HomeMy WebLinkAbout31879-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No, Z-32600
Date, 09/14/07
THIS CERTIFIBS that the building
ELEVATOR
Location of Property: 4522 GREAT
(HOUSE NO.)
County Tax Map No. 473889 Section 128
PECONIC BAY BLVD
(STREET)
Block L- Lot 19
LAUREL
(HAMLET)
Subdivision
Filed Map No.
Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MARCH 26, 2006 pursuant to which
Building Permit NO. 31879-Z
dated
APRIL 3, 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 INSTALLATION OF AN ELEVATOR IN AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to FAIR WINDS, LLC
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DBPARTMEIIT OF HEALTH APPROVAL
N/A
BLECTRlCAL CERTIFICATE NO.
113152C
11/27/06
PLUMBERS CERTIFICATION DATED
N/A
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Rev. 1/81
----"'I
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
S\=Q \ 3
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled 111 by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of propel1y 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 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. 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. Cer1ificate of Occupancy on Pre-existing Building - $100.00
3. Copy ofCer1ificate of Occupancy - $.25
4. Updated Cer1ificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ocr /1 J. It> 7
Date.
Location of Property: n4 51.?:-
Houtie Nu
Old or Pre-existing Building: X
':71::CONLC i'?I7Y (fL \/1./
Street
(check one)
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New Construction:
, NY
Hamlet
5/E/=1=6AlS
1 > \" '1"1175 C (11(="'I<v S'. .j LI/vei" i=>.
Owner or Owners of Property: (0=, /1", V"-." LL. _IV I . /" I
Suffolk County Tax Map No I 000, Section 'i 73 8l?'( 1 (l.B. -'-/-/1 Block Lot
SubdivislOn
Filed Map.
Lot:
Pennit NoBe# 3/87'1-Z Date of Penn it. 0'1/01/00
Applicant: /-::;(~IIZ 'v-II(\!I/:i
G6 C
Health Dept. Approval:
Underwriters Approval: _
Plmming Boarc1 Approval:
Request for:
Temporary Certificate _.__
Final Certificate:
/
(check one)
Fee Submitted $ "J- 5.00
&-J,c.7"!>6.5Q
Q.O~3.2(PO~
Electrical Inspection Certificate
Issue Date
11/27/06
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Pate hogue, New York 11772
(631) 286-6642
Application Number
113152C
Issued To:
Street:
Village:
Section:
Mr. Henry Steffens
4522 Peconic Bay Boulevard
laurel
128
Block: 4
Zip: 11948
Lot: 19
Town: Southold
Contractor: Scott A. Johnson ILl Lie. # 5154-E
Was examined and found to be in compllance with the National Electrical Code.
" Commercial [J NV Defects Pool l ~ 1st Floor 00 Indoor IX: Basement I Hot Tub
iK Residential r-. Det. Garage ,"! Attic"! 2nd Floor "! Outdoor 1._ Addition 1_ Survey
-----.-
Switches Receptacles Fixtures GFI Heaters AlC Fans
1 1 1
Dishwasher Washer(Afllps Dryer/Amps Oven Range/Amps Microwaves
Furnace Oil Gas Circulators Smoke Detector Bell Transformer
Meter Amps Phase UG/OH Jacuzzi Television CO Detector
/
Bldg. Permit:
Other Equipment
[EjElVator Only I 30amp ac disconnecfT15amp I
lac disconnect
,
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President
Rough Inspection:
Inspector:
Final Inspection: 11/21/2006
Inspector: John Me Mahon III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
31 t 77 ~
TOWN OF SOUTH OLD BUILDING DEPT.
765.1802
INSPECTION
] FOUNDATION 1 ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
] FRAMING I STRAPPING y>(FINAL
] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRucnON [ ] FIRE RESISTANT PENETRATION
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INSPECTOR ~~
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DATE ~ ---t--- tJ 7
31'l7~ Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [.Xi FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMAR~: t. . ~
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DATE ~-?j- 0 h
INSPECTOR ~ ~
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.
31879 Z
Date APRIL
3, 2006
Permission is hereby granted to:
FAIR WINDS
4522 PECONIC BAY BLVD
LAUREL,NY
for :
INSTALLATION OF AN ELEVATOR AS APPLIED FOR
at premises located at
4522 GREAT PECONIC BAY BLVD
LAUREL
County Tax Map No. 473889 Section 128
Block 0004
Lot No. 019
pursuant to application dated MARCH 26, 2006 and approved by the
Building Inspector to expire on OCTOBER 3, 2007.
Fee $
150.00
{~ C~~
! Authorized Signature
ORIGINAL
Rev. 5/8/02
!'lUG 2 9
ARCHITECTS P.C
August 27,2007
Town of Southold Building Department
Attn: Mr. George Gilles
PO Box 1179
Southold, NY 11971
RE: STEFFENS RESIDENCE
4522 PECONIC BAY BLVD
LAUREL, NEW YORK
BUILDING PERMIT #31879
Dear Mr. Gilles:
I inspected the elevator pump room for fire separation on August 22, 2007.
To the best of my knowledge and belief fire separation on the above installation was done
to code.
If you have any questions or require any further information, please feel free to call.
Ve y truly yours,
A LEY MCGRAW ARCHITECTS, P.C.
, ~~O.~ty ,
Donald A. Denis, A.LA.
Senior Architect
DAD:dmh
CC: Mr. Hemy Steffens, 275 Mountain Ave, Ridgewood, NY, 070450
508 MAIN ROAD. P.O. BOX 595 . AQUEBOGUE, NY 11931 . PHONE: (631) 722-3511 . FAX: (631) 722-3859 . WWW.A$HlEYMCGRAW,COM
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FIELD INSPECTION REPORT DATE
COMMENTS
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FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
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INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/South~Jd/
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health No 7""
4 sets of Building Plans Yes ./
Planning Board approval "'10
Survey V~S : /"
Check Yo . ,/
Septic Form' .' NO'. ..-
NYS.D.E.C. NElL:
Trustees
Contact:
PERMIT NO.
3/F7'j E/
Examined
+~ 200f,
):20 d-
NY 11931
Malllo Donald A. Denis
PO Box 595, Aquebogue,
722-3511
Approved
Disapproved ale
Phone:
Expiration
IOh,2007
/
( c.J,L.
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
,10_
INSTRUCTIONS
.
a, This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets or 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 ofOccupan,cy. , ' , , I
f. Every building permit shalt 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 shalt 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 co e, and regulations, and to a
authorized inspectors on premises and in building for necessary inspections.
State whether applicant is owner, lessee. agent, architect, engineer, general contractor, electrician, plumber or builder
Owner
Name of owner of premises
/::/, II~
VViN(/S L LC
(As on the tax roll or latest deed)
thorized officer
Sli~I={-:i:f"'>
(VI<r~S-II/I:IUT )
I'-IENIZY S'
j"1I3M iJl~ t-?,
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
"
"
"
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I. Location of land on which proposed work will be done:
4<;77 Pee-onie !lat Blvd, LallrF!l
I louse Number Stree
lIamlet
128
19
4
Lot
Lot
llIock
Filed Map No.
County Tax Map No. 1000 Section
Subdivision
(Name)
,'..
'.,.
2. Slalc existing use and occupancy of premises 'Td in~nded 1e and OCCUPCWl;Y of F{oposed construction:
a. Existing use and occupancy S1-ng e am1- y reS1-0enc
b. I ntended use and occupancy
same
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition Alteration
Other Work install elevator
(Description)
5. If dwelling, number of dwelling units
If garage, number of cars
rce $150.00
(To be paid on filing this application)
Number of dwelling units on each floor
4. Estimated Cost $ 3 5 , 000
6. Ifbusincss, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: :Front 27 I
Height Number of Slories
Rear
41 .
Depth
80'
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear
Height 30 ' Number of Stories two
Depth
9. Size oflol: Front
Rear
Depth
HEN/2Y
10. Date of Purchase
1175
Name of Former Owner
5 Ti7(:rf=t3N5
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 orOwner of premises Address Phone No.
NameofArchitectAshley McGraw Addre:l?O Box 595 Phone No 77.7.-1<;11
Name ofConlractor AddreAOUebOque Phone No.
15 a.ls this property within ]00 fe~t ofa tidal wetland or a Ireshwater'wetland? *YES~NO_
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMtTS MAYBE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES ~ NO_
* IF YES, D.E.C. PERMITS MAY BE REQU]RED.,
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.
STATl or~~:fr~<ry'
5S'
COUNTY O~.ss.4lq .
_t!!={\I (21 5 5 FE ,=-/=Cii'/;; being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
''1i=i'1Fi:t<, (!7I<i;>U/I;IVT)
(S)IIc is the v
(Contractor, Agent, Corporate Orficcr, etc.)
of saiiJ owner or owners, and is duly authorized 10 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 maimer set forth in the application filed therewith.
200 ,p
Notary
,
A.IW\I"NA j STOE8LlNG
NOTARY PU~C OF NEW JERSEY'
MY COMMISSION EXPIRES FEB. 5, 2009
.