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HomeMy WebLinkAbout35810-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34556 I~ate: 09/14/10 THIS c~TIFIES that the building INTERIOR ALTERATION Location of Property: 670 FOUNDERS PATH SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 64 Block 2 Lot 19 subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 2010 purs,,~t to which Building Permit No. 35810-Z dated AUGUST 27, 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" BATHROOM ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. q~ne certificate is issued to GENEVIEVE FIELD & THEODORE MCCANN ( OWNER ) of the aforesaid building. S~)~K~I)~DBP~/~)~IT OF ~]E~J~TH;~PPRO%~%L N/A EI~-rKIC~J~ c~KTIFICATE NO. 35810 09/14/10 I~L~BERS C~KTIFIC2%TION DA'r~ 09/07/10 JOE WHITECAVAGE ~/or~l/d Si~g at ure Rev. 1/81 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. 35810 Z Date AUGUST 27, 2010 Permission is hereby granted to: for : "AS FIELD & MCCANN 605 FOLrNDERS PATH SOUTHOLD,NY 11971 BUILT" INTERIOR ALTER3ITION (BATHROOM) AS APPLIED FOR at premises located at 670 FOUNDERS PATH SOUTHOLD County Tax Map No. 473889 Section 064 Block 0002 Lot No. 019 pursuant to application dated AUGUST 16, 2010 and approved by the Building Inspector to expire on FEBRUARY 27, 2012. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 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 with the following: A. For new building or new use: 1. Final survey of properly with accura[e location of all buildings, propen'y lines, streets, and unusual natural or topographic featvrcs, 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S.9 form). 3. Approval of electrical installation from Board o f Fire Undenvriters. 4. Sworn statement from.plumber c~rtifying 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 Planuing Board Approval o f~6ompleted site plan requirements. B..For existing.buildings (prior to April 9, 19~?) non.conforming uses, or buildings ~nd !~pre-existing' land uses 1. Accurate survey of property showing all property lines, streets, building and unusual naturat or topographic features. 2. A proper!Y completed application and eenseat to inspect signed by the applicant, if a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writ~g 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 ofOc~apancyon 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 Pm-existing Building: J (check one) Home No. 8t~t ~et owrier or Owners ofP~opertY:'. F]~C/~) · 8U-ffolk Co~mty Tax Map bio 1000, Section Subdivision No. Health Dept. Approval: Planning Board Approval: Filed Map. . Lot: 'Date of Permit. 'fi~/Z'~O Applicant: 2), ~./~',~}-~/NV2.-g'i to/,4- U demitmApp : W'/*- Request for: Temporary Certificate Final Certificate: Fee Submitted: $ (check one) - Appll~ant ~gnature To~ n 1 lall Anlwx ,5 t375 Mare Road P.O. Box 117!I Sottthold, NY I Telephone (631) 765-1802 Fax (631) 76,3-9,502 ro.qer, richert~town.southold.n¥.us 1½! !ILl)IN(; DEI~AI/TMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Genevieve Field Address: 670 Founders Path City: Southold St: NY Zip: 11971 Building Permit #: 35810 Section: 64 Block: 2 Lot: 19 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: as built DBA: License No: SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement ~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: second floor bath room Ceiling Fixtures ~~ ~ HID Fixtures Wall Fixtures Ill Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur~ Pumps Emergency Fixture Time Clocks Exit Fixtures I I TVSS Notes: I ft track lighting, 1 baseboard electric heat Inspector Signature: Date: Sept 14 2010 81-Cert Electrical Compliance Form Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD OlOHlflOS 30 NAAOi CERTIFICATION Date: Building Permit No. ~ ~ ~ (Please print) (Please print)'- I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this dayof ~ , 20/o' Notary Public, ~ County TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~I,ATION [ ] FRAMING / STRAPPING [ p,~I:INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSi~CTION [ ]Fe~R~mSTANTCONSTRUCflON [ ]IqR~n~mSTANTI,EXLr'rR~I'H)N DATE INSPECTOR ~o~m'~o~ Os'r) ~o~-~r~oN (~m)) . ROU~ ~ · O ~ON ~ N, Y, ~ STA~ ~ " ~D~ION~ COUNTS . ,2 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net / Examined ~/~? 20 ,~ ~/¢~, 20 /O Approved Disapproved a/c Expiration ,~/~ 720 PERMIT NO. f~-ff/~ 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date ,20 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. F' 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./~'-",~ ~ (.~ignamre-o[apl~ca~t orLam~e, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~'/b/~/~6/~' Fl~/ 7~rl0/~ffff~ (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. ~ Plumbe/'s License }NO. ' Elec{ricians License No. Other Trade's License No. Location of land on which proposed work will be done: 0:70 House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block 72- Filed Map No. Lot Lot /? 2. State existing use and occupancy o£premises and intended use and occupancy o£proposed construction: a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units / If garage, number of cars Addition Other Work Fee .~/.//(.~ ,~t_ (Description)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 2- 2- Rear 2~.> ~ c//~' Depth Height ~ Number of Stories 2.. 9. Sizeoflot: Front 10. Date of Purchase Dimensions of same structure with alterations or additions: Front Depth ~ r Height. 2.0 8. Dimensions of entire new construction: Front d7 ~ Height 20 Number of Stories /b~ Rear '~/ff/~ ~/u~c9 c/l ,~' Name of Former Owner 11. Zone or use district in which premises are situated Number of Stories Rear 2_~ ' ~ l, Rear ~:~¢' .2- Depth 5-~ ! Depth /~ ,,4,4; f&4rr¥,.TZ_ - 2/0 12. Does proposed construction violate any zdning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES__ NO ,~ill excess fill be removed from premises? YES 14. Names of Owner of premises ~,.a,,r.o~t~£ Name of Architect Name of Contractor Address ""Phone No. Address Phone No Address Phone No. l 5 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 cfa tidal wetland? * YES NO ~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, with accurate tbundati0n 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 ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY~'X ~ O~ J-~)/:~[~ '-ff ~t~/b/(~,,~'-~4 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~~ ~ CONNIE D. BU~ NO~ P~, ~e ~ ~ Y~ (Contractor, Agent, Co~orate Officer, etc.) ~. 01BU61~ or owners, and is day that all statements contained in this application are tree to the best of his ~ow]edge and belief; and that the work will be perlb~ed in the manner set fo~h in the application filed therewith. Sworn ~q before me thisA ]~ day of~~ 20 I~ Notary Public Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR.'.". PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SI3~M!_~$1ON OF STORM*WATER, GRADING, DRAINAGE AND EROSION CONTROL CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION a. What is the Total Area of the p, ui=,.;. Parcels? (Include Total Area of all Parcels located within the Scope of Work for Proposed Consbtmfion) b. What is the Total Area of Land Cleadng (S.F. and/or Ground Disturbance for the proposed construction activity? ITEM # / WORK ASSESSMENT Will this Project Retain All Storm-Water Run-Off Genemtecl by a Two (2") Inch Rainfall on Site? O'his item will include all mn-off created by sits cleadng and/or construction activities as well as all Site Improvements and the permanent creation of imperWous surfaces,) PROVIDE BRIEF PRO. I'F, CT DF~CRIFHON ~,~,~as~a~ General DEC SWPpp Requlmment~: Yes No Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changas and stopes Controlling Sorface Water Flow. 3 Does the Sits Plan and/or Survey describe the emsion .~]// J ~' ~'~ and sediment control practices that will be used to contrcl site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Peded. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Exis~ng Grade Invatving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdic~on or within One Hundred (100') feet of a Wetland or Beach? 7 Will there be Site preparation on Exisgng Grade Slopes which Exceed Fifteen (15) feet of Vertical PJse to One Hundred (100') of Hodzontal Distance? 8 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 fight-of-way? 9 Will this Project Require the Placement of Materfal, Rem0val of Vegetaiton and/or the Construcgon of any Item W'flhln the Town Right-of-Way or Road ShoUlder Sworn to before me this; ............................................... dayof ............................................. ~20 ..... Notary Public: .......................................................................................... FORM - 06/10 STATE OF NEW YORK, ~-~ ,~ /') ~ CC) --~' · OF ................ ss That I, /~ .]/~ .~..~.,~.....~...~...~ 2t being duly swom de ses an And that he/she is the ................................. ..~7.....~...d~.....W.....~..../J'/~'~ ...... (oval. con~, ^g~i;~ig'Bi~i~4:~Ej ......................................................... Owner and/or representative of the 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 herewith. Tovm I-hll Annex 54375 Mah Road P.O. Box 1179 $outhold, NY 11971-0959 Telephone (631) 76,%1802 rooer. Hcherii~.t~ (v~n~.ls) gu6~mq~, nv. us REQUESTED BY: Company Name: BUII .FflNG DEPARTMENT TOWN OF SOUTHO{.n APPLICATION FOR ELECTRICAL INSPECTION Date: Name: Eicense No.: Address: Phone No.: JOBSITE INFORMATION: (*IndiCates requ red information) *Name: ~4,J~ V/~V'~_~ ~'1~"~ *Address: · *Cross Street: *Phone No.: Permit No.: Tax Map District: 1000 Se~ion: . ~ Block: ~ Lot: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) (Please Circle All That Apply) *Is.job ready for inspection: ~Do you need a Tamp Certificate: {~ NO 'l~0ugh In ~ YES / NO Tamp'Information (If needed}. *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form ,5 t375 Main Road P.O. Box 1179 S.udlold, NY 11971-0939 Tclcl)honc (63 I) 76,;-I 802 Fax (631) 763-!t302 BI 511,1)IN(; I)I';PA1),TMENT TOWN OF $OUTHOLD September 10, 2010 David Jannuzzi, Esq PO Box 1672 Mattituck, NY 11952 RE: Field/McCann, 670 Founders Path, Southold TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: Application of Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $25.00. / Final Health Department approval. / Plumbers Solder Certificate. (All permits involving plumbing aft~[/4/l/84) Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board approval. Final Fire Inspection from Fire Marshal. Final Inspection from the Building Dept. Final Landmark Preservation approval. Building Permit:~W.7_-7---' ~,.:,..' PlO LOT ~4 PlO LOT ~5 NI 64'05'00"E LOT 25 iR LOT 26 LOT 27 STOC~.~DE FENCE L'HOMMEDIEU LANE t- 150.00' i, GUARANTEED TO: THEODORE McGANN GENEVIEVE FIELD CiTIMORTGAGE CORP. FIRST AMERICAN TITLE INS. CO. PROP UNE S 64'( LOT 28 ' RESIDENCE SURVEY OF DESCRIBED PROPERTY' SITUATE SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: THEODORE McGANN GENEVIEVE FIELD TM// 1000-064-02-019 SURVEYED: I MARCH 2006 SCALE 1"= 50' AREA = 15,000 OR 0.344 ACRES SURVEYED BY STANLEY d. ISAKSEN, JR. P.O. BOX 294 NEW SU/.................P~OLK. N.Y. 17956 /'~'~ ~'~'F' ,~z/,~/' 06m480 ~u t,u Bt.~S'