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Home My WebLink About25028-zFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall $outhold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25028 Z Date JULY 14~ 1998 Permission is hereby granted to: HAYDEN F & LOIS B ALLEN 29 GLADIOLUS AVE. FLORAL PARK~NY 11001 for : CONSTRUCT AN ALTERATION AND ADDITION TO A SINGLE FAMILY DWELLING AS APPLIED FOR~ AND TO THE CONDITIONS OF FEMA CHAPTER 46 TOWN OF SOUTHOLD. at premises located at County Tax Map No. 473889 Section 097 pursuant to application dated APRIL Building Inspector. 320 EUGENES RD Block 9 1998 CUTCHOGUE 0006 Lot No. 003 and approved by the Fee $ 175.00 Includes $100.00 Flood Dev. Permit Fee Building Inspector/ ORIGINAL Rev. 2/19/98 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-=26286 Date: 02/16/99 THIS CERTIFIES that the building ALTERATION & ADDITION Location of Property: 320 EUGENBS RD CUTCHOGUE (HOUSE NO.) (STREET) (m~LET) County Tax Map No. 473889 Section 97 Block 6 Lot 3 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 9, 1998 pursuant to which Building Fermit No. 2S028-Z dated JULY 14, 1998 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 ADDITION & ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR · The certificate is issued to HAYDEN F & LOIS B ALLEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 02/02/99 Rev. 1/81 N/A N-477675 01/22/99 MATTITUCK PLUMBING & HEAT Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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. 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,S25.00, Swimming pool $25.00, Accessory building $25~.,00, Addztions to accessory building $25.00. ,Businesses ;~$50.00. ' 2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $t5.00 Date ...~./.~..?.(?(. ............................ New Construction ..... ./.... Old Or Pre-existing Building. Location of Property....~.'..~. ....... .~.'.~..~..~./~.e.~".../~.~/.]i]i]i]][i''~, Zcfl_~ ....... House No. Street Hamlet Onwer Owners of Property 14 ? .4 County Tax Map No 1000, Section...iQ. . ...... Block ....... ..... ?. ............. Subdivision ..... Filed Map Lot Permit No. ~ ~0~-~ .Date Of Permit. ~/q/...~f .... apF mu ~¢...,.~-,-... .......... ,.~. Health pept. Approval .......................... Underwriters Approval ....................... .. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~.. ...... Fee Submitted: $.,..~.~ ................... .~_ _, ............. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 BUILDING DEPARTMENT TOWN OF sOUTHOLD January 27, 1999 Environment East, Inc. P.O. Box 190 Peconic, New York 11948 RE: Hayden & Lois Allen, 320 Eugenes Road, Cutchogue 1000-97-6-3 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX for Certificate of Occupancy is application // not on file. (Enclosed) XX 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. XX /No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT % 25028-Z Thank you for Please contact our office on this matter. cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 76~;-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF $OUTHOLD ,CERTIFICATION Building Permit No. ~),~'~-'O~--~' -~- Owner: 14~, ~ ~,:~ ~ ' (p~eaSe print) ' ' I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Public, ~ County :OUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING' INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: JUDITH T. TEHlv. Y TOWN CLERK OFFICE OF THE TOWN CLERK TOWN OF $OUTHOLD Town Hall. 530t15 Mare Road P.O. Box I Southold, New York IH~71 Fax (516) 765-1823 Tcleptlonc (516~ 765- 1801 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING FIELD ON AUGUST 24, 1993: of the Code of the Town of Southold: Application" [FDP(93)], and "Certificate Special Flood Hazard Area [C/C(93)]. RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations "Floodplain Development Permit of Compliance for Development in BLDG. DEFt. ; TOWN,,OF, SO'.JT.O~ Southold Town Clerk August 25, 1993 TOWN OF SOUTHOLD APPLICATION # PAGE 1 of 4 FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill hical, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make ieasonable inspections required to verify comp[iunce. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO . THIS APPLICATION ARE, T,O~H--J~.,.O.)~i'~ KN~OWLEDGE, TRUE AND ACCURATE. ~__..~" (AP eLI CANT S S1G NATU EE~._.._ _'~'-']~_~~-~'~d'"° DATE )SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANT) NAME ADDRESS TELEPHONE PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FOP(93) APPLICATION # PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT A(~TI'V1TY STRUCTURE TYPE 12:1 New Structuxe r~ Addition [] Alteration [] Relocation [] DemoLition [] Replacement [] Residential (1-4 Family) [] Residential (More than 4 FataLly) [] Non-residential (Floodproofmg? [] Yes) [] Combined Use (Residential & Commercial) [] Manufactured (Mobile) Home (In Manu- factured Home Park? [] Yes) ESTIMATED COST OF PROJECT B. OTHER DEVELOPMENT ACTIVITIES: [] Fill [] Mining [] Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) [] Watercourse Alteration (Including Dredging and Channel Modifications) [] Drainage Improvements (Including Culvert Work) [] Road, Street or Bridge Construction [] Subdivision (New or Expansion) [] Individual Water or Sewer System [] Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3: FLOODPLAIN DETERMINATION (To be comvleted bv LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: [] Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). [] Is located in a Special Flood Ha'zard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) [] Unavailable [] The proposed development is located in a floodway. FBFM Panel No. Dated [] See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4: ADDITIONAL INFORMATION REQUIRED (To be completed bv LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: [] A site plan showing the location of all existing structures, water bodies, adjgcent roads, lot dimensions and proposed development. [] Development plan~, drawn to scale, and specifications, including where applicable: details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the fzrst floor, details of floodproofmg of utilities located below the ftrst floor and details of enclosures beloxv the first floor. Also, [] Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise awfilable). [] Plans showing the extent of watercourse relocation and/or landform alterations. [] Top of new f'dl elevation Ft. NGV2D (MSL). Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in a_~ increase in the height of the 100-year flood. A copy of all data and calculations supporting this £mding must also be submitted. [] Other:. SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity: A. [] Is B. [] Is not in conformance with provisions of Local Law # ,19 attached to and made part of tiffs permit. · The permit is issued subject to the conditions SIGNED , D~.TE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPEALS: Appealed to Board of Appeals? U) Yes U1 No Hearing date: Appeals Board Decision --- Approved? ID Yes Conditions [] No APPLICATION PAGE 4 OF 4 SECTION 6: AS-BUILT ELEVATIONS (To be submitted bv APPLICANT ¢efore Certificate of Comoliance is issued) The following information must be provided for project structures. This section must be completed by a registered professional engineer or a llceused land surveyor (or attach a certification to this application). Complete 1 or 2 below. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal Hi~;h Hazard Areas, bottom of lowest structural member of the lowest floor, exclud~g piling mad columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproof'mg protection is FF. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be com~>leted bv LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete th. is section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES7 [] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: [3 NEW BUILDING FI EXISTING BUILDING [2 VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: Ao COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS LOCAL LAW # .... , 19 SIGNED: DATED: OF COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19__, AS MODIFIED BY VARIANCE # DATED ' SIGNED: DATED: C/C(~3) 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ,~,/~ J *'~/~--,~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUND~TIONIST [ ] ROUGH PLBG. [/~)uNDATIoN//2ND [ ] INSULATION [u~] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ] FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL []FIREPLACE&CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R~I~HpLBG. [ ] FOUNDATION 2ND [ ~" INSULATION [ ] FRAMING [ ]FINAL []FIREPLACE&CHIMNEY 765-180:~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ].~JkATION [/-~ FINAL [ ] FIREPLACE & CHIMNEY ,INSPECTOR THE.NEW YORK BOARD OF FIRE UNDERWRITERS PA E 1 leelegZ .UREAU ELECT..C.TY ~ 40 FULTON STREET, NEW YORK, NY 10038 D~te' .' JANUARY 22,1999 ' A l'cation No. on He 16799698/98 N 477675 CERTIFIES THAT ~.~a'~ITi NO. ~28 only the electrical equipment as described below and introduced by the applicant named on the above applicaHon number is in the premises of ALLEN, 320 EUGF~NS ROAD , POLE g4C, CUTCHOGUE, NY in the following location; [] .Basement [] 1st Fl. [] 2,d Fl. GAR/ATTIC/OUT Section Block was examined on JANUARY 19. 1999 and found to be in compliahce with the National Electrical Code. Lot FIXTURE OUTLETS 33 DRYERS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT OTHER 5 OTHER APPARATUS: IRONING CENTER 1.5 KW-1 2 TON AIR CONDITIONER-1 AIR HANDLER- 1 6OA DISCONNECT- I G.F.C.I:-7 SMOKE DETECTOR:-4 DOROSKI ELEC. INC. 425 MONSELLLANE CUTCHOGUE, NY, 11935 E~ R V I' C NO. OF CC COND. A.W. G· PER ffi OFCC COND. i 2/0 NO, OF HI-LEG OF HI-LEG 2/O LIC.#2941 GENERAL MANAG,ER Per. ~ This certificate must not be altered in any manner; return to the office of the Board tf incorrect. Inspectors may be id~e~tified by their credentials. ~ COPY FOR EUILDING DEPARTMENT· THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ] NSTRUCTI (}NS noaru m, u aur, ,.,,,<....- ....... SURVEY y .................... CIIRCK . · · ........ · .......... FOILm'I NOTIFY: HAIl, TO: .................... n. 'lhl..Fplicntlm mmC lm cot~leLely ,filled ill by tyl~vriCer or In {l~ 3 ~ts o[ plans, aca~r. Le ploc pl.a ~o ~ale. F~ 8ccordJ~ to pr~J sen or b. PIOC plan ~J~ l~att~ o~ lot n~ oE Ix, tldl.~s ~ pr~{~, relntJon~dp to ~joJn{~ .tr~. or nr~a~, ~l Btvi~ a ~Lall~{, ~{p~imi o[ ]~ o[ pro~rty ~mt c. - 'lhe ~ c~r~ I~ diJs aa,licadm my ,ut l~ cm,~,~al I~[ore isam~e of i~mlt gmll ~ kept ~ O~ ~l~s available for tns~tt~ tll~lt the t~rk. e. ~ ~iidi~ ~mll I~ ~pt~l or ~1 tn ~le or tn ~rt ~or m~ ~ ~mt~er ~mtJl a C~rtJflcate Of ~,IC~'FI~ 19 I~ ~ to t{~ {klJ]dJn8 ~l~rt~n~ [or the issue o~ ~slatt~8~ [or tl~ ~st~t{~ o[ ~iildi~s. ~lt{~. or air.ratios, or lot r~al or ~lJtion, as {~re{n , i~scrt~. ~1~ applier ~s to ~ly vt~ alt s~li~bl~ l~s. ordl~,~s, ~lldin8 E~EROH~S~. E~ST..INC ................ ~ ....'... (9iS,~tur~ P. O. · .~ox. SLa~e ~tl~r a~lJcant is mr, ]'es~, ~ent, arddt~t, en~h~r,'gei~r~l cmtr~ctor, electrJcion, pl~r or I~s{{d, i~AY~a ~ .~Xi~ ~OXS ~ ~3~ ....................... ~ o[~r o~ pr~ · .. · ................................ (~s ~ tl~ tax ~11 Or latest d~) I[ a~licanC is a co.ratio, slp~e of ~lly ~cl~)rt~l o~flcer. ........................ P~..S.. · S~o~.e~burgh, Pres. (~ a~ title of co.rate Otlmr ~'s Ltcen~ ~ .............. ... · .-- ~ , ~; ~, ~... ~ . I. l~u~i~ O[ 1~ ~ O~idl pr~l ~rk rill {~ ik~ ................................................. hp. gR~ ugene' s Rd. Cutc ....................... ~lty Tax~p~. I~D ~ti~ .. ~.~. .. .. .. .. , . Bilk ...a6 .......... l~t ..... 0~ ......... a,l~ivisi~ ................................ ...... Fi{~ ~g?p ~ .......... a. Faisti~ ~ a~ ~m~y · Sinqle .~X.~.~$~ag .................. ain le F~m~12 ~l~i~g ~t~ A~i~ia~ .................... b. lnte~ u~ ~ ~ ........ 9 ................. , .~ -~, ,<,~ la~aat~ clearly m~l dial:inel:ly al, ~dietl~r interior or cor~r lot:. ............... · · t er ~ ........ ~....: ........... .................. S~.JC*,* ~ ..... If Inmi~aa, ~m~rclal or mi ~mqm~y, ~ei~ ~tura m~ ~tene oi ead~ ty~ of u~ ................. , ..... IH.enaimm o~ ~l~ring atnm~rga, It a.y~ I~t3.6.~ .... ~ar3~.~L. ~pth ............. a.7 ~.S .......... I~i~r ..2Z.D.', ....... ; ....... ~ ~d~r oe 8toriea .... .%-.%/-2 .......... I)i.en~l~m oi o.m atnmmre wl~h alterations or ~ltlona: Front 44~ ........ ~ar ...4~01 ..... lhpth -~-7~-8~ ............ Ih[~l "2~'~0.' ............ gad~r of. ator~ea ..q.q_ ......./~ t)i.eaul~ of entire ~ ~,at~:tkm~ l~t .~.~ .......... ~ar ..~.'.07. ....... ~pth .22.a~ ...... ...................... ~li~r o~ 8tori~ ] - ~ pro~el ~at~tlm viola :e any ruling J~, ordl~me or regulatiml ........... ~0 .......... 9ill lot I~ rearm~ ..... g.g ............ 9ill ~eas .till Im r~ ~n pr~ni~al ~ (~) Flora~ Park ~Y 11001 ~ 734-7474 It IhJ~ pml~rLy uiUiJo ~ i~ ol u thai ~etl~fl? * ~1~ ...~ ..... ~ 11958 Jl~k a~li~r or i~erl~lm according to a~, a~ ~ ~treet ,SS ...]~.e.~;.e. ,r., .S.... Stoutenb~rgh ...................... ~ ................... I~i~ll~ duly m,x>rn, delXmea at~l m;ys that he ia the al}pl. Jmmt i. fha ..G~a-i~.~Lrac.to~ ........... ' ....... ....... , ................................. amd t~m~ or ~ m~l la (lulI a~tl~rJ~ to i~rfotm nr hr;va ix}rl'or.~nl the mlicl ~fk taxi to n~tke arxl flla thl. IIIIIL thg ~)[k will IM ~r~on~l ltl the ~lUl/ll~r ~ ~orth iii the fll)pJrJCfltha) Ei]~ tl~rml~J. ...... ' ~m nlon ~elres Oeo, 8,