HomeMy WebLinkAbout32685-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33172
Date: 07/25/08
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 350
(HOUSE NO.)
County Tax Map No. 473889 Section 103
TRACK AVE
(STREET)
Block ~
CUTCHOGUE
(HAMLET)
Lot 3
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JANUARY 24, 2007 pursuant to which
Building Permit No. 32685-Z
dated
JANUARY 31, 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 UNHEATED ENCLOSED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to DAVID & SALLY M BLADOS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMKI!IT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
120283H
OS/27/08
PLUMBERS CERTIFICATION DATED
N/A
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Rev. 1/81
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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This application must be filled in by typewriter or ink and submitted to the Building Department with the, fullbwi~
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A. For new building or new use: \ --
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusuat.natllr"lo,.-
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
CD 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:
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 - $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
Date.
New Construction: ;<
Old or Pre-existing Building:
(check one)
C..fJ.o5~
Hamlet
Location of Property: '3 .s- c:)
House No.
7~ .4ve
Street
Owner or Owners of Property: ~~PVII:>... S ,o.1/y /3Ln-.o"S;
Suffolk County Tax Map No 1000, Section ~') ~ ~8 '1 Block 00/.2...
Lot 003
Subdivision
Permit No. J ~(., ~ ~
Filed Map.
Lot:
Date of Permit. 1- 3/-0)
Applicant: /~v#A ,1~S
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate;f
(check one)
Fee Submitted: $ ;)5,0 0
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Applicant SIgnature
Electrical Inspection Certificate
Issue Date
5/27/2008
Electrical Inspection Service, Inc.
375 Dunton Avenue
East Patchogue, New York 11772
(631) 286-6642
Application Number
120283H
Issued To:
Street:
Village:
Section:
Mr. David A. Blados
350 Track Avenue
Cutchogue
Block:
Zip: 11935
Lot:
Town: Southold
Contractor:
Lie. #
Was examined and found to be in compliance with the National Electrical Code.
Commercial NV Defects Pool X 1 st Floor X Indoor Basement Hot Tub
X Residential Det. Garage Attic 2nd Floor X Outdoor X Addition Survey
Switches Receptacles Fixtures GFI Heaters AlC Fans
7 11 8 1 1
Dishwasher Washer/Amps 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
J:!?L/4'
President
Rough Inspection: 11/21/2007
Inspector: John Me Mahon III
Final Inspection: OS/21/2008
Inspector: John Me Mahon III
This certificate must not be altered in any manner. Inspectors may be identified by their credentials.
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUIWING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
32685 Z
Date JANUARY
31, 2007
Permission is hereby granted to:
DAVID & SALLY M BLADOS
PO BOX 228
CUTCHOGUE,NY 11935
for :
ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at
350 TRACK AVE
CUTCHOGUE
County Tax Map No. 473889 Section 103
Block 0012
Lot No. 003
pursuant to application dated JANUARY
24, 2007 and approved by the
Building Inspector to expire on JULY
31, 2008.
Fee $
200.00
re
ORIGINAL
Rev. 5/8/02
Date: October 1, 2007]
To: Town of Southold
JAMESJ. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-5506
Re: First and Second Foundation Inspection
Blados
350 Track Ave.
Cutchogue, NY 11935
Permit# 32685
To Whom It May Concern:
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TIns letter certifies that a first and Second foundation inspection was preformed on the
above mentioned property and was all done correctly as per plan. Any questions please
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Date: July 14, 2008
JAMES]. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
To: Town of Southold Building Dept.
Re:
FranringInspection
Blados
350 Track Ave.
Cutchogue, NY 11935
Permit# 32685
To Whom It May Concern:
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A Framing Inspection was performed on the above mentioned Structure, and all framing
was done as per plan, and also meets all state and local building codes. Any questions
please feel free to call.
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING t><1 FINAL J!J<....:
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON
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REMARKS:
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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 PENETRATION
REMARKS: . ~
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INSPECTOR
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FIELD INSPECTION REPORT DATE
COMMENTS
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FOUNDATION (2ND)
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INSULATION PER N. Y.
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/SouthoId/
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans /'
Planning Boa1)l approval
Survey /
Check ~
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
PERMIT NO. 3 bib ~ ':) b
Examined
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Approved
Disapproved ale
,20-1:-
,20_
Mail to:
Phone: q 64, Cf91.f 9
Expiration
7hl
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,20l
Q72
Building Inspector
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APPLICATION FOR BUILDING PERMIT
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Date
I-~S-
,200 I
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
are!,s, 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
shull 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 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. Yl...~ ~
(Signature of applicant or name, if a corporation)
f{) kK oU.J:> C.')J0~W> NY If 'lU--
(Mailing address of applicant)
State whether applicant iS~lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
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Name of owner of premises {:),40 uA +- S-A.J I 'f dLA-/Jo r;;:
(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.
1. Location of land on which proposed work will be done:
SO ~ fE
House Number Street
Hamlet
County Tax Map No. 1000 Section 10 3
Subdivision
Block I J..
Filed Map No.
Lot
Lot
"3
(Name)
2. State existing use and occupancy of premises and intended use agd occupancy of proposed construction:
a. Existing use and occupancy I F.4m'/y !JlA/eI I,...vf
b. Intended use and occupancy / ;;"")1 .bLvel7ov5 I-vl~~ c/Ok4 IN t>~/{.cl.f
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work C/"s-t..b
Alteration
Ih Po<tc.4
(Description)
4. Estimated Cost
{:>eJO .a'3
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
Depth Height Number of Stories
R€cI.ta--
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: 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 X-
13. Will lot be re-graded? YES_ N~ Will excess fill be removed from premises? YES_ NO..K-
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14.NamesofOwnerofpremisesJ>^"I~~S Address~~~C.... Phone No. 7r'f-S-3u)
Name of Architect Address Phone No
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.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 topographical data on survey.
STATE OF NEW YORK)
SSL
COUNTY OFS "\.pr.,~rc.
bAvt6 bc..,a.ooS: being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
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(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.
Notary Public
D~~
t 19nature of Applicant
Clelre L. Glew
Notery Public. Slete of New York
No.01GL4879505
Qualified in Suffolk Coun!\', _ ,
Commission Expires Dec. 8. ~ 0
/600- j63-/2-,J
OWNER
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FORMER OWNER
{30$
K A TI-/ ;:: y'/t/ 'A
m. c;;1J () SEAS.
LAND
IMP.
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100
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'illable
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louse Plot
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TOWN OF SOUTHOLD PROPERTY itEeORD CARD
ACR.
/, OR'
TYPE OF BUILDING
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STREET 35
TIfAcl( AVE
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VILLAGE
DIST.
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W
Be~be - c.pi 71) i(
COMM. CB. MICS. Mkt. Value
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VL. 9 FARM
TOTAL
REMARKS IV Ew (2 A If I) (onJ C!fJ/'.I:;
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DATE
SUB.
LOT
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FRONTAGE ON ROAD
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DEPTH A V
BULKHEAD
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Ist"'1 (5""",20 = '300 > 00 900 Foundation -P,c.. Bath "2- Dinette
~o7::h % 7 1\3"'Il. =- 2/(P , s<:> 108 Basement 1="Ul-L Floors K. I
P h f,- ~7~-.g7e,:> ~ ~ ~I Ext. Walls \]C=(2..{ <.'l.(iO()'\'(( Interior Finish .-s- \< LR.
orc 117 -\ !
B~z'eway; 1 ~:l..,,,: 220.> l.{oo Fire Place - Heat hwGB DR.
,Q_,., I Q,-, .2.s- 100
Garage -:20)(;z. -;; =- -4(,,0 1,2S ~7 C:;, Type Roof GA 8.l-F-- Rooms 1 st Floor 5 BR. 2-
~ Aft- ~ I ~^-r ,Zpo Recreation Room Rooms 2nd Floor FIN. B
O. B. %<" Me1AJ -Z-S- Dormer Driveway
Total - 54"Dr
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OAV'D A, &LADOS 4 SALl. 'i M. &LAOOS OCT. 30,1985
MAY 30,1985
DATE' NOV.ZI,I'lM
SCALE"" -SO'
NO. 64-lIl8
.3
AT CUTCW;)6U8
TOWN OF SOUTNOI.O
SUFFOLK COUNTY. NEW 'YORK
. _UTHORIZlD ALTlRArlOM DR MOlTlON 10 THIS
SURVEY. , VIOL,nON ,. .ECTION 7208 Of 'HE.
NEW YOR_ STATE roucAroOM LA.
.. 1;01'11:* 11'" ,"II ","Vly'NOT liAR'" lNI LANO
SUftYEYOA"S INKlD SEAL OR EM,OIlED SIAL SHALL
NOT I! CON,IDERED TO II: A YALID TRut copy
..GU,.....n:P INDICATlD "fMOM SHALL RUN (IIILY TO
T1C ~RICM 'RfII WIIOM THE IUIItY[y IS PRe-PARED
AND ~ HIS KHALF TO !nTU: CONPANY, ,OYPN-
MENTAL AKMCY AMe LlH G INSTITUTION LISTED
NEJlEON. &NO TO THt! AISI NUS Of THE LENDIH.
I.STlTUTlON. QUAIl'HUII ARI lOOT T"""".RULI
TO ADOITIONAL IH~ ntuTlOHI Oft SUIs€QUENT
OWNEftS'
* DIITANCII SHOWN HERlOIf 'IItOM "OPUTY UNCI
TO EXIITIH8 .TRUCTURII' AIIIE'OIt ""ICIPlC
PUft'OSE AND .R~ NOT TO al USED TO ElTA.L1IH
HtOPEIITY LIMES OR FOIt THl ERleTlON Of 'INCEI
GUARANTEED TO'
SOUTH OLD SAY.
CHICAGO TI
YOUNG a YOUNG
400 OSTRANDER AVENUE
RIVERHEAD, NEW YORK
ALDEN W.YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR H.Y.S.UCENSE NO. 12845
HOWARD W. YOUNG, LAND SURVEYOR
N.Y.S..LlCENSE NO.45893
. i; 4
473889 103.-12-3 OWNER: DAVID & SALLY M BLADOS
NUMBER# DATE TYPE CO # USE/DESCRIPTION
13642 12/20/84 PERMIT 14069 N/D B.P.#13642 1 FAMILY DWELL I
20405 1/27 /92 PERMIT 20502 BP #20405-Z CO Z-20502 ISSUED
20507 3/27 /92 PERMIT 20612 Building Permit #20507-Z CO
23007 9/11/95 PERMIT 24836 ADDITION & ALTERATION
0/00/00
0/00/00
0/00/00
0/00/00
0/00/00
0/00/00
F1=More F7=Permit Detail F8=Co Detail F9=Preco F12=New Swis/Parcel F3=Exit
ARPR VED AS NOTED
DATE;! 21 ';f B.P. # 8 :J-G. <6'6""2
FEE' ./ BY~
NOTIFY BUILDING DEPARTMENT AT
765.1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION. TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YCDK STAT::: & TOWN CODES
AS RECJ,r-,ELJ AN'J COND'T:ON
1!/i=... - '. ,~:""
.~." .~, ~ ;'!,:\' ',~~~IIN~ 80
--~. --. ,'". ~ C'm ~ ARD
co."."" ,;Mi !,9USTEES
NYS. DEe
. Wf>.1E.R RUNO f
RE.1f>.\N S~O~~SE.C1\ON45-1
PURSUr\1N oWN COOE..
OF1HE.
CERTIFICATION OF
NAILING & CONNECTIONS
REQUIRED.
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.
FLOOD ZONE ,1 x /.
COMPLY WITH CHAPTER. 46"
FLOOD DAMAGE PREVENTION
SOUTHOLD TOWN CODE.
ENCLOSED FORCI-l
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RIDGE VENT
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ENCLOSED PORCI-I
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PC>. ~ J 0'" 2001 SCALE 1/4" = "0" JD
J anuar~ "',
WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS
,.-
ue.E TIolE FOLLOWING OR APPROvec U6P METAl.. CONNECTOR!. FOR F>I'llOPEllll: WIND l'Ole&f6TANT CON&TlQ:UCTION,
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4 IJanuar!:j 08, 2001 e.CAL.E 1/4" = 1'0" JD
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