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HomeMy WebLinkAbout30644-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31201 Date: 10/11/05 T~IS CERTIFIES that the building ALTERATIONS Location of Property: 1160 GOOSE CREEK LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 8 Lot 5.1 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. 30644-Z dated SEPTEMBER 20, 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 STRUCTURAL REPAIRS & ALTERATION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR, The certificate is issued to GRAHAM & BARBARA HEAD (OWNER) of the aforesaid building. SUFFOLK COUIFI~I DEpARTI~EIqT OF ~ALT~ ~kPPROVAL N/A ELECTRICAL CERTIFICATE NO. 1044034 04/11/02 PLUMBERS CERTIFICATIO~ D~r~o 09/27/05 GARY STAHL Authorized Signature Rev. 1/81 Form No, 6 TO~7~ OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application tnust be filled in by typewriter or ink aad subnfitted to tile Building Department with the following: For new building or new use: 1. Final survey of property with accurate location of all buildiugs, property lines, streets, aud unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fbm~l. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plmnber certifyiug that the solder used itl system contains less than 2/10 of 1% lead. 5. Cormnercial buikliug, iudustrial building, multiple residences aud siufilar buildings aud installations, a certificate of Code Compliauce from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For exisOng buildiags (prior to April 9, 1957) uon-confm'ming uses, or buildings and "pre-existing" land uses: 1. Accurate sta~,'ey of p~ol)erty showing all prope~%' lines, streets, building and unusual natural or topo?aphic fcatuI cs 2. A properly completed application and consent to respect sigmed by the applic,~nt, lt a Certificate of Occnpancy is denied, the Building inspector shall state the reasons therefor m writing to the applicant. Co 1. Certificate ofOccupaucy - New dwelling $25.o0, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinuning pool $25.00, Accesso©' building $25.00, Additions to acccssoD' building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Cop3' of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certiticate of Occupancy - Residential $15.00, Conunercial $15.00 Old or Pre-existing Building: Street New CollstructioD: L°cati°n °f er°l'erty: Suffolk County Tax Map No 1000, Sectiou ~ ~ Block (check one) Hamlet Subdivision Permit Nc,. ~ 06 ~ Date of eeunit. Health DepL Approval: Platming Board Approval: Request for: 'l'empora~T Certificate Fee Subnfitted: $ ),20/ Filed Map. Lot: Underwriters Approval: Fiual Certificate: (check one I FOUNDATION 2ND ROUGH F~i~G & PL ~'~ G ~S[~ATION PER N. ¥. STATE ENERGY CODE F~x 15161 765- 1823 Te~phone i ~; 16 } 765-18(1(I Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 TO: FROM: DATE: RE: SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION $outhold Town Building Dept. Southold Landmark Preservation Comm. - Herb Adler May 2, 2002 Graham Head Residence 1160 Goose Creek La., Tax Map #78-8-5.1 APLIA NO. SD 129 Southold The Landmark Preservation Commission has reviewed the proposed installation of steel beams and columns to support the existing structure internally. The Commision endorses such plans. 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. 30644 Z Date SEPTEMBER 20, 2004 Permission is hereby granted to: GR3tIiAM & BARBARA HEAD 55 WALKER ST APT 5A NEW YORK,NY 10013 for : EMERGENCY STRUCTUR3tL ALTERATIONS TO AN EXISTING DWELLING AS APPLIED FOR. THIS PERMIT REPLACES EXPIRED PERMIT #28401 at premises located at 1160 GOOSE CREEK LA County Tax Map No. 473889 Section 078 Block pursuant to application dated SEPTEMBER 20, 2004 SOUTHOLD 0008 Lot No. 005.001 and approved by the Building Inspector to expire on MARCH ..---~, 2~/~ ~ Fee S 300.00 ~~/~ Aut~y-~d Sig~e ORIGINAL Rev. 5/8/02 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT ~ Upon4he application of upon premise~owned by ~ TOP GUN ELECTRIC GRAHAM & BARBARA HEAD ~ P.O. BOX 1464 GOOSE CREEK LANE ~ SOUTHOLD, NY 11971, SOUTHOLD, NY 11971 ~ Located at GOOSE CREEK LANE LAST HOUSE ON RIGHT ,.qOUTHOLD, NY 11971  Application Number: 1044034 Certificate Number: 1044034 ~. Section: Block: Lot: Building Permit: BDC: NS11 ~ Described as a Residential occupancy, wherein the premises electrical system consisting ~ electrical devices and wiring, described below, located in/on the premises at: r~ Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, Fa was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was ~ found to be in therewith the 4th of November, 2002. compliance Day on Fa Name QTY Rate Rating Circuit Type ~ Additional Charges ~ rough done on paper app, r~ when originally subnuted ~ .Alarm and Emergency Equipment r~ Sensor I 0 Carbon Monoxide ~ Sensor 9 0 Smoke ~ Appliances and Accessories Fa Exhaust Fan I 0 F.H.P. Fa Furnace I 0 Oil ~ Pump/Motor I 0 F.H.P. ~ Water Heater I 0 4.5 KW Fa DishWasher I 0 1.2 KW ~ Panels Fa 1 60 4 ~ Wiring and Devices Fa Receptacle 41 0 General Purpose ~ Switch 41 0 GeneralPurpose seal ~ Fixture 39 0 Incandescent I~ Continued on Next Page I of 2 ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the~application of upon premises ow~e~by TOP GUN ELECTRIC P.O. BOX 1464 SOUTHOLD, NY 11971, Located at Application Number: 1044034 Section: Block: Described as a Residential GRAHAM & BARBARA HEAD GOOSE CREEK LANE SOUTHOLD, NY 11971 GOOSE CREEK LANE LAST HOUSE ON RIGHT SOUTHOLD. NY 11971 Certificate Number: 1044034 Lot: Building Permit: BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 4th Day of November, 2002. Name QTY Rate Rating Circuit T~e Dimmers 3 Receptacle I 0 20 amp Laundry Receptacle I 0 30 amp Dryer Receptacle 5 0 GFCI Service I Phase 3W Service Rating 200 Amperes Service Disconnect: I 200 cb Meters: 1 seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN Olv SOUTHOLD CERTIFICATION Fax (631) %5-9502 Telephone 163 l) 765-1802 Date: BuildingPemfitNo. Owner: Plumber: ~-~ (Please print) /Please print) I certify that the solder used in the water supply system contains less than 2.'1 lead. Sworn to before me this ( 3-- ''' ( p l nm be rs'mS 1-'"' ~1 a-t u re' da3'of ~ - · 20 O~ 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ]ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION ] FRAMING ~.~FI NAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ ~ ~ ~ ~ DATE '--~- ~- o_.~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL '~x~ FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE ~ ;~S-- o_~- INSPECTOR~' ~ 765-18O2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/I~SULATION / [ ] FRAMING [;/] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND [ I INSULATION I FRAMING ~ FINAL ,,~; [ I FIREPLACE & CHIMNEY [ I FIRE SAFETY INSPECTION REMARKS: ~-~ ~ d'~ iNSPECTOR_~-, ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATI.ON [ ] FRAMING / STRAPPING [~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION COMP · AINT REPORT. ADDRESS DATE ACTION 'TAKEN FILE # (IF APPLICABLE) RE-INSP DATE, WARREN SAM~AC, 5167347492 P.02 WARREN A. SAMBACI'I, ~$R. 76'75 COX LANE · P,O. 8OX 10~kl CuI'CHOGUE, NY 11935 631 -t~!~) 2002 Building Department Town of Southold Town Hall 5309~ Main Road $outhold NY 11971 Graham Head 1160 Goose Creek Lane Southold NY 11971 Gentlemen: Examination of the existing &esidenc at the above address' reveals that the building should be B~ored and supported by steel beams before any renovation commences. Warren A. Sambach Sr. P.E. was:s / WARREN A. SAMBACH, SR. CONSULTING ENGINEERS · PLANNERS 7675 COX LANE · P.O BOX 1033 CUTCHOGUE, NY 11935 May 14 2002 Building Department Town of Southold Town Hall 53095 Main Road Southold NY 11971 Re: Graham Head 1160 Goose Creek Lane Southold NY 11971 To Whom it May Concern: Respectfully request an Emergency Permit be issued for the above residence to prevent the possibility of a collapse of the interior bearing walls that have deteriorated. Installation of structural steel beams and lally columns to be installed as per plans submitted. Application and plans will be filed for complete interior alteration and installation of new plumbing, interior walls, kitchen equipment, electrical and mechanical equipment if required. Applications and plans to be filed with the Town Trustees of Southold and Ne%~ York State Department of Environmental Conservation and any other authorities, if required. Requested building permit does not constitute a substantial renovation/addition pursuant to FEMA. Si.~erely, W~rren A. Sambach Sr. P.E. was:s cc: WARREN A. SAMBACH, SR. CONSULTING ENGINEERS - PLANNERS 7675 COX LANE - PO BOX 1033 CUTCHOGUE, NY 11935 6 3 1 _(~6~. 734-7492 May 10 2002 Building D~partment Town of Southold Town Hall 58095 Main Road Southold NY 11971 Re: Graham Head 1160 Goose Creek Lane Southold NY 11971 To Whom it May Concern: The proposed alteration work on the Head residence at 1160 Goose Creek Lane does not constitute a substantial addition or renovation pursuant of FEMA regulations, Sincerely, Warren A. Sambach Sr. P.E. cc: Graham Head WARREN A. SAMBACH, SR. CONSULTING ENGINEERS . PLANNERS 7675 COX LANE - P.O. BOX 1033 CUTCHOGUE, NY 11935 6 3 1(~) 734~7492 Hay 9 2002 Building Department Town of Southold Town Hall 58095 Main Road Southotd NY 11971 Re: Graham Head 1160 Goose Creek Lane Southold NY 11971 To Whom it May Concern: Respectfully request an Emergency Permit be issued for the sbove rzsidence to prevent the possibility of a collapse of the interior bearing walls that have deteriorated. Installation of structural steel beams and lally columns to be installed as per plan submitted. Applicztions will be filed for complete interior alteration and installation of new plumbing, interior walls, kitchen equipment, electrical and mechanical equipment. Applications to be filed with the Town Trustees of Southold, and New York State Department of Environment and any other authorities. Cellar to be backfilled to grade to conform with FEMA regulations. Sincerely, Warren A. Sambach Sr. P.E. was:s cc: Grahm Head WARREN A. SAMBACH, SR. CONSULTING ENGINEERS - PLANNERS 7675COXLANE PO BOX 1033 CUTCHOGUE, NY 11935 6 3 1 -~) 734.7492 May 3 2002 Building Department Token of Southold ~,~ Hall 53095 Main Road Soutbold NY 11971 Graham Head 1160 Goose C reek Lane Southold NY 11971 To Whom it May Concern: Examination of the existing residence at the above address reveals that steel beam support should be installed as soon as possible to shore up the first floor before it collapses. Plans have been prepared showing steel beam support and lally columns. Sincerely, Warren A. Sambach Sr. P.E. Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda · peggy ~. Djc. k_e_r_sjo _n BOARD OF TOWN TRUSTEES TOWN OF SOUTItOLD Town Hall 53095 Route 25 P.O, Box 1179 Southo[d. New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 November 26, 2002 Mr. Bruce A. Anderson Suffolk Environmental Consulting, Inc. Newman Village. Main Street, P.O. Box 2003 Bridgehampton, New York 11932-2003 Re: Situate: SCTM #: Property of Graham Head Goose Creek Lane, Southold 1000-078-08-005.1 Dear Mr. Anderson: In response to your letter dated November 14, 2002, please be advised that the Southold Town Board of Trustees do not regulate activity consisting of interior renovations within an existing dwelling where thera is no expansion of the footprint. Likewise, any renovation of the existing detached garage does not fall within the purview of the Trustees as the garage is greater than 100 feet from the landward edge of the tidal wetlands. This letter represents the decision of the Board of Trustees and shall not be deemed a determination of any other agency or department considering an application for the same or similar project. Very truly yours, /' Albert J. Krupski, Jr. President, Board of Trustees cc: Building Department WARREN A. SAMBACH, SR. CONSULTING ENGINEERS · PLANNERS 7675 COX LANE - P.O. BOX 1033 CUTCHOGUE, NY 11935 6 3 ~ -- ~.5~734-7492 May 14 2002 Building Department Town of Southold Town Hall 53095 Main Road Southold NY 11971 I%00D FLOOD DAMAGE PREVENTION $OUTHOLD' TOWN Re: Graham Head 1160 Goose Creek Lane Southold NY 11971 To Whom it May Concern: Respectfully request an Emergency Permit be issued for the above residence to prevent the possibility of a collapse of the interior bearing walls that have deteriorated. Installation of structural steel beams and lally columns to be installed as per plans submitted. Application and plans will be filed for complete interior alteration and installation of new plumbing, interior walls, kitchen equipment, electrical and mechanical equipment if required. Applications and plans to be filed with the Town Trustees of Southold and New York State Department of Environmental Conservation and any other authorities, if required. Requested building permit does not constitute a substantial renovation/addition pursuant to FEMA. Si,~erely, Warren A. Sambach Sr. P.E. was:s cc: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 E×amined ~'//~ .20 Appro,, ed ~/~,> ,200..,2 Disapproved a c Fxpiration ,20 BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO. ~2~,~-o / ~. Do you have or need the following, before applying'? Board of Health 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S,D.E.C. Trustees Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date 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 prenfises 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. .~U?PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pemfit 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. ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ l~l:h {'{t~:r'}'k ~ (As on the tax roll or latest deed) ph~n~pt'l~ration, signature of duly authorized officer ~" ~" - ~Na~//w~nd title of corporate officer) Builders LicenseNo. ~ ~ t Z~ - ~ Plumbers License No. ~ ~ ~ Electricians License No. ~ Other Trade's License No. ~ Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section '7~' Block Subdivision Filed Map No. (Name) Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy '~--~t~"X.~ 6~- b. Intended use and occupancy 3. Nature of xvor~heck which applicable): New Bn/lding Addition Alteration Repair ~ Removal Demolition - Other Work Estimated Cost ~[~ '~t~l~ If dwelling, number of dwelling un/ts If garage, number of cars Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Dimensions of same structure with alterations pr ad,,ditions: Front Depth ~'O '-~'~ Height 2_-? .- E, Number of Stories .Depth Rear Dimensions of entire new construction: Front Rear Depth Height Number of Stodes 9. Sizeoflot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated l 2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO / 13. Will lot be re-graded? YES NO t,'~ill excess fill be removed fi.om premises? YES__ NO __ 14. Names of Owner ofpremises~g.~,~a~ ~(~s~l~ Address Itl.~ ~~Phone No. Name of Architect Address Phone No o ~ Name of Contractor bt~lJ.a~ ~ Address 4~,tt, O,$~ ii~ Phone No.(~t~44~-~: . 14(~, ~ 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 sutw,ey. STATE OF NEW YORK) SS: COUNTY OF ) :'7 ]~?_~:~ex \(~ - %,~',N~_~ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 tree 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 day of Nota'r~ublic ~A~licant ELIZABETH A ~TATHIS NOTARY PUBLIC, State of New Yo~ No. 01ST6008173. Suffolk Coun_t~ ~ Term Expires ,June 8.20L1,7_~..~