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HomeMy WebLinkAbout27148-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28606 Date: 07/17/02 THIS CERTIFIES that the building ADDITION Location of Property: 50 INDIAN NECK LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 86 Block 4 Lot 1.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 2001 pursuant to which Building Permit No. 27148-Z dated MARCH 16, 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 SCREENED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & KATHLEEN L NODELMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1062898 07/05/02 PLUMBERS CERTIFICATION DATED N/A )- /�C4 i //Au/4oriz-04 Signature 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. 27148 Z Date MARCH 16 , 2001 Permission is hereby granted to: ROBERT NODELMAN 96 WILSON BLVD. NEW HYDE PARK,NY 11040 for . NEW SCREENED PORCH ADDITION 25 ' X 19 ' TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 50 INDIAN NECK LA PECONIC County Tax Map No. 473889 Section 086 Block 0004 Lot No. 001 . 003 pursuant to application dated MARCH 12 , 2001 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD n �! _ n BUILDING DEPARTMENT TOWN HALL6 201(}2 765-1802 ' 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 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. _ J✓L + �(�, o� 00 New Construction: Old or Pre-existing Building: (check one) Location of Property: A/014 N Al e-6) t4 Al A/I L N, J- House No.., Street Hamlet Owner or Owners of Property: yd 06-elV Ag Al Suffolk County Tax Map No 1000, Section /-/ 79 F8 cJ0 S Block p p Lot 0 n 1. 0 0 3 Subdivision Filed Map. nn Lot: Permit No. A 71 ��a Date of Permit. Applicant: /f0 R"7- f t-/97-9 C 61✓ Health Dept. Approval: Underwriters Approval: vooe 7&lo .2. Planning Board Approval: / Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ Z S Ct C— Applicant Signature 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 crj BUREAU OF ELECTRICITY 5 40 FULTON STREET -- NEW YORK, NY 10038 C� CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 ROBERT NODELMAN ROBERT NODELMAN 5 5 WILSON96 AD HYDEDE PARK N.Y. 11040 PECON C NY 11 58 NEW 5 5 5 Located at 50 INDIAN NECK ROAD PECONIC, NY 11958 5 55 5 5 Application Number: 1062898 Certificate Number: 1062898 5 Section: Block: Lot: Building Permit: BDC: NS11 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, Outside, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5 rj found to be in compliance therewith on the 5th Day of July,2002. 5 5 Name QTY Rate Rating Circuit Tvoe Amount 5 5 Additional Charges 5 5 family room $1.00 5 Wiring and Devices 5 5 Receptacle 7 0 General Purpose $1.75 ej Switch 6 0 General Purpose $1.50 5 5 Disconnect 12 0 Incandescent $0.00 Crcj Receptacle 2 0 GFCI $200 Cj � Paddle Fan 2 0 $4.00 5 5 Invoice Total $50.00 5 5 5 5 5 5 5 5 seal 5 5 5 5 I of I 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 0rJ�cPrJ�rJ�rJ�rJ�rr�r�rJ�rI RI�rPrJ�rJ�rJ12FUnrJ�cnrPcPrJc E,c,�rJ�rJii!J�rsr�rJ�r:ncnrJ�r ncnrJ�rJ�rJ�rsrJ�rJ�rJ�rJ�rJ�rJrJ�rJ�rJ�rJ�lrJ a�rrJ�rJrJ�rJ�r�r�rJ�rJ� 5O BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: 2 /A, /o/ APPLICANT NAME: �J °�C/Mn DATE SUBMITTED:/ /2/of SCTM# --- DISTRICT: 1,000 SECTION: BLOCK: 4 LOT: 3 PROJECT LOCATION AND TYPE OF PROPOSED WORK: / PROJECT DESCRIPTION ADD LT ACC OR N/D: 12 o %e, f, , ys y l�T STREET:_S �/� /`�•c,� 41� CITY: < <a vL SUBDIV. NAME: ARCHITECT/ENGINEER: -r`�/, .sem_, FAST TRACK: YES o aN SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR 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 7/1/83 ZONING: PERMIT ESTIMATE AMOUNT:-UNT: S 36e S . .00 PERMIT USE: EXISTING: o �6 INTENDED: 15r/3 "IJ A41 ZONING DISTRICT: R40, R80,00 CONFORMING: YES o//NO REQUIRED LOT SIZE: SoX SQFT. WHERE ACTUAL LOT SIZE FROM?TAX CARD _4 yve v 4,1 ACTUAL LOT SIZE: 43GO7 SQFT. REQUIRED 4So REQUIRED REQUIRED FRONT:SO 'PROPOSED4_!- 7 ' SIDE YD: �9_3 '/ 40 ' PROPOSED: i'30 '/ ' REAR: GO'PROPOSED:*40' LOT COVERA ALLOWED:10 % EXISTING: sf_% NEW: sf % TOTAL: sf_% CORNER?(YES))R NO WAT ER FRONT? YES OR O DESCRIPTION: FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: /6Z FLOOD ZONE:_ K AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APP11CATION TOWN SPETIC PERMIT: YES or SUFFOLK COUNTY HEALTH DEPT: YES or (BED #): DTE: / PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or TO- ,AN PLAN. BOARD APPROVAL: YES o NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT: NOTES: 7k. vel _ a �` � � �° 0.51.0 ...iaa.IC �✓ r >«,t4; Vf FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR 469 SF SECOND FLR SF INIT OTHER TOTAL TOTAL: -f99 SF FEE FEE FEE T( f9I'3 SF)- ( SF)= SF X $ =$ +$ +$ = $ low-1 Soo 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I SULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: - gsk: LZ DATE 7 0 1/ INSPECTOR ?A M-1802 BUILDING DEPT. SPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: C DATE -3 INSPECTOR Zi 765_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY d REMARKS: - DATE EMARKS: -DATE a INSPECTOR FIELD INSPECTION REPORT DATE COMl SU -------------- � ____ p i --- - J Of FOUNDATION OST) gyp, Ittit ii FOIINDATION (2ND)______Itt �1 - ^ ---------------- — DUAWJ ur rmaatfm.aG . .. .... ... .. . . . 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 'OT" 3 ���m/ CAL 3/) . Ermined. `�.�. ....,�78?0.. MAIL TO: to.. . . .. . . . . �✓ . . . . Approved...... ........... R. Permit No. V.n 1. 01614101/V 4-1- A-, .... ....... . .. Disapproved a/c .................................. ...... ..... ............................................. ....... (Building Inspector) �"�//�� 3�! 1 . L - APPLICATION FOR BUILDING PERMIT Date. L�:i,:1.`T.. . , 1 . . . C ;•i OF SOUTH-:OLD INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and admitted to the Building Inspector wj 3 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 streets or areas, and giving a detailed description of layout of property uawt be drawn on the diagram which is part of this application. c. The worm 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 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. AFMCATION IS MW MATE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Oudinance of the Town of Southold, Suffolk Canty, 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 bunn��g--for ssary in actions. K�1/l� . ................ ................... (Signature of applicant, or name, if a corporation) �`a L)iL.sou 31-✓pN�� f41� ............................z (Mailing address of applicant) IID�� State whether applicant is� lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ©"IvEAE�' ........................................................................................................................ Name of owner of premises .........0�.�....�Dl.E V............................................. (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. //qq 1. . Location of land on which proposed work will be done..........................�G=GO .uG................J/Yr ....... ........................................................................................�..�........ House Number Sttrget Hamlet �l Camty Tax Map No. 1000 Section 0..:_.......... Block ..:k.;. ......... Lot ....1t. ....... Subdivision ...................................... 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 ............... .....................................I...................... b. Intended use and occupancy ............... S ..i........r............................................... 3. Nature of work (check which applicable): Nese Building ..... Addition Z..... Alteration .......... Repair ............ Removal ............. Demolition ............ Other Work .................................. (Description) S. Estimated Cost ...ao 00o'............. fee .............................................. �. / (to be paid on filing this application) 5. If dwelling, number of dwelling units ....L...... timber of dwelling units on each floor ................. Ifgarage, number of cars ...................................... 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... F. Dimensions of existing'structures, if any: Front...4q......... Rear .., .7......... Depth ....� ......... Height ..... r�..:............ timber of Stories ..........!........... Dimensions of�� structure with alte i or.additions: Front .......... 0. Rear ............... Depth._......'7�1........... Height .... �....... Number of Stories ..... ...... c 3. Dimensions of ,entire new construction: Front ..��/. ��... Rear .... �/ ry.. Depth y , - Height ... �!.'I... ........ limber of Stories ...... /- ............... �. Size of lot: Front .... k.. ......... Rear .................... Depth ..............:..... 10. Date of Purchase .A� .......... Name of Former Owner MA06-01P6 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 ........ 4,// .... Will ezm fill be removed from ses. YES .& ro 14. Names of owner of premises .... .. .... ... as ..... ..� ,.. No. ........ Name of ArchitettIYMdl .. 4!DEQSo.............. Address L• gw 5 '@ ....... Phoebe No. �`........... r Name of Contractor ................................... Address ........OND . .....Phone No. .............. 15. Is this'prvperty within 300 feet of a tidal wetland? * YES .......... ..... *IF YES, SQAIiDID 11741x1 1IWMES PEHWT HAY BE MYlldrD. PLOT DIAGRAM 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 names and indicate whether interior or corner lot. SfA1E Or • + SS WW1Y OF� ....... .............V ..lt`: ....!l IY IY+ C..............being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, lieis tire ...........................ew'.�N'!............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed die 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 ,/ BARRY SOMUMN o4.,7........day of .JK�7......X4. .:� Notary Publlo, Stme of Nm York No. 24.4000041 . .GuailNad If*roeOJuly 18,y 2 Votary Public ......... '. ................ brWn (Signature of Applicant) C SUFE K O. HEALTH DEPT.APPROVAL. H.S. NO _ %., ,� �NZ ti✓ cam"// ��z// 1 STATEMENT OF INTENT > _ ��� C• t --. _ f THE WATER SUPPLY AND SEWAGE DISPOSAL G. `rvwvEl, ! '? I -.-X1+1`-/ _ f_ jSYSTEMS FOR THIS .RESIDENCE WILL CONFORM TO THE STANDARDS OF THE j v i --- .-._ -_- I H-� It t'; - '- ' -" I SUFFOLK CO. DEPT. OF HEALTH SERVICES. I ISI APPLICANT '7-� 1 .. - •�" ! i__ I CANT - I _ d I SUFFOLK COUNTY DEPT OF HEALTH Ln. /- - •', _f ;:� - _ rr=_r;;-y ` = SERVICES -- FOR '--A-PPROVAL' -:�'O- 1 . 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FRAMING UNTIL SURVEY APPROVED AS NOTED 1 OF FOUNDATION LOG TION DATE: 3 /G or g,p # 2J/+�E3 UNDERWRITERS CERTIFICATE - - - -- -- - - - ---- -- ----- -----_--- - _ 1Ll HAS BEEN APPROV, - � � I� ,` QwaED Ip----� - - - — - - - � _ FEE: IN DE / '• I I 4 - NOTIFY BUILDING DERhRifirrw765-1802 9 AM TO AST I ' FOLLOWING INSPECTIOPi^ FOf - i I FOUNDATION - PV -f'+ r D FOR POURED COPb i 2 ROUPII - FFAM;" I i U m I CGGiG ..IL it DESIGN OR CONSTRUL,lulu C,,jjj � , cc cc I z q Irf ill O O --- Q } o , y` --- - -- — — -- --- z z I � I SII I I I I I I OF NEU,r Y FOTI E n !I i C? 0 � a � I a r l�G 121�F� Pf? r r , ,25!2 I z tf" 3' �° �(� 3, 3,� /�" �J,3" y-' 'i,on [l° 3;3n 5�„ 3,� „ 'f'' 3„✓ "3,� „��yo I � I � r m' I' TIfGRf1A 4� Jlei W 2Nr2Did P11 l I �G.�'(�I�L �.{h✓�II �•/�/�/ _�I I � V - Iff{L■I',��'� it \ V r-I d _—VY Inti 2- 2xic �s� i�- --- - - - - � --- --- — ---- ro 3. r > D O ,�> I w — -- # � n ' rzC�et� rr� t�oY2G I-I OF NEW y F.,AIVI,n ,q�r 3 co a * Y 4 ��FO,o No. osna'�i �i2 Rom st �tv m Y v'1 LL 31? a e a n GENERAL CONSTRUCTIONNOTES L,,. ALL CO TION WORK SHALL COMLl,Y WITH TOWN OF SOUTH ILQ ANIS NEW YORK ST,►Yfi tU1LDNG ODES. 2. PRIOR TO CONSTRUCTION START:CONTRACTOR SHAD: r i''A %T- G VERIFY AND LOCATE ALL UTILITIES, SERVICES, PIPES,. TANKS, ETC.,AND RELOCATE WHERE NECESSARY., ,. HALL BE CONSTRUCTED ON FIRM T. ALL FOOTINGS REARING SOIL. CONCRETE SHALL DG'PSI @ SB DAYS (ASTM OBTAIN A MINIMUM 1 COMPRESSIVE STRENGTH 0 1 ,70 C- !4). 4. ,STRUCTURE META CONNECTORS REQUIRED FOR ALL , FLUSH STRUCTURL LOAD CARRING CONDITIONS- �I w S. SILLS AND OTHER LUMBER IN CONTACT WITH CONCRETE FOUNDATION SHALL BE CCA TREATED LUMBER. I 6. ALL LUMBER AND PLYWOOD SHALL BE GRADE STAMPED. • d FRAMING SHALL BE DOUGLAS FIR B2 OR BETTER- , Inll I�¢I 2- I '1t9y¢' WU t21CkaC u" 4 4�,i,.iti �Lm dPSAl ( i a LOr VIP T"(4 . Scorn RS 25oi 6To "I^rr. 4 aWAWL M � R L j I ISI I �I 1 ' L / i � II - I � Y I� •..'•§Y� � . c (� . A•k4 W ��1? 1tz � . I 1 I _ � '� � 'I I :, II . lJ�`" n i. � r zvLanwar� Zoll UP FROM " 4 . _ � � R RLy aST , W1 STANDOf f I' 4" FbUR r D W I RxT-�/I►P!q no ^� fbLY ._ - -- - ----- I�WW �' I I �n�00DJI cps 1'J/ I s al i PSI m i RRILING TO CsRRUEI Fo 4J 04. 1— I u Pvlilt.DW 'Ge4pe WITH r�naa 11W x W1 K5y I- - �F NEW 7 y2 2 Rya/ �SFppRNo. 0E4 y, O :33 ¢ �