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HomeMy WebLinkAbout27008-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27522 Date: 01/19/01 THIS CERTIFIES that the building ALTERATION Location of Property: 2200 BROADWATERS RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 9 Lot 14 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 20, 2000 pursuant to which Building Permit No. 27008-Z dated JANUARY 10, 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 ENCLOSE PORCH ON EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" . The certificate is issued to SUSAN C OIESTAD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 01/11/01 PLUMBERS CERTIFICATION DATED 01/16/01 GEORGE SEBESTA A riz 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. 27008 Z Date JANUARY 10, 2001 Permission is hereby granted to : SUSAN C OIESTAD CUTCHOGUE,NY 11935 for ENCLOSE AN EXISTING PORCH AS APPLIED FOR "AS BUILT. " at premises located at 2200 BROADWATERS RD CUTCHOGUE County Tax Map No. 473889 Section 104 Block 0009 Lot No. 014 pursuant to application dated NOVEMBER 20, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorik6d SigneZure ORIGINAL Rev. 2/19/98 Form No. 6 f i 1c. Ian I� �� �` TOWN OF SOUTHOLD 154 BUILDING DEPARTMEN21 T �E 'JAN 6 ,'Jill TOWN HALL 765-1802 �� (/ RL0 a.DLV. 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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19 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. f 2. A properly completed application and a 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 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 $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - .25xp 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . 1 . �b�. . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . ..r. . . Old Or Pre-existing Building. .11 . . . . . . . . . . . . . Location of Property. . . Y.2.,o.-D. . . . . . u . . . . . . . . . . . . :'� , . . . . . House No. Stre t Hamlet Onwer or Owners of Property. . . . . � . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . .n. . . . . . . . . . Permit No. .- 7 . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant.�� lam. . . . . . Health Dept. Approval. . . . . . x. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . .. . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . .. . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .ly'. . . . . . Fee Submitted: $. . . . .. . . . . . . . . . . . . . . . . . (5 C, Sq 0 )D . . . . . . . . APPLICANT . . . . . . . . . . . Co-�azs�22 Or M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE A CHIMNEY REMARKS: Z, C'Q _ � ` ,DATE ! Lo� INSPECTOR 414 WARREN A.SAMBACH,SR. CONSULTING ENGINEERS.PLANNERS 7675 COX LANE - P.O.BOX 1033 CUTCHOGUE,NY 11935 (516)734-7492 January 11 , 2001 Building Department Town Of Southold Town- Hall - - 53095 Main Road P.O. Box 1170 Southold NY 11971 Re: Susan Olestad 2200 Broadwaters Road Cutchogue NY 11935 Enclose existing screened Porch To Whom It May Concern: Be advised that all esterior walls, ceiling and floor joists were insulated, minimum R-13 for exterior walls, minimum R-19 for ceiling and floor. Heighth of room 810" . Sincerely, n n IF- Warren A. Sambach Sr. was: s ��ab i Town Hall, 53095 Main Road C2 Z Fax j51'6)765=1823 P.O. Box 1179 �r0 ii P„ Telephone (516)765-1802 Southold, New York 11971 r OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE Building Permit--,No...____ar)n- Q Owner: �Jrj/v (please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. lu e . ig ature) Sworn to before me this day ofoo Notary ublic, U FO Count` ELIZABETH PUBLLIICt,,Statet of ew York No.Term Expires J n 8 ZOOS G L^ FIELD INSPECTION REPORT DATE COMMENTS--===--- ---- -- FIELD ------TI— ____ G I - 0 if FOUNDATION IST) II I 11 0 II —jj FOUNDATION OND) tt--II o ROUGH FRAME h PLUMBING ii ii Cj ii it — II >r— 1fit 1I INSULATION PER N. Y. 11 -- I� H STATE ENERGY CODE 01 II ii I II ii II jj tl _II --- The FINAL I New York Board of Fire Underwriters C�(r� Bureau of Electricity ii is in the P rocess of issuinga certificate of Q — ---- compliance for the electrical installation pp ---------------- -----------------------------ADDITION as provided for in the application for to inspection # 210© '1UWP w ---- -------------- New York Board of Fire Underwriters Bureau of Electricity Inspection activity O pursuant to Application H 0 0 # z has been completed and a certificate of compliance se ' orth the detail of the el sys 77 repared y I II G ( Inspector Date Form 00 V.06/'0 H 17 nhpl""q�X>, .,. .j . .. ... ...._......... _ ._.......w.+.wNNUWYw BOARD OF HEALTH 02000 FORM NO. 1 3 SETS OF PLANS . . . . . . .. . . . . . . . TOWN OF SOUTHOLD SURVEY . BUILDING DEPARTMENT CHECK . TOWN HALL SEPTIC FORM . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . SOUTHOLD, N.Y. 11971 DEC . . . . . . . . .. . .. .. . ......... . . TEL: 765-1802 TRUSTEES . . . . .. . . . . . . .... . . . . . . NOTIFY: CALL . . . . Examined .., ti.4V r� ,�` MAIL TO* . . . . . . . . . . . . . . .. . . . . App r .,a G.0/ Permit No. .i .D � Z ................................... Disapproveda/c .................................. ................................... (Building 7 .Cor) APPLICATION FOR BUILDING PERMIT Date�rl.V: .��. . . ., 2Q20 INSTRUCTIONS a. 'this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector w: 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. 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 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 Occupanef shall have been granted by the Building Inspector. APPLICATION IS H6[WW MW to the Building Department for the issuance of a Building Permit pursuant to the Building Tone Ordinance of the Tam 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 or nuecessainspect' �b.n ...... ..�4' .................. Si a of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .......OWA�................. ......//...�..........p.............................................................. Name of owner of premises .........�?�t5 4.l,dE Q.-``,�()P.Iti............................................................ (as on the tax roll or latest deed) If aptilicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) J Builders License No. .6,S).'T# .. Plumbers License No. ....... c Electricians License Other Trade's License No. .................... 1. Location of land on which proposed work will be done............................................................... Q...UOA-D.W.�}:�...ISP...............................r.-�.T E-fg4R&�........................... House Number Street Hand t County Tax Map No. 1000 Section ...14©.y..... Block ..... ...r Lot ...J. ......... Subdivision � 7�9(I...���hf(............... Filed Map No. ...... rut ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy'...jZ1�F✓SIG .........................................,......... r ��` b. Intended use and occupancy ..........,.Y....N.....................................f.................... 3. Nature of work (check which app}icable): New Ikiilding .......... Addition ........ . Alteration .. .......• Repair ............ Removal Demolition Other Work ....... G�✓,. (Description) 4. Estimated Cost ...1:04 .. ........ fee .............................................. // (to be paid on filing this applicatibn) 5. If dwelling, Tauber of dwelling units .../ ...... Number of dwelling units on each floor ................ Ifgarage, rmnber of cars ....041.•............................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use,::--..............•• 7. Dimensions of existing structur@s, if arty: Front................ Rear ............... Depth ................. Deight ........................11 Umber of Stories ...I.................. Depth duh alterations or additions: Front ............... Rear ............... Dimensions. .. o. sane structure...... H wi t ••.......•••••• Nuner of Stories .. ... Height .. S. Dimensions of entire new constriction: Front � z— ..••. Rear •••••••••••,••, Depth .......•....•• lleight .........................il Umber of Stories ..................... 9. Size of lot: Front ........... i........ Rear .................... Depth ..............:..... 10. Date of Purchase ...1.. 97...... Nage of Former Owner ..... } ......................... ... I•..... II. Zone or use district in which prem �.premises are situated ."ag-+F ............................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...YW................. 13. Will lot be regraded .... p ..........Q.. Will excess fill be removed from premisees':/� y. YES IA 14. Names of Owner of premises ?a o1p C ........... Add re.. Blaati! G rS V u GN.Gwn Phare No. q C.. tl Nare of Ardmitect tM(VYC'PAa.�*CA .( ................ Address '�4�F_p� .4�!?,i,�j,,R....... Pkwre No. 7 `.{::74F.2 Name of Contractor. . wft �r amt{I Wr W% No Z3!1. ........................... Addres 15. is this property within 300 feet��)� of a tidal wetland? * YGS .......... NJ .......... *IF YIS, SOUd UD lam mid III S l'LMIT MAY BE Imo( HRT-.D. PLOT DIAGRAM } Iocate clearly and distinctly aL buildings, whether existing or proposed, and indicate all set—back dimensions from property lines. Give street and Mock number or description according to deed, and slow street names and ilddicate whether interior or corner lot. Surue -Wdo"Seli 'Susi eticlo6ed Ehe 2kia� n� �o�c Q� TIVIr DE MW xuc, SS OONIY OF .� •.••••V�is �` +•4�'•••• I•.:.�.� ......being duly sworn, deposes and says that he is the applicant Name of individual signing contract) hove rmaned, eis the ........O1{2 /1�................................................................................ (Contractor, agent, coporate officer, etc.) f: said owner or owners, and is duly authorized to perform or have performed the said work ad to make and file thi.a pplication; that all statements contaffied in this application are true to the best of his knowledge and belief.; and hat the work will be performed in the i nanner set forth in the application filed therewith. worn Co bef re ne this A Publ. �... .. ... CLAIRE L.GLEW ............................. Notary ublic,StateofNovi 0 (Signature of Appl.i.ctmt) No.01GAAS79506 Quellf6d in Suffolk Courl)Y��j'� Commission Expires Dec. g Dat Owners N c Owners Name Rcvlcwcd ------------ Daic linginccl < �rrn� 11 I)ISIIIc1 0 Sadiun 1,91-z li loci. �� 00 PloiecI r��/� Subdivision / ��y yam• timglc R scpalalc Itcyulrcd 'ar10cauon Yes/NO) yp�[,� Req /umnc D.1(110_L�—w 11.oI siu /,r lu.J�_.._ r / 7� ILnI cu,oiegc�zQ Pinpu..J ___ Rcq Rcq / Req _- 1110,11 Pard Proposed 1 I$Ide Yard Proposed 1 IRcar Yard Propo,cd 1 Project Description: .X/`�G�e?e ��/f • AGENOVEMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? !/ Flood Zone: /Sa Notes.: 1" CR 4BB£RS R q P/o LOT 265 UNI )EFI-NEC CURvE 5 720 17'30"E 3 3 351.50` �O 24L &.5 2P41L zEV�E 7 - _--� -� C i 57 ( L �.+., niiYF B'� �:� 7• 14C3.8_cv 03r- � Fa _ IT 282 - ..-��gr��'� ,. 1 i,7 "• 1 z<i w00L- 2zol f i f PAM � C � AsHvat7 +xcF4nM rF 20 i-Es --{ : LL F: Ca.� J J P36 S 9 °vo 0r 2 V.;4 F£vCEG NO V 72' 36'40" W 42141' P/c LOT 2C,6 $URVEYEJ 22 auSU57 199,' P/o LOTS' 2 5 5 P-CE SCALE t =40' !RE4 = `22,946 $3 S F !r. Gr AMENDED MAPA OF fMSSI4U POINT J 5�7 ACRES k",VNED BY NASSAU POINT CL.OtB PROPERTIES, INC. SIT, r 3 C UTCHOG UIE,. TOWNCT 5.1- rNf='L f) 's t S'JFFO, K COJNTY fvE* YORK j i 4 SURVEYED BY,, SURVEYED FOR: SJSAN O!ESTAD i oOFr, Y STAWLEY S4KSEN, L/F a;"a#icatedhere, 4-n t " t* x ?C tiOX 294 ! � � 1e c yic°�'i4r .JEW SUFFOLK V / 119.56 /J � c n person ftw Vf)WM tle sre Se• 's, :- 72W o$ ; /, egABB£RS RD 4 / F1c LOT 265 :N E r,';EJ CURVE S 720 17'30"E s ..::r \, 351.50 � p ........_ �2aC �B.5 75 7 IAl I 82 �E /" : L.;•lt--_ rrq i ! \ 2_SrCgr { , 282 � � Cl /E. . rR.7.'t- ' Ii AS per_ ?a� 9 59 24.7/_ FE�aCE G ='�__- __ 7.�d;�2^•�S ;cv:'c A,J O=� �a� N 72036'40" w 42141 F/c LCAT 2F5 - c, SUS✓EYE t2 ��SUS� 1997 tic LOTS 4^Ci5 .�..t' PCE. SCALE ! =40' r. "'REA = `22,946 83 S F 0,- AMENDED /AMENDED MAP A OF Iv4SS<ty POINT 5LV4CPES - GVVNED BY NASSAU POINT CLUB PROPEPTIES, INC. CUTC HOGUE, T,`? VN )F `.J• ' T4_ SUFFOLK COJNT); NEW "'ARK SURVEYED BY^ S.1R';EYE ) FOR. SUSAP, DIES TAD ? C'F !r r" ' STANLEY ✓. /.SAKSE."v, ✓R^. ;ndieoted Isere i:>-- --tsag rid: . 8.?Ttc PC, BOA 294 .......__ [_._ ..n -. - <.�r.,�. . .. .. - .. �_ ivf-;p' C! cFOLK b r 11956 /1 e, p { s I " � ^ t .,, :m, .;. 4 • 4� '43 b_ � 6rit`� a s 00 TIFY SUI WIiMG'DEPA9 T_A -1802 9 AN TO 4'PM FOR t PLUMBER CERTIFICATIO V QeL0rA-1 owING INSPECTIONS: ON LEAD CONTENT BEFO _ FOR NDATIPOURED N - TWTEREOUIRE `o CE Q UPA ,a ROUGH FRAMING & PLUMBIN ' # SOLDER USED IN WATER INSULATION k' ` FINAL CONSTRUCTION MUS SUPPLY SYSTEM CANNOT � 8E COMPLETE FOR C.O. EXCEED 2/10 OF 1%LEA . *LL CONSTRUCTION SHALL ME °h THE REQUIREMENTS OF THE N. t4 Ora- TATE CONSTRUCTION d� ENERG ODES. NOT RESPONSIBLE F EIGN OR CONSTRUCTION ERRO KM1 ALL PLU b WATER LINEA NEED _ s �. STING BEFORE COVERING Copper. ibing is toed PROVIDE OPENINGS FOR for water distributing EMERGENCY ESCAPE AS _`� � r' ' -' system;piping shall be • Of types K or L only REOUIREO BY PART. 714 OF — N Y. STATE BUILDING CODE. UNDO W 11MCERiIF1CATE C IZ-a>pli*,� ,� rz-ra ts�tta' REQUIRED -- zaL-. L f p ftt� Q .� W V j JE3 TA 0 L ` } f�Xt�Ttu4 ra f1Via 0¢` 6I x0WAvb - ;_ N Z SSV `-4 d W- M 064rt�- I WAMAk COWIXTM P C7 f� �-� � OCCUPANCY 0 ?� f "Y '•1':- 4-0, �sUSE IS UNLAWFUL p.47L t4w 12 WITHOUT CERTIFICA w"'N' ' t;t lr