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HomeMy WebLinkAbout35417-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPD~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34270 Date: 04/12/10 THIS c~KTIFIES that the building ADDITIONS Location of Property: 235 AZALEA RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 115 Block 6 Subdivision Filed Map NO. Lot No. MATTITUCK ~t 12 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15, 2010 pursuant to which Building Permit No. 35417-Z dated MARCH 29, 2010 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" PORCH ENCLOSURE WITH HOT TUB AS APPLIED FOR. The certificate is issued to RICHARD K LUTZ of the aforesaid building. ( OWNER ) SuFfOLK COUNTY DEPARTMENTOFHEALTHAPPROVAL N/A ELECTRICAL C~u(TIFICATH NO. 133119H 03/10/10 PLIERS c~KTIFICATION DA'r~u3 N/A gnature Rev. 1/81 · , FormNo. 6 11111 II; Ig · Town oF soumOLD IIZ/ I BUILDING DEPARTMENT III }11 111 I APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by t~ewfiter or i~ ~d submitted to the Building D~men~ A.. For new building or new use: ~ Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or 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. 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 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 New Construction: Location of Property: Date. House No. Old or Pre-existing Building: Street (check one) Hamlet Owner or Owners of Property: ~r~ Suffolk County Tax Map No 1000, Section Subdivision Block Filed Map. Lot Lot: Permit NO. 'g ~ q I 7 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Subn~itted: $ Date ofPermit.'~q/1'11~t~ '~O/O~pplicant: Underwriters Approval: Final Certificate: (check one) Applicant Signature lesue Date 3/10/2010 Electrical Inspection Certificate Electrical Inspection Sewlce, Inc. Application Number 375 Dunton Avenue 133119H Esot Patehogue, NewYerk 11772 Issued To: Richard K. Lutz Street: 235 Azalea Road Village: Mattituck Section: Block: Contractor: Zip: 11952 Town: Southold Lot: LIc. # Wa~ examined and foend to be in compliance wilh Ihe National Eiect[icel Code. Commemial NV Dofecte Pool _X lst Floor X Indoor X RestdofltJel DeL Garage . Attic 2nd Floor X Outdoor Switches - Receptacles Fixtura~ GFI Heaters 4 4 8 3 Dishwasher Washer~Amps Dryer/Amps Oven Range/Amps Furnace Dil Gas Clmulatora Smoke Detector Mater Amps Phase UG/OH Jacuzzi Television Ibaomeflt ~ Hot Tub Addition Survey A/C Fans Microwaves Ball Transformer CO Detector Bldg. Permit: Other Equipment Small Enclosed Porch & Detached Shed 1-50 amp Hot Tub Disconnect Hugo S. Surdi President <'~nslMclm: / John ~ ~ Ill This certificate musl tint I~ altered in any mariner. Ifllpectom may be identified by their cmdentiaia. 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. 35417 Z Date MARCH 29, 2010 Permission is hereby granted to: ADRIENNE A LUTZ PO BOX 42 MATTITUCK,NY 11952 for : "AS BUILT" PORCH ENCLOSURE WITH SPA & ~CK ADDITION AS APPLIED at premises located at 235 AZALEA RD County Tax Map No. 473889 Section 115 Block MATTITUCK 0006 Lot No. 012 pursuant to application dated MARCH 15, 2010 and approved by the Building Inspector to expire on SEPTEMBER 29, 2011. Fee $ 900.00 zed ? ORIGINAL Rev. 5/8/02 123 FIEADLINE ROAD DEER PARIC NEW YORK 11729 631-254.O930 AI:~'I 8, 2010 Town Of Smllt~lld Re: Lutz Residence 235 Azalea Road Mattltuck, NY Permit #35417 Please be advised that the work performed and shown as per the above referenced peemlt and the approved construction documents ls completed, Specifically, the existing Insulation and framing were In verified in place and the new footings Installed. Louis J. ,Santoea, R.A. APR ~ 20]0 BLDG DEPT. TOWN OF SOUTHOLD TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSU~.AT-ION [/.~NAL [ ] FIRE SAFETY INSPECTION FIRE RE~f~T CONS~. ~ [ ] FIRE RESISTANT PENETRATION // V DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined 20__ Approved ,20 Disapproved a/c Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ~*l 4 sets of Building Plans Planning Board approval ~,~ Survey. Check I'~OLh , 0 © Septic Form NY.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: ¢.O.l'z.,olf q'Zt ~t~IT'iTI,I~_C Ilq~L sets o b. Plot plan showmg location oI areas, and waterways. Building Inspector PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS /1/t t eq [5' ,20 ~pletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 ?ee according to schedule. ot and of buildings on premises, relationship to adjoining premises or public streets or 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, 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 building for necessary inspections. (Signature of'applicant or name, if a corporation) ' (IV~ailing address ofapp icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder O~Oto~ I~ Nameofownerofpremises ~.lOa/'4~lglD I~ LLt, fAs 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. ?lumbers LicenseNo. Electricians License No. Other Trade's License No. 1. Location of land on w~hich proposed work will be done: House Number Street Hamlet 'County Tax Map No. 1000 Section Subdivision Block 6 Lot Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .,~ I P,,Ft~,o (~,~- ,~-'-1~-~,, l, I..-"'( I~) ~l,j }~U~.,/AJ ~:~ b. Intended use and occupancy ~/A/"b [./~ '~ ~ [ ('V Owe.. L.~ 3. 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 .P~_~ _t:~'t) (Description) Fee (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 exis[ing s[ructures, if any: Front 70~.-'''/ Rear '"]L~- '7 Depth Height [~-O' ,r Number of Stories ~ Dimensions of same structure with alterations or additions: Front Depth ~_~ o- Height 8. Dimensions of entire new construction: Front '7 O--'~ Height llZ.~-o~ £ Number of Stories 9. Size oflot: Front I~:1~O' Rear [~o ~, b~- 70-'7 Number of Stories ~ Rear ~,,r)--"'/ Depth Depth '7~ ~"- ~ OI Rear 7~,-'-7 10. Date of Purchase Name of Former Owner l 1. 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. Names of Owner oflpremise.~s,. Name of Architect [,IM~ Name of Contractor Address Phone No. Address~Phone No & ~ Address Phone No. 0 93'0 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * 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 on survey. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO .J~ STATE OF NEW YORK) COUNTY 0F5'4~ 10 fl-r* 14. Lcd'ca. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He 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 J ~;- '-~. day of ~ (~ 20 ] ~) Notary Public Signature of Applicant Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: District ~on Blo¢d( lot THE FOLLOWING ACTIONS MAY RGQUIRE THE 8UBMI8810N OF A 8TORM-WATE GRADIN DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGH PROFE881OHAL IN THE STATE OF NEW O Item Number. (NOTE: A Check Ma~k (~) for each QuesUo~ is Required for a Coml~ete Appticatlon) Yes No Will lhls Prajant Retain All Storm-Water Run-Off Generated by a Two (2') Inch Rainfall on Site? (This item will include all ran-off created by site clearing and/or construction activities as well as all Site Improveraenis and the permanent creaUon of knpe~ious sun'aces.) Dces the Site elan and/or suwey Show AIl Pro~ DmJnage $lractures incli~ting Size & Location? __X r'~ 1his Item shall Include 811 Proposed Grade Changes end Slopes Controlling $urraes Waten~3wi _ Will this Project Require any Land Filling, Grading or Excavation where them is a change to the Natural Existing Grade Involving mom than 200 Cubl~ Yards of Matedal within arty Parcel? Fwe Thousand (5,000) ~ara Feet of Gmond Surface? Is this Pwjec( within the Trustees jufisdictlon or within One Hundred (100') feet of a Wetland or Beach? -- 8 . Will this Project Require the F~acemont of Ma~eriat, Removal of Vngataeon and/or the CO~.lStmction of any Item Within the Town Right-of-Way or Road Shoulder Area? {This Itera ~dll NOT Include the Installation of Driveway Aprons.) Will this Project Require Site eraparafio~ within the One Hundred (100) Year Floodplain of any Watercoume? r~ __~ NOTE: If Any Answer to Questions One through Nine I$ Answered with a Check Mark In the Box, · Storm-Wator, Grading, Dratcege~ & Ereslon Control Plan I$ Required and Must be 8ubralttod for Review Prior to Issuance of Any Buitdlng Pemtltl 9 EXEMPTION: Yes No Does this pmJeof meet the minimum standards for dasslfic~tion es an A~tctdtural Project? Note: ff You Answered yes to this Question, a StormANater, Grading, Drainage & Erosion Control Plan Is NOT Requlredl X STATE OF NEW YORK, ( p ~- I~- COUNT~ o~ .............. ~..... ss ThatI, ..~...104LII~-P ..~.' ~ ' ~. d~ ~m ' ' ' ....................................................................... ~ y , de~ ~d ~ ~ h~she ~ ~e ~p~t for Pe~h ~m ~ M~dua s~ ~ CONNIE D. BUNCH ~ ~ N0~ Public.S~te ~ N~ Yom ~d ~at hdsh¢ is ~e ....... .0.~ ........................................ ; .......................................................... ~.-O~BU6~ .............. (~r, ~, ~ ~ ~, ~ . Qualifieri in Suffolk ~unb . uomm~ssi0n Expjr~ April]& ~ ~or mp:~mUv¢ of ~e ~¢r of ~s, ~d ~s d~y au~o~d m ~ffo~ or have ~ffo~med ~ ~e work ~ ~ ~o~ ~ ~e m~ner set fo~ ~ ~e apportion filed .................... ........ (~ o~) FORM - 06107 Z ~o-I 9 ~ ~: TOWN OWNE.~'~ ' ' js,~ ~' "F0~ER~NER , __ ~D IMP. TOT~ DATE OF SOUTHOLD PROPERTY RECORD CARD --,~-r~ VILLAGE JE W COMM. CB. MICS. Mkt; Value RE~RKS ~ AGE NEW FARM ! Acre BUILDING CONDITION BELOW ABOVE Volue Per Value Acre FRONTAGE ON WATER J ~ONT^GE O..o^D l/~,~. ~ "~r-, DEPTH BULKHEAD DOCK Flo~rs Interior Fihish SH£ET?.~ c/Cj LR, Hea~ 0 ~ ~ Rooms 1~ Floor . BE, Roo~ 2nd Floor FIN. Dr~vew=y J B.P. ¥ BUILDING PERMIT EXAMINER CHECKI.IST *Date Submitted: .fl~,.S~'/O Date Reviewed: .3 · SCTMg 1000- [[~- ~ I~ Subdivision: '- Zone: ~- ~O Conforming? Property address: ~)~ ~ ~ Ci~: ~~ Pre COs? Building Permits (Open/Expired): BP~f~ -Z / ~0 Z- )9/~Info. ~ B~/A~ Z / C/0 ~ ~a/D , info· - Single & Separate Search Required? Y o~etermination: ' ~" ~Q. ~t Size: ~ o ~ o ~f, 'ACT. ~t Size: ~ ~ ~ ~Q. ~t Coy. ~ O~ACT: ~t Coy. ~Q. Front ~CT. Front 6q,7/~QSide /~/ACT. Side ~/ ~Q. Re~ ~o~PROP. Re~_~ ~Q. Height. ~/ACT. Height ~1o/ ~ ~ ~l~ ~/~ 7g,7' Waterfront? Y o~ ' lfy~, water body: ~ Panelg ~ Flood Zone: Bul~ead/gluffDistance: ..... ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or(~- If yes, *Bed#: *Date: / / *Permit#] - If no, certification required: Y or N Received: Y or N By: NYS DEC: eR~-o~cglu75 Y o0- Date: Southold Trustees: y 0~)- Date: /__ Southold ZBA: Y o~..N~ Date: __/ /__ Southold Planning: Y o~ Date: Town Landmark C of A: Y o~DTE: __ Notes: Town Septic: Y or lq / / Permit #: Permit #: Permit #: Permit #: / or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *NYS CODE Compliance (page 2~r N Fee Structure: Foundation: bC-c~ First Floor: f01~ ~ Second Floor: Other: 7~oT 7"t~ ~ Total: Calculation: SF 13/~,,%< g.,/ ~,~/;~, ~ ,,2. ~r~,~,+initialFee:$ SF + Additional Fee ( ): SF 2. ( .SF)- ( SF)= SF X $ =$ SF + Initial Fee: + Additional Fee (d~: ~t4/~7-): TOTAL:$ 700, oo Ground Snow Load: ~0 Weathering: Severe__ Design Temp: I1 NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CmTEm^ Oq/k'' ~ Wind Speed; 120MPH SelsmlcDesign CategoryiB . · ·Frost Depth: 36" __ Termite: M-H' Decay: S-M. · Ice shield Underlay: YES Flo~d Hazards: USE/OCCUPANCY CLASSIFICATION: - HEIGI~IT/FIRE AREA: ~9~ TYPE OF CONSTRUCTION: 'bda¢~5 HEADERS: Y/N WALL STUDS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: LU1M[BER SPECIES AND GRADE: Y/lq GIILDERS: Y/N ROOF IL41i'TERS: Y/N WINDOW AND DOOR SCHEDULE: ,MISSLE TEST RIg~O~UIREMENTS EOm;SS s.v LIGHT 8 °/o :~N VENT 4 % f~ NA[L~G/CONSTRUCTION SCHEDULE: Y~ ~S OF EG~SS: Y~ PL~B~G ~SER D[AG~: Y~ o~ LOCATION OF F~ PROTECTION EQU~MENT: Y~ CERT~ICATION: Y~ O~ E~RGY CALCS: Y~ d~ TOTAL COMPLIENCE? Y/N (~TU~ TO PAGE ONE) II GENERAL NOTES .----,h,--..,~,""--'"""',"'""--"""'""""'""'''' '~"'"~"""'''"~"'" "' ""'' --'Z'~- ~'"=~'"?-- .... .,,.,,..,,...~'t:,,.,".'""",,.".,'.--."-'-"'"'""'"'""' ""' """"""' r, atkagl, ~,~t~ ,a,d k,,.i ~,dm. g,o~,,,:a~, mSu{aum~ ~. ~mm,a,~ .,~ ..-. moj, w,~ a=~W:,~k,k im~a~J k,.l~i . __ ............ k~lh~l~ ~r ~xdak~,ll~ W i~l, mti~ ~1~ aJdltdd k Itti~ ,~ th~ dko~w,~ m:l wp~dll ~ -..,,-,--..,.-- DRAWING INDEX T-1 NOTES PLOT PLAN A-1 FLOOR PLAN - ELEVATIONS A-2 FOUNDATION PLAN DETAILS PLANS REFLECT AS BUILT CONDITIONS W/ REMEDIATION OF EXISTING REAR ENCLOSED PORCH (BUILT APPROXIMATELY 1980)AS PER ARCHITECTS VISUAL FIELD INSPECTION - NO OTHER WORK WAS AUTHORIZED, APPROVED, OR DESIGNED BY THE ARCHITECT 'N / PLAN ', \', N RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODE8 OF NEW YORK STATE, UNDERWRTTERS CER~IFICAT~ ! REQUIRED APPROVED AS NOTED DATE' NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM 10 4PM FOR THE FOLLOWING ]NSPECTiONS' 1, FOUNDATIOi~I - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SFIALL MEET TNE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLy V~/I'TM ALL CODES OF NEW YORK STA'I E & TOWN CODES AS REQUIRED ,~ND OCCUPANCY OR ir!SE IS UNLAWFUL ;~/iTFIOUT CERTIFICATE OF OOCUPANOY T-1 EXISTIN~r ENCLOSED PORCH ,,, I ~XiSTiNO BEDROOM ~XISTIN~ KITCHEN EXISTINO DINING ~OOM ]1] ~ ~-- EXIST'~ ~A~E EXISTIN~ BEDROOM NELU CONCRETE FOR EXTERIOR F~UND.4TION UJALL5 AND PIERS 5HALL BE AIR ENTRAINED BETLgEEN 5~ AND T~,. ALL NELU FOOTING5 AND PIER5 TO BE ON VII~IN L,INDI~TUP~ED ~OIL HINIHUt"/ ~ TON BEARIN~ G.APACITY I-- ............. ~Xl~Tl~Vi~? ............. EXISTIN~ C~ EXISTIN~ 8" X I~," C~ENli~ EXISTING 'VENTED 8pACE ,'3 sa. ©C~. E×ISTIN~ ~ FOUNDATION SCALE: I/4" - 1'-0" i J[XISTIN~~ PLAN ~ ~,~E UNDERPINNING NOTE5 ~S, ECTION THF~U UNDEr, PINNED SLAB EXI6TING ~ EXISTIN~ ENCLC 5ED PORCH P,T. I~OD DECK JOI6'~ AND LEDGER