a/c / >. X- /S /6c-z � S ` Phone: Gal 765 � �86 / uilding Inspector APPLICATION FOR BUILDING PERMIT / Date 200/ INSTRUCTIONS a.This application MUST be 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 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 throughout1he work. ' e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan is issued by the Building Inspector. 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.' (Sifhature of aprlicant or name, if a corporation) /v Y i/ 314j (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect,engineer, general contractor, electrician, plumber or builder o c.J /JE Name of owner of premises B Fa'A ," SWA ae*[A*e,')0 (as on the tax roll er-latesi•daad) 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 w ch proposed work will be done: 1i 7-0, s,a/ /lc143 5�=l 9 , Aar House Number Street Hamlet County Tax Map No. 1000 Section Block 6 �I Lot /8, Subdivision Filed Map No. Lot (Name) ,.n,ou jg ubo amu vccupaucy of premt es and intended use and occupancy of proposed construction: a. Existing use and occupancy AfS13ENTiX[ b. Intended use and occupancy �FyS�3r N ;r 1,'rL / f�K/c�L" �� /2MA/A &VrrjA./G end RN /•-1 fi � � i. Nature of work (check which applicable): New Buildi g Addition Alteration Repair _Removal Demolition Other Work E�Liirc' C XisT�rb6 3!� (Description) 1. Estimated Cost Fee (to be paid on filing this application) If dwelling, number of dwelling units 0,JF Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front fir{+�` Rear /`f t 8= 2-Ji- Depth ' f /z= Height I-?- Number of Stories 2- Dimensions Dimensions of same structure with alterations or additions: Front 1-0 Rear Zo i Depth V4 Height ZZ Number of Stories L Dimensions of entire new construction: Front Rear Depth / Height 27, Number of Stories z_ Size of lot: Front 2.3'L Rear LS l • Depth Z Z • J'� 0. Date of Purchase Z Q/ Name of Former Owner -9F-Y-< S17"ae-cQd4r,p 1. Zone or use district in which premises are situated Q �o 2. Does proposed construction violate any zoning law, ordinance or regulation: /J,;Z1 3. Will lot be re-graded /vim Will excess fill be removed from premises: YES 10 4. Names of Owner of premisesQF�y/6C_ /JCc ddressAtl •'4•'mXIi/ Phone No. C3/ Name of Architect Address_ ,*J Y Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: 'ODUNTY OF Ste) �C Ea C� Ll�iy being duly swom, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, ;)He is the 6--J j" (Contractor, Agent, Corporate 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; at all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ,rformed in the manner set forth in the application filed therewith. vom to before me this 0 day of e ru 20(:;) L n L � j� �2 Notary Public SignME ature of A� E B&YR& pplicant A"Rmaa No Yak Vo.494M �rak3)alaoa� PO BOX 151 Peconic, NY 11958 ph. 631 765-6861 November 4, 2002 Southold Town Building Department Main Road Southold, NY 11971 l'I_i NrlBING RE: Building Permit #27447Z f"='-.I.k.a-01r,-1B1NG WASTE 46975 main Road `}` � LINES NEED Southold, NY 11971 Tax # 1000-69-5-18.1 Please amend the above mentioned building permit to include replacing the old galvanized plumbing with new cooper pipe and also replace and update all the electrical wiring. The expected cost of such additional improvements will be $2500.00. Sincerely, If copper tubing is used for water distributing � � system; piping shall be of types K orL-only Reynold Blum ----� UNDERWRITERS CERTIFIUt -- REQUIRED "z COVED AS NOTED +'IJILDING DEPARTVf�: ' !T R AM TO 4 PM t`HI ' s` `Vr NG INSPECTIONS :ONDATION - TWO ?R P REDCONCRI: FRAMING & ;='1.!'ftJIBF,1- SULATION JN -' y� f 3NAL - CON STR0('T'. MLe. _ � ��% ,J RE COMPLETE Ft�� C �`:-_ �n!�SER CERTJFICA �" L CONSTRUCTI'.,. ALL NIF D CONTENT BEFC �'= PROVIDE ANTI-SCALD AND/OR ,E REQUIREMF6� ' = THE f;;ATE OF OCCUPANCY �IATE CONSTRU "t- & EN Er �!�J 1A✓�11�ER THERMAL SHOCK PREVENTING CODES. NOT E � , 'SIBLE r, n+ner DEVICES AS TO PART. 902.6( () DESIGN OR CON-71koC T ION ER; I.Y. STATE BUILDING CODE. 14) Ko% ISI Peconic, IN 11958 631 765-6861 June 27, 2001 Southold Town Building Department Main Road Southold, NY 11971 RE: Application for Building Permit 46975 main Road Southold. NY 11971 Tax # 1000-69-5-18.1 Proposed renovations to existing one family residence; 1. Repair water damaged / rotted sill plate and west side entry way. Replace the existing 6'x 8' covered shed entry way with same size using new material as depicted on attached sheet "A". 2. Replace existing rotted 2" x 4" roof rafters with 2"x 6" rafters 16"o.c. 3. Replace existing wall siding with new 5/8" exterior plywood. Size of existing building is 14' x 28', two story, with no additional living space to be added. All construction is to repair and up date existing. Sincerely. Reynold Blum (O A6sr w '774 Ayr /4Ys; C AJ-1 TT-1, -o s "u�rctJ1 1 ✓`yam S.YC /�sarr c Tjc,a EYt's• saR'/s'Soa u / Cet'F.�ter- io._� AA-41 5.e �eCa✓r.c<4 /N,4r,.� .-J ,,.e•✓.�irtlta•f g c'7�/S// $� /'� nr_� /� �' /-�l�i� ti Al T . 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