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HomeMy WebLinkAbout29336-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29787 Date: 10/23/03 THIS CERTIFIES that the building ALTERATION Location of Property: 465 OLD HARBOR RD NEW SUFFOLK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 117 Block 3 Lot 11.5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 22, 2003 pursuant to which Building Permit No. 29336-Z dated APRIL 25, 2003 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 PORCH ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BERNARD TELSEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A A thor zed 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. 29336 Z Date APRIL 25 , 2003 Permission is hereby granted to: BERNARD TELSEY 465 OLD HARBOR ROAD NEW SUFFOLK,NY 11956 for ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 465 OLD HARBOR RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0003 Lot No. 011 . 005 pursuant to application dated APRIL 22 , 2003 and approved by the Building Inspector to expire on OCTOBER 25 , 2004 . Fee $ 150 . 00 Authorized Signature COPY Rev. 5/8/02 _ Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL OL'j 2 20 765-1802 C—xee��cc� APPLICATION dFOR CERTIFICATE OF OCCUPANCY This applicatiorymusfhe 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 applictutt. If a Certificate of Occupancy is denied, tl:e Building Inspector shall state the reasons therefor in writing 10 the applicant. C. Fees L 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 Builcling- $100.00 3. Copy of Certificate of Occupancy -$.25 4. Updated Certitica(c of Occupancy­ $50.00 5 Temporal% Certificate of Occupancy - Residential $15.00, Commercial $I5.00 Date. !— 7— V- --- New Construction- _ Old or Pre-existing Building: (check one) Location of Property: QID HA(-b r QO /OffLisuffOL/- House No. Street Hamlet Owner or Owners of Property: A1AAL_, rnac• wr0 gERNE� tE/fL� __ Suffolk County Tax Map No 1000, Section Block Q3 Lot p/ Z. Subdivision Filed Map. Lot: Permit No. a Date of Permit Applicant: Health Dept, Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted:11$ p plican rgnature Applicant/ Date Owners Name: Reviewed: �5 Architect/ Date Engineer: F tacGl Submitted: z O SCrM M: District 1 ,000 Section: 4-4-7— Block. �_ Lol. III ojecI _ (( Subdivision - I_oit calioll 0)d �J-a.vbor — N Name.- -- _-- Single S- separate Required rt�fcation: (Yes/No) N�A— ce _ Rva. �,(f�J� It" /ovine Dist"Cl I 1,0(size w"J Actual. �3 D�0 g 1 0-01 coverage �U Proposed I Req. Rcq Req. 11 ton( Yard ProposcdAJLI,1�-,I [Side Yard Proposed4;,6 L� [Rear Yard PnProposcAe-ti✓` 1 Project Description: .,-Si / A�, U � AGENCY 'ERMITS Permit REOU RED FOR I2EWEW MA. NO YES Number Suffolk County Health Dept. -Z— New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIRECK ACE A CHIMNEY REMARKS: f DATE 03 INSPECTOR �7 7�77-- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: _ DATE ` © ®� INSPECTOR V `"7 FIELD INSPECTION REPORT DATE COhIMEN15 FOUNDATION(1ST) H x ----------------------------- C m FOUNDATION(2ND) x 0 d-ri7 i P- ROUGH FRAMMG& "3 PLUMBING INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDMONAL COMMENTS 0 2 m z 3 04 c � l d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DE'PAHCI'MENT Do you have or need the foyowing,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey-./- www. urveywww. northfork.net/Southold/ PERMIT NO. �3 3(=L— Checker Septic Fonn N.Y.S.D.E.C. Trustees Examined 20 0.3 Contact: Approved yJ ,20 03 Mail to: Disapproved a/c Phon 7 Expiration L O a"S ,20 D Building Inspector Qr 2 2 mon APPLICATION FOR BUILDING PERMIT i Date 20 �o 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. 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 the Building Inspector issues a Certificate of Occupancy. f Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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. (S Lure of applicant or n te,if a corporation) L m a 11T 14 AOE n? (Mailing address of applicant) I (4(1 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises A N N 6— M A R I+3k3 1362 N Arm D 'TG LSE ti (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. r M6R t l Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 46S nL_Q HggfCa2 FOAL) toe tc)L SopFo k House Number Street Hamlet //5 County Tax Map No. 1000 Section 117 Block Q 3 Lot 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 1-Z CS t r) E r0 C b. Intended use and occupancy 3. Nature of work(c ck which applicabll ): New Building Addition Alteration Repair Removal L/ Demolition Other WorkN cafL TGl9 C C � (Description) f6r" 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars 1 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 32 ''7 Rear -2�Z • 'Z Depth Ll '3 • �, Height a I Number of Stories _D1 Dimensions of same structure with alterations or additions: Front S /1 Yet L` Rear S Y1/-1& Depth �/q r-`E Height 3 19 {"1 I= Number of Stories StLa 8. Dimensions of entire new construction: Front -" Rear Depth _- Height Number of Stories 9. Size of lot: Front 3 S l b4 Rear _Depth 10. Date of Purchase ;"i 'ja 0 1 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? YES NO 13. Will lot be re-graded? YES_NO ✓Will excess fill be removed from premises? YES__NO �^ 14. Names of Owner of premises Address Phone No. ( Name of Architect _ vy E 7 6 N To f7-C' Address Phone No 7 3 It Name of Contractor --VaEL QAL.�Address (-;/LEE u�PhoneNo. 7G,S 2 2 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO_L,<j * IF YES, D.E.C. 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) S: COUNTY OF 't`CS1_ I U P L Y being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Q.(Contractor, gent, 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. Swom to before me this ;0L VVA day of 2 NotlFWb EEW Signature of Applicant Notary Public,State of New York No.01 GL4879605 Qualified in Suffolk CoWMy.../t9_ Commission Expires Dec.8,_LC.lez� 0 o K Y O 7 F0uN0 Z CM PE- 186.2 186.27 wnRLE MON. N/F GLEASON EAST !,]' OF CORNEF N26'I5'20'W �• S 83'37'00"E 36.4)' Q"'".�in•+__ - o e ASPHALT 470.00' N--- w30 RIGHT —.— _ OF WAY DRIVEWAY 2 N fiJ'Jl'00'W 44J.95' --- I �. �c � e N TAX MAP NUMBER o 1000-117-03-11.5 y Ery AREA = 86,274.61 SF y O OR 1.980 ACRES N 83'2290'W 156.67' O FRAME ly N/F CII'EN - GARAGE w 58 ;nro h 6 �y 0 3 7110 yOq�n TAX MAP NUMBER ld .Sp. 1V ,A• O ' �� � 5p0510E11cE•/ / � by A�L 1000-117-03-012 P, NE 40' g AREA = 1,118,78 SF VEC RP o R4C OR l ROiMBEn c"oo1110 5. F S 16'26'10" ,W 100 00' 0.025 ACRES 6UARANIEE9INOIWIEO NLPr N SNAIL RNn ry 74• 0,12' W 5763930 FOUND N/F GIVEN O HEDGES_ PIPE ONLY NO TONE PERSON FON INDIA, MF SURVEY � N 83• \ IJ IS E CULEO• ANO N HIS ETIIALF IO ME �pry DUE CCAI STOU,L . I LISIO, ERM. C.15T 0 CIA '37'40"W FO -� . N B332'00' C-�-� _ �- \ 1L LENDING INSONTON, IF b5R0 NEPFN. ANO .1ST 69 ON (INF CM 10 �" N' _ 151.0 cunnnx¢Fs nni Nor mnti TRneLF roDO N a+ 218.80' Eo 6' RIG OF "—?— _ $ &-u5� 0(j0 \ \'\ APPROX. 0� AOUIRONAL INSPNPNS OR..WIN,OMIJ£R5. CM S 83.32'00"E WAY 1{RUB_ 3 E 1 '\N\J\s TOP DF BLUFF 153.68' N 78'39 ;taw o h(1] SURVEY 15 UALAUTIMA MAnPONR Of SECTION LIN OR ADDITION 2097 OF MIS ELECTRICAI ME NEW LOOKS XMUMnN LAW. TRANSFORMER >726` \'\ jJ 26 JO" ` "'0004 1'000 N/F KOEHLER 30 Lc 26424• \ \ �s> N 28'09'30"E o 9]• fEON 0 ,UO UINo surnlEsiins[nmFls[or.1 NNOALL �5. 8.12' woo Q OCk NOr ee eLWsrOEREU TO ee n vAMR rnuF \ \ �M o' DOPY P/PE \-\ v o L•,} FOONO -\ 2 q^m O}�eQJ 28 .66 Nor z6 y Q�ro (Ji 2z.f3 07 V� V P L I SURVEY OF DESCRIBED PROPERTIES IN NEW SUFFOLK, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. TAX MAP DESIGNATION AS SHOWN SURVEYED FOR: ANNE MARINO BERNARD TELSEY SURVEYED: 10 OCTOBER 2002 SCALE 1"= 50' AREA = AS SHOWN SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NEW SUFFOLK. N.Y. 11956 631- 34-5835 GUARANTEED T0: ANNE MARINO BERNARD TELSEY FIDELITY NATIONAL TITLE INS. CO. ��_- __rO2R CITIMORTGACE, INC. CENSE '("'JSURVNYS Lic. o. 4927382 „ Y u,M ►Ftc� �I U .. cal > I ' nu coy e ' E ppP HED AS NOTED MEET THE R 03 02%3 i� ���{^� rAiE. T B.P.L _ I �'iI "L f"+� DES ,,,Mnu DATE' f o , .. '' r . SY SEE: � ` ” r Ll+3'. I2Dr� } M I{A} '. NOTIFY BU4[NNG"DEPARTMENT-AT 1' IG4F'rE • - 765-7�tl2. A11M1, To ',JPM FOR�TRE+ 7 _ �� ; - � � '• , FoLLOWINGr1N9PECTION6 i _ t- Fp_UNDATION� TWO REGUIREO .� FOR POURED-CONCRETE �2. RQUGH�-FRAMING i PLUMBING k IO F C�hI�Jf I'>Ja a l wt SNA(MI)lE3" ; N PuW s INSULATION 4'GINA,L CONSTRUCTION MUST_ F CE54G+tL L? TO Ntll` " 'C4 L£riD- r.:Fck,S,0, L, NiT]R TE FCR RA 'ALL CONSTRUCTION 6HALL MEEI•TH " H .a = 4.Pon ,i,o t�v— l'im a �'�MILE:WT fAI_ � � � � REQUIREMENTS OFTNE CODES OF NE NS184E F0, , NOT R ESPO YOR ..STATE. K . I CJNCOMM ''�,. 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