HomeMy WebLinkAbout33881-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33046
THIS CERTIFIES that the building ALTERATION
Location of Property: 630 WIGGINS ST GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Nap No. 473889 Section 48 Block 1 Lot 29.1
Subdivision
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 23, 2008 pursuant to which
Building Permit No. 33881-Z dated MAY 8, 2008
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" BATHROOM IN AN EXISTING ONE FAMILY DWELLLING AS APPLIED FOR.
The certificate is issued to JUAN SECAIDA
of the aforesaid building.
(OWNER)
Date: 05/27/08
SUFFOL% COONTY DEPARTMENT OF HBALTH APPROVAI, N/A
ELECTRICAL
NO.
PLDABERS CERTIFICATION DATBD
4000739 05/21/08
05/14/08 G A STAHL
( `
Au orized Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT Z 0 ~ ,
TOWN HALL
765-1802
. ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY "°
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:
1. 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. Swom statement from plumber certifying that the solder used in system contains less than 2/10 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 Apri19, 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. 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 of Occupancy -Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
House No.
Owner or Owners of Property:
C
Hamlet
Suffolk County Tax Map No 1000, Section t b Block B ~ Lot Z- (, ~ 1
Subdivision Filed Map. Lot:
Permit No. 3 ASS l Date of Permit. ~O Applicant:~CG(~ (yp~Rt~/r'c/y
Health Dept. Approval: nderwriters Approval: /
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:
Fee Submitted: $ ^~
~ ~ a~
~~~~35~
Old or Pre-existing Building:
ate. S~zo ~8
(check one)
?: C9/'eew,poJ
(check one)
Applica ature
Town Hall, 53095 Main Road
P.O.. Box 1179
Southold, New York 1197]-0959
O~~gpFFO(,~co
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Fax (631) 765-9502
Telephone (631) 765-1802
Date: Y,~W 2~
Building Permit No. 3 3 ~ p
Owner: ~f~~j(fC(7 C I(1~~.
(Please print)
Plumber: ~~~ (,i ~ o c`~ ~ c _ /~j~
(Please print) Q I r' 1
lead.
I certify that the solder used in the water supply system contains less than 2/10 of 1%
Sworn to before me this
day of /%~, 20 O 0
j~ ~ ~_
Notary Public, Sy ~~~/~ County
i
umbers Signature)
CORWNE E. NENIMAN
Notary Public, Stare of N:w York
No. 473&FiSo
Qua{ified in Suff~:k C unit'
i.Y~t If9S
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
BILL GORMAN PO BOX 1447
MATTITUCK, NY 11952
Located at 803 WIGGINS ST. GREENPORT, NY 11944
Application Number: 4000739
Section: Block:
Lot:
ANTONIO SECADA
803 WIGGINS ST.
GREENPORT, NY 11944
Certificate Number: 4000739
Building Permit: 338812 BDC: ns11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Second Floor, bathroom,
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 21st Day of May, 2008.
Name 2 Rate
AdditionalCbarges
as built 2nd floor bathroom-2002
Wiring And Devices
Fixture 1 0
Receptacle 1 0
Switch 1 0
Rating Circuits Tvoe
Incandescent
GFCI
Gen, Purpose
M as built visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is
believed to be in conformance with the applicable reference standazd for the estimated period of construction of the premises wiring system
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.
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
BILL GORMAN PO BOX 1447
MATTITUCK, NY 11952
Located at 803 WIGGINS ST. GREENPORT, NY 11944
Application Number: 4000739
Section: Block:
Lot:
ANTONIO SECADA
803 WIGGINS ST.
GREENPORT, NY 11944
Certificate Number:
Building Permit: 338812
BDC: ns11
Described as a Residential occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
Second Floor, bathroom,
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 Cade Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 21st Day of May, 2008.
Name TY Rate
AdditionalCharges
as built 2nd floor bathroom-2002
Wiring And Devices
Fixture 1 0
Receptacle 1 0
Switch 1 0
4000739
Incandescent
GFCI
Gen, Purpose
M as built visual inspection, of the delineated electrical installation, determined [ha[ an obvious hazard is not present and the installation is
believed to be in conformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
seal
I of I
Rating Circuits Tvoe
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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. 33881 Z Date MAY 8, 2008
Permission is hereby granted to:
JUAN ANTONIA SECAIDA
803 WIGGINS ST
GREENPORT,NY 11944
for
"AS BUILT" BATHROOM ALTERATION AS APPLIED FOR
at premises located at 630 WIGGINS ST GREENPORT
County Tax Map No. 473889 Section 048 Block 0001 Lot No. 029.001
pursuant to application dated APRIL 23, 2008 and approved by the
Building Inspector to expire on NOVEMBER 8, 2009.
Fee $ 400.00
~horized Signature
ORIGINAL
Rev. 5/8/02
33~~/~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] IN ATION
[ ]FRAMING /STRAPPING [ INAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT COMSTRUCTION [ ]FIRE RESISTANT PENETRATION
DATE ~ ~ INSPECTOR
33gg ~ ~
TOWN OF SOUTFIOLD BUILDING DEPT.
765.1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING ~ FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ] FlRE RESISTANT CONS7RIlC110N [ ]FIRE RESISTANT PENETRATION
REMARKS:
~!~
DATE ~ ~3 ~ ~ ~ INSPECTOR ~'
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
Date: May 19, 2008
To: Town of Southold Building Dept
Re: 803 Wiggins Rd.
Greenport, NY
To Whom It May Concern:
An Inspection was preformed at the above mentioned property, and the bathroom ceiling
height measures T-1" from fmished floor. All Framing, insulation, fire caulking, sheetrock,
and Plumbing was installed as per all State and local Building Codes. Any questions please
feel free to call.
,;.
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4,
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JAMES J. DEERKOSKI, P.E. ~
260 Deer Drive ~ T '
Mattituck, N.Y. 11952 -- -- =-r~ ~~
(631) 298-7116
Date: May 6, 2008
To: Town of Southold Building Dept.
Re: Ceiling Height
803 Wiggins Rd.
Greenport, NY
To Whom It May Concern:
A Site Inspection was made at the above mentioned site an it is shown that the ceiling
height in the bathroom measures 6'-10" from the finished floor. In order to meet NYS
Building Code this ceiling will be raised to a minimum of 7'-0" from the finished floor.
Any other questions please call.
FIELD INSPECTION REPORT DATE ~ COMMENTS
b
FOUNDATION (1ST)
\~
FOUNDATION (ZND)
z
0
~~
ROUGH FRAMING &
BING H
`~
PLUM ~,
C
`~
_ _ x
_ __ _ _
-
---- -
INSULATION PER N. Y.
STATE ENERGY CODE - --
'~
,
~~
~
.
C
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FINAL ~,
ADDITIONAL CONIlVIENTS
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
Do you have or need the following, before applying?
Board of Health
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net PERMIT NO. S 3~/
Examined
205
Approved 3 ~, 20 ~ y
Disapproved a/c
Expiration t ( , 20 m`
~ I
;~.m ~'23
I.
Building Inspector
Phone: ~7 J~ ~ r__(~
APPLICATION FOR BUILDING PERMIT
Date Z 3 , 204$
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 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 of Occupancy.
£ 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 regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Sign a applicant or name, if a corporation)
~o ~X 147 , H.(r~z7Z7y'~, NY
(Mailing ddress of applicant) (~ f/ ,s2
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises /¢'/J r~~ ~ S-E~~~
(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 N
land on
House Number
proposed work will be done:
County Tax Map No. 1000
~~
BUILDING PERMIT APPLICATION CHECKLIST
4 sets of Building Plans_
Planning Board approval
Check
Septic Form
N.Y.S.D.E.C
Flood Permit
Storm-Water Assessment Form
Contact:
Mail
Filed Map
2. State existing use and occupancy of
a. Existing use and occupancy
3.
4.
b. Intended use and occupancy
1
;s and i~,tended tie and occupancy of proposed construction:
Nature of work (check which applicable): New Building Addifior
Repair Removal Demolition Other Work
Estimated Cost ~[ dC~t Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units
If garage, number of cars
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front_
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Depth
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase Name of Former Owner
11. 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_
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address
No.
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 MAYBE IEQUIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NO
* IF YES, D.E.C. 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 topogaphical 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:
COUNTY OF,~
~(LL! ~~ (~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ~~~~
(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 toYb fore me this ~
day of Y~ ~ 20 p ~''
No ~~~ ~IMIwM1iM ignature of Applicant
Rear
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Alteration
(Description)
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~G~ '~' _~ _ ~ TOWN OF SOUTHOLD PROPERTY
RECORD CARD
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OWNER'' STREET '' '' ~ VILLAGE DISTRICT SUB. LOT
~~~~ 1'
~ FORMER QWNER
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U F F TYPE OF BUILDING /
V ZF`J 0~ ~u.~.f3
RES. ~e~ SEAS. VL. FARM COM/vl. IND. CB. ~ MISC., ~ ~~
LAND IMP. TOTAL DATE REMARKS ,~ ', ~ %, t' ~ ~ --~ '" '
r:
e~Q ~~ ~ ~ ~ 3 a.., % y~G- 7w 3r ~~ I r l ~- D ~° ;. Q ~ Fi E,OG
~ _3ooC> 35OV a a 0 3 ~ 2~ ~,>'"S- !"~' ~•,~~"; /r., ~~~ ~ ~ZrC ~/s ~- - `~'~ ~g
AGE BUILDING CONDITION a ag 0'>- i4 -~ CffIC t ) l' a iY
NEW NORMAL BELOW ABOVE 7 ,~'
X ''' ~! s ° '~ - 3 ~'
Farm. Acre Value Per Acre Va lue- ~ a~ R
03 {~~ a~ ~~ - C)el'Y10 { 671
Tillable t ~ j a-1 gPa~ 33zS~ ( ceS BPS ~9~7Z
Tillable 2 ~J ~ ~~~~';
Tillable 3
Woodland
Swampland
Brushland
House Plot
Tctalg ® ~,~„
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t, :
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au
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79
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M. Bld
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oundation C"v`r ~
~
~
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Bath
o
_
Extension Basement u L Floors ~ ~
Extension Ext. Walls ~ ~ ~ Interior Finish S~ ~ ~
oc
Extension Fire Place Heat CU ~~~
~
_~e,
l~~7= r ~
S~
Z Porch Attic
Porch Rooms lst Floor
Breezeway ~ ~ X ,~ _ v ~ ~ j U ~c~~. atio Rooms 2nd Floor l e 5
Garage ~ ,; ,~ , _ e / ~e O .3 6 ~ ~riveway
O. B.
asp g
~~,/s "' Sate
~i
~,
~.~,,,, - ~,~_, - a ~ TOWN
~.
...-s._....: ~
Of SOUTHOLD PROPERTY
RECORD
OWNER ~ STREET ~~ VILLAGE DIST. SUB. LOT
r ~ ~ FS
/FORMER OWNE
r~la N E
~ ~ ~% ~~i, ACR.
. ~ ~ .~.,
~ S ~
~r/~tazza~erl-tr9~ W
.~~~K'b'F _Cos~~-~-D TYPE OF BUILDING
RES. SEAS. VL. 3~D FARM COMM. CB. MISC. Mkt. Value
LAND
IMP.
TOTAL
DATE ___--•-
REMARKS ~?~,/,. ~,<~ ~r}~,.ty~. _ ~,,r ~,lr~ ~,
~
~ ,,~
-FlaflP~ ~n ~~ri~~ ~3~~0
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per
Acre Value
Tillable 1
Tillable 2
Tillable 3 ~//~. `,~`/j~
Noodland
iwampland FRONTAGE ON WATER
3rushland FRONTAGE ON ROAD ~' ~~ r ~j'' /C`/
-louse Plot DEPTH :/~ A
BULKHEAD
otol DOCK
~R
48-1-29.1 10/03
~• Bldg. Foundation Bath Dinette
xtension Basement Floors K.
:xtension Ext. Walls Interior Finish LR.
:xtension Fire Place Heat DR.
Type Roof Rooms lst Floor BR.
'orch Recreation Room Rooms 2nd Floor FIN. B.
'orch Dormer
Breezeway Driveway
garage
Patio
O. B.
Total
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~taanvs srn,. ~R' SURVEY OF PROPERTY
eocea<.w,xx, AT GREE'NPORT
TOWN OF SOUTHOLD
SUFFULK COUNTY, N. Y.
s s'J 'JO' io2.22' SaDD-4B-DT -231
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a~w MARCH 12, 2008
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-~~~ axw 60r NUMBERS REFER TO "MAP OF PLAN OF S BUEL
N89'3190"W 102.03' CORWiN EBFAb;" FILED /N THE SUFFOLK COUNTY
P/o Lor n ~ Pub LOT x CLERK'S OFFICE a'J 0£CEMRER 2J, 1930 Ab fl {y
N/0/(' EUGENE & MARY AfA2ZAFERRO ' // n x{\y~
®=MONUMENT /b.X ~. Y \
ANY ALIERARDN OR AD@npy TO Arys SURYEY lS A WQARgV
OF SECRON TzOSEr RYE NEIY Yp4N STA IE EOUCAi1tiN UIN
FXC~'PT As PFR SFCR0.R )$DV-9/BDlyygigy 2. ACL CERMiC.I nLWS
-f ~" LT S wE ~ as scM/6 REAR iNE IMPRESSED .~EAC of RVe~SVRVEmR
AREA-111/ 2 ~. I 1. YMDSF YLxARME APPEMS MEREd1.