Loading...
HomeMy WebLinkAbout29042-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30764 Date: 02/14/05 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 2445 MINNEHAHA BLVD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 3 Lot 47 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26, 2002 pursuant to which Building Permit No. 29042-Z dated DECEMBER 29, 2002 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DOLORES MUROLO ULLMANN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 2016464 10/08/04 PLUMBERS CERTIFICATION DATED 11/30/04 MATTITUCK PLUMBING & HEAT f Authorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING ALL D HMENT TOW765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY-- This CCUPANCYThis 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$15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: A?inn Sp w�A Z) .6 0-Y House No. A$treet Hamlet Owner or Owners of Property: mYa b q r Suffolk County Tax Map No 1000, Section ? 7 Block 3 Lot L} Subdivision Filed Map. Lot: Permit No. 9/) y Date of Permit�.2 - y- O a Applicant: Health Dept. Approval: Underwriters Approval: . Planning Board Approval: _ Request for: Temporary Certificate Final Certificate: \1l (check one) Fee Submitted: $ e D Applicant Signature Ca -�. 3o ��hf 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. 29042 Z Date DECEMBER 29, 2002 Permission is hereby granted to: DOLORES MUROLO ULLMANN PO BOX 43 SOUTHOLD,NY 11971 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2445 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0003 Lot No. 047 pursuant to application dated DECEMBER 26, 2002 and approved by the Building Inspector to expire on JUNE 29, 2004 . Fee $ 159 . 00 ri Signature Rev. 5/8/02 ORIGINAL Towle H,u, 510115 MaIil Flood I n (S 16 7 1923 P. o. flex 1 178 1 1't,) lvIo3pI )n9 (515) 7r�.•1002 Snothu1d, H9w York 11971 OFFICB OF TIME BUILDING IN SPFCTon TOWN OI' SUUT•I (OLD C R T I F I C A 1 0 14 DATF Dui l d.1 ng PeYmlt No. Owner 1. _ ( pl e print)- -......_ Plumber! e. ,Tv�� please prim:) I certify that; the solder used In the w4aer. Supply sy:; tem contains loss than 2/ !0 of 11, lend . '-( flllmf�er.q L;Ignn1.111-r? ) Sworn to before m thlq clay of _..__..,�t9 �1 Notary Public, C;o1111ty Y No � . >> wy�qq 4 Commission in Juni 30 201J� e � 5 BY THIS CERTIFICATE OF COMPLIANCE THE ` NEW YORK BOARD OF FIRE UNDERWRITERS, 5 5 BUREAU OF ELECTRICITY 5 40 FULTON STREET NEW YORK, NY 10038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 PETERSEN ELECTRIC CORP. *ORTMANN 5 85 SILVER COLT RD. 2345 MINNEHAHA SCUTCHOGUE, NY 11935, SOUTHOLD, NY 11971 5 Cj Located at 2345 MINNEHAHA SOUTHOLD, NY 11971 5 eS SApplication Number: 2016464 Certificate Number: 2016464 5 5 Section: Block: Lot: Building Permit: BDC: nsl1 S Residential 0-599 square ft. Described as a q occupancy,.wherein the premises electrical system consisting of S electrical devices and wiring, described below, located in/on the premises at: SBasement,First Floor,Outside, 5 SS5 A visual inspection of.the premises electrical system, limited to electrical devices and wiring to theextentdetailed 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 8th Day of October,2004, 5 Name OTY Rate Ra ine Circuit Tvoe Alarm and Emergency Equipment Sensor 1 0 Carbon Monoxide Sensor 2 0 Smoke Appliances and Accessories Exhaust Fan 1 0 F.H.P. Electric Heater Baseboard 1 0 1 KW Electric Heater Baseboard 2 0 .5 KW Panels S 1 100 9 Wiring and Devices Outlet 9 0 Fixture . 5 Fixture 9 0 Incandescent 5 Outlet 22 0 General Purpose Receptacle 6 0 General Purpose Switch 11 0 General Purpose Paddle Fan 1 0 Receptacle 9 0 GFCI seal Service Continued on Next Page I of 2 �j 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 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10+038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 PETERSEN ELECTRIC CORP. "ORTMANN 85 SILVER COLT RD. 2345 MINNEHAHA. CUTCHOGUE, NY 11935, SOUTHOLD, NY 11971 S Located at 2345 MINNEHAHA SOUTHOLD, NY 11971 Application Number: 2016464 Certificate Number:. 2016464 5 Section: Block: Lot: Building Permit: BDC: ns11 5 Residential 0-599 square ft. 5 Described as a � occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located Won the premises at: 5 Basement,First Floor,Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 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 authority having jurisdiction, and found to be in compliance therewith on the 8th Day of October,2004. 5 Name EOT Rate Rifing Circuit Type 1 Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 cb I' Meters: l S 5 5 S 5 5 5 5 seal 5 7 2 of 2 5 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. 0 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: November 17, 2003 TO: Dolores Ullman 2445 Minnehaha Blvd. Southold, NY 11971 Please take notice that your application dated November 17, 2003 For approval of a foundation location survey for under construction additions and alterations to an existing single family dwelling at Location of property 2445 Minnehaha Blvd., Southold,NY County Tax Map No. 1000 - Section 87 Block 3 Lot 47 Is returned herewith and disapproved on the following grounds: The foundation location, located on a non-conforming 16,117 square foot parcel in the R-40 zone with two front yards, is not permitted pursuant to Article XXIV, Section 100-244B, which states that, parcels measuring less than 20,000 square feet in total size, require a minimum front yard setback of 35 feet. Although a permit was issued to the applicant on December 29, 2002, allowingafront yard setback of 35 feet. Following the submission of a foundation location survey, it came to the Building Department's attention that the foundation was located 32.5 feet from Opechee Avenue. Total lot c a e wi be less ent. Authorized S' ature Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: File, ZBA w APPEALS BOARD MEMBERS �4�SpFF CO� Southold Town Hall Ruth D. Oliva, Chairwoman 53095 Main Road \v� Gerard P. Goehringer 4 = P.O. Box 1179 Lydia A. Tortora 5 • Southold,NY 11971-0959 Vincent Orlando y 0! Tel. (631) 765-1809 James Dinizio,Jr. l �►a Fax(631)765-9064 20 http://southoldtown.northfork.net FE823 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF FEBRUARY 12, 2004 Appl. No. 5464 - DOLORES ULLMANN Property Location: 2445 Minnehaha Boulevard, Southold; Parcel 87-3-47. SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: The applicant's 16,117 sq. ft. parcel directly fronts along three streets in Laughing Waters: (a) 133 feet along Opechee Avenue, (b) 113.74 feet along Minnehaha Boulevard, and (c) 102.60 feet along Wabun Street, Southold. The dwelling faces east towards Minnehaha Boulevard, a 30-ft. right-of-way, with a nonconforming setback of 34.9 feet; to the south is Wabun Street, a 20 ft. right-of-way, and the.dwelling has a nonconforming setback of 34.9 ft.; and to the north, the dwelling is 37.2 feet from Opechee Avenue, a 30 ft. right-of-way. The property is improved with a single-family, one-story frame dwelling with a concrete patio and frame shed, shown on the survey prepared by November 6, 2003 by Peconic Surveyors, P.C. BASIS OF APPLICATION: Building Department's November 17, 2003 Notice of Disapproval, citing Section 100-244B stating that on parcels measuring less than 20,000 sq. ft. in total size, a minimum front yard setback of 35 feet is required. The applicant obtain a building permit (#29042-Z) on December 29, 2002, for additions and alterations to an existing single-family dwelling and installed the foundation as it exists today. The required foundation inspection revealed that the distance between the foundation and the northerly lot line is 32.5 feet. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 22, 2004, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: Applicant wishes to construct a 26 ft. by 20 ft. two-story addition at the north side of the dwelling on an existing foundation under construction, as shown on the foundation survey dated November 6, 2003 prepared by John T. Metzger, L.S. with a setback of 32.5 feet from the northerly front property line, at its closest point. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: rage 2—February 12, 2004 • • Appl. No. 5464—D. Ullman CTM 87-3-47 1. Grant of the relief requested will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. No information was found to indicate any undesirable change the character of the neighborhood or nearby properties resulting from this 2.5 ft. front setback reduction at the northeast corner section of the existing construction. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The foundation has been built in its present location, and the only remedy possible that would not require a variance is to reduce the foundation. This option would be very expensive and an unwarranted burden on the applicant in light of the circumstances in this application. 3. The variance granted herein is not substantial. The front yard setback is minimal and permits a 7.5% reduction from the code required 35 ft. minimum setback. 4. The difficulty was not self-created. The difficulty exists because the lot fronts along three rights- of-way that require a 35 ft. minimum setback in not only the true front yard facing Minnehaha Boulevard, but also the obvious sides of the house. 5. No evidence was submitted during the hearing or in the written. record to indicate that the grant of the relief will have an adverse effect or impact on physical or environmental conditions in the neighborhood or district. 6. Grant of the relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an addition, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Dinizio, seconded by Member Orlando, and duly carried, to. GRANT the variance as applied for, as shown on the survey prepared by November 6, 2003 by Peconic Surveyors, P.C. and maps prepared by Penny Lumber dated 12/16/02. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other + '.Page 3—February 12, 2004 � • Appl. ITU. 5464—D. Ullman CTM 87-3-47 features as are expressly addressed in this action. Vote of the Board: Ayes: Members Oliva (Chairwoman), Orlando, and Dinizio. (Member Tortora abstained; Member Goehringer was a nt. This Resolution was duly adopted (3-0). Ruth D. Oliva, Chairwoman 2/1q/04 Approved for Filing Permit Number MECcheck Compliance Report Checked By/Date New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release I Data filename:CAProgram Files\Check\MECcheck\ullman.cck TITLE:Ullman COUNTY: Suffolk STATE:New York HDD: 5750 CONSTRUCTION TYPE:Detached 1 or 2 Family HEATING TYPE:Non-Electric DATE: 12/23/02 DATE OF PLANS: 12/16/02 PROJECT INFORMATION: Addition Southold NY COMPLIANCE:Passes Maximum UA=78 Your Home=74 5.1%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 280 30.0 0.0 10 Ceiling 2:Cathedral Ceiling(no attic) 140 30.0 0.0 5 Wall 1:Wood Frame, 16"o.c. 512 21.0 0.0 25 Window 1:Wood Frame,Double Pane with Low-E 39 0.340 13 Door 1:Glass 42 0.490 21 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans,specifications,and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this page,they are attesting that to the best of his/her knowledge,bel' and professional judgment,such plans or specifications are in compliance with this Code. Builder/Designer Date Z'22>—©2 ay i Yu l a MECcheck Inspection Checklist New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release I DATE: 12/23/02 TITLE:Ullman Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: [ J I 2. Ceiling 2:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: I Above-Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: I Windows: [ ] I 1. Window 1: Wood Frame,Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ J Yes[ ]No Comments: I Doors: [ ) I 1. Door 1: Glass,U-factor:0.490 #Panes Frame Type Thermal Break?[ ]Yes( ]No Comments: I Air Leakage: ( ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials.If non-IC rated,the fixture must be installed with a 3"clearance from insulation. I Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. i Materials Identification: [ ] I Materials and equipment must be installed in accordance with the manufacturer's installation instructions [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] I Supply ducts in unconditioned attics or outside the building must be insulated to R-8. [ ] I Return ducts in unconditioned attics or outside the building must be insulated to R-4. [ ] I Supply ducts in unconditioned spaces must be insulated to R-8. [ ] I Return ducts in unconditioned spaces(except basements)must be insulated to R-2. Insulation is not required on return ducts in basements. I Duct Construction: [ ] I All joints,seams,and connections must be securely fastened with welds,gaskets,mastics I (adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted. I Exception:Continuously welded and locking-type longitudinal joints and seams on ducts I operating at less than 2 in.w.g.(500 Pa). [ ] I Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions. [ ] I Cooling ducts with exterior insulation must be covered with a vapor retarder. [ ] I Air filters are required in the return air system. [ ] I The HVAC system must provide a means for balancing air and water systems. I Temperature Controls: [ ] I Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space I temperature set point of the largest zone. I Electric Systems: [ ] I Separate electric meters are required for each dwelling unit. Fireplaces: [ ] I Fireplaces must be installed with tight fitting non-combustible fireplace doors. [ ] I Fireplaces must be provided with a source of combustion air,as required by the Fireplace construction I provisions of the Building Code of New York State,the Residential Code of New York State or the New York City Building Code,as applicable. I Service Water Heating: [ ] I Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the I water heater has an integral heat trap or is part of a circulating system. [ ] I Insulate circulating hot water pipes to the levels in Table 1. I Circulating Hot Water Systems: [ ] i Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% I of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 105 OF or chilled fluids below 55 T must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature Fl Un to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Tvoes Range(0 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) 2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] UGH PLBG. [ ] FOUNDATION 2ND [J]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: C �� ' DATE � I� o � IN8PECTOR (�j 765-1802 BUILDING DEPT. INSPECTION [ ] FOUN ION 1ST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE 7// eO INSPECTOR suaniNo DE". INSPECTION [ ] FO ATION iST [ ] ROUGH PLBG. [ OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP CE & FIIMNEY R� D � 0 DATE INBP M-1W2 suu.uiNa uepr. ,,MSPECTION [ dA(0UNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY R17NA S: DATE BUILDING DEPT. INSPECTION [ Vf FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � l Z" -ZZ DATE A91.2-310 INSPECTOR Ka-A-A- 765-1 soz S-37— BUILDING DEPT. 9 a72, INSPECTION � [ ] FOUNDATION 7ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING FINAL [ ] FIREPLACE 8 CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: Ice- 0 DATE II � �� � INSPECTOR��;��" 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: UtAJ4,00vt& 0 L , ,e i c5�r�l—S• bAgL5 0, k . DATE $ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ J FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ATION [ ] FRAMING [ J FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: &M4s �°�' leo A, (( 04iglc eftte-d IAA Sllow� A-G( oT et [��—S"OVVN o� dila a o d1 o b i S�I'EET(�-C+C. Vry Car Kc DATE �� IDY INSPECTOR C�'�' ` 4� 7 ' 765.7802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING � FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE — INSPECTOR '�o"° 1 51 mg 1 - id' 4 FOUNDATION(IST 11111 Mir i j PLUMBING ' � c URSA INSULATION PER N.Y. STATE ENERGY t' • 1 �� ►. REW /� ... ADDITIONAL • 1 I;H AMPV ins=1 ol • TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DIEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. q Check Septic Form 17 N.Y.S.D.E.C. Trustees Examined q 20 Contact: . Approved 120 Mail to: Disapproved a/c TC"_^1 rW Phone: Expiration 20 Buili g Inspector J��, APPLICATION FOR BUILDING PERMIT Date /� - - D a , 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. (Signature of applicant or name,if a corporation) . fo x J18 '!S&4,�A.O.i° A/y (Mailing address of applicant) 6tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder cue,w�-- �`ame 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. Location of land on which propo ed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Block Lot 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 b. Intended use and occupancy Nature of work(check which applicable): New Building Addition / Alteration Repair Removal Demolition Other Work (Description) Estimated Cost �� � 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 Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories S. 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_X,-Will excess fill be removed from premises? YES NO 14. Names of Owner of premises �.AddressA S94-)9�J,Phone No. 76 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 freshwater wetland? *YES NO_jt�— * 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 * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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 ) X01 Ll LLrrmGl n r1 being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the ©W�l P 1-- (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. Swo to before me this day of 20y t:L, �' 'b "k-'- of Public —TV Signature of Applicant JOYCE M.WILKINS Notary Public,State of New York No.4952246,Suffolk County Term Expires June 12, -)00,1 BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: /L. lL 102 APPLICANT: y��M r(�, •�,o��S DATE SUBMITTED: / /02 SCTM#DISTRICT: 1,000, SECTION: BLOCK: LOT: STREET ADDRESS: 2qf 5-A h,a�gjy, . _CITY: 1s:QrHoLb SUBDIVISION: PROJECT DESCRIPTION:.I,Dh/4LT- SF•17 2 Tag NTS�, ESTIMATED PROJECT COST: ARCHITECT/ R:Dee-,VLFAST TRACK? Nb SINGLE & SEPARATE CERTIFICATION-REQUIRED? -10 NOTES: LOTS 40,000SF-100-24.Lot recogn i tion.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8: ZONING DISTRICT: CONFORMING? VO REQ. LOT SIZE: CT. LOT SIZE: 11,11:F REQ. LOT COV. o ACT. LOT COV. REQ. FRONT i OP. FRONT REQ SIDE Z„r ACT. SIDE REQ. REAR v1 PROP. REAR ` ; REQ. REIGHT PROP. HEIGHT WATER FRONT? DESCRIPTION: PANEL #: _ FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D T: YES or4o, (BED #): DTE:_/_/_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y or NEW YORK STATE DEC: PRE-DEC 9/1/75 YES oro - SOUTHOLD TOWN TRUSTEES: YES or, TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORI PRE (SPLIA): YES or NYS ENERGY Y R NO EGRESS (18 H min.? 4 sq total) ENT(SQ. FT. x 4%) LIGHT(SQ. FT. x 8%)------- BUILDING %)/BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: N4/0 SF FIRST FLOOR: (® SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE PEE 1. � SF – SFX$ ��� –$ +$ i� +$ =$ �> > ( —SF)- ( — )– �, ,_ 2. ( SF)- SF)= SFX$ =$ +$ +$ _$ r ' j 7 ?nn3 I SURVEY OF PROPERTY AT LAUGHING WATER S�?40a�• ' TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. i FE 1000-87-03-47 SCALE: 1'=20' Y\ 00• NOVEMBER 6, 2003 -Z Ery OW O Ih. 7— f O e, 19.4 i c- 4 \ j u N CONCRETE `" u M F^.,, Z 4. FOONO,TION 4 160 m �\ V� `10 b 4 m 4.1 ly 4.1 1 O 0ta�� 28.J' iv 218' - a 11„ r o > 11 (,1 4 OUT. D ^�<,1�� SHON£R 41 -. 43 m n o = 1 I, 4.1 1 O T 1 O 1 �1 6.0 EONC 3.4 ' rl m I 4.1' N J l p 1`�, •w N v � 20. I cn b m � DECK i m 1.4 Ur FEF AREA=15,3 'oNN i.Kerr,�0�6 J ��str Fp t wool? FE IT 0.5'S FENCE w 587'26'00 W 1036 4,0 /9bJs 104.70' (DEED) FQ . � 49678 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A V70LA77ON DIRT ROAD yVrABUN STREET ECONIC SURVEYORS, OF SECTION 7209OF THE NEW YORK STATE EDUCA7ON LAW (631) 765-5020 FAX (631) 765- 1797 EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF F4 „� Z._ -w� F.,a FEF'M 1230 TRAVELER STREET SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 03-280 wHOS£ SIGNATURE APPEARS HEREON. r_ I G. G J •y �' SOLITHOLD, N. Y, 11971 r ' ' , - - ' '. , .-, - , '�%YJQlnj�k!✓L /�Ui� '�6" "S�/8Ac"�L�j OCCUPANCY OW-, USE IS UkAWFUt L I f WITHOUT-CERTIFICATE �i OF OCCUPANCY, P R ED'AS NOI . . FEE, a� NOT Y BUILDING D WIT E�NT AT - I 765-18H 9 AM T0- 0111 OR THE NG INSPEG TWNO FIEGUIRED FOLI QWI �Fl1UNDATIp,N, FORPOUREDOONCRETE 7. RUG FRAMING &1,4 H ,MBING 1 ,t 3 INSULATIONk '4",FINAL OdNSTRUCTIdN. MUST ., • - . .. .. ALL COMPILETE bONSTRUCTI,ON HALL.MEET r SY �: - _ THE'REOU14EMENTS OE THE N Y ;i 4 � . ` STATE CONSTRUCTION A ENAll ERGY COPES NOT 'RESPONIELE FOR - f p DESIGN OR CONSTRUCTION ERRORS Apr�PoyA U' tD sG, lr UNDERWRITERS CERTIFICATE REQUIRED PROVIDE PROVIDE OPENINGS FOR - EMERGENCY ESCAPE'AS P""DEr r SMOkELLIJETECTING ) 4� ',M.` ��! REQUIRED BY PART. 719 QF ICES 2 I N.Y. STATE-BUILDING', ODE ALARM DF�V, L AS TOPART"720DE � N Y,S BUILDING C P4�nASIAIG D - ALLPWMeFN ,WASTE TESTFNGBEFO EL cbvG, ERIN 4 la r rtl4negeV ex9e I L d It ca NowFZor 1 ter r� " - -Id.I�rlw,,I:}:U ,�^�, -., ` , slStcst,•.pLF! Itiq S"+7�IZ,ba , .._ - .. I - _ �.,� -a..-..—_�,. —.� �_..._ ";��-'•• � ' -1, ' - �"-- ( of Y�Pies h Gr I_''tYiF+r ' , • .;_ , _— .-:— _„., i. •; '.:„ IkRITERS C€R7iFICATE CQMO ;;mw ' , *,T . �OIP,FL4�p �1 I1 12 UNDER' _ T /FY;A 'ON p/ `/Ml36R Ir L C,E�f,. � FN9NTT gF (7 CClld 1N W4 IWA -Sokp CY PL, "w rtY 'T -,; ':: , _. – --------,n;”: �•, t r^'n""''�"""a'*2- _ . �ytl""'r}uc.,'z'"^^±g'-; —5m- 77 + P.ROVIUE ANtj"`SCA[U ANO/OE K ,s T,HEI�MI�L SN..III p iEVE�1TING__r :' NEVICES AS',tORA;RT 9C2 fi(N) K. i• I ,t v N Y:STATE BW1 IN1;CQDE Irl R ILI% Jr �1 1! '_r , A,QNOT,PROG, ,> fM1fAGl4}TIL SURVEY ' �4�hARLPROEu „ i „ a - _ f.f,LTILI tom? LL r x• �r - - 9 , I } I � w ++ IIE V^ I _ I it Mct lie 9x VIC r rMti ; j it Z4 _y- W CL i i i i i d bC % �zt{ lug cc l _ c CC � i,� w' i � I� {i''x ire .�- -+.- _w, �"=l�:=_--•�`�—�. AtfFL3 rf! �Jjta}�� eta L3 , ; i, ( ,20r 2 t ,. � � �r�dl'� __ _ _ __ III f`y)�`` - � .-.-„.... �-,- -•� Ail� V-ga.Iu LL- kipLL, — .- � � �I �i I UISI t+ `� i I � , � I �I I k61 Lf1']►(' t� { I Iv. �,h. � ! i --�^ 4 j f . I �" " � _ � 2 2xYGG}1�D�.iL -�„-� �I��II I i { I +s� l :! � � (✓� .3f�4'- '{=�L�Gf� � � I , or.5e 1a , � I � � SII .� � �• + "I� -t ---�- -. -' - -�- -- ._f— --- . -. .. F � ! I� I. 1` (I�i•f78Li Q4 CL a - InxoDrlVD6rz - I Pfk/0M4- t- , Z x z Er?._ a F -- roULjC)A,,-r1oU RAJ l II +k I II i I J I � � W I