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HomeMy WebLinkAbout26793-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27462 Date: 12/12/00 THIS CERTIFIES that the building ADDITION Location of Property: 870 HORSESHOE DR CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 95 Block 4 Lot 18.18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 2000 pursuant to which Building Permit No. 26793-Z dated SEPTEMBER 25, 2000 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 REAR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & DIANE KOSCIUSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A u oriz d Sign ure 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. 26793 Z Date SEPTEMBER 25, 2000 Permission is hereby granted to: ROBERT & DIANE KOSCIUSKI PO BOX 355 CUTCHOGUE,NY 11935 for NEW 16X20 WOOD DECK ADDITION TO REAR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 870 HORSESHOE DR CUTCHOGUE County Tax Map No. 473889 Section 095 Block 0004 Lot No. 018. 018 pursuant to application dated JULY 20, 2000 and approved by the Building Inspector. Fee 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD • �_ �9�t LI �`� BUILDING DEPARTMENT TOWN HALL 1 765-1802 DEC 4PPLICATION FOR CERTIFICATE OF OCCUPANCY F BLDG D i i)3. s TOWN OF,SGUTE� -J7 s A. This s 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 bu-ildings 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 off' 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 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 Buildini? - $100.00 �. Copy of Certificate of Occupancy - .25Vi 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .A? ." ii i. . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . Old Or Pre-existing Build ng. . . . . . . . . . . . . . . Location of Property. .60.24 . . . . . . . . . . .Aje-S.e5 .f -E-DIZ. . . . . . . . . .�, ,4.1.��'°�.4/. �s.. . . . House No. Street Hamlet Onwer or Owners of Property. . .) Cpaov�'. . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .0.91. . . . . .Block. . .(93 . . . . . . . . .Lot. ./ W D. . . . . . . . . . . . Subdivision.Q,''E '. . � :5. . . . . . . . . . . . .Filed Map.6.���. .Lot. . !. . . . . . . . . . . . . . . . .` Permit Nop?l(� !. ..J-.-,.Date Of Perm _460 % ��14 it/ - . . . . . .Applicant.�4� J. C. � Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .'..t____- Fee Submitted: $. s-�'.a0 . . . . . . . . . . . . . . . . . . . & hg/z e�' a-9-er- 5S-$-� �- . .d. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . C O • ,�d- APPLICANT M-11W2 suauiNc oar. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: �.�...-.� ,DATE-,//// 60 INSPECTOR - BUILDING DEPT. JNSPECTION [ L, FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ j FINAL [ J FIREPLACE & CHIMNEY REMARKS• DATE ! INSPECTOR ✓�^� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 71NAL ULAT N-- [ ] FRAMING [ [ ] FIREPLACE 8 CHIMNEY REMARKS: Qx�= ce-�) /No ,DATE ! ao INSPECTOR II it Z7 tVd 'UA''t►LON ( I ST) 11 u ii II 1`'r u UNDATION (2ND) u N ---------- -------- --------------------------------------- ________---- _ ____________ ii ------fl— — - 0 °Q UGH FRAME & u if------II PLUMBING I� J! II 0 11 II II II H SULATION PER N. Y. u STATE ENERGY t -- CODE rr u b II II II FINAL N II N C, k----- -_=====ccc=_== ====c=c====-____________=====cc ADDITIONAL COMMENTS: lJ r� z a ry n ` BOARD OF HEALTH . . . . . . . . . . . . . V, FORM r. � ' ' FORM N0. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . _ TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK . . . . . . ... .. . . . .. ... . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . .. . . . . . . . SOUTHOLD, N.Y. 11971 DEC .. . . . .. . .. .. ........ . . . . . BLDG. DEPT. TEL: 765-1802 TRUSTEES . . . ........ . . .. . . . . . . . T VAPV F S UTH01 D NOTIFY' CALL : .-a Y&23,. . . . Examined .......... 20-40 MAIL TO: . . . . . . .. . . . . . . . . . . . Approved...9/ZZ.........,sdoo.. Permit No. ................................. Disapproved a/c .................................. ................................. ...................................................... .... ...`... ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. 1.��ff ;;R.-V . :: . . . . . 20 INSTRUCTIONS a. This application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location' `ldr and of buildings on premises, relationship to adjoining premises or public stfeets 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 vrill 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. APPLICATION IS HffM MATE 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, ord5'upces, building code, housing code, and regulations, and to admit authorized inspectors on premises and in bui i ssary nspections. r ... ............� .. . ... ..... ............ (Signature of appli t, or name 'f a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or built Name•of owner.of.premises...�. .. .... ..... .:..!...-.• ..................................... (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............................................................. • '" . 14 � p .7Q.................. 1 .......................01'6,Zc. t .............. House Number Streetaammlet County Tax Map No. 1000 Section .. Z. ... Block //...... Lot Subdivision ...... ..... ........... Filed Map No. ID �..... Lot �........ 2. State existing use and occupancy of 'ses and intended use and occupancy of proposed construction: a. Existing use and occupancy ... �.......................................................... b. Intended use and occupancy ..../! ' /,...................... 141408 .m ASI'M 110d1r wsU do 's; ;�' '�q-YA ID*.......... J x)A 3. Nature of work (check which applicable): New Building .......... Addition .......,, Alter ion .......... Repair ............ Removal ............. Demolition ............ Other Work ... OCA .................. < ' (Description) 4. Estimated Cost p� �................. fee .............................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ lWher of dwelling units on each floor ................ Ifgarage, number of cars ...................................... 6. If business, commercial or mixed occupancy, specify//napture and extent of//each type of use...................... 7. Dimensions of existing structures, if any: rront.�P..4�..c .r... Rear .CO.e77. /j... Depth .246..e....... Height ......................... Number of Stories ...................... Dimensions of same 'structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... 8. Dimensions of entire new construction: Front ...�. ....... Rear .Z—q.t....... Depth .l�.l..... Height ...... ...... ........../....-p.... /Nwber of Stories ............... c� 9. Size of lot: front .l�P.l.:�.R..:... Rear ............. Depth G7F ^ 3O3 10. Date of Purchase ..Jl.�..... Name of rormer Owner II. Zone or use district in which premises are situated ..,IC. . : .. .............. ................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .....�.�.f............ 13. Will lot be regraded ..... ......... Will excess fill be removed from premises: YES GDl 14. Names of Owner of premise f?- xe.4Q?Nr..��.. Address P22.A W.Cc (4j*?fZ..... Phone No. . .�':�P.Z�3 Name of Architect ..... Address .............................. Phone No. . Name of Contractor ................................... Address ...............................Phone No. ......... • 15. Is this property within 300 feet of a tidal wetland? * YES ..........0........ *IF YES, SULMUD 10idd Tfi[>,SIIIS PMWT MAY BE MQJIRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions from property lines. Give street and block number or description according to deed, and show street names,and indicate whether interior or corner lot. L03 to. s� s�nlr or N� ,r . �........... Ss ..............being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, /, r I;e is Lhe .......................L.�,�yy.G( 1ve7. ? ........................................................ (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 f a phis application; that all statements contained in this application are true to the best of his knowledge and belief-; and LhaL the work will be performed in the manner set„forth in the application filed therewith. yworn to before me this :29 Q�Q......... ay of .. ... .40. joi Notary Public ..... .. .....!..'.:. 10....... ............ ... ............. (Signature of Applicant) Y` LYNDA M.BORN NOTARY Puauc,state of New y&* No.01806020932 Ouallfled In Suffolk CounW Term Expires March 8. DO NOT PROCEED WITH 2Y OR FRAMING UNTIL SURVEY OF FOUNDATION LOCATIONA IFUL WE IS UNL HAS BEEN APPROVED. AP?ROK 1 0 AS NOTED CERTIFICATE DATE:-&-24�0-0 13 P # TOP VIEW CUSTOMER -- ROBERT KOSCIOSKO FEE: BY-/ RRK06205 It"-;,�- - DATE 07117/00 REF 11 i NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY NOT RESPONSIBLE FOR STRUCTION ERRORS UNDEMM CERTIFIME REQUIRED LL: cc, L LL -T -T 1r) t-J BEAM LAYOUT CUSTOMER -- ROBERT KOSCIOSKO ' DATE 0-7/17/00 REF RRK06205 C- -- - �r- ao co BEAM BEAM POST POST LABEL LENGTH COUNT SPACING A 16' 3 7' 10 1/4' B 16' 4 5' 2 3/4* C 16' 3 7' 10 1/4' Post spacing is measured center-to-center. Depth of post-in-connote footers --- 36 inches. ' I'.11f +7Z! l:ll,l 1��''';1�r ^%'�lf'/ 1111• liai �i�1� '. 'li '1�4�;1°:'� ljo .- �5+ u: Ij i ' 3c'F+� ii. fi J �i�BlJll� r �� rr s cep , t 1nr PLAN VIEW Cl1STOMER -- ROBER-1 KOSCIOSKO ' DATE 07/17/00 REF HHK06205 �o• -a h LOAD AND SUPPORT: Your deck will support54 live load. Posts have 36' below-ground post support. DECK AND POST DIGHT: You selected a height of 30' fiom the top of decking to level ground. The top of the deck support posts will therefore be 21.26' above ground level. Your salesperson can provide Information for unevon or sloped ground. JOISTS: Set joists on top of beams. 16" center to center. NOTE: The design may require knee braces and bridging between joists. You materials list DOES NOT include theses items. The suggested design is not a finished building plan. You are responsible tot all measurements being correct, for verifying that the design land any substitutions or modifications that you make) meets all local building codes and requirements. To verify that the suggested design. and any substitutions or modifications, is consistent with condtions at the construction site, review tfie design with your architect. Also consult your architect for proper construction and use of malerids in the structure. Itali1I�1�'kl►�{ �,;; t,itr, l.lri,�� s r : r, 00 1. 1 -Irlf �+r CUT LIS 1 CUSTOMER ROBERT KOSCIOSKO DATE 07/17100 REF ARK06205 L- A A: A - .77 I A A --� tA , 5,�� C ---.�_... ---- ----- U LABEL LENGTH BEVELS LABEL LENGTH BEVELS A ,;vsst c22� r' ]0 's°%P' F section 5' . :1•�' B ;edger 16' G cap 15' 5 F45 SO C ;edaa. 19' G' G sactcon 4' S ?%•.' D ledgEl- 16' H cop 1' S ? Fp S4S E :edger l9' 3, I cap 1E' A F'45 :>C F !F' f ],12- r"Q 11345 -/uY t ;us 13_&k7d C4 0.L z g wr:-i rF. t., -. : r. t 'inr TO 39vd 000 00000000000 000000000000 6£:9T OOOZ/90/60 o��S�f FO��cOG yam► Town Hall,53095 Main Road Fax(516)765-1823 P.O.Box 1179 � Telephone(516)765-1802 Southold,New York 11971-0959 X01 � Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD November 30, 2000 Robert & Diane Kosciuski P.O. Box 355 Cutchogue, NY 11935 RE: 870 Horseshoe Dr. , Cutchogue . To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) / No Underwriters Certificate on file . XX The check is (not on file. ) $25 .00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26793-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name:Q aAnto* a-j,, r e LJ S� � a Reviewed: Architect/ Date Engineer: Submitted: o7a Q SCTM #: District: 1.000 Section: � Block: _ Lot: Project Subdivision G Location: O 90 34014,,A� QAAI L CAM�4An� Name: Single&separate Required., 0 certification: (Yes/MV ReqReq. Zoning District: [Lot size: ti Ol< Actual: ,Y/sa Sri [Lot coverage �1 Proposedr 7 �D �,� .4E Req. f r Req' / ' / Req' [Front Yard �Q_Proposed: ��� 1 (Side Yard�a '� Proposed:� ]� [Rear Yard 4910 Propos L Project Description: c/C 32lj SF AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval. Flood Plane Elevation??? Flood Zone: "JA to • 9 / Do — i F7 may. f AL NOM.. Att SAIV�TARY AND EWUS SUR Ohl .kXC SS OF 150' 0 THER THA NIF MA TWIECZYK y . 551• Sff sm WELL >, L LOT 17 d FP 4 N WELL s�s• ?,a28. I STORY WOOD FRAME .4T' GARAGE RES. 42. 1" 21.0• o uos• Ro , etc* XI 144# TEST P HO � saris NLANK •� cr$sPM x _ 75' cEsspm �? 2 R' 4.3'4.19' A„ 16&06• ee 4 si e '30.10 TQC 47.30 7C 47.70 77.24 47.33 t. HOR or-7 OR VE OWNER HAS NO KNOWLEDGE ' OF WELL OR` CESSPOOL LOCA flON. LOCAL PLUMBER IN RESIDENCE IN LOT 17 STATED MOST AfLLS ARE IN FRONT WITH SANITARY WELL IN REAR NOTES: 1. 9 NOV. 2. 15 FEB.. WELL BY 01 3. CORREt . ROUNDIIV-O PRoER T Y N S140*W HEREON. rMt-HOLE- DA TA SUPPLXD 8Y : 'McDONA40 GEOSCIENCE . EXISTtMG GRADE �\�\ t.o• fit► t SUR VEC'Y OF iA�:! AGt+Ft so• LOT, 18 IN MAP OF OREGON MEW ESTA TES cur edw SITUA TE CU TCHOGUE �.o. TOWN OF SOUTHOCD SUFFOLK COUNTY, MY SAwv r MA VEL ZONED AC i4.o• TM 1000-098-04-18.018 FINISHED GRADE FM 11T 6241FILED 4 APRX,1975 -�--�' j'—M/N. /S./�. �2' MAX. SURVEYED : 23 JULY, 1998 _0T 19 �.. SCALE 1"--JO' 300 S.F. AREA— 41,667.42 SF SIDE WALL OR AREA 0.957 ACRES LEACHING a „r« POOL GUARANTEED TO RICHARD H. ANDERSON 2' MIM. GROUND WA TER JULIE HALPIN FIDEUTY NA770MAL 77 TLE INS CO. row OF SOUTHOLD TYPICAL CESSPOOL SYSTEM 0 N. T. 5 'NOTE' ELEVAWNS SHOW HEREON Q ARE ASSUMED DATUM n1 O FINISHED GRADE V MIN. CESSPooL 2' MAX. _ SURVEYED FOR ROBERT & DIANE 114' '• ''—�d �� - KOSCIUSKO 8' M1N. TO CESSPOOL 900 GAL. SEPTIC TANK R= 24.56' A� 39.01' TYPICAL SEPTIC TANK - g 78g1, Guarantees indicated here on shall no _ SUFFOLK CO. HEALTH DEPT. APPROVAL only to the person for whom the svfV4 1=4& is prepared, and on his behalf to the �a H.S. NO. I title company,-Covermental Agency, lending irsttution, if listed hereon, and STA TEMEN T OF /N TEN T to the cssignees of the lending institut'�ori: Q,C� Guarcntees are not transferable to r- THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS :ddittonal institutions or subtecluent OWN" y FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS tr OF THE SUFFOLK CO. DEPT OF HEATH SERVICES S Unauthorized alteration or addition to fhis APPLICANT survey is a violation of Section 7209 of TOWN OF SOUTHOLD the New York State Education 4pw• FOR APPROVAL OF CONSTRUCTION ONLY Copies of this svrvey map not bearing DATE the Land Surveyors embossed seal shalt not be considered to be a valid 11c" APPROVAL C,py, SUFFOLK CO. TAX MAP DESIGINA TION SURWYE© DIS T. SEC T. BL OCK PCL. STANLEY ,L I $ 'N, , 1000 095 04 18.018 Nfil/ 8 Y1 3 98 L OCA TE FOUNDA TION OWNER 516 99 FINAL SURVEY. i AND SANITARY PROVIDED ROBERT & DIANE KOSCIUSKO { fN NNER. _ ! NYS Ll '. 'T SANITARY TIE. 31 MAR99 8C720