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Home My WebLink About30698-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30701 Date: 01/21/05 THIS CERTIFIES that the building FIRE REPAIR Location of Property: 3675 WELLS AVE SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 4 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 13, 2004 pursuant to which Building Permit No. 30698-Z dated OCTOBER 14, 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 EMERGENCY FIRE REPAIR TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANNA GRADOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2024569 12/10/04 PLUMBERS CERTIFICATION DATED N/A Authorized 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. 30698 Z Date OCTOBER 14 , 2004 Permission is hereby granted to: ANNA GRADOWSKI PO BOX 511 SOUTHOLD,NY 11971 for EMERGENCY FIRE REAIR TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 3675 WELLS AVE SOUTHOLD County Tax Map No. 473889 Section 070 Block 0004 Lot No. 004 pursuant to application dated OCTOBER 13 , 2004 and approved by the Building Inspector to expire on APRIL 14 , 2006 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 r Form No.6 TOWN OF SOUTHOLD - BUILDING DEPARTMENT TOWN HALL 765-1802 JAN _ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by. writer 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. I I I JoS New Construction: Old or Pre-existing Building: 1( (check one) Location of Property: 3 L 9jr id 4_Ll,s O►/ i• S 00 THo t—a House No. Street - Hamlet Owner or Owners of Property: 6/two C-Q R o ti j IG i Suffolk County Tax Map No 1000, Section µ7 3 g t�y 7o. 4'13lock Lot Subdivision Filed Map. Lot: Permit No.?a( y $L- Date of Permit. id,w Applicant: ,✓„r j,,,�t rc I' Health Dept. Approval: Underwriters Approval: Planning Board Approval: _ Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ a,�•''� � 1 Applicant Signature � -. 65-)S 6 Qox D cJ�chrJ"� 5 BY THIS CERTIFICATE OF COMPLIANCE THE S NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 S Upon the application of upon premises owned by 5 5 COMMANDER ELECTRIC ANNA GRABOWSKI S P.O. BOX 526 36 WELLS AVENUE BOHEMIA, NY 11716, P.O.BOX 511 5 SOUTHOLD, NY 11971 5 Located at 3675 WELLS AVENUE P.O.BOX 511 SOUTHOLD, NY 11971 5 5 Application Number:PP 2024569 Certificate Number: 2024569 5 SSection: Block: Lot: Building Permit: BDC: ns11 5 SDescribed as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of Selectrical devices and wiring, described below, located in/on the premises at: 5 First Floor,Attached Garage,Outside, .. 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed--- herein, etailed° °herein, 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 authority having jurisdiction, and found to be in compliance therewith on the10th Day of December,2004. 5 Name OTY Rate Rating Circuit Type n 5 Alarm and Emergency Equipment 5 Sensor 1 0 Smoke 5 Wiring and Devices C5� Receptacle 1 0 General Purpose 5 Switch 6 0 General Purpose 5 Fixture 5 0 Incandescent S Receptacle 3 0 GFCI 5 Service 5 1 Phase 3W Service Rating 100 Amperes SService Disconnect: 1 100 cb SMeters: 1 S 5 .. 5 . 5 sea/ 1 of 1 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 o � BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ' " D DATE ( � ^ �� r INSPECTOR 306 � %- z 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE f� �� 04 INSPECTOR ' r - r FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) -ro c H ----------------------------------- (y1 FOUNDATION(2ND) v ' k H ROUGH FRAMING& PLUMBING y ---------------- INSULATION PER N.Y. STATE ENERGY CODE 3 FINAL - - ADDMONAL COIVIIVIENTS _0 z ,m � O z H d � CrJ .b y 1 r 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy A%kr�WA4CV b. Intended use and occupancy 3. Nature of work(c c which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units_ Z Number of dwelling units on each floor If garage, number of cars 2-- 5. 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 3. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 1. Size of lot: Front Rear Depth , 10. Date of Purchase Name of Former Owner 11. Zone or dust,district in which premises are situated 12. Po&sprbp68ed construction violate an7zo •ng law, ordinance or regulation? YES NO l3. Will lot be re-graded? YES NOll excess fill be removed from premises?YES NO 14. Names.of Owner of premises C,2.lm / Address os- � ,=ji Phone No. Name of Architect Address Phone No Name:of Contractor Address Phone No. .5 a. Is this,propertywithin 100 feet of a tidal wetland or a freshwater wetland? *YES /No * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMPTSAAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ��// NO * IF YES, D.E.C. PERMITS MAY BEREQUIRED. .6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. ;TATE OF NEW YORK) SS: 'OUNTY QF ) s� - -� C0A being duly sworn, deposes'and says that(s)he is the applicant (Name 6T.ixr4ividual signing contract)above named, S)He is the_ ` �-x1h •iia (Contractor,Agent,Corporate Officer, etc.) .f said ower or owner,and is duly authorized to perform or have performed the said work and to make and file this application; hat all statements contained in this application are true to the best of his knowledge and belief, and that the work will be ierformed in the manner set forth in the application filed therewith. ,worn to before me this day of - 20 0 `F N tary Public tune of Applicant JOYCE K WILKM8 NOTARY PUBLIC,Oft W NmYok NO.01W1405M4 8LOR Tum Expina Juni Its'q., 1rOWN`OF SOUTHOLD BUILDINGPERMIT APPLICATION CT-IECKLIS' BUILDING DEPARTMENT Do you have or need the following,before applying' TOWN HALL rZOO4 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.- Check Septic Form ' N.Y.S.D.E.C. Trustees Examined wl13 ,200 Contact: Approved /d / ,2 Mail to: Disapproved a/c Phone: Expiration '20 D;& Building Inspector APPLICATION FOR BUILDING PERMIT 9 Date INSTRUCTIONS r � a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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,each 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. £ 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 pgrriiit for an addition six months.Thereafter,a new peririit`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,Ordinandes 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 co e,housing code,and regulations,and to admit authorized inspectors on premises'and in building for necessary inspectio -4sig I 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 �.tJ��,�yrsrsre Name of owner of premises (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. i 1. Location of land on which proposed work will be done: Sys- Gelays Aetx' �ts�lJ9�6L�D House Number Street Hamlet County Tax Map No. 1000 Section 70 Block Subdivision Filed Map No. %*+{b •.51-J 66q YFJAar,. (Name) VM400 lalJ%ss?-er,1wI().,.;4 �1 Scope of Work Demolition: REMOVE ANY CHARRED RAFTERS AND SHEATHING AND ' Remove and properly dispose of roof shingles, lath and roof rafters REPLACE IN KIND AS NECESSARY "Remove and properly dispose of all gypsum board wall and ceiling coverings,wood trim KITCHEN details etc.In breezeway and as necessary in garage. 'Remove all frelwater damaged roof framing members over kitchen area. CHIMNEY 'Remove all windows and doors in breezeway. NEW 2%4 ROOF RAFTERS 102%4 CEILING JOISTS REMOVE AND REPLACE CEDAR 'Remove all electrical wiring in breezeway. REMOVE EXISTING ROOF ROOF SHINGLES IN KIND SHINGLES AND SHEATHING LNG AND REPLACE IN Repair/Replace in Kind BRE EWAY REPLACEATTICWALL - ' STUDS AND WALL _ 'Replace all fire/water damaged gypsum in garage as necessary. SHEATHING IN KIND AS NECESSARY ON REAR — ® "Replace/repair damaged siding exterior trim as necessary in breezway. WALL 'Replace any charred roof rafters and cedar shingles over kitchen as necessary. — — — — "Install new roof framing garage and breezeway in kind as shown. Install new cedar shingle roof over garage,breezeway and front side of main building. Cedar shingles to match existing. ' Install new walls in breezeway. 'Install new storm doors and windows in breezeway. Install Floor finishes in breezeway as specified by the owner. 'Rewire all outlets and ceiling boxes etc. in breezeway and attic over garage, S "Install new 1l2 inch gypsum board in breezway and tape,spackle and finish all joints. Paint GREENHOUSE ARAGE '� Walls,ceilings and interior trim as specified by owner. CHIMNEY F ALL C (STS o"J T� CVAPLt 0,T R N Ys T,clLr U>C- cow. �S REMOVE EXISTING ROOF REMOVE AND REPLACE SOUTH ELEVATION SHINGLES AND REPLACE IN EXISTING WALL,WINDOWS PND KIND STORM DOOR IN KIND REMOVE AND REPLACE CEDAR ROOF SHINGLES IN KIND REMOVE AND REPLACE CHARRED 2X6 RAFTERS ROOF & ATTIC PLAN - - CERTIFICATION OF KITCHEN LL �NIMUNG&CQNNECTKM REPLACE SHEATHING, _ _ .. . SIDING AND DOOR IN - KIND APPROVED AS NOTED CHIMNEY REPLACE 2X4 STUD WALLS,EXISTING WEST ELEVATION io �5 g06yS� WINDOWS AND STORM DOORS IN KIND REPLACE CHARRED SHEATHING AND ROOF FEE: zi7_. BY: RAFTERS Aa NECESSARY AND REMOVE AND NOTIFY BUILDING DE ARTMENT AT REMOVE AND REPLACE REPLACE CEDAR SHINGLES IN KIND ALL SHINGLES THE BREEZEWAY ASHINGLES ROOF KING7\ ON FRONT ROOF SLOPE FOLLOWING BAN TO 4PM FOR REMOVE AND REPLACE CEDAR FOLLOWING INSPECTIONS: NEW 112'GYPSUM ON CEILING ROOF SHINGLES IN KIND 7. FOUNDATION • TWO REQUIRED — — FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FMJAL. - CONSTRUCTION MUST BE COMPLETE FOR C.O. - — ALL CONSTRUCTION SHALL MEET THE — — — -- — REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR REPLACESHEATHING,SIDING _ -- DESIGN OR CONSTRUCTION ERRORS. ANODOORINKINo OCCUPANCY OR 5��a0ft ° Oqy USE IS UNLAWFUL WITHOUT CERTIFICATi W OF OCCUPANCYfG\.051684, ' PC'�FFSSVUMP\•• 4OLI.LLCoNgrRUI 'IMDERWRITERS CERTIFICA GARAGE MEET THE REQUIREMENTSOFTHE REQUIRED GREENHOUSE I CODES OF NEW YORK STATE. CHIMNEY Plans are prepared by Condon Engineering,P.C. It is a violation of the New York State Education Law,Article 145,Section 7209,for any person unless acting under the direction of a licensed Professional Engineer,Architect,or Land Surveyor,to alter any Item in any way.If an Item bearing the seal of an Engineer,Architect,or Land Surveyor Is REMOVE AND REPLACE altered, the altering Engineer,Architect,or Land Surveyor shall affix to NORTH ELEVATION EXISTING WALL,WINDOWS AND EAST ELEVATION the Item hlslher seal and the notation"Altered by'followed by his/her STORM DOOR IN KIND signature and the date of such alterations,and a specific de5cripti n of the alteration. GRADOWSKI RESIDENCE SCALE:AS SHOWN Condon Engineering, P.C. 3675 WELLS AVENUE FLOOR PLAN Drawn by:JJC 5 SNew YDRkoa11952 SOUTHOLD, NEW YORK S M 1 Mattto FIRE REPAIR Dale: 101612004 (631) 298-1986 PLAN