HomeMy WebLinkAbout33868-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33272
Date: 09/16/08
THIS CERTIFIES that the building ALTERATION
Location of Property: 3190 HAYWATERS RD
(HOUSE NO.)
County Tax Map No. 473889 Section 111
Subdivision
CUTCHOGUE
(STREET) (HAMLET)
Block 11 Lot 13
Filed Map NO. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 16, 2008 pursuant to which
Building Permit No. 33868-Z dated MAY 5, 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 ALTER BASEMENT IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JSC RESOURCES INC
(OWNER)
of the aforesaid building.
HIIFFOLKCOL~Fl~fDEPARTMENTOFHEALTHAPPR01rAL N/A
EL~-i~ICAL CERTIFICATE NO. 8366 08/30/08
FLD]~BERS CERTIFICATION DATED 07/07/08
GEORGE FREDERICKS
~u~Au orzzed~
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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
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. Sworn 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 April 9, 1957) non-conforming uses, or buildings and gpre-exisfing" 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 a consent to inspeat signed by the applicant. If a Certificate of Occupancy
is denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
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 - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Old or Pre-existing Building:
Sfreet
New Construction: v~
Location of Property: TI q[~
House No.
Owner or Owners of Properts':
(check one)
~J Hamlet
Suffolk County Tax Map No 1000, Section [000 -II I Block
Subdivision ]kJ0{g{] 0 P~l{/[+C.ll)~O~'~/O~h'Cr Filed Map. ~lXq~
Pe~itNo. ~L Date;fPe~it~ ~l~Oe Applic~t:
Health Dept. A;pr;val: ~/~ Undemfiters Approval:
Pla~ing Bo~d Approval:
Request for: Temporary Certificate
Fee Submitted: $ ~'
Final Certificate:
~3heck one)
Nassau Suffolk Electrical Inspections,Inc.
P.O. Box 549, Aquebogue, Ne,a' York * 11931
Tel: 631-591-3097 Fax: 631-591-3098
Application: 8366 Date: 8/30/08
lssned to: Zizzi Contracting Corp
Address: 3190 Ha)3sater Rtl Introduced B)rl STS Electric
Village: Cutchogue License #: 41857-M
Residential [] Commercial []
The following was examined and approved up to the above ;rate and found to
be in compliance with the NEC:
Attic 1st Floor 2nd Floor 3''d Floor Garage Conversion
Basement [] Hot Tub Addition [] Detached Garage Pool
13 23 3~; 3 2
__
This certificate must not be altered in an)' manner
P,O. Box 1179
York ! 197] .0~9
I~UILDJNO DE~ARTMI~N~
TOW~ OF SOUTHOLD
CERTIFICATION
(please print)
Plumber:
I certify that the solder used in the water supply system contains less than 2/10 of 1% lead.
Sworn to before me this / 0
day of~ , 20(~)~
Notary Public, ~~ County
/ (Pluq~rs S'ig~ature)
LYNDA M BOHN
NOTARY PUBLIC, State of New York
NO. 01B06020932, Suffolk C,o, unty
Term Expires March 8, 20 t,\
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUI~DING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 33868 Z Date MAY 5, 2008
Permission is hereby granted to:
JSC RESOURCES INC
3190 HAYWATERS RD.
CUTCHOGUE,NY 11935
for :
ALTERATION TO AN EXISTING BASEMENT AS APPLIED FOR
at premises located at 3190 HAYWATERS RD CUTCHOGUE
County Tax ~ap No. 473889 Section 111 Block 0011 Lot No. 013
pursuant to application dated APRIL 16, 2008 and approved by the
Building Inspector to expire on NOVEMBER 5, 2009.
Fee $ 542.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING ['~,~xAx~a~..~.,..~, ~,~--~ ~ ~ ~ .7_ ~
SOUTHOLD, ~Y 1197~o o t en~et~t k
TEL: (631) 76~1~" ~s~,2e' ~o, ~
FAX: (631) 76~ ' ~' - -'- '~' .....
~. northfork.neUSouthold/ PE~IT NO.
Examined O'~/)~ , 200~
Approved ~/~,20 O~y
Disapproved a/c
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
N.Y.S.D.E.C. --
Trustees
Contact: '~w~' ~'
Phone:
Expiration //~ ,~20 ~)Y /~.~.~._.~
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
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.
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 regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicator name, ifl(/~rporafion)
(Mailing ad, ess of applicant)
p/'~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder
State
whether
applicant
is
Name of owner of premises .d ~-4 ~/~, '~ -t ,
/f' ~ (As on the tax roll or latest deed)
If appl/~.an, t)~ a cfljp6~tio~, signature of duly authorized officer
////~fame and titl~ of corporat'e officer)
//q3uilders License No. f(/~/¢c/.
Plumbers License No. ~////t ~'
Electricians License No. ~/(/?_ f ~:
Other Trade's License No. -~-
1. Location of land on which proposed work will be done:
Hous~ Number '~ Street
Ham~let
County Tax Map No. 1000., ~ection /// Block //
Subdivision /~/~ ~ ¢~0 .~'~'~.~e.~ ~_-~_-
· '(Name)
Lot /D
Lot
2. State existing use and occupancy of pr .emises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~'g't~t.¢_
b. Intended use and occupancy
Nature of work (check which applicable): New Building
Repair ~ Removal ~ Demolition
4. Estimated Cost
5.
If dwelling, number of dwelling units
If garage, number of cars
Addition ,-- Alteration ~--
Other Work~;, -~d/flyc~ff-- ~
Fee ~4t'2Y ~'~/'fl/~,~flJ~/'¢/('Description)
(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 ~ ~ ~' Rear
Height 7 o Number of Stories
Depth
Dimensions of same structure with alterations or additions: Front
Depth .ff~ Height 2%¢-..~_ Numbe? of Stories
8. Dimensions of entire new construction: Front ~ Rear
Height -- Number of Stories .---
Rear -cfi'a--.-
Depth
9. Size of lot: Front g '2 Zof Rear ]Zo Depth
10. Date of Purchase ~ 'g! 'Z~,,: ? Name of Former Owner/~,,~d~,~
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 NO
14. Names of Owner of premises ~5'~
Name of Architect
Name o f Contractor. ' 7///v.~.
15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES
IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE J1EQUIRED.
'* b. Is this property within 300 feet ora tidal wetland? * YES NO
· IF YES, D.E.C. PERMITS MAY BE REQUIRED.
Address ~o~te-,.~O'y///5~: Phone
Address~ ~f Phone Nod
Address~ '~/-'5-r Phone No.
NO
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)
COUNTY OF ff't4~/''''j)°:
'~/'"2'~4 ~ ~'< ~ ~ 't, --t, being duly swom, 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.
/Signature of Apphcant
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ] FRAMING / STRAPPING ~FINAL ,/~
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
,~ FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
~)~/I NSULATION
[ ] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
REMARKS:
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
I NSPECT ION
[ ] FOUNDATION 1ST [ ,~ROUGH PLBG.
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
[ ] FOUNDATION 2ND
] FRAMING / STRAPPING
] FIREPLACE & CHIMNEY
] FIRE RESISTANT CONSTRUCTION
REMARKS: ~
FIZLD/NS}'ECTION REPORT I DATE I C OM1VIiENTS
FOUN1)ATION (1ST)
/
ROUGH
PL[FMiBING
ENERGY CODE
STATE
FI~NAL
~DITION~
>
Checked By/Dnte
~'-'~check Comntiance Certificate
New York State Ene/d~y Conservation Construction Code
REScheck So~ Vor~ic~ '~ 6 Release a
Data 6lename: C:\Prog,mn Files\CheckkREScheck\ClientsXHaywater. tck
PROJECT TITLE: Finished Basement For
COUNTY: Sufolk
STATE: New York
HDD: 5750
CONSTRUCTION TYPE: Detached I or2 Finally
HEATING TYPE: Non-~i~mc
WINDOW / WALL RATIO: 0.36
DATE: 05/05/08
DATE OF PLANS:
PROIECT DESCRIPTION:
Zizzi Construction Inc.
Haywat~ Road, Nassau Poim
Town Ofgouthold, New York
DESIGNER/CONTRACTOR:
Midmci W. Bchdngcr Archit~c~
1375 North Sea Road
Southampton, New York 11968
COMPLIANCE: Passes
Maximum UA = 177
Your Home UA = 115
35.0% Better Than Code (UA)
Finished Basement: Wood Frame Wall 1~/8ht: 9.0'
[naulatiou depth: 9.0'
Anden~en CWlS: Wood Fram~Doublc Pane with Low-E
3070 EnUy: Solid
· ~ Glazing
Area or C~flty Cont. or Door
perimeter ]~-V~uc R-Value U-Factor UA
1878 II.0 0.0
12 0.280 3
21 0.340 7
COMPLIANCE STATEMENT: Thc propor, ed b~ing represented in this documcnt is consi~.ent with the building
piaa~, speeiicaaons, and other ~culaaons sab~i*~wi~h this pamit
~i~ to ~ ~N~ Y~ S~e En~ C~ C~on C~ ~ts. Wh~ a R~st~
05-0S-2008 09:48 SOUTHOLD BUILDING DEPT 163176S9S0~ PRGE2
Ha~ 05 08 08:23a ~ehr~ncer p.3
Professional has stamped and signed this page, they a~ attesting that aa the bern ofhis/he~ knowledge, belief and
professional judgment, such pleas or speaiications ~e in oompli~aen with this Cc<lc,
05-05-~00EI OC):~.EI SDUTHOLD I~UILDING DEPT 16~1765950~' PFIGiE~
New York State Insurance Fund
Workers' Compensation & Disability Benefits Specialists Since 1914
199 CHURCH STREET, NEW YORK, N.Y. 10007-1100
Phone: (888) 997-3863
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
LOVELL SAFETY MGMT CO., LLC
110 WILLIAM STREET 12TH FLR
NEW YORK NY 10038
POLICYHOLDER
JAMES V ZIZZI CONTRACTING CORP
PO BOX 1551
QUOGUE NY 119591551
CERTIFICATE HOLDER
TOWN OF SOUTHOLD
P.O. BOX 1179
SOUTHOLD NY 11971
POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE
G 1044 660-7 147108 04/01/2008 TO 04/01/2009 4/9/2008
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 1044 660-7 UNTIL 04/01/2009, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER
FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW.
IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 04/01/2009 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE,
30 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WiLL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE.
NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW
YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE.
THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY.
U-26.3
NEW YORK STATE INSURANCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
This certificate can be validated on our web site at https://www.nysif.com/cert/cerlval.asp or by calHng (888) 875-5790
VALIDATION NUMBER: 366538988
OWNER STREET
FORMER OWNER N
TYPE OF BUILDING
ES..~//~/~k3 SEAS. VL. ¢ [FARM COMM. CB. MISC.
AGE BUILDING CONDITION
q~b' NORMAL BELOW ABOVE
:ARM Acre Value Per Value
Acre ~ 0'~'
Ibble 3 ,' ~¢ ~¢_ ¢,
oodtend
,~mpbnd FRONTAGE ON WATER
ushbnd FRONTAGE ON ROAD
~use Plot DEPTH
BULKH~D
t~l DOCK
NASSAU
SURVEY OF
LOTS 411 & 412
MAP OF
POINT CLUB ?RO?ERTIES,
SECTION D
FILE No. 60B F~LED MAY 7, 1926
SITUATED AT
NASSAU POINT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
1000-111-11-1:5
SCALE 1"=20'
SEPTEMBER 14, 2004
SEPTEMBER 20, 2004 SURVEY
JUNE 8, 2005 REVISED PROP. SEPTIC SYSTEM LOCATION
DECEMBER 27, 2005 FINAL SURVEY
JANUARY 29, 2008 UPDATE SURVEY
AREA = 59,045 sq. fl,
0.896 ac.
54.8
INC.
LOT (~ 156.00'
2 O'
S'T~p$
/0' x 2~
LoT ~
LOT ~
NOTES;
1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
EXISTING ELEVATIONS ARE SHOWN THUS: 25.0
CERTIFIED TO:
STEVEN HILL
LIHDA HILL
UNITED GENERAL TITLE
LIBERTY TITLE AGENCY
INSURANCE COMPANY
N,Y,S. Uc, No. 50467
Nathan Taft Corwin III
Land Surveyor
PHONE (651)727-2090 Fax (651)727-1727
TNE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
40,9
$ 76'53 $
BB.07'
STORAGE
ART AREA
EXERCISE AREA
SCAPEWEL WINDOW WELL
UNEXCAVATED
1
EJECTION
PUMP
BASE CABINET
DRYER
1'-6~ 10'-2"- 14'
LAUNDRY ROOM
BATH
SITTING AREA
EXISTING 9'-0"
J~
BASEMENT
CLOSET
4,*
EXISTING EXISTING EXI~qNG
STEEL
COLUMN GOLUMN COLUMN
HALF WALL
4't
GAME ROOM
WINE
STORAGE
i
ICL)_ .....
PROPOSED
BASEMENT
FINISHED AREA= 1,705 SQ.FT.
PLAN
SCALE: 1/4"=1'-0"
MECHANICAL ROOM
0'--8
DOOR
EXISTING
2-CAR
GARAGE
,~ITER$CERTJ~ICA~E
,PLUMBING
ALL PLUMBING WASTE
& WA't'~[~'~JN ES NEED
T~STING BEFORE COVERING
PI. UMBER CERTIFIC.4 T/ON
ON LEAD CONTENT BEFORE
CERTIFICATE O~z OCCUPANCY
BOLDER UBED IN WA TER
SUPPL Y'SYSTEM CANNOT
EXCEED 2/I0 OF 1% LEAD.
OCCUPAItIC. v OR ~
USE IS I..rr,/l ,:'~V/"FUL I',,~,1,, ·
WITH()[r .....
· ~ ~,iF/CATE
OFOC,,.,~., , -v
A~PROV~.D AS NOTED
NOTIFY BUIt-DI~ D~
~65-1802 ~N,,~ TO 4PM FOR THE
~OLLOWIN~. IN?ECTIONS:
' FOR POU~ED CONCRETE
~. INSULATION
4. FINAL - COHST~UC~iON MUST
;ALL CON~TION SHALL MEET THE
~EEOU[REMENTS OFTHE CODES OF NEW
VCBN S~ATE. ~NOT RESPONSIBLE FOR
IDESIGN~OR CONSTRUCTION EBBORS~
v ;I
**REVISION DATE:, 05/01/08
I
FINISHED BASEMENT FOR i~~~
ZIZZI CONSTRUCTION INC( :
HAYWATERS ROAD, NASSAU POINT ~ I
TOWN OF SOUTHOLD, NEW YORK ' ' :i'~,~~. ~..'_.~
SOUTHAMPTON, N.Y. 631-g87-9474 I i
'-, .4 04/1
I i
BRICK PATIO
KITCHEN
KEEPING ROOM
[0
DINING ROOM
DEN
BATH
COVERED PATIO
FAMILY
ROOM
MASTER
BEDROOM
FOYER
EXISTING
FIRST FI,OOR
(NEW ELEVATOR)
PIAN
SCALE: 1/4"= 1'-0"