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HomeMy WebLinkAbout27070-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27592 Date: 03/23/01 THIS CERTIFIES that the building ADDITION Location of Property: 1160 SECOND ST NEW SUFFOLK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 7 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 20, 2000 pursuant to which Building Permit No. 27070-Z dated FEBRUARY 14, 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 "AS BUILT" NON-HABITABLE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to STEPHEN & CHERYL BONDARCHUK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uth razed 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. 27070 Z Date FEBRUARY 14 , 2001 Permission is hereby granted to : STEPHEN & CHERYL BONDARCHUK GREENPORT,NY 11944 for AS BUILT NON-HABITABLE ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED. at premises located at 1160 SECOND ST NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0007 Lot No. 024 pursuant to application dated DECEMBER 20, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 IV" Ur SUUTHULU BUILDING I)EPARTMENT "TOWN HALL 765-1802 9 "30 10 �3� 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 sewerag !!=d>'s�o l��-IQ 3. Approval of electrical installation from Board o� Fire Unde pie S. 4. Sworn statement from plumber certifying that the solder used' pi `s stem F! z{ less than 2/10 of 1% lead.5. Y contains � . ' D Commercial building, industrial building, multiple residence an, similar buildings and installations, a certificate of Code Compliance from arc ite t"off ex�gee� -' responsible for the building. ri �.� ,; ,, er- 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 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - . .2511 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $155.00, Commercial $15.00 Date . !/. :? YY'. 0.0. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . .11. Old Or Pre-existingBuilding. . . ./. l.�. . . . . . . . . Location of Property. . . . . .1.1�Q. . . . . . . . . �?yj0.,/I . . .!'Ar-e r, . . . . . . . /VY��!. . House No. L Street / Hamlet Onwer or Owners of Property. t/?!:en. ,I. Aktr'll. . . .60f)n 7�sr.11V. �. . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. M. 7 . . . . . .Block. . . ;7 . . . . . . . . . .Lot. . ::;. .4. . . . . . . . . . . . . . . Subdivision. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . ..Dat e Of Permit. . . . . . r... . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . ./`:.1!: . . . . . . . . . . . . . . .Underwriters Approval. . 4.17 .. . . . . . . . . . . . . . . Planning Board Approval. . . .rY .�A . . . . . . . . . . . . . �( Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. Fee Submitted: $. . . : . . . . . . . . . . . . . . . . . . . . . . . . �y2c,.s �e21 �' . . . . . . . .I ANT. . . . . . . . . . . . . . . . . . . . . . . . C0�a�Sq 2 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ] FIREPLACE A CHIMNEY REMARKS: (17 ,DATE INSPECTOR i FEB 2001 ! I N/F KA TSOULAS N 06. 57' 30" E 135' 2.6 PIPE FR. Z SHEOO 5554 00 t LJ LJ N 8 _ N/F VICTORIA 2 e CONC. PA RO 2.8'OVER N/F PURIC - Z 1 STORY CONC. PA 710 O 27' OVER WOOD p� a FRAME _, y I 2-RAIL RES. . FENCE PIPE L 1.7� 2A7' 3.1' PIPE S 06' 50' 33" W 135' 2 0 TIE= 65' SECOND S TREE T GUARANIEES INDICATED HERE ON SHALL RUN ONLY TO [HE PERSON FOR 6HOM DHE SURVEY IS PREPAR£0, AND ON HIS BEHALF TO THE RR£COMPANY, GOVERNMENTAL AGENCY, LENDING INSP7UPOV, IF LISLEO HEREON, AND TO 7H£ASSIGNEES OF THE LENDING INSIHUROV. GUARAN7EES ARE NOT TRANSFERABLE TO ADOIRONAL INSRIUPONS OR SIBSEWFNT ONNLRS UNAURIORIZED AL7ERAR0N OR ADOIPON TO IHIS SURVEY IS A NOLARON OF SECPON 7209 OF THE NEW YORK STATE EDUCA71ON LAW. COPIES OF RH/S SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. SURVEYED 3 MAY, 2000 SCALE i"=30' AREA= 13,700.614 SF TM 100°-117-07-24 OR 0.315 ACRES SURVEY OF DESCRIBED PROPERTY SITUATE l ' NEW SUFFOLK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. SURVEYED FOR: $TE'PHEN BONDARCHUK CHERYL VICTORIA BONDARCHUK GUARANTEED TO SURVEYED BY STEPHEN BONDARCHUK STANLEY J. ISAKSEN, JR. CHERYL VICTORIA RONDARCHUK P.O. BOX 294 _ NEW'SUFFOLX. NY 1 95 63I 734-5 5 �t L/CLAW. LAND L S V YOR NYS4927J 5 FEB 01 REMOVE NAMES, 4.0X6.4 SHED FROM REAR OFH015EI ADD REAR YARD SETBACK OOR908 i i M AJIF KA TSOULAS N 06' 57' 30" Eco 135' 0 N, Ys uA"� _ s. N VICTORIA n cr v N,/F PURIC C:e'o�a I STORY is IT WOOD i'�srrxanA>, RES. 30 - La_ rJ� 31' C Irr S 06' 50' .I3" W 735' 2.O �IFs�pS SECOND STFEET ?Ar',V MAW MA_QV 9A{L R4V X,N w ICr3PV FIX NICK w"MY ra IK0.A.IN xieMMl N Mr nRe NWiw•r 0MANi 1.ASNCY. 11'MyN XSNtiW.r UsR Mqr�.,AW m nr.fsNsnSsn eruN AvsnNnw. C4MANrRS IM wr M lar ro AWWA.111jW2 M spsAS.'Ex)cMuns ~IMNMAW M AMY Nnas VNKr R A M1AMW K SrC/IW TAU p' nY NfW rOlY SII:[[iM.Al10V NN GYCs o'MR M4t1'1✓P Nnr MAM MP!lW¢AiKRl15lWCALV Y4 9VLl. w1r y spvygpeo N K+✓Au0 hK CMr SVRYEYEO J MAY, 2000 SCALE 1'=30' AREA. IJ 700.614 SF TM 1000-117-07-24 OR 0.315 ACRES SURVEY OF DESCRIBED PROPERTY 57UA TE NEW SUFFOLK, TOWN OF SOUTHOLO SUFFOLK COUNTY, N.Y. i SUR4EYE0 FOR:STEPHEN BONOARCHVY CHERYL WCTOMA BGWOARCHUK JOHN OCTORIA CUARANIEED TO 0ORO/NY WCTCPIA SURVEYED BY, STEPHEN BCNOARCHUK ST1N ,.t,; rt,QSEN, JR. CH0n 19CYORIA RONDARCHUK 88 _ JOHN NCIORIA294:' ''- DOROTHY ACTO.MA JEif',$UFFOLIC,�NY 11956 Ic;FN t:RNU S VEYOR NYS '.N0. 49T 3 OJR908 MAR U2 7 ni 3 Affidavit we the mid'ereigned'hereby attest and affirm the following facts pertaining to premises now known as 1160 Second Street, New Suffolk, New York, Suffolk County Tax Map Number-District 1000; Section 117; Block 7; lot 24: 1.) We are the current owners of said premises and we acquired said premises in the existing condition as is". 2.) The one story frame house on said premises was constructed prior to 1950. 3.) It has been occupied consistently since it's construction. 4.) All systems are in excellent working order and have always been maintained-as such. (This information was acquired from family members - the home was owned by Stanley & Prances Victoria, grandparents to Cheryl Victoria Bondarchuk.) 4 Step en Bondarchulz %a t Cheryl Victoria Bondarchuk State of New York, County of Suffolk: On the 12`h day of March in the year 2001 before me, the undersigned personally appeared: Stephen Bondarchuk & Cheryl Victoria Bondarchuk Personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to on the within instrument and acknowledged to me that xecuted the same. In the re ace of: Veronica R Cidone Notary Public, State of Newyork No:52-4661406 Qualified in Suffolk County�� Commission Expires Dec.31_ FIELD_INSPECTION-REPORT DATE _ _. � ` COMMENTS SII IR I� H d FOUNDATION OST) It it II I Q FOUNDATION (2ND) II p III 11 �� ROUGH FRAME 6 PLUMBING In It INSULATION PER N. Y. �� H STATE ENERGY CODEIt II II IIS II III jj II - FINAL -- II t ADDITIONAL COMMENTS: z r � I — --- - e ro H I U wlv yr 6V U I nvLL hUILDINU PhKNII I APPLICATION CHECK-LIS BUILDING DEPARTMENT 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. '2 740 20 F-- Check Septic Form N.Y.S.D.E.C. Trustees Examined / S ' 2006 Contact: Approved Y 14 1200/ Mail to: Disapproved a/c Phone: Buildinklinspector O�{ 2 0 ` Q l I�( APPLICATION FOR BUILDING PERMIT Date� 20e)O 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 Ihspeotor will issue a Building Permit to the applicant. Such a 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 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 regulati ns, and to admit authorized inspectors on premises and in building for necessary inspections. (Signatur of plicant or name, if a corporation) (NISiling address of applicant) State whether applicant is owner, !lessee, agent, architects engineer, general contractor, electrician, plumber or builder 4re'Dl F�c� Name of owner of premises S�G+��h lr/Itr/i' ®VCd�`tt/(\ (as ri 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: 5e�a1.4r�c�— House Number Street Hamlet �y County Tax Map No. 1000 Section_ L Block 7 Lot 7 Subdivision )~sled Map No. Lot (Name) Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a a. Existing use and occupancy; JQ o5ye�s c e— b, Intended use and occupany� <;/�G 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal_ 1 Demolition Other Work4 eve (Description) 1. Estimated Cost Fee (to be paid on filing this application) If dwelling, number of dwelling wits N/Uf 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 .2 g Rear Q , ¢ Depth 5� Height } 15 umber of Stories 1 Dimensions of same structure With alterations or additions: Front 5A/17C 'Rear Depth Height Number of Stories Dimensions of entire new construction: Front AIIA Rear Depth Height Number of Stories Size of lot: Front )355- Rear 13 5 Depth f 0. Date of Purchase I Name of Former Owner 1. Zone or use district in which prernises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: _ 3. Will lot be re-graded M0i Will excess fill be removed from premises: YES l.��L C (1 ryI �.�orjC r�k _O I,,�a 4. Names of Owner of premises_ Address Phone No. -4 O YY Name of Architect RIA lr/uHh, �AddressG"vleAyl Phone No 734 -20/j Name of Contractor Address Phone No. 5. Is this property within 100 feet of' 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: 'OUNjTQY OF being duly sworn, deposes and says that(s)he is the applicant (Name of individual signinyg� contract) above named, i)He is the ,yti Contractor, Agent, Corporate Officer, etc.) f said owner or owners, and is duly auth'rized to perform or have performed the said work and to make and file this application; iat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be crformed in the manner set forth in the application filed therewith. worn to before me this �,. day of Plt. LOBO otary Public Signature of Applicant JOYCE M.WILKINS Notary Public,State df Now York No.4962246,Suffok County Term Expires June �2,aQU / !I FFB 15 M' �DG.. i Affidavit 7(7V 4.OF SOUTHOLD v We the undersigned hereby attest and affirm the following facts pertaining to premises now known as 1160 Second Street, New Suffolk, New York, Suffolk County Tax Map Number-District 1000; Section 117; Block 7; lot 24: 1.) We are the current owners of said premises and we acquired said premises in the existing condition as is". 2.) Upon information and belief, the area between the pre-existing house and the added garage was built in late 1968 or early 1969, shortly after the completion of the added garage. (This information was acquired from family members -the home was owned by Stanley&1 Frances Victoria, grandparents to Cheryl Victoria Bondarchuk.) Stephen Bon Bondarchuk Cheryl Victonia Bondarchuk State of New York, County of Suffolk: On the 15`1 day of February in the year 2001 before me, the undersigned personally appeared: Stephen Bondarchuk & Cheryl Victoria Bondarchuk Personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to on the within instrument and acknowledged to me thaLthesenc, uted the same. t I e of: Veronica i s Cidone Notary Public, State of New York No:52-4661406 Qualified in Suffolk Count Commission Expires Dec.31 0 � BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: / /S A3y APPLICANT NAME::�r) DATE SUBMITTED: LX �/OJ SCTM# --- DISTRICT: 1,000 SECTION: BLOCK:_ LOT: 2 '¢ PROJECT LOCATIO STREET: ` 1 l00 SCI " CIT 4 S SUBDIV. NAME: ARCHITECT/ENGINEER: FAST TRACK: YES r -- SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o O NOTES: ZONING: PERMIT MATE AMOUNT:_$ .00 ZONING DISTRIC : R401 R80 AC CONFORMING: YES oNO REQUIRED LOT SIZE: SQF WHERE ACTUAL LOT SIZE FRO .TAX CA ACTUAL LOT SIZE:/.3 SQI REQUIRED ''` REQUIRED Ew REQUIRED A3 a�' FRONT:'PROPOSED /.7' ' SIDE YD: /O '/�' PROPOSED:3. '/ REAR:�S ' PROPOSE 4 695 LOT COVERAGE: ALLO D:�% EXISTING: sf % NEW: sf % TOTAL: 6a sf CORNER? YES OR NO WAT ER FRONT? YES OR NO DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.) PROJECT DESCRIPTION• ADD LT ACC OR N/D: �aex/ /-A,>a /A il 7. b,� AGENCY PERMITS REQUIRED FOR REVIEW NEED TOWN SPETIC PERMIT: YES or SUFFOLK COUNTY HEALTH DEPT: YES or EO)(BED #): DTE: / / PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: E r TOWN PLAN. BOARD APPROVAL: YES or i f�Dy FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: SO / FLOOD ZONE: , NYS ENERGY: YES O EGRESS: VENT: LIGHT: NOTES: /jar ,O a.�.ue- �G Gt/ 306/ % c,� c�`a FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR a SF SECOND FLR SF INIT OTHER TOT TOTAL: ?-4O SF FEE FEE s TOT( SF)- ( SF)= SF X $ _$ +$ +$ $ y\ ,:: r , ,. ,. . ,:.+ „ ,' , < ,,. a : . . y _, ! n n r. .y v. " , a „ 1, ,.. , , . . Y , , , , , l , 4 ,; ,,.n, x.: .: , �' . : - ♦,; ,+ ., ., , , . .., s , -. r „yi .,, a , ., , .a . " - ' r ., s: r . , J '.Q a , e Jd 131 e. . ,'. , - . , . . r. , Q , a ,' „ < , r . . • , : „ " _�, , M s r : , , . :. 1VIAIN � AlN ' . . , ,^ . a ' 1 EXIS N > ',.. y , .. . s -., . . , m , , : a •:..,,. . .. �:., ., .r. . ' 0 Z ;: .n ' t >. , . , XQR. rc I t t l .. ♦ r t , , . . ,,. , : , - y , ,. : i' r r • , ' , eJ BQNDARCHIJK , 4 � r , ,. , - , r . cA - ,TOP F'PIAT@ .. LL,� .. S� U- N RbOM , WM, i. . ; ..,. :,..,, .... . , .. 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