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Home My WebLink About33130-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 10/15/07 NO: Z-32669 THIS CERTIFIES that the building FIREPLACE Location of Property: 360 JASMINE (HOUSE NO.) County Tax Map No. 473889 Section 70 LA (STREET) Block 1 SOUTHOLD (HAMLET) Lot 6.10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 5, 2007 pursuant to which Building Permit No. 33130-Z dated JUNE 14, 2007 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 A FIREPLACE IN AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & ROSE ANASAGASTI (OWNER) of the aforesaid building. SUFFOLK COU!lTY DBPARTMEI!lT OF HBALTH APPROVAL N/A 07/30/07 ELECTRICAL CERTIFICATE NO. 3040886 N/A PLUMBERS CERTIFICATION DATED 4J4 Au izei Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 T WN F SCUTHOL.O I APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Depariment 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 fonn). 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) lion-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 tnerefor 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 Ceriificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. /0 - / J -n") Location of Property: ':3 60 House No. Old or Pre-existing Building: ~ASpYljAk LA./ Street ------- (check one) Sou 'l--lto/tJ New Construction: Hamlet Owner or Owners ofPropel1y: ~_..A4.~_L ,j 1Lo'ie 4 AI;1-.l/rg'11 r+./ Suffolk County Tax Map No 1000, Section Block Lot Subdivision Filed Map Lot: Pennit No. -:3 '31 3 D _~ Applicant /'11-~ ~4e/.sLj7()~. ANilMg.4..Sf/. Underwriter, Approval: Date of Permit. Health Depl Approval' Planning Board Approval: ____ Request for: Temporary Celiificate Final Certificate: (check one) Fee Submitted $ ;)')00 ~~~ &--o.K-.73dSS CO-?:: 2>).& G Y 70. - I - t;. . I 0 I!I.I!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 ~ ~ ~ ~ MICHAEL ANASAGASTI MICHAEL ANASAGASTI ~ ~ 360 JASMIN LANE 360 JASMIN LANE ~ I SOUTHOLD, NY 11971 SOUTHOLD, NY 11971 I ~ Located at 360 JASMIN LANE SOUTHOLD, NY 11971 ~ I 3040886 3040886 I ~ Application Number: ~ce :,- ~ ~ Section: Block: Lot: Building Permit: 33130 C: ns11 ~ ~ ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ First Floor, fire place, ~ ~ 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 and/or 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 30th Day of July, 2007. ~ ~ Name OTY Rate Rating Circuit ~ ~ ~ Miscellaneous ~ ~~~b ~ ~ gas fire place ~ ~ Wiring and Devices ~ ~ Receptacle 1 0 Special ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ H~ ! ~ ! ~ 1 of 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. I I!I~.I!I 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. 33130 Z Date JUNE 14, 2007 permission is hereby granted to: MICHAEL ANASAGASTI SOUTHOLD,NY 11971 for : CONSTRUCTION OF A FIREPLACE AS APPLIED FOR at premises located at 360 JASMINE LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0001 Lot No. 006. 010 pursuant to application dated JUNE 5, 2007 and approved by the Building Inspector to expire on DECEMBER 14, 2008. Fee $ 200.00 4tA~ eLL , Authorized Signature ORIGINAL Rev. 5/8/02 3 .3 l ") o~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] I~ATION [v1'FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE /0/((/07 . INSPECTOR 3s13o TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST [ [ ] ~NDATION 2ND [ [0FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ REMARKS: f ~ r 1M ' ~ fcr(C' ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE R~STANT PENETRATION W~~ DATE INSPECTOR 33(30~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 [4N~A~~S~E~]!~~~. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRAnON REMARKS: ,~a.~~ ~ to..e:: 1~~:.o ~ DATE 7lrftJ 7 ( ( INSPECTOR FIELD INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL -. -. DATE I ~ft J;.. h / ' COMMENTS . Fu7....: &I A ( ~ -:+-.. \. /./ .-I~J // 'J , Q:2. /, /.. /Y'o- / .., .A d. ( ~ K~ -//77 tY 7/.d'"7 b.. 1/ / ---f-_. --.--..- -_. !---.--.----.--. /olli/" 7 ,.'JIt/u rA f E '~//. . (OJ';' .,<2_ // I / P" I u. ---1"" , ',:::? / -. ADDITIONAL COMMENTS v>J ...., \Yt'i CJi':J 1" == . o-j 1'1-' .. :::l\ ~ ~ .J- '" ~ t'i ~ <0-. - r 2: p ) G" '" 0 o-j ~ G; t'i ("> o-j / V'\ '2 J (' r~ ~ t'i o-j LJ'\ C (" L :Y ~ " ~ ::s:> :; " iJ' l') Y ~ ~ z V !a t :;; ...:J --t'i ~~ ]' ~ , o-j <:;. - c( i ~ Z_ ~ -o-j .:)= 1:1 i'j ..., ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH OLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ .... 33 J30l: 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 Check Septic Form NY.S.D.E.C. Trustees Contact: PERMIT NO. (;/rt{ ,20ll kif 'f. 20 QL Examined Approved Disapproved aJ c Mail to: 'df t' 20~ Phone: 7 G5 - /7 {? c; Expiration uilding Inspector .- Oil' @ ~?j;\ Uti 'I'~":;fi ~ BLUVOEP-. \ TC"',ItoIQF'l(:'I'IHOL')__, Ii: '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 is~ues 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 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. APPLICATION FOR BUILDING PERMIT Date 6-'1- ,2001 INSTRUCTIONS (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Ol.lhJ{' ,L Name of owner of premises Mca.-"-",,,- ( ANArAv.A..f; (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. 0 ~.""JlSA....- Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: j'6 <::> --1A S-,-Y\ lIVe LA:. House Number Street s:;,.J Tf;.,; (.p Hamlet County Tax Map No. 1000 Section Subdivision /6 Block 0 I Filed Map No. Lot 6 . / D Lot (Name) .... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration F,u PL"'c~ (Description) 4. Estimated Cost S-OOc).,)D 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. Ifbusiness, 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 Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 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 I I. 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 fVI'c-t..~cf .4J1'(S,(6~ddress 3'6'" ..iI.S'I'-...''-t. c.;< Phone NO(6'j' U 76 J-l7g.(;. Name of Architect Pb-Juy tV/,(L.:r............ Address"''''''' R<) a-.u~AJ...""Phone No '-t77-t>r7<l Name of Contractor Address 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.e. 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. 18. Are there any covenants and restrictions with respect to this property? * YES_NO ~ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: being duly sworn, deposes and says that (s)he is the applicant contract) above named, ~)He is the Ol.u(\~ (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. 20~ ~ Notary Public B BARA ANN RUDDER Notary Public, State of New York No. 4855805 Qualified In Su1tolk Count~..A Commission expires April 14~ ~G~ ~ Signature 0 pplicant Erosion. Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes No EXEMPTIONS: A. Does this project meet the minimum standards for classification as an Agricultural Project. Note: If you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan Is not required. ------------------------------------------------------------------- ACTIONS REOUlRlNG THE SUBMISSION OF A STORM-WATER. GRADING. DRAINAGE & EROSION CONTROL. PL.AN CERTIFIED BY A DESIGN PROFESSIONAL. IN THE STATE. OF NEW YORK. Item Number: (A Check Mark (J) for each question is required for complete application) 1. Will this project retain all Storm-Water Run-off generated on Site? (This will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Yes No -L'g (d~ g/ ./ Gd bJ" g~ Gd/ bl ../ Note: If any answer to questions 'One through eight is answered with a check mark in the Box, a Storm-water, Grading, Drainage & Erosion Control Plan is required and must be submitted for review prior to Issuance of any building permit. 2. Will this project require any land filling, grading or excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? ------------------------------------------------------------------- 3. Will this application require land disturbing activities encompassing an area of five thousand (5,000) square feet of ground surface or more? STATEOFNEWYORK'~ LlL. COUNTY OF . Thatl, (f11cW... ~ (Name of mdlVldual Signing Docume~;).lJ.......... ...... .... 5S .... being duly sworn, deposes and says that helshe is the applicant for Pennit, Sworn to before ~s; .................Lf. .. ...........dayo And that He/3treis the ......,~ .............. (Owner, Contractor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner or Owner's, 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 !me to the best of his knowledge and belier; and that the work sill be performed in the manner set forth in the application filed herewith. 4. Is there a Natural Water course running through the site or is this project within One hundred (100) feet 'of wetlands or a beach? 5. Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to One hundred (100) feet of horizontal distance? 6. Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction ofa Town Right-of-Way? 7. Will this application require the placement of material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? (This item does not Include the installation of driveway aprons.) 8. Will there be site preparation within the one hundred (100) year floodplain of any watercourse? ~~.... ,............ ...... - '''l (Signature of Applic t) Notary Public: .. ......... Notary Public, State of New York No. 4855005 Qualified in Suffolk County,.,. ,() Commllllon Expires Apr1l14~ ~.~. _.41 f'" .... ". L9 \ '- ..g to ~ 'I -- , - "'Il, - I I I -- 'J', i ~" ~. ' '~':L " z~ . ""l:,... - , i ~ ~"". ,......1;-, "l Y-..,: ~i~ , ~~~ -'3 - -=< ~ Ie ~ : =~ == -3 - ,~7~ - ~~ l.. ==It) .r .J ==- ~ - ::.- ,. r~ i- r~ ~ -=l ~C\I .. ::.::: .5~ . . ~ ... ill .-. ~." -1<t,c: ","'~':~_ . t> - _11, e '~~ i.!o"~- .. '-l f . ... "".~" - c;l' ;~ ~-... \ .'- l.--_ .I 1 -~