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HomeMy WebLinkAbout31406-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31400 THIS CERTIFIES that the building ALTERATIONS Date: 01/17/06 Location of Property: 740 NORTH VIEW DR ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 13 Block 1 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 2005 pursuant to which Building Permit No. 31406-Z dated AUGUST 29, 2005 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 "AS BUILT" ALTERATIONS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to of the aforesaid building. SIMM L DAVID SZCZEPANKOWSKI (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 105434C 01/04/06 PLUMBERS CERTIFICATION DATED Rev. 1/81 IYIG1 ori ed 'gnature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31399 THIS CERTIFIES that the building ALTERATIONS Date: 01/17/06 Location of Property: 740 NORTH VIEW DR ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 13 Block 1 Lot 4 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 2005 pursuant to which Building Permit No. 31406-Z dated AUGUST 29, 2005 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 "AS BUILT" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED The certificate is issued to SUSAN SIMM & DAVID SZCZEPANKOWSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 105434C 01/04/06 PLUMBERS CERTIFICATION DATED Rev. 1/81 12/13/05 KING PLUMBING ho zed ignature Form No. 6 TOWN OF SOUTHOLD BUILDINGTOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCX, 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: I. 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. 11'a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees ,I. 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, os — New Construction: Old or Pre-existing Building: Location of Property7_ AO / � ` L11 ew _)%! _v -: House No. Street Owner or Owners of Property: J bt-1 / %y1 ^ 7 �� '/y Suffolk County Tax Map No 1000, Section _ J 3 Subdivision 22 _- _ c, Permit No. 11 / Date, of Permit Health -Dept. Approval _ Planning Board Approval Request for: lenaporary Certificate Fee Submitted: l 6.2,_-- 0 515 cdd-t 3)y00 Block_ (check one) -- ----- -- ---- Hamleet_ �-2- Filed Map 1-ot: Applicant: U `terl N r Underwriters Approval: Final Certificate: l/ (check one) Applica tt Signature I Form No. 6 1 TOWN OF SOUTHOLD ( 1 BUILDINGTOWN HALL 765-1802 SAN APPLICATION FOR CERTIFICATE OF OCCUPANQ} .,�. 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. Comrnercial 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, Switruning 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: T (check one) Location of Property: _ 7 V O /VD ry HouseN(o. Street �+ Han-Jet Owner or Owners of Property: S %n n �� '�/ J 2 G z c- 'of y )C ,o t v S / Suffolk County Tax Map No 1000, Section / 3 _ Block Lot — Subdivision _._ __. _ Filed Map _ Lot: Permit No. ! 7 Date of Permit 8 D r Applicant: ✓ U �f _ l H" r Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Fee Submitted Temporary Certificate 1211?. (0 eL) 3139 9 Final Certificate: (check one) Applicat t Signature 31yo6--E Electrical Inspection Certificate Issue Date Electrical Inspection Service, Inc. Application 1/4/2006 375 Dunton Avenue 105434C East Patchogue, New York 11772 (631)286-6642 Issued To: Ms. Susan W. Simms Street: 740 North View Drive Village: Orient Zip: 11957 Town: Southold Section: Block: Lot: Contractor: Lademann Electric Inc. Lic. # 4141-E Was examined and found to be in compliance with the National Electrical Code. ❑ Commercial ❑ NV Defects ❑ Pool ❑ 1st Floor ❑X Indoor ❑ Basement ❑ Hot Tub X Residential N Det. Garage ❑ Attic ❑ 2nd Floor © Outdoor ❑ Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 3 5 1 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector of Bldg. Permit: Other Equipment 1- 100 Amp Sub Panel / 1- 30 Amp A/C — Disconnect Hugo S. gurdi President Rough Inspection: Inspector: Final Inspection: 12/29/2005 Inspector: John McMahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 co at Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CE R T I F I C A T 10 N Bujldin- Permit No. 31yv(p Owner: (Please print) Plumber: -)�/ rVC "-v Y�oe- (Please prinP lead. Date: I certify that the solder used in the water supply system contains less than 2/10 of 1% (Plumbers $Kiature) Sworn to before me this IS4", day of 2 0 0 CA Notary Public, —4, County BARBARA ANN RUDDER Notary Public, State of Now York No�4855805 Qualified in Suffolk County 0 �ornrnlssion ExpIrso April 14,112a— 6� 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. 31406 Z Date AUGUST 29, 2005 Permission is hereby granted to: SUSAN SIMM 740 NORTH VIEW DRIVE ORIENT,NY for : AS BUILT ALTS TO AN EXISTING DWELLING AND TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. 2 COS REQUIRED. ADDITIONAL CERTIFICATIONS MAY BE REOUIRE at premises located at 740 NORTH VIEW DR ORIENT County Tax Map No. 473889 Section 013 Block 0001 Lot No. 004 pursuant to application dated AUGUST 25, 2005 and approved by the Buildinq Inspector to expire on FEBRUARY 29, 2007. Fee $ 450.00 Rev. 5/8/02 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPT. 76S-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND[ ]71NAL ULATION [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE C f INSPECTOR SURVEY OF PROPERTY CERTIFIED 701 nT HEIBI fRLO SOMNERS AT ORIENT HEATHER IT S MERSATWAR MOP` "J`° TOWN OF SOUTHOLD :4 SUFFOLK COUNTY, NEW YORK 1000-13-01--04 SCALE: 1"=40' APRIL 17. 2002 i so" SOMM _Y: 172bB' N BZ J��Mxvx I p rj 4%47FD4 A �1 Ti 1��. vmE PIEw Dl� �.. m NO1�T me"" oe 4 i qN� NB /��/J��J7'�! LIC. NO. 49610 �L�Y7M.aN.Y.S. 'PECgNIC TMUCYORS, P.C. (631) 765 - SOLO . TAX,(631) 765-1797 P. a BOX 909 :a'+NONLWENT 1230 TRAV&ER STREET SOOTMXA," N.Y. 11$710? -75 kw f FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (1ST) --------------------------------- -------------------------------------- FOUNDATION 2ND) FOUNDATION n z 0 ROUGH FRAMING & y PLUMBING – — ------ -- -- - 7 INSULATION PER N. Y. STATE ENERGY CODE -- -- -- _ – -- --- – --_- FINAL�f - ADDITIONAL COMMENTS -- - -- — - --- - - -- -- o -- - -- - - - - -- — z (/1 m -- — -- -- — - -- .---- --- -- — - Q- m --- --- - O O ----- - -- - J z to b TOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ 20 J 20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health_ 4 sets of Building Plan Planning Board approval Contact Survey Check ;t % Septic Form___ N.Y.S.D.E.C._ Trustees Mail l o: Phone:_ 3 � M 8 4- BuildiRf I spector APPLICATION FOR BUILDING PERMIT Date Y� 20�%J' i a - ., • � �� o INSTRUCTIONS 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. 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 is:yres 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 a licant or name, if a corporation) -2—e9i o s' /4 of 1 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumbe or builder u Sli n .) Y /✓GCiv� G� �Z C Z e, A6L S�/ Name of owner of premises W ' � � %`� (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. -2— Plumbers 2Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on wh'ch proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section -Block l Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and in a. Existing use and occupancy / h b. Intended use and occupancy% 3. Nature of work (check which applicable): New Buil Repair Removal Demolition 4. Estimated Cost D u o Fee occupancy of proposed construction: 2/ v R' /'h i Other (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars / g=4 r 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 NOA 13. Will lot be re -graded? YES NO Will excess fill be removed from premis v 14. Names of Owner of prmihes -ZAddress 7 y� Phone N©3 L 3 ' t% Name of Architec �'4 h Address/.//W4 G Phone No �G S� Name of Contracto a z K Address Phone No. Y —zzee 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 O&Atu ) M,zo' '/�lK e r (Name of individual signing contract) abov named, being duly sworn, deposes and says that (s)he is the applicant (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 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 efore me this / }L- day of j 20 0 J Notar blic MELANIE DOROSKI NOTARY PUBLIC State of New York No. 011304634C-1,0 Qualified in Suifulk County Commission Expires September 30,{�1LJ O X114 //- lc--� Signat re of Applicant n w 9 0f �0 LONG ISLAND SOUND N 8244435 "• 5 172.68' TIE LINE BOTTOM OF BANK I 1 \is rO\ .O �O _ TOI° OF BANK j Z SLATE 5TEP9 � O ' I � � 1i J STY N I �i 5 8D%pc�I0011 w 150.00' SITE DATA SCTM # 1000-13-01-04 PROPERTY: 740 NORTH VIEW DRIVE ADRESS ORIENT, NEW YORK •11957 OWNER: SUSAN W. SIMM & DAVID SZCZEPANKOWSKI 188 E. 64 STREET NEW YORK, NY. 10021 SITE: 51,836.4 SQ. FT'. = 1.19 ACRES TO TIE LINE ZONING: R-40 SURVEYOR: PECONIC SURV'EYERS P.C. 54655 MAIN ROAD SOUTHOLD, NY. 11971 (631)-765-5020 N.Y.S. LIC. NO. 49618 DATEDAPRIL 17, 2002 LOCATION MAP �l / APPROVED AS NOTED DATE: 5 B.P.# FEES' BY -Y WITH ALL CODES OF NOTTOWN COOFS 1 BUILDING DEPARTMENT AT, YORKER Afy� CONDITIONS OF FOLLOWING GAM TO 4 P FOR THE AS REOU FOLLOWING INSPECTIONS: SOU'HOLDTOW'ti3A 7. FOUNDATION -TWO REQUIRED FOR POURED CONCRETE sou THOLDTOWNPLANNING BOAflD 2. ROUGH - FRAMING & PLUMBING $OUTHOLCTOWNiflUSTEES 3. INSULATION 4. FINAL - CONSTRUCTION MUST N.V.S. DEC BE COMPLETE FOR CA. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. OCCUPANCY OR USE IS UNLAWFUL ALL CONSTRUCTION SHALL WITHOUT CERTIFICATE MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. OF OCCUPANCY urILUTY FOLE WITH6UYFURE \/EVIEWIDRIVE NORTH V 4' SITE (PLAN SCALE: T' = 20'4 - I .11 J' I U a` o W c /' . ., pWq// Id. .w >0 Q . Z~ d. N11 S�NAA' V; k w -j r co) 0) Ur 5~pS� T �'A� 9� 2017953-1 h s.FR�D 0503 DRAWN BY: RJB CHECKED BY: DATE: 8126106 SCALE: V. = 20'-0" I SHEET TITLE: SITE PLAN SHEET'NO.: s P i ECK R MASTERi - - --- ----T ---- ----� BEDROOI�i �I � � ' I 2-2x6 I d 30X43 51t'V'!}16HT— _ H2-2XI06 (2 LOG. ,'L.R)17 .I I LIVINGu ROOM, I) II EXI5TIN6 RIDGE ATH I ul ——�— II EXISTING RIDGE AT ® HALL I u nI II II — ' REMOV@ ISV, It— _ui_. FR pp I BEDROOM ii HALL =X 3O SKYLIGHT --1 1 p� I ° KITCHEN I I II II i I NM -- ----6w- - I I I -------------------------------I FIRST IFI PLAN - AS BN ;Y Z, Z OW B H O� IM/ I.I. Z, ui �I ca Z. k w -j: I? �<Lu � W • o Y.. OF N,I,1Y PSE Ao� p Z ti 2 17953 FRfD A � ROJE NO: 0503 RAWN Y: RJB 8/25/05 1/4" -�,V -0" HEET.TITLE: t AS BUILT FLOOR PLAN SHEET NO: