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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 ~d~ Rev. 1/81 ----"'I Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 S\=Q \ 3 7 ~- , 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) {...(OjUIZ6'L 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 , ~w~~ 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 ~~' ~ /1_ . II ~~1:i-' , Ak \~ . INSPECTOR ~~ " 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. . ~ !\Jr C~ r )It) ~A-<-( (!~:d3 f'~ 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 - , l FIELD INSPECTION REPORT DATE COMMENTS w - ." d\t<1 --1~ ..5)- i1J;; FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING I INSULATION PER N. Y. STATE ENERGY CODE FINAL . (\\ QiiJ "' l"J y-' -, :2 So 1/\' 'CV Q)", .., ~~ -t'.., :'0 (l, r> ~. r l~ to< ~eJ .c:. s::.... 'f -:J?I /0 rT <~ . ~ ~ ~ 'v\ '--'" AI" tn.l...A. ~ Q J::l- / ~f?11 /~'jI/J -.- , '1-fo/()1 AloAl '/Ju _. nM.-IA /'r./J~ .A.,"'''~*',J (/. ~ ~ 01>; .0. n.... rL>>.~~/. I~\'~ ~IJ/>n.;:-h-n...., ~ cln...L"';;;;..I"-P';(T/,/ v, ~J./ -;)- 'h 7 rlu-'J..Tfr ~ ,N ~ 'J!J.lI .-./J .. 7 01 k c...- M.- 0 ~V; ~'_1/) c 'Tjj ";P'i, ~' rI-- v - 0 A. d '77'/.....;>r :J\ ADDmONAL COMMENTS v D .". ~ Z 0 ::E 2: z m, D ;lJ \J' . \ r - l"J , 0 ~ ." vJ - ~ S .., d - 0 :2 . := l"J ?-~ .., := 00 l"J ." :-' ~ .. ,. 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. " " " " 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 .