HomeMy WebLinkAbout27491-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28169 Date: 01/14/02
THIS CERTIFIES that the building ADDITION
Location of Property: 730 EASTWOOD DR EXT CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 103 Block 14 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 2001 pursuant to which
Building Permit No. 27491-Z dated JULY 23, 2001
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 COVERED SCREENED PORCH AND DECK ADDITION TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to JOHN J & CAROL K GARVEY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N 575452 11/06/01
PLUMBERS CERTIFICATION DATED N/A
utrize Signature
tr
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. 27491 Z Date JULY 23 , 2001
Permission is hereby granted to:
JOHN J & CAROL K GARVEY
210-07 29TH AVENUE
BAYSIDE,NY 11360
for
CONSTRUCTION OF A DECK ADDITION WITH COVERED SCREEN PORCH AS
APPLIED FOR
at premises located at 730 EASTWOOD DR EXT CUTCHOGUE
County Tax Map No. 473889 Section 103 Block 0014 Lot No. 012
pursuant to application dated APRIL 12 , 2001 and approved by the
Building Inspector.
Fee $ 75 . 00
t
Authorize Signa re
ORIGINAL
Rev. 2/19/98
pw 51
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1185077 ,1,�a BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW YORK, NY 10038
Date NOVEMBER 06,2001 Application No. on file 13095801/01 N 575452
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
GAR VEY, 730 EASTWOOD DRIVE EXT. , CUTCHOGUE, NY
in-the following location; ❑ Basement ® 1st Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on OCTOBER 30,2001 and found to be in compliance with the National Electrical Code.
FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES INCANDESC10 FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. I K.W. AMT. K.W. AMT. H.P.
1 7 2 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS M SYSTEMS T DIMMERS
K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE EQUIP. 10 2W 1 0 3W13 0 3W13 0 4W NO.OF CC GOND. A.W.G. NO.OF HI-LEG A.W.W. NO.OF NEUTRALS A.W.S.
PER 0 OF CC.CONO. OF HI-LES OF NEUTRAL
OTHER APPARATUS:
PADDLE FAN F-1
G.F.C.IT-2
ROSLAK ELECTRIC LIC.#3677 1 L L
P.O.BOX 164
CUTCHOGUE, NY, 11935--2453 GENERAL MANAGER
11
Per
This certificate must not be altered In any manner;return to the office of the Board If Incorrect.Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Form No.6
TOWN OF SOUTHOLD LD11 8 M
BUILDING DEPARTMENT
TOWN HALL
765-1802 EY BLDG. DEPT.
F S UTN LD
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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.
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. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date. U
New Construction: Old or Pre-existing Building: 4 ( 6-..1 ,(check one)
Location of Property: 3r, thn&atb zey< tn-_ Gy1Z d�y�(fes
House No. Street Hamlet
Owner or Owners of Property: -Jb5)N3 rS , ht& f_h2kx, y- . 6„pU
Suffolk County Tax Map No 1000, Sectiony 3 Block QO( 9 Lot 10('Z
Subdivision , ' QN Filed Map. L�:?3 —Lot:
Permit No. 131 q ( Date of Permit. ,Jui,•1 �. 2(c I Applicant: (SOV(- M C(eNjf&�
Health Dept. Approval: A Underwriters Approval: aV-1
Planning Board Approval: wt R
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
C �0 O Applicant Oinature
BUILDING-PERMIT. RE IEW CHEF CK LIS'--f-
Applicant/ Date
Owners Name: C &2.VeLA Reviewed: 2� 0
Architect/ Date
Engineer: RK��ILDE12 S Submitted: ( 2. O .
SCTK4 #:
District: 1 X00 Section: /0.3131ock: l.ot: /�
Projectpp Subdivision
I..ocation: ?J6 e6t woo Name:_ rf,6E_�
Sin&le& separate Requir
certification: {Yes o
Rey. Req.
Coning District (lot siu: YO/4000 Actual:eC O ) JIAt coverage �V Proposed _I
Req. Req. is- Req. ,1
(I=ron(Yard '10 PrO�osed: 9 [Side.Yard 5 � Proposed: S*t' J [Rear Yard Sy Proposed +50 J
Project Description:
AGENCWERMITS 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: ouF X Pi4iut2 X63
Notes:
- rO-f(A L sa F 3g�
�� 0r CIfL
6;2
M-1802
BUILDING DEPT.
1 PECTION
[ ] F NDATION IST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY j
REM KS:
Z)IL
DATE Aw INSPECTO
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ j ROUGH PLBG.
[ ] F DATION 2ND [ ] INSULATION
[ ] FRAMING [ j FINAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS• ce0oC
DATE � 101 INSPECTOR ✓�
J
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE � INSPECTOR
3
FIELD INSPECTION REPORT hA. _ 4_' '
.__.. �.� _ COMlIENTS _
xx=-=xx===xxax=x= _xx r.=-x s= =a== -x===a=a=x=axsaaaaaamx=xxc
OF
FOUNDATION ( 1 11
FOUNDATION (2ND) C;tl
n
ROUGH FRAME >� ,
PLUMBING
v� c
INSULATION PER N. Y. f
STATE ENERGY
CODE
I
Fn
c
FINAL
: ADDITIONAL CUWWNTS:
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TOWN OF SOUTHOLDAPS I ?001
BUILDING PERMIT APPLICATION CHECKLIST:
BUILDING DEPARTMENT Do you have or need the following,before applying
TOWN HALL Board of Health.
SOUTHOLD, NY 11971 3 sets of Building Plans
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees !�
Examined 20 D�
Approve 20 &T/ PERMIT NO.
Disappro d a/c
Building Inspect
APPLICATION FOR BUILDING PERMIT
Date — 1Z , 200k
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to sale.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 a 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 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, ordinances,building code,housing code, and regulations,and to admit
authorized inspectors on premises and in building for necessary inspections.
(SignatMreWaTNJicant or name,if a corporation)
rw
. . 0 t 50Z (o b-7" G�1G�o lu1
(Mailing address of applicant) tK 3
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
CONTur-c"1'2_
Name of owner of premises "3bt-WJ C-t'2oL- awQe
(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. 20-Z 3 t-"
Plumbers License No.
Electricians License No. 2�J SLL,
Other Trade's License No.
i
1. Location of land on which proposed work will be done:
House Number Street .-w €iet R> s
County Tax Map No. 1000 Section Block 1 Lot IL
Subdivision Fk E'gt5 Near __ Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 51C%4al ua
b. Intended use and occupancy S NSR � s'Gt2,�1••
3. Nature of work(check which applicable): New Building Addition �0 Alteration
Repair Removal Demolition Other Work
4. Estimated Cost t l y' , oob - Fee (Description)
(to be paid on filing this application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, 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 I
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front 1 b Rear to Depth k6
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase G -2q - O 0 Name of Former Owner (,U D A
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 re-graded f-M Will excess fill be removed from premises: YES la
14. Names of Owner of premises G Aaq" Address DO aD PR-, Phone No.
Name of Architect Address Phone No
Name of Contractor VA-Y f,1 p"_ get oDV-j Address 13ox 6 a 2 Phone No. 93�( 6't7o
15. Is this property within 300 feet of a tidal wetland? *YES NO A7
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey, indicate scope of project, to scale,with distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
STATE OF NEW YORK)
S:
COUNTY OF Su SS
POV CADS fyLc igh%.� being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
09e is the ( Qh
(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 's
f 2' day 20 Q �
otary Public Si e of Ap icant
ROBERTI OTT,JR.
Notary Publi ate of New Yorft
Qualified' Suffolk County
No.01SC4725089
Term Expires May 31,.
t-ur1 JInVVI — qVF
OR AFTER IN
FENT WITH T
J `sTi
OR NEW CO
ON OR AFT OQ T R9 Refer to the FLOOD INSURANCE RATE MAP effective date shown on this map to
Q
9gCf determine when actuarial rates apply to structures in the zones where eleva-
J� tions or depths have been established.
QO P To determine if flood insurance is available in this community, contact your
insurance agent or call the National Flood Insurance Program at(800)63M620.
Coastal Bo 'FST
;oastal Barricq
13) 253-861 FFA q�
F ZONE X
ZONE AE
ERENCE zy ZONE Qo aFQUgs (EL s)
X °may ti,q VF
cQ APPROXIMATE SCALE
ESCRIrT10N
�ORSN 500 0 500 FEET
I disk stamped
:oncrete post �SnL i
7ound, located
.-theast along 000 t j
'ice at Cutcho
ery and T-Jun
southeast, ap ZO
t of centerl
ately 22.3 fe m z
ne of highway FLEETWOOD NATIONAL FLOOD INSURANCE PROGRAM
�c
RD
disk stamped
ely 0.7 mile o 09 " ' ✓� Q/ - - .*�t�✓� �0._
Avenue from
e in center
culvert and a y 4-tq.A4
theast of cen FIRM
r`
disk stamped FLOOD INSURANCE RATE MAP
t in top ofc
2 inches ahoy Q'C
nately 0.3 mi 90
ut 25 from po e°��
to road inter SUFFOLK COUNTY,
t south of ce �� ZONE X YORK ately 10 feet
to road. OCG ��eaOPO W`{� YOM'<
0
J
1929 (ALL JURISDICTIONS)
ZONE
X
5� PANEL 163 OF 1026
(SEE MAP INDEX FOR PANELS NOT PRINTED)
CONTAINS:
COMMUNITY NUMBER PANEL SUFFIX
SOUTHOLD,TOWN OF 360813 0163 G
CUTCHOGUE -NOTE-
-,HARBOR THIS MAP INCORPORATES APPROXIMATE BOUNDARIES OF
COASTAL BARRIER RESOURCES SYSTEM UNITS AND/OR
OTHERWISE PROTECTEb AREAS ESTABLISHED UNDER THE
COASTAL BARRIER IMPROVEMENT ACT OF 1990(PL 101-691).
Notic3�4 User:The MAP NUMBER shown below should be used
when placing map orders: the COMMUNITY NUMBER shown
above should be used on insurance applications for the subject
community.
MAP NUMBER
3610300163 6
4 1'00' 00
72`28 07.5 :.- EFFECTIVE DATE:
Y f'
ZONE X �
ZONE X a MAY 4, 1998
L
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RDAD
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Pad'• W U. 16.4. ►rap s eo . CUrCHOGUE
> _ •�` TC)WN OF SC,UT'H0L.I N,Y i
o _ 404t
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z SCALE-QOM- l"
8 5 39°43`30°W. I5O.0O O:I PON PIPE
a= MO( iL�MENT" �
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22 1
AS SUQ\/EYED rDE�C�,13,19"71 1
NOPE-LQT-N05.SHOWN RR.EFETO°MAP OF EA6'rWOOD E5r/jT-ES- VAN �UYL` a)lJ i V 1
ON FI Lk t rl THE SUFFQLK COUNTY CLERKS OFFICE
As MAO a 4210.
UCENSED LAND SURVEYOR`,,
- GREE PORTa.N.Y.
i
V �� � Zxb ��,o�T=• ANCY OR
zxlo eaD4E
IS UNLAWFUL
Dw p 4,� pvs , g,a, �Lu�,w°°� WITHOUT CERTIFICATE
z'�-�L'o k�y�1-R�-r ems✓1�. - - -
- C0�1e-a6T6 2.A G
APPt'fiYED AS NOTED /
E+a5 NL l
DATE:
�'�'7-c�`�3—U/—B.P.#
NOTIFY BUILDING DEPART AT
765.1802 9 AM TO 4 PM FOR THE
\f FOLLOWING INSPECTIONS:
Ora TWO REQUIRED
FOR O�)RED
Sr 4`I 514` ---- CONCRETE
2.ROUGH-FRAMING&PLUMBING
3. INSULATION
4.FINAL - cONSRUCTION MUST
_ Zlo>Zle 7c�u BE COMPLETE FOR C.O.
CS ALL ALL CONSTRUCTION SHALL MEET
{r - H Ccn - s - THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
DESIGN OR CONS RPUCTION ERRORS
A-Rcr1 c*F'
IYE'YJ G�ESI�
C/6
161O eeatS �" O
f�
Ing Ccd So,!nFt> 01, 2KiZ KiM
I, 1 11 2'/+.I
51�nIle51y1 slyr '
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v
BAY CREEK BUILDERS
D. W. Mcgahan BHBETNO.
P.O. Box 602 cA�cuaTED av �vJ M DATE y'l o-b 1
CUTCHOGUE, NEW YORK 11935
(516)734.6270 CHEMD BY DATE
SCAB LIN l
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