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Home My WebLink About29499-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29646 Date: 08/19/03 TI{IS CERTIFIES tl%at the building ADDITION Location of Property: 2270 HIGHLAND RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No, 473889 Section 102 Block 8 I~t 27 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 16, 2003 pursuant to which Building Permit No. 29499-Z dated JI/NE 18, 2003 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ALDO BARSALI TRUST (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~EALT~ /kPPROVAL ELEC'~RIC~J~ CERTIFICA~ NO. PLUMBERS CERTIFICATION DA'i~u N/A N/A N/A ut~ized 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. 29499 Z Date JUNE 18, 2003 Permission is hereby granted to: ALDO TRUST BARSALI PO BOX 130 CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A REAR DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2270 HIGHL~kND RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0008 Lot No. 027 pursuant to application dated JUNE 16, Building Inspector to expire on DECEMBER Fee $ 2003 and approved by the COPY Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD 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 3. 4. 5. topographic features. Final Approval frotn Health Dept. of water supply and sewerage-disposal (S-9 form~)i ' i Approval of electrical installation from Board of Fire Undmavriters. Sworn statement from plumber certifying that tile solder used in system contains less than 2/10 of Conunercial building, industrial bnilding, multiple residences and similar buildings and installations, a certificate of Code Compliancc from architect or engineer responsible for the building. Snbmit Planuing Board Approval of completed site plan requirements. ', - · · ' B. For existing buildings (prior to April 9, 1957) uon-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property silo wing all properly lines, streets, building and unusual natural or topographic features. 2. A properly completed application and cousent to iuspect signed by the applicant, lea Certificate of Occupancy is denied, the Building Inspector shall state tile reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.0(}, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimnfing 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 ofOccupaocy - Residential $15.00, ConanerciaI $15.00 New Construction: .............. Old or Pre-existing Buildiug: Locatiou of Property: ~-~2 ~0 /J/~.,q/~-,*9,~'~9 ,~ (check one) House No. Owner or Owners of Properly: AlZ~O Suffolk County Tax Map No 1000, Section Subdivision Street Block Filed Map. Pemit No. 2 ~ ~q q ~ Date of Pe~it. ~ ~/~ 3 Applicant: Hamlet Lot ,22 7 Lot: Health Dept. Approval: Plamfing Board Approval: Request for: Temporary Certificate Fee Submitted: $ Underwriters Approval: Final Certificate: (check one) Applicant Signature BUILDING PERMIT EXAMINER CHECKLIST DATE REVIEWED: ~//~/03 APPLICANT: ~/~g4~' DATE SUBMITTED: 0~ //~/03 SCTM# DISTRICT: 1,000, SECTION: /0~9 , BLOCK: ~., LOT:,,,~9 ~ SUBDiVISION: ADDRESS: ~2:~O ~/~/,~ CITY: ~ZONING DISTRICT: ~-~qO CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP_ I~/~[} -Z/C/OZ-IOed'}~ ,1NFO S['I'5 /Bp~0~7~;}O -Z/C/0Z-O~Ctpt~ ,INFO BP -Z / C/0 Z- ., INFO / BP -Z / C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED .)~/D NOTES: LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time after '7/1/83 REQ. rOT S ZE: ¢0, 00 ACT. LOT StZE: REQ. LOT COY. c o% ACT. LOT COV. REQ. FRONT ~-~.p PROP. FRONT ~ REQ SDE trS~ ACT. SIDE REQ. REAR f~,% PROP. REAR ~ REQ. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: ~c~ ~m~ '-to '~' [.~5. ESTIMATED PROJECT COST: < WATER FRONT? A[O DESCRIPTION: PANEL APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or O (BED #): __ DTE: TOWN SEPTIC RECEIPT: Y or(~ NEW YORK STATE DEC: PRE-DEC9/I/7$ YES orO DTE: SOUTHOLD TOWN TRUST~ YES or ~ DTE: TOWN ZONING BOARD APPROVAL: YES or~ DTE: TOWN PLAN. BOARD APPROVAL: YES or~ DTE: TOWN HISTORICAL PRE (SPLIA): YES or NEW YORK STATE CODE COMPLIANCE (SEE PA~r NO ot~ NOTE S: ( "-'-~ } FLOOD ZONE: / / / PERMIT #: / / PERMIT #: / / PERMIT #: / / PERMIT #: / / PERMIT #: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: SF SF SF SF INIT SF FEE 1. ( _SF)- ( .SF)= SF X $__ 2. ( _SF)- ( .SF)= SF X $__ 3.( .SF)-( .SF): SF X $ OTHER TOTAL FEE FEE =$ +$ +$ = $ =$ +$ +$ = $ =$ NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load' 45 ~ind Speed 120MPH Seismic Desi Category' B Design Temp: 11 ~Ice Shield Underlay: ~ Flood H~ds: /- USE/OCC~CY CLASS~ICATION: ~ ~" ~' ~ { k-'~ ~' HEIGHT~ ~A: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERE~ ~ ,: c ~ FULL FRAMING DESIGN ELEMENTS~ HEADERS: Y/N WALL STUDS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS:~N GIRDERS: Y/N ROOF RAFTERS: Y/N LIVE: Y/N DEAD: Y/N SNOW: Y/N SEISMIC: Y/N WIND: Y/N WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS~i~i~N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: 0/N MEANS OF EGRESS>~)iq PLUMBING RISER DIAGRAM: Y~ ~'/~ EQUIPMENT: Y/~ LOCATION OF FIRE PROfECTION TRUSS DESIGN: YA~ r CERTIFICATION: Y/~) ENERGY CALCS: Y~ ,/k /~ TOTAL COMPLIENCE.~/~ (RETURN tO PAGE ONE) 765-1802 BUILDING DEPT. ISPECTION [/]~F~BUNDATION 1ST [ ] R~UGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL/~=~& CHIMNEy DATE?~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [[ ]~,~ FRAMiDNA~ION 2ND [[ ]] IF~NSAU~ATION [ ] FIREPLACE & CHIMNEY REMARKS'. ~_ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~I. ATION [ ] FRAMING [/.~'~FINAL [ ] FIREPLACE & CHIMNEY _ REM~ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~U~/~.IDN~- [ ] FRAMING [/.~-'FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR~-~/'/~'~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined g/~ E __, 20 3 Approved 6 / ! ~ __, 20 3 Disapproved aJc Expiration t?~ { I¥ ,20 ~ PERMIT NO.o)~'~ q q ¢I £ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following,,before ~pplying? Board of Health 3 sets of Building Plans Plamfing Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: ' [ 6~ ' · ! Date (o / /4¢ 20o~ ; ~ INSTRUCTIONS a.kThis' ~.ppl~aj~o~TMLIS~e'~p submitted to the Building ~spector with 3 ....... letely filled in by t~ewriter or in i~ ~d' sets ofpla~rate plot plan to scale. Fee according to schedule. b. Plot pI~ showing location of lot and of buildings on premises, relationship to adjoining pre~ses or public streets or ~eas, ~d wate~ays. c. The work covered by t~s application may not be co~enced before issu~ce of Building Pemt. d. Upon approval of ~s application, the Building ~spector will issue a Building Pe~t to the applicant. Such a pe~t shall be kept on the pre~ses available for inspection tMoughout the work. e. No building shall be occupied or used in whole or in pa~ for any propose what so ever ~til the Building ~spector issues a Cegificate of Occupancy. 5 Eveu building pemt shall expke if the work authorized has not co~enced within 12 months a~er ~e date of issum~ce or has not been completed within 18 months from such date. If no zoning amen&ents or other re~lations affecting the propeny have been enacted in the intehm, the Building hupector may authorize, in writing, the extension of the pe~t for an addition six months. Thereager, a new pemt shall be required. ~PLICATION IS HE,BY M~E to the Building Department for the issuance of a Building Pe~t pursuam to the B~lding Zone Ordin~ce of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ordinances or Relations, for the cons~ction of buildings, additions, or alterations or for removal or demolition as herein described. The applic~t agees to comply with ali applicable laws, ordinances, building code, housing code, and re~lations, and to a~t authorized inspectors on pre~ses and in building for necessa~ inspections. (~i~namre of applicant ~ n~, if a co~oration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises "'~t~Q%&t--t AL/BO T~ k)%~- (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: 2-270 /4/~,~,z_,ea./3 ~-/3- House Number Street County Tax Map No. 1000 Section Subdivision (Name) /o Z Block ' ~' Filed Mip NO. Hamlet Lot Stat& existihg use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / ~--,'O,W,~_V r/o~G b. Intended use and occupancy Nature of work (check which applicable): New Building_ Repair Removal Demolition Estimated Cost ~000 - e° Fee Addition C/ Alteration ~" Other Work If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Dimensions of same structure with alterations or additions: Front ~ · . o '? . Depth. /x?~.--~/~" Height. ~ · ~ Number of Stories _Depth Rear 8. Dimensions of entire new construction: Front Height / '- q '/z ' 2~' Rear 2;~5 ' Depth /c3 '- /" Number of Stories 9. Sizeoflot:Front 22/.2~? ' Rear ff-2../.2q ' _Depth 10. Date of Purchase Name of Former Owner l 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO__ 13. Will lot be re-graded? YES__ NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal xvetland or a freshwater wetland? *YES NO y * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ofa tidaI wetland? * YES __ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide 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. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual si~aing contract) above named, (S)He is the (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 manner set forth in the application filed therewith. 0 Nota~ Public LYNDA M; BOHN NOTARY PUBDC, Stste of N~ York No. 01 BO6020932 Qualified in Suffolk Coun~ Term Expires March 8, 20~ Signature of Applicant TITLE NO. 8108- 272780 ~ ~', . ~' ~... , ' ~- ,. AL~ ~ALI & L~ISE BARSALI ~ :) ~I //~_Q~ LOT 30. 'HI6HLAND ESTATE~' AT CUTCHOGUE DATE: SEPT. 25, 1981 , ~WN ~ sOuTHoLD sc~E: ~":5o~ ~:~ SUFF~ ~TY, NEW ~ ~T BE CONS~OE~O TO ~ A VALID Tnu[ C~Y HEAL~ ~RTM~NT-~TA ~ A~R~ TO C~STRUCT ~S mDI~T[O NIKON ~L ,.,,.., ,,...,0