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HomeMy WebLinkAbout32392-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32037 Date: 11/29/06 THIS CERTIFIES that the building FOUNDATION REPAIR Location of Property: 16500 MAIN ST (HOUSE NO.) County Tax Map No. 473889 Section 117 (STREET) Block 9 NEW SUFFOLK (HAMLET) Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 2006 pursuant to which Building Permit No. 32392-Z dated SEPTEMBER 26, 2006 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 FOUNDATION REPAIR OF AN EXISTING DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH H & JOAN M. FUDJINSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~,~. Rev. 1/81 . Form No.6 TOWN OF SOUfHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 r I ! , Ii' r:Ui 2 8 C ~"',. ~~. I ....--.,.---.1 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 I % 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: 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 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. 1/ u/-o& I)] a.(~~ Old or Pre-existing Building: 1/ (check one) M ,.~ 'f. e 1-<./ S cJ t Pol" s-r . Street Hamlet New Construction: Location of Property: I C:: 5" c () House No. Owner or Owners of Property: -~CIS I? to It H + I Suffolk County TBj< Map No 1000, Section 1/-7 3 ~ f q Joan In Fudj (/is~ i Block I / 7 I - 1 Lot I? Subdivision Permit No. 3^-31 ~ .-Z- Date of Permit. Health Dept. Approval: Planning Board Approval: Filed Map. 10 /)..0 h? Applicant: I I Underwriters Approval: Lot: Fuctj (I~Sf.. f Request for: Temporary Certificate Fee Submitted: $ :J. C:;, (.Ie) Final Ce,rtificate: l/ ( check one) ~1 '. , APPli~ ~~. 711.{ (2- Co 'e;:J03 7 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. 32392 Z Date SEPTEMBER 26, 2006 permission is hereby granted to: JOSEPH H & WF FUDJINSKI 564 FIRST ST BROOKLYN,NY 11215 for : FOUNDATION REPAIR OF AN EXISTING DWELLING AS APPLIED FOR at premises located at 16500 MAIN ST NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0009 Lot No. 013 pursuant to application dated SEPTEMBER 19, 2006 and approved by the Building Inspector to expire on MARCH 26, 2008. Fee $ 150.00 re ORIGINAL Rev. 5/8/02 ~ y~ iPC:ScdE PROFESSIONAL ENGINEER 1725 HOBART ROAD I PO Box 616, SOUTHOLD, NEW YORK 11971 TEL631.7652954. FAX631.6143516 . e-mail: j05eph@fischetti,com Date: Reference: September 19, 2006 Fudjinski 16500 Main S1. New Suffolk Southold Building Dept PO Box 1179 Southold, NY 11971 fr'-r'- 'i r:l ,i~ Ii:' ~"\J I ~~fP I 9 2~06 I /.,' ", ," J ----.:....'': ,~-f':.'-l{-: :-'1" ~, ,,' -~.~ r" Dear Sir, The Fudjinski's obtained building permit #21211 Z on 2/4/93 for there property on 16500 Main Street in New Suffolk for the installation of a new foundation under an existing accessory building, They obtained a CO for that work, This past week ends storms caused the east foundation wall of that structure to collapse, Because of the unsound condition I have directed the contractor to temporarily support the floor structure, I am presently working with the contractor to rebuild that east wall out of reinforced concrete consisting of B"x 16" concrete footings with an B" concrete foundation wall. This reconstruction will be consistent with that prior permit. Because of the emergency nature of this work I am attaching a permit application for this work that should be expedited, Also enclosed is a check for $150,00 from Ms, Fudjinski. I will be overseeing the reconstruction of the foundation wall to completion, MEMfORM.OOc 1,'\()ARD CFfUH"lET) ~~,T;;iU(>UF/;i EN(~INEt_:R 3~3~;LZ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION lXf FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: r~~ . ~ Ok.. o 10 ~~ 7,- & t ..&-A t2 >/ld. DATE INSPECTOR ........... ~ ~ FIELD INSPECTioN REPORT . FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS COMMENTS OJ..., ~~ ~ ~ tV" ~ 2 o .-' . b (/\ o ~ Ci r;:; ~ .., f ") .ft ~ ~ .., - ~ t (j) ~ l: ) 0 I/' :e .Z m ;U t--/ w~ . ~ ~..., ~~ o ::l o 2 = 9 ---.., 1'-= = ~ ~ Examined Approved Disapproved ale PERMIT NO. .2f;J51d-~ BUILDING PERMIT APPLICA nON CHECKLIST Do you have or need the following, before applying? Board of Health ,. 4 sets of Building Plans Planning Board approval '" Survey ...... Check Septic Form N.Y.S.D.E.C. Trustees Contact: TOWN OF SOUTHOLD BUILDING DEP;\RTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlS ,20~ 20+ ",'~ Mail to: Phone: Expiration ,20_ ~. __,___~___r-~--:---r \\ ~.-. r; '- f (' "',' , .\ '. $?pt- \ 9 Olo APPLICATION FOR BUILDING PERMIT .. , )1,1"" __J ,:__..~ Date 9//Cf ,20M 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 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 ofthe Town of Southold, Suffolk County, New Y and other a licable ws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or ~ r re oval or d ition a he in described. The applicant agrees to comply with all applicable laws, ordinances, building c de, h sing c de, d re latio ,and to admit authorized inspectors on premises and in building for necessary inspections. ( . gnature of applica t name, if a corporation) 172~ Ihb~f ~~ (Mailing address of applicant) State whether applicant is owne , lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ; ~ Vl.W) Name of owner of premises J ()'5 e Ph Fe) d I !/lAG" k I J , (As on theYax 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. County Tax Map No. 1000 Section_I I 7 Subdivision Block 9 Filed Map No.- tY~ $; f;1/c HamletlllMMWMOInM 1I,;;'( ....''3.~q~. !'.I6J2 '_.~ " .' . ',ilAW10. ""f~~'!l, r "'Lbt{.,.","!",,~ 1. Loc tion 06land on which ~osed w~ ~ill be done: ouse Number Street (Name) 2. State existing use and occupancy of premises a. Existing use and occupancy se and occupancy of proposed cons,truction: b. Intended use and occupancy /fly ~ j 3. Nature of~r (check which applicable): New Building Repair _ Removal Demolition '- Addition Other Work Alteration 4. Estimated Cost /O} cmo (Description) Fee 5. If dwelling, number of dwelling units If garage, number of cars (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 Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: 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_Will excess fill be removed from premises? YES_NO_ 14. Names of Owner ol;:emises ih Name of lw:hitect '\.1"; i1 ScAt Name of Contractor Address Address /?2fJ JIo6~J-fi!rI Address Phone No. Phone No 6'J( -76.5'-469- 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: CO~TY OFS A~~ --..J{)S 9p h hs. ~1/J being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) aro~amed, (S)Heisthe ~f ~~,--- (Con ractor, Agent, Corporate Officer, etc.) Sworn to before me this ~ dayof~2<\.:2"..a ~ary~c . Q~~ ....,. 140448 bk !uffoIk CoU"" CammlaIianfxpires J.nua~ ;. ~O (C) ork and to make and file this application; and elief; and that the work will be of said owner or owners, and is duly authorized to perform or have performed the s that all statements contained in this application are true to the best of his knowled performed in the manner set forth in the application filed therewi n..... ~-:. .. c ~~ " -~ ~... J-' rV'f.. ~~ ~ . 1;;<:., "'\. . ~ '" ,.~ ~~ I \ \-y- l\ ~ .:: "- . ~ ..::. -..- ,. ..s:. "0- . o i o oS: ~ ....~ ~~ .." r>\ ',.' ;~, ", ~, .' .~ . " ,\,. '.. r..~?~,--:jl h r";j I ~ c..n I~.~.." :" ~cl _.J t'....::> .:., :, J , &S Co. :. ._~3J ~ ~ -+-~ 'OJ" ~f ~i ,< € - j::\)1 o (D "'-d\ , -c: '=> ~' - AS NOTED B.p. II -;;/:2. / ;;, ~ ~ mffiFY Ul ""- 765-1802 9 A ~ $'"' FOllOWING IN ""'-- b 1. FOUNDATIO .... - FOR POURE t2. ROUGH - F ~ . 3. INSULATION! ~ 4. FINAL - NSTRUCTION MUST ~ ee COMPl FOR C.O. ~ ALL CONSTR' ON SHAll MEET THe REQUIR. NTS OF THE N.Y. STATE CONSlll cnON & ENERGY CODES. Nor I ESPONSlBLE FOR DESIGN OR TRUC110N ERRORS B. DEPARTM :r 10 4 PM FOR THE ECTIONS: - lWO REOUIRED .ONCRETE MING & PLUMBING pi I. c.. 0 C DOlO'-. <-1(5 _ -' -- . .., --- --..C.><= L..-- n..-o..:\ LJ ~ f('<r:l . "t'R,r,\.,~,r\ Ur" ^1\{\';. ry....t''l~''if..lV,"'''',.,..~ . ~"JtJ\J,Ljt ~~.t~ '\':'.;s'''l.~l. 'l\~.t: \S. u.t\:.U....:.:,,-l(\r..,.~ '...;"'" '. C'" r;; , n'" 'I , ,,\ \ .... i " ~--.- *... h-o:, -h ~, .. ~ -f"'"" ,nt, \ ~ . JL~\ ~. V:1 I \ "\)\.",U ~ '( ;;....~\,.fI """"\.,,",t(',,, , ~ ' ,. ''4 " ~ -j I.\., ~. . }'~f\~ ! 'J"" ~._;, to",\J ,,",, f....~." ~ I.( ~. I" ~" [\~:"" ',- :': \.) I. ~. 1,>, tf"<l.' :. . Q ""'N " ~ : I l/' V\ ~ ~ <> , c 7 ::> ---- \ I ~I\ ~ r- :-;- -..; ,... ~ i' >- .. \ V' -< ,r,- ~~ \ ,''', 'j.:.:! <n' c) Ii :':i ': ,-.-." (~ I ,. L a 1- C) ~ .,. ~ LJ :' ~ '" ,.. G''' ",\ -ll ~ , / . \\. , \' "l Ji ! C/) CB N U1 ~ C:::> en ,. 'OW~ .- AP~rO~~D AS NOTED DATE: ').I, B.P. # 'D'J.'tA"d.. ~ FEE: 11~ BY: D{>p... NOTIFY BUILDiNG DEPARTMENT AT 765.1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION. TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL. CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED ANr:J COND'TiONS OF SOlrfrD~:' ~,~ \ :~;~, SO'-<> '"n",i': pi 'NNINGBOARD ',-,' , j'I'..I. _' ~.,"~ I Vel ' , SO\J;HOLD TOWN TRUSTEES N.Y.S, DEe OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. '" aJ -L --~ A -I - - 2:: ---- --- , - I, I r::. ~ .~- c_ ~'-!7- -- -- 1__ - 1--- -- r- r- - -- - -- --- .c- I --__ _ _ __~I- -_c ,-- 1'1 _ ----- --- --r :[: --- -- r~ c __ __ I- "" ~--- I - -- r~ L: _____ ------- ---- - ---1- ,- ,-,-- -- - -1- - --i;\ __ 1_-1--'-1 ___, ___ ~_ - -r-I- ------ - __ r- '-I-I_r:-~-=I _._ _, _~ _._-_ :_I~ _=~ --- - - i- -- --I ~--,-, --~--r- ~ ~ t~... \\ ~ " ,,"- - - \.J-. '< \ _r ~ ~ ~ '" ~- - - --I- ~ ~ t~ . ~> ~, ~~. '> '; . '-"" .. /" -< \> - >:. ~ , '. ---. , ~, Bldg. 1 Foundation xtension xtension xtension , , !IJ{) I I .Pe+ie ~y ireezeway joroge () .-riftJ ~ -: ()O 'Y~ ). B. {illS )(Cll~!/ t-<\H ) ,'( ,I(.. .....1' /' I 1/1 : 1 , I.. ~ i i i , fJ.. I 1 1 . " I , i : -- I Ij , I I , , ; , i ,I I i I , I , i , 1 i I I I , i , ! I I , i ,~ i l , I i I z..} I \ I' 7, 1,,[ , i i ;;::; '" rIi , I i , I l! I , , i i , , 1 , ! I 1 ).. I I I i /' I 1 I I , I I .,.<!).,! ' I' i I i 1 i , ~i , . 1 I, 'i : , I it I I .tJ...I uv,)-.J1f I i , ! I I I I , I i;h ,c:;<:.' i Bath 0, f f>' Floors I .' ,;j!'!J -I' Interior Finish . . I Heat I , Y ! Roof Type )I: ;' ~ooms 1st Floor , 1 1 If,!, / ~ Rooms 2nd Floor Dormer ,-,' I aJL / /, I , lr/hll'( "---... . ~J"'; .c TOWN OF SOUTHOLD ex;; /II rJ. ~ J-I-J.. elf N . n d./1l.Jn.et.-f- VI;' 'f-I/.If, S .1"'V/~ lie K.e~ . tRJo VL FARM 'iJOo - - /-3 STREET I (i,J e I. 1ft F;;' ' /' .r,e/ <J..tJt:f, FORMER OWNER VILLAGE , stOPE RECORD CARD .::) /'1 - 2. DISTRICT SUB. LOT #/:r ACREAGE 'OI$' TYPE OFBUILDING -Ve wi <2,fS:C j /'i E hil...fh "fhu 1- W G,,!), D8. ",i4'" 'l-Mr-f. I IND. I CB. /)esc. 1/y ~, ?;4l111 t.~..> I Est. Mkt. Value .ES. I MISe. . " ..-"- ... -,:~ TOTAL DATE LAND IMP. \ '100 .s-S-40 W G;.i:) ...r 0 tJ t/ 5100 (0 If 06 AGE NEW BUILDING CONDITION NORMAL BELOW Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable. 3 Woodland SwamplefM _ ...... -- Brushland Hause Plat T...........I -4 ...... --- -- REMARKS , ! ., -! tL- J "; I ,I~! C f,,( ,;t.) -,1. L , o;j,~2bOI1 (.tn~Acc.~LJ .. l,i 8"otJ, M u L; , 1/., fJre.; 'V ~ ..~ DOCK .J T De 7 lj ~~jOcI~ ~1~f'S om1 G .' I'll r..!J-''' "21 " NOSllJQI-~ f:il6Iat lXl 3A 91 -ifi 39'1"lll:l<J,l d" A.t..~-iUil AJ.NI'10Hiii"w 'Wi am ~ .I.smJ.L lINlOlNW "liiioj 'HI~3HfOl a33.LN'<nl'9f1!) l-N3WriNOW<;g ~':O€ 31'<f:JS .l:N m6H100sJl~NRii )(IO:JJni /'\3N l.Y f>1sNfronJ"w N'tJOf.;HHd1Sor MO:I. tr.I.l..'V.)I'S _ CN~' :lO dVW .......,._,,...;,.;.J''"~~,~'. i i I , I J N '. "'...". ~ \~ 8 tu ,,'~' ,; p" '~. .... \",," ~I 8 f.. l1! 'lI':f)l~ 0'001 -- " ! ;..tK)..i.Gl ~ Ol.l'dd ,I'llOM.. 3WWJ !>llQl5'il lOOIOd fr<XlI 133~lS ~. _ iIi' 'f'\.ai .- .;W'N .... ~ ~ IlOf ,'0 1IJN:i.l ':3.~.c>>.S'I!l'S N\'ltW 'Z in . 8. !" I '"" ... 1<1 nI' I ~i ... Ii - ",\C ~lg \ - ~ \ ~ \ ~ , a ,!Ii,', .~ ,"",'. MAIN STREET 5,eso<<>'300&, FlHClt 0, - f'DAtH 2 S1tlR'l FAAME "lIOTEL' Pl\~ " .J Ill.' !5 ~\ ... !~ PAilO: <", l&mRY I tr; i. :~ .~ ~ , ~' .. \ ~ ~ '" ... ~ t: ~ \ ~ IS \ ~ 100.0 I'(.t<J;;R - .,. .,;'.. :-.",'" N r ';~~'r.o:':""""_.._,.. - MAP Of V.l>lD ~w FUR JOSEPH H.. JOAN M. FUDJ I N5K! -.--...T---.--....... - NEW SJrFou<. ~rLWSOUIHgI..P, )'l.Y SCALE. 30" ~., \!l..~~_Ei-lf GLAAANTEED TO '!'HE !I()\llTH FORI< 8ANi<-AND TRUST~' AND TIlE I!'tTfINOUNTY 1I1'U: (il.J/llRAl'ity' -- ~~. TGN;iE Ol=---.'~ - ~. .-- ca.l1D~ ..n.__iL ~50N IZ. v__rW ~l~ 3JRVt'l<lRS POftt, N.V. Mfl.IN 5.65'<<)'3:/'(. FlHClt 0.' toll ~ ~\~ . . J III - ~ >- :~ '.... i'i , .. ..... >c' ,~ \~ \ ~ f t.; - \ ...../1:.... STREET o 1'OAtH 2. SlUR" FAAME "!lOTtL' ',', 'Ii.,.,....,.... g PAilO ~ ~\ ISroRY \ tn -~ , '" ~ ... ~ ~ f2 8 ~ iii f ~ .00.0 N'oKf;R ..- ,'- ..1 ~.. ~~"" N r ..;.~~-;or.v:,r."~-- '...,.. . ..." MAP Of L~I'W SIJR\"OU1 RJR JOSEPH H. t J()b.N M.FUDJ I NSKJ -------jf---.-------- - NEW SurFOLK 'It?.'''!~'~~ SOUII-l()I.P, )'4:'1"- SCALE. 30', ,., ~ \~~!"l_Ei-lf GUARANTEED TO TilE ~n; FORK BANKN-lP TRUST COM~- ~ iii:. mnlHDUNTY TITLE &uAAANrY - ~[) I'ilRT ---r.m=-- - A!> E (.i.T.~ YL... TUYL ~ SON e. VoLoo---rW llc.E~ IN-lP SlRV{.'IORS ~t, N.V.