HomeMy WebLinkAbout30233-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30187 Date: 05/11/04
THIS CERTIFIES that the building ALTERATON
Location of Property: 325 FOUR WINDS CT SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 6 Lot 13 .33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 2004 pursuant to which
Building Permit No. 30233-Z dated APRIL 12, 2004
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 ALTERATION OF UNFINISHED ATTIC SPACE OVER GARAGE FOR NON-SLEEPING
HEATED REC/STORAGE ROOM AS APPLIED FOR "AS BUILT" .
The certificate is issued to ANTHONY & HEDY LAVIOLA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2000041 05/06/04
PLUMBERS CERTIFICATION DATED N/A
W
Authorized Si ature
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. 30233 Z Date APRIL 12 , 2004
Permission is hereby granted to:
ANTHONY & HEDY LAVIOLA
325 FOUR WINDS CT
SOUTHOLD,NY 11971
for
AS BUILT ATTIC ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR. ADDITIONAL CERTIFICATION WILL BE REQUIRED.
at premises located at 325 FOUR WINDS CT SOUTHOLD
County Tax Map No. 473889 Section 088 Block 0006 Lot No. 013 . 033
pursuant to application dated APRIL 9, 2004 and approved by the
Building Inspector to expire on OCTOBER � _I 20
Fee $ 300 . 00
/
�Yu
thorized Signature
ORIGINAL
Rev. 5/8/02
' Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 �1Y
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 I% 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. Certi,f tate 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
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 3 �5 r7pL4(�' W 1/4dj G / 1w /I``�
House No. Street
/ Ha nl�
Owner or Owners of Property: !"�'�`� � ���y 1 4l�//y L/�
Suffolk County Tax Map No 1000, Section Block d d U 45" Lot
Subdivision d A1C.Vl 4(j,e es Filed Map. Lot: 2
Permit No. 3a. �`7 Date of Permit. L t' Applicant: )A/jj,,1,4 f )41141
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: l/ (check one)
Fee Submitted: $ S7. U
r GDf_ Applic t Si ature
Q_13 ? 301 ��
un
5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS S
S S
SBUREAU OF ELECTRICITY 5
5 40 FULTON STREET — NEW YORK, NY 10038
SCERTIFIES THAT 5
5 S
5 Upon the application of upon premises owned by S
5 c5
SANTHONY LAVIOLA ANTHONY LAVIOLA 5
5 325 FOUR WINDS CT 325 FOUR WINDS CT
SSOUTHOLD, NY 11971 SOUTHOLD, NY 11971 5
5 Located at 325 FOUR WINDS CT SOUTHOLD, NY 11971 S
5 5Application Number: 2000041 Certificate Number: 2000041 5
cS
5 5 Section: Block: Lot: Building Permit: 5
302332 BDC: nsl1
5 Described as a occupancy, wherein the premises electrical system consisting of 5
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 Second Floor, 5
5 5
5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
5 authority having jurisdiction, and found to be in compliance therewith on the 6th Day of 5 May,2004.
QTY Name Rate Ratinr� Circuit Twe
5
5 5 Miscellaneous 5
as built 2003 5
5 boxes opened for inspection 5
5 Alarm and Emergency Equipment
5 Sensor 1 0 Smoke
5 Wiring and Devices 5
5 Receptacle 10 0 General Purpose 5
5 Switch 1 0 General Purpose 5
5 Fixture 6 0 Incandescent ,CD]
SAn as built visual inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the instailabon is
5 believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wii in&system. 5
S 5
5 5
5 5S
5 seal 5
5 S
5 1 of 1 5
S S
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
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Basement
Ext. Walls
r
• I , f �� ••
FirePlace
Woodstove
i Dormer
-� sL,•1
11.53 TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET -.32 VILLAGE DIST. SUB. LOT 3
( d rp .5 .
ACR. I �3 REMARKS f }
TYPE OF BLD.
Lhana p3
(T1e ^dof
PROP. CLASS
QC1 Ia ! OGtC lS 3 -t d z. 2-7,?-33 IVe,W -` A17
LAND IMP. TOTAL DATE
Z+lS kpo 7,775 -
� ---
E o Z 3 1 ZQ
13 Itc
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
1
WRVEY OF LOT #31
'MAP OF ANGEL 5HORES" N
FILED 8-23-85 AS #g72a
SITUATEb BAYVIEH W E
TOWN, SOLM40LD 2�t 3 ' ;-5 IG <2
SUFFOLK COUNTY, NY
5URVEYED 04-20-00 Icnt•w,qi
FOUNDATION 02-19-02
FINAL Oq-23-02
SUFFOLK COUNTY TAX LOTp
1000-bb-b- 13.33
GERTIFIED TO:
Anthony L&Aola
Hedy LaVlolo
Peconw Abstract Inc.
toto�<a
V
C�/I
� F
0-1
115
Lot#31 CQ
3s.
a,
YV• � _ 11 � NT _ _ _ .J
•� _ � -Id yy,TER RVI '
381'S9'�°
Lot#33
NOTES: F�bANo SVP .........« ....-......,.- ....
STAKE
AREA - 3073 SF OR 0.13 ACRES
JOHN C. EHLERS LAND SURVEYOR«
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC SCALE I"= 40'_ RIVMUMAD,N.Y.11901
369-8288 Fax 369-8287 MP wrvft%M0S120-137D.pro
BUILDING PERMIT EXAMINER CHECKLIST
DATE REVIEWED: // /L194
APPLICANT: DATE SUBMITTED:-417�/04
SCTM# DISTRICT: 1,000, SECTION: iT , BLO K: , LOT: /?l3 SUBDIVISION:
K/:
ADDRESS: ` '-" �/ . CITY: ZONING DISTRICT: r. CONFORMING'?
BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N
BP -Z/ C/0 Z- , INFO /BP -Z/C/0 Z- , INFO
BP -Z/ C/0 Z- , INFO T� /BP -Z/C/0 Z- , INFO
SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,19831,,UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83
REQ. LOT SIZE: ACT. LOTS REQ. LOT COV. ACT. LOT COV.
REQ. FRONT PROP. F NT REQ SIDE ACT. SIDE
REQ. REAR PRO . REAR REQ. HEIGHT PROP. HEIGHT
PROJECT DESCRIPTION:
ESTIMATED PROJECT COST: ARCHITECT/ENGINEER:
WATER FRONT? DESCRIPTION: PANEL # FLOOD ZONE:
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE: / / PERMIT #:
TOWN SEPTIC RECEIPT: Y or N
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or NO DTE: / / PERMIT #:
SOUTHOLD TOWN TRUSTEFS: YES or NO DTE: / / PERMIT #:
TOWN ZONING BOARD APPROVAL: YES or NO DTE: / / PERMIT #:
TOWN PLAN. BOARD APTROVAL: YES or NO DTE / / PERMIT #:
TOWN HISTORICAL PRE (SPLIA): YES or NO
NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO
NOTES: 7 `eer 4, "-� ,
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
1. ( SF)- ( SF)= SF X $ _$ +$ +$ _ $
2. ( SF)- ( SF)= SFX $ _$ +$ +$ _ $
3. ( SF)- ( SF)= SF X $ _$ +$ +$ _ $
FINAL TOTAL: $ ?-0`'
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC DESIGN CRITERIA:
Ground Snow Load: 45 Wind Speed: 120MPH Seismic Design Category: B
Weathering: Severe Frost Depth: 36" Termite: M-H Decay: S-M
Design Temp: 11 Ice Shield Underlay: YES Flood Hazards:
USE/OCCUPANCY CLASSIFICATION:
HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE
FULL FRAMING DESIGN ELEMENTS: Y/N
HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N
CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N
LUMBER SPECIES AND GRADE:Y/N
DESIGN LOAD CALCULATIONS: Y/N
LIVE: Y/N DE*D: Y/N SNOW: Y/N SEISMIC: Y/N WIND: Y/N
WINDOW ANDDOOR SCHEDULE:
MISSMYEST REQUIREMENTS: Y/N f
EGRESS 5.7 S.F.: Y/N
LIGHT 8%: Y/N
VENT 4%: Y/N
NAILING/CONSTRUCTION SCHEDULE: Y/N
MEANS OF EGRESS: Y/N
PLUMBING RISER DIAGRAM: Y/N
LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N
TRUSS DESIGN: Y/N
CERTIFICATION: Y/N
ENERGY CALCS: Y/N
TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE)
:�O6� 33
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU TION
[ ] FRAMING AL
[ ] FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS• j
(�21 12
L !��Xoo J-J�2�
DATE -V-/3 INSPECTO
c
r
INSPECTION REPORT DATE COMMENTSOUNDATION(1ST) _ — W
-----------------------------------
FOUNDATION(2ND)
� z
ROUGH FRAMING&
PLUMBING
H
INSULATION PER N.Y. r
STATE ENERGY CODE
CalFINAL a�
ADDITIONAL COMMENTS o
C
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. _�0�2 3 5� �Check
Septic Form
N.Y.S.D.E.C.
� Trustees
Examined � /Z ,20� Contact:
Approved z ,20__�
Mail to: 3.)Y 60012 1(//.VO e
---�Disapproved a/c SvU Tl► vy /`/v
Phone: 6 3 i— 7 65- ds-9 /
Expiration ,20
Building 4Kspector
APPLICATION FOR BUILDING PERMIT
Date , 20
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. lz��
w
(Signature appl cant or name,if a corporation)
Sas )r0u r2l,U,vvdsC� s�L,7�ol�I A./y //9)C
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises �Q X/ nc �i-Z L/g( /O /fq
(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:
3 J S_ Fo(4 2 162iAO S G7'
House Number Street Hamlet
County Tax Map No. 1000 Section 0 D • 0 d Block 0( , 00 Lot 0/ 3 , 033
Subdivision Filed Map No. Lot
(Name)
r
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:,
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration V/
Repair Removal Demolition Other Work S
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units J 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 _
Height Number of Stories
9. Size of lot: Front Rear 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? YES NO ✓
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
/rn�i7wy-` (,r'►I/toL� 3.2,S- Fo144 &iNOf C7`
14. Names of Owner of premises,#,o�r/hi Lo✓a Lu Address .5a,L1,,/,j 4V Phone No. 7d5 d ry f
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland o ,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 I
* 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)
SS:
COUNTY OF fV a 954
X111 all �/1�y L/¢ being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is theC-- 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.
Sworn to before me this
I day ofl4lv1 C 11 200 q
otary Public Signature of Applicant
1
WRVEY OF LOT #31
'MAP OF AN6FL 5HORES" N
FILED 8-23-a5 A5 #11I'T24
SITUATE, BAWEK w e
TOWN SOUTHOLD
SUFFOLK COUNTY, NY
SURVEYED 04-20-00 h"I�c t y i r.�iLA I•i,j iS
FOUNDATION 02-19-02
FINAL 09-23-02
SUFFOLK COUNTY TAX LOT+I
1000-88-6- 13.3'3
CERTIFIED TO:
Anthony LoVlolo
Hedy LaViolo
PecoMG Abstract Inc.
tot
s8
1,ot#31 CQ
10
lba
qT—_`. . 'fir^O•
R w - 138.81'
S81°59'��
Lot#33
NOTES. SF0IANo SSP ..«..«....::...«.:....:.. . ,
STAKE
AREA =3013 5F OR 013 ACRES
JOHN C. EHLERS LAND SURVEYORw
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC SCALE 1"= 40' _ RIVERHEAD,N.Y.11901
369-8288 Fu 369-8287 \\Hp smva' ft0S\20-137D.pro
>ivozAl Vo,� OF�IGC Yo -s-N - rz�ez �� S��Hz1�
z.T-a2 z rN4o� r l ao rd2
UNDERWRITERS CERTIFICATE yf51dC� AA v *y
REQUIRED fl rsA os at -oaf
APPR VED AS NOT9ED ` "'" s�
DATE: `��' B.P.4 34
FEE:
7fi T78B2B81AMNTO U4 PM FOR THET OCCUPANCY OR
FOLLOWING INSPECTIONS: USE IS UNLAWFUL
1. FOUNDATION - TWO REQUIRED J
FOR POURED CONCRETE WITHOUT CERTIFICATE
2. ROUGH - FRAMING & PLUMBING OF OCCUPANCY
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPILE FE FOR CO
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEWD����
YORK STATE. NOT RESPONSIBLE FOR
vl
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF I I --
--
SOUTHOLD TOWN ZBA - -
SOLTHOLDTOWNPLANNINGWAAD -
SOUTHOLDTOWN TRUSTEES
N.Y.S.DEC
INSuLt�Tto I
fl
FLOOD ZONE k ee wALL s; s
COMPLY WITH CHAPTER"46" _ _ -
DAMAGE PREVENTION
SOUTHOLD TOWN P`�
VENT 1xoR
WN CODE. . ?i3
LvL,
—IN 1SHEA
I
3.5 5H!'F CS 'AAGE . 'REA
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