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HomeMy WebLinkAbout35864-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~-RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPAiQCY No: Z-35864 Date: 09/21/10 THIS c~TIFIBS that the building ALTERATIONS Location of Property: 1900 ALDRICH LA LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 125 Block 1 Lot 2.18 Subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 1, 2010 pursuant to which Building Permit NO. 35864-Z dated SEPTEMBER 15, 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 WOOD STOVE AND COVERED CELLAR ENTRANCE ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. 77~e certificate is issued to HOWARD & BARBARA DILLINGHAM JR ( OWNER ) of the aforesaid building. SUFFOLK CODlqTYDBPART~T OF HEALTH APPROVAL PL~E]{~ ~-rIFICATION DA'r~J3 N/A N/A Rev. 1/81 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. 35864 Z Date SEPTEMBER 15, 2010 Permission is hereby granted to: for : "AS BUILT" HOWARD DILLINGHAM 1900 ALDRICH LANE LAUREL,NY 11948 WOOD BURNING STOVE & CELLAR ENTRY AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 125 pursuant to application dated SEPTEMBER Building Inspector to expire on MARCH 1900 ALDRICH LA -{~%~5f / LAUREL Block 0001 Lot No. 002.018 1, 2010 and approved by the 15, 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 mu~t b~ filled i~ by typewriter or ink and submitted to the Building Department 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 ~oprOval fi. om Health Dept. of water supply and sewerage-diSposal (S-9 form). 3. Approval of electrical installation fi'om Board of Fire Underwriters. : 4. .qwom statement fromplumber certifying that the ~older used in system contains less than 2/10 of 1% lead.. '$. C°mmemial building, industrial building, muitiple residences and ~imila~ buildings and installationa, a ~ficate. of Code Compliance from architect or engineer responsible for the building. '6. Submit Planning Board Approval of-~omPleted siteplan rcquiroments. "B. -For existing.buildings(prior to April 9, 1957) non-~onforming useS~ or buildings and ~'pre-existing" land uses: 1. Accurate survey' o f property showing all prep~rty lines, streets, building and unusual natural or topographic features. - ' 2. A propcr!y completed application and consent to inspect ~igncd 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, Swimmtng pool $25.00, Accessory building $25.00, Additions to accessory building ~25.00, Businesses $50.00. 2. Certificate of Occupaneyon Pre,existing Building - $100.00 3. ' Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporm'y Ceflificate of Oc~oupancy - Residential $I 5.00, Commereial $15.00 tqew Construction: Lochtion of Pmk. Date. ~/3 ) / / 0 . . Old or Pre-eXisting Building: ~ (check One) · Iq~r) " ~/r/a;,.-d~ I"~,o~ H'o~ise N~). Street . Hamlet Lot Subdivision /d tel CS~d ~5 '~*q~ FiledMap.. Lot: Permit No. ~ ~ ~ .~ 'Date of Permit. Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Underwriters Approval: Final Certificate: (check one) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION ~,,FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RES~TANT FF. NETRAT~N [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMIHG / STRAFFIHO [ ] FIREPLACE & CHIMNEY [ ] mEREmrANT~ST~UtmON [ REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined p'//~,F , 20 / Approved ¢~5-- , 20/1~ Disapproved a/c Expiration $3//.ff", 20/'~, PERMIT NO. ,~ ~ ~ cf9 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, betbre 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: Buil~ling nl~spector APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date /~1#~ ~,/ ,20t~ a. This application MUST be cmnpletely 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 promises, 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 f?om 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 ora 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~pplicant or n~e, ifa corporation) (Mailin~ ad't/ess $? apph/can0)' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises /~?~tW, t-r~/) W, ~-~e (~s ~n the tak roll or ~test d6ed) If applicant is a co¢oration, si~ature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License Location of land on which proposed work will be done: House Number Street Hamlet CountyTax Map No. 1000 Section /'2( Block rDi Subdivision '~ q~ Filed Map No. Lot r~, D/~/ Lot ~ 2. State existing use and occupancy of prel~se_s.a,r,)d intended use and occupancy of proposed construction: a. Existing use and occupancy ~ b. Intended use and occupancy ~ 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 Fee Addition Alteration Other Work ~,qJ /,4 z,o,~ ¥-o,~ ./ (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 Height Number of Stories Z~ Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front /~)C3 Rear / ~ e3 Depth 10. Date of Purchase ,/~;PJ/~ Name of Former Owner .Depth Rear 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO,u// 13. Will lot be re-graded? YES__ 14. Names of Owner of premises ./,~,~,w,~rza'~_ ,//,'~,?J&Address Name of Architect Address Name of Contractor Address /gOO '~ 'dthg,~,Z,O't~Phone No./~ ~g/' ~,(5"k/2-/~ ~ NO -,,,,,/Will excess fill be removed from premises? YES l tl-,~ ~ ! Phone No Phone No. NO / 1 $ 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,,~QUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO v * 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. l 8. Are there any covenants and restrictions with respect to this property? * YES NO · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY O F~ tt~ ' ~')S: t~~%,lJtktd-~'~k.& Ox..._ 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 am 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 thisr3 - ' Nota~ Public NO. 01T0$lg~ ToWn of Southold t~ Erosion, Sedimentation & S,torm-Water Run-off ASSESSMENT FORM P~Pz:Ni 1' LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SU~M!=e*:_~!._nN OF I~n ) ~, )~ STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL District Bloc/; Let C"I(TiI'IED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. $COP]~OFWO~ - PROi~OS,~) CONSyI~UC't~OH 1'1~# / WO~:ASSy. SSi~IT a. Wlmt is the Tote/Ama of the Project Parceis? (Include Totel Ama of all Parseis located within '~ Will this Project Retain NI Stetro-Water Run. Off the Scope of Work for Pmpceed ~) Generated by a Two (2') Inch Rainfall on Site? . b. What is the Total Area of Laud Clearing (S.F.I~) (This item will include all run-off craatad by site ~// clearing and/or constraction actlvit~s as well as all and/or Ground Disturbance for the prop~ed Site Improvements aM the permanent creation of constmciton activity? impervious surfaces.) (s~=*l~) 2 Does the Site Pisn and/or Survey Show All Propesed PROVIDE BR.I~ff PROJ~,CT DESCILIFTION ~ ~. ~ Drainage $thJCtUraS Indlcaf~g Size & Locaf~n? 'fills Item shall Include all Proposed Grade Changes and Slopes Conlmlllng Surface Water Flow. 3 DonstheSItePlananc~/orSurveydeson'betheeroslon ~ contro~ site ercefan and storm water discharges. This item must be rnainteined throughout the Entire Construction Period. 4 Will this Project Require any Land Filling, Grading or Excavation where them is a change to the Natural r~ Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activittes ~ Encompassing an Area ~ Excess of Fwe Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6is them a Natural Water Course Running through the General DEC SWPpp ReClufreme.nis: or within One Hundred (100!) feet of a Wetland OrL~J . Submission of e SWPPP is requfred fo~ all Co~strucUo~ actfvl6es Involving soiJ Beach? dlstu~cesofo~e(~)orntoreacms; Includk~gd~storbance$oflesstheno~eacmthat 7 WilttherebeSiteprepamtinnonExistingGradeSIopes ~ are part of a larger common p~an that will uNmatoly dlstorb one ~ more acres o~ ~; which Exceed Fiit~e,,en (t5) feet °f ver§cal Rise to I I iocluding C~struction acflvlUes Invctviftg soil disturbances of isss than one (1) acre where One Hundred (100) of Horizontal DistanCe? L~J the DEC has determined Ihat a SPDES pem~t is required fo~ storm wate~ discharges. · k 'm, Sm~,P ~l ~ ~ ~ to th~ ~,~ of ~ ~:a.'r~ ~ ,~# ~ into and/or in Ihe dlrac"Uon of a Town required, post-c~nstn~on strum ymisf ma~geme~ pmctlc~ Ibm will ~ used and~ Removal of Vegetefl.on and/er the Construc~on of any compliance with the terms and ~ of this permit. In af~1~0n, the SY~=PP shal Item Within the Town Right-of-Way or Road ShoUlder · ~..nd tl~t he/she is the ................................................................ Owner and/or reprcscnta{7,,c of the Owner or Owners, and ~s d~y authorized to pc~orm or have p~d'onned thc said work a~d to make and fiJe tJ~s application; that ail statements contained in tl~s application arc t~c to the best of'his knowledge and I~]~ and, t~at t~c wor~ w;J] Dc ]:)~J'ormcd in t]'l~ mann~' set £orth in thc application filed h~th. Sworn to I~for~ mc d~s; FORM - 06110 Qualified in Suffolk County -- Commission Expires .rulv 2,~ 2~ ( r._,. TOWN OF SOUTHOLD PROPER~y~..RECORD CARD OWNER STREET /r.~ 0 ~ VILLAGE D]ST. SUB. LOT j S W ~.EOF BUILDING / R~. S~. VL ~/O FARM CO~. CB. ~1~. Mkt. Va~e ~ND IMP. TOTAL DATE R~RKS Tiilab~ FRONTAGE ON WA~R W~d FRONTAGE ON ROAD ~ ~ ~ ' ~d~d DEPTH ~ ~ Hm~ PI~ BULKH~D Extension -'xtension Por.~e /' Breezeway s/ z_/ Foundation ~, (~, Bath Basement Floors F_xt. Wa}ts Fire Ptace Interior Finish Heat .2.3~' ,,2.... ~ ,Z. t Pool ATtic Patio Rooms 1st Floor Driveway Rooms 2nd Floor HEJd.TN DEPARTMENT *DATA FO~ ,td:)PROVJa- TO COt~iSTRUCT N*nlEJl~ JJ~ IlO DWEI. LINIR WITHIN lO0 FEET OF TIME PROPERTY OTHER TNM THOSE SHOWN HEREON. WEll SURVEY FOR HOWARD DILLINGHAM LOT NO. 9 "LAUREL ESTATES AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTYt NEW YORK #I.MAUTNO~IZEO ALTERATION OR ADDITION TO 'I~IS SURVEY IS A VIQ(.KYION Q~r SECTION 7~OSI O~1 THE NEW YORK STATE IrDUOATION #COPIES Glr THIS ~J~RVEY NOT EARING THE LAND SUNVETOR'S INKED ~AL OR rMSOSSED SIr~L. SHAL.(. NOT R[ CONSIDERED TO M A VALJO TRUE COPY EAST, SECT, I" APRIL 10,1986 OCT. 22,1985 ~JULY 22,1985 DATE: FEB. 2~3,1985 SCALE: I": 50' NO. 85- 184 YOUNG & YOUNG I Jk [] I HOWARD W. YOUNG, LANO SURVEYOR ~ N.Y.S. LICENSE NO.45893 sR^NOIS & SONS ~,C. ~046 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK Dutchwest ~-~ RFACE ACES Parallel Installations Installations Parallel Installations Installations Stove Clearance Side Rear Comer ~j ~ '~ea~ Comer No heat shields iAI 22~ (560 mm) [B] 24" (610 mm) lC] 18' (460 mm)t iD] 12'~300 mm) ~[E"] 14"/360 mm) iF] 10~ (250 mm) Rear exit, rear h.s. [G~ 22" (560 mm) rH] 14" (360 mm) N/A [I] 12' (300 mm) [J] 12" (300 mm N/A Top exit~, rear h.s. Single-wall connector [K] 22" (560 mm) iL] 24~ (610 mm) [MI 16" (460 mm) iN] 12" (300 mm) '[O] 14" (360 mm [P] 10" (250 mm) Top exiP~ , rear h.s. Single-wall connec- [Iq 22" (560 mm iL] 14= (360 mm) [M] 15" (380 mm) iN] 12"(300 mm) [O] 12" (360 mm) [P] 8" (200 mm) Top exit~ , rear h.s. Double-wall connector [lq 22" (560 mm ill 19" (480 mm) [llE] 15" (360 mm) iN] 12~ (300 mm [O] 11" (280 mm~, [PI 8" (200 mm) Chimney Connector Clearance: Single-wall connector 19" 480 mm) 9" (230 mm) No connector h.s Single-waiF connector 9" (360 mm) 7~ (180 mm) Double-wall connector 14" (360 mm) 6" (150 mm) Fron~.L~earance to Combustibles: 48" (1220 mm) (All Installations) 2462 ~ Comer ~ Corner Parallel Ins~llations Ins~llatio~s ~lel Ins~ll~ Ins~llations Stove Clea~nce S~de Rear Corner ~ Side ~ ~ Rear J Comer No heat shields iAI 20" (510 mm) [BI 23" (580 mm) iCI 18" (460 mm) iD] ~mm~ [~ l~mm [~ 17' (430 mm) Rearexit~marh.s. [G] 20"(510mm) ~H] 18"(460mm) N/A ~(460mm) ~(300mm N/A Top exit~, mar h.s. Single-wall~nne~or [~ 20"(510mm) iL] 23"(580mm) ~] 18"(460mm) [~ 18"(460mm) [O] ~8"(460mm [~ 1T'(430mm) Singl~wall~nnec- [~ 20"(510mm) iLl 18"(460mm) ~] 1T'(430mm) [~ 18'(460mm) [O] 12"(300mm [P] 15"(380mm) Top exit~ , rear Double~all~nne~or [~ 20"(510mm) ill 14"(360mm) ~] 16" (410 mm) ~ [~ 18"(460mm) [O] 12"(300mm ~ 15"(380mm) Chimney Connector Clearance: Single~all ~nne~or 18" (460 mm) 13" (330 mm) No conne~or h.s Single-wall~ ~nne~or 13" (330 mm) T' (180 mm?~ Double~all conne~or 8" (200 mm) 6" (150 mm) Front Clea~nce to Combustibles: 48" (1220 mm) (All Insta~afions) Shielding for a top exit stove must include a shield insert to protect the area behind the flue collar. 2 Chimney connector heat shields must extend exactly 24" (610 mm) above the flue collar of the stove. 3 All installations venting straight up to a factory built chimney require a 24" (610 mm) diameter or square ceiling heat shield. The ceiling heat shield shoutd be 24 gauge sheet metal or equivalent mounted on 1" (25 mm) non-combustible spacers 1" (25 mm) below ceiling. 4 Chimney connector heat shields must extend to within 1" (25 mm) or less of the ceiling heat shield for installations venting straight up to a factory-built chimney, in top exit installations using an elbow to vent to the rear. the chimney connector must be shielded over the entire vertical length. 5 If a single-wall oval-to-round adaptor is used, a shield must be used to protect combustibles to the rear of the adaptor. 7001135 13 Dutchwest The section that follows contains chants with the infor- mation that you'll need to make your installation safe. Included are a chart to tell you exactly where to cut the hole in the ceiling so that the stove will meet clearance requirements, a chart that gives stove clearances for all installations, and a chart to illustrate the required sizes of wall shields for vadous installations. Refer to these chants as you plan the installation and do not compromise on any of the dimensions listed, Unprotected Surfaces Parallel Installations I Corner Installations C Refer to the diagrams below when using the Stove and Chimney Connector Clearance Chart which fol- lows. For example, the letter "A" gives the minimum side clearance for installations in which the stove is not equipped with a rear heat shield and the wall beside the stove is not protected. "D" gives the minimum side clearance when the stove does not have a rear heat shield, but the wall is protected. Measure clearance distances from the top plate of the stove or chimney connector to the wall, not the wall protector. ,cted Surfaces E Comer Installations Installations with no stove heat shields N/A N/A Rear exit, rear heat shield installations Top exit, rear heat shield and chimney connector heat shields or double wall connector ST255a 12 7001135 APPROVEDAS NOTED r F~: 77- BY fi: { ~ ' ~ BUILDING DEPARTMENT AT .7o6-1602 8~ TO 4 PM FOR~E IF~Lt.O~NG INSPECTIONS: ~ ~ ~NDATION - ~ REQUIRED STR~I~, . L & CAULKING 3. IN~ 4 FINAL- CONSTRUCTI~ & ~C~ICAL UuST BE COU~E~ F~ C.O ALL CONSTRUCTION SHALL MEET ~E E~QUIREMENTS OF THE CODES OF NEW YO~K STATE NOT RESPONSIBLE FOR ~SIGN OR CONS~UCTION ERRORS. Y ;JNLAWFU v ;,~,LIT CERTIF!C OF U,..L :PANCY ,¢, CER'IIFIUATiON OF NAILING & CONNECTIONS ~,~' 6E REQUIRED.