HomeMy WebLinkAbout34008-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33376
Date: 11/05/08
~{IS CERTIFIES that the building DECK D~DDITION
Location of Property: 2680 LAUREL AVE
(HOUSE NO.) (STREET) (HAMLET)
Co~ty Tax Map No. 473889 Section 56 Block 1 I~Dt 2.19
Subdivision
Filed Map No. Lot No.
SOUTHOLD
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 17, 2008 pursuant to which
Building Permit NO. 34008 Z dated JUNE 24, 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 DECK DJDDITION TO AM EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
· ~ne certificate is issued to JAMES V & JANE M KASPER
( OWNER )
of the aforesaid building.
SUFFOLK CO[~wi"fDEP~OF h~F2%L~{~PRO%rAL N/A
ELEt-rKIC~%L CERTIFIC3%~ NO. 4007020 07/25/08
PLL~4BERS CERTIFIC3%TION DASD N/A
Rev. 1/81
~,LDG. DEPT.
i_ .! WNO--W--~gZ~---°L'~-'''''-J.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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. 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 "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topograpbic
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
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: / Old or Pre-existing Building:
Location of Property: 2~ (~0 L~Ui~Z I~T'¥'~i/~/~:
House No. Street
Owner or Owners of Property: ",J~t/¥1~-.5 V. JOt~Orb
Suftblk County Tax Map No 1000, Section 0 ~"/o
Subdivision
Date.
Block
Filed Map.
(check one)
Pot .-r't4oc IVV IIq7/
/ Hamlet
Lot:
Per,nit No. _ ~/-/0 0 g
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Sub,nitted: $
DateofPer,nit. ~,/~f/O~ Applicant:X/'/~l/T)~'o
Underwriters approval:
Final Certificate: (check one)
v Applicant SignatUre
BY THIS CERTIFICATE OF COMPLIANCE THE ~
NEW YORK BOARD OF FIRE UNDERWRITERS
E BUREAU Of ELECTRICITY re
I 40 FULTON STREET ~ NEW YORK, NY 10038 re
CERTIFIES THAT r~
Upon the application of upon premises owned by
~ Q.C. ELECTRIC JAMES CASPER
E PO BOX 518 2680 LAUREL AVE
~ LAUREL, NY 11948-0518, SOUTHOLD, NY 11971
~ Located at 2680 LAUREL AVE SOUTHOLD, NY 11971
~ Application Number: 4007020 Certificate Number: 4007020
~ Block: Lot: Building Permit: BDC:
Section:
~ Residential whereto the electrical system consisting of
premises
Described
as
occupancy,
re electrical devices and wiring, described below, located in/on the premises at:
re Basement, Porch/Deck,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted ~n 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 25th Day of Jul),, 2008.
Name OTY Rathe Rating Circuits Type
AdditionalCharges
sub panel in basement and recpticles on
deck
Panels
I 60 2
Wiring And Devices
Receptacle I 0 GFCl
Receptacle 3 0 Gen, Purpose
This certificate may not be altered ~n 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. 34008 Z Date JUNE 24, 2008
Permission is hereby granted to:
JAMES V & JANE M KASPER
69-54 184TH ST
FRESH MEADOWS,NY 11365
for :
DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
at premises located at 2680 LAUREL AVE SOUTHOLD
County Tax Map NO. 473889 Section 056 Block 0001 Lot No. 002.019
pursuant to application dated JUNE 17, 2008 and approved by the
Building Inspector to expire on DECEMBER 24, 2009.
Fee $ 200.00
Authorized Signature
Rev. 5/8/02
ORIGINAL
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING
FIREPLACE & CHIMNEY
FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[ ~]~INAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
~REMARKS: · ,, ~-- ~-~
INSPECTOR ~~//~
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
INSPECTOR
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ]INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE
FOLrNI)ATION (1ST)
FOErNDATION
ROUGE FP--~(I~G &
PILU~VI~IN G
I~SLrLATION ]PER N. 5'
STATE ENERGY CODE
ADDITIONAL C O/VI/V~NTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork. net
Exmnined ~['~'4' 20 ~,~'
Disapproved a/c
Expiration
PERMIT NO.
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 ~
Cheek ,~
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
'Building Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
I7 ,20 op
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 uray 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. Eveu 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 ma)' authorize, in writing, the extension of the pennit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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. Thc
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 necessau inspections. ~
(Signature of~ applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises /~4- ~ .~ '~. ~//q ~ ~-5 ~_~ 5~ ~-
(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 LicenseNo.
Plumbers LicenseNo.
Electricians License No.
Other Traders License No.
Location of land on which proposed work will be done:
House Number Street
~.'~& z~ 7-lAd £4~
Hamlet
County T~x Map No. 1000 Section ~ Block { Lot
Subdivision/~.ua~/Sa/~ ff'~?wrc> ~'~cF/a~ ~_~ Filed Map No. c"'Y~'/ Lot ~5--
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
4. Estimated Cost'~ff~?/ 5~'°U
5. If dwelling, number of dwelling traits ~3,~ff_~
If garage, number of cars
Fee
Addition ////Alteration
Other Work ~ ~e.
(Description)
(To be paid on filing this application)
Num~eriof 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 tP ~ Rear
Height / ~ ' Number of Stories
Dimensions of same structure with alterations or additions: Front ~ ff
Depth fS-~? Height / ~ ' Number of Stories
.Depth
Rear
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size or lot: Front / 5~'~z'- Rear / %~ Depth ~ 5~5~6~'~ dTJ2~
10. Date of Purchase
Name of Former Owner
11. Zone or use disthct in which premises are situated ~ ~ S L'~
l 2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO C~
13. Will lot be re-graded? YES__ NO /Will excess fill be removed from premises? YES v///NO--
14. Names of Owner of premises /~a 5~'~',,q- Address
Name of Architect 5~ 7~/; .~ .~ ~,,, Address
Name of Contractor APd7~- ~ ~ ~ ~'~r~ Address
PhoneNo. 765~ ~6'~?
Phone No 7 ,( 7-- ~¢ > -2>--
Phone No.
15 a. Is this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES__NO
* IF YES, SOUTHOLD TOWN TRUSTEES & DEC. PERMITS MAY BE/REQUIRED
b. Is this property within 300 feet of a tidal wetland? * YES NO
* IF YES, DEC. 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 l 0 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions wHh respect to th s property. * YES NO
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY
~.x/4~z ~. ~/'ff. ~-'J'7-~ -f 4.' q' being duly sworn, deposes and says that (s)he is the applicant
(Na~ne of individual signing contract) above named,
(S).e 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 to before me this_
/Y77/ day or dJ~:: -- 206~ff
NorAny PUBLIC, N~w 'Fork
No mr O S
Ou~od - Suffolk Coun~
Comm. Expires ,July 31,
.... -. VILLAGE DIST. SUB. LOT
OWNER STREET "',','
AcR. , :t¢~ RmARKS~~Q· :-
PROP. CLASS
, I
A t ' /~-'~':'~r''~-
lb ~0 ~,o~p~ -~ :o~a7:'/~ j~/
FRONTAGE ON WATER TELLABLE
FRONTAGE ON ROAD ~WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
COEOR
M. Bldg. (~ ~' ~ /~E~ ~ :~ ~ ~ ~ ~ Foundation -.~_..~_~ Bath Dinette
Iq ~ ~ ~ ~! - Basement ~RAWL
Extension
~ ~[ / ~_ s~*s Floors ~D~ Kit.
Extension Ext. Walls Interior Finish L.R.
/ X ~ ~ ?~ Fire Place ~f ~ Heat ~l~ e'a'
xtensl¢
Patio Woodstove BR.
Porch Dormer ~ B~
Deck Attic
Breezeway Rooms 1st Floor
Garage ~/ ~ ~ ::; ~3 /.~ ~:¢ Driveway Rooms2nd Floor
O.B..
Pool
FOUNDATION NOTES :
All footings shall bear upon undisturbed soil having an assumed bearing capacity of 4,000 p.s.f.
Bearing capacity of soil ss to be verified by the contractor prior to placement of footings.
The Contractor is ts verify all field conditions prior to beginning of construction and is to report any
and all discrepancies to the Architect immediately.
3. All construction must comply with all national, state and local codes, latest editions,
4. All concrete construction must conform to the American Concrete Institute's "BUILDING CODE
REQUIREMENTS FOR REINFORCED CONCRETE" ACI - 3t8, latest edition.
5 The ultimale compressive strength of concrete at 28 days will be 3,000 p.s.i,
6. All post footings must have proper post anchors "Z-MAX" coated or stainless steel and be imbedded
1(]" (min.} into concrete footings or as per manufacturers specifications,
<
OCCUPANCY OR
USE IS UNLAWFUL
oWITHOUT CERTIFICATE
F OCCU F'AN,,'3,Y
ALL CONS~ ~'i,!C, TiON SHALL
MEET THE RE,,,, :?;3/lENTS OFTHE
CODES OF NLW 'FORK STATE.
I
RETAIN STORM, WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
APPROVED AS NOTED
DATE:
FEE'
NOTIFY~BUILDING UEPARTMENT AT
765d802 8AM TO 4PM FORTHE
FOLLOWING INSPECTrONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED 60NORETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O,
ALL OONSTRUCTION SHALL ME~ THE
REQUIREMENTS OF THE OOBES OF NEW
YORK STATE· NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS,
HI iH WIND ZONE CONNECTOR SCHEDULE
LOCATION MANUFACTURER/ MODEL # MATERIAL/FINISH
PRODUCT
DECK JOISTS TO SIMPSON STRONG-TIE MTS 12 tll GA METAL TWIST STRAPS
DECK GIRDER Z~IAX COATED
DECK GIRDER TO 2 - 5la" DIA. GALV. MACHINE
POST BOLTS, NUTS & WASHER~
DECK POST TO SIMPSON STRONG-TIE PBS 6; t2 GA. BASE, t2 GA. STRAP, POST
GARRETT A. STRANG
architect
1230 TraveLer Street Southo~d N.Y. 11971
631'- 765- 5455
0
ELECTRICAL LEGEND
I GAI::II::IETT A- STRANG
architect
1230 Traveler Street Southold N.Y. 11971
631 - 7t55 k 5455
GENERAL NOTES: