HomeMy WebLinkAbout31604-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31750
Date: 08/10/06
THIS CERTIFIES that the building ADDTIONS/ALTERATIONS
Location of Property: 680 TRUMANS
(HOUSE NO.)
County Tax Map No. 473889 Section 31
PATH
(STREET)
Block ~
EAST MARION
(HAMLET)
Lot 2
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 16, 2005 pursuant to which
Building Permit No. 31604-Z
dated
NOVEMBER 16, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MATTHEW BLOCH & MARILYN PASIERB
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
2092211
07/26/06
PLUMBERS CERTIFICATION DATED
07/10/06 PECONIC PLUMBING & HEAT.
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~orrd Si ature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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:
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 buildiugs and "pre-existing" land uses:
I. 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,
7/10 fOb
I I
New Construction:
Old or Pre-existing Building:
~ro Irv.rl\GU\..1 P6.--'I-L
House No, Street
./
(check one)
Location of Property:
EWI-t- mo.f'l~
Hamlet
Owner or Owners of Property:
m ().... '\-\-V\ e..vJ v'6 \ 0 e... \.-..
Suffolk County Tax Map No 1000, Section
<'1
Block I '2-
Lot
'L
Subdivision
Filed Map,
Lot:
Permit No. 3\\I)04-?::
Dateofpermit. l\ \ \lD (OJ/' Applicant: -(SO'n('\ v3~, 0\c!.r~
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Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ J),/ VO
Underwriters Approval:
Final Certificate:
,/
( check one)
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pphcant Signature
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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 owned by
G & S ELECTRICAL CONTR.
P.O. BOX215
SOUTHOLD, NY 11971,
MATHEW BLOCH
680 TRUMANS PATH
EAST MARION, NY 11939
680 TRUMANS PATH EAST MARION, NY 11939
Application Number:
2092211
Certificate Number:
2092211
Section:
Block:
Lot:
Building Permit:
BDC:
ns11
Described as a Residential 600-1199 square ft. occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Second 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 ECnforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 26th Day of
July, 2006.
OTY Rate
Ratin2
Circuit :ll1!!!
Name
Miscellaneous
second floor addition
Alarm and Emergency Equipment
Sensor
Sensor
Wiring and Devices
Outlet
Fixture
Outlet
Receptacle
Switch
Paddle Fan
Heat, Light, Vent
Receptacle
I 0
2 0
Carbon Monoxide
Smoke
Fixture
Incandescent
General Purpose
General Purpose
General Purpose
13 0
13 0
21 0
14 0
13 0
2 0
1 0
I 0
GFCI
seal
I of I
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
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Date: --J lJ...-\d
10 LOO'=>
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Building Permit No. '3 HoD 4 ~
Owner: _m[J-..~l:-uJ f6 \o~
(please print)
Plumber: Pe.cOAC'(' M-tf
(please print)
GCO'aE 1': 8ei'rt ;f~
I certifY that the solder used in the water supply system contains less than 2/10 of 1%
lead.
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(umers~ '
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Sworn to before me this _I 0
day of -:r v-l'-1 , 20 0 to
0~ k:.;' 'd, cR~
Notary Public,
County
VICKI L. LOPER
Nolary Public, state of New 'IoIt<
No.OIL06071lO81
QualifiodinSUtlQll~I'.
Commission EJpim~ 0
James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
John Holzapfel
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0124C Date June 29, 2006
THIS CERTIFIES that the second floor addition and sanitary system
At 680 Truman's Path, East Marion
Suffolk County Tax Map # 31-12-2
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 6/21/05 pursuant to which Trustees Permit # 6149A
Dated July 20, 2005
Was issued, and conforms to all of the requirements and conditions of the applicable
provisions of law. The project for which this certificate is being issued
is to construct a second floor addition and install a new sanitary system.
The certificate is issued to
Marilyn Pasierb and Matthew Bloch
owner of the
aforesaid property.
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Authorized Signature
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.
31604 Z
Date NOVEMBER 16, 2005
Permission is hereby granted to:
MATTHEW BLOCH
675 WATER STREET APT 19F
NEW YORK,NY 10002
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
680 TRUMANS PATH
EAST MARION
County Tax Map No. 473889 Section 031
Block 0012
Lot No. 002
pursuant to application dated NOVEMBER 16, 2005 and approved by the
Building Inspector to expire on MAY 16, 2007.
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Fee $
427.80
ORIGINAL
Rev. 5/8/02
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] I~TION
[ ] FRAMING I STRAPPING [ 41NAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
-
DATE 7fi'r.
INSPECTOR
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
To: Town of Southold Building Dept.
Re: Insulation Inspection
Bloch
680 Trumans Path
East Marion
Permit#31604
To Whom It May Concern:
After an Insulation inspection was preformed on the above property, it is deemed that all
Insulation was installed correctly, and meets all building codes. Any other questions
please call.
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JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
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To: Town of South old Building Dept.
Re: Framing/PlumbinglStrapping Inspection
Bloch
680 Trurnans Path
East Marion, NY
Permit# 31604
To Whom It May Concern:
After a Framing, Strapping inspection was preformed on the above property, it is deemed
that all work performed was completed to plans and meets all state and local codes. A
Plumbing Inspection was also performed on this structure with a pressure test on the
copper and the vent stack being filled with water to the roof. Any other questions please
call.
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FIELD INSPECTION REPORT DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
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ADDITIONAL COMMENTS
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Albert J. Krupski, President
James King, Vice-President
Artie Foster
Ken Poliwoda
Peggy A. Dickerson
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 6149A
Date of Receipt of Application: June 21, 2005
Applicant: Marilyn Pasierb & Matthew Bloch
SCTM#: 31-12-2
Project Location: 680 Truman's Path, East Marion
Date of Resolution/Issuance: July 20, 2005
Date of Expiration: July 20, 2007
Reviewed by: Trustee Artie Foster
Project Description: To construct a second-floor addition to the existing
dwelling and install a new sanitary system on the landward side of the dwelling.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 97 of the Southold Town Code. The
issuance of the Administrative Permit allows for the operations as indicated on
the survey prepared by Joseph A. Ingegno dated July 14, 2004.
Special Conditions: Drywells and gutters must be installed to contain the roof
run-off.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 97 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
~.J9.~'0.
Albert J. Krupski, Jr., President
Board of Trustees
MER Y L K RAM E R
architect
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Mr. Damon Rallis
Southold Town Building Dept.
Southold Town Hall
PO Box 1179
Southold, NY 11971
VIA FACSIMILE 765,9502 and mailed original
November 15, 2005
RE: PASIERB RESIDENCE
TAX MAP # 1000-31-12-02
Dear Damon,
As per our telephone conversation earlier today, I am writing to certify that the existing septic system for this
property will be adequate to senle the proposed addition.
Please call with any other questions or concerns,
B st e ards,
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31 SOUTH STREET p,o, BOX 683 GREENPORT, NY 11944 631-477.8736 631.477.8936 FAX
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
NUMBER
3408100001
CllITYIPROGRAM NUMBER(S)
.
PERMIT
EFFECTIVE DATE
11 April 2005
EXPIRATION DATE(S)
30 April 2010
Under the Environmental
Conservation Law
TYPE OF PERMIT . New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to Operate
::J Article 15, Title 5; Protection of
Waters
o 6NYCRR 608; Water Quality
Certification
o Article 27, Tolle 7; 8NYCRR 360;
Solid Waste Management
::J Article 15, Title 15; Water Supply
o Article 17, Titles 7, 8; SPDES
o Article 27, TiUe 9; 6NYCRR 373;
Hazardous Waste Management
] Article 15, Title 15; Water Transport
o Article 19; A'Jr Pollution Control
] Article 15, Title 15; Long Island Wells
o Article 23, Tolle 27; Mined Land
Reclamation
o Article 34; Coastal Erosion
Management
] Article 15, Tille 27; Wild, Scenic and
Reerea tlonal Rivers
. Article 24; Freshwater Wellands
o Article 36; Floodplain Management
o Article 25; Tidal Wetlands
o Articles 1, 3, 17, 19,27,37;
6NYCRR 380; Radiation Control
PERMIT ISSUED TO
Mari Pasierb
ADDRESS OF PERMITTEE
675 Water Street, l. 19F, New YOI1<, NY 10002
CONTACT PERSON FOR PERMITTED WORK
M I Kramer, PO Box 683, Green NY 11944
NAME AND ADDRESS OF PROJECTIFACILITY
Pasierb , 660 Trumans Path East Marion
LOcATION OF PROJECTIFACllITY
SCTM;j00ll'iJ31-12-2
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TELEPHONE NUMBER
212-619-3511
TELEPHONE NUMBER
631-477-8736
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DESCRIPTION OF AUTHORIZED ACTMTY:
Add a second story to the existing single story residence. All work is to be done in accordance with the attached plans
stamped NYSDEC approved.
By acceptance of this permR, the permittee agrees lhalthe permit is oontingenl upon strict compliance with the ECL, all applicable
IQulations, the General Conditions specified (see _ 2 & 3) and any Spec/a1 Conditions included as part of this permR.
PERMIT ADMINISTRATOR:
George W. Hammarth,
Deputy PermR Adminstralor
9U
AUTHOR EDSIGNA~
ADDRESS
Region 1 Headquarters
Bldg. #40, SUNY, Stony Brook, NY 11790-2356
DATE
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Page 1 of4
BUILDING DEPARTMENT
TOWN !;IALh
SOUTIIDLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
wwW.northfOrk.net!SOUlhOl~7.NO. ,
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Do you have or need the following, before applying'!
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Cheek
Septic F onu
NY,S,D.E.C
Trustees
..,Intact:
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Examined
Approved
Mail to:
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Phone:
Disapproved ale
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\Vf:. I~\\\\ ". ~2PLICATIONFORBUlLDINGPERMIT
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a . It>p~IrlUuST~] \~\ ly filled in by typ~writer l'r in ink and submitted.to the ~uilding Inspector with 3
sets of plans, a . ~ateplot p~.tO~.i& c\la cording to schedu1~ . :', T }"" ":.~
b. Plot \sh~"lo~t~f lq of buildings on premises, relationship to adjoining premises or public streets or
areas, and wat . 1 r
c. The ork er~'b'y' t1filraRR\ifati~ may not be commenced before issuance of Building Permit.
d. Upo appr~ " . i n, e Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on e 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 South old, 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 onrr. 0 i' rt p~ b~ldi~g!:. n,,_ecessary inspections.
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State whether applicant is owner, lessee, agei'it;"atchitect. engineer, general contractor, electrician, plumber or builder
(As on the tax TO
If applicant is a corporation, signature of duly authorized officer
eed)
Name of owner of premises
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
bee> '"'TP..\JMt\...tJ\.S 71H"H-
House Number Street
eAs-r Y'rm~~
Hamlet
County Tax Map No.1 000 Section
Subdivision
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Block 12-
F~led Map No.
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Lot
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(Name)
2. State existing use and occupancy of premises imd intended use and occupancy of proposed construcJion:
a. Existing use and occupancy 'Dill"'" 1.1 ~~ )
b. Intended use and occupancy ~"'\t'r
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated costj:.l0tl, ()()O
5. If dwelling, number of dwelling units--1
If garage, number of cars
Addition
Other Work
v
Alteration
(Description)
Fee
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front-Jig. t6 I Rear it o. " ' Depth
Height--..2G".Jt '. Number of Stories.::~- --1
Dimensions of same structure with alterations or additions: Front ~ O. " I
Depth ~ ~ _ '2..' . Height ~"I-' - 4 ~ Number of Stories
. . . 2'2' _ I u-
8. Dimensions of entire new construction: Front_ 7 '7" If Rear ~ ~ -,
Height :2 ~ 1_ ItW Number of Stories :L
9. Size oflot: Front_f3tJ. "0' Rear ~Lf' 211 Depth -:;O~;\~.~I
-36.z.'
11~1 I. 0 ,_,1
"R.ear~
2.
-t I .
Depth "'~ _ Z
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated /{. '1-
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO -
- -
13. Will lot be re-graded? YES_NO-Will excess fill be removed from premises? YES_NO_
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address
Address
Address
Phone No.
Phone No
Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V- 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 !:)v F f. II. )
--.1Jl,eyfl J "'1M _.,,~ being duly sworn, deposes and says that (s)he is the applicant
(Name o~ct) above named,
(S)He is the ~~
.. 0 - '(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
l~"~ day of -:r~ll 20 o~-
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Notary Publi~" .'
John M. Judge.
NOTARY PueLlC6,State of New York
No. 01JU605940
Qualified In Suffolk County
Commission Expires May .29, 20 J2J.
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