HomeMy WebLinkAbout30651-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30527 Date: 11/04/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 510 LAKE DR SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 80 Block 4 Lot 24
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 20, 2004 pursuant to which
Building Permit No. 30651-Z dated SEPTEMBER 21, 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 ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to EDMUND H & JOAN PRESSLER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 2024490 09/23/04
PLUMBERS CERTIFICATION DATED N/A
Au riz d 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. 30651 Z Date SEPTEMBER 21, 2004
Permission is hereby granted to:
EDMUND H & JOAN PRESSLER
650 GROVE DRIVE
SOUTHOLD,NY 11971
for
CONSTRUCTION OF ACCESSORY GARAGE AS APPLIED FOR. (THIS REPLACES
BP #26994Z)
at premises located at 510 LAKE DR SOUTHOLD
County Tax Map No. 473889 Section 080 Block 0004 Lot No. 024
pursuant to application dated SEPTEMBER 20, 2004 and approved by the
Building Inspector to expire on MARCH 21, 2006 .
Fee $ 112 .20
tho d Signature
ORIGINAL
Rev. 5/8/02
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. 26994 Z Date DECEMBER 29, 2000
Permission is hereby granted to:
EDMOND & JOAN PRESSLER
650 GROVE DRIVE
SOUTHOLD,NY 11971
for
ACCESSORY GARAGE AS APPLIED FOR.
at premises located at 510 LAKE DR SOUTHOLD
County Tax Map No. 473889 Section 080 Block 0004 Lot No. 024
pursuant to application dated OCTOBER 25, 2000 and approved by the
Building Inspector.
Fee $ 59 . 80
LVA(
/ Autho iz d Signature
/ l
ORIGINAL
Rev. 2/19/98
Form No.6
TOWN OF SOUTHOLD
BUILDING 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.
-. 5\1'viu Sial.c;itt:;:l i1 Ji1113ii.:i:ii ,i"Ci;tlij llib:lai�.i:; SOIU(:1 USii iii SjS1�i11 CCi.lt'.illi�+ i'S5 Miall <�;lU 01 1i'u ll'ii;i.
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 �f Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Update.l Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00,Commercial$15.00
Date. ��i 2 2 OD
v
New Construction: Old or Pre-existing Building: (check one)
Location of Property: -2 �y - L-�)
House No.��•—��, lSStree`t� Hamlet
Owner or Owners of Property: 44 u.V 11
Suffolk County Tax Map No 1000, Section `/73 06 f Block &9 00 Lot 2 2 Y'
Subdivision /4/# Filed Map. Lot:
Permit No. :Z 99el —Date of Permit. /Z 2 9 6Applicant:
Health Dept. Approval: k/l Underwriters Approval:
Planning Board Approval: Alfa
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
c . G ?1e3
III ,3n�����nr�n�n�n���.r��������n�n�n��nr����n��.r�n���.r�Rn21 P 2�Qn�.n�n��nr.r�n��������n�n��ren co
5 BY THIS CERTIFICATE OF COMPLIANCE THE S
S NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 5
5 BUREAU OF ELECTRICITY
S
5 40 FULTON STREET — NEW YORK, NY 10038 c�
5 CERTIFIES THAT 5
5 5
5 Upon the application of upon premises owned by
5 5
5 EDMUND PRESSLER EDMUND PRESSLER
5�j 510 LAKE DRIVE 510 LAKE DRIVE 5
SOUTHOLD, NY 11971 SOUTHOLD, NY 11971 5
5 5
SLocated at 510 LAKE DRIVE SOUTHOLD, NY 11971 c�
5 Application Number: 2024490 Certificate Number: 2024490 S
5 S
SSection: Block: Lot: Building Permit: SEE PG.8 BDC: ns11 S
5 5 Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at: S
First Floor, Second Floor,Detached Garage,Outside,
5 5
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
Sherein, was conducted in accordance with the requirements of the applicable code and/or standard
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5
5 authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of September,2004.
5 Name QTY Rate Rating Circuit Type
Miscellaneous
SS as built 2002 5
Panels LSA
5 1 30 2 S
5 Wiring and Devices 5
Outlet 4 0 Fixture
5 Fixture 2 0 Incandescent 5
5 Fixture 2 0 Flourescent
5 5 Outlet 13 0 General Purpose 5
Receptacle 9 0 General Purpose
SSwitch 6 0 General Purpose 5
5 Receptacle 1 0 GFCI 5
SAn as built inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation ir>believed to Lj
5 be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5
5 5
5 seal
S 5
S 1 of 1 c5
LPffiffifflE.
ertificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.rJrrrJ�r�cJ�rJ��ncJ��.rrrcnr nr up a
Edmund Pressler -
i'
Grove Dr.
Southold,NY 11971
IIII _
_ f
APPRO ED S NOTES
()ATE: uQ .P. #— — t } x r
/r Q�
v
FEE: `� r lEy:
_ NOTIFY BUILC3i�1G, D RTia���P�I P.1
/ 4
�,
. �3L!-C1�9f��iC'a 04V�PEGTiC'D".`_. F� 1
765-1802 9 AM TO 4 Pik F'� E.
F ._
FOR POURED�,ON ��T E —
Y 21. ROUGH , FRAMING• tq&
Zo
o .. ('r : �g 3:
l
_ ram
I
{ Y
�ri -
��®II
t
ISN i uc
IF
t' r.
i
ifa ?;
UR#ze
3 8
jj
/ M
C�
,
lr
T RoF . 8
o
v4Nl--�(Z...f✓ S�L C ScnL
-7 E'Rn-%/rc -s141643-
2- CGA 2X41 5/� L
i
`'"
i f x B _mac . T�N,r /il w.4 t
at -- -
i � I
1
4;�
T
{aI .
���'l � v6 -• /Bt�Cu-meg
r _
I
I
I ,
I
t I
r _
1
r I
I
,
-T
`-'
r
I ,
E
,
, t �
J r
t
t
E
' h1-
i
I
-
'No
44
j I Eft
I l �OYttaAM-
9
i
r
{ t
I T
d l r -Y xd r , 8—
I � .
—
�
COX
iV
— 4,;., '
y
I I M
, a7T
(( i
• Y
H
^ FP
I J
Z
x
-- - - -m IH_] 1-
- - - t --- -
f
;1-1111
-., —_ - --_ - --
•s.
,65.1SOZ
BUILDING DEPT.
INSPECTION
[ ,"] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ) FRAMING [ j FINAL
[ ] FIREPLACE & CHIMNEY
7RE7RK5:�4�''�w
zo;u� Z�? Z'
Zaja 12,c9 Q
)v7/
PATE -`� D INSPECT
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE $rCNIMNEY
REMARK
PATE � �/ � INSPECTO
765.1802
BUILDING DEPT. i
INSPECTION
[ ] FOUNDATION 7ST [ ] ROUGH PLBG. i
[ ] FOUNDATION 2ND [ J INS lON
[ ] FRAMING [,o, FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
fie
DATE � � INSPECTOR
v
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 U
[ ] FRAMING [ FIN�CL 1�
[ ] FIREPLACE & CHIMNEY [ J FIRE SAFETY INSPECTION
REMARKS:
DATE �� � � INSPECTOR
W
FIELD INSPECTION REPORT DATE COMMENTS
-------------- -----------------=a=
II II H
rr—�-
FOUNDATION ( IS ) ° ° c.. ►
FOUNDATION (2ND)---___II_ u
______________ ____ _--_ ___-_____
_ _---- -- _---- __ t�
-----__ - -- ----
u
r
ROUGH FRAME &
PLUMBING 11 ii
-II
II�11
INSULATION PER N. Y. `- -i� y
STATE ENERGY
CODE u ii
ii
uil
u
G S
FINAL
ADDITIONAL COMMENTS:
________
/p ✓��� h
a ,
9.1w
H
O
z
ro
H
OCT 25 BOARD OF HEALTH . . . . . .. . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . .. . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . ... . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . ... .. . . . . .
SOUTHOLD, N.Y. 11971 DEC . . . . . .. . . . . . ........ . .
TEL: 765-1802 TRUSTEES . . . . . . . . . . . . ...... . . . .
NOTIFY:
CALL . . . . . . . . . . . . . . . .. .
Examined...... ........, 29.... MAIL T0:
Approved...1 �2c1..i., �.� Permit No. .��?��#-Z- ..........•..........................
Disapproveda/c .......................... ....................................
.................................... .. ..........
......�. .. ....�.......
(Buildi• I• tor)
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . 2G. . . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector vii
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 giving a detailed description of layout of property mist be drawn on the diagram which is part of
this application.
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
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 whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATI(N IS HEREBY MALE 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, or name, if a corporation)
...................................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluiber or builder
........................................................................................................................
Name of owner of premises ....; !�M y!tJ.'�.. .TD!4N.. fT�SsL E?Z............................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................NA...........................
(Nam 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.......i?e s..l�ON.5, 5...............................
G5'0 Cid V6 bp/va,
.......................................................................................................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...80........ Block .... ......... Lot ...Z.�/ .......
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Nam)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .........f��i�� ..............................
....................................
CV q R 61.6.
b. Intended use and occupancy ........ ..................................
..................................
3. Nature of work (check which applicable):PP ): New Building .......... Addition
Repair ............ Reuoval ............. Demolition ............ Other Work•- �l i_. Alteration 4'.h
... i� ��:............ (Description)
4. Estimated Cost 1- fee ...........................................
7 .,
(to be paid on filing this application) .
S• If dwelling, number of dwelling ,/�/
units .... .61.. Uxtiber of dwelling units on each floor . 4y
�^ ..
....l.u'',�Q�z�..................... ... ......
If garage, number of cars
b. If business, commercial or mixed occupancy, specify nature and extent of each type of use....N,4
7. Dimensions of existing structures, if any: F`ront..../�I„`/N 8... ... ..
Rear Depth /
Height ...A........... .... Number of Stories •0?1 C(.1).. �- ..........
Dimensions of same structure with alterations or additions: Front.• (r, •.--.. ,2
Depth .. ... /
P .Z.?E�--......... height ..../.9•�......... Rear �.........
Number of Stories
8. Dimensions of entire •� G/............
new construction: hoot .. !
........ Rear ...2 Depth
Height ....�./. . ' Number of Stories ....OA) �/,. ....
9. Size of lot: Front ..���',. .�. /.?Y,, 131 . .....
Pt
�+ .... Rear ... Depth ....7, /Q
10. Date of Purdhase ....�P7.d2g ..:.....
Kane of Former Owner .�4S,l?,
11. Zone or use district in which premises are situated ......!�o:y View -.... .
12. Does Proposed construction ` excess fill be violate any zoning law, ordinance or regulation:•./VO.......................... ... ..
13. Will lot be regraded .....lK O.......... Will ..................
l removed from premises: YES NO
14. Names of Owner of premises Address �..
h
. _. ��. .... phone No.
Nave of Ardnitect .................................... Address ....
Phone No.
Nave of Contractor .............................. .. Address ..... ......... .............
IS. is this ..............Phone No. .............
Property within 300 feet of a tidal wetland? * YESNO
QA
*IF YES, SIl<HD MM TRIMS M TI' MAY BE R!QMRm........... ....
PLOT DIAGRAM
I,ocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
frau property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
XMIT OFyL i 1 SS
........being duly sworn, deposes and says that he is the licant
Name of indivi 1 signing contract) PP
'bove named,
e is the ....... ....... .1�
(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
pplication; that all statements contained in this application are true to the best of his knowledge and belief; and
hat the work will be performed in the manmer set forth in the application filed therewith.
wo.r.n.,t.o{� oeme this
.... -.
.20G� .
Notary �
....
s
CLAIRE L GLEW (Signature o Applicant •....•••
Notary Public.State of New York
No.01GL4879505
Qualified in Suffolk '?Y
Commission Expires Dec.8,,
>00
3p.
L ; ° C�
c� gp bio- �L
3010, TJ e r .rd
pr
�r L
Ae- ej. ' ; I
SURVEY OF PROPERTY tie ��� y ,�
AT SOUTHOLD o o 9
TOWN OF SOUTHOLD
P
SUFFOLK COUNTY, NY
1000 - 80 - 04 - 24. � = P ! � ao� � ���
SCALE 1" - 30'
A UG. 28, 2003
O p n; 0~
Q O 0, NOTES' LOT NUMBERS REFER TO "MAP OF REYDON
_ SHORES' FLED IN THE SUFFOLK COUNTY
CLERK'S OFFICE ON JUL Y 2, 1931 AS MAP NO. 63t
� INSUFFICIENT DATA SHOWN ON FILED MAP
TO DETERMINE RADII AND LENGTHS OF CURVES
0�
tiP L,•
NTo.36go+ �4 5/ jti
l 'V41 9,6G
Ol" ,
s
/ 9
• qF NEW Y
F
_ 0 . 0
AREA - 11,528 sq. ft. to chords
ANY AL TERA TION OR ADDITION TO THIS SURVEY /S A VIOLATION
OF SEC-,ICN 7209 OF THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS FE,4 SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY /F / < ►�'
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR �V. IC. NO, 49618
WHOSE SIGNA TURF APPEARS HEREON.
6N .
ADDITIONALLY TO COMPLY WITH SAID LAW TERM " ALTERE,: 9Y ECON/ C.
MUS' 9F USED 5Y ANY ANC ALL SURVEYCRS L'T'LIZING A COPY !631; 765 - 16311 765 - 1797
OF ANOTHER SU'RVEYOR'S MAP. TERMS SUCH " INSPECTED " AND P. O. BOX 909
BRCUGHT - TO - DATE " ARE NOT /N COMPLIANCE WITH THE LAW. 12,30 TRAVELER STREET
SOUTHOLD, N.Y. 11971
nn n n r