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HomeMy WebLinkAbout30100-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspecnor Town Hall Soutbold, N.Y. CERTIFICATE OF OCCUP~kNCY No: Z-30158 Date: 04/30/04 THIS CERTIFIES t~t the building ALTERATION Location of Property: 6865 BRIDGE LA HOUSE NO. Co~ty Ta~ 5~ap No. 472889 Section 84 Sutxi~vision Filed Map No. CUTCHOGUE (STREET Block 1 (HAMLET) Lot 6.7 Lot conforms substantially no the Application for Building Permit heretofore filed in this office dated FEBRUARY 19, 2004 pursuant to which Building Permit To. 30100-Z dated FEBRUARY 23. 2004 was issued, and conforms no all of the requirements of the applicable provlszons of the law. The occupancy for which this certificate is issued is "AS BUILT" GAPJkGE CONVERSION TO LIVING SPACE IN AN EXITING ONE FAMILY DWELLING AS APPLIED FOR CONSTRUCTION CERTIFIED BY MARK K SCHWARTZ. AIA. The certificate is issued to PETER G & DIANE G KARPOICH ,DWNER} of the aforesaid building. S~FOLK CO~ DEPAR~qT OF ~t~%LTH ~_PFROVAL N/A ELECTRICAL CERTIFICATE NO. 1196478 03/02/04 PLUMBERS CERTIFICATION DATED N/A 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. 30100 Z Date FEBRUARY 23, 2004 Permission is hereby granned to: PETER G KARPOICE CUTCHOGUE,NY 11935 for : AS BUILT ALTE~LATIONS GARAGE CONYERSION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premmses located at 6865 BRIDGE LA CUTCHOGUE County Tax Map No. 473889 Section 084 Block 0001 Lot No. ]06.}07 pursuant to application dated FEBRUARY 19, 2004 and approved by the Building Fee $ Inspector to expire on AUGUST 300.00 23, 2005. S ature ORIGENAL Rev. 5/8/02 Form No. 6 I'OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 7654802 APPLICATION FOR CERTIF][CATE OF OCCUPANCY Tkis application must be filled in by typewriter or irkk and submitted to the Building Depa~a~With~the foltow;~ng: A. For new bu~kgng or new use: i. Final survey of proper;y with accurate Iocation of all buildings, property lines, streets, and unusual natural or topographic features. 2. FinaI Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electr/cal installation from Board of Fire Underwr/ters. 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. Subrrfit Planning Board Approval of completed site plan requirements. For eyAst[ng buildings (prior to April 9, 1957) non-conforming uses, or bui~d~ngs and "pre-e:fisting" [and uses: 1. Accurate survey of property showing all property iines, streets, building and unusuai natural ur topographin features. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building knspector shall state the reasons therefor in writing to the applicant. Fees I. Certificate of Occupancy - New dwelling $25.00. Additions to dwelling $25.00. Alterations to dwelling $25~ ~0. 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 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.013. Commercial $15.00 New Construction: Old or Pre-existing Building: Location of Property: (~ ~ ~¢~-' ~P~e~e~ ~ House No. Stre& Owner or Owners of Property: ~?-~f ~ ~ e ~C ~ Suffo~ Co~ty T~ Map No 1000, Section O~¢ Date. (check one) Perm/t No. ~ ~ k D~ Date of Health D~t. Approval: Plying Bo~d Approval: ~] ~ ~nlet Request for: Temporary Certificate Fee Submitted: $ Block ~[ Lot Flied Map. Lot: Underwriters Approval: Final Certificate: (check one~ P.O. Box 933 Cutckogue, New York 11935 April 23, 2004 $outhold Town Building Departme i Main Road Southold, NewYork 11971 Re.' Karpoich House 6865 Bridge Lane Cutchogue, New York Bldg Permit # 30100 & 30217 Phone: (631) 734-4185 Fax: (631) 734 -4185 To Whom Tlds May Concern: have reviewed the garage conversion and the pool area deck. To the best of my knowledge, I certify these areas have been constructed as per code requirements when bulk in 2002. Please cat1 this office if you have any questions or require additional informatiov~ Very hxtly yours, BY TH~S CERTiFiCAtE OF COmPLiANCE THE YORK BOARD OF F RE UNDERWRITERS figURE:AU OF ELECTRiCiTY 40 FULTON StREEt - NEW YORK, NY ~0038 CERTIFIES tHAt Upon the application of upon premises owned by PETER KARPOICH 6865 BRIDGE LANE CUTCHOGUE. NY 11935 Located at App~icat~em Nember. 1196478 Section: 84 Block: 1 Described as a Residential PETER KARPOICH 6865 BRIDGE LANE CUTCHOGUE, NY 11935 6865 BRIDGE LANE CUTCHOGUE NY 11935 Certificate h~umber: 1196478 Lot: 6.7 Building Permit: BBC: ns1 ' occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the pram,sas at: First Floor. was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 2nd Day of March, 2004. Name QTY Rate RatLng Circuit Type Miscellaneous XFEAR BUILT 2003 NEC CODE YEAR 1999 GARAGE CONVERTED TO LIV1NG SPACE Wiring and Devices Recc~ptacle 5 0 General Pm~pose Switch 1 0 General Purpose Fixture 6 0 Incandescent A visual inspecuon, of the delineated electrical installation, determined that an obvious hazard is not present and the installationis believed to be in comformmnce with the applicable reference stmndard for the estimated period of construction of the premises winng system. scsi 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location ir dicated pARK ~ pLAYGROUNP 536.66'/ riv~rhs~d, n~w york (516) 569-IZi7 MAY 15, 1985 dOB N 1000-084-0l~05.7 SCAEE: APPROVED AS NOTED 765-1802 8AM TO 4PM FOR THE FOLLOWING ~NSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGF~ - FRA~NG & PLU~BNG 3. ~NSULAT~ON 4. RNAL - CONST~UCTION BE COMPLETE FO~ C.O. ALL CONSTRUCTION SHALL ~E~ THE REQUIREMENTS OF THE CODES OF N~ YORK STATE. NOT RESPONS~BLE~m DESIGN OR CONSTRUCTION ER~ 1000-054~01-0B.7 Dss ~reCscs I Tenco - mod. PS24R; = COMPLY WITH ALL C~Ow'~zS OF NEW YORK STATE & TOWN CODES AS ~R=D AND ~OND , IONS OF SOU?r/OLD TOWN ZBA T F~OO;: 2×12 - 12"dC 3/4" Subf]O0~ finished wood 17'5 r13 insulstion e×istin9 Structure r30 sheetrock USE IS UNLAWFUL A --r ~ iI · FI[~LD LN'SPECTION RE?ORT FOUNDATION (~.ST) FOLrNDATION (2ND) ROUGt~I FRAiVI~G & PLU'Nr_BI2~G 12~SULATION ~IER N. Y. I~E~AL DATE COMMENTS ADDITIONAL COM/VIENTS TOWN @? SOUTtlOLD BUILDING DEPARTMEi~ TOWN HALL $@UT~©LD. NY 11971 TEL: (6311} FAX: ¢31) 7~-95~2 www. northfork, net/Southo~d/ PERMIT NO. Exam/ned ,20 Disapproved a/c ~ ,~r~,~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: ~w~ Mail to: ?hone: A~?LICATION ]FOR BUILDING PEPJVI1T Date INSTRUCTIONS ,20 Oq a. This application MUST be corapletely filled in by rypewrker 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 parr 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 with/n 12 months aRer 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 ?ermit 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 bulldings, 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 adm/t authorized inspectors on premises and in building for necessary inspections. X~)2/ (S~gnamre of a~pl{cant or name, if a corpomtmn) c~la/~I/ng addre~s%f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofpremises ~c{-~' ~& F~ ~_a~e-k (As on the tax roll or latest deed) If applicant is a corporafion~ signature of duly authorized officer (Name and title of corporate officei;) Builders License No. Ptumbers License No, Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street' ' County Tax Map No. 1000 Section Of~q Block 6! Subdivision ~ tr lar~_'4- ~l r't~ Filed Map No. Lot 00,7 Lot 7 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction~ a. Existing use and occupancy_ ~m~e ~,g~ ~[~ b. int~ded ~e ~d oceup~cy ~. 3. Na~e of work (check w~ch applicable): New B~lffmg R~ov~ D~oHfion 4. Es~at~ Cost ~,, ~Oo 5. If dwelling, nmber of dwelt~ng ~B [ ~f ~ara~e, number of cars Add/fion Other Work Fee ¢~dO ~ Alteration_ ~ (Description) (To be paid on filing this application) Number of dwelling lmits on each floor/ If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Height_ Number of Stodes Dimensions of same structure with aRerations or additions: Front Depth. Depth Rear Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front Rear Rear Depth Depth 10. Date of Purchase /J/;¢¢{¢ Name of Former Owner Zone or use d~shSet in wkich premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulations. YES NO ~ i3. Will tot bere-graded7 YES NO ~ Will excess filI be removed from premises? YES NO 14. NamesofOwnerofpremises~e~t~(~O~e~ Address ~o4~.~ PhoneNo.~t-q/~6 Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a fi:eshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES & D,E.C. PERMITS MAY BE REQUIRED. b. Is th'is property within 300 feet of a tidal wetland? * YES NO ~ * IF YES. D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foandation 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 SS: COU2qTY OF ) ~,~ t ~- ~ ~-'~O~ t being duly sworn, deposes and says that (s)he is the applicanl (Name of individual signing contract) above named, (S)He is the &~ ~ (Contractor. Agc~nt, Co,orate 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 ali statmnents comained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~ forth/n the application filed therewith. Sworn to before me this ~ No~ ~ublic Si~ture of Applicaht