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HomeMy WebLinkAbout29396-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30866 Date: 04/19/05 THIS CERTIFIES that the building ALTERATION Location of Property: 14909 MAIN RD EM/ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 23 Block 1 Lot 2 .3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 28, 2003 pursuant to which Building Permit No. 29396-Z dated MAY 19, 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 ALTERATION OF AN ENCLOSED PORCH ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to NORMAN WHITEHEAD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1187997 01/02/04 PLUMBERS CERTIFICATION DATED N/A A--, - A q iz/96 Sigrfature Rev. 1/81 1 i I Form No.6 1 U (J v-/- LR 8 2005 ��,I 1 TOWN OF SOUTHOLD + BUILDING DEPARTMENT rP�"ST Hil f i O / N J TOWN HALL T. DEP 765-1802 Sr tin, ?_ 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 11/0 lead. 5. Cornmercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance front 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 L 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 $15.00 Date. New Construction: Old or Pre-existing Building: X (check one) Location of Property: 90 9 11y /Al AO,0 D EA$ T M Rf� f U N N House No. Street Han-Jet Owner or Owners of Property: /101t M A N H. W H 1T ja E R 1� T.� Suffolk County Tax Map No 1000, Section o� 3 Block Lot 2. 0 3 Subdivision Filed Map. Lot: Pennit No. 02 1 3 Date of Permit. J� / U 3 Applicant: MA 9 ,70/2 I E W 14ITE I-1 E A Health Dept. Approval: Underwriters Approval: i Planning Board Approval: Request for: Temporary Certificate Final Certificate: _ (check one) Fee Submitted: $ © O Applicant Signature OirLP�Pr3rL3r3L3rL3rrJ�rJ�rJ�rJ�rPrJ�rJ�rJ�rJ�rJEUEUrJ�rJrJrJ�rJrJrJrJ�rJ�rJrJrJrJdJimimirm ::: 0:: 1::11 �c1 1 1 1 2PLLPLr3PLPLPLLrL3r3 @ O 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 rCj 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 Q.C. ELECTRIC INC. NORMAN WHITEHEAD 5 P.O. BOX 518 14909 MAIN RD 5 5 LAUREL, NY 11948-0518, ROUTE 25 5 EAST MARION, NY 11939 55 Located at 14909 MAIN RD ROUTE 25 EAST MARION, NY 11939 5� 5 Application Number: 1187997 Certificate Number: 1187997 5 5 Section: 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 inion the premises at: 5 5 First Floor,PORCH,Outside, 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 2nd Day of January,2004. 5 5 Name OTY Rate Rating Circuit Type 5 5 Wiring and Devices �T Receptacle 3 0 General Purpose 5 5 5 Fixture l 0 Incandescent 5 Receptacle 1 0 GFCI 5 5 5 MIN 5 5 5 5 5 5 L, seal IN 5 1 of 1 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. o cPr�rJ'rJ'crurJ'r�rrr.nrJ'rJ'rJ'rJ'rJ'rJ'r�r�r�rJ'r�rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ�r�rJ'r�cn�ncnrJ'rJ'rJ'r�rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'rJ'r�r�rJ'rJ'r�rJ'rJ'r� o _�3 3 TOWN OF SOUTHOLD PROPERTY RECORD- CARD 2-8 OWNER STREET 1 9cqVILLAGE DIST. SUB. LOT FORMER OWNER N E ACR. u ' L •liC� `i +' �(�CJ 1�4' �. jAlfiG - r��i� S W TYPE OF BUILDING `1 ` Z GlLl15 lE C. S. GALLISPJE RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS /3 Y f + ' / /0 3/1 �$ W�i1 ESY. of /�, �:i! _ JS/" /o 'Al.F. -li&c 'v✓HiiEf�fND 1J r? Z ZOO . 5 /.- v`+o – sGo Cf L- L1I74, 7 25Z -�/� �1I�P ?Z'✓0 i' <'cc l/� X00 ?Ai 5 3� f J ^� (JJ 3 � 1 3 Y G l 1 , rlc) Ji/.'C : 'r/r.f 4PJ N.C. ®`Tc, �' 1 'ao`.'o o A g Jam;, _ ...✓ L' '1 a,9_'1., J' � 1t oat t# .t a� � Qo00 \,2,700 70c 12 no I(o3 cox/ 2¢061 1 AGE BUILDING CONDITION ra .4rl?)cr NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD –"-=— _ -(2bt . Meadowland DEPTH House Plot I - (r Q BULKHEAD DOCKafJ --- _r� , - -- 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. 29396 Z Date MAY 19, 2003 Permission is hereby granted to: NORMAN WHITEHEAD 2 MARTHA CIRCLE BARRINGTON RI , 02806 for L=NG(.b5&D REPLACEMENT OF AN EXISTING 81iEY PORCH TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 14909 MAIN RD EM/ORIENT County Tax Map No. 473889 Section 023 Block 0001 Lot No. 002 . 003 pursuant to application dated APRIL 28, 2003 and approved by the Building Inspector to expire on NOVEMBER 19 , 2004 . Fee $ 150 . 00 Xa Authorized Signature ORIGINAL Rev. 5/8/02 i COLOR ,.r'.r" t. IJ TRIM �/W A---�# � x r 1 M. Bldg. Extension ; FT77RM - r / Extension vl �` J Extension.: dation ��� i2 GNBath Dinette , perew Basement L Floors ? r K. Ext. Walls—t'- (Interior Finish I ` LR. Porch ` Breezeway Fire Place- 1 %/ Heat r. I DR. Garage Type R f ` Rooms lst Floor BR. _ Patio n ;. L ( Recreatio Roo Rooms 2nd Floor FIN. B 15—fl. � .` I �/�� �' L � Dormer r� Driveway Total 4 . L y l�, BIZ kesi55o� x' M-1802 ILDING DEPT. SPECTIQN /IFOUNDATION NDATION1ST [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 4� NSPECTO M-1802 BUILDING DEPT. INSPECTIO [ ] FO:NDATION ND TION IST [ ] ROUGH PLBG. [ ] F 2ND [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE �� INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ;FINAL " OUGBG. FOUNDATION 2ND [ LATION FRAMING [ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE -3 0� INSPECTOR FIELD INSPECTION REPORT DATE COMIVIENTS FOUNDATION(1ST) O 6 -------------------- C y FOUNDATION(2ND) � O yy ROUGH FRAMING& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL CONEWU TS ND-r� Z m P �y a 'o x ( m 1 � v /l/d2 M r3 ^f Y. 04-1 t T c /3EA D isf9o9 ^J 20/-3 /) n� y If SEwlso .i Soui H PO 2c H � 5 /30) -1- F/ QTc/ Notary puW c Sta a of Neuv York No.4P22583,Srffolk CZno Teri irss Decal eer i, so!,.00,6 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applOng4 TOWN HALL Board of Health_ SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 p Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form_ NX.S.D.E.C. ''ll 2 Trustees Examined_ ?OV 3 Contact: Approved_ Mail to:---- Disapproved o: _Disapproved a'c 'L�� Phone: 3) V 3 t Expjiation ,20 _ Building Inspector 28M3 APPLICATION FOR BUILDING PERMIT Date / � , 20 0 3 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) P ° ER-5T 3"' otJ A)j (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder o gun/,P� Name of owner of premises /Va1,HAA/ R• L✓H t fE N t:A r7, (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. 5b o G Col in Ac Tim/ !r Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: /IY9/1q -4,41 Al ,r, aflr) G- /dsT MHK /o /V/ House Number Street Hamlet County Tax Map No. 1000 Section C: Block I _Lot •3 _ Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises andintendeduse and occupancy of proposed construction: a. Existing use and occupancy �7 /r6V 1,l_LIIVL b. Intended use and occupancy_ 3. Nature of work(check which applicable): New Building Addition Alteration Repair _Removal_ Demolition_ _OtherWork�tE��Rcf}N�,r Ncy y' (Description) 4. Estimated Cost / yS� `!� 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 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_X 13. Will lot be re-graded? YES_NO 7t Will excess fill be removed from premises? YES_NO x 14. Names of O,.Irttr of premises Address Phone No. Name of Ar&tltect jbS6'hN Flic N E71f P Address 1325 do I42T AP Phone Nodi 3/ 7,�S 2 915-1 Name of Contractor Address SOdJNo`D loy Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a 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 — • 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 C 1 ) �� Z o n 1� A - W t �� being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the C c 7n16 tq_ (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 c�� day of QAA� 20 93 otary Pu rc Signature of Applicant LINDA J.�t�C+r f° Notary Public,State of New YorP No.4e22563,Suffolk C,=rnty Of- s SURVEY OF PROPERTY �'o. � AT EAST MARION ti� F T 0 WN OF SO UTHOLD ti�,bJ ,� � SUFFOLK COUNTY , N. Y. I 1o00-ta-of-t.s SCALE: 10-40 MAY 10. 1999 AUG. 23, 1999 ( addfnon ) OCT. 29, 1999 ( cont. foandaBon 1 M � _ I M 'yam H WM\ I ��. \ — ur?It. �°GPiI � e O � O 22 �1 22 �? is.-10 I \ 22 cA 21 i W / 169 30 R v� w s �r 21 ° - �•oo - \ S 2°•- — AST Pa w \ 1410 if M O TO 189 95 S 79O R� 5p'S6 PRS g0 AREA = 1.5000 act to tie lines �r 0V NEw/, P 0 Elevations referenced to N.G.V.D. 5� orN wT„f 4 3 R. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION R�� / N. Y.S. LIC. NO. 49678 OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, �: • /V. V ON/ VEYORS, P.0 EXCEPT AS PER SECTION 7209—SUBDIVISION 2 ALL CERTIFICATIONS 'JF °' (##N�� - 5020 HEREON ARE VALID FOR THIS PAP AND COPIES THEREOF ONLY IF U ( NIJ�'� 909 SAin MAP OR (. )PIF"S REAR THF IMPRFSSFD SFAI DF THF S"11RVFYOP T,, . ,,,_, -- I _ _ SEAS0n/A4. /ZOOM-04 5 ASO,, L.7— F�SCy y0 -11V^1 oSE?) So e/ 7-H P'ak e H Norman H.Whitehead,III �r�. f F0dNO19 T/ o n!/ 14909 Main Roade C ROSS SE eT!o n/ ✓!En/ 9 P.O.Box 337 i Y! East Marion,NY 11939-0337 S c Tio ✓ A / FESSIONP\ j �xlsrn/a ave ^/,o-ve- 1 �X '� T-rnl lam' n 4,0 l<° APPROVED AS NCTED ! DATE:_Sa/ ! _ B.P.t c3 b tQEiNsfAtcE I -1 S': T E FEE: / 40) BY: NOTIFY BUILDING DEPAp ENTx*l�tt �,)/Z CoC earn! 7651802 8 AM TO 04 R ,?W-S c FOLLOWNG INSPECTIONS: Ld 1. FOUNDATION - TWO RE IREf>so1Tr! i FOR POURW CONCRfT 2. ROUGH - FRAMING &, L)USING V11,9 L4- 3. INSULATION ,��� NSo L-47 o0✓ 4. FINAL - CONSTRU(J1q6i A s !e E a�,rc a BE COMPLETE FOR'C ° WJST ' ALL CONSTRUCTION SH MEET THE I REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPO SIBLE FOR DESIGN OR CONSTRUCT ERRORS. �7 6L SAP�E ! eWrleY ONpKETE '-� - Q�e�rc /yNCNort /3 etT a.'�X R •' EXIST N Sic Pt ATc /b'� p'.C. I 3 �Eion/ / Povlden 624pE ro.ve.tETF I Foo i/lvt, (Foor.iJ(r 1 � OCCUPANiy OR , USE IS I %LAWFUL. ALL Cn °'^ "'aI l JOSEPH FISCHETTI, PE WITHOf •ERTIFICATEmEcoDtSl/r ,._.. ,,,,,fATE.HE P25HOBARTRD POBCX611 OF OC; L -.. 1CY SOUTHOLD_NY 11971 Norman EL Whitehead,III NE 14909 Mein Road Of y EASaN a East Marion'NY 11939-0337 Fj��9f EIVL'k 0 is So U TAs !'oma C H pCL ul 2 FOU/V/J' l3TiaN / �� oc2 ,f�EA�✓ JOSEPH FISCHETTI, PE o *o. os25 2 PROFESSIONAL ENGINEER FESS►ONP� .5"C A IL E 1725 HOBART RD/PO BOX 618 SOUTHOLD, NY 11971 631-765-2959 PRE C-X/STi�vCr ,�riz✓cT�rcE (/ruusE� NF w A 'f F rIT ' I _ I0. 0- 0 C . o0 o 0 c o o s,« NGA76 /bASonsR ✓ /j74at STOn/E C/9PPE_6 EnJt.ey PIA7"Ga2 y A su s't'n Q Tin/ /f E/Ng 7AI t E!7> ^ptuM NS O -- /b "" (j�.ocK / v'od.ee r co�c"eErE - FOVAI DAT7U�1 '9c340V45 CpNC "tE%-r. FOoin/G-.S SE/9'.50/V-41-- AodH - ,95 6U/t—Norman H.Whitehead,III of NEN, ENC.L-a sE� Su a TJf oGo /2 'q 14909 Main Road P.O.Box 337 �F1SCyF�/0.9� /Z p N T L t VAT/a n% East Marion,NY 11939-0337 * .. • Z = s NEw G✓/Ni�oWs Tp F/ 7- in/TO � k/STiNb Ie. O . Al S TiP U c rL-1 a E l f10 U-5 4F /SRF e-x /STiNfr He=gPC/i` ' 77i 00 IYZ � DO { X C f -� N, 7 ,� _ r j 2-'X 3CO^/C.I-E765 'UUI✓ r7Ri1 ow/ /3 Lo GI` '} JOSEPH FISCHETTI, PE PROFESSIONAL ENGINEER 1725 HOBART RD/PO BOX 616 i SOUTHOLD, NY 11971 631-765-2859 B'UI L---pI -1:11: 1:1]�,r VrT� : _i ST- 'Applicant/ Date Owners Name: Reviewed: Architect/ � ��- Date Engineer: Submitted: SCTM #: / 3 District: 1,000 Section: !flock: ! Lot: _ Project Subdivision Location: l`f 9©`� l� G t _-- — Name: Sin&Ie& separate Required certification: (Yes/NoJ ,AJ/4 Req. n'wt� Req. Zoning District: 11.01 size: U -� Actual: �� (Lot coverage 1'rul>ciscd 1 Req. Req. (Front Yard Proposed: J [ i c r Popo J (Rear Yard Proposed 1 Project Descriptio AGENCUEERMITS Permit . REQUIRED FOR REVIEW N.A. ISO YES Number Suffolk County Health Dept. f New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: �OteS , ,)