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HomeMy WebLinkAbout27862-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29793 Date: 10/27/03 THIS CERTIFIES that the building ADDITION Location of Property: 700 LATHAM LA ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 9 Lot 1.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 1, 2001 pursuant to which Building Permit No. 27862-Z dated NOVEMBER 2, 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 SUNROOM ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES M SVRCEK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1162455 09/09/03 PLUMBERS CERTIFICATION DATEDN/A ( - 4� Authorized 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. 27862 Z Date NOVEMBER 2 , 2001 Permission is hereby granted to: JAMES M & ANO SVRCEK 700 LATHAM LANE ORIENT,NY 11957 for CONSTRUCTION OF A SUNROOM ADDITION AS APPLIED FOR at premises located at 700 LATHAM LA ORIENT County Tax Map No. 473889 Section 015 Block 0009 Lot No. 001 . 008 pursuant to application dated NOVEMBER 1, 2001 and approved by the Building Inspector. Fee $ 150 . 00 Autho -Ized Signature COPY Rev. 2/19/98 Form No.6 ------- TOWN OF SOUTHOLD BUILDING DEPARTMENT , TOWN HALL 765-1802 i APPLICATION FOR CERTIFICATE OF CCUPANCV 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: 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 consent to inspect signed by the applicant. If a Certif icate of Occupancy is denied, the Hudding Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - Ncw dwelling $25.00, Additions to dwelling 525.00, Alterations to dwelling$25.00, Swimming pool $25.00, Accessory building$25.00, Additions to accessory building $25.00, Businesses $50.00. 2. CetiificoteofOccupancyolPre-existineBuilcling- $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated C erllflCllte of Occupancy - $50.00 5. TcmporaryCC]tilicatcofOccupancy- PcsideutialS15,00, Conuncrcial $ISAO Date - /`7/0 3 New Construction: _ Old or Prc-existing Building: (check one) Location of Property: lea ���� T// �/ �Y �/ 9S7 House No. Street Hamlet Owner or Owners of Froper(): _J 07G S 5 I? e 49 /C Suffolk County Tax Map No 1000, Section Block Lot Subdivision -_ Filed Map, Lot: Permit No. `Z 7 9� 2 Date of Permit. t 7AP 3 Applicant: -AlIV Y S//R L X/C Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature (9-D-p— (94 y� eo � .z9 -)9 ��rs��s���ssss�n�� 5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY C5 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT S Upon the application of upon premises owned by 5 JOHN LUDMANN JAMES SVRCEK 5 C5J P.O. BOX 621 700 LATHAN LANE 5 5 NEW SUFFOLK, NY 11956 ORIENT, NY 11957 5 Located at 700 LATHAN LANE ORIENT, NY 11957 C5U 7C Application Number: 1162455 Certificate Number: 1162455 Section: Block: Lot: Building Permit: BDC: NS11 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 Second Floor, addition, S 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 9th Day of September,2003. 5 5 Name OTY Rate Rating Circuit Tyne 5 5 Miscellaneous 5 porch addition 5 5 Wiring and Devices 5 Receptacle 3 0 General Purpose A visual inspection,of the delineated electrical instal iation,duteirnined thai an AN ious hazard is not present and thu'installation is believed to be 5 5 in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 5 5 5 5 5 5 5 5 seal LJ 1 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. o rJ��JrJ�r?�rJrJrJrJrJrJcPrJrrr�cnrrrJrJrJrJrJrJrJrJrSrJ�rJ�cncnrJrJrJr�rJrJrJrJ�JrJ�r?�rn�nrJcPrJrJrJrJrJrJrJrJrJrJrJrJrlrJrJ arJ�rJrJr?� o Town of Southold Building Dept. May 16, 2003 Main Rd. Southold.NY ' 9 RE; 6 month ext. on permit#278621 Please ext . Permit#278621with is a 10x24 room addition Framing inspection was already completed now asking for a insulation inspection House owner and location is James Svrcek 700 Latham Lane Orient , NY 11957 STATE OF NEW YORK ) ) ss COUNTY OF SUFFOLK ) ,p t+,i fytG (fj& being duly sworn, deposes and says: That deponent Is over the age of 18 years and resides at sl+c�i iso N`j That on the J2*day of oc v7 + 2001 deponent architect/engineer, licensed by the State of New York, hereby states that s/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- r) - Cl —1 - street address '7oo HA" LArJ In opc-A(; *cttecVEngineer�� tto +mJ� 2001. Notary Public Jeanne Randall Notary Public,NYS#5002973 Suffolk Ca.,Comm. Exp,101131 / cc: Applicant BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: /i /Z /Ol !� DATE SUBMITTED: /L/0l APPLICANT NAME: V WE;St' h Ir .jfac "_� SCTM# DISTRICT: 1,000 SECTION: /,r� BLOCK:__ LOT: 8 STREET: -Aoo I ArY (AM L,A • CITY: ,ele'Alr SUBDIV.NAME:L PROJECT DESCRIPTION: Ju r/lPoq A4 /9 b t T7 CV ARCHITECT/ENGINEER: Nr- FAST TRACK? G� SINGLE& SEPARATE CERTIFICATION-REQUIRED? / (J' NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LO),TSSFROM JAN.1997 100-25.Merger.(A nonconforming at any time atter 7/1/8: ZONING DISTRICT: �- yU CONFORMING? /G ' REQ. LOT SIZE: y�/ ACT. LOT SIZE: y � REQ. LOT COV p ACT. LOT COV. REQ. FRONT - Yo PROP. FRONT-2 REQ SIDE 1 1/51-' ACT. SIDE V REQ. REAR ;To PROP. REAR � N la WATER FRONT? o DESCRIPTION: PANEL #:_J64 FLOOD ZONE: AGENCY PERMITS REQUIRED FOR REVIEW APP S REQUIRED: SUFFOLK COUNTY HEALTH DEPT: YES or O, ED#):_DTE:—/_/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1n5 YES o SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES lor TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OR EGRESS (18 H min.? 4 sq to a) VENT ( Ff. x d%) LIGHT(SQ FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP 11 'S Z/C/0 Z- I f. !�} HAVE PRE CO'S : Y OR N BPaLZ/C/0 Z 12 ' l C c r 1: NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR SF SECOND FLR : SF I111IT OTHER TOTAL TOTAL: e-Q 09 7 _SF FEE FEE FEE 'OT�, 6 y SF)- ( — SF)=,SF X$�_$ r '+$ 1 ',!r&+$ =$ ) 50 G o� 7F6 2� 765-1802 BUILDING DEPT. INSPECTION [ ] FOU DATION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REM RKS: DATE D 2---TNSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU LBG. [ ] FOUNDATION 2ND [ SULATION [ ] FRAMING [ ] FINAL [ ] FIREPL CE CHIMNEY REMARK DATE LI)3 INSPECT G a 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMN Y REMARKS: v2 l DATE INSPECTO FIELD "INSPECTION PriPORT DATE COMMENTS " esss�a=�=cx=ems_--....--m---= -_es- �-=m=rcac=ca=axxaeecam_aca=c>mav=a=am=xoaasx H6 FOUNDATION ( IST)" �R a ROUGH FRAME fi PLUMBING mt S1z � INSULATION PER N. T. STATE ENERGY CODE C r 14 FINAL < ADDIT COMMENTS: yD / 03 . c� U 0 w TOWN OF SOITTH QLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HAUL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. Check Check Septic Form N.Y.S.D.E.C. / �/ Trustees Examined / G 20—OZ Contact: Approved 20 O 1 Mail to: Disapproved a/c —7- Phone: qg7, uilding�nageeior U. o APPLICATION FOR BUILDING PERMIT DateCX i?INSTRUCTIONS 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. 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 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. (Signature of applicant ortharna,if a corporation) ,001347xi0b$eCA�6L7ex 15L*Avp V� lli'`t (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or.builder Name of owner of premises cl A ail cS (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. 1. Location of land on which proposed work will be done: Toa ©.+z/ew - uY House Number Street Hamlet County Tax Map No. 1000 Section 0/.57 Block Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed consoction: a. Existing use and occupancy ( FSM tc`(— t--£s/D f5 f Gly b. Intended use and occupancy sN ," L- No Ct4,&�^,j6— 3. Nature of work(check which applicable):New Building Addition [� Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 3e ado — 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 i 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Z:_Rear Z 7 Depth 37 Height 3� ' Number of Stories z Dimensions of same structure with alterations or additions: Front 2-7 . Rear Depth Height 3 3 Number of Stories '-- 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front—!(, f , I -2Rear—LA, $Z Depth 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: (� 13. Will lot be re-graded 0 0 Will excess fill be removed from premises: YES NO �7s•�i N`f 14. Names of Owner of premises IL4 r L�S S Y/10Eiz-Address -7ooG.�-n-+� to Phone No.Gs/ 5z-3 5 S79,,9 NameofArchitect Joy-4,j Fie„vc Address Agoxioevs#ek-.-r;vsixt,honeNo /S�6 Name of Contractor Address Phone No. 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 Sy[� )r L/n ALA,.' y-� rte//1/e-- /-` being duly swom,deposes and says that/ � rr' (Name of individual signing contract)above named, ' )He is the 6 iT � (Contractor,Agent,Corporate Officer,etc.) :)f said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; :hat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be )erformed in the manner set forth in the application filed therewith. iworntoefor me ' of pp� otary public Signature of Applicant Jeanne Randall Notary Public,NYS#5002973 ftolN Ca, SuComm.Exp.10/13/O' .11 2 S NOTIFY BUILD" 766.1602 ! AM TO 4 FM Fail we 1.F FOUNDATION REQIMIIAII v,� SITE P LAN L] FOUGH -IFRAMIN & TMS PROJECT KMLVE& 2 ROUGH • FRAMING 4 PliI11i1N! 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