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Home My WebLink About35966-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector To~n Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34688 I~ate: 11/19/10 THIS C~K'rIFIES that the building ALTEPJ~TION Location of Property: 1250 WHITE EAGLE DR LAUREL (HOUSE NO.) (STREET) (HAMLET) County TaxMap NO. 473889 Section 127 Block 9 Lot 18 Subdivision Filed ~4ap NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in th/s office dated SEPTEMBER 21, 2010 pursuant to wh/ch Building Permit No. 35966-Z dated OCTOBER 25, 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" SITTING ROOM AS APPLIED FOR PER NEW YORK STATE VARIENCE PETITION ~2010-0483. The certificate is issued to DONALD F & ROSEANN GAVIN, (OWNER) of the aforesaid building. JR SuF~OI,KC~)~DEPART~qTOFHF~tLTHAPPRO~-AL N/A EI~-rKICAL C~K'rIFI~TH NO. 35966 11/01/10 PLIghtERS CERTIFICATION DA'r~u3 N/A A~horized Signature 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. 35966 Z Date OCTOBER 25, 2010 Permission is hereby granted to: DON GAVIN 1250 WHITE EAGLE DR LAUREL,NY 11948 for : "AS BUILT" SITTING ROOM AS APPLIED FOR; STATE VAR. #2010-0483 at premises located at 1250 WHITE EAGLE DR LAUREL County Tax Map No. 473889 Section 127 Block 0009 Lot No. 018 pursuant to application dated SEPTEMBER 21, 2010 and approved by the Building Inspector to expire on APRIL 25, 2012. Fee $ 400.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TO;VN 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 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 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 cot/sent 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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: Owner or Owners of Property: Suffolk County Tax Map No t 000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~/--9 ~ Old or Pre-existing Building: ~ House No. Street · '/~'~ Block Date of Permit. (check one) · Hamlet Lot /~:~ Filed Map. __ Lot: Applioant: Underwriters Approval: Final Certificate: ~,~ (checkone) ~gnature rl'o~ln Hall Alulex 5 [375 Main Road P.O. Box 1179 Southohl, NY 1151714)959 Telephone (631) 76,5-181)2 Fax (631) 765-9502 ro.qer, richert~town.southold.ny, us BITILI)IN(; DEPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: D Gavin Address: 1250 White Eagle Dr City: Laurel St: NY Zip: 11948 Building Permit #: 35966 Section: 127 Block: 9 Lot: 18 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 ~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCI Recpt Main Panel A/C Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: 1-paddle fan Ceiling Fixtures ~r~l~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures 161 CO Detectors Fluorescent Fixtur(~J~ Pumps Emergency Fixture Time Clocks Exit Fixtures ~ TVSS Notes: bonus room Inspector Signature: Date: Nov 1 2010 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY F~ RF. Sm'ANT ~ [ ] ROUGH PLBG. [ ] INSULATION ~FINAL FIRE SAFETY IILfi~G"TION FIRE RESlSTAIR' PENETRATION REMARKS: DATE /////0 '"'-//D __ iNSPECTOR ~ /~-~--~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined /o/ 720 7o Approved Disapproved a/c /o/..,4'20 /o Expiration PERMIT NO. ~5~7~, ~ 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 ~/~ {.ff~;:~ .' Phone: ~ ~/. -,~.~'~. -- _ ,~ ~ , a, r~ r'zNq Building Inspector F5~lC/~F ~"- I11 111 ~P~ ICATION FOR BUI LING PE~IT D ] I INSTRUCTIONS , ms appliq0~e cnmp~ly filled in by typewriter or in ink and submitted to the Bulldog ~spector with 4 sets of plax s, accurate plot pl~ to scale. Fee according to schedule. b. Hot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and wate~ays. c. The work covered by this application may not be co~enced before issu~ce of Build~g Pe~it. d. Upon approval oft~s application, the Building ~spector will issue a Building Pemit to ~e applic~t. Such a pe~it shall be kept on ~e premises available for inspection ~oughout the work. e. No building shall be occupied or used in whole or in p~ for any p~ose what so ever until ~e Bulling ~spector issues a Cenificate of Occup~cy. f. Eveu bulldog pemit shall expire if the work authohzed has not commenced within 12 monks aRer ~e date of issuance or has not been completed within 18 months kom such date. If no zoning amen~ents or other re~lations affecting the prope~y have been enacted in ~e interim, the Building Inspector may authohze, ~ whting, the extension of ~e pemit for ~ addition six monks. ~ereaRer, a new pemt shall be requked. ~PLICATION IS ~BY M~E to the Bulling Dep~ment for ~e issu~ce of a Buil~g Pemit p~su~t to ~e Building Zone Ordinate of the Town of Sou~old, Suffolk County, New York, ~d o~er applicable ~ws, Ordinates or Re~lations; for ~e consmction of buiIdings, additions, or alterations or for remora1 or demolkion ~ here~ deschbed, The applicant a~ees to comply with ~1 applicable laws, ordin~ces, bulling code, hous~g code, ~d re~lations, ~d to admit authorized inspectors on premises ~d in building for necess~ ~spections. (Signature of applicant or name, ifa 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 ~>~,,(/',~,~ ~,,~ ~,,-/~/ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and.t, itle of corporate officer) Builders Llcens,~, NO'.:: .',: Plumbers Licen~e No'.~ , ' Electricians License No. Other Tradeis License No. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section /~::~f'- Block d~t::~ Lot ¢/~:~ 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 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 Fee Addition Alteration Other Work ,,,~ e'~&Y,//--~r- (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~:~.~:~ Rear ff~ Depth Height ~ .~,/ Number of St°rie~' Dimensions of same structure With alterations or additions: Front . ~.~ ! Rear ~-~' Depth /',,,,,'~-! Height ,u ~/t Number of Stories ~.~ 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front_~.4~/ 10. Date of Purchase '~ 11. Zone or use district in which premises are situated Rear 220. ~ff' t Name of Former Owner Depth Delh Z v2. ' l 2. 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 pL.,~ises Name of Architect Name of Contractor 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 gEQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO Addres~~one No.-4~. ~ Address~v~,~ ~ PhoneNo ~{. AddreSs !///~Phone No. 16. Provide storey, to scale, with a~curate 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 restriciions with respect to this property? * YES NO V'/ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ~Z~fft~/~ · "~A.J~" ~tt~/--T~.Z.~t{*/~),~--~ being duly sworn, d~oses ~d says that (s)he ~s the applicant (Name of individu~ si~g comract) above named, c~NIE'D. BUSH (S)He is the ~~ ~ NO*~ P!~: ~te ~ N~ Yo~ (Contractor, Agent, Co~orate Officer, etc.) No. 018061~ Ou~ In ~k Co~ ~/~ ~fll I ~ ~ ~ of owners, to p rfo or apphcao ; thru all stmements contained in this application are tree to the best of his ~owledge ~d belief; and that the work will b~ performed in the manner set forth in the app!ication .filed therewith. Sworn to before me this ~ day of ~ 20 ttt~) Notary Public it~fAppUcant T~F~ P.O..Bo~ 1179 · .,~-thol~ NY 11971-09~ ro~er, ridl~~.n¥~,j~ TOWN OF $OOTHOLD .APP.LICATION FOR ~LI:::CTRICAL INSPECTION, BY: Name: Date: JOBSITE INFORMATION: (*!ndi~ates. required information) *Address: · - *Cross Street: *Phone No.: Permit No.: Tax Map District: 1000 Section: . /~--~--~ Block: *BRIEF DEscRIPTION OF WORK (Please Print. clearly) .(Please .CirCe All That Apply) *Is jOb ready for inspecli0n: ,*Do you n¢c,d a Temp CePaficate: Temp'lnformation (If needed}* *Servi<3e SIze: 1 Phase 3Phase *New Sel'v~oe: Re-connect Additional Information: ROugh In"" F!nal. L~ 100 150 200 300: 350 400 Other Underground Number of Metem Change of Service Overhead PAYMENT DUE WITH'APPLICATION r~ % \~'~'~,~ Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. ~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A /'~ /,,~ ~,~ /,,~ STORM-WATER/GRADING? DRAINAGE AND EROSION CONTROL PLAN mseict s.~o, mo~ ~ CERTIFIED BY A DESIGN PROFF.~SIONAL IN THE STAT~ OF NEW YORK. $COPE OF WORK - PROPOSED CON~I'RUurION l'l'~'~# / WORKA~E,~ I Yes No a. What is the Total Ama of the p~j~ct Parcels? I Will this ~ Re.in/~1 Sts,rm-Wal~ RunOff (Inctucl~ Total Ama ot al~ Parcels located within the Scope of Work fo~ Pmposed Conslmctkm) 'g~/- ~Z~ Ge~emtsdbyaTwo(2')lnchRainfail~Site? '~'* D b. What is the Total Ama of Land Cisadng ' (s.F. / ~) (This item will include alt run-off created by site clearing and/or commuct~ ac'dvities as wea as all -- and/or Ground Disturbance for the proposed ,,~ Site Improvements and fl~e pem~anent c~ea~ of construction activity?~ impe~k~s surfaces.) ~"*"") 2 Does the Site Plan andfor Su~ey Show NI Proposed PROVIDE BRIEF PRO. W.,C~ D~I'tON (~.~'" :~-',~ DmlnageS~mctureslndlcafing Size&Localfo~?Thts I,/I Item shall incl~te all Proposal Grade Chang~ and -- .~_q ~- g~,F,/~'- ~/U~ ~0~ SlopesContr01llngSurfaceWatsrFfow. ,~,U~ ~i[~ }ll~ L/~--'~ ,/~ L/'~./ item must be maintained through~ut the Entire Excav.tion wh~'~ b~i~ i$ 8 ch~. to the Natural D V//~ Existing Grade Involving mom than 200 Cubic Yards of Matedal within any Parcel? 5 Will this App#ca§on Requim Land Disturbing Ac6wiies D V/~' Encompassing an ~ in Excess of Five 'l~ousand (5,000 S.F.) Square Feet of Ground Sudace? -- 6 Is there a Natural Water C°urse Running thmughthe O Site? Is this Project within Ihe Trustaes jurisdiction STATE OF NEW YORK, ~.., // · ~. Owner and/or rcpre$cnta~vc of the Owner or Owners, and is dui)' ant~oH, zcd E) perforra or ~avc performed thc said work and m make and file this application; that all statements conlaincd in this application are tree to thc best of his knowledge and belief; and that thc work will.be performed in thc manner set forth in thc application fried herewith./~ / Sworn to before me this; /// /~t , . · A?PROVED AS NC'rED DATE' FEE NOTIFY'~UILDING BEPAR~ENT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1 FOUNDATION- TWO REQL FOR POURED CONCRETE 2 ROUGH STRAPPI~ ;AULKtNG LEGEND ~ EXISTING STRUCTURE AS-BUILT BONUS ROOM BONUS RM. SUI~CEf ~ ~ F. TRRICh*ON JR., P.O. ~: 5/11/2005 LOT ~EA = ca, 41,726 SF RESIDENCE AS-BUILT BONUS RM. 4 MUST BE(- DECK OPEN TO MASTER BR g THE ~ REQUIREME -- , OF NEW ~ . FOR ~ 1250 ~HIE EAGLE LN LAUREL, NY 11948 ARCHITECT P.0.B)X 61~El~l~f, ~ 119,14 EL: 651-,IT/862~. OWNERS Ilk~f, FL 527~ MBR ~: SITEPLAN SCTM~ = 1000-127-09-18 WHIE EAGLE DR~ SUFFOLK C0~lflY, NL~ Y0t~ PLOT PLAN ,AS-BUILT PERMIT APPLICATION OCTOBER 7, 2010 DAE: 09/07/'~10 ~ 1/$6' = 1'-0' SITE PLAN ] TO ~BR -- I __ ~ MBR lNG AREA DRYWALL, 5/8' DRNA~ ~'-6' GARAGE AS-BUI[IS DECK & BONUS R~I. I VaNI RESIDENCE 1250 WHI]E EAGLE U~ b~UREL NY 119~ ~RCHIECT SEC~ON ~ ~ ~ ~ MBR ~400 SF ceiling height: 8' b 10' CEILING GRILLE CARPEl HIGH HAT i ~ ~J HIGH HAT 19'-10' SITTING AREA ARLk ~463 SF I i ~ i i SEP UP { -6'-0' OPENING - F J MBATH BONUS RU PLAN & SEC'DON FLOOR PLAN