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HomeMy WebLinkAbout29543-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30632 Date: 12/14/04 THIS CERTIFIES that the building ADDITION Location of Property: 875 WELLS RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 8 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 2, 2003 pursuant to which Building Permit No. 29543-Z dated JULY 2, 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 GARAGE ADDITION WITH NON-HABITABLE STORAGE SPACE ABOVE TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to EDWARD & SANDRA J MUNZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1084339 02/21/03 PLUMBERS CERTIFICATION DATED N/A 1"IlL - -/"�/' Itth ize Signature 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. 27458 Z Date JULY 9, 2001 Permission is hereby granted to: EDWARD & SANDRA J MUNZ FLORAL PARK,NY 11001 for NEW CONSTRUCTION OF A GARAGE ADDITION AND NON-HABITABLE STORAGE ABOVE GARAGE AS APPLIED FOR. at premises located at 875 WELLS RD LAUREL County Tax Map No. 473889 Section 126 Block 0008 Lot No. 022 pursuant to application dated MAY 25, 2001 and approved by the Building Inspector. Fee $ 246 . 90 Autho4edSignature COPY Rev. 2/19/98 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) F-�-dam._-L�'rC � �� `► PERMIT NO. 27458 Z Date JULY 9, 2001 Permission is hereby granted to: EDWARD & SANDRA J MUNZ FLORAL PARK,NY 11001 for NEW CONSTRUCTION OF A GARAGE ADDITION AND NON-HABITABLE STORAGE ABOVE GARAGE AS APPLIED FOR. at premises located at 875 WELLS RD LAUREL County Tax Map No. 473889 Section 126 Block 0008 Lot No. 022 pursuant to application dated MAY 25, 2001 and approved by the Building Inspector. Fee $ 246 . 90 i Authorized Signature ORIGINAL Rev. 2/19/98 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. 29543 Z Date JULY 2 , 2003 Permission is hereby granted to: EDWARD & SANDRA J MUNZ FLORAL PARK,NY 11001 for . NEW CONSTRUCTION OF A GARAGE ADDITION & NON-HABITABLE STORAGE ABOVE GARAGE AS APPLIED FOR. THIS PERMIT REPLACES 27458 . at premises located at 875 WELLS RD LAUREL County Tax Map No. 473889 Section 126 Block 0008 Lot No. 022 pursuant to application dated JULY 2 , 2003 and approved by the Building Inspector to expire on JANUARY 2 , 2005 . Fee $ 246 . 90 ed ature ORIGINAL Rev. 5/8/02 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. 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 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 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. l ec, $ 2-004 New Construction: p Old or Pre-existing Building: (check one) Location of Property: 81 S W eA 9 ad. N y House No. Street Hamlet Owner or Owners of Property: E d w av A d S a"dY n M uti 7- Suffolk Suffolk County Tax Map No 1000, Section I d 6 Block p Lot 0 Z Z Subdivision Filed Map. Lot: Permit No. 19 5 L{3 Z Date of Permit. 71'7101 Applicant: E,Au,1,3r d rnu.N Z Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature cod 30� J 5 BY THIS CERTIFICATE OF COMPLIANCE THE S NEW YORK BOARD OF FIRE UNDERWRITERS S BUREAU OF ELECTRICITY 5 40 FULTON STREET — NEW YORK, NY 10038 5 5 CERTIFIES THAT 5 5 Upon the application of upon premises owned by 5 c5 5 EDWARD MUNZ EDWARD MUNZ S 5 102 IL FLORAL PARK NY 11001 LAUREL HOLLOW, NY 11845 5 5 Located at 875 WELL ROAD LAUREL, NY 11845 5 5 Application Number: 1084339 Certificate Number: 1084339 5 SSection: 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: SFirst Floor,Attached Garage,Outside,Attic, S 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was Sfound to be in compliance therewith on the 21st Day of February,2003. 5 NAn OTY Rate Rating Circuit _.yM Wiring and Devices Receptacle 11 0 General Purpose Switch 6 0 General Purpose Fixture 4 0 Incandescent Receptacle 2 0 GFCI Service 1 Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 cb Meters: I S 5 5 5 5 seal 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 indicated. � A L ' Y Ft 0.5 % M.4P OF OfL ;► c" AESrG'R/ P 'RT Y c T- SMATED AT CA '10 16 MAr77rVCK row CF 80&7)YCW 1 -7 SUFFOLK CO, Ai r w O 1 ell � d+' �9ly m a 160.00 6 0 00 CAW" rmF ASMANCE raa+A W $ QMt 6A0.4EPFl E L ~ � OIL co B •7Cia and +pie Rrs� . surveying El 9•r�'la�w F R� engineering pc. �* 5•e aF1y 4o— west main street ' r ALB - riverhead, new york 11901 (516)369-1717 January 22,1987 Job W 83-3M .SAF& Gaon aa Pr Tamm Aar/ rraarr r_:as 1400-126-08-22 $colo: I"s'.c' rte. .� s STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) / // , being duly sworn, deposes and says: That deponent is over the pge of 18 years ano resides at to Zoo/ That on the // day of /�Q y , 2=deponent t/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- street address i A►rchi eet/Engineer Sworn to before me this jL day of , 2000. of E.__ .SAWORA NOTARY{pUMjm C,S ale of tart .`�� `T No.30-4916MO flogl{fieIn d E � mlpioa xNrer v Notary Pub isau y 632254-t ��af ESSIONP� cc: Applicant BUILDING PERMIT REVIEW CHECK LIST 5 3 DATE REVIEWED: T / S /01 DATE SUBMITTED:JI /,261/O1 APPLICANT NAME: /� Z SCTM#--- DISTRICT: 1,000 SECTION:_ IP,6 BLOCK: LOT: AX STREET: 8-75 We// A4 CITY: l�N,,�� SUBDIV.NAME: PROJECT DESCRIPTION ADD ALT-AR N/D: w a.,( 141,4ile 4-k ARCHITECT/ENGINEER: uT,y«l FAST TRACK:?AOR NO SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8 ZONING: PERMIT ESTIMATE AMOUNT:-$ ISA .00 PERMIT USE: EXISTING: s INTENDED: rwocxx'� ZONING DISTRICT R4 80 AC CONFORMING: YES oN REQUIRED LOT SIZE: #aK SQFT. WHERE ACTUAL LOT SIZE FRO TAX cARD ACTUAL LOT SIZE: I432S SQFT. REQUIRED REQUIRED REQUIRED IST FOUND:FRONT:&' 'PROPOSED: 6� ' SIDE YD: !o V ?l ' PROPOSED2 VA _' REAR:3S 'PROPOSED:' 2ND FOUND:FRONT: ACTUAL: SIDE YD: '/ ' ACTUAL: - '/ ' REAR: ' ACTUAL: ' LOT COVE E: ALLOWED: O % EXISTING: sf_% NEW: sf_% TOTAL: —sf�% CORNER? R NO WAT ER FRONT? YES o NO DESCRIPTION: FLOOD CO IANCE ZONE: PRE-FIRM 3/18/80 PANEL : FLOOD ZONE:_Z�, AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED.IN APPLICATION TOWN SPETIC PERMIT: YES or NO SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED#): DTE: /_/_ PERMIT#:R10- APP OVALS RE UIRED: NEW YORK STATE DEC: PRE-DEC 9/1/75 YES 0 SOUTHOLD TOWN TRUSTEES: YES o 9 TOWN ZONING BOARD APPROVAL: YES Ow TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES o O NYS ENERGY: YES OR(O: EGRESS: VENT: LIGHT: BUILDING PERMITS O N/EXPIRED: BP -Z/C/0 Z- HAVE PRE CO'S : Y O BP -Z/C/0 Z- , NOTES: pJ& —e.r e".41111a rse.•�o 40 4 .y 1/-,/ /N FESTRUCTURE: FOUNDATION: SF FIRST FLOOR WP-,CSF SECOND FLR 7z SF INIT OTHER TOTAL TOTAL: j SF FEE FEE FEE TOT( Ag;U SF)- ( SC3 SF)= _SF X$,36 =$ 9W96 +$ /Sa +$ $ �2*Q- 96 2 M-1802 BUILDING DEPT. NSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REM o/ -c INSPECTOR „_, / suaoiNc DE". INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ F0 DATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY i REMARKS: DATE /0YINSPECTOR ��, �4 2�� ]��q� suauINc DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU N [ ] FRAMING b., INAL [ ] FIREPLACE & CHIMNEY r REMARKS: ole c DATE � � 3 O.3 INSPECTOR X65-,8oz BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I CATION [ ] FRAMING ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR FIELD' INSPECTION REPORT bA r COMMENTS _ H FOUNDATION ( 1ST) Ii�11 1 p 1 FOUNDATION (2ND) A16-f _ �o v ROUGH FRAME & PLUMBING 1= INSULATION PER N. Y. STATE ENERGY CODE Nk � 3 D � H �\ u 3 FINAL - - N ` ADDITIONAL S: 16 leee, n M tr /rca / loll yk /'J d► /� r ftdL• tI'G,re i..t 60040 Y iTN go r,-oJ 4hrA x Af ,- W,t � /al o a rn qgy 1 tv � 4H N ' TOWN OF SOUTJaOLD BUILDING PERMIT APPLICATION CHECKLIST: BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL t , ! ` Board of Health SOUTHOLD, NY 11971 X 3 setsof Bu,�ding Plans *#.00'F Survey �' x.. _ l(Check Septic Form a! W 2 ar? 1001 .. ' N.Y.S.D.E.C. ' Trustees GiDG.DEP . Examined WN OF UTHOI.[� � c) -CA Approved ,20AL_ PERMIT NO. Disapproved a/c 1000Z4 Building Inspector APPLICATION FOR BUILDING PERAHT Date may d5 , 20 o INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 set-of plans, accurate plot plan to sale.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 must 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 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 whatever until a Certificate of Occupancy shall have been granted 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 or name,if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder owner Name of owner of premises Jwa0 i andr.� n?(A/V-z- (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. 10 Be _beterr tvtC k Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 975 e dl s House Number Street Hamlet County Tax Map No. 1000 Section 10210 Block 8 Lot a a 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 8w e_l L e n a b. Intended use and occupancy a arag e 4- J 0 3. Nature of work (check which applicable): New Building Addition 1( Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost $ ( 5, noo 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front a8 e 8 Rear 18. 5 Depth 3 7. L1 Height Number of Stories I Dimensions of same structure with alterations or additions: Front 46. 9 Rear 18, 5 Depth 37, 4 Height Number of Stories I 8. Dimensions of entire new construction: Front f Rear t 8 Depth 3,Z Height Number of Stories 1 9. Size of lot: Front 100 Rear 1 o o Depth 160 10. Date of Purchase 9 IqX Name of Former Owner Joseph Lernee'ise 11. Zone or use district in which premises are situated R q D 12. Does proposed construction violate any zoning law;ordinance or regulation: No _ 13. Will lot be re-graded No Will excess fill be removed from premises: YES NO Ft oda I fa,K N 14. Names of Owner of premises Eduard M urs-y Address Io2Iroil na Rue, ` Phone No. Name of Architect E t l ee h San kora Address Pe n n Lum be r Phone No r j-7-7- o N o o Name of Contractor Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *YES NO X • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Pr6vide survey, indicate scope of project, to scale,with 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 cAc"/ jqt"-Vy L being duly sworn,,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the IQ UV f��'y�— (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 tolpAd t this y f OL 20 tary Public LYNDA M:BOHN Signature of Applicant NOTARY PUBLIC, State of New York No.01 B06020932 Qualified in Suffolk niv Term Expires March 8,2oul STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) / �4``�h{nc¢ M ✓-�/, l% , being duly sworn, deposes and says: That deponent is over the ge of 18 years and resides at /2 15 p 200 / That on the `/ day of , 2=deponent t/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- 0.2 , street address i Air ' st/Engineer Sworn to before me this -,�Z' day of , 2000. of #fw y EIUiEN S.SANTOPA qE OJOTAAY PUBLIC,Stale of N&*XP* `�' r,E T No.30.4916018 Qwllfied in Nay�y y� an Notary Pubic k a32z54,� ;90C 0 fESSION���� cc: Applicant m M m A R r6° 00 69 N p/0F - `� MAP OF �.w DIE"18M PA Q WR7'f' a ,� �a,+�•�s v► s' S/TrlATED AT a C MA=UCK SWMLk' Gid, Ikf r ot F f ff• � � o-OH c it as 1 CERT,sW M' 60.00 C.,er.49V MLE ASURANCE COMM C 3�. Q Mt r MA„ 029EPN E LEJIElM M 1p O �' ft�6° $ sealand PIE Rf S� • surveying & E 6g•t3'1° N/F R ISE engineering p.c. aR 0 west main street A L 94 riverhead, new york 11901 (516)369-1717 Jonuory 22,1987 Job W 83-308A M ■ AWA- rsma sa sr. fns Ar...) uPaarF ;_824, 1000-126-08-22 Scots: t •30 A�PPPRROVED AS NOTED DATE:I.,GIL=L--B.P.# 4 S FEE: 24G-� By . NOTIFY BUILDING DEPARTMENT AT x 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH . FRAMING t PLUMBING s 3 INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET - THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS D� R' . DO NOT PROCEED WITH FRAMING UNTIL SURVEY OF FOUNDATION LOCATION HAS BEEN APPROVED. w ssL qi PROVIDE % HR. FIRE RATED SEPARATION TOG17�rz5z4 a 14Pp PART. 717.3 (f)(1) OF N.Y STATE BUILDING CODE. R' PROVIDE OPENINGS FOR ERGENCY ESCAPE AS REQUIRED BY PART. 714 OF N.Y. 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