HomeMy WebLinkAbout32564-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32582
Date: 09/05/07
TIllS CERTIFIES that the building
ALTERATION
Location of Property: 2710 HYATT
(HOUSE NO.)
County Tax Map No. 473889 Section 54
RD
(STREET)
Block 1
SOUTHOLD
(HAMLET)
Lot 14
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 1, 2006 pursuant to which
Building Permit No. 32564-Z
dated
DECEMBER 13, 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 ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to SILVANA D BURDICK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTII APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3030100
05/11/07
PLUMBERS CERTIFICATION DATED
04/03/07 BURTS RELIABLE, INC.
~~-
Authorized Signature
Rev. 1/81
r:=:-:--;.:
!: ~. '
I'
!
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
AUG24
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Thi~ application must be ~115'd 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 2/1 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" 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
I. 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 OfOccllpancy - Residential $15.00, Commercial $15.00
Date.
5"-/7-07
Old or Pre-existing Building:
V'"
;j Y /-rlT RorJ-'[:>
Street
IS u rc.t> J CJ::(
(check one)
New Construction:
House No.
2-7/0
6/t..v/TN/7
50 vT7-/-0L):>
Hamlet
Location of Property:
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section ~____
Block
Lot
Subdivision
Permit No. 3:2.57oL/ - Z Date of Penn it.
Health Dept. Approval:
Filed Map. ___
Applicant:
Lot:
. Underwriters Approval:
Planning Board Approval:
v
(check one)
Request for:
Temporary Certificate
Final Ceriificate:
Fee Submitted: $
~
6("". -)30 oc6
C&"t 3~5 S-;)..
S'I- 1- I
l!I.~l!I
I BY THIS CERTIFICATE OF COMPLIANCE THE I
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ SILVANA BURDICK SILVANA BURDICK ~
~ 140 E. 56TH ST. APT. 16G 140 E. 56TH ST. APT. 16G ~
ii!I NEW YORK, NY 10022 NEW YORK, NY 10022 ii!I
~ ~
~ Located at 2710 HYATT ST. SOUTHOLD, NY 11971 ~
~ 3030100 3030100 ~
~ Application Number: Certificate Number: ~
~ Section: Block: Lot: Building Permit: BDC: ns11 ~
I Described as a occupancy, wherein the premi~::'I~t~a1system consisting of I
~ electrical devices and wiring, described below, located inion the premises at: ~
~ fu.~~ ~
~ 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 11th Day of May, 2007. ~
~ Name OTY Rate Ratine Circuit ~ ~
~ Miscellaneous ~
~ alteration to kitchen & ~
~~ ~
~ as built-2000 ~
~ Wiring and Devices ~
~ Outlet 6 0 Fixture ~
~ Fixture 6 0 Incandescent ~
~ Outlet 4 0 General Purpose ~
~ Receptacle 2 0 General Purpose ~
~ Switch 1 0 General Purpose ~
~ Receptacle 1 0 GFC1 ~
~ An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to ~
mJ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. ~
~ ~
~ ~
~ seal ~
~ ~
~ 1 of I ~
~ ~
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. I
l!I~.l!I
f '~',(,''1 "'81\, 5J09: MJI~'\ 11,)"3]
PO 80) 1\79
S,~~\r',old, New Yor"K 1,S71
raJ (S! C 7~;-,
Tf;eO",:::'n~. i~' i~
OFFICE Of: THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I FIe A T ION
Date '1-3-01
Building Permit No.
3d5(o+
Owner:
S 1\ VM{;,. (J),J(d.i<.-t<...
(please print)
Plumber:
Burts 'Re.-\iohle \ nc.
(please print)
I certify that the solder used in the water supply system contains less
than 2/10 of 1 % lead.
"#~ /$~
(plumbers signature)
Sworn to before me this
3 rcl day of _fi-rn '\
Notary Public, ,S',) ful \(...
20~
County
~ q"~~
/lJoiw'y PUb/,c- -# L/J'WMJ
BERNADETTE L TAFLlN
NOTAR': 1'"Bue #4844893
SL~<; of New York
R~..r;;,;"" in ~uifdk Ccu::'~,1
co,,:::~:.xP"es,~,);' ;~, oct
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.
32564 Z
Date DECEMBER 13, 2006
Permission is hereby granted to:
SILVANA D BURDICK
301 EAST 62ND ST.APT 5E
NEW YORK,NY 10021
for :
CONSTRUCT AN ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR AND TO CODE.REPLACES BP# 24210
at premises located at
2710 HYATT RD
SOUTHOLD
County Tax Map No. 473889 Section 054
Block 0001
Lot No. 014
pursuant to application dated DECEMBER
1, 2006 and approved by the
Building Inspector to expire on JUNE
13, 2008.
Fee $
75.00
1
, ~
ft(~____ ~
Authorized Signature
ORIGINAL
Rev. 5/8/02
3?--Skt~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
r..><f FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
REMARKS:
F~ ~. ~ CJ-A(.
~ rI--~ ~
~A!-~I-) d ,
c . 0 -4 .?-c'J. 0 "
DATE
3-J--07
/
INSPECTOR
~.~
cJFrJJtJ ~
765-1802
BUilDING DEPT.
INSPECTION
~
~OUGH PlBG.
[ ] INSULATION
[ ] FINAL
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
~SJ~ - =,,- ,~
(;?~/-,~~ ~~
DATE // II) If?
I /
;< C;;; /0 t-'
765.1802
BUILDING DEPT.
] FOUNDATION 1 ST
] FOUNDATION 2ND
] FRAMING
[ ] FIREPLACE & CHIMNEY
azKS. !r~/J1a-.,.& ;;~
:-y~~ ~~
~
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
~W~Y-
DATE / / f If 7 INSPECTO
I I
;?- f;);D ~
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
PLBG.
[ ] INSULATION
[ ] FINAL
REMARKS'p
rl
/l-i.f j} ~
DATE
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1'0101 NO. .
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)
Ng 24210 Z
Date .......... . .......... ...:!~.................. 19.92
Permission is hereby g~ to: ~ ". / '
Yk~4~..Ik~~f;I.M
...;?d?...~4t1k;~"fJ':"'~"""""'"
......I!:.K.c../..../.k':,Y....../.Qe/.L................... .
to~~~~..~~.~.~/~
~~...........~~~...J..:?t::...~..::............................................
................................................................................................................................................................
~~..~~~:;~~~..;~~~~~.~:::..:::::....::::cii2;9:..M;~~:::::::~~~<.<:::::::::::::
County Tox Mop No. 1000 Section ....~~....... Block ....../............. Lot No. .../.y............
pursuant ta opplicotion doted ........~4;1...;J??................, 1992 and approved by the
Building Inspect()r.
Fee $....7.J. ..........
.........~......................~.....
Building Inspector
Rev. 6/30/80
f//(I_haL15
JQRMER OWNE~
b-d wo ( cI 'yjl
/ . ,
C/l..-:; " ( ..,-,' ( :: . :. " / J (' "
RES;"i-IQ
SEAS.
LAND
IMP.
uc)
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56U
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~'5C>O
?fOO
NORMAL
Farm
Tillable 1
Tillable 2
Tillable. 3
Woodland
Swampland
~
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f
I House Plot
f
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~~.
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Total
Acre
/\
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(1
TOWN OF SOUTHOLD PROPERTY RECORD CARD
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S~ eO!fAz,'Z.)N/ wJ:C;:aI..DSH'O~fr TYPEOFBUILDING 14.&j- ~~dJl (
FARM COMM. I IND. CB. I MISe. . I
DATE REMARKS '/~7/fc {J.t? / ('];sl,.. acee '5 tll'F-~c_~() '(o_~___
J- L / .:,: ,~~ '~;~e~hf>/~( InSfJ(2ec $/5S;Cl(, )
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VILLAGE
DISTRICT
SUB.
LOT
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VL.
TOTAL
d "1
A ';/
t' ;,..,. .1.. -/ f? d:..o -:. q/,-. m
,
ABOVE __ _&0 -F /
Value Per Acre
Value
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Ext. Walls
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Heat
Porch
Attic
Porch
Rooms 1 sf Floor
Rooms 2nd Floor
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Cree" Th~"
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nTLE NO.
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NBJ"20'OO"W
"
127.23'
TEST HOLE
2/27/98
OARK BROWN LOAM
LOAMY CLAYEY SANO
LA'ND 'N./
/ F OF SHEILA
A'ND STANLEY 8 BAKERMAN-CILSO'N
(i . CILSON JR
DWeLlINC) ,
/~
( C' 'c p.
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I'
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BROWN CLA YEY SANO
WITH HEAV'/ GRAVEL
ANO HIGH WA TER CONTENT
.,'
BROWN FINE TO
COARSE SANO
4"
CERTIFIED TO:
SURVEY OF
PROPERTY
SITUA TE AT
SOU THOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
EASEMENTS ANO/OR SUBSURFACE STRUCTURES RECOROED OR UNRECOROED
ARE NOT GUARANTEED UNLESS PHYSlCALL Y EVlOENT ON THE PREMISES AT
THE TIME OF THE SURVEY.
GUARANTEES INOICA TED HEREON SHALL RUN ONL Y TO THE PERSON(S) FOR
WHOM THE SURVEY 15 PREPARED, AND ON HIS BEHALF TO THE TITLE COM-
PANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON,
ANO TO THE ASSIGNEES OF THE LENOING INSTITUTION. GUARANTEES ARE
NOT TRANSFERABLE TO AODITIONAL INSTITUTIONS OR SUBSEOUENT OWNERS.
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO
THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE ANO USE AND THERE-
FORE ARE NOT INTENDED TO GUlOE THE ERECTION OF FENCES. RETAINING
WALLS, POOLS. PATIOS. PLANTING AREAS. AODITIONS TO BUILDINGS ANO
ANY OTHER CONSTRUCTION.
JOB NO. F4759
REVISIONS:
SCALE 1" = 30'
FEBRUARY 20, 1998
S.C. T.M. DIST.1000 SEC.54 BLK.1
LOT/4
3760 Exprf!ss Drive South
IsJondio, N. Y. 11779
(516) J42-9292
FAX 342-9218
surveyors
ts planners
el] I~ :-,
"'-'----q;j;
..,
, '! ~
MAY :i 0 1991 d.:;
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802 '.
BOARD OF HEALTH ...............
~3 SETS OF PLANS ...............
SURVEy........................
,..--CHECK .........................
SEPTIC FORM...................
Exanined. . .
G.DEPT.
F SO<JTHOLO
......:?-3, I .? ;1v~"
.-k'-, 197!2 Pennit ltl. .........~r--
~~
CALL ..................
HAIL TO:-M.~.~jJ.qd
])~ ~,C. Xl:.~:. ./-CA I}..........
Approved. .
Di
ilding Inspector)
CATION FOR BUILDING PERMIT
. Date................, 19....
INSTRUCTIONS
a. This application DIlSt be C<JI1l1etely filled in by typewriter or in ink and subnitted to the fuilding Inspector with
3 .sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relatiooship to adjoining premises or Jd>lic
streets or areas, and giving a detailed descriptioo of layout of property DIlSt be drawn on the diagran which is part of
this applicatioo.
c. The ""d covered by this applicatioo ""'Y not be cu",,,,,lCed before issuance of fuilding Pennit.
d. Upon approval of this applicatioo, the fuilding Inspector ..ill issue a fuilding Pennit to the applicant. Such
pennit shall be kept 00 the premises available for inspectioo throoghout the ""d.
e. ltl building shall be occupied or used in whole or in part for any prrpose whatever until a Certificate of
Occupancy shall have been granted by the fuilding Inspector.
APl'LlCATIlJI IS JEIlEBY !WE to the fuilding Departn8lt for the issuance of a fuilding Pennit plrsuant to the
fuilding Zone Ordinance of the Town of Soothold, &1ffolk Ccunty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for renrJY81 or demlition, as herein
described. The applicant agrees to C<JI1l1y with all applicable laws, ordinances, building code, housing code, and
regulations, and to lIllnit aJthorized inspectors 00 premises and in buildi ssary. inspecti?"".
(Signature of applicant, or "'0J if a corporatioo)
.. .fJ..~.w&AA:.~.......~. ...... ....
(Mailing address '~~licant)
. N"jr!---j NY WDlf
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumer or builder.
.................. .<$?~?./f.!k:.~~:...................................................................................
time of owner of premises ..........2/.l:-:}(.-1-.0!1......l?r......P.II.f./)!~.............................
(as 00 the tax roll or latest deed)
If applicant is a corporatioo, signature of duly aJthorized officer.
(time and title of corporate officer)
Builders License ltl.
Plumers License ltl.
Rdlf:/'t
Other Trade's License ltl. .................... /.1,,,,tR-/f j) AJ /--7' ta. \
I. location of land ~ which proposed liOrk will be rJi:Jroe..1o.r...I./f...t?J:2..u. !-J!........~..u.(!.L!.~..U
.dE . SoM.11J0.e.N. -:. .?:.1!??.. .1frt.W.~..............;3.Q?!.!. tl.~0.................
lkJuse Ib1ber Street Hanlet
Ccunty Tax Map ltl. IlXXl Sectioo. . ..5:t. . . ... Block .... J. . . . . . . . . .. IDt .....L t. . . .. .. .
Electricians License ltl.
&1bdivisioo ...................................... Filed Map ltl. ............... IDt ...............
(time)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constructioo:
a. Existing use and occupancy ..........~~~t:~~~~..........................................
b. Intended use and occupancy ...............~~~................................................
-..~
o-t.lUO:':. ..
. .~->l';::;,...~~
1.
I'blllre of ..."k {check ...id. applicable):
l!erair ... i:'....... Rawval .............
Estin",te" Cost ...f..!.~.r?J??....
~
New Iklilding .......... hklition .......... Alteration ..........
llenDlition .... v.:-:'.... Olher Work ..................................
(!leseri "tianO
,,.
fee
(to be paid on fil ing this al'(llication)
5. If ck~llingr n..Jlber of ~lling units ............ t~llher of dwelling units exl each floor _...............
I f garage r Illlll>er of cars ... _ . . . . . . . . . . . . . . . . _ . . . . . . _ . _ _ . . . . . . .
6.
7.
If businessJ canrercial or mixed occupancy. specify nature and extent of ead, type of use......................
Dimensions of existing structures, if any: Front....1.7.~..... Rear .....t7.~.... !lerth ..?f.:~..I......
lIeight ......................... !bIller of Stories......!..............
Il' . f '1 I . .........., 5A1-/YJ11> ~~
lR~nsl~ 0 sane stnlCture ~lL' a teratloos or dlJUltlons. l'ront ..:_..~.'.:~ Rear .---?.......... ,.
Ilerlh ..;J~..... llelght ....p~.... lbber of Stones ....::?~
8.
1'1.
nilllensiolls of entire new constructiou: ]i"root ......... _...... near.............. _ Depth ........ _. _. _.
lleight ......................... Ii..i",r of Stories .....................
Size of 1 at: l'mnt. .I ?:..<? .~ .. .. '" Rear ..../ P.. 7 . .. . . ... !lepth . /. ?:P. /. ! ~t?
Hate of I\Jrdlase ...2j.'?:'fil11. Hare of Former o.n",r ..'2e/..~.z.....................
Zone or use district in Ylidl premises are situated ... _..... .. ... ...... ... .. '.' .............. ............ . . .... . ..
Does proposed constnJCtion violate any zoning law~ ordinance or regulation: ........................
Will lot be regraded ..~~?!t,.. Will excess fill \", renoved frOlll premises: W NJ .
Nares of o.n~r of praIli;- ...-;?:.p.:;~tj~p.(~. MlressK~.~~.~i.. ftm, ytf;:r;~~~
N....", of Ardlltect ....... ....??.If./!?J?..~.......... MJresr..~.... 7.. .I!y.d........ I'hone No. ..............
Nare of r.ontractor ................................... "'klress .............................. .ftlOOe No. ..............
~
Is this property within 3(X) feet of a tidaL ""tland? * YES .......... NJ ..........
*11' YES, &lInnD 1lHI1llUSIFES PElMrf Hl\Y BE Rf[~JlREJ).
9.
10.
II.
12.
13.
15.
L'\.O"l' IlIAGRAH
\.ocate clearly and distinctly all buildings, ..",tiler existing or proposed, and indicate all set-back dimensions
hUll prO(Jerty lines. Give street and block D.J1lber or descriptioo according to deed, and shCM' street nares and indicate
,....letllec interior or corner lot.
sr~m (J' 1I~ ymK, c.b it
c . 55
mINLY OF ..~ ....... ... ,
.....$.tv~.~... ....~..d,1.~...........IK!i,~\ dilly sworn, del"ses aid says that lie is the al~)licllllt
(N....le of individual signing contract)
above n.....re<I,
. . (J~y
lie 1 s the ...................................................................................................
(unltraclor t agent t corpoTate officer, etc.)
of said (J.lner or OWllerS, and is duly authodzed to perform or have perfonred the said work and to mke arK] fi le this
appl icatiol1; that all staterents contained in this appl ication are tnJe to the hest of his knowledge and helief; a1xl
lhat lhe wurk wi LL he perfonred in the manner set forlh in lhe applicaticHt filed therewiUl.
~~:.~~p.~~~~<~:Spf ...~... . ...../1.
I Y//O. ._
Notary I\IDI~.........
~13 .
-- .-------...
....~..:/.._. ......-..............
I'
(Signat.ure of ^ppl icant)
(p