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Home My WebLink About26956-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27818 Date: 07/19/01 THIS CERTIFIES that the building ALTERATION Location of Property: 595 GREENFIELDS LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 59 Block 4 Lot 5.13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11, 2000 pursuant to which Building Permit No. 26956-Z dated DECEMBER 5, 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT BRASLOW (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 06/27/01 PLUMBERS CERTIFICATION DATED 07/13/01 NORTH FORK PLUMBING c ,// utho 'zed 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. 26956 Z Date DECEMBER 5, 2000 Permission is hereby granted to: ROBERT BRASLOW 595 GREENFIELDS LANE SOUTHOLD,NY 11971 for ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at, 595 GREENFIELDS LA SOUTHOLD County Tax Map No. 473889 Section 059 Block 0004 Lot No. 005 . 013 pursuant to application dated SEPTEMBER 11, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No. 6 1a ~ A TOWN OF SOUTHOLD J q 7 BUILDING DEPARTMENT ;r ---' TOWN HALL G. 765-1.802 • F' 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 o� 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 building; 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 3 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.-00. Businesses $50.00. , 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - . .24%p 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residen;X-r / f 150, Commercial $15.00 .Date . . . . . . .. . . . .. . ... . .. . . . . New Construction. . . . . . . . ... Old Or Pre-existing Building. . . �.. ..'.11__. . ... . i LA Location of Property. .�. .... N��.� �� ti►T�1 �► :!. �� . S �? e� ...... .. .. .S°. ,. . .�. .D House No. Street Hamlet.• Onwer or• Owners of Property.. . .. .•'�eR R f1 S 110 40.4 . . , . . . ..G . ..♦ .. . . . . . . . . . . . .. . . . . .. . .. . . County Tak Map No 1000, Section.P5.:J • .B1ock. .0.� ®. , . . . .Lot. QP .d. . . '. . . . . . Subdivision. . .. .�4 . . . . . . �'�,�. . . . .Filed Map. .': 3 1 3. . .Lot. . �.a� . . . . . . Permit No.4.q .p. . . . .Date Of Permij . ..� �. ... . .Applicant. �obly .N:. f . . Health Dept, Approval. . . . . . . . . . .. . . . .. .. . . . .. . .Underwriters Approval. . ... . . . . . . . .. .. . . . . . . . Planning Board Approval. . . .. . . . . . .. . . . .. .. . . . . . Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. . . . . . . . . 2 5 00 Fee Submitted: $. . . . . .• Lilo � 'ate�1 � o��g�fFO(��OG y� Town Hall,53095 Main Road y Z Fax(516)765-1823 P. O.Box 1179 • Telephone(516)765-1802 Southold, New York 11971 dol �a 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. Owner: III P, R-ObeR po'S 16 w (please print) Plumber: IVO T� Fog Plum � I✓l �/'�Gt irl �rrct,✓�L�. (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. N Sworn to before me this 13 day of GLg2aa Notary Public, 6-r< County ELIZABETH A STATHIS NOTARY PUBLIC,State of New York No.01 ST6008173,Suffolk County Terre Expires June 8.202-2-�— o�1 ,%% SFFOtlr�, o - N Town Hall,53095 Main Road Fax(631)765-1823 P.O.Box 1179 �f. o�� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD July 16, 2001 Robert Braslow 595 Greenfields Lane Southold, NY 11971 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) v xx No Underwriters Certificate on file. xx The check is (outdated)$25.00 No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) • BUILDING PERMIT # 26956-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 0, C CO DATE O INSPECTOR d-6?J�� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FQUNDATION 2ND [ ] INSULATION [ v FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: --/ DATE -,7-11-41671 INSPECTOR �'/ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] �RH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL ( ] FIREPLACE 8 CHIMNEY REMARKS: ;DATE � 0 lo l _INSPECTOR hZ1,1' )6?r6op�' BUILDING DEPT. INSPECTIO [ ] FOUN ATION IST [ ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: . �� ,DATE INSPECTOR T65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: PATE INSPECTOR '"" "/ INSPECTION REPORT DATE COMMENTS acxxxaasxxsxxssxxxssx=�xsssxassa.sx==csxs=s=s=ss=sss======xssaaax=aaasss==ansa=sxa-___- 11 11 jj i„� 11 y FOUNDATION OST) II u � CAI FOUNDATION (2ND) ____ =_ ------ ------ 910 / 4&e'-e o �1 ROUGH FRAME & I�---�� of v. PLUMBING II 1 10, 0 U) II j N INSULATION PER N. Y. �— I y STATE ENERGY u CODE II ii u C II II01 _ H -1000, II p FINAL n xaaaea=axxaasxxxs_xxaxxs________s�rsaa=sxxasaxxasaxoxaaxxa=xx as=saa�xaaaaxxxaaasxxaaaaa 0 ADDITIONAL COMMENTS: aaxaaxe=xxasxxaaassxsasxxssaxxsaxxa�sxxaaaxxaaaexsxxaaaxz=xxsaaaxsasxaaaaxsaaasa=sxasasss � y ypf� r9 1 �l H "Z r c�a ro H I BOARD OF HEALTH . . . . . .. . . . . . . . . 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: ! to S-_I -J 3 CALL �. [ , +� ll Examined...�� ......, c@QP. — MAIL TO: .��a:&. b Go . Approved....�� ...... 2e... Permit No. " / �... Disapproveda/c .................................. ................................... ...................................................... _.. .... . ............. `. (Building Inspector) r APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . .. 20. . . . INSTRUCTIONS a. L-aFO!ication 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. 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY M&M to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Canty, 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, s, build' code, housing and regulations, and to admit authorized inspectors on premises and in ildi f nneces inspections ... .... .r� .. .... ... . .................. (Signature of applicant, or name, if a corporation) S Gr2EsNF= QLD$ LA-NE-,, SaAA-Inot..o,� 119"71 ................................................... (Mailing address of applicant) State whether applicant is ower, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..(!?w ?........................................................................................................... Name of owner of premises ....2�Wg�...�!:. RP►S L�� (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.............. ................................................ .5015- GI( EENFIEt_DS LPNE. Swu-r�o L-0 1\J-Y' l9 —71 ......................................................................Haslet........... ................ House Numober Streget County Tax Map No. 1000 Section 1...... 1r Lot .�...... 3 .... ' � ..... Block ................` c. ,�.:. Subdivision Reenrd e-�S Filed Map No. .......(None:......................... .�� .7...... Lot ............... 2. State existing use and Occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. a I`4en.-- A _ wnre(- 0cC P,IeD ......................................... . .......I................ b. Intended use and occupancy t Nm� �................. .. .......... 3. Nature of work (check which applicable): New Building .......... Add iti°°�,, .SAlte at'on . Repair ............ Removal ............. Demolition ............ Other Wokk ...... ............M s.. (Description) 4. Estimated Cost �.Td............ o...... fee .............................................. (to be paid on filing this application) S. If rkaelling, number of dwelling habits ....!... .... Number of dwelling units on each floor ................ Ifgarage, number of cars .2.................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...N�.............. 3� 7. Dimensions of existing structures, if any: Front..5-0............ Rear ..5........... Depth ...�............ Height ......................... Number of Stories .............. �ci+r;•;`6 A Dimensions of same structure with alterations or additions: Front .... Rear . NC. . Depth .�� "� �. ... Height .f.�l�:c• . :.. Numnber of Stories 5�,,, C�fln. ... 8. Dimensions of entire new construction: Front ................ Rear ....:.:........ Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Front .. .?............ Rear ..'Z 2 8 ........... Depth 2......... 10. Date of Purchase J.( ?�q........... .. Name of Former Owner ... ...... ......................... 11. Zone or use district in which premises are situated ... in?n: 1 ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: MIXE................ 1# 13. Will lot be regraded ...NP............. Will excess fill be removed from premises: YES (:N§D 0AU-J&40 14. Names of Owner of premises Address 5xi 5 qR ,e,'�iew s:LANr- ... Phone NO. 7�.15SE Name of Architect .......................��`•.. ..... Address .....S A. :........... Pthone No. .............. Name of Contractor .� � .GU j L c�e2:... .. Sq$.G-treeN-G'ea Ps �.A .SoK Phone No. 716.515 6 3 Address .. ..... .�.... 15. Is this property within 300 feet of a tidal wetland? * YES ..........O ..�.... *IF YES, SWMD IUM 18Us1FES PE[NIIT MAY BE RETIRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. flter..cK �ASe �+"� e,4*^wcE coNc� aero �k I GP�h•6E 1-7 L IiJ, C rry Er r LANE su it or NZJ Yow, SS COUR17 {$ ..........(.�.... . ..... �C)� � ...1:.:. 1:I. ...............being duly sworn, deposes aril says that be is the applicant (Nave of individual signing contract) above named, lieis the ............... ��l✓ .0...................................................................... (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 true 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. Sworn to before me this i Notary Public ..... ... ... ............................�......... (Signature of Applicant) Notery� of JOYCE StaM.te lNewyork No.4962246,Suffolk Co my Term Expires June 12, "0..601 SURVEYED POR: .�08E,�- B�4SLov.,/ -ocATEG A �SOU�!-�OL� -over, �= SOUT�/OLD SJFFOLK COUNTY N.Y. MAP OF C�E��/F/E��Jc CC. CLK. N0. eo.343 FILED AlOt /O 197-5- SCALE 975SCALE 1 SUFFOLK CC. TAX MAP DATA:- DIST./z2!570 SEC. ,59.CO ;,�_ .--. /�/ �� • �✓ �d � �'EL. BLK. 4f.00 LOT 005. 0/3 2�7z .z QQ - f SERVICES Y�SUFFOUCOUNTY DEPARTn9ENT OFH C OFFSETS FROM STRUCTURES $ �INfY � 30 �S TO RELATIVE BOUNDRY LINES, UN U $ j Q RE-F - D�,Tf� H.�. _.. NJ.". /63 ON SURVEY, ARE FOR A The sewa_e disposal and ��ate; s:.!nrl � , ,ss R fi<. ; .;_� for this SPECIFIC USE ONLY, AND locatio:? h3ve feel?inspY.ted by th :;wpa: mien"and/or SHOULD NOT BE USED FOR other %c sand CONSTRUCTION OF FENCES OTHER STRUCTURES. Chic of Bureau of Wastewater Man nt « w OOR DEee 4 e s , 5 7y '� � —FE!57 NOSE- 23.¢ c��ioe�.c,TE-v J-o. 0 �l V//r �rcE ��owv �f,//CDGO ��E iC/SGle,4NC'E � bio 7/ ` / DD Ii(/ No WA7LX--' F/SURVEYED Q2.—. -V-cc:l 1 9&<6BY ti/o S�acE G decE C .4A.14F. 1'a.' WILLIAM R. SIMMONS JR. P/O BOX 377 r ,iAMESPORT, L. I., N. Y. i i 947 A G�A7zjmr - _c ry i,�5 e 7 PAGE DRAWN B� - i V11Nf7O%� TIT 7 sIBJ 1, 4 `/ It c.d /u /l �h+vfrfCTi'.1�d -VecCT%(cc4 N ' V •� /.d t cu{j� `'�a/a ti 15 -4<-e-,.� � $L'Tf3�{ K >4 CS ++.4 �,rt KnN t „L1 L/ At /�eQur.�c-D, 3��"��Y !,s • ..1)'SCSC /� ,�adwr.Le.:l, �� _ ; PR SPA-t-\ \ _ I PROVIDE3/4 HR. FIRE � �°qtr `��''� ��/�` `' � �•� �G4� � RATED SEPARATION TO -= PART. 717.3 (f) (1) OF 1 N.Y. STATE BUILDING CODE PROVED AS N D 6 f 1+ � C ` ° S —1 L4 i DATE: B.P.# 2 ---— —� FEE: D wAn NOTIFY BUILDING DEPARTMENT AT PROVIDE 3/4 HR. FIRE '765-1902 �n7 0`^� — -- 765-1802 8 AM TO 4 FOR THE RAT 5"f 1'`r i _ j:FOLLOWINGINSPECTIO , RED ED SEPARATION TO PLU�-BS tY CER;IFIC Tl()^.►� I = g 4 � I wa L-�-eF- E UI t Q40 ' PE LlNf�1tT[ON TW R a PART. 717.3 (f) (1) OF 0i" LEAD CONTEI' T 8E;�0 ., rOFTPOUREOZONCR N.Y. STATE BUILDING CODE. C'Es;TIFICATEOFOCCUPAI '�° I - r-- �af�2 2- ROUGH - FRAMING & PLUMBING Phu�>>E 1 3. INSULATION SOLDER USED Itl WATER _ �---- 4. FINAL - CONSTRUCTION MUST SUPPLY SYSTEP4CAf4l''V0 n I BE COMPLETE FOR C:D. \ ; PROVIDE ANTI-SCALD AND/OR .EXCEED 2110 OF 1%LEA,D ALL CONSTRUCTION SHALL MEETTHERMAL SHOCK PREVENTING Plac�l� l�� THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & FNERG DEVICES AS TO PART. 902.6(x) N.Y. STATE BUILDING CODE. CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR � FNis AUL HID y CoN�R+2 Cc bc1AF b 1 1 it . _,• E � " �1 1 Ste. ke 6'ekk 404 L—w1rtc�,�.J Ro 3816X�� N - .• r �. : , � � I 3Y2 � l , �- 3 k;r.eJeR wA111 _3�3 1 ' If cnn €s 'r a a �r �y(�„ Iu rna►NCr Ir,A1�/QAC h Atk�A R ( i �Ioc}Ricfi.� ?A6 E � S1eRv1•c+E� PROVIDE SMOKE-DETECTING ApaRFSS; Sri uS �A ALARM DEVICESRD.,t- �(` Sa�+Ar �� E"402APIC vi OvJ AS TO PART 721 _ pµ�N� : 7bs 15fa� N.Y,S 9LIItDifiiG CO E. LINDERWRlTERS CERTIFICATE -2 3' 4 rr L I REQUIRED 34X'' S - 3iGs PROVIDE OPENINGS FOR n Gt�eeN- ' c�•�S -- 9_Sx ' 4 x 7 EMERGENCY ESCAPE AS D`S+ 1 C>Q u 5r e 59 - 00 RFQIt►RFt1 t?Y PA ° 714 Cr t 0-c Ov. vv Lo+ 005'. 013 Sc�� N.Y- STATE BUILDING CODE. S BUILDING PERMIT RIJArILW CHLCK Applicant/ Date Owners Name: g ( °l Reviewed: /l _ Architect/ Date 9—/I—o,—Engineer: Submitted: ('—/I—o, SCTM N: District: 1,000 Section: E31ock T I,ot Project C� /� i qSubdivision Location: I �cg&pr" tX �S L�--- ��1 Name: -- --- Single &-, separate Requir Cut,Irlc� on (Yes/ o� p 7 .9 _ s ncr. ILot size Actual J 11_ot coverage Ptopoxd I-- Req Req, Req W !/�Q [Front Yard Proposed: J (Side Yard Proposed. J [Rear Yard Proposed J J J _� y T Project Description: —r o T ,B/1sc�.«�+rr A� .4-wg,,g.ea Fair. AGENC)MERMITS 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: �s to • —4Z