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HomeMy WebLinkAbout34117-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPkRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33976 ILate: 09/24/09 THIS U~KTIFIES that the building HORSE BARN Location of Property: 1995 ALDRICH LA (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 125 Block 2 Subdivision Filed Map No. Lot No. __ LAUREL ( HAMLET ) Lot 1.17 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 20, 2008 pursuant to which Building Permit NO. 34117-Z dated AUGUST 20, 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 HORSE (POLE) BARN AS APPLIED FOR. The certificate is issued to P~AYMOND & CYNTHIA B SCALZO (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPART~TOFHEALTHAPPROVAL ELE~-rKICAL C~RTIFICATE NO. PLUMBERS C~KTIFICATION DA'£~U N/A N/A N/A Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA This application must be filled in by typewriter or ink and submitted to the Building De SEP 2 3 2009 roy BLOG DEPI TOWN Of S0[IIHOL~} ,artment 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 iustallation fi'om Board of Fire Unde~vriters. 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 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 I. 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: Location of Property: / ~'~ Old or Pre-existing Building: (check one) House No. Street Suffolk County Tax Map No 1000, Section ~ ~'~'~ ~ Block Subdivision Filed Map. Permit No._ "~ [ ~ ~1 __ Date of Permi.. Applicant: Health Dept. Approval: Underwriters Approval: Hamlet Lot Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ . cOC'~ Final Certificate: (check one) ~pplic~nt ~*~at'e FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIDING PEI~4IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34117 Z Date AUGUST 20, 2008 Permission is hereby granted to: for : CONSTRUCTION OF A 36'X56' ROSEMARIE FILASKY (SCALZO) 1995 ALDRICH LANE LAUREL,NY 11948 HORSE (POLE) BARN AS APPLIED FOR. at premises located at 1995 ALDRICH LA LAUREL County Tax Map No. 473889 Section 125 Block 0002 pursuant to application dated AUGUST 20, 2008 and approved by the Bllilding Inspector to exq)ire on FEBRUARY 20, 2010. Fee S 893.60 ~i/~~ Lot No. 001.017 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RES~TANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~ _ DATE / '-I~' "- O 7 INSPECTOR '~'~'/~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING ~FINAL ~-~ / [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ REMARKS: ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 ] FOUNDATION 1ST INSPECTION [ ] ROUGH PLBG. ] FOUNDATION 2ND ] FIREPLACE & CHIMNEY [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: //~/~ ~ ~ '~f~-~ ~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~/FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE FOL~DATION (2ND) ROUGH F~G & PE~G STATE ENERGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL , SOUTHOLD, NY 11971 TEL: (631) '/65-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined '~//~'~ ,20 Off Approved ~ / 3~"., 20 U~ Disapproved a/c Expiration 7-/g- c', 20! O 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: Mail to: Phone: '-~-~---~L~ [~ ~ r~--"-7~ Building Inspector Date ,20 ~0~. OE~. ~ [ INSTRUCTIONS a. ~is application MUST be completely filled in by t~ewriter or in ink and submitted to the BuildMg ~spector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ showing location of lot and of buildings on premises, relationsMp to adjoining premises or public streets or ~eas, and wate~ays. c. ~e work covered by this application may not be commenced before issu~ce of Building Pe~it. d. Upon approval of this application, the Building Msp~ctor will issue a Building Pe~it to the applicam. Such a pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or M p~ for any pu~ose what so ever umil the Building inspector issues a Ce~ificate of Occupancy. f. Ew~ buil&ng pe~it shall expire if the work authorized has not commenced within I2 months after the date of issuance or has not been completed within 18 months fi'om such date. If no zoning amendments or other regulations affecting the prope~y have been enacted in the imefim, the Building h~spector may authorize, M writing, the extension of ~e pe~it for an addition six months. Thereafter, a new pe~it shall be required. ~PLICATION IS HEREBY M~E to the Building Depa~ment for the issuance of a Building Pe~it pursuam to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin~ces or Re~lations, 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, oMinances, building code, housing code, and re~lations, and to admit auth~zed ;~neet~rs on aremises and in building for necessa~ inspections. I~t t,O.J~~ '~ (Signamreofapplicantorname, ifaco~oration)~ ~ *. .... ~_~'~THOL~ 5 (Mailing address ofapp ican~) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electfici~, plumber or builder --.3 -(-As on (he~ax_)roll (~r 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~lan, d on .which proposed work House Number Street will be d°ne~,xxC~__[ Hamlet Block D Filed Map No. I County Tax Map No. 1000 Section ! cY,.~ Lot Subdivision Lot State existing use and occupancy of premises and~inten,ded use and occupancy ofpropose, d construction: a. Existing use and occupancy ~\~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building -,/ Addition Repair Removal Demolition Other Work 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 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 Depth Height Number of Stories Dimensions, of same structure with alterations or additions: Front Depth .5~ ~ ~ Height ~.;~,~ ! Number of Storie-q-- Rear .~ ',~' ' ~ Depth . Dimensions of entire new construction: Front ~ Height Number of Stories ]~..~,'"~00 Rear .,C'? ~, 9. Sizeoflot: Front 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated Depth FIE_. 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES __ 14. Names of Owner of premises Name of Architect ~.Oo~ ~ Name of Contractor NO Will excess fill be removed from premises? YES 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. ,~ 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 o~ survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE 0. 8UNC8 no. 01BU6185050 (S)He is the n,,,~,~ ~. o ........... (Contractor, Agent, Corporate Officer, etc.) Comr~[~:~i~'~'~l~,'~0 I~-, 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, c:~O~-~ dayof..~.A (.-1~'4- 20 O017 Notary Public -- / -' Sig~reofApplicant ~ O~O: I ~ £- F.- I. I ~rTOWN OF SOUTHOL OPERTY R C CARD OWNER STREET 1~'~5 VILLAGE DIST. SUB. LOT J..~ Fa~R ~NER . ~ N E AC~. J ~ S W ~PE OF BUILDING LAND IMP. TOTAL DATE REMARKS ' Tillob~ J , ~5 ~ ~ ~ ~,) ~ r7 : FRONTAGE ON WATER W~lond FRONTAGE ON ROAD ~~ /~0o '/~OO DEPTH M. Bldg. .~ ~ X /~- = / ~ 5 0 3'] ~"© 5 ~? 5 Foundation p[~. Bath Extension ~ ~ ~ ~S S.~o 7~? Ba.ment Fo)~ Floors Extension Ext. Walls ~eobe ~Sk~P Interior. Finish Extension Fire Place ~65 Heat ~"~ ~ ~ ~ g: ~ ~ ~_ . ~o /~ G Pool Attic Oe~ /¢~}G : SS~ ,~. ~ Patio Rooms l~ Floor Breezeway Driveway Rooms 2nd Floor Aug. 26. 2008 IO:13AM AVIS [NSURA~NC~' No, 5268 P, 1/2 ACORD. CERTIFICATE OF LIABILITY INSURANCE ~,RODU¢~ (717) 625-3770 ~: (7Z7) 625-3777 TH~ C~F~ ~ ~UED A8 · ~ ~ IN~T~N ONLY AND ~NF~ ~ ~H~ U~ A~m Z~u~ HO~ TH~ ~F~ ~ ~T ~ ~D OR 3399 J~= Drive AL~ THE ~ A~D~ ~ ~E ~L~lff8 ~L~, ,,~tz PA 17543 ~NSURE~ A~I~ C~ gAiC~ THE POL~IEE OF INSURANCE U~'~D MLOW ;,~VE BEEN iSSUED TO ~E INSURED ~ED A~VE FOR THE POL~ ~OD INDICTED. NO~ANDING ~Y ~IR~E~, ~ OR ~NDITJON ~ A~ CO~T OR O~ER ~E~ ~ REEPE~ ~ ~ICH ~1S C~F~ ~Y BE ISLED OR ~Y ~E INSU~CE ~FO~ED EY ~E ~iC~ES D~BED HE~IN IS SU~E~ ~ ~L ~E ~S, ~CL~ON8 AND ~NDITI~S OF SUCH P~CIES. C~ GENE ~U~ T REN~ 100~ OOC A I~m~e~ ~ ~9~49~1 10/16/2007 10/16/2008 u~~) I 5~00C ~~ ~ 2,000, OOC A -- ~O~eD~G ~91493~ 10/16/2007 10/16/2008 1 ~D~YINJU~ om~;~Em ~200[] [t2e/200e 5/2~/2009 ~[-~LO~e I 100(000 CERTmlCATEHOLDER (631)765-9502 ~OBox 1179 $ou*bhold, 1~ 11971 ACORD 25 (200t/05) 0B-~'6-~008 lB: 16 Aug, 26, 2008 IO:I3AM AVIS INSURANCE No. 5268 P. 2/2 IMPORTANT If the cerlificate holder i~ an ADDITIONAL INSURED, the policy(lee) must be endorsed. A statement on this certificate does not oonfer rights to the ~e~tiftcate holder In lieu of t~uch endorsement(s), If SUBROGATION I$ WAIVED, subject to the terms and conc~tions of ~e poli~'y, c~main policies may require an endorsement. A statement on thi~ certificate does not cenfer rights to the certif, catt hokler in lieu of ~udn endomement(s), DISCLAIMER The Certificate of insurance on the m eide of thi~ form doe~ not ~nstitute a contmol be~:.~'ccn ~e I~sulng insurer(a), authorized representative or producer, and the certificate hotder, nor doe~ it aF~,~-~Jvely or rmgattvely amend, ex~end or alter the coverage afforded by the policies listed thereon. ACORD 2S 0~-26-B008 10:16 SOUTHOLD BUILDING DEPT 1631765~50B PAGE2 Tow___ n o__f S. uthol d Erosion, Sedimentat,on & Storm Water Run-off ASSESSMENT FORM TIlE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A PROPERTY LOCATION: S.C.T.M. #: ~)'~) [~.~ ~ l-~'--~ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL pLAI~ ~ Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF N~ YORK. Item Number: (NOTE: A Check Mark (,~) for each Question is Required for a Complete Apptication) Yes No Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfafi on Site? ._~ (This item will include all run-off created by site clearing 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? ~/ r~ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural r~ x Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? ~ -- Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of F ve Thousand (5,000) Square Feet of Ground Surface? ~ -- ~s there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') fee of a Wetland or Beach? ~ -- Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vedical Rise to r"~ one Hundred (100') of Horizontal Distance? Will Driveways, Parkin9 Areas or other Impervious Sur[aces be Sloped to Direct Storm-Water Run-Off F'~ into and/or in the direction of a Town right-of-way? L..~J -- Wilt this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any em W th n he 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 Floodp a n of any Watercourse? r~ 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 Pemlitl EXEMPTION: Yes Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl -- No STATE OF NEV/YORK, COUNq[Y ~ (Name of individual signing Documenfi C0NNF ~' - ' nmdve of tim Owner of Owne , to m~e m~d file this application; ~at MI smtemenLs contained in tiffs application are mm to the best of his ~owledge m~d belief; ~d that tim work will be performed in fl~e rammer set lbrfl~ in ~e application filed herewith, Sworn to before me d~is; ................................... day ................................ Notary Public: ...... ~ ......... i ...................... ~1%"~'L ....... FORM - 06/07 I06 25 I05 24 I04 ;UR~EY FOR SUFFOLKCOL~N~¥ [~EPARTMENTOF HEA~THSERVIOF-S LEONARD g. FILASKY ~ ROSE MARIE FILASKY "' ~. YOUNG ~-uu,~o JAN 0 8 2009 BY: N N Lot 4 '""?~. ~:~I~V~i~{:::~ ~ C,L=t~TIJ=I~ATION ~0~ ~ZO LOT 4 "HAP OF ~ Laurel, To~n o~ ~u~hold ~F¢olk GountB, Ne~ York I FINAL ,~i~V~¢ ] G~unt~ T~lx H~Ip Dillri~t IOOO S~ti~ I2D Bl~k 02 Lot I.I'T ~ANITAt~.¥ WlEA~U~Ef'4ENT~ 5T ID' ~O' LP ~4' ~"/' 4~ ~ ELEV'ATIGH ~JLLET L ~JNLAWFUL ,L~T CERTIFICATE ~UPANCY ALL CONSTRUCTION SHALL MEET THE FIi=QUIREMENT$ OF THE GODE$ OP NEW YORK STATE. ARPROVED, AS NOTED DATE: _?__~./.o.E LOFT PLAN FC, R POURED CONCRETL 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONS1RU"TiON MUST BE COMPLE1E FOR C.O. ALL CONSTRUCTION SHAf L MFET THE REQUIREMENTS OF THE Cn3E5 OF NEW YORK STATE. NOT RESP~ r,,blBLE FOR Df:SIGN OR CONSTRUCTION ERRORS. RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. II II ~.LEYATION (~ F ON,T, ELEVATION ~ELEvATION F~F_..Z ~";'-~__.~_._4,_~._~E L E YAT I ON RI.E: INFO. t40 < ; AUG I 8 2008 PROJECT NO. O8,13'~ MANAGED BY E:). KIJLINA DRAWN BY R. ENED¥ REVISIONS DATE AUGUGT 14, 2¢¢~, DRAWING lilLE FLOOR PLAN EXTER. ELEYATIC~,t,~ 5ECTION~ SHEET NO. A. 1 FILE INFO. P.T. eve poeT& IsE¥<::a,~ (UP TO R, aF'rE~) ~ .SC;ALE: I/2''= I'-~" -- I I 12 (2) 2xl2 fl ~,~r'~ HEADEI~, u~'. (*24) 12~ C~ALV'. N~IL8 J I/4 2xe, T~ pArtiTION 12 MAX. E~,UILDIkk,~ HEIGHT ~, __ FIN. FLR. ~;~ _ I P2" DIA. kI.~RAI ~ I~F~RE~ · 24" ~ 5T~I~ pET,A, IL ~ E,C;ALE: NTE~ TYP 'T' E~f~AC, E DTL. ~ ~'CALE-' I/4"' $"¢" LG~-r FL~ ~ Fii,L FL~ · ~. AIeLE { eT~',tE DL~T 12 4 ~ FIH. FLR. (~,~L,E LUALL SECTION ~ WALl 5EC.,TION EX:ALE: I/2% 1-O" ~ E~C:ALE: I/2"= 1'-O" © < <.I> PROJECT NO. MANAGED BY D. t<ULINA DRAWN BY R.. ENED¥ REVISIONS DATE AUC~UST 14, DRAWING TITLE .~ECTION DETAILS SHEET NO. A.2 CODE I1~'0. GN 5TRUC~RE: 5YI~lt~OL LEGEND I U4 II II (~ LEFT ~IDE ELEV'~,TION GCALE= I/~"= I-O" ~ SCALE: I/~"= 1'0';' II : II ,11, (~ ~IC=NT 51DE, SCALE: I/~'"= 1'-0" ELEV,~TION ~CALE: I/~'"' I-0" ELE'v',,~TION FILE INFO. o SEP 2 3 Z009 PROJECT NO. O,e,13~ MANAGED BY D. KJJL INA DRAWN BY ~ ENED¥ REVISIONS DATE FLOOR PL4,N EXTEI~ ELEVATIONS .~EOTICrN~ SHEET NO. =. C~ ~p. ,~CALE= I/2"= I-~" TYF::> '¥,',, E~f~,,~,C.E DTL. 4 ~ E~::;ALE.- 1/4"= 1'-O" 2x1~) R~DC,~ POLE u~/. (24) 12ci GAL'v,. NAIL6 12 MAX. ~UILDI~ HEIGHT 12 I/4 ~TALL C. GNC. FTC, "/AI~JEe PL.N~ FOf~ ~.IZEE~ ~CTION Q WALl,, SECTION ~ALE= lh · 1'-O" FILE INF0. DIMENSIONS ON S~ PRIOR PR~E~ NO. D~N ~ DATE: ~UST 2~ DRAWING lilLE SEC;TI(~',I DETAILS SHEET NO. A.2