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Home My WebLink About26922-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27916 Date: 09/05/01 THIS CERTIFIES that the building ALTERATION Location of Property: 22420 MAIN RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 18 Block 5 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 6, 2000 pursuant to which Building Permit No. 26922-Z dated NOVEMBER 15, 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 OF EXSITING BUSINESS BUILDING WITH REPLACEMENT FLOOR AS APPLIED FOR "AS BUILT" The certificate is issued to WILLIAM J HEINS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Authorized SignatAre 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. 26922 Z Date NOVEMBER 15, 2000 Permission is hereby granted to: WILLIAM J HEINS 5244 SOUTH RIVERVIEW DR HOMASASSA FL, 34448 for "AS BUILT" ALTERATION OF AN EXISTING BUILDING WITH REPLACEMENT FLOOR AS APPLIED FOR. at premises located at 22420 MAIN RD ORIENT County Tax Map No. 473889 Section 018 Block 0005 Lot No. 004 . 001 pursuant to application dated SEPTEMBER 6, 2000 and approved by the Building Inspector. Fee $ 150 . 00 Authorize Signature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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--ter 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 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 Building - $100.00 3. Copy of Certificate of Occupancy - .25'qn 4. Updated Certificate of Occupancy - $50.00 ' 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . LOld /OOr Pre-existing Building. . . .f6 . . . . . . . . ...p. Location of Property. . . ! Y.'. . . . .. . .. ((1;),�il,.l l`�, i� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . �.4�.i�� m. . . . . . . .�. � .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . �3 .! . .Block. . !!�P?'Q.,?. . . . . .Lot. .�� :. �. . . . . . . . . Subdivisio!n)/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .FFi,led Map. . . . . . . . . . . .Lot. . . .,.. . . . . . . . . . . . . . . tl Permit No.":4M. . . .Date Of Permit.[ :Z.. UP. . .Applicant- D y ;�,';), . ��•h . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary rrC��ertificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $ . . . . . . . . . . . . . . . Goons . .9,1 . . . . . . . . . . . . . . . . . . . . . . . . (5 Rx'. APPLICANT 00 Z;?716 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING IN/LL [ ] FIREPLACE & CHIMNEY REMARKS: ///? i ,DATE �� INSPECT :ELD INSPECTION REPORT DATE COMMENTS JI II p q ►UNDAT ION OST) --ii ii ii o r v I�— It to )UNDATION (2ND) >r u o )UGH FRAME & II ii II N PLUMBING If O II II ------------- II ---- ------------- II ji y �I +SULATION PER N. Y. if H STATE ENERGY CODE u-moi if u ii if u u if if II H II N- --aI FINAL II �u II jj ADDITIONAL COMMENTS: xassaaaaaasaaa==xxe=asaaa=ex=.=xsasaaa_a====ssaaa=ssa==aaaxx=sasasassaaasseaaaexa=aaa==a U, t F-I J`" � r� �1 J� o V z T a r ro H 4 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 TEL: 765-1802 NOTIFY: CALL 3 d.� : .� S , Examined.... /J,a........ 2066MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved... /1.!d........,2�''oa. , Permit No. �.4..... z� .................................... Disapproveda/c .................................. .................................... ................................................. .... . .. . ...... .... . .......... (Building Inspector) � 4 L�,�, • SEP APPLICATION FOR BUILDING PERMIT L:. _,._..... Date.. 0. . . . . .. 2001?. INSTRUCTIONS a, this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 my 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 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 Lags, 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 regulations, and to admit authorized inspectors on premises and in 'ld' for necessary inspections. ................ % L cl :................... (Signature of applicant, or name, if a corporation) Q.,�- �A...(:�Z. lS?,".�-..&'y.....1.ftS.1.. (Mailing address of applicant) State whether applicant i�C owner essee agent, architect, engineer, general contractor, electrician, plumber or builder 0- ....`('S��.... .......................................................................................... Name of owner of premises .4 .I.l!.* �(5,M: :....�e:!n.�.................. ................................ (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.............................................................. .z... ...:0.............M. t'.... �...................... �.................. Hoe Number Street Hamlet .............. Home County Tax Map No. 1000 Section ..I X.4W. Block. ...... ....... Lot ...,.....Ff.../.. Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occW-11! a. Existing use and occupancy ........................................k!� �$008T�� AN........ w�+b T b. Intended use and occupancy ... :�'... 1.1....�,..:1 �.S �...... � } 3. N�of work (clw-k winch applicable): New Building .......... Addition .......... Alteration ~ Repair ........... Removal ............. Demolition ............ Other Work .................'............... MM (Description) 4. Estimated Cost, 3 Co..on........... fee .............................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ Number of dwelling units on each floor ................ Ifgarage, number of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use... 7. Dimensions of existing structures, if any: 'Front................ Rear ............... Depth ................. 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 ............... Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Front .................... Rear .................... Depth .................... 10. Date of Purchase ..................... Name of Former Owner ........................................ 11. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES NO 14. Names of Owner of premises ........................... Address .............................. Phone No. .............. Name of Architect .................................... Address .............................. Phone No. .............. Name of Contractor ... Address ................................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... No ..15....... *IF YES, SQTIIi(HD TOWN THE FE.S PERMIT MAY BE BRED. PIAT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block ember or description according to deed, and show street names and indicate Acether interior or corner lot. mar.. or NN, Y(m, SS JUjU 17 or ,........................ -naa- . --• � � ..................being duly sworn, deposes and says that he is the applicant 'Name of individual signing contract) above named, lieis the �� .... ........................................................................ (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 chat the work will be performed in the manner set forth in the application filed therewith. 3aorn to before me this ........i.0.. d y of ........... Notary Publ. �� 1� ! /�... 1�(�► U41 ASTA1FIle �A� g�p(�Vbl� (Signature of Applicant) NO�Q1�$u11�Ntft BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: /i /, APPLICANT NAME: Aler-1 s DATE SUBMITTED: 914 /66 PROJECT LOCATION STREET: 22 42d /"�.�h,.► �o,�� CITY: JO rr SUBDIV. NAME: ARCHITECT/ENGINEER: a ��T &0.-1.-1 FAST TRACK: YES oRNO SCTM# --- DISTRICT: 1,000 SECTION: /,9 BLOCK: S LOT: 4. ZONING: A+ ZONING DISTRICT: R40 C CONFORM G: YES OR NO QUIRED LOT SIZE: SQFT. WHERE ACTUAL LOT SIZE FROM? ACTUAL LOT SIZE: SQFT. Q. FRONT: 'PROPOSED: ' SIDE YD: '/ ' PROPOSED: '/ REAR: 'PROPOSED: OT COV ° ING: sf % NEW: sf % TOTAL: sf °/ CORNER? YES oR O WAT ER FRONT? YES o NO DESCRIPTION: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o O OTES: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION: ADD XL r1 ACC OR N/D: f r4.L /J �: _ loo //t5 a / AGENCY PERMITS REQUIRED FOR REVIEW J NEEDED TOWN SPETIC PERMIT: YES or kW SUFFOLK COUNTY HEALTH DEPT: YES or (BED #): DTE:_/ / PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: 82 FLOOD ZONE:_, NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: NOT S x'.//300. FST ..«,. FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR I" SF SECOND FLR — SF INIT OTHER TOTAL TOTAL 120 — SF FEE FEE FEE del I TOT( /2,0 SF)- ( /606 SF)= SFX $ — =$ +$ 1_Q +$ _ $ ` — , '6s 'APR r._, MARTIN F. SENDLEWSKI A.I.A. ARCHITECT — PLANNER March 30,2001 Town of Southold Building Department Box 1179 Southold,NY 11971 RE: Larosa Residence Permit#: 26952 2 To Whom It May Concern: Please note that the following revisions to the existing permit drawings are acceptable to this office as follows: 1. Damp proofing shall be omitted at new foundation wall in that the proposed addition consists of slab on grade. Said slab shall be located over a vapor barrier and no damp proofing of the exterior wall is required. 2. An alternate monolithic foundation wall and footing in accordance with the attached detail drawing SK-1 is acceptable. Should you have any concerns regarding this informatiFndlewski, l free to contact this office. Very MartiA.I.A. MFS:la Enclosure \3�ERED A/? V.MVO 4 leo 0' �O 017163 9TFofNEW �D� 209 EAST AVENUE ■ RIVERHEAD, N.Y. 11901 ■ (631) 727-5352 0 FAX (631) 727-5335 4' C o►.,c, C.L.A la w 1 2 X 4- cua S ILL wl (D-4-CO tol(o WWH ON 't•L' -ttIT� slalt3w d to Mt► Va4oe- ,os?�►�. 17-it 8.. A,,F,• Q 4g`1oc 8`1 C,M U P l U..- SOU D wl 3�o Pst ccsnlc.. •ll . Ile I Z 41 8�1 i31rCx-Y� M 4� 5 Coo-YfINUDUS Tor i $v-r-to M o • MoNC>LxtA 1 G 3•uvvv Qst CoNZ04- � hoar►� I_ u A Cy�T G1�►7� 44.G \� . SE F0 Q �p No J�jgrF of NEW yo�� PROJECTS: YAffM F.SENDLEWSKI, AJ.A. L.A ►'z-�s A �1�S t i�lT1GE, ARCHITECT - PLANNER (631)727-5352 Z DRAWINGS IIIII s� - I 215 ROANOKE AVENUE ► ATE*: RIVERHEAD,NEW YORK 11901 1_/16/2000 11:10 5167275335 MARTIN SENDLEWSKI PAGE 02 MARTIN F. SENDLEWSKI, A.I.A. ARCHITECT — PLANNER II-III M LaRosa Residence Project 9737 .�� 60 v STATE OF NEW YORK) ) ss.: COUNTY OF SUFFOLK M p 9:rr I w C r sf!I,being duly sworn,deposes and says: That deponent is over the age of 3 years,and sides at 20cl "o A%z' . YA ga"j—zo N - That on the_I_5�day of lam)tYnP,�2000,deponent,being the (Arehitec ngineer,licensed by the State of New York,hereby e/he Accepts full responsibility for the accompanying plans compliance th a New York State Fire Prevention and Building Code(9 NYCRR). Architect/Engineer Sworn to before me this 16*day of Aldycmbec 2000. NoWy Public NSON Notary Public, State V. of New Yak No. 01 AT6019878 Qualified in Suffolk County Commission Expires February 16.20.4�r�L Cc: Applicant 209 EAST AVENUE 0 RIVERHEAD, N.Y. 11901 0 (631) 727-5352 0 FAX (631) 727-5335 7-- 5", j. 3", (\I ISSUES REVISIONS sY APPROVED AS NOTED if5k—13.P 0 DATE �/' FEE: 150 NOTIFY 0UILDING .DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE H - FRAMING & PLUM 2. ROUGH BIP412 02000 3 INSULATION ALL MGH175 Rf5EPVEE) 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. INSTRUCTION SHALL MEET • THESE rLAN5ARf AN IN5TRUMENT OF ALL CC 5ERV?CE AND ARE THE PROPERTY OF 10,41 THE REQUIREMENTS OF THE N.Y. THE ARCHITECT. INFR?NdEMENT5 WILL CONSTRUCTION & ENERGY STATE I3IlMMfCIJTED. CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS f -Y b • IL EMOTING FOUNDATION OCCUPANCY OR z lu USE IS UNLAWFUL Lu I Iof I WITHOUT CERTIFICATE OF OCCUPANCY ON EX151ING BLOCK!FOUNDATION UNDEWWRffERs CERTIFICATE REQUIRED 0 0) IZ-- b NEW 314" D(rmOR a CLIENT OWNER IL- I f rLywa6D,FL00RJNG (y) A • I G'XrX I 21.CCA WILLIAM J. dEIN5 N RT. 25 EX15TING 5ILLWN13LOCK5 I ORIENT, N.Y. 1 1957 x PROJECT TITLELL- — — — — — — — — 12 2Y' i Lu I 5TORY REPAIR FRAME BLOC. DRAWINGC TITLE ffl REPAIRED Ln < FRAMING A/Ao B UILT A5 BUILT s- rJl FLOOR PLAN 5CALE; IJ4'=iV' LLJ DATE SCALE JUN - 92000 1/4' = 110' j� ISSUE JUNE 6. ZOOO DRAWNG NO. ITISAVTOUTIONOF7HE UJ - LAW LAW FOR ANY PERWN, UNLESSACTINGIINDERTHE A 11110TIONMAUCENSED A"KITECT.M��PW TIEMONTHISOM"W" tu ANYWAY.AWAUTHOFMD ALTERATION NIUV 01i NOTED SEALED,AND ACCORDANCE 41 ScRiSED IN ACCORDAN REF.'NO. DE 2� "t; NEW4 WITH THE I.A. 0000 _9