HomeMy WebLinkAbout26278-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27718 Date: 05/29/01
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 555 HILLCREST DR ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 13 Block 2 Lot 8.5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 20, 1999 pursuant to which
Building Permit No. 26278-Z dated JANUARY 18, 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 SINGLE FAMILY DWELLING WITH DECKS AS APPLIED FOR. NOTE; STATE VARIANCE
PETITION #2001-0177 FOR EGRESS WINDOWS & HEIGHT VENTALATION IN SECOND
BEDROOM.
The certificate is issued to JOHN ASCHER & EDWARD SYPNIEWSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0230 05/24/01
ELECTRICAL CERTIFICATE NO. PENDING 05/05/04
PLUMBERS CERTIFICATION DATED 05/23/01 KING PLUMBING & HEATING
Authorized Signa e
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. 26278 Z Date JANUARY 18, 2000
Permission is hereby granted to:
CHRISTINE REESE MCCULLOCH
641 SOUTH FEDERAL HWY
POMPANO BEACH FL, 33052
for
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH SCREENED PORCH
AND DECK ADDITION AS APPLIED FOR.
Amended tib include screened porch with deck and side deck.
at premises located at 555 HILLCREST DR ORIENT
County Tax Map No. 473889 Section 013 Block 0002 Lot No. 008 . 005
pursuant to application dated DECEMBER 20, 1999 and approved by the
Building Inspector.
Fee $ 515 .40 D
Aut ized Si nature
ORIGINAL
Rev. 2/19/98
05/22/01 13:08 FROM-EMERY-PRINTING-212-517-3883 4 16317651823 NO.752 P003
{
Form No. 6
j TOWN OF SOUTHOLD In)1 l U
7 BUILDING DEPARTMENT
L
765-1H802
APPLICATION FOR-CERTIFICATE OF OCCUPANCXllj �l�
A. This application must be filled in by typewriter OR ink and submi(,t4ed MAY q45 dihh "
inspector with the following: for new building or new use: k
1. Final survey of property with accurate location of all buil ing��s;"pGrs e s,
streets, and unusual natural or topographic features. a{�Urdfil.pp,r, .,
2. Final Approval from Health Dept. of water supply. and sewerage-disposa -
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 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and Installations, a certificate of Code Comp=liance 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.conseut to inspect signed by the applicant.
If a Certificate of Occqpancy 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 $25.100. Businesses $50.00. . .
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - =�5�
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...Z�. . . ... . .. .. . ... ... . . . . . . . •-
New Construction. .... .. . Old or Pre-existing Building. .... ....... .....
' Location of Property....e,•5S. �:�' ": �' �J . ......... ...9P-A4 3T
. ......... ...... .. .. .. . ..
House No. Street Hamlet
Onwer or, Owners of Property....
...Ol.. `SU. .... . ... .. . . .. . . . . ....... . .
•SYQwl.�15K")•
County Tax Map No 1000, Section....*3.. .. ...Block. .. PZ. ... ... .Lot.. $;5. .. . . . . . . . . . . ..
Subdivision. . ... ...*....... ... ......... .... .. .. .Filed Map. 12\ . .``.Lot. . . ... . . .. . ... . . . . . . .
Permit No:14P.V1.1'7'.... .Date Of Permit. .l�19 OO.. .Applicant. V� .!: �. j�.�^
Health Dept. Approval..... . . .. ..... . .... .......Underwriters Approval. .. . . .. . . .. . .. . . . . . . . . . . .
Planning Board Approval... ........... ..... . . . . .
Request for: Temporary Certificate. .... . ... .. Final Certicate. . .�` . . . . .
Fee Submitted: $.... .... . .. . .......... . . . .. .:
. . .. .... . . .. .. ...... .. .... .. . . .. . . . . . . . . . . . . .. . . .. .
C O z n 7 /�O APPLICANT
spFFO(kcoGy
Town Hall,53095 Main RoadFax 516 c =� ( )
765-1823
P.O. Box 1179 W Telephone(516)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 17, 2001
Edward Sypniewski &
John W. Ascher
345 E . 80th St . , Apt 4K
New York, NY 10021
RE: 555 Hillcrest Drive, Orient
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
XX 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 # 26278-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
o- SpFFOL't
Town Hall, 53095 Main Road y Z Fax(516)765-1823
P. O. Box 1179 W- Telephone (516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE• �o�?� U
Building Permit No. o24L' a0
Owner:
(please print)
Plumber: ,/L loci 1 -LAX—
(ple se print
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signature)
Sworn to before m./e{ his
2,3a day of 9'9 �
Notary Public, / County
CLAIRE L.GLEW
Notary NobOIGL4879505w York
Qualified in Suffolk CounAY
Commission Expires Dec.8.-
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REMARKS �—
�Z
ATE INSPECTOR
FI -.0)__7SPEGTTON=REPORT==n=DAT COMMENTS__--
FOUNDATION < I
FOUNDATION (2ND)
_-_______________
ROUGH FRAME 6 -'Oe U-,
PLUMBING it �i � — /d✓/��_� �o Ce
INSULATION PER N. Y.
STATE ENERGY
CODE777
u----- i{ !%i. C/A �OL07/Yn YlUl er •�c./L�
N _ B khtizo 1%4
FINAL
ADDITIONAL COMMENTS:
2
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71 lie
a
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41
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(
APPLICANT
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethicsrohibits conflicts of
Interest on the part of town off cera agd employees. The
purpose of this form is t0 rovide inFormahion which can
alert the town of nose ble conflicts of interest and allow
it to take whatever action is necessary to avoid same.
YOUR MAHEx
Leet name, Eirat name, middle initial, unless
you are applying in the name of someone else or
other entity, such as a company. IF so, indicate
the other person's or company's name. )
NATURE OF APPLICATION: (Check all that apply. )
Tax grievance
Variance
Change of zone
Approval of plat
Exemption from plat or official map
Other X
(If ^Other," name the activity. ) R iii 1 ding permit,
Do you personally (or through your company, spouse, sibling,
parent, or child) have a relationship with any officer or
employee of the Town of Southold? -Relationship" includes
by blood, marriage, or business interest. "Business
interest- means a business, including a partnership, in
which the town officer or employee has even a partial
ownership of (or employment by) a corporation in which
the town officer or employee owns more than 5% of the
shares.
YES NO v
If you answered "YES,". complete the balance of this form and
date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself (the applicant)
and the town officer or employee. Either check the
appropriate line A) through D) and/or describe in the space
provided.
The town officer or employee or his or her spouse, sibling,
parent, or child is (check all that apply):
A) the owner of greater than 5% of the shares of the
corporate stock of the applicant (when the applicant
is a corporation);
B) the legal or beneficial owner of any interest in a
noncorporate entity (when the applicant is not a
corporation);
C) an officer, director, partner, or employee of the
applicant; or
D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
n/A
Submitted this da f DE
Signature
Print nme JOhri ASChOr
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO=ATION
BG.
[ ] FOUNDATION 2ND [ ] IN
[ ] FRAMING FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: 1cf
IVJ
,DATE C INSPECTOR
7PIA-w
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUG LBG.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACES CHIMNEY
MARKS:
,DATE INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ NSULATION���„�_`
[ ] FRAMING [ ] FINAL //����
[ ] FIREPLACE A CHIMNEY
REMARKS:
,DATE IO /" INSPECTOR Y�
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO UH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
RE
,DATE INSPECTOR 2WIZV
M-1802
BUILDING DEPT.
1NsPECT0
[ ] FOUNDATION IST [ ROUGH PLBG.
[ ] UNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
FIREPLACE & CHIMNEY
REMARKS: .
DATEINSPECTO
p,.
OJZ3dSNI % 3JLVCI,
A
• ONE NOIJLVaNnozi
D 91 • NOIJLVaNnozi
':1 0..
4P 0U33dSNI
G
r 1 Maims
f i
CHRISTOPHER R. STRESS, A.I.A.
ARCHITECTURE AND PLANNING
P.O. BOX 821
JAMESPORT, NY 11947
PHONE/FAX(516)722-7865
y�
Cto April, z000 APR f f dip
Southold Building Department
`Vy 4
Southd Town Hall
P.O.Box 1179
Southold N.Y. , 11971
RE :Proposed Residence
for Steve Mauter,builder
Ref.No. 262784
To Whom It may concern,
Please be advised that a recent inspection made by the building department
revealed that the foundation walls were poured at 8 " instead of 10" as shown on the plans filed .
Also the proposed concrete piers were poured on the inside instead of outside of the foundation as
shown on the plans .
I Christopher Stress Architect of record for this house find these revisions
acceptable and as such are signing off on same .Should there be any questions on the above
or should the building department require any additional information ,kindly contact me
directly .
erg Yours,
0
Christophe4tress A.I.A.
cc:Steve Mauter,Builder
I
7P4
765.1802
BUILDING DE
INSPECTIO
[ ] �FODATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ]
FIREPLAcrm S CHIMNEY
R ARKS:
07
DATE INSPECTT5���
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY nn
REMARKS: J_ i� �s�/ly'�✓y
1-0
6
DATEINSPECTOR")P�
:...... .
- TORN N0. 1 3 SETS 0 LAMS
� SUP"
pp p TOMN W .SOUTUOLp
Cll¢CR . J oS��•, •:. . . . . . . . . . . .
r' `BUILDING
'L'OWN IiALti_al l AR'PML'NT t�
i • ; i SL'PTIC FORM ...
-
DEC, .�_.�� SaUTUOLD, NJ, 11971
765-1802 NOTIFY:298_5968 ,Jt AQlaalski
(., CALL for Pick-Up.
-. 11 MAIi. TO;. .. . . , Thank.-YOU.-
lxuniredh••. .,o�9R9�? 44�. �.4.Z� ... .
((/ �l .^�"c� Penni C No.
Y"' ...........
Aifrrovcd
Wsapproved.a/c ....................
not
a tor
(lkrildirng d
APPLICATION FOR BUILDING PIt1ttar a ateD,ege,lp}pgx , 16 ,19,99.
INSTRUCTIONS
s. 'Otis application must be completely filled in by typewriter or in ink and sulmitted to the ik:ilding Inapeotor wi
o accurate plot plan to scale. Fee according to schodule• Dining premises or pdnl3c
seta of plana,. promise relatioasldp to adj re ices is part of
b. Plot plan allowing location of lot and of buildings on pr r must be drawn on tine diagr
streets or area$, and giving a detailed description of layout of property
`this application. lication ray rnmenced before issuance of Building Permit.
plicant. Stxln
D,e
Inspector wilt issue a Building Permit to tine up
C. ' work covered dry ication. t
dols app Y not be c
d, upon approval of this applhe WildingInspector
l'l: rout the work.
permit shall be kept on tine preniseavailable
rWtwleeor in part arty purpose vlatever until a Certificate of
e. No building stall be occupied
Occupancy shall have been granted by the Wilding Inspector.
APPI.ICliRtN IS ll;lijW lmW to tine Building department for tine issuance and
a iter applicable
Rennet pursuant na the
ifuilding Zona Ordinance of lite Town of Southold, Suffolk County, New York. and odter applicable Iays, ordinances or
additions or alterations• or for remwal or demolition, aS herein
Regulations, for the caatruction of
buildings, code, and
described. Ti,e applicant agrees to comply with all applicable laws, ordinmtcea, building Dods, housing
reguribed. INA to admit authorized inspectors or premises and in building f nacese�srY i�nsP�°ti°ns_•
im
(Si Cure of applicant, or nape-`,)\i"ff acocorpora Cion)
34 Eas 80th St. Apt. 4-R
NewY 0c.NY .. .......................
(Mailing address of applicant)
SLate whether applicant is oiner, lessee, agent, architect, engineer,.general contractor, electrician, plurber or Wild
..
............................
...........
9. er.............: ........
None of owner of premises ........John:.Arcaher,.&..ono.„........
(as on tine tax roll or latest deed)
If
opplicant is a corporation, signature of duly outb°rizch officer.
................. .
(Nano and title of corporate officer)
Iknilders License No. . 27..• 909-HI.........
Plumbers License No, .t/bf.................. �.
Electricians i.icense No.tW`f...............
.........I..........
Other Trade's License - 555 Hill Crest Drive
work will be done. •• ••
.......... .......
1. i.xal'icn of land an wilir]n proposed :
Orient ..............
.....................................
.....��.5..................:aa.�.�..Crest.Rr�,vs?.............:. lomat
house Naber Street
�.$: Ulock ....t Z.. ..... tat ...$:5.........
County Tax Map Nn. 10(10 section .... ....... ••
Subdivision .90,1 Crgst. Estates .......... Filed Map No. .�pr�$•:�••••• Lot ..�...........
2, State existing use and occupancy of preetaea snl intended use and occuiancy of pr°po� construction'
IaC@Rt. ?ane .
............... ........•...........................
a. Existing use and occupancy •......
residential
bIntended
. use and occupancy ..............................................................
I
3. ttuure of work (dick dildo applicable)I Neu Dallding .......... Addition . .. ., Alteration ..........
Ilalxtir ............ penwal ............. Ilanotitlon ............ Other tJork ..}........... .....I......I......
(Descrlption)
4. Latiueted Coat .� S D:............ fee • (to be uh..[:....................
paid rMd fllg �hta ni>[niteatIon)
5. if dwelling, uuber of dwallina unitssingle f J�in�'rl'of d%mlling units on eadh floor ................
it g
tg ,nrommrcialr
6. ifnsiess
or trimf occupancy, specify nature and extent of each type of use..., ............
7. Ulonnelodm of existing structures, if anyt Front................. hear ...... Depth .................
IktigitL .......................— Mnilsr of Stories ...........................�
Wrensloos of Barn structure Writ alterations or'additlonst Front ... pear ...............
llaptlh .................I.. llaiglit .................... tkinlmr of Stories .I.......
8. 1lluensiodm of entire new construction, Front .3.2 -
,+, ......... llenr .5.0....Jj.... Depth 30... ........
Ilel'gtnt .gn:4a>:..3.5:.......... Haber of Stories
.:�..15.0............ 1.h ...2Ei
9. size of 1oCt pront ...irSY............. Rest p 7.............
10. Dare of Yurcreae •••••. Nam of Ironmr Cwner ................ ....................
It. Zane or use district in tAtidn premises are situated ..R..40 Residential) , ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
12. [bee proposed oanatruction violate any zoning law, ordinance or regulation) ..'.PIP..................
13, Will lot be regraded ,...YAP ........... will excess fill beremov removed least )=X NO
345 E. NY,. NY '10021 �2-288-4669-h
14. mama of Odner of premises .iT4khil.$E3CYhP.> .&.dri0... Address ......PYA.. ' K ........... luxle . ...........
mate of Ardlitect ' h ..... Address AerGicks.Ia. 3amasportj I'Ihonc No722-790.,
5 p
SteFi:?P.??�:1W& . ....212. lame o15...........
Num of Contractor . .............. AtWrceei.. ............ cm
15. is tints property Witiln 300 feet,of a tidal wetland? * YRS .......... Na ..X.......
*IF Wr , StN1110ID 1llldi 11WSITO PMUrr MAY W W'VIRRD.
PLOT DIAGRAM
locate clearly and distinctly all buildings, wbedher existing or proposed, and indicate all set-beck dimensions
from property lime. Give street and block number or description according to dead, and alcw street roma eat indierre
hAnetlner Interlor or corner lot.
Single-family dwelling
as per attached plans. (3) , sets enclosed.
f I
sl'AI1i (W Mtil YWK,
JQbFIW+SFYI@x.......................................Ixaing duly sworn, delnnes and says Lint be i9 the applloult.
(mill of Individual slanting contract)
above hnmed, I,
lie istl�{.s1 .CA:9iv110X................................... ...............................................
(Cantractor, agentr corporate officer, ate.)
kir sold cmier or owners, non is duly nuLlhorized to perform or have perronned Lill said work and to make and file 1.1119
aluplicntiahl Lunt kill statements contained in title applicatiat are true to die )nest of bis knowledge slid WHO; oxl
(lint Lite wutk will lxt perfonred.ln tie nrnner met rordi in We application filed tierewith.
9,;orn before me lila
..........day of > X. �9.....
(S Im(:ure of App1,�,icanC)
Y6LAN0 +EREZ
Notary Public,Stats of NeW York
No.03.4980654
Quallt'led in Bronx County
Certificate Riled in New York County
Commission Expires April 2Z 9b-/
I3UILDIN rl. _ I I VILW CHECK L .�
Applicant/ Date �J
Owners Name: Reviewed: �/ 4
Architect/ Date
Engineer: Submitted.
SCTM #: aa
District: 1.000 Section: I31ock: 0:2, Lot: Os_
Project Subdivision
Location: Name:___
I
Single&separate Required /Ll
certification: (Yes/Nod
Rey QOa Rcq.
7, 1
oning District� � (Lot siu ) Actual 0 QJ� J [Lot coverage ^�O/�r f'rot�scd=�
Req �-y� �( Rey r 6�1 Rey 4 A�i
[Front Yard J Proposed _j (Side Yard Proposed ] [Rear Yard VTJ Proposed
02.0
Project Description:
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: ✓ 9 o 3
Flood Plane Elevation ???
Flood Zone:
Notes: y 0 G /rl;' O c
o c.
SURVEY OF
LOT 3
MAP OF
HILL CRUST ESTATES
SECTION No. 1
' 150.00' S �gy�4o• W °�` �� FILE No. 7218 FILED AUGUST 15, $983
"� SITUAT6D AT
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�$34'40N ORIENT
11 d TOWN 0f SOUTHOLD
1 N SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000- 13-02-8.5
SCALE 1 "=40'
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1 SEPTEMBER 22, 1999
N �• 1�
o — - OCTOBER 21, 1999 ADDED PROPOSED HOUSE
Ilm S17pCL' c'o47=;^razh MARCH 27, 2000 LOCATED FOUNDATION
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