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HomeMy WebLinkAbout27553-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28461 Date: 05/24/02 THIS CERTIFIES that the building ALTERATION Location of Property: 1500 GRATHWOHL RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 4 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 2001 pursuant to which Building Permit No. 27553-Z dated AUGUST 13, 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 "AS BUILT" ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to JAMES A & KATHLEEN A BLACKLEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1052810 05/15/02 PLUMBERS CERTIFICATION DATED N/A -4A4ho ignature 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. 27553 Z Date AUGUST 13 , 2001 Permission is hereby granted to: JAMES A BLACKLEY OCEANSIDE,NY 11572 for AS BUILT ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. INCLUDES FLOOD PERMIT FEE $100 . 00 at premises located at 1500 GRATHWOHL RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0004 Lot No. 005 pursuant to application dated AUGUST 9, 2001 and approved by the Building Inspector. Fee $ 1, 068 . 40 Authorized Signature COPY Rev. 2/19/98 r- _ - - . . :-, �,-e c �� l2 }j i O Form No.6 nrn� TOWN OF SOUTHOLD BUILDING DEPARTMENT 1 4 2G02 TOWN HALL - --- 1 765-1802 i 4 G07 APPLICATION FOR CERTIFICATE OF OCCUPANC This application must be filled in by typewriter or ink and submitted to the Building Depa wii 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. &pr 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. ees Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00, r 'ons to dwellin $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. Q New Construction: Old or Pre-existing Building: tX (check one) Location of Property: 7T� � lOt ;(A ,jW 0 C House N/o�� �� Street / H et Owner or Owners of Property: l� Vi I L' vii V owes a C' 1�( ,, Suffolk County Tax Map No 1000, Section Block 0007— 11,7 Lot Subdivision 6 " _Filed Map. �- Lo/t-: Permit No. p2 7 5,j�j — 7 Date of Permit. Applicant: 76(kA* Q Health Dept. Approval: Underwriters Approval: 5-e-L 0.40 rkeA v1 Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ IX b Applicant Signature O rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�r1rJ�r�rJ�r1rJ�rJrJ�rJ�rJ�cPr�rJrJ�cPrJ�cP�Pr1rJ��l�rJ�rPrJ�rJ�rJ�rJrJ�rJ�rJ�rJ�rJ�cPrJ�r.J�rJ��P�1rPrJ'rJ�r�rJ�r�rJ�cPrJ�rJ��P�Pr�rJ�rJrJ�rJ� O 5 5BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 rS 40 FULTON STREET -- NEW YORK, NY 10038 c� CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 5 JAMES BLACKLEY JAMES BLACKLEY 5 1455 GRATHWOHL RD 1455 GRAITHWOHL RD 5 NEW SUFFOLK,NY 11956 NEW SUFFOLK, NY 11956 5 5 Located at 1455 GRAITHWOHL RD NEW SUFFOLK, NY 11956 5 5 5 eee7��5 Application Number: 1052810 Certificate Number: 1052810 5 Section: Block: Lot: 5 5 Building Permit:27553Z BDC: NS11 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 found to be in compliance therewith on the 15th Day of May,2002. 5 Name QTY Rate Rating Circuit Type 5 5 Alarm and Emergency Equipment 5 Sensor 4 0 Smoke 5 5 Appliances and Accessories 5 5 Exhaust Fan 1 0 FHP 5 Wiring and Devices L+ 5 Fixture 1 0 Incandescent 5 5 Switch 2 0 General Purpose 5 5 Receptacle 2 0 GFCI 5 5 5 5 5 5 5 5 5 5 sea, 5 5 1 of I S 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 O rJ�rJ�rJ�nr�rJ�r��PrJ�cPrJ�rJ�cJ�rJ��nrJ�cnrJ�inrJ��lcn�lrJ�cPr rrJcnr�rJ�rJ��nrJ��nrJ��nr PcncPrJ�rJ�rJ�rJ�rJ�c rrJ�r r�rJ�rJ�rJ�r�rJ��nrJ�rJ�rJ�rJ�rJ�rJ�cPrJ O DATE: 7 OFFICE USE ONLY occ -- j t, 0 OWNER LAST NAME INSPECTION uss.�AyE OCCjI ; (;let i i €v'-, " OWNER FIRST NAME STREET t STREET 1 STREET 2 STREET 2 CITY . CITY COUNTY STATE ZIP CODE STATE ZIP CODE CONTACT PHONE HOME PHONE UTILITY COMPANY WORK PHONE ESCVJOB NUMBER SIZE OF MAWS POLE NOJUNIT BUILDING FEEDERS PERMIT T NUMBER J >> CHARACTER OF WORK SECTION BLOCK LOT ! O EXPOSED O CONCEALED UST ELECTRICAL DEVICES FOR WHICH I SPECTION IS REQUESTED DATE WORK TO BE STARTED i l DATE COMPLETED SERVICE ENTERS BUILDING O OVERHEAD O UNDER(YIOUND .... . . DATE INSPECTION REQUESTED .. • ,. _ _� r 041611 AS NEM AS POSSIBLE) THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION.THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT. Applioant affirms that there is not an application for electrical inspegion pending with a q electrical inspection authority,for the installation listed hereueFlied in. MUST ENTER APPLICANTS I I I I I ( I r This application is valid for a period not meeding one year from the date received by the Board. IDENTIFICATION NUMBER'► AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.#LL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF DA, OF APPLIC/UION SIGNATURE F PLICA-".r . 4A L STREET#DDRESS / , / TELEPHONE NO. 3 .ter td6r TELEPHONE CITY OR POST OFFICE ZIP CODE LICENSE NO..WHEN APPLICABLE f ❑40 Ftrhort Street I ❑18 corporate woods Blvd,4th fl.(03291 Lake snore Road 0 80 weal Avenue,surra los ❑202 Aderid Road NEW YORK,NY 10038 ALBANY,NY 12211 BUFFALO,NY 14219 ROCHESTER,NY 14611 SYRACUSE,NY13200 (212)227.3700 (518)463.2122 (716)827.1156 (716)436-"80 I (315)4634552 NEW YORK BOARD OF FIRE UNDERWRITERS O,g (4 APtZV ro "'� 3p, ;0� DivR�r N 30;s ROAD 7,)p.E ^rur d as -`M Cj '�y^ /'A� , ET !dity i v i �rpp .o er N C 4 b 67.p3, SURVEY OF � 4 � ,� S'O'sem•,, . PROPER T Y s"a`► a� ^` " -- A T NEW SUFFOLK rvu"v °A TOWN OF SOMHOoLO "' SWFCXK COLWTY ...�.+ . .,�► �. . x000 - m� 1�J� - 01 !te LLA.Lt. p r..�. *,gl.�..r. a •.�ir►.d 04 os w.d �rrd MMr»a •..� - 6w WAA r» by The New Ywk Srae loadcf6�`LAND Joe .YQ� . TWO Aeaar en. W�6 lVp 7 �O C£14Ti�D Tp. E'ECILw AA.fnRACT kxoRpoNA TED MGM 605 S 329. a MY.S LK. NO, 49668 OARG KAAMdEh { M1 � ARS Q ENGWERS, P.C. �P, SW92O A"W ROAD SOUl'Hao, my. /1971 QWN�.- STREET VILLAGE DISTRICT SUB. LOT fORMER OWNER N E ACREAGE Sv WC.* TYPE OF BUILDING RES, SEAS. VL. FARM- comm. I IND. I CB. I misc. 3tst. Mkt. Value � LAND IMP. TOTAL DATE REMARKS A C",2j SLS c 6 yjj A � 000 4 3 4—S,- C) Z4 d / ,-I Ce t -Az- C) ILL-, f r AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE F.RONTAGE ON WATER Form Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot Total y ,,v FltDNT M. Bldg. 2f �,6oundation Bath Extension ment v Floors Extension Ext. Walls Interior Finish Extension i' Fire— Fire Place 0 Heat 5 Roof Type i S Porch / -X ---- — - S — M PorchRooms 1 st Floor P�o �J Rooms 2nd Floor Garage -_- Driveway !Dormer ----- 66 — �, _ ,� TOWN OF SOUTHOLD PROPERTY RECORD CARD NNER STREET `• VILLAGE DISTRICT SUB. LOT j1H _ �r�-a- t! wo ti J /Pads �w fv ;'i; /S— - RMER OWNERI N E (�-1--d ;4wOG, f 0 0( ACREAGEGf P �Q 2�E'VJd l� Y1(vor rrnmerJ&ays S W TYPE OF BUILDING ,I li t , �_. l�tix:fFr� Q Gr I �� �•, S �' 1 Wesf CV-ee /c /3 SEAS. VL. FARM COMM. IND. CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS CJr f0, y c - _ a5� - fw,r 8-L 1 a 4-a s. t 8/4 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER//Q f✓e�r f (_ n Form Acre Value Per Acre Value FRONTAGE ON ROAD//G 4'�; o�1 l�U d G. able 1 BULKHEAD ible 2 DOCK ible 3 Aland mpland >hland ise Plot AUG-24-01 10:23 FROM: ID-SISS034114 PAGE 1/1 2457 Foxdale Avenue Oceanside, NY 11572 August 23, 2001 1 Z ond �i Mr_Bruno Semon Biding Department Town of Southold Southold,NY RE: Property at 1455 Grathwhol Avenue,New Suffolk Dear Bruno: This letter is in response to your request for an estimate of costs associated with our Permit filed by Mark Schwartz last week. We've estimated that the total y45,000. $ cost to date is approximatel As we discussed, we will pay the associated fees at the time we pick up our pest. We hope to arrange the necessary inspections as soon as possible so we can move rmi with our exterior planorward Thank you for your patience in this matter. Very Y Yours, James and Kathleen Blackley ,}�5U ' UL11 'tea ;n,553 51"'n Hall. S1(1uS ITH T. TERRY Main Itoa,i Ji.ID P O R„� 1 17v TOWN CLERK � � � •;t,+.; Jt Siw,hold. Nc1% l (irk I I'171 1i1=:GI SfRAR OF`/iT/U.STnll.SllCS �j I � �-- Fax (5161 765-1911 MARRIAOF OFFICER _ Tcichhunc !S I<„ 7(,t. I X0I RECORDS MANAGEMENT OFFICER iJo� �U �� FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : - b 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 of the Code of the Town of Southold : "Floodplain Development Permit Application" (FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93) ) . D L9 B: G. C7Cr. TOWN OF SOUTMOLD Juditt T- /Terry Southold Town Clerk August 25, 1993 APPLICATION a PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DE«LOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SEMQN 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 betAy informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE APT O 10 DGE TRUE AND ACCURATE. (APPLICANTS SIGNATURE) ° DATE 2� 6 SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANII NAME ADDRESS TELEPHONE APPLICANT .amu ct slrtiz A'o 6Px 933 ti 734-4A8S BUILDER UiVi('�fOtuN ( /�2o/SAbL�Js1Sat/ L,EO.v.�}rab) ENGINEER 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. MES A+W 1 T7- Al (Zoa�e G�rH�otLe, 1���a,J sUFFoc,�e �J Y /S o00 i 7 -D/ —/ /vcio -i/7 - A4 -0 FDP(93) APPLICATION r PAGE 2 OF 4 DESCRIPTION OF WORK (Check all appbcablc boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure X Resideutial (1-4 Family) ;Addition DECD ❑ Residential (More than 4 Family) X ARcratioa 1Ntfp_jiR❑ Nou-residential (Floodproofmg? ❑ Yes) ❑ Relocation O Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT 3 GS,00lo B. OTHER DEVELOPMENT ACTIVITIES: O 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 completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: ❑ Is NOT Iocated in a Spedal 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 Hazard 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 3OF4 SECTION 4: ADDITIONAL INFORMATION REOUIRED (To he completed by LOCAL ADMINISTRATORI 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, adjacen( roads, lot dimensions and proposed development. ❑ Development plans, 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 first floor, details of floodproofng of utilities located below the first floor and details of enclosures below 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 4rsif they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodprooftng 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 any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. O Is • B. O Is not in conformance with provisions of Local Law tR 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE 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 bearing from the Board of Appeals. APPLICATION a _ PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following informadon must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal Hieh Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: Fr. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FI. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION fro be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the communitys local law for Rood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8: CERTIFICATE OF OMPLIAN E(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: +ro r 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: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19AS MODIFIED BY VARIANCE # DATED ' SIGNED: DATED: C/C(93) BUILDING PERMIT REVIEW CHECK LIST ?S�3 DATE REVIEWED: ll�r/a APPLICANT NAME: /Q c rc Le y DATE SUBMITTED:AV/ Q /c SCTM# --- DISTRICT: 1,000 SECTION: l 0 BLOCK: 04 LOT:y:5� PROJECT LOCATION STREET: CITY,--j S A�/kSUBDIV. NAME: ARCHITECT/ ENGINEER: FAST TRACK: YES o�% SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NOTES: ZONING: PERMIT ESTIMATE AMOUNT:_$ .00 ZONING DISTRICT• 4 R80 AC CONFORMING: YES o-�&REQUIRED LOT SIZE: SQ: WHERE ACTUAL LOT SIZE FROM?TAX CARD ACTUAL LOT SIZE:71,S SCS REQUIRED REQUIRED REQUIRED FRONT:' PROPOSED:/wF ' SIDE YD: /6 PROPOSEEWe '/ ' REAR; -9,_< ' PROPOSED^CF—' LOT COVERAGE: ALLOWED: sd % EXISTING: sf % NEW: sf % TOTAL sf CORNER? YESoRO WAT ER FRONT? E oR NO DESCRIPTION: josn� LOTS 40,000SF--100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.) PROJECT DESCRIPTION• ALACC oR N/D: d n AGENCY PERMITS REQUIRED FOR REVIEW NEEDE TOWN SPETIC PERMIT: YES or SUFFOLK COUNTY HEALTH DEPT: YES or (BED #): DTE: / / PERMIT#:R10- N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: OE ,or TOWN ZONING BOARD APPROVAL: r NO s (? 6,e- >aUstepri-ys.) - <e.4 TOWN PLAN. BOARD APPROVAL: YES or I� - FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: .SD/ FLOOD ZONE: A—$', NYS ENER Y: YES OR O EGRESS VENT: LIGHT: NOTES: a�.-S 4 /, , O �a ec rr'r — G. sa O'�r�sv FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR /4G4 SF SECOND FLR SF INIT OTHER TOTAL TOTAL: /9Cf" SF FEE FEE FEE AA" /f TOT( /9 SF)- ( 9--56SF)= ///* SFX $.3C) =$334i2o+$ /-46) +$ �/c76- _ $ +S*?6XZ /c rc ' .r,•d �'c,..)�C�..S �4_ f� S'f� � �/tel 4'/,� /-arCc- -�I7..+ar7't ��Tt..T��.✓� -- pea .40 /t T'�r A-.1 ,Se+�S /_�"�7^' //`rijJ f'b ucvj..1/ �� // ���0� . BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: 5///2/0/1/ 0,ja.j A�.�fi., !k)�o/ APPLICANT NAME: BLACKLEY 1 DATE SUBMITTED:-6/06/00 SCTM#--- DISTRICT: 1,000 SECTION:-117 BLOCK:-4 LOT:-5 PROJECT LOCATION AND TYPE OF PROPOSED WORK: PROJECT DESCRIPTION AD ALT ACC OR N/D: 13e cK- /10 /i7 til / 00 STREET: 1455 GRATHWOHL CITY: NEW SUFFOLK SUBDIV. NAME:_ ARCHITECT/ ENGINEER: FAST TRACK:N YES RNO SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o OTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LolS,F M JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83 ZONING: PERMIT ESTIMATE AMOUNT:_$. X _.00 PERMIT USE: EXISTING: 3f D INTENDED: Sfo� ZONING DISTRICTR40 R80 AC CONFORMING: YES OR NO REQUIRED LOT SIZE: SQFT. WHERE ACTUAL LOT SIZE FROM?TAX CARD ACTUAL LOT SIZE: / ,f.3>f SQFT. REQUIRED REQUIRED REQUIRED FRONT:34S 'PROPOSED: SIDE YD: /o '/A:r ' PROPOSED: '/ ' REAR:-t< 'PROPOSED: LOT COVERAGE: OWED: .p % EXISTING: �sf_% NEW: sf_% TOTAL: , sf_% CORNER. YES o NO WAT ER FRONT? YES o DESCRIPTION: FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: SU/ FLOOD ZONE445-e- , AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPUCATION TOWN SPETIC PERMIT: YES o SUFFOLK COUNTY HEALTH DEPT: YES or (BED #): DTE: /_/_ PERMIT#:R10- AP VALS RE UIRED: NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or kf'*.$S SOUTHOLD TOWN TRUSTEES: or TOWN ZONING BOARD APPROVA CYES)rTOWN PLAN. BOARD APPROVAL: o NYS ENERGY: YES OR NO : EGRESS: VENT: LIGHT: BUILDING PERMITS OPEN/EXPIRED: BP Z/C/0 Awv-. .J/ BP 6d43 -Z/C/0 NOTES: �� t :o� , ou//''+ la,)f J/ - ff FEE STR CTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE TOT( SF)- ( SF)= SFX $ =$ +$ +$ /�_ $ June 25, 2001 j ON t Mr. Bruno Semon Town of Southold, '�' ' ;� Building Department 2 P.O. Box 1179 Southold,NY 11971-0959 This letter is to update you that we have received your Order to Remedy dated May 25, 2001 and we've been working hard to retain architect's services and proper certifications for all work done at 1455 Grathwohl Road,New Suffolk. As we discussed, our original architect Robert Gruber was not available at this time. We've were able to find Mark Schwartz through a recommendation from a neighbor and met with him last weekend. Mark has assured us that he understands the priority and will begin work right away. We will get back to you as soon Mark has the drawings ready so we can discuss the next step. Thank you for your patience. Kathleen Blackley CK Town Hall,53095 Main Road C= Fax(516)765-1823 P.O. Box 1179 Telephone(516)765-1802 Southold,New York 11971-0959 %O yZol �ao� BUILDING DEPARTMENT TOWN OF SOUTHOLD ORDER TO REMEDY VIOLATION Date : May 25, 2001 TO: James & Kathleen A. Blackley 2457 Foxdale Ave. Oakdale, N.Y. 11572 PLEASE TAKE NOTICE there exists a violation of : Zoning Ordinance - CHAPTER 45 Other Applicable Laws, Ordinances or Regulations TITLE 19 NYCRR SEC 444 .3 (b) & (c) at premises hereinafter described in that : 1. RENOVATING A STRUCTURE WITHOUT A BUILDING PERMIT 2 . OCCUPYING A STRUCTURE WITHOUT A CERTIFICATE OF OCCUPANCY In violation of CHAPT. 45-8 CHAPT. 45-15A YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the law and remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at : 1500 GRATHWOHL RD. , NEW SUFFOK, N.Y. SUFFOLK COUNTY TAX MAP 41000-117 . -4-5 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute offense punishable by fine or imprisonment or both. BRUNO S N BUILDING INSPECTOR (encl . ) (CERT. MAIL) o��gUFFO�,�co Town Hall,53095 Main Road p 4 Fax(516)765-1823 P.O.Box 1179 W Z Telephone(516)765-1802 Southold,New York 11971-0959 41, !� ��l BUILDING DEPARTMENT TOWN OF SOUTHOLD ORDER TO REMEDY VIOLATION Date : May 25, 2001 TO: James & Kathleen A. Blackley 2457 Foxdale Ave . Oakdale, N.Y. 11572 PLEASE TAKE NOTICE there exists a violation of : Zoning Ordinance - CHAPTER 45 Other Applicable Laws, Ordinances or Regulations TITLE 19 NYCRR SEC 444 .3 (b) & (c) at premises hereinafter described in that : 1. RENOVATING A STRUCTURE WITHOUT A BUILDING PERMIT 2 . OCCUPYING A STRUCTURE WITHOUT A CERTIFICATE OF OCCUPANCY In violation of CHAPT. 45-8, CHAPT. 45-15A YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the law and remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at : 1500 GRATHWOHL RD. , NEW SUFFOK, N.Y. SUFFOLK COUNTY TAX MAP #1000-117 . -4-5 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute a ffense punishable by fine or imprisonment or both. RUNG SEMON BUILDING INSPECTOR (encl . ) (CERT. MAIL) 765-i 2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE A CHIMNEY REMARKS: L cr r DATE 1 [ C� INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS TION [ ] FRAMING [ FINAL [ ] FIREPLACE &, C1HIMNEY REMARKS: / © �5S DATE 1%l ( 1 INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUG LBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -Z- kl r DATE --s D INSPECT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH,PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: '00/ DATE v ` INSPECTOR FIELD INSPECTION REPORT DATE 1.{.F COMMENTS saaaaaaa---= ssmos=-- -+--�-sx3x�sxxx --rss==aaaxxe- -xaaaxaaax=xsaasca�aaa n ` ': YJ FOUNDATION ( IST) H U b FOUNDATION (2ND) r ROUGH FRAME h 0 PLUMBING O C> g INSULATION PER N. Y. T STATE ENERGY # c CODE T 3 . C-Q FINAL ADDITIONAL COMMENTS; 6 @ i o 00, w H � .3 OY z w JUN 162000 l.% BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . BLDG.DEPT. TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . "GOWN OfSO'ITHOLD BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . .. . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: 7/ / 7/ ��uG CALL Exmined.�. U :. ..., / MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved...... �.?' ..., W.. Permit No. . Disapproveda/c .................................. .................................... �. .. . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. a-b. . . . . . . . . ,tl '. . . INSTRUCTIONS a. 'lois application must be completely filled in by typewriter or in ink and submitted to the Building Inspector crit sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sharing location of lot and of buildings on premises, relationship to adjoining premises or public :reets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of uis 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 ?rmit 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 ,cupancy shall have been granted by the Building Inspector. APPLICATICN IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the .milding Zone Ordinance of the Tam of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or >gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein ascribed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and gulations, and to admit authorized inspectors on premises and in builing for necessary i spections. rs (Signature of applicant, or name, if a corporation) (Mailing address of applicant) Late whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .............................................................................................. ane of owner of premises ty............................................................ (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. ........................................................ (Name and title of corporate officer) BuildersLicense No. ......................... Plumbers License No. ......................... Electricians License No. Other Trade's License No. .............. Location of land on which proposed work will be done..... -�^' ....................r..,,..k�: ........... 1..x.5.�:..................�� ���1.................................!U.......... ......... House Neer Street Hamlet County Tax Map No. 1000 Section .....41.7...... Block ....(?.!........ Lot ...f9......... Subdivision .......................��.7.......... Filed Map No. .. ........... Iot .�. ......... (Name) >_. State existing use and occupancy of premises and intended//use and occuupaficy 6 c"' traction: a. Existing use and occupancy .....�0A.,✓!i ....f.'7T' L...... ` ° ............ b. Intended use and occupancy ......io .!..... ........ ............................. Nature of work (check which applicable):- New Building .... Addition .......... Alteration .......... � Repair .. .. -. Removal .....i!..... Demolition ...... Other Work ................. .......... ...... Description) Estimated Cost .... Q �oKe.. �DjO cc'fee .......................... ...I................ ,r (to be paid on Filing this application) Tf ckoelling, number of dwelling units ....3...... lkmber of dwelling units on each floor �../.: K.. Ifgarage, nurber of cars .......0............................ /I If business, commercial or mixed occupancy, specify nature and extent of each �e of use..... ^/.4.......... .;n Dimensions of existing structures, if any: Front........ `ite'r Height ......................... Number of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear _. Depth .................... Height .................... lknber of Stories ............... Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Ika:,.fir 'ct,.,.- ..f Chnri.?... _. . ..... of lot: Front ../i_eTA: ... Rear ptih ..... Purchase ..�. %9.......... Nare of Former Owner ."..[�•9 !!iia 4..... ............ of use district in which premises are situated ...... ...................................... .. ....... .. Does proposed construction violate any zoning lana, ordinance or regulation: ....C1!n............... 3. Will lot be regraded ...t.J.(O........... Will excess fill be removed frau �;j s„ `YES dv) 14. Names of owner of premises .....SA J z... Address Phone No.Name of Architect .................................... Address .............................. Phone Flo. ............ Name of Contractor ................................... Address ...............................Phone No. ....... .... 15. Is this property within 300 feet of a tidal wetland? ... NO ..........�/ *IF YES, SOLM D TUNTI111SIFES PMWT MAY 13E - .:L S/°ncc J6 �+�Z �Rus�t S Tnt y� Guts d�vhf w i Y•f, nr� �Os'v�JO S f /J PLOT DIAGRAM /efs°'}is3 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 nares and indicate Tether interior or corner lot. flfl�t/Z J a F SPATE OF NU YORK, �1 S� SS Wl1NNY OF ...... ......... ..4m-zS..... 1.!l .¢5°.................being duly sworn, deposes and says that he is the applicant (N_-, o_` irxlivic.'•u l 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 aryl to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; arx] that the work will be performed in the m m-er set forth in the application filed therewith. .Sworn//to(bb/Aee__fore me this f4P.y.........day of �I�Ls? ......,,a -90D Notary Public .o� r Z . .... ••.' tune of Appli.cant)` CAniAMNE K.S AONNQ Nobly Public.State of New York No.41-4611433 Qualified in Nassau Count 2,061 Commission Expires May 31,' - (ftt ' cenF> 3x071Jol^IdF U ty`4� P r r r `1736 ° w ,tFrrapr._ PR ENING - EME)t CY ESCAPE AS REQUI BY PART. 714 OF _rv_kgd __- N.Y. BUILDING CODE. 4A' IICL" ALSi, L 1HRV EcSN[IG. j 1APsikoofr_ PLAN_ I APPROVED ASNDTED i �7 '... -- — DATE: B'g B.NII r / D6&Ao L FEE: fl �Yk NOTIFY BUILDING DEPANTMENT AT - - 766-ISM9 AM TO 4 FOR THE FOLl.O1MNG INSPECTIONP NG & PLUMBING , 1- FOUNDATION - TWO REQUIRE 2. ROUONPOUNED�NCRETE S. INSL LMION - - -- --T—--T—___— __ 4. FINAL - CONS?RUCTION MUST - - • -_ .-'._ }; ._ O BE COMPLETE FOR C.O. THE RREEQUIREMEINTS OF THE NY t STATE CONSTRUCTION & ENERGY OCCUPANCY yq CODES. OCIL U _- I LDESI N OR CONSTRUCTION III' Upl - - OF Lf�/l . Ca ., fJl' ` a O LT rn,ayj/ . _ CCU 14 prh P78ER CERTIFICATION ON LEAD CONTENT BEFORE �I ¢ p CERTIFICATE OF OCCUPANCY If copper tubing is use d SOLDER U , TEA for water distributing ioSUPPLY SYSTEM system; pipingshall be UNOERWRITFRS CF IFICAE REQUIRED EXCEED 2/10 OF 1%LEAD. of' T .D ., , , • w, PROVIDE OPENINGS FOR trb EMERGENCY ESCAPE AS PROVIDE ANTI-SCALD AND/OR `� «r REQUIRED BY PART. 714 OF THERMAL SHOCK PREVENTING PLUMBING N.Y ALL DEVICES AS TO PART. 902.6(K) PLUMBING WASTE . STATE BUILDING CODE. &WATER LINES NEED N.Y. STATE BUILDING CODS. TESTING SEPOHE COVERING --- r1 2, 5 : > Co� w mN .+YssC 7� r oo s Tow v aroma _ �_ _. .__.-___•_. _-_— _. f� - -_ PQr?' `� G��nN�V�a � �/ La.�o/T< � Lse.<V 5 I{ A G.�/.2 zoic /Ay-,la/l , rod.pl /TV/ /�Y&3c 414 ,Qa .�r 2� C SUVJry lGr�/ /r lr Nol` <'e�oa/74 ' --- �� x�/ a77 I -- - gNVY4WW�� . 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