HomeMy WebLinkAbout32577-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32673 Date: 10/15/07
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 430 OAK RD
(HOUSE NO.)
County Tax Map No. 473889 Section 11 7
(STREET)
Block 2
NEW SUFFOLK
(HAMLET)
Lot 4
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 11, 2006 pursuant to which
Building Permit No. 32577-Z
dated
DECEMBER 18, 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" INTERIOR ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to NEIL J.TEVEZ & ANTONINO DIBENEDETTO
(OWNER)
of the aforesaid building.
SUFFOLK COUlllTY DEPARTMERT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3031173
OS/24/07
03/06/07 BRIAN WALBFLEISCH
PLUMBERS CERTIFICATION DATED
~~
Authorized Signature
Rev. 1/81
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">>{ ~,?J 9.//7 '1(.
Form No.6
TOWN OF SOUfHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPtCX'_-.J
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.
~Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
. 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
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 - $ IOO.OO
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $ I 5.00, COlmnercial $15.00
Date. f/lz_~
Location of Property:
4~D
House No.
Old or Pre-existing Building:
~l Coal
Street
RYs~o C-revU)
111
v"
(check one)
Ak1J s.A4IL
New Construction:
Hamiel
Owner or Owners of Property:
Suffolk County Tal' Map No IOOO, Section _
Block
000).
Lot
ootf
Subdivision .....__._ .__ Filed Map. _._,,___ Lo(: ____._.______
Pennit No. '3 J- <;77 z. __ Datc of Permit_I.~.J,-.~_o__~ Applicant:_ ~'l (;~z,_.__ ____
Health Dept. Approval: Underwriters Approval: _._
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
,/
~
lIi~
( check one)
Fee Submitted: $
)S O\)
8-Q.(,.1}~v'Q
CO -& 3~G 73
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.
32577 Z
Date DECEMBER 18, 2006
permission is hereby granted to:
PHILIP J RYSKO
PO BOX 202
PECONIC,NY 11958
for :
AS BUILT INTERIOR ALTERATIONS TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at
430 OAK RD
NEW SUFFOLK
County Tax Map No. 473889 Section 117
Block 0002
Lot No. 004
pursuant to application dated DECEMBER 11, 2006 and approved by the
Building Inspector to expire on JUNE 18, 2008.
Fee $
300.00
ORIGINAL
Rev. 5/8/02
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I Located at
~ Application Number: 3031173
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~ 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 24th Day of May, 2007.
~ Name OTY Rate Ratin. Circuit ~
~ Service
~ 1 Phase 3 W Service Rating 200 Amperes
~ Service Disconnect:
~ Meters: 1
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BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
BRIAN BROOKS ELEC. INC.
BOX 1001, 455 BEEBE DR
CUTCHOGUE, NY 11935,
ANTONINO DIBENEDETTO
430 OAK RD
NEW SUFFOLK, NY 11956
430 OAK RD NEW SUFFOLK, NY 11956
Certificate Number:
3031173
Section: Block: Lot: Building Permit: BDC: n511
Described as a Residential occupancy, wherein the ;~m'1?e~;::Zal system consisting of
electrical devices and wiring, described below, located inion the premises at:
Basement, service only, Outside,
200
cb
seal
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
J/o'/o;
Pax (631) 765-9502
Telephone (631) 765-1802
Town Hall, 53095 Main Road
P.O.. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date: O~-aIo-o?
Building Permit No. 3zs - 1'7 Z.
Owner: Ai'! ~v~Z- 'IJD Ckt 11. I4J j"AIk-
(Please print)
Plumber:
Pe.-tA-JJ y{~~CIt--'
(Please print)
I certify that the solder used in the water supply system contains less than 2/1 0 of 1 %
lead.
~~~
(Plumbers Signature)
o
Sworn to before me this ~
No 01004673789
QJ4lit:Qd in Suffolk Gouniy
Notary Publffi!;~(IJ<Mni9tO
f II feingold & gregory · architects · p.c.
118 west 83'. st.' new york, n.y. 10024. tel. (212) 595-6895. fax (212) 787-8992
August 21, 2007
TOWN OF SOUTH OLD - Building Department
Town Hall Annex Building
54375 Route 25
PO BOX 1179
SOUTHOLD NY 11971-0959
631-765-1802 BP
631-765-9502 BF
Re:
Building Permit # 32577Z Dated: 12/18/06 By: DPR
430 Oak Road, New Suffolk NY 11956
Plans Submitted By: James V. DeLucca, R.A. N.Y.S. Lie. No.: 023655
Plans Dated: 12/10/06 Job No.: 15-2006
To Whom It May Concern:
In reference to the Framing and Insulation at 430 Oak Road, New Suffolk
NY, the as built construction of the above mentioned project has been
performed in compliance with the plans and specifications stated on the
approved plans for Building Permit No.: 32577Z.
Paul Gregory,
N. Y.S. Lie. No.: 26717
C:\I doc's\27000cmp Tevez 4300akRdNewSuffolkNY.doc
3'J-S77 :z
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] ROUGH PLBG.
[ ] INSULATION
[r><&INAL 4;
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRlJCnON [ ] FIRE RESISTANT PENETRATION
REMARKS: ~ ~~ ~-t
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DATE
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INSPECTOR ~ ~
3'J-S77 Z.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING D<f FINAL ~ ~
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: ,F~ ~ ~
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3~S77 L
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING ~ FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
REMARKS: reM. ~ ~
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[ ] FRAMING I Sm.WING ~'IIIAL
[ .}PIREPI.. t- .. (otillMNiY [] RRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUC11ON [ ] RRE RESISTANT PENETRATION
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TOWN OF SOUTH OLD BUILDING DEPT. hL./ (--
765.1802 J 3 ~
INSPECTION /
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REMARKS:
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] RRE RESISTANT lJCnON
M ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT PENEtRATION
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DATE .3 - / Lf -- 0 7
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INSPECTOR
FIELD INSPECTION REPORT DATE I
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COMMENTS
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STATE ENERGY CODE
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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/Southold/
Approved
Disapproved ale
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/2.// <;',20 (,.
,
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
PERMIT NO. , f!>;;),O:;' "7-r Check
Septic Form
N.Y.S.D.E.C.
Trusiee.
Contact: ~
Mail o~ ~IJILr
Examined
-,
~:
- Phone: !'/ ,,. ~t./I. ~~ 26
'I,,/? ,20~
Expiration
---
.1
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,APPLICATION FOR BUILDING PERMIT
..__.J
Date
I ~/ II
,20e-'
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 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 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 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, housing code, and regulati , and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applican e, if a corporation)
~71k..i',1L~(, Or., ~;y I-6lh pY1I7'1 (.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
~w.tr
Name of owner of premises
Alul
Yilt z,.
(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 of land on which p
House Number Street
!county Tax Map No. 1000 Section
Subdivision
(Name)
117
Y 9)/
Hamlet
lI'~'_
~ -"'1 ~r,"
Block '.. 1:.J:kj:~ot
Fillld Map No.. '" baoIIlaue Lot
f?lfQUI'IOIl2Ir,,;i
tf
/State existing use and occupancy of premises and inte
('. a. Existing use and occupancy
d occupancy of proposed construction:
b. Intended use and occupancy
12 e..S' .0_ - -.c......
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration
~
(Description)
4. Estimated Cost
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. If business, 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
Depth
Rear
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Depth
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
9. Size oflot: 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.
IS 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---.L
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
cf.7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
, STATE OF NEW YORK)
SS:
COUNTY OF~:L-J'Pn\<l
IV f \ ::\ \ (" \ J(' 7 being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
o\~r,y(r
(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
\ \ dayof CRCef:""'\he( 20~
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Signat~t
Notary Public
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behc f I' the tW_ compony. gowrnmental agency o"a ronQlng
here n, ft'. not., certification of title. zonIng or frlleclom from
or _ bu quent owners.
CerURcoUon8 are not troneferoou,
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I /d: SURVEy
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h:: offsel& or dImensIons shown f,-om the slruchires to tke property lines orc ror a spaci1 c purpose and use
lJ KJjde in the erecllon of fences. retaining walls, poots. patios, plontlnq oreaS, additions tl buUdJngs and any
:0' Ulons not ....own. Eosem~fltS. Rights-ot-Way of Record, If ony, net 5"0""". Propert)' t:orn_r ."onumenls were not
I
Barrett, Bonacci & V an W eele, P.c.
CIVIL ENGINEERSlSURVEYORSlPLANNERS
175A Commerce Drive, Hauppauge, NY 11788
TEL 631f435-11 I I FAX 631/435-1022
www.bbvpc.rom
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REVISIONS:
lO:: f:
~;; p OF: DESCRISED PROPERTY
F'I ED: __ NO.--
SI 'UATED: NEW SUFFOLK
CO. SUFFOLK
TIT'''' NO.' RR28681 S
~,
TOWN OF SOUTHOLD .tOPERTY RECORD CARD
STREET l.!3 0
a. I( f?o a d
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7-J.-t/
VILLAGE
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135
RES. LID
LAND
SEAS.
FARM
COMM.
VL.
IMP.
TOTAL
DATE
60
1100
~60
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DISTRICT
SUB.
,OT
no!-
$/s-
ACREAGE :J.&
,&fr /...:.
TYPE OF BUILDING
~ {vz,.yf.t..-.
I Est. Mkt. Value
.t?e..I'C'1
I CB.
I MISe.
AGE
NEW
BUILDING CONDITION .......---....,
NORMAL
ABOVE
FRONTAGE ON WATER
FRONTAGE ON ROAD
BULKHEAD
DOCK
BELOW
Farm
Acre
Value
Value Per Acre
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
B rush land
House Plot
Total
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