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HomeMy WebLinkAbout27578-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29029 Date: 10/29/02 THIS CERTIFIES that the building ADDITIONS Location of Property: 4950 NORTH BAYVIEW RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 79 Block 2 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5, 2001 pursuant to which Building Permit No. 27578-Z dated AUGUST 27, 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 DECK AND FAMILY ROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARY K SMITH & BARBARA JO GABRIEL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1038081 09/21/02 PLUMBERS CERTIFICATION DATED N/A Authorized P gnature 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. 27578 Z Date AUGUST 27, 2001 Permission is hereby granted to: MARY K SMITH 600 W BROAD ST APT 4F MOUNT VERNON,NY 10552 for DECK AND FAMILY ROOM ADDITION TO A SINGLE FAMILY DWELLING at premises located at 4950 NORTH BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 079 Block 0002 Lot No. 005 pursuant to application dated JUNE 5, 2001 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature COPY Rev. 2/19/98 ���� Form No.6 Z TbWN OF SOUTHOLD BUDDING DEPARTMENT TOWN HALL 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. �" Q New Construction: Old or Pre-existing Building:% (check one) Location of Property: ' 5-0 r4 .1 13 owxu I'e House No. t Hamlet ti Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block © n a Lot Subdivision Filed Map. Lot: A Permit No._ -� �77!6 -7,Date of Permit. Applicant: 73—&4-tM S S W 1 Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ ��� t7y a 7/G Applicant Signature D rJ�rJ�rJ�rJ�rJ�cPrJ�r�r�rJ��nrnrJ�rJ�PrJ@nrJ�rJ�rJ�r�rJ�rJ�rJ�rJ�rJ�rJ�cP�ncncPrJ�rJ�rJ�rJ�rJ�cPrJ�rJ�r��nrJ�r�cPrJ�rJ��n�Pr�r�rJ�r�rr�n�Pr:PrJ��.rcPr�rrrsrn ca 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 c5 BUREAU OF ELECTRICITY c5 40 FULTON STREET — NEW YORK, NY 10038 c� 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 55 5 TWIN FORK ELECTRIC 'GABRIEL/SMITH 5 5 P. 0. BOX 48 4950 NORTH BAYVIEW5 JAMESPORT, NY 11947, SOUTHOLD, NY 11971 Located at 4950 NORTH BAYVIEW SOUTHOLD, NY 11971 C� Application Number: 1038081 Certificate Number: 1038081 5 7� Section: Block: Lot: Building Permit:3488 E BDC' NS11 S Described as a Residential occupancy,wherein the premises electrical system consisting of S 5 electrical devices and wiring, described below, located in/on the premises at: 5 First Floor,Outside, Lj 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 21st Day of September,2002. c5 5 Name QTY Rate Rating Circuit Type 5 5 Wiring and Devices Receptacle 6 0 General Purpose 5 5 Switch 5 0 General Purpose 5 55 Fixture 6 0 Incandescent 5 Receptacle 1 0 GFCI 5 5 Dimmers 2 0 5 5 Paddle Fan 1 0 5 5 Lighting track 12 0 ft 5 5 5 1'j 5 5 5 5 5 5 seal 5 5 I of 1 5 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 M0611001000 n��rr�r��r�n��rr L•'NERGY COUE CALCULATIONS (Lor Non-ElecL•ric Ilea L) Design CriLeria 6 , 000 Vegree'.Days O.A. lU°P I .A. 700P FOR: U 4 ��-� C PER: Pehh q �'i S� D/ �J��h V ey Vr P" DA'Z'ED: T SUBSYSTEM AREA DESIGN THE12MEL REMARKS "U" RATING Exterior Walls (Opaque) 20 -7 bs' + Z3' Glaziny 29 Doors — C;eililly/Roo L- (Opaque) 186 o 3 3 + 3 Sl,yliyliL•s Floor roundation Walls Slab Insulation TOTAL Z Notes: Duildlug Envelope Systems to meet requirements of 7015. 2 11VAC Equipement to meet requiremerlLs of-, 7U15. 11 11VAC Systems to meet requiremerrL-s of 70.15. r2 Duct SysLems to meet requiremeirLs of 701.5 . 13 VeIiLilaLions Systems to meet requiremenLs of 7015 . 19 InsulaL-ion of k'iping Systems to meet requiremernl-s of 7U15 . 15 Service Water Heating Systems & Equipment to meet requirements of '1015 . 21 E.lecL-rical & Lighting SysLems & Equipment- to meet- requiremerrL•s of 7UJ.5 . 31 To the beet of my knowledge, GEIy belief, & professional J judgement• , these plans are in compliance with L•he code. # r btu sr a E`® 032254-1 FSSION�'� 1 � /7 � STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at 1215 to le/ eP,< 209/ That on the 2/ day of 4 y 2906 deponent amt/engineer, licensed by the State of New York, hereby states that f/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- 55ec. 17q ?%AC 2 ,LfDr5 street address AQ5D Act/Engineer ctot Nft Sworn to before me this day of , 200; r 3 4 m oszss4-1 � Notary Public FoA OFFRM014P�tfr cc: Applicant Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT Date: 06/06/01 Receipt#: 0 Transaction(s): Subtotal 1 Septic Permit- Construct- Resid. $10.00 Total Paid: $10.00 Name: Arnold, William 9 Canterbury Dr. Sayville Clerk ID: LIZS Internal ID:33481 BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: .DATE SUBMITTED: /S /O1 APPLICANT NAME: � Ry K SM rte123WAeA M R I El_ SCTM# DISTRICT:: 1,000 SECTION: 79 BLOCK: L LOT: STREET: X15-0 hlOXTr// "h1y111E CITY:S2 SUBDIV. NAME: n PROJECT DESCRIPTION: h1bAlTlo►J -7a ARCHITECT/ENGINEER: I- n FAST TRACK9 c f SINGLE & SEPARATE CERTIFICATION-REQUIRED? WO NOTES: LO 40,O0Q�F-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83) �aa +cr / 103�t.2,f6.. ZUNING DISTRICT: A-C CONFORMING? /�/ O /39z r ao$ X600 REQ. LOT SIZEf1'*' ACT. LOT SIZE37'"}REQ. LOT COV. o ACT. LOT COV. % six lYn2� REQ. FRONT y0 PROP. FRONT_' 3. REQ SIDE /.5- ACT. SIDE t9/. / a; REQ. REAR PROP. GI �) �REAR/ + Q c3 f iy. (!14(3)(r" WATER FRONT? Nd �Wr ESCTION: PANEL #: _ FLOOD ZONE:, AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS RE UIRED: SUFFOLK COUNTY HEALTH DEPT: YES o , (BED#): DTE: / / PERMIT#:R10- ��//`► NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or T SOUTHOLD TOWN TRUSTEES: YESorpq TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES or NYS ENERGYYIE R NO : o EGRESS (18 H min.. 4 sq total) VENT(SQ. FT. x 4/o) LIGHT (SQ. FT. x 8/o) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z-02(011 "0U.W-0 1 kC W (Ze? HAVE PRE CO'S : Y OR N BP -Z/C/o Z- b/ NOT S: 744 FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR 6$ g_SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE OT(�KS SF)- (_ SF)= SF X $,— =$ 1,5-6) +$ +$ — =$ /,'-) 0 765-1802 BUILDING . -DEPTINSPIEON [ -�-rFOU ATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUN TION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /L c_ DATE ! INSPECTOR 7j M-1802 BUILDING DEPT. INSPECTION [ ) FOUNDATION IST [ ] ROU PLBG. [ ) FOU ATION 2ND [ NSULATION [ MING [ ] FINAL [ ] FIREPL C & CHIM Y REMARK DATE D INSPE M-1802 BUILDING DEPT. SPECTION A.[ OUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL CE CHIMNEY REMARKS: DATE � PECTOR 57F M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ J FIREPLA & CHIMNEY REMARK a I= y W DATE O1/ INSPECTO 57ffl M-1802 BUILDING DEPT. INSPECTION [ j FOUNDATION IST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ j INS TION [ j FRAMING [ INAL [ j FIREPLACE & CHIMY REMARK N6,ecD dlp DATE (/ cW v 1NSPECTO FIELD INSPECTION REPORT DATE COMMENTS � k. 1 FOUNDATION ( IST) - gyp. O 4 y b i FOUNDATION _ . (2ND)_--- -- _ 1110-7) CIO) -` ROUGH FRAME77 h PLUMBINGmt U 01 ro INSULATION PER N. Y. ` STATE ENERGY CODE r : o ©ice_ FINAL (� r ADDITIONAL COMMENTS: 2C H , 1 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION-GHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Buil Jing Plans TEL: 765-1802 Survey , PERMIT NO. Check 4,*-� � Septic Form N.Y.S.D.E.C. Trustees Examined /Z7 200/ Contact: Approved 2001 Mail to: Disapproved a/c Phone: 16-313 Int, I Building Inspector APPLICATION FOR BUILDING PERMIT Date 6 200 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 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 waterways. o. 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 what-so-ever until a Certificate of Occupancy is issued 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. V"I Signature of applicant or name,if a co ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 6 tA , \A-eiz- Name of owner of premises v-A 4Ai f v-,cA Y;q ata flc� U—c) 6o,loa (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. 1-7, Plumbers License No. Electricians License No. p Other Trade's License No. Locution of land on which pro osed work will be done: ` L-, - { S0 r4 . Tt4! . ule—ckl 50ti+tr% C, l House Number Street U Hamlet c County Tax Map No. 1000 Section __7 Block 0L_ Lot C�— 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 W if b. Intended use and occupancy 9 LVe \A 3. Nature of work(check which applicable): New Building 0 L____Addifion___\L/ Alteration Repair Removal Demolition Other Work D (Description) 4. Estimated Cos �� , ��� . Fee (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 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth L� Height Number of Stories 9. Size of lot: Front ') ( Rear V 3 C> Depth Q-Cra / 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: 1/1 O 13. Will lot be re-graded 1/10 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 Contractory tq4yl4 CN Address Phone No7A3 i qS Y1 3 5- 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and 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) SS: COUNTY OF ) 1 - �►��£S f".�^I • � �1 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract above named, (S)He is the L' O�/1 &6'e-4 2 (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. Swornt efore me this day of/1� 200/ /✓- Notary Public Signature of Applicant JOYCE M.wiuONS Notary Public,State of New York No.4952246,Suffolk County Terra Expires June 12, -Io o� Z LAND G LEIVq�O9pA.�. r ,L r �FNEW Y� // Fy a V / �tC• N /O � �V a�� qb R9DIT7ol� i Q / D b m � y�a•er �I ►� a /ShJ6� 200.Oo ' I -sZ/� ZZ, 3D"K/ Su,Pi✓EY,�-ae-/�H.PY.f��ib/Tiy�S�PI�.Pd9.f�9./d C�1�.•r'/c�G •4NT�,�/s� K�Ltss�•4NG17/ks.E �.�vo x�cvotta� Lccrrioy. :3ou�yo�y ✓�dF.�"ocr G'c�wTy N, y goX-f�s/B ' �irrtacvN.y,/iy7i ,,�.�.tea issc�ot� .9.�h/u2As��c� �G6"d TJr�s�'.9c.F,e��s�/ c• . F I APPROVED AS NOTED DAM"! ?' � B.P.# FEE- NOTIFY EE NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION p p 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS UNDERWRITERS CERTIFICATE PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS REQUIRED BY PART. 714 Of PROVIDE SMOKE-DETEC 1 N.Y. STATE BUILDING CODE. ALARM DEVICES AS TO PART.721.1 OCCUPANCY OR H•Y•S BUILDING CO AIP�*1 IJ �J . � _ USE IS UNLAWFUL A WITHOUT CERTIFICATE f OF OCCUPANCY- + T14 JUW j al i I 1f� ai -L LI -------—— 1 i ,-� �-, tof NEW C7 W 1U 032254 :. : R�FESSIONP S t o m m ' i% W tp cc !E i Al A toF NEW , CE qr * . Iif ii 632254-1 �U A9OFESS110k � f mak. 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