HomeMy WebLinkAbout35630-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~uRTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-34632
Date: 10/25/10
THIS CERTIFIES that the building UNHEATED SUNROOM
Location of Property: 1000 GREEN HILL LA
(HOUSE NO.)
County Tax Map No. 473889 Section 33
subdivision
GREENPORT
(STREET) (HAMLET)
Block 3 Lot 7
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 20, 2010 purs%u~nt to which
Building Permit NO. 35630-Z dated JUNE 9, 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 UNHEATED SUNROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JOSEPH & FR3%NCES BORRELLI
( OWNER )
of the aforesaid building.
SuF~OLKCOUNTYDEPARTMENT OF HEALTH APPROVAL N/A
~.R~-i-KICAL c~KTIFICATH NO. 35630 10/08/10
PLIERS C~K-£IFICATION DA'rmu 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. 35630 Z Date JUNE 9, 2010
Permission is hereby granted to:
JOSEPH & FR3kNCES BORRELLI
GREENPORT,NY 11944
for :
CONSTRUCTION OF ~kN UNHEATED SUNROOM TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at 1000 GREEN HILL LA GREENPORT
County Tax Map No. 473889 Section 033 Block 0003 Lot No. 007
pursuant to application dated MAY 20, 2010 and approved by the
Building Inspector to expire on DECEMBER 9, 2011.
Fee $ 200.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOT 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. Commemial 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 co~sent to inspect signed by the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
, ' 0.00, $50 00,
s~ry bu'~ s $51 00.
/)[:< §t 130
$ 0 }
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwellir
Swimming pool $50.00, Accessory building $50.00, Additions to access~
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:
Date.
New Construction:
Location of Property:
Old or Pre-existing Building: xx x
1000 Greenhill Lane Southold
(check one)
House No.
Owner or Owners of Property: Joseph Borrelli
Suffolk County Tax Map No 1000, Section 3't
Subdivision Eastern Shores
Street
Block 03
Filed Map. 5234
Hamlet
Lot 07
Lot: 141
Permit No. 35630Z
Health Dept. Approval: NA
Planning Board Approval: NA
Request for: Temporary Certificate
Fee Submitted: $ $ 50.00
Underwriters Approval:
Date of Permit. May 20th 2010 Applicant: Richard Saetta
Final Certificate: xxx
(check one)
Apphcant S~gnature
Town Hall Annex
34375 Main Road
P.O. Box 1179
Soulholll, NY 11971-09.59
Telephone (631) 765-1802
Fax (631) 765-9302
ro.qer, richert~.town.southold.n¥.us
BI 7ILDING I)EPARTMENT
TOWN OF $OUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Joseph Borrelli
~,ddress: 1000 Green Hill La City: Greenport St: NY Zip: 1194,~
Building Permit #: 35630 Section: 33 Block: 3 Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Jim Sage Electric License No: 3635-e
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only [~
Corn medcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt Wall Fixtures ~ 11 Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixtureu Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect Switches Twist Lock Exit Fixtures [~l TVSS
Other Equipment: sun room, 1 paddle fan
Notes:
Inspector Signature:
Date: Oct 8 2010
81-Cert Electrical Compliance Form
TOWN LJTHOLD BUILDING DEPT.
765-1802
NSPECTION
FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING / STRAPPING
] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ [ ] INSULATION
[ [ ] FINAL
[ [ ] Frae SAFETY ,.S~EC'nO.
[ ] Fm[REmST,~'rcoNs'rnUCl'~N [ ]
REMARKS:
DATE
INSPECTOR~
v/ t~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1ST
[~/FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
DATE
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION
2ND
~/]/FRAMING / STRAPPING
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SArc, ~' INSPECTION
[ ] FIRE RESISTi~'r CONSTRUCTION [ ] FIRE RESIST4NT I~NETRATION
REMAR//KS: /~"'/./--~---~--~-- C-/q-~_'
DATE ~')/~/~
INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[~ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
DATE ~/'~ ~/~ INSPECTOR~~/~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ !~PLBO.
[ ] FOUNDATION 2ND [)~]"iNSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FleERESiSTAHTC4X4S'mU~H~ j ] nBE~sL~r~rr~JeE'r~'no~
REMARKS:
DATE
INSPECTOR~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ii. FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT C0flS~UCTI~ [ ] FIRE RESISTANT PENETRATION
REMARKS: ~/~ /~ ~, ~
DATE
INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ~.~ELECTRICAL (FINAL)
REMARKS:
DATE / ~__/__~0
INSPECTOR~/~
~O~A~ON OST)
FOUNDATION (2ND)
· ~OU~H ~N~ ~
~NSULATION P~. N. Y.
STAT~ E~G'~ CODE
ADDITIONAL COMMENTS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined &/ff ,2d ~
Approved ~ /~, 20 ( O
Disapproved a/c
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
Surve~
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Stom~-Water Assessment Form
Contact:
Mail to:
Phone:
Expiration /~ '~ ,20 t /
Date May ., 20 10
~.. lflWU 0~
l~r, hi.~~ 8 t 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.
¢' 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, 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.
Richard Saetta General Contractor inc.
(Signature of applicant or name, if a corporation)
PO ROW ?flA7 ~roonpnrt Wy 11044
(Mailingaddressofapplicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
General Contractor
Name ofownerofpremises Joseph Borrelli
(As on the tax roll or latest deed)
If applicanLi&a corporatmn, sigit~t~re of duly authorized officer
~me~n~'tit~ of c~¢or~e officer)'
Builders License No. 13086HI
Plumbers License No. SA
Electricians License No. 3635E
Other Trade's License No. NA
1. Location of land on which proposed work will be done:
1000 Green Hill Lane
Greenport
House Number Streei
County Tax Map No. 1000 Section 33
Subdivision Eastern Shores
Hamlet
Block 03 Lot 07
Filed Map No. 5234 Lot 141
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residential
b. Intended use and occupancy. Residential
3. Nature ofwork (check which applicable): New Building_ Addition xx Alteration
Repair Removal Demolition Other Work
4. Estimated Cost $40.0OO.00 Fee
5. If dwelling, number of dwelling units NA
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. lq),
7. Dimensions of existing structures, if any: Front 59.5 Rear 59.5 .Depth 44.5
Height 28 Number of Stories 2
Dimensions of same structure with alterations or additions: Front 6.~,5 Rear 65
Depth 4 44.5 Height 28 Number of Stories 2
8. Dimensions of entire new construction: Front 65.5 Rear 65.5 .Depth 44.5
Height 28 Numberof Stories ?
9. Size of lot: Front 125 Rear 125,5 Depth 146
10. Date of Purchase 1997 Name of Former Owner
11. Zone or use district in which premises are situated Residential
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO~cI_
13. Will lot be re-graded? YES __ NO__Will excess fill be removed from premises? YES NO xx
14. Names of Owner of premisesJ°e Borrelli
Name of Architect
Name of Contractor RRichard Saetta
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
Phone No. 477-1384
Phone No
Phone No. 765-4900
Address Greenport
Address
Address Southold
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. ls this property within 300 feet of a tidal wetland? * YES NO xx
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
NO xx
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 xx
STATE OF NEW YORK)
O NTY OE
Richard Saetta being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Contractor
(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.
WENDY L. KUKLA
Notary Public, State of New York
Qualified in Suffolk County
Sw°r~ '5 '"-~be f°%tymoeihi~9,.~ ~ 20~ No. 01K0017~871
~ignature ({f Applicant
Tovm l-Iall Annex
54875 Main Road
P.O. Bo~ 1179
· Southold, NY 11971-0959
BUII I'~ING DEPARTMENT
TOWN O1~ ~OUTHOLD
APPL]CAT[ON FOP, ELIZCTR]CAL [NSPECT[ON
Company Name:
NO.:
Phone No.:
Date:
JOBSITE INFORMATION: (*Indicates required information)
*Address: ,~'cOO~ ~L~nT, ,JD~ ~ ~, ~,~
*Cross Street: ~ /
*Phone No.:
Permit No.: ':~ ~ ~ '~ C~
Tax Map District: 1000 Section:,
Block:
*BRIEF DESCRIPTION OF WORK (Please Print. Cleady)
Lot: 7
(Please Circle All: That Apply)
*Is.job ready for Inspection:
.*Do you need a Temp Certificate:
Temp'lnformation (If needed}-
*Service size: 1 Phase 3Phase 100
*New Service: 'Re-connect Underground
NO . Roug,
YES / NO
150 200
Number of Meters
Final
Additional Information:
82-Request for Inspection Form
PAYMENT DUE WITH APPLICATION . ,-~ ~ '~.,-,
300 350 400 Other
Change of Se~ce Overhead
.Town o_ f $outhold
Erosion, Sed,mentation & Storm-W~e_er Run-off ASSESSMENT FOK~.~
r~,G.,,,',:K~ · LOCATION: S.C.T.M. th. THE FOLLOWING ALq'lON$ 11~4,Y Rt:~'"a" THE SUnum~"'.',l O~: ~
.Item Numbec (NOTE: A Check Mark (~) for eacfl Quench Is.Required for a Complete Appllcalten) Yes No
~ .... run*on cma= oy s~e c~arl~ and/or ca~tru~o~ ~.
I~ and ~e ~n~t =~ of I~
2 ~, ~e ~ P~n ~ su~ ~ ~ P~d ~ ~ ~
~ ~ ~111~u~ afl P~ ~ ~s a~ ~ ~ 8~ Wa~ --
3 ~ ~ Pm~ R~u~ a~ ~ R~ng, Gmdl~ ~ ~ ~m ~m ~ a ~an~ to ~e NaOmi
~ng G~e Inm~ ~m ~n ~0 Cu~c YaMs ~ Mat~l ~ln any Pa~l?
4 ~i ~ ~p~flon R~ulm ~ DIs~ ~s ~ ~ ~a
Is ~ls ~Je~ ~fl ~e Trustees jedsdi~on ~ ~ln ~e Hu~red (1~') f~t of a Wefla~ or Bea~?
~1 ~e ~ SEe ~pam~ on ~sfl~ Grade Sl~es ~i~ ~ed Rfl~n (15) f~t of Ve~l ~ to
One Hued~ (100') of H~I DiVans?
6
7 Will. Driveways, Parking Areas or other Impervious Surfaces be S{oped to Direct Storm-Water Run-Off
Into and/or in the directfo~ of a Town fight-of-way?
8 Wilt this Project Require the Placement of Material. Removal of Vegetation and/or the ConstmcSon of
any Item Within the Town Right-of-Way or Road Shoulder Area?
(This item will NOT laclude the Installation o~ Driveway Aprons.)
9 ~rdl this Project Require Site Preparation within the O~e Hundred (100) Year Floodplain of any Watercourse? [~
NOTE: if Any Answer to Questions One through Nine Is Answered with a Check Mink In the Box, a Storm-Water, Gradlng,
Drainage & Erosion Control Plan is Required and Must be Submitted fro' Review Prior to Issuance of Any Bulifflng Pm'miff
EXEMPTION:.
Do~.s this project meet the mlntn~Jm standards for c~asslflcellon as an Ag~l Project?
N~e: If You Answerod Yes to this Quesifon, a Storm..Watar, Grodlng, Drainage & Erosion Control Plan is NO.r Requlredl
STATE OF NEV~ YORK, ~ _/,'~,/'~_ ] ~
COUNTY OF.....~..~..L~... ss
Yes N._..~o
And that he/she is &e ......... .~..a..~..~. :.r.. .~ ....................................................................
(OYmer. Cer~mc~, A~ Coq~a~ Offer. e~)
Owner ~or m~vc of ~e ~ of O~'s, ~d ~ d~y au~o~ m ~ffo~ or ~ ~o~ ~c ~d ~ ~d ~
~e ~d fie ~ ~pU~on; ~t ~ s~ con~ in ~ app~mdon ~ ~e ~ ~e ~ of~ ~o~ ~d ~ ~d
~t ~e ~& ~ ~ ~o~ed in &e ~aer set fo~ in ~e applica~on ~ed he~. WENDY L. ~
S~m to ~fore ~e ~s; . N~a~ Public, State of New Yo~
............. /. ............................. dayof .~ ~- 2 n Ouallf, e~in Suffolk Cou~
-. ............ .. ............... ................... .......... ......... ....................
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET I C)~)O VILLAGE DIST. SUB. LOT
~RM~R OWNER , N E ~- ACR.
$ W ~PE OF BUILDING
RES. ~lO / S~S. FARM CO~. CB. MICS. Mkt. Value
A~E BUILDING CONDITION O~~
N~ NORMAL BELOW ABOVE
FARM Acre Volue Per Vclue
Till=hie FRONTAGE ON WATER
W~l~nd FRONTAGE ON ROAD / ~ ~ ~
Me=dow~d DEPTH / ~,
Hou~ Plat BULKH~D
Total ~ D~K
,, %
~o~(~)
0%0
SURVEY OF
LOT 141
MAP OF
EASTERN SHORES
SECTION FIVE
FILE No. 5254 FILED DECEMBER 31. 1968
SITUA TED A T
GREENPORT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-55-05-07
SCALE 1"=20'
NOVEMBER 26, 1997
APRIL 24, 199B FOUNDATION LOCATION
OCTOBER 27, 1§9B FINAL SURVEY
AI~A = 19,086.22 sq. ff.
0.458 oc.
S.CDH,S No RIO 98 0003
CERTIFIED TO:
JOSEPH BORRELLI
UNALr~QRIZgD ALTERATION OR ADDITION
TO THIS SURVEY lB A VIO~T[ON OF
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
NYS Lic, No. 504B7
Nathan Taft Corwin III
Land Surveyor
PHONE (631)727-2090
OFFICES LOCATED AT
Fax (651)727-1727
97 498C
NOTIFY BUILDING DEPARTMENt ~
765-1802 8 AM TO 4 PM FOR TIlE
FOLLOWING iNSPECTIONS:
1. FOUNDATION -TWO REQUIRED
FOR pOURED CONCRETE
2, ROUGH - FRAMING, pLUMSING~
STRAPPING, ELECTRICAL & CAULKING
3 INSULATION
4 FINAL- CONSTRUCTION & ELECTRICAL
MUST BE COMPLETE FOR C O
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS,
RE~AIN STORM WATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
I
UNDERWRITERS cERTIFICATE
flEOUI~ED
ALL CONSTRL,,,, I, ,= :, ,, J L
,,, THE
MEET THE REQU;;:"-c
CODESOFNc ~ u .....,~TE.
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