HomeMy WebLinkAbout27502-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27851 Date: 08/02/01
THIS CERTIFIES that the building ADDITIONS
Location of Property: 285 MEADOW BEACH RD CUTCHOGUE
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 111 Block 10 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 22, 2001 pursuant to which
Building Permit No. 27502-Z dated JULY 25, 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 & SUNROOM ADDITIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR, "AS BUILT"
The certificate is issued to WILLIAM C & TERESA M. MEEHAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
tho zed S gnature
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. 27502 Z Date JULY 25, 2001
Permission is hereby granted to:
WILLIAM C MEEHAN
3980 VANSTON ROAD
CUTCHOGUE,NY 11935
for
AS BUILT DECK AND SUN ROOM TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
at premises located at 285 MEADOW BEACH RD CUTCHOGUE
County Tax Map No. 473889 Section 111 Block 0010 Lot No. 019
pursuant "pplication dated JUNE 22 , 2001 and approved by the
Building Inspector.
Fee $ 300 . 00
t-Au ed Signature
ORIGINAL
Rev. 2/19/98
t
1 ._. Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
...�_,.4 TOWN HALL
765-1.802
.
APPLICATION FOR-CERTIFICATE OF OCCUPANCY
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 of Fire Underwriters.-
. 4.
nderwriters:. 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 buildin;
and -installations, a certificate of Code Comp.lianoe 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 .anc
•pre-existing land uses:
+ 1. Accufate survey of property showing all property lines, streets, building and
d unusual natural or topographic features.
�' . 2. A properly completed application and a.consent to inspect signed by the applicant.
If a Certificate of Occgpancy 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 $25.90. Businesses $50.00. - , .
2. Certificate of Occupancy on Pre-.existing Buildine - $100.00
3 Copy of Certificate of Occupancy - .25%0
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .. . . .. ... ../ .. . . . .. . .. .
New Construction. . . .. .. . . Old Or Pre-existing Building. ..... . . . . ... .
Location of Property. . ) L. . . .. .. .... .... ... . . . ... . . .h3,� 9.e-.N... ; :CE. .. . . . . . . .
.. .. x .. . .
t House No. Street Hamlet
Onwer or. Owners of Property.. . .. . . . . . .. ... .:?;�}?..�; �, 5F :.�?E•�:�:,f;1�.... . . . . . . . . . .
County Tax Map No 1000, Section. . . . .:��. . . . .Block. 9
. , . . . . . . . .Lot. . . . . �. . . . . . . . . . . .. .
Subdivision *,
.. . . . . . . . . . . . . . ... .Filed Map. . . . . . . . . . . .Lot. . . . . . :.'. .. . . . . . .
. . .
Permit No. . r� o .. . . .Date Of Permit. . .Z,G.°--'AA . .. .Applicant.^': :: :':�. .�:: :�':f:Y
Health Dept. Approval. . . . . . . . . . . . . . . .. . . . . . .. . ..Underwriters Approval. . ... . . . . . ... . . . . . . .
Planning Board Approval. . . .. .. . . . .. . . . .. .. . . . . .
Request for: Temporary Certificate. . . .. . . . . . . Final Certicate. . . . . . . . . . .
#ee Submitted: $. ... . . . . . a . . .. . . . .. .. . . . . . :
PROFESSIONAL ENGINEER
1725 HOBART ROAD/PO Box 616, SOUTHOLD, NEW YORK 11971
TEL 631-765-2954 • FAX 631-614-3516 • e-mail: joseph@fischeW.com
Date: July 23, 2001
Reference: SCTM#111-10-19
Southold Building Department
Main Road
Southold,NY 11971
Dear Sir,
The deck and the metal manufactured sunroom structure located at 3980 Vanston Road
for Mr. William Meehan have been constructed to the best of my knowledge in accordance with
the New York State Building Code.
of NENy YD
1P �F1SC/y
4
1y
Fp �0. 05251� r
A9CFESSION�
Joseph Fischetti, PE
STATE OF NEW YORK )
) ss:
COUNTY OF SUFFOLK )
Joseph Fischetb, PE , being duly sworn, deposes and says:
That deponent is over the age of 18 years and resides at
1725 Hob rt Road, Southold r
That on thet LD jay of �J C 2001 deponent architect/engineer,
licensed by the State of New York, hereby states that s/he accepts full
responsibility for the accompanying plans compliance with the New York State
Fire Prevention and Building Code (9 NYCRR); said plans pertain to property
located at SCTM# 1000-)Ai , f()- I
street address 3y 80 L)A9yi15/MVitect/Engain_eer__
,�l�
�K rt 285 M,94�v l3a� PA
Sworn to before me this
4, f`day of , 2001.
Notary Pdblic
uNDA I COOPER
Notary Public.State of Newyork
No.4822563,Susi ► p;-
cc: Applicant Term ExpirozD969m
suauiNa oar.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ON
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ee, �I
DATE INSPECTOR ,�
FIELD INSPECTION REPORT _ DATE _ „,,s: COMMENTS J
H
FOUNDATION ( 1ST)
� t
a�
FOUNDATION (2ND)
II �_ 9.3
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
' H
STATE ENERGY
CODE
H
FINAL r
ADDITIONAL C0149MS:
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'�,A�",l�1• t� � '�.l�i��f'r M _'fir fr, _ � �.�L• � _ � .�$.�^Ywk��" .�,��� ,y yk vJ 7��e-• r
..ea`.f ''�•.^ �}pI ,t ��. iZ 'r.: Y ��,'r(� U `� a� k L �i _� "r�`�-•h� 8/ "",.y4 ��.
M1 � 3� .F �, �+.: � ,'4. �� .pL 4�''�.,.fiw,n.,..,,,rs..,+.^•�.r'+h....+...«........�.r.....w.rr+•.:.�k +,«4.w�: .,�-...}H� r ;',. �M3. .�
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BOARD OF HEALTH . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY `.
BUILDING DEPARTMENT CHECK .I"-§. . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL „ 1:34'"66 7
Examined...... ....... 20. MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved.......>/14....... Ql Permit No. �SO� .. ...................................
Disapproveda/c .................................. ...................................
..................................... .....
.. ...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT l
"T.
Date. 6�?0 , 20�/.
_. .
INSTRUCTIONS
a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
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 giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
C.,, jbe 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
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. ,
APPLICATICN IS HEREBY MALE 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, other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alter r r removal or demolition, as herein
described. The applicant agrees to comply with all applicable 1 i s building code, housing code, and
regulations, and to admit authorized inspectors on premises and in bui ing for ssary tions.
• .....
•
(Sture of applicant,.or ,•if.a corporation).
� 2s /,�6�►.'�- pv�ve Svu��
......................................:............
(Mailing address of applicant)
State whether applicant is owner, lepsee, agent, architect, engineer, general contractor, electrician, pluuber or builder
.... .............. ,,^�..............................................................
Name of owner of premises ..... 4 I.I r&41 C` V r'x
. • • • • ...................................................
(as on thetaxrollorlatestdeed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No.
PlumbersLicense No. .........................
Electricians License No. .....................
Other Trade's License No. ............
1. Location of land on which proposed work•will•be
done...
2 8S � ���! Id.".... _.'"" ..
.... ............. .. .................�.
........................
House Number Street 1 Hamlet
County Tax Map No. 1000 Section ...i 1......... Block ......f.S-1...... Lot .....1!........
Subdivision ...................................... Filed Map No. ............... lot ...............
(Name)
2. State existing use and occupancy of premises ar>� intended use and occupancy of proposed construction:
a. Existing use and occupancy ........ ur2 ......................................................
b. Intended use and occupancy .........!Y.' .. /..................... W WVy .... ,.Y"10vOti...
brain.-a- ,,�a-o-►�.- (,��.:: ,Ili �.,.,tell!"y
3. Nature of work (Check %Midi app licable `
): New Building .......... Addition
Repair ............ Removal .. ....... Alteration ..........
............. Demolition ............ Other Work ..................................
/ ......... (Description)
4. Estimated Cost ...(.0i
• fee ..(to.be•paid•on•filing•this.application)
5. If ml<aellirrg, numi�er of dwelling units ............ Number of dwelling units on each floor ..
Ifgarage, number of cars ......................................
6. LE business, commercial or mixed occupancy, specify nature and extent of each type of use..
7. Dimensions of existing structures, if any: Front.............. Rear ..
.. ..................
............. Depth
height Numiber
of Stories
Dimensions of same structure with alterations or additions: 'Fkont.......
Depth .................... ............... Rear ...............
Height .................... Number of Stories .......
8. Dimensions of entire new construction: f .......Front ................ Rear ........ Depth Depth ..............
Height ......................... Number of Stories .....................
9. Size of lot: Front .................... Rear .................... Depth ........... 1 ...
10. Date of Purchase ..................... Name of Former Owner ................ .
11. Zone or use district in which premises are situated ........... .
12. Does proposed construction violate arry zoning law, ordinance or regulation: .....................••
13. Will lot be regraded .....................l^�1Will excess fill be
/I,,••�� removed from premises: YES PD
14. Names of Owner of premises .� �
Address /,
Name of � Tor .i.... ........ ..1�.��.�.�(IGTi: f�2S��tl�?I ,C,..:... Phone rb. ....^....... .
........ Address ..... Phan No.
Name of Umtractor ................................... Address .........
... ......................Phone No. .........
15. Is this property within 300 feet of a tidal wetland? * YES ..........
*IF YES, SQUID MM-1>iUSMS PEI IIT MAY BE REQUMM.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
From property livres. Give street and block comber or description according to deed, and show, street names arK, indicate
whether interior or corner lot.
As Qui �Cic � c�
SS
(A1NIY (V 1
moo.. nS.��..
..."" ..... .........................being duly sworn, deposes and says that he is the applicant
Name of it ividua.l signing contract)
bove mmamed,
e is Lhe ................. ...
(('.cnrtractor, ag it, corporate'officer,•etc.).. .. .. .... ..
f said owner or owners, and is duly authorized to perform or have performed the said work and to make arx] file this
pplication; that all statements contained in this applica re true to the best of his knowledge and belief; and
hal the work will be performed in the manner set forth i the a lication filed therewith.
worn fto�before me th i s
y of ..... .. 20.C7.1.
Notary Publi .. ' ............................
LYNDA M.BOHN (Si •re of•Appli.cant)....••.
ri o 01806020 of�
QWWW in
� M�S.��
� 7SaZ�
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED: /,?</O1
_ DATE SUBMITTED: /Az-/O1
APPLICANT NAME:
SCTM# --- DISTRICT: 1,000 SECTION: /// BLOCK: /O LOT: If
STREET: 2&S CITY: SUBDIV. NAME:
PROJECT DESCRIPTION AD ALT ACC OR N/D: s. /� ec,, 10 '! �sc o,..,
ARCHITECT/ ENGINEER: �,,E 4 � FAST TRACK YES o O
SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o NO OTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOT JAN.1997 100-25.Merger.(A nonconforming at anytime after 7/1/8
ZONING: PERMIT ESTIMATE AMOUNT:_$ /O.0 .00 PERMIT USE: EXISTING: INTENDED: S.054_
ZONING DISTRIC . R4 R80 AC CONFORMING: YES o N EQUIRED LOT SIZE: SQFT.
WHERE ACTUAL LOT SIZE FRO ?TAx CARD ACTUAL LOT SIZE:IY46SQFT.
REQUIRED &< IRED REQUIRED
11T FOUND:FRONT:-16 'PROPOSED: SIDE YD: /o '/) PROPOSED:-jS VAX ' REAR:'PROPOSED:'
2ND FOUND:FRONT: ' ACTUAL: SIDE YD: '/ ' ACTUAL: '/ REAR: ' ACTU '
LOT COVERA : ALLOWED:20 % EXISTING: sf_% NEW: /4sf f� TOTAL:
CORNER YE R NO WAT ER FRONT? YES OR C05 DESCRIPTION:
FLOOD CbtdPrlANCE ZONE: PRE-FIRM 3/18/80 PANEL #: /6 FLOOD ZONE: X ,
AGENCY PERMITS REQUIRED FOR REVIEW
INCLUDED IN AP TION
TOWN SPETIC PERMIT: YES o
SUFFOLK COUNTY HEALTH DEPT: YES NO (BED#): DTE: / / PERMIT#:R10-
A OVALS RE UIRED:
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o
SOUTHOLD TOWN TRUSTEES: YES o
TOWN ZONING BOARD APPROVAL: YES
TOWN PLAN. BOARD APPROVAL: YES o
TOWN HISTORICAL PRE (SPLIA): YES o
ON
ac a eeI crs
NYS ENERGY: YES O NO EGRESS: VEN/I': LIGHT:V
BUILDING PERMITS O /EXPIRED: -Z/C/0 Z- ,
HAVE PRE CO'S : Y OR N BP -Z/C/0 Z- ,
NOTES::
ma l �vr 1p-4.x e�
Wo- o
FEE STRUCTURE: FO DATION: SF /-A r Ar<4 a, lov
FIRST FLOOR SF
SECOND FLR SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
TOT( SF)- ( SF)= SFX$ =$ +$ /S® +$ _ $ /SO
cam-_
u v P_.1 ( y
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xl'.'�,'1 x�r VI ' r �t&"��� [ "!1'x ~ry *r „� . � . �w. t..)` ✓r y '� � ke , r'k ,','f`�"'� i,
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i
APPR ED A5 NOTED -- ------ ----- — --- �--— -
B.R x
�
NOTIFY BUILDING DEPARTMENT AT
765-1902 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING --
-;-
3. INSULATION �y
A
4. FINAL _ CONSTRUCTION MUST _._--- —__-- ♦
9E COMPLETE FOR C O. � I � I �f_ I!-1 G
ALL CONSTRUCTION SHALL MEET
THE REOUIREMENTS OF THE NY. , L
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR UR9 wffERS CERTIFICATE
DESIGN OR CONSTRUCTION ERRORS REQUIRED
Lo
OCCUPANCY OR
PROVIDE OPENINGS FORUSE IS
UNLAWFUL
EMERGENCY ESCAPE AS
REQUIRED BY PART. 714 OF WITHOUT CERTIFICATf-
N.Y. STATE BUILDING CODE. C' ;' OCCUPANCY -
I - ----------
X"40 7' '' �3r, err
,gyp `I �---- �------- --�
Gvncs iY3 +Y caul�. ��� I Imo . 1 I V% }-
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uv CN 9RRir4� 7JLFtA db3z f�E- irwFTrMcS
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�h N.ErtfL :2141Y,1J,6t,n�. _
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i
SII
APPROVED AS NOTED
s Jso�z. '•
DATE: 1c B.P.q ' i i -•___ ..._- - ''
FEE: 449.42. nd BY:� �
1 NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1 FOUNDATION - TWO REQUIRED I
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
j S. INSULATION -
' 4. FINAL - CONSTRUCTION MUST -- - - — - \N I'1 I� ;� "I .-T :`7 f� 1 •� ti'-_
BE COMPLETE FOR C 0.
ALL CONSTRUCTION SHALL MEET -
THE REQUIREMENTS OF THE NY.
STATE CONSTRUCTION & ENERGV
CODES NOT RESPONSIBLE FOR IINDERWRDDIS CERTIFICATE
�i I
DESIGN OR CONSTRUCTION ERRORS REQUIRED
OCCUPANCY ORLi
= I
PROVIDE OPENINGS FOR _ "
EMERGENCY ESCAPE AS `�fM
I -
REQUIREDBYPART. 714OF VIS U CERTIFICATE
e — -- —
}I tl I'-oa���
N.Y. STATE BUILDING CODE. (If- (',-
1-o°`a 6'.,ncS
PT Srre ✓,�,r ncY rte FJ,-r.,ee s.?< <<sf��t�u��
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OFESSION