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HomeMy WebLinkAbout26837-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28562 Date: 07/01/02 THIS CERTIFIES that the building ADDITION & ALTERATIONS Location of Property: 4775 PARADISE POINT RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 81 Block 1 Lot 24.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18, 2000 pursuant to which Building Permit No. 26837-Z dated OCTOBER 11, 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 ALTERATIONS & SECOND STORY DORMER ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JO ANNE CUMMINGS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N561549 06/19/01 PLUMBERS CERTIFICATION DATED 05/14/01 MATTITUCK PLUMB.&HEATING A) Authorized ' nature 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. 26837 Z Date OCTOBER 11, 2000 Permission is hereby granted to: JO ANNE CUMMINGS 4775 PARADISE POINT RD SOUTHOLD,NY 11971 for . ALTERATIONS TO A FOUR BEDROOM SINGLE FAMILY DWELLING WITH 2ND FLOOR DORMERS AS APPLIED FOR. at premises located at 4775 PARADISE POINT RD SOUTHOLD County Tax Map No. 473889 Section 081 Block 0001 Lot No. 024 . 005 pursuant to application dated AUGUST 18, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature COPY Rev. 2/19/98 �.^ 1 Form No.6 1' a� TOWN OF SOUTHOLD r-� ( BUILDING DEPARTMENT TOWN HALL 765-1802 (\1 --'-APP CATION FOR CERTIFICATE OF OCCUPANCY This pplication must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. 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. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential $15.00, Commercial$15.00 Date. 2� New Construction: Old or Pre-existing Building: / Ll__� check one) l Location of Property: 47 7S �� r a Gd i S<Z }� T /590 Q G� ��C� GI -' 4 o �� House No. ( .N1l Street Hamlet J Owner or Owners of Property: � (� �} 4)e— Suffolk County Tax Map No 1000, Section Block Lot Subdivision p Filed Map. Lot: Permit Ne-.,? D 3 7--;-7 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Te porary Certificate Final Certificate: (check one) Fee Submitted: $ ��s Applicant Signature co a s-s&. THE NEW YORK BOARD OF FIRE UNDERWRITERS PA3E 1 1f3`15` BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date .TUNE 19,200.1 Application No. on file N 561549 THIS CERTIFIES THAT PERI,1IT NO. ;'683T Qtly 41e CO only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of EDVIARD CWHINCS, PARADISE POINT ROAD, SOUTHOLD, NY in the following location; ❑ Basement ❑ 1st Fl. 0 2nd Fl. Section Block Lot was examined on JUNE P 5,2001 and found to be in compliance with the National Electrical Code.- FIXTURE OUTLETS RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS NO.OF FEET AMT WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER AMT. AMP. TYPE EQUIP. 10 1W 1 0 3WI 3 0 3WI 3 0 4WI NO.OF CC GOND, A.W.G. NO.OF HI-LEG A.W'G. PER 0 OF CC.GOND. OF HI-LEG NO.OF NEUTRAl3 OF NEUTRAL OTH APPARATUS: G.F.C.I:-1 SMOKE DETECTOR: - REP ELECTRIC L L P.O. BOX 635 MATTITUCK, NY, 11952 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. III INI 11111 IN 1111111 m COPY FOR BUIL IN TMENT.-T—HIS COPY OF trH1It-IUATE MUSIN E ALT ED IN ANY MANNER. Town Halt, 530.45 Main Road ; ` ;..' r .){ I ax (516) 7c;5.1823 P, 0. Rox 1179 1 Telephone(516) 765.1802 Southold,New York 11971 1 ` 1 > 3' OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I c A 'r i O N DA'ff: j. 1 O Duilding Permit No. a4a<F -7 Owner: -LL�4 c m I S (please pr_lnt) Plumber: C��P. (please print) v 6 I certify that the solder used in the water supply system contains less than 2/10 of ]% lead. ( P I limbers y 0t:u Sworn to before me this - L .— day. of Aam 0�0�� Notary Publico 5u po (� County KATHLEEN MABLI Notary Public MA5e Of New wYork No Qualified In Suffolk County Commission Expires November 3, T ad� Rt� iP- 5 TOWN OF SOUTHOLD 00OPERTY RECORD CARD _ �►. )WNER STREET VILLAGE DISTRICT SUB. LOT =ORMER OWNER Comm N E ACREAGE 07i S TYPE OF BUILDING W cJTL 1. — ES. SEAS. VL. FARM comm. IND. . MISC. r 'r 71 LAND IMP. TOTAL DATE REMARKS .6714c. 4 -9'.ZSD A-d d e.T --a - i iS Ns.)'? :. •+r .a =. )0'0xrq c-(,ref�•,%r�.,�. 7-o_ L t, y. - 0 (2�STrI.���� 300 .30 0 ,It - B 8G CON 1T ON, t o• u �Ce T . PAGE S u v 5`� ABOVE 3/� 7 0 D g 7� 9 oc '- `i` - s 7-o 0 /codland Hompland _ _ � a�g f qGl- _ � aC055 Um�1;�' ;1 �V _ • � _�'9_:. rushland iouse Plot SMI - 1 + T- .., —A- } i G � I s —P Id - Foundation Bath �I - u > 1 (cL Floors G I � ��� � Basement .�� �ension '7 �5 � g in Ext. Walls Interior Finish ,-Tso JG� tension �� O r I I ' Fire Place Heat ( C_ (D X 9-0 Po Attic (o Z�j ZG y Porch Rooms 1st Floor — eezewoy - Patio _ Rooms 2nd Floor iroge X / _ �. G� z-'�v '� Driveway - - B. - - - — - � 3t4 44 4p 4 iq3 BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: DATE REVIEWED: /a/ii / od ——— ����`6c DATE SUBMITTED: 8- //&/06 PROJECT LOCATION —— STREET: CITY: Sa �atrt SUBDIV. NAME: ARCHITECT/ENGINEER: L 717M,4.1- FAST TRACK: YES o e SCTM# --- DISTRICT: 1,000 SECTION: 2 BLOCK: LOT:24. S ZONING: ZONING DISTRICT: R40 R8 AC CONFORMING: YES 49 REQUIRED LOT SIZE: SBX SQFT. WHERE ACTUAL LOT SIZE FROM? / .¢?c[ . REQ. Sd) �r. ACTUAL LOT SIZE: ?2c6 5 SQFT. REQ. REQ FRONT:'PROPOSED: r,� ' SIDE YD: jS '/�' PROPOSED: /'tC'/ ' REAR: LOT COVERAGE: ALLOWED: �d'PROPOSED: A&' EXISTING:3�� sf ° _�sf- % TOTAL!! 6_?' sfj6% o NEW: _ CORNER? YES OR WAT ER FRONT? ES R NO DESCRIPTION:_ /9'a>1 �21 SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o O OTES: '11A 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 19 1983.) PROJECT DESCRIPTION LT ACC oR N/D: f - n �� A_,7 o e ' AGENCY PERMITS REQUIRED FOR REVIEW TOWN SPETIC PERMIT: CEDE / SUFFOLK COUNTY HEALTH DEPT: YES or ``mss S (BED #): DTE:_/_/ PERMIT#:R10- NEW YORK STATE DEC: YES or SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or FLOOD COMPLIANCE ZONE: PANEL #: /c 7 FLOOD ZONE: N NYS ENERGY:94 /ec,4 OR NO f¢� EGVENT: LIGHT: RESS: ✓ NOTES:��a ✓ /� 8�t30/,x299 — 2K /f 5 rs axt s, SEE STRUCTURE: FOUNDATION:7.2 SF FIRST FLOOR /1U SF SECOND FLK 518 SF INIT OTHER TOTAL TOTAL: 730 SF FEE FEE FEE DT( 730 SF)- C82�o SF)= SF X $ =$ +$ +$ _ $ 7651 BUILDING DE INSPECTIO [ ] FOUNDATION IST [ ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION S� A° [ FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY R ARKS: �l� idlo ,DATE lAlef/o d INSPECTOR 768-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMAR S: i 7,DATE � INSPECTOR ^= Y77 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ( OU LBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY RE KS: y ,DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -� � DATE INSPECT �✓iiiI _ _ ..5-eeI /Iaf C1WWA �lJJJ► '*_►. / i / ti • i�_ ! I � BOARD OF HEALTH . AUG 18 LUUO 3 SETS OF PLANS . . . . . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . . . . . . . . . . . . BLDG.DEPT TOWN OF SOUTHOLD CHECK . . . . . . . . . . . . . . . . . . . . . . TOWN OFSOt;TH01_D ..�gUILDING DEPARTMENT SEPTIC FORM TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY �// TEL.: 765-1802 CALL . . . , (26.-.3 . . . . . . . Examined . . . A6,4 . . . . . . .,"4rj. (� MAIL T 0 : Approved . . . . . . . . . . . . . . . .. 19 . . . Permit No. :-�Q 2.3— Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT / Date . . . . .�/�g1v . . . . ., 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli. cation. 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 issued a Building Permit to the applicant. Such permi: 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 inspec ' ns. (Sintuor. mif a poratton)g #7/YI-11 A,>t;5o5r 1r ;gyp7b,�Ai vbP, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /14?71. . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name Of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . 3 0 5 H F Plumber's License No. Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . S X15 ' r.7 3 0 3 9 1, Location of land on which proposed work will be done. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . . . . . . . . . . . �: // 7 y. . . . . . � , House Number Street Hamlet . . . . . . 47390 za/ 77 County Tax Map No. 1000 Sectio . . . . .WIP. . . . . . . . . Block -*. . .-2 4. , , . , , Lot . . . . . . . . . . . . . . . . . . . Subdivision . . i9�'�9�i��. . " . . . . . . . . . . . . . . . . . . . . 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 . . . . b. Intended use and occupancy . . . . . . .�. . .��lE — � iz �i. . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . • , Repair . . . . Addition . . . . . . . . . . Alteration . . . . . . Removal . . . . . . . . . . . . . . Demolition Other Work . . . . . . . . . . . . . 4. Estimated Cost . . . . . . . . � J D (Description) Y. . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S. If dwelling,number of dwelling . 'JJ (to be paid on filing this application) units . A'A. • • • • . • . . Number of dwelling units on each floor ../YIN. If garage, number of cars . . . . . . N� . . . . . . . . . . . . . • • • , , , , , .. 6. If business, commercial or mixed occupancy, specify natur�nd extent of each type of use , 7. Dimensions of existing structures, if any: Front . . . . , 'V`� Height Rear . . Depth . . . . . . . . . . . . . . • . . . . . . . . NumberofStories . . . ?� , , , , , • • • , . Dimensions of same structure with alterations or additions: Front Depth . . . . . . . . . . . . . . . . . Rear . . . .5; .., �. . . . . 8. • • • • . . truc Height Front . . . . . . . ,�• Number of Stories . . .11 S Dimensions of entire new construction: Front . . . . . .`Vf�. Height . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Number of Stories . 9. Size of lot: Front . . . ././.�sO. . . . . . . . . . . Rear . . !�1.7? . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase • • • • • Depth . . . . . . : Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction v,I to any zoning law, ordinance or regulation: , l... . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . p, , , , • A'` . . . . . . . . . . .. . . . . . . . ... . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes 14. Name of Owner of premises . . . . . . 77� . . . . . . Address . , , pxl!i" . . . Phone No.,6.:.7 j�5. 3 Name of Architect . . . . . 1 h• �"•�i�sr . . Address ��!' ypr� . Phone No. 47.7.'-Q,-f�'BQ Name of Contractor . Lv: ., , ,1 hL� r!+s , , . Address �4:b'Rx .` g?cx, 15.Is this property located within 100 feet of a tidal wetland? *YES �, .NO.I *If yes , Southold Town Trustees Permit may be required. .._ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. e ajec I STATE OF NEW YORK, COUNTY O,F/. .Su/= SS G�fshe?!1 , .22 .? . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contractQ above named. He is 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . day oj Notary Publi DLt/ i1 . . . . ., County ELIZABETH A STATHIS NOTARY PUBLIC,State of New York No.01ST6008173,Suffolk County ' ' ' ' . ' . ' • • ' • • • • • • • . . . . . . . Term ExDiresJune 8,209P--- (Siann.,,.P 1 4q ' 13NERGY COUE CALCULATIONS (For Non-Electric heat) Desiyn Criteria G , 000 Uegree'.Ut O.A. JOOF I .A. v �„ 2/20 "UI Uu DATED: : 2 DESIGN 'rIIERMEL REMARKS SUBSYSTEM AREA „U,+ IU1TlNG t'.xLerio Walls (Opaque) L131 Glazing _ 417 ,3L �• eYoc -- Doors Cci.liiiy/Itvof (Opaque) 5 u 05, v Skylights % Floor foundation Walls Slab liisulation TOTAL x p Motes: Uuilcli.ny Lnvelope Systems to meet requirements of 7815. 2 HVAC Lqui.pement to meet requirements of 7015 . 11 HVAC Systems to meet requirements of 7015 . r2 Uuct SysLems to meet- requirements of 7815 . 13 VentilaU0119 Systems tomeet requiremenLs of '1015 . 19 Insu:lativn of k'ipiny Systems to meet requirements of 7015 . 15 Service Water heating Systems & Equipment' to meeL- requirements of 7915 . 21 Electrical & Liy)iting Systems & Equipment to meet- requirements of 70J.'' . 31 'I'o the best of my knowledge, POF NEW�0 belief, & professional �a ��CE juclyemenL, these plans arc in compliance with the code . v!t`0 032254.1 A9QFESS 14N P�'� PROVIDE ANTI-SCALD AND/OR THERMAL SHOCK PREVENTING DEVICES AS TO PART. 902.6(K) N.Y."STATE BUILDING CODE. R Zj 1 If copper tubing is used for water distributing APP ED AS NOTED system; piping shall be o ii o0 of types K or L Onl DATE. B.P.M�� 7�` , $C "' FEE; BY: /�/�- wjj v UNDERWRITERS CERTIFICATE. NOTIFY BUILDING DEPARTMENT AT ► REQUIRED - �" . - - 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: �{ _ 1 FOUNDATION - TWO REQUIRED , _ '1 - FOR POURED CONCRETE - PLUMBING 2. ROUGH - FRAMING 8 PLUMBING ALL PLUMBING WASTE 3. INSULATION .� &WATER LINES NEED 4. FINAL - CONSTRUCTION MUST - 1 TESTING BEFORE COVERING BE COMPLETE FOR C.O. i� ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE STRUCTION --------------- CODES.NOT RESPONSIBLE ENERGY - --- - DESIGN OR CO TRUCTION ERRORS -7 OCCUPANCY OR Lew r' X16 ' USE IS UNLAWFUL core+`1�F- \�� %' � i - 1VITHOUT CERTIFICATE l 11I %' OCCUPANCY o .. TIF 1E NDERWRREQ SR� - --' -- _ 1 r AK d. 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