HomeMy WebLinkAbout34370-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPA=RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33480 Rte: 01/10/09
THIS CERTIFIES that the building "AS BUILT" DECK ADDITION
Location of Property: 1135 GREEN HILL LA GREENPORT
(HOUSE NO.) (STREET) (HANLET)
Co~nty Tax Map No. 473889 Section 33 Block 2 I~Dt 28
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 2, 2009 pursuant to which
Building Permit No. 34370-Z dated JANUARY 2, 2009
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 DECK ADDITION TO AN EXISTING SINGLE F~4ILY DWELLING AS APPLIED
FOR.
/~ne certificate is issued to SUSAN DELEO - FP~ANCIS YAKABOSKI
(OWNER)
of the aforesaid building.
SUFFOLK COU~F~YDEPARTM~NTOF }~%LTHAPPRO¥]%L
ELRurKICAL CERTIFICATE NO.
PLU~ERS CERTIFICATION DA'£~U
N/A
N/A
N/A
Rev. 1/81
-- Form No. 6
' Il ~ BUILDING DEPARTMENT
I TOWN HALL
[ ~ R ERTIFICATEOFOCCUPANCY
~DG DEPT. ~PPLICATION FO C
This application must be filled in by typewriter or ink and submi~ed to the Building Depa~ment wi~h ~he following:
Ao
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.
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 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.
Co
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. December 30, 2008
New Construction:
Old or Pre-existing Building: X
(check one)
Location of Property: 1135 GreenhJ 11 Lane Greonpnrl-
}louse No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 33
Subdivision Map of eastern Shores, Section 5
Block 02
Filed Map. 5234
Lot 28
Lot: 129
Permit No. Date of Permit.
Health Dept. Approval: N/A
Planning Board Approval: N/A
Request for: Temporary Certificate
Applicant:
Underwriters Approval:
Final Certificate:
(check one)
Fee Submitted: $
[/- ~:6~t4~ignature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 34370 Z
Date JANUARY 2, 2009
Permission is hereby granted to:
F YAKABOSKI FOR S DELEO
1135 GREEN HILL LA
GREENPORT,NY 11944
for :
"AS BUILT" 7'X 35' DECK ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 033
pursuant to application dated JANUARY
Building Inspector to expire on JULY
1135 GREEN HILL LA
GREENPORT
Block 0002 Lot NO. 028
2, 2009 and approved by the
2, 2010.
Fee $ 400.00
/ ~v Auth~orized Signature
ORIGINAL
Rev. 5/8/02
'TOWNOF ~OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork. net
Examined
Approved //~ ,2C~
Disapproved a/c
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
Septic Form
N.Y S D E.C
Trustees
.... -~ Flood Pemqit
"% i-~ (~ F~ Il ~ lb ' ~ Stonn-WaterAssessmentFom
~ b~O~; DEPT ' ]
Building Inspectm
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date De_c_ember 30 ,20 08
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 beibre 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 Ibr 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 line zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, m writing, thc 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, Suftblk 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 bnilding Ibr necessary inspection
~'~turc.,~pplicant or name, ifa corporation)
456 Griffina Avenue, Riverhead, New York 11901
(Mailing addre$5 of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nan]e of owner of premises
(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.
Olher Tradds License No.
1. Location of land on which proposed work will be done:
1135 Greenhxll Lane
Greenport
House Number Street Hamlet
County Tax Map No. 1000 Section 33 Block 02
Subdivision Map of Eastern shores Filed Map No. bZ~4
Lot 28
Lot 129
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existlng use and occupancy single famSly dwelllng
single family dwelling
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of exlsting 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 Rear .Depth
Height Number of Stories
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
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO__
14. NamesofOwnerofr~rem~es see p.1
Name of Architect""'ar~-es Thomas
Name of Contractor
Address Phone No.
Address gu BOX 877 PhoneNo
Address Oamesport, NYPhoneNo.
15 a. ls this property within 100 feet eta tidal wetland or a freshwater wetland? *YES
* 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 X
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO X
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
· IF YES, PROVIDE A COPY.
NO X
STATE OF NEW YORK)
SS:
COUNTY OF Suffo)lk
Francis J. Yakaboski
being duly sworn, deposes ~md says that (s)he is the applicant
(Name of individual signing contract) above named,
of said o,aner or owners, and is duly authorized to perform or have perfommd 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 belier~, and that the work will be
performed in the manner set tbrth th the application filed therewith
S,aorn to before me this
30 da, of DocembeD 20 _08
see annexed survey
see annexed survey
Cheil A. Bliss
Notary Public, State of NewYork
EO. OLBL6056053
C ..:::f ir, ~uffolk County ~. ,.
Cc ' ~ Expires Mar. 12,~}~
TOWN OF SOUTHOLD BUILDING DEPT.
765- t 802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING / STRAPPING [~111~'~
[ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT~CONSTRUCTION [ ] FIRE RESI~TANTPENETRATION
REMARKS:~
DATE
INSPECTOR
FIELD INSPECTION REPORT: DATE COMMENTS
FOUNDATION (1ST)
..................................... FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FIN~
ADDITION~ COMMENTS
CONSENT TO INSPECTION
Frm~cis J. Yakaboski, As Executor
Owner(s) Name(s)
, the undersigned, do(es) hereby state:
That the undersigned (is) (are) the owner(s) &the premises in the Town of
Southold, located at 1135 Greenhill Lane, Greenport
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 33 , Block 02 Lot 28
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
CO for deck around pool
That the undersigned do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property, including any and all
buildings located thereon, to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all &the laws, ordinances, rules and regulations &the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct &such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated:
December 30, 2008
Frandis J. Iakaboski (Print Name)
(Signature)
(Print Name)
FRANCIS J. YAKABOSKI
MEMO
Hand Delivered
DATE: January 8, 2009
TO: Gary Fish, Building inspector, Town of Southold, Building Department
RE: Estate of Susan H. Delco, 1135 Greenhill Lane, Greenport, New York
Dear Mr. Fish:
Per our conversation of this morning, I am delivering herewith statement of Charles
Thomas, R.A., regarding the construction of the deck you recently inspected together
with my affidavit concerning the situation regarding the inground pool.
Time is of the essence in this matter and I would appreciate it greatly if you would issue a
certificate of occupancy for the deck at your early convenience.
Thank you.
Very truly y~ours,
FJY:cb ~
FRANCIS J. YAKABOSKI
ATTORNEYAND COUNSELOR AT LAW
~5G GRI~IFX2qG
P. O. BOX 389
MEMO
ttand Delivered
DATE: December 3 l, 2008
TO: Building Department, Town of Southold
To Be Attached to Building Permit and CO Applications
RE: Estate of Susan H. Deleo, 1135 Greenhill Lane, Greenport, New York
I am submitting herewith an application fbra building permit and CO for the deck /7
located at the rear of the premises situate at 1135 Greenhill Lane GreenporL~New Yotk.
i! aI--~'~am also subm-itting a~n application orTb-ffT~e?m~t an~D-F$~Fthe~de~klng that currently ~[x "~o,z,~-.. r'~
exists ~ound the swimming pool:ffl'he home and~he ~W[mm~n~g~oth have -~ '~,
certificates 0f 0ccup-~nc~ The~ertificate of occupancy lbr the home is #Z4844 dat?d~mT*
October 10, 1972. The certificate of occupancy for the pool and deck and fence is/~-.
#Z 14170 dated January 17, 1986. Copies of both certificates of occupancy are submitted
herewith. I am submitting a drawing with respect to the wood deck. I am not submitting
any drawing with respect to thc decking around the pool except for the new survey
shmving the decking. The decking around the pool is at grade level. Should you have
any further questions concerning these applications, please do not hesitate to contact the
undersigned.
Thank you.
Ve?'t~rruly~rs,
~s~"'jf/Yakaboski
FJY:cb '
Enclosures
CONSENT TO INSPECTION
Franris J. Yakaboski, As Executor
Owner(s) Name(s)
the undersigned, do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at 1].35 Greenhill Lane, dreenport
which is shmvn and designated on the Suffolk County Tax Map as District 1000,
Section 33 , Block 02 , Lot 28
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
CO for deck around pool
That the undersigned do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property, including any and all
buildings located thereon, to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances, rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated:
December 30, 2008
---~(.g~4at ure) '
Francis J. ~(akaboski
(Print Name)
(Signature)
(Print Name)
AFFIDAVIT
STATE OF NEW YORK
ss:
COUNTY OF SUFFOLK
Francis J. Yakaboski, being duly sworn, deposes and says:
I am the attorney for as well as the Executor of the Estate of Susan H. Deleo.
I make this affidavit regarding the premises situate at 1135 Greenhill Lane, Greenport,
New York, owned by the Estate and knowing that the Building Department of the Town of
Southold will rely on my statements.
I am aware that the pool at the premises is in disrepair. The Estate has entered into a
contract to sell the premises in "as is" condition. The purchaser has inspected personally as well
as with an engineer the premises and all structures on the premises including the inground
swimming pool. The purchaser is aware that repairs are necessary and in the interim however, I
am representing to the Town Building Department that the Estate will secure the fence including
locking the gate in order to continue to protect the grounds pending a sale.
As indicated, this affidavit is made knowing that the Building Department will rely
thereon and issue a certificate of occupancy for the deck at the rear of the home on the parcel.
Dated: January 8, 2009
Sworn to before me this
~-?hday of January, 2009.
Franci~l: Y~akabosjki
I~,HAI~LES 5'1. THOMAS, R..A.
1135 Green Hill Road
Greenport, NY
January 6, 2009
Dear Southold Town Bldg. Dept.,
This letter shall serve to certify that the existing above grade deck attached to the West
side (rear) of the above referenced residence had been constructed in accordance with the
NYS Building Code
Please/~ontact our/~ffi~ ~r comments.
Charles M. Thomas,~k~..~P~k ~ /,~I7/~,
08-29-2008 14:12 SOUTHOLD BUILDING DEPT 16317659502 PAGE3
FO RM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Seuthold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the build/n8 .... P. 9 g.l.,..,,19.c,k., &.../'.e.q 9 p.. ......................
lx~cation of Property .~.135..licee~,hi1~ .~l~O/l ................... qC~p~tlc~',t; ...........
/-Iom~ No. Sl*m~ N~m/et
County Tax Map No. 1000 Section ... 03~ ...... Block ..... ~ ......... Lot..~8. .............
Subdivision ..... ~p.~.~.o. ~p..S.h. ,o?.e.~. ......... Filed Map No~. 5.2.3. ~ .... Lot No ..... '~.2, .9 ......
conforms substantially to the Application for Bu/lding Permit heretofore t'fled in this office dated
.... .J.u.n. $. ?. .......... 19 ~.2. pursuant to which Building Permit No. I 1736 Z
dated .... .J.u.q ~. ,~.1 ................ 19,8,~., was issued, and ¢onform~ lo all of the requirements
of the applicable provisions of the law. The occupallcy for which this cerfiflcato is issued is .........
..... Y. ngro~nd. ~t/imm,!.~g. pP. ql ,. ;i.q~k. ~../'.ap.ce. .. .......................... . .....
The certiflcate is iS~ued to . Ap/~uq.t, L.a,z'mann and ~lEe
of the at'o~.~a/d build/hi.
~;uffolk County Dcpartmen; of Health Approval .... ~ ./.A. ..................................
UNDERWRITERS CERTIFICAT~ NO N572606
Buildin$ Impcctor
0~-~-~008 l~: ~l ~OUTHOLO BUILDIN~ C~RT ~317~5950~
PRC~2
TOWN OF $OUTHOI~
BUILDIN/; DEPARTMENT~
Town Clerk'~ Office
$outhold, N. Y.
Certificate Of Occup, m:y
THIS CERTIFIES that the building located at ...({~'~, I~L~.I], .Z~rm ...... Strcct
conforms sub~antiaHy W the Application f~ Building P~rm~t hcretoi~re fil~ in this office
dasd ............ ~ .... ~.~., 19~2., w~ i~ued, aqd ~ntn~s to all of the r~uire-
men~ oi the applicahle provisions of the law. The ~eqpa~cy for which this certifh~at~
The cer/ificatc is issued to
(eWer, ieee ~ ten.t)
of the ~orc~fid b~lding.
Suffolk County Dcpa~,tment of Hc~th ApproVal -., ~,,~.~.. { ~.. b~.. ~ZXa ....
Ih[lrdmg Irl~l)CC/Or
TOWN OF $OUTHOLD PROPERTY -~"/
STREet it35
N
S
FARM
LAND IMP. TOTAL DATE
V l LLAGE
W
CON'dv% CB. MICS.
REMARKS
RECORD CARD
DIST. SUB. LOT/c~ ~/
Mkt. Value
~CR.
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre
Tillable
Woodland
Meadowla~d
House Plot
Total
Value Per Value
Acre
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
COLOR
M. Bldg.
Extension
Extension
Porch
Porch
Garage
Patio/7¢
Total
~oo
Foundation
Bosement
Beth
Floors
Ext. Walls
-"ire Place
Interior Finish
Heat
Type Roof Rooms 1st Floor
'Recreation Room Rooms 2nd Floor
Dormer Driveway
iRR.iette I
FIN. B
LOT ~
bO~
hOT
t~5
?0' 9
\
SURVEY OF
LOT 129
MAP OF
EASTERN SHORES
SECTION FIVE
FILE No. 5234 FILED DECEMBER 31, 1968
SITUA TED A T
GREENPORT
TOWN OF' SOUTHOLD
SUF-F-OLK COUNTY, NEW YORK
S.C. TAX No. 1000-35-02-28
SCALE 1"=30'
SEPTEMBER 11, 2008
AREA = 20,602 sq. ff. 0.473 ac.
CERTIFIED TO:
SUSAN DeLEO 99% INTEREST
FRANCIS J. YAKABOSKI 1% INTEREST
PREPARED IN ACCORDANCE
STANDARDS FOR TffLE
FOR SUCH USE
N.Y.S. Lic. No. 50467
Nathan Taft Corwin III
Land Surveyor
UNAUTHORIZED ALTERA~ON OR ADDmON
TO THIS SURVEY IS A ~OLA'~ON OF
COPIES OF ~-IIS SUEV[Y t~ NOT BE.~RING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHN_L NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTWICA~ONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO ~HE
~TLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTiTU3iON US'TED HEREON. AND
TO THE ASSK~NEES OF THE LENDING INSTI-
I~TION. CER'RF~CATIONS ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
Title Surveys -- Subdivisions -- Site Plons -- Construction Layout
PHONE (651)727-2090 Fox (651)727-1727
OFFICES LOCATED AT MA~LING ADDRESS
322 Roonoke Avenue P.O. Box 1931
Riverheod, New York 11901 Riverheod, New York 11901-0965
EXISTING
HOUSE
EXTG, BAR
& SINK AREA
HAND
SINK
:0 ~2
I ~[JCOh ENTRY I
OCA D
I I
I I
22(12 BOX GDR.
IEXIIS~IN~ I
WOOD STEP TO GRADE
I 13°°1sF I
1(2) ~x s IACQ I
4 x 4 ACQ POST ON
8' SONO TUBE
MIN 36' BELOW GRADE
O PLAN
~,~' -- ,'-o'
EXISTING OUqOOOR
'BAR' ~ITH SINK
EXISTING
HOUSE
BEYOND
DESIGN CRITERIA
765-1
FOL[ ' '
1. F
3. I ~,,-,, , ';~T
BE :~ ,~ ~J-~T THE
~T/,,'----~WEST ELEVATION ~FC~'~LC~wOFRuL~°~s
WITHOUT CERTIFICATE
OF OCCUPANCY
SUBJECT TO DAMAGE PROM
GROUND WIND SEISMIC WINTER ICE FLOOD LIVE DEAD ROOF UPLIFT LOAD WALL SHEATHING USE/ HEIGHT FIRE
SNOW SPEED DESIGN FROST DESIGN SHIELD HAZARDS LOAD LOAO SUCTION LOAD OCCUPANCY AREA
LOAD (MPH) CATEGORY LINE TEMP~ UNDERLAYMENT CLASSIFICATION
WEATHERING DEP~ ]~RMINA]E DECAY REQUIRED
I,I
O
SHEET NO.
1