HomeMy WebLinkAbout34922-ZFORM NO. 4
TOWN OF SOD~fHOLD
BUILDING DEP~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33920
Date: 08/24/09
THIS c~KTIFIES that the building DECK
Location of Property: 739 OLD WOODS PATH
(HOUSE NO.)
County Tax ~p No. 473889 Section 87
Subdivision
SOUTHOLD
(STREET) {HAMLET)
Block 1 Lot 23.6
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 11, 2009 pursuant to which
Building Permit NO. 34922-Z dated AUGUST 12, 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 ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to ANITA M DILWORTH IRREV TR
( OWNER )
of the aforesaid building.
SUFFOLK COUNTYDEPARTMENT OF HEALTH APPROVAL
~CT~ICAL c~KTIFICATH NO.
PLDMSE~S c~KTIFICATION DA'r~D
N/A
N/A
N/A
~/' uth i~z ed~ign&ture7~ut
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 w
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.g forml.
3. Approval o f electrical installation from Board of Fire Underwriters.
4.
5.
Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
Commercial building, industrial building, multiple residances 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 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.
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, Additiong 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 o f Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction:
Location of Property:X/~ 'q'bq
House No.
Owner or Owners of Property:X 1~ N 1 -r
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building: ~ (check one)
Strut H~let
~ Block I Lot l ~, ~
Fil~ Map. ~t:
Date ofPe~it. ~ X~ o~ Applic~t: ~T ~ T V
Unde~fitem Approval: ~
Permit No.
Health Dept. Approval:
Planning Board Approval:
.Request for: Temporary Certificate
Fee Submitted: $ '~),,x.~ ,
Final Certificate:
~f. (check one)
Applicant Signature
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)
PERi, IT NO. 34922 Z Date AUGUST 12, 2009
Permission is hereby granted to:
ANITA M DILWORTH IRREV TR
739 OLD WOODS PATH
SOUTHOLD,NY 11971
for :
AS BUILT DECK ADDITON TO SFD PER APPROVED PLANS AS APPLIED FOR
at premises located at 739 OLD WOODS PATH
County Tax Map No. 473889 Section 087 Block
pursuant to application dated AUGUST 11, 2009
Building Inspector to exloire on FEBRUARY 12,
SOUTHOLD
0001 Lot NO. 023.006
and approved by the
2011.
Fee $ 400.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Robert Barratt PE CEng FIMechE Eur Eng
4295 Vanston Road
Cutchogue,
NY 11935, USA
Tel, 631 875 0275
Fax, 631 734 2730
robertbarratt~optonline, net
August 23, 2009,
Attention: Gary J. Fish, Building Inspector
Southold Town Hall
53095 Main Road
PO Box 1179
Southold, New York 11971
Delivered by hand
Subject: Building Permit 34922 Z, 739 Old Woods Path, Southold, NY 11971
Gentlemen,
Following a detailed inspection of the as-built deck at the subject residence, including an
excavation of a footing, I certify that the structure as built meets the requirements of the
NYS Residential Code dated 2007
Robert Barratt PE
AUG 2 4 2009
BLDG. DEPT.
TOWN OF SOUTHOLD
TOWN OF SOUTHOLD BUILDING DEPT.
765-t 802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [/~INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
INSPECTION REPORT DATE
~o~o~ OST)
~o~u~r~o~ (2~)
PL~G
~S~ON P~ ~. Y,
STA~ R~R~ CODE
, .
TOWN OF'SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Approved
Disapproved
12
BLDG, OEP[
TOWH O~ SOUTHOL0 --
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
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mailto: ~. ~lO~*q'T"F
Phone: ~3/-- ~-)b'~ -- O'2~/. ~'
C) LT'-
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date ~uq~Js-r "!+k ,20Oq
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 applicant or name, if a corporation)
(Mailing address of applicant)
applicant is owner, lessee, agent, architect~ general contractor, electrician, plumber or builder
State
whether
Name of owner of premises /3,~ t -r.~ . Al.
(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.
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section ~;7 Block I Lot ~-~,. (o
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy -~'t,'~t:ft_& /:',~?--r~tt-,-f
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 ;n~C-
(Description)
Fee 4-oc~ ~o
(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 ~'7 Rear
Height_ 2~o Number of Stories
Depth ~-~..
Dimensions of same structure with alterations or additions: Front
Depth 4-~' Height
8. Dimensions of entire new construction: Front ~ 17_. Rear
Height I, ~ Number of Stories !
9. Size of lot: Front '~.¢.ca Rear '~q.o _Depth
Rear ~'7
Number of Stories , '-'", :2_.~ ~!¢,!^
10. Date of Purchase /°/el ~ 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 __
14. Names of Owner of premises ~. ~o~ Address xo ~ ~ ~ Phone No.
Name of Architect ~. g~ Address ~ ~¢~r Phone No
Name of Contractor Address Phone No.
NO ~
gar-
15 a. ls this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~ NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS~VlAY BE REQUIRED.
v/ NO ~ '"--Z. 0/~A
b. Is this property within 300, feet of a tidal wetland? * YES
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES __
· IF YES, PROVIDE A COPY.
NO
STATE OF NEW YORK)
SS:
COUNTY OF )
,~,t'g~,-' g~l~,~.'r'~ being drily sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor~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.
Signature of Applicant
Mrs. Anita M. Dilworth
739 Old Wood Path
Southold,
NY 11971-1854
August 7th, 2009
Subject: SCTM# 1000-087-00-01-023-006, 739 Old Wood Path, Southold NY 11971
To whom it may concern,
My husband and I purchased the subject property and the deed was recorded on 4/27/99
in the Suffolk County records deed book/page 11960/980. My husband is now deceased.
Regarding any actions associated with granting building dept approval to legalize the pre-
existing deck constructed since the issue of the current Certificate of Occupancy, I hereby
appoint to act as my agent and engineer:
Mr Robert Barratt PE
4295 Vanston Road,
Cutchogue, NY 11935
Tel 631 875 0275
Fax 631 734 2730
Thank you in advance for your cooperation,
Anita M. Dilworth
Town of Southold
Erosion, Sedmmentation & Storm.Water Run-off ASSESSMENT FORM
PROFERTY LOCATION: $.C.T.I&~ THE F~L~HG. A~ON8 ~Y REQUI~ THE 8U~ISSION OF A
~ ~ O~ BY A D~ P~OF~SI0~ ~ ~E STA~ OFN~
It~t Number:.
1
2
3
4
5
6
7
9
(NOTE: A Gl~:;k Ma~ (~) for enctl C~e~ Is I~d for a ComplMe Appli~Uon)
Will ~ projeot Reteln ~1 Storm*Water Run-Off Generated lay a Two (2') Inch Rainfall on ~e?
(This Item will-include all run-off crente~ by site ~le.adng endfor const~cflon activt~ as well as all Site
Imp~emente and ~e permanent ~ea~en.of Imperious su~acas.)
Oens the Site P~en and/a[ Survey Show Ail Prol~ Drainage $~ Indicating ~ & Losation?
This Item shall include all propce~ Grade Changes and Slopes Co.rolling Surface Wate~Clowi
Wtil this pruJe~:t Require any Land Filling, Grading or Excavation where them is a change to the Natural
Existing Grade Involving more than 200 Cubk~ Yards of Matedal within any Parcel?
Will this Appiicetice Require Lend Dlstud:~ng Ac~lvittes Enoumpassing an Area in Excess of
Five Thousand (5,000] Square Feet of Ground ,Surface?
Is there a Natural Water Course Rm',rflng through theSlte?
Is this project wilhln the Trustees judediofion Or within One Hundred (100') feet of a Wetland or Beach?
Witl there be Site preparation on Existing Grade Slopes ~ich Exceed Fifteen (tS) feet of VeFdcal Rise to
0'
One Hundred (10) of Horizontal Distance?
~itl Driveways, Parking Areas or other Imperious Surfaces be Sloped t0 Direct Stetro-Water Run-Off
into and/or in the direction of a Town fight-of-way?
Will this Project Require the placement of Material; Removal of Vegetation and/or the Construction of
any Item Within the Town FUght-of-Way or Road Shoulder Area? .
O'his item will HOT Include the installation of Driveway'Aprons.)
Will this Project Require Site Preparatiori within the One Hundred (100) Year EIoodptain of any Watercourse?
NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 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 Peretitl
-- -- Yes No
EXEM pTION~'
Does, this project meet the minimum standards fo~ ctusslfisat!on as an Agrio~Jftural Project?
Note: If You Answered Yesto this Question, a Storm-Water, Gra~ng, Drainage & Erosion Control Plan Is NOT Requimdl --
STATE OF NEW YOEK.
COUNTY OF ..-...~...¥..E.~.~..~.--.~-- ............. SS
FEat I, .....~.'~,.~T........~..~,~l~.~['.T. .................... . being duly sworn, deposes and sa)~ that he/she is the applicant for Permit,
And that he/she is the ........... ~ .................................................... ::~'"' ..............................................................................................
Owner and/or representative of the Owner of Owner's, and is duly authorized m perform or have performed the said work and to
make and file this appfication; that all statemen~ coritained in this application are true m the best of his knowledge and beliefi and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me tl~s;
~'7 ...Fl -day of : ~-~ ....... P~O..??.
.... . ........ .............
l'~otary ruouc: ......................................................................... NO. 01T06190696 (Signature of Applicant)
FORM - 06107
/
MAP OF NUNiVAKOMA WA TER$
AT SOU THOLD
FM/Y 6088 FILED JUL Y 9. ~968
~04'
239. 46
N/F
(VACANT.)
/ ~v/F JOHtVSON
Notes
Date of construction: 2000 approx
Foundation: Sin dia 4ft Sona-tubes and cement , ~"'~' '-~u~' ~,,>o'r ~<~E.~ ~,~'~
Columns: 4in x 4~ Doug Fir grade 2 or equivalent ~ ~" ~" ~o~ ~, CERTIFICATION OF
m/ NAILING & CONNECTIONS
Girders: 2in x 8in Douglas Fir grade 2 or ~uivalent . ~ . . ~ ~
Jolts: 2in x 8in Douglas Fir grade 2 or equivalent ~ I REQUIRED.
Floor ~ards 2in x 6in STK C~ar or equivalent
Jolt to girder joint: Teco's used throughout
Column to Girder joint: ~ in bol~ '_ ~ . .
Flor fasteners: SS ] ~ ~ ]~
~ien Conditions , ~ '
Live ~ad 40psf ~ ~ ~
Dead load lOpsf ~ ~ ~ ~ ~ ~
Snow icad 20psi ~ ~ / ~
En ' ~rin d~i n
In accordance with ~S Resident~l code 2007 and accepted engin~ring practice ~ ~ ~ ~
Flor Area
House incl gauge 4150 sq ft ~~
Pr~xisting d~k 325 ~ ft ~ ~ ' ,.j
To~l 4475 sq ft ~
To~l
~.00
PpROY? 4S N TED
~ ~ NOTIFY BUILD,
~'~ : 7~5~1802 8AM T FM FOR THE
J i FO~ _OWING INSPECTIONS: .
~ ' ' 2. ~GH - FRAMING & PLUMBING
., ~ '~: ; ~ 3. 4SULATION
~j HO~ ~"~' ' C~ ~lo~l ~ :4 4. ;EINAL'coMPLETECON3TRUCT~ONFoR C.O. MUST
_ ~ /~ AL CONSTRUCTION SHALL MEET THE
. , RE )UiREMENTS OF THE CODES OF NEW
[ I ', ~: YC ~K STATE. NOT RESPONSIBLE FOR
FI ..... A_ CONS7RL: ,~iL , ~I;ALL DE ~IGN OR CONSTRUCTION ERRORS.
~ ~ ~q t ~ ~ ~ ~ ......... - '~ , ,
~*' ~ ~ c ~6 q'~,~,':.: ,~ .... -' PURSUANT T0 6HAPTER 236
~ ~%'= ~,; ~ Pb~M ~ ~ OF IHE TOWN CODE.
ROB 739 OLDWOOD PATH, SOUTHOLD, NY 11911 DWGNO
ANITA M. DILWORTH, Owner
0 Barra As-built deck permit application
~e~ [n~n~r The~e p[~ ~re ~n in~trome~t of the se~ice ~d ~re the pro~ of the de~is~ profe~ion~l ~bo~e ~e~l i~ ~zed ~N
4~ ~ao~ton ~d hereto. Infria~emen~ will ~ pro~ecu~d to the full~ ~te~t of the I~w. Cootr~ctor ~h~ll ~eri~ ~11 field
C~cho[o~ eo~flitio~ ~nd dlmen~io~ ~nd ~ ~olely r~poa~ible f~r field fit. The de~i~n professional ~ume~ no li~bili~ for ~][~KED
]Y 119~ - omi~io~ du~ to un~ow~ or unforeseen field condifio~ ~nd or ~dditio~ b~ed upo~ comme~t~ not [orm~lly
Phone 631 875 0275 ac~owl~g~ as revisions to th~ plans. SCALE
F~ 631 734 2730