HomeMy WebLinkAbout32295-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 02/06/07
No: Z-32189
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 2955 HYATT
(HOUSE NO.)
County Tax Map No. 473889 Section 54
RD
(STREET)
Block 1
SOUTHOLD
(HAMLET)
Lot 11
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
AUGUST 16, 2006 pursuant to which
Building Permit No. 32295-Z
dated
AUGUST 16, 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 "AS BUILT" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to PHILIP E LAGRECA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3016821
12/04/06
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 2/1 0 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" lankI uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topograpHic
features. J
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occu ancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant. :
New Construction:
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. ~4fJt,
~~ltrO'1'J h ~/(.
Old or Pre-existing Building:;"/ (check one)
~~ .A ~CI'fllOl~
Street
Location of Property:
/) f ~I)
House No.
AlY.
Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, SectiL f72>!ft:f
Subdivision ~. itl9f
Permit No.
3 'y 'Yf t)" 2.. Date oCPermit.
Block (9{7((7/ Lot PI!
Filed Map. Lot:
Applicant: ~/X~ 1:::- /g~
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ =-< 5, ,.....
Final Certificate:
(check one)
4.~L
C9?-..-u- 7 r7 ~r')....
LO-E:3Jr ~
[!).~[!)
I BY THIS CERTIFICATE OF COMPLIANCE THE I
i NEW YORK BOARD OF FIRE UNDERWRITERS i
~ BUREAU OF ELECTRICITY II ~
~ 40 FULTON STREET - NEW YORK, NY 10038 5/f, - I - ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ PHILIP LAGRECA PHILIP LAGRECA ~
~ 133 CAMPBELL AVE 133 CAMPBELL AVE ~
~ LEWlSTON PARK, NY 11596 LEWISTON PARK, NY 11596 ~
~ ~
~ Located at 2955 HYATT RD SOUTHOLD, NY 11971 ~
I Application Number: 3016821 Certificate Number: 3016821 I
~ Section: Block: Lot: Building Permit: 32295-Z BDC: ns1 ~ ~
~ ~
~ Described as a occupancy, wherein the premises electrical system consisting of ~
i electrical devices and wiring, described below, located inion the premises at: i
~ First Floor, ~
~ 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 andlor standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 4th Day of December, 2006. ~
~ Name Ory Rate Rating: Circuit ~ ~
~ Miscellaneous ~
i ::~:~t~~~~ration i
~~~~ ~
~ Outlet 2 0 Fixture ~
~ Fixture 2 0 Incandescent ~
~ ~~;~e;tacle ~ ~ ~:~:;:: :~;:~: i
~ Dimmers 3 0 ~
~ Paddle Fan I 0 ~
~ An as built inspection. oflhe delineated electrical installatinn, determined that an obvious hazard is not present and the installation is believed to ~
~ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. ~
~ ~
~ ~
I seal I
~ ~
~ I ~ 1 ~
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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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.
32295 Z
Date AUGUST
16, 2006
permission is hereby granted to:
PHILIP E LAGRECA
13 3 CAMPBELL AVE
WILLISTON PARK,NY 11596
for
"AS BUILT" ALTERS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR. ADD'L CERT. MAY BE REQUIRED. THIS PERMIT REPLACES BP 29836.
at premises located at
2955 HYATT RD
SOUTHOLD
County Tax Map No. 473889 Section 054
Block 0001
Lot No. 011
pursuant to application dated AUGUST 16, 2006 and approved by the
Building Inspector to expire on FEBRUARY 16, 2008.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
3 ~2--9s -c-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] ~ULATION
[ ] FRAMING I STRAPPING [v("FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE
INSPECTOR
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:FIEtD:iNSPECTIONlUmOxr' DATE
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FOUNDATION (lST)
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FOUNDATION (ZND)
'ROUGH Jl'I>" Mll,fG &
PLUMBING
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STATE~CODE
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
STREET ;29 SS; VILLAGE DISTRICT SUB. LOT
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OWNER
AGE
VL. COMM.
IMP. TOTAL DATE REMARKS
1~6 0 /~o 0
/$00 /7t:; 0
3 ~-o. 6 DOD
ll- / &-0 L./-~ a-U
BUILDING CONDITION
NORMAL BELOW
Acre Value Per Acre Value
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ACREAGE
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TYPE OF BUILDING
~a n, ( .
CB. I MISe.
LAND
NEW
o. ,)
ko
;2 eel
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Soo
Farm
Tillable 1
TilLable 2
Tillable 3
Woodland
Swampland
Brushlan<L.
House Plot
Total
; Ext. Walls "
Fire Place /ilo
Porch O/~
Porch
Patio
Driveway
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vi. Bldg.
Foundation
:xtension
Basement
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:xtension
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Interior Finish
tw! LL 8/)
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Heat
Attic
Rooms 1st Floor
Rooms 2nd Floor
. .
BUILDING PERMIT APPLICATION CHECKLIST
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:
TOWN OF SqUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
3-~)qs fc",
PERMIT NO))!1r:~( r:-
,20 ?
,20-L
Examined
Approved
Disapproved alc
ExpiratioQ:'---"O "_
,20_
.~--._-.
r --_____
'., f
2~
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
Date Der. f
INSTRUCTIONS
,2oe3
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 oflot 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 affucting 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 pursuaJjtt 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, hou' code, and regulation and to admit
authorized inspectors on premises and in building for necessary inspections.
lure of a licant r name, if a corporation)
~ ~. Cd ;4510 ~ k ,di
(Mailing address of applicant) / / fL'
State whether apPlicant(:w~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises ~#TT /1;10 - ~4I!1l 'S If. SlClmn(o
(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.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location 0 and on wJych proposed work will be done:
~~,. . uJ - 4J,efpl-,f . all/l.L/J
H use Number Street t..J."'7 .. t'
I I 3fJ"j
'/ County Tax Map ,No.1 000 Section ,<;'1-
Subdivision N / /J
f (Name)
Block /
Filed Map No.
AJV
I
Hamlet
Lot /!
.Lot
~2.
State existing use and occupancy of preI1J!:ses
a. Existing use and occupancy J:es I
d intended use and occupancy of proposed construction:
/IK.. -.
\3.
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost ';;. (J IJ 0 .
Alteration p("/
(Description)
5.. If dwelling, number of dwelling units
If garage, number of cars
Hji4
,
6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use.
AI/;;
7. Dimensions of existing structures, if any: Front
Height Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflo!: Front
Rear
Depth
10. Date of Purchase
Name of Former Owner
II. 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 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 _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.
(S)He is the
STATE OF NEW YORK)
ss:
COUNTY OF ~iS:.sJ..V )
14, I, /:::> E. !CLrSre C' '^- being duly s;orn, deposes and says that (s)he is the applicant
(Name of'individual signing contract) above named,
(f)(),I.() G<1C-
(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 ,J:), -1 jJe
e; 14- day of (jelO r- 20 ~
, lJA~, #/'~.
6(otary Public
JUUE DlFRAHCO
Nolaty I'ubIlc, StIli" New Yolk
No.010l6071238
Qualified. SUIIaI~
Convnlssion~ /J!.u"J(,
ENERGY CODE CALCULATIONS
CHAPlER5
SECTION 501
Detached One and Two Family
(For Non-Electric Reat)
For. n,~, j Ii &.rec (
~~j RHI
__ -,I
Design Criteria
5750 Degree Days
Zone lIB
Per:
. ~ I /
Dated: J/~"JI.I IO/lI!b":l
/ I I
SUBSYSlEM AREA DESIGN CODE DESIGN CODE
"U" "D" UA UA
Exterior Walls 283 O.loJ~ 0.14 29.31 39.61/
,
Ceiling Roof /58 ~; """0.031 7. /,8 1./. 7' D
Floor Over Unheated Space JS8 O.t) S 0.05 7. ?1J '7.90
Heated Slab On Grade 6.5
Unheated Slab On Grade 4.5
Basement Wall 0.1
Crawl Space Wall 0.06
'1'1 } s' $'2. <f'?-
N01ES
Construction shall comply with 502.1.1 moisture control and 502.1.4 air leakage
Building Envelope Systems to meet requirements of Section 501
The mechanical systems and equipment including:
HV AC Equipment, HV AC Systems, Duct Systems, Ventilation Systems and Insulation of Piping Systems to meet
requirements of Section 503
Service W &ter Heating Systems & Equipment to meet requirements of Section 504
Electrical & Lighting Systems & Equipment to meet requirements of Section 505
To the best of my knowledge,
belief, & professional judgement,
these plans are in compliance
with .the code.
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APPROVED AS NOTeD
DAlE:~B.P.~
FEE~ 600 By':J)9(7
, ,NOTIFY BUILDING DEPARTMENT' AT
765-1802 , 8 AM TO 4 PM FOR THE
FOlLOWING INSPECTIONS:
NDATION .. TWO REQUIRED
RED CONCRETE
, 2. ING & PLUMBING
" -- --.~ -- ,.f:: ~~~TCONS KlNMU$T--~ t"
, i ' BE COMPLETE FOR C.O. ' t
1 ,.AU. CONSTRUCTION SHAlL MEET THE
p___. .-====' ~UIREMENTS OF THE CODES OF NEW
! 2 ~ 2 81/-1.:, YORK STATE. N07 RESPONSiBlE FOR
, . ' DESIGN OR CONSTRUCTION ERRORS.'
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OCCUPANCY OR
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