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Home My WebLink About33910-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33886 Date: 08/05/09 THIS CERTIFIES that the building ACCESSORY GAR3~GE Location of Property: 15895 NEW SUFFOLK AVE (HOUSE NO.) County Tax Map No. 473889 Section 117 Subdivision NEW SUFFOLK (STREET) (~3~MLET) Block 6 Lot 23 Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 8, 2008 pursuant to which Building Permit No. 33910-Z dated MAY 15, 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to GAIL O TISKA & STEVE C FLURRY (OWNER) of the aforesaid building. S~FOLKCO~I~fDEPART~ENT OF }~ALTHAPPI~O~L~L N/A ELEC~RIC3%L c~KTIFICATH NO. 4006724 05/28/09 PLU~ERS C~TIFICATION DA'I'~O N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC~ This application must be filled in by typewriter or ink and submitted to the Building Departi A. For new building or new use: Final survey of proper~y with accurate location of all buildings, property lines, stree topographic features. Final Approval from Health Dept. of Water supply and sewerage-disposal (S-9 form Approval of electrical installation from Board of Fire Underwriters. LIL[l AuG -5 La)O s, an~unusual natural or BLDG. DEPT. TOWN OF SOUTHOLO Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requwements. '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 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 Occupaney- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: 01d or Pre-existing Building: Location of Property: ~ ~' ~ ~ ~ House No. Street Owner or Owners of Property: ~-1 L'~ k[ Suffolk County Tax Map No 1000, Section Subdivision Permit No. '~-O'~ ~ ] O '2., Date of Permit. Health Dept. Approval: Planning Board Approval: (checkone) Block ~ Filed Map. Applicant: Underwriters Approval: Hamlet Lot Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) 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 PLATINUM EAST ELECTRIC GALE TISKA 1320 KENNEY'S RD 15895 NEW SUFFOLK SOUTHOLD, NY 11971, NEW SUFFOLK, NY 11958 Located at 15895 NEW SUFFOLK NEW SUFFOLK, NY 11956 Application Number: 4006724 Certificate Number: 4006724 Section: Block: Lot: Building Permit:. ~,/ 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: Basement, First Floor, Detached Garage, Outside, 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 the28th Day of MaY, 2009. Name QTY Rate Ratin~ Circuits Tvoc Alarm and emergency equipment Sensor I 0 0 Carbon Monoxide Sensor 2 0 0 Smoke Appliances and Accessories Exhaust Fan 1 0 F.H.P Panels 1 50 6 Service Service Disconnect: 1 200 cb ServicelPhase3w Service Rating200Amperes Wiring And Devices Dimmer I 0 120 V Fixture 4 0 Fluorescent Fixture 28 0 Incandescent Outlet 32 0 Fixture Outlet 32 0 Gen, Purpose Peddle Fan 1 0 1 0 20a Appliande-a/~ Receptacle Continued on Next Page I of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. rJImlr~lr~wm~ r~l~lr~ Irm r.~lr~lr~lr~lmlrmr~lralrJ~ ~ ~ ~ ~mlrJIrJ irJirJir~ irJir~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~1 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by PLATINUM EAST ELECTRIC GALE TISKA 1320 KENNEY'S RD 15895 NEW SUFFOLK SOUTHOLD, NY 11971, NEW SUFFOLK, NY 11956 Located at 15895 NEW SUFFOLK NEW SUFFOLK, NY 11956 Application Number: 4006724 Certificate Number: 4006724 Section: Block: Lot: Building Permit: . 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: Basement, First Floor, Detached Garage, Outside, 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 28th Day of MaY, 2009. Name QTY Rate Rating Circuits Tvr~ Receptacle 2 0 GFCI Receptacle 21 0 Gen, Purpose Switch 16 0 Gen, Purpose seal 2 of 2 certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. This [] I~..I0 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. 33910 Z Date MAY 15, 2008 Permission is hereby granted to: GOTLOP 15895 NEW SUFFOLK AVE NEW SUFFOLK,NY for : ACCESSORY GARAGE IN THE REQUIRED REAR YARDAS APPLIED FOR at premises located at County Tax ~4ap No. 473889 Section 117 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 15895 NEW SUFFOLK AVE NEW SUFFOLK Block 0006 Lot No. 023 8, 2008 and approved by the 15, 2009. Fee $ 164.00 / Authorized Signature ORIGINAL Rev. 5/8/02 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 [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING / STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENE'll?ATION REMARKS: ~ ~ ~/~ DATE ~' ~ ~ INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION ~/STRAPPING [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~~~'-~ ~:~~ INSPECTOR '~, ~~'~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND ~FRAMING ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. ]INSULATION ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE '7'- TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~/~FOUNDATION 1ST [ [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY ] ROUGH PLBG. [ ]INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS:__~~__ ~ DATE ~':~ ~ INSPECTOR~ COIVI342ENTS ~TEI,D INSPECTION REPORT I DATE :T, ..................................... v FO~DATIO~ (2ND) ' ~S~ATION PER N. Y. STATE ENERGY CODE ~DITION~ ~O~S Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: District Section Block Lot THE FOLLOWING ACTIONS MAY REQUIRE THE 8UGMISSION OF STORM-WATER~ GRADINGf DRAINAGE AND EROSION CONTROL CERTIFIED BY A DESIGN PkO~aSIONAL IN THE 8TATE OF NEW yORK. Item N umber: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes No 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by site c~earing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces,) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surfaca WatonClowl Will this Project Require any Land Filling, Grading or Excavation where there Is a change to the Naturel Ex[sting Grade Involving more than 200 Cubic Yards of Matedal within any Pamel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through Ihe Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feel of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town dght..of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This Item will NOT include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Answer to Questions One through Nine is Answered with a Check Ma~k in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit( EXEMPTION: Yes No Does this project meet the minimum standards for classification as an Agricullural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required] -- -- STATE OF NEW YORK, COUNTY OF.~.,,. ........................ SS That I, ....~.~?......i....~..~...7..~...._~eing duly sworn, de'poses and says that he/she is the applicant for Pennit~ (Name of individual sigrdng D%umenl) And that he/she is thc ........................................ .~~ .................................................................................. (Owner, Contractor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner of Owner's, 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 Iris knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; /'*-'~ff,l~--.· .-'~.. ,~'/. 1'- PATRICIARICH£1~' Nota~ Pahn~: /....../~.~..~......~m~.~b~,.S~ of N~wY.r~/...~.............._...~...:....~.. ................... NO. 30-4741154 (Slgnalure FORM - 06/07 Commission Expires '/~/~¢//~'~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ql~f ,20 O~ Approved ~/~{~,20 0~ Disapproved a/c Expiration i ,20 PERMIT NO. l Building Inspector 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 Storm-Water Assessment Form Contact: Mail to :~ ~:~ ,~ ~.. ~t"~- Phone: ~-~3 - ,~,~ -~ APPLICATION FOR BUILDING PERMIT Date ~/~' INSTRUCTIONS ,20c , 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 heroin 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. (-Sigfiature of app~ant ~r'~a~e, if a corporation) (Mailing address o~ applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises . (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 propos__ed_ work will be done: House Number Street Hamlet County Tax Map No. 1000 Subdivision (Name) Section I ~ "] Block (~ Filed Map No. Lot q--'~ Lot a. Existing use and occupancy .1~22>14,1~14~,~ vo ~ b. Intended use and occupancy [~h~~ ~C6 ~ ,,/~42~d-IY.~"' 3. Nature of work (check which applicable): New Building ~ Addition Repair Removal Demolition Other Work State existing use and occupancy of premises and intended use and occupancy of proposed construction: 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Depth Dimensions of existing structures, if any: Front ~-O Rear Height I ~ Number of Stories ~ Dimensions of same structure with alterations or additions: Front c-~'O'l~' Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front ~'~ ' Rear ~) .Depth ~2-'~ ~" Height I '"1 ' Number of Stories 9. Size of lot: Front q 5 Rear °1% 10. Date of Purchase d0 ~ 4 I 'gC~ ~. Name of Former Owner 11. Zone or use district in which premises are situated Depth 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 G~q t~ '~4g--~ Address 1~8 ~ [l~0~a,c-J/~k Phone No. NameofArchitect .~ .4-~-~-It.~(t- Addressf~p~r~ ~-O/ ~p-TFmzy,.PhoneNo Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a 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 ~' * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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. 18. Are there any covenants and restrictions with respect to this property? * YES __ NO >4 · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF~ ~}~\~ ~, ~{~ being duly swom, deposes and says that (s)he is the applicant (Nar~e'o-f'individual sigriing contract) above named, (S)He is the r, '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 tree 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 _ - ~ day 9,f~ ~ . 20 t~ ~' Notary p~[l~lA RICH'ERT r~o~ary ~uo,c. State of New York No. 30-4741154 Qualified in Nassau / Suffolk.'Count~.2 Commission Expires Signal/e~App lcant TOWN OF $OUTHOLD ~I~oPERTY RECORD CARD OWNER LAND AGB NEW Tilloble 1 ¥illoble 2 Fillable 3 Woodland Swampland 3rushlond -tau,se Plot Fatal IMP. TOTAL 31o o NORN~L ACFe FARM DATE BUILDING CONDITIOF BELOW Value Per Acre ABOVE Value VILLAGE E DISTRICT SUB. ~1~- /_)e, rc, ACRE~E ,~?/ TYPE OF BUILDING COMM. I IND. CB. MISC. REMARKS ON WATER LOT &ll'/h e/o ~.~ aah DOCK Est. Mkt. Value BULKHEAD J ! I Extension Extension Extension 3reezeway Garage Foundation Patio Driveway Floors interior Finish Heat Roof Type Rooms 1st Floor Rooms 2nd Floor Dormer y STREET ADDRESS: 15895 NEW SUFFOLK AVE, CERTIFIED GAIL U, TISKA LA~/YER$ TITLE INSURANCE CURPURATIBN N/D/F · ~MONUMENT AREA.=16,097 S,F, SURVEY OF PROPERTY A T NE W SUFFOLK TO WN OF SOUTHOLD SUFFOLK COUNTY, NEW' YORK 1000-117-06-23 SCAT.E: 1"=30' MAY 2, 2002 oOL ¥ $, zOO0 tloundotion locations) ,JUL 49618 31) 765-1797 1230 TRAVELER STREET 0