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HomeMy WebLinkAbout35384-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY 6/24/2011 No: 35023 Date: 6/24/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: RESIDENTIAL ALTERATION 510 Cedar Drive, Southold, Sec/Block/Lot: 78.-9-7 Filed Map No. conforms substantially to the Application for Building Permit heretofore 3/5/2010 pursuant to which Building Permit No. 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: minor alteration to an existin~ one family dwelling as applied for. Lot No. filed in this officed dated 35384 dated 3/12/2010 The certificate is issued to Gibson, Jonathan & Gibson, Heather (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 35384 6/10/11 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. 35384 Z Date MARCH 12, 2010 Permission is hereby granted to: JONATHAN GIBSON 510 CEDAR DRIVE SOUTHOLD,NY 11971 for : MINOR ALTERATION TO AN EXISTING DWELLING AS APPLIED FOR at premises located at 510 CEDAR DR County Tax Map No. 473889 Section 078 Block pursuant to application dated MARCH 5, 2010 Building Inspector to exl~ire on SEPTEMBER 12, SOUTHOLD 0009 Lot No. 007 and approved by the 2011. Fee $ 200.00 / - Autho~i~d ~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 property with accurate location of all buildings, property lines, streets, and unusual naturat 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 o f completed site plan requirements. 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 $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: Old or Pre-existing Building: Location of eroperty: C[~--~ ~' ~"~ q__ ~)('l~a,_ House No. Street Owner or Owners ofProperty: ~'~fxO.~T),~,. pc~ Suffolk County Tax Map No 1000, Section ~ c.% Subdivision Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Foe Submitted: $ Date of Permit. (check one) Block ~ Lot Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: (check one) Apphcant S~gnatm e 'l'ox~, Hall 51373 Main Road P.O. Box 1179 Soulhohl, N'x 11971 Tclcphollt' (63 ] ) 765-18()~2 Fax ((it4 l) 765-9502 ro.qer, richertC, town southo d.ny.us 1~,1 qLI)IN(; I)I,;I'AIITMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Gibson Address: 510 Cedar Dr City: Southold St: NY Zip: 11971 Building Permit #: 35384 Section: Block: Lot: 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 ASic Garage INVENTORY Service 3 ph Hot Water GFCl Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: paddle fan-1 Ceiling Fixtures [~ RWeacl le: isX; r: iSx t u r e s ~ Fluorescent Fixture ~.~ Emergency Fixtures~_ Exit Fixtures L HID Fixtures Smoke Detectors CO Detectors Pumps Time Clocks TVSS Notes: Inspector Signature: Date: June 10 2011 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG.  [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION REMARKS: ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 INSPECTION [ ]FOUNDATION 15T [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ p~SSULATION [ ] FINAL [ ) FIRE SAFEI'Y INSPECTION [ ].RERESb'T4#TCO.S'mUCI'~O. [ ]F~RE.ES~STJ~n'~ETR~'nO. RE.ARKS: /.~ ~~/~ r~ DATE ~ INSPECTOR INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] ~l~.,~"r~r~m~t~rm~ [ [ ] ROUGH PLBG. [ ] IN~ATION [ ',~INAL [ ] FIRE SAFETY INSPECTION ] RI~ RESIS'rAm' I'BIETRATION REMARKS: INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND I ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [~- ELECTRICAL (FINAL) REMARKS: DATE ~-~/~ INSPECTOR~ MAR-11-~010 11:~6 FROM: T0:1631765950~ P.1 a design studio MAR 11 2010 BLDG. DEP]. TOWN OF SOUTHOd) ~--~x: (~t6) 971-0979 TO: Town of Southold March 11, 2010 Town I-Iall 53095 Main Road Southold, NY 11971 Attn: Pat RE: Gibson Residence 510 Cedar Lane Southold, NY To Whom It May Concern, The following modifications have been to above-mentioned project in the field: Hurricane strapping has been added to the existing wall / ra~er connections on every raiter, which are 16" o.c.. 2. 20% of the east and south wall were repaired due to termite and mold damage. If you should have any questions regarding any of the items listed above, please feel fi'ce to call me at my office. Registered Architect - NYS License No. 027126 FIELD mspECTI/oN, RgPORT DATE FO~A~ON (lS~ . ROUGH ~G & STATE E~R~ CODE ~D~ION~ COmNTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined ~ //O , 20 ! o Approved ~/{t) , 20/O Disapproved a/c Expiration ~(~, 20 t I PERMIT NO. BUILDING PERMIT APPLICATION CIIECKLIST Do you have or need the following, betbre applying'? Board of Health 74 sets of Building Plans Planning Board approval Survey_ ~'heck eptic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Building Inspector ~=, ~ ~ ~ ~ 5~PPLICATION FORBUILDING PERMIT ~A[I 5 2010 I ~L.~ [ Date ,20 [ J I1I INSTRUCTIONS - ' 'h~s a ~.~ST be completely filled in by typewriter or in mk and submitted to the Building Inspector with 4 sets, ~ '::: ~- v,~. ,s ucme. ree 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 wate~ays. c. The work covered by this application may not be commenced befbre issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such a pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pad for any pu¢ose what so ever until the Building Inspector issues a Ceaificate of Occupancy. L Eve~ building pe~it 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 re~lations affecting the propeay have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pemit for an addition six months. Thereaaer, a new permit shall be required. ~PLICATION IS HEREBY MADE to the Building Depaament/hr the issuance of a Building Pe~it pursuant ;o the Building Zone Ordinance of the Town of Southold, Suflblk 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 regulati~, and to admit authorized inspectors on premises and in building for necessa~ inspections. ~ [ / ~ /] (Signature of applicant or ~me, ifa co~orafion) '(M~iling a~dre~s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises 3"-'""~-Oo 0f~. (_q~LSOkX (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. Plumbers LicenseNo. Electricians License No. Other Trade's License No. Location ofla~h proposed work will be done: House Number Street Hamlet CountyTax Map No. 1000 Section ~"-~ Subdivision Lot ¢ '-'/ Lot 2. State existing use and occupancy of premises and intendqt a. Existing use and occupancy ~'~'-~~ b. Intended use and occupancy_ use and occupancy of proposed construetion: 3. Nature of~voj;k (check which applicable): New Building Repair x~ Removal Demolition / 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (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, ir'any: Front ~_-~' O~. Rear Height Number of Stories 10. Date of Purchase Dimensions of same structure with alterations or additions: Front ,: Depth I ~ c,_ Height Number of 8~or4es, Dimensions of entire new construction: Front Rear Height Number of Stories Size of lot: Front I(~OO Rear IC10© Depth Name of Former Owner _Depth ~) ~" 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~i 13. Will lot be re-graded? YES NO__ Will excess fill be removed from premises? YES__ NO ~ ' 14. Names of Owner of premises ~ o r~ff~n~xr~ ~ .(-~,~a"dress~_/~. ~l~,r t2~',v¢ <Lea~lJ pl~one No. G3 J ."](og%~"]~g, Name of Architect,,~SI~x~"O ~ "'~[- Address ['~/--/¥f-~..~Phone No {~o)~- l~ff~[ Name of Contractor Address~ 1~ Phone No. 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 B~EQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOrdx * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO?( 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 NO · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) · 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 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. S~gnature ofApp ~cant ,-. ?..", TOWN OF SOUTHOLD PROPERTY RECORD CA_R? TYPE OF BUILDING VL COMM. CB. MISC. Mkt. Value SEAS. LAND IMP. TOTAL DATE REMARKS NEW NORMAL BELOW ABOVE FA PJ'A Acre Value Per Volue Acre Tillable 1 Tillable 2 ,0 RONTAGE ON WATER ~ONTAGE ON ROAD Tillable 3 Woodland Swampland Brushlond House Plot Total )EPTH BULKHEAD DOCK -[ M. Bldg. Extension Extension Extension Porch Breezeway 6arage Patio o. B. Total 'Foundation Basement Ext. Walls ,.Recreation Roorr Bath Floors Interior Finish Fire Place Heat ~i , Type Roof Rooms 1st Floor Rooms 2nd Floor Dormer Driveway Tow_ __n_n o_ f $outhold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM ~o~a~.~,mo~ S.C.T.,.~. ,-~ ~E FO~NG A~ON8 ~y ~QUI~ ~E 6U~N OF A ~"G DRAINAGE AND EROSION CONTROL PLAN CERTIFIED YADESIG. R0 ESSIONAI. IN Itera Number: (NOTE: A Check Mark (~) fo~ eaah Qeastlea IS Requlrad for a Complete Appllcetiea) Yes No Will this Projec~ Retain All Storm-Water Run.Off Gecerated by a Two (2") Incfl Rainfall on Site? v'/ r'~ (This item will include all mn-off ereatad by site clearing and/or constmcfiea ac~r~les as well as all Site Irnpmveroects and the permanent creation of Impe~4ous surfaces.) r:ces the Site plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Loceitee? -L~r~ This Item shall Include all Proposed Grade Changes and Slopes Controlling Surface Wate~--Iowi -- Will this Project Requlra any Land Filling, Grading or Excevation where there Is a change to the Natural r'~ Existing Grade Involving mom than 200 Cubic Yards of Martial withln any Parcel? -- Will thIs Appitceflec Requira Land Disturbing ACl~s Eneompesalng aa Area In Excess of r'~ Five Thousand (5,000) Square Feet of Gro~ Surfiaon? __ Is thi* Project within the lrosteas |urisdiotion or within Oee Htmdrad {100') feat of a Wallund or Boach? OneWill thereHundredbe Site(100,)preparatieaof Horizontal°n ExistingDistance?Grade Slopes which Exceed Fifteen (15) feet of Vertical R/se to Will Driveways, Paddng Areas or other Impemious Sulfaces be Sloped to Direct Storm-Water Run-Off . Will this Project Require the Placement of Ma~edal, Removal of Vegetatiee and/er the Construction of r'~ any Item Within the Town Right-of-Way or Road Shoulder Area? L~ ~/-- (This Itaro will NOT Include lite Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Walemouroe? NOTE: If An)' Answer to Questions One through Nine LS Answered with a Check Mark In the Box, a Storm-Water, Grading, Drathag~ & Eruslon Control Plan Is Required and Must be Subroltted for Review Prior to Issuance of Any Bdildthg Perollti 9 EXEMPTION: Yes No Does this project meet the minirouro standards for dasalitcetkxl as an ,~4]flcuitural Pm~'? Note: If You Answered Yes to this Question, e Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Requlredl __ ~ STATE OF NEW YORK, ./ ..... ......... ss That i, ""~"'" "~"'"'"~"-"~-'"."~..~;~X - ..~.. ' being duly swam, de'poses and says that he/she is dte applicant £or Permi (N~o~di~~ ~- . ~ , ~d ~at he/she is (~, No~ Public: .......................................................................................... ...................... ~ORM - 06/07 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 119714)959 Telephone (631) 765-1802 ro,q er. richortdt~w(~s) oT~'l~o~l.ny, us TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Date: Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Cross Street: ~ ~ tG gC~%~; ~ . . Tax Map District: 1000 Section: Block: *BRIEF DESCRIPTION OF WORK (Please Pdnt Clearly) Lot: · (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed] *Service Size: I Phase *New Service: Re-connect Additional Information: ~ NO Rough In ~..~_Fi_~n~J ..~ YES / NO 3Phase 100 150 200 300 350 400 Other Underground Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form P.O. P,o× 1179 SoulllohL NY 1 Tclcphonc (631) 76.%1802 l:ax (631) 76,3-9302 BI!III)IN(; I)EPARTMI']NT TOWN OF SOUTHOLD January 25, 2011 Jonathan Gibson 510 Cedar Drive Southold, NY 11971 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 $50.00. __ Final Health Department approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ 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:: 35384-Z alteration TITLE NO 69S O0 SURVEY FOR SUSAN d RIKER AT BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY~ N, Y SCALE: II'= 30' MAR 25, 1969 REFERENCE MAP OF BAYSIDE PARK FILED MAR li~ 195;3~ FILE NO 2034 SUARANTEED TO HOME TITLE DIVISION CHICAGO ~TLE INSURANCE CO. SUSAN J RIKER LAND SURVEYOR N, Y S. LIC. NO E87',~5 RIVERHEAD; N Y GIBSON RESIDENCE EXIST. SLAB-Oq GRADE EXIST. 51. AB-Oq GRAPE EXIST. CELLAR N~ FOUN~,,T[ON PLAN SCALE: I/4 = I-~ 510 CEDAR LANE . SOUTHOLD, NEW YORK ~ ~ MOLD and ~1~ D~E I I [ , I I~ I . I ,,- ~/ / WlTH~;~T ~,~l~mT~m'mx~ ', / , CODESOFNE~YGtKSFATE. I ,.,I ~ -- ._~, , ,,_~. ¢ E D A ~I A N E CEaTiFICATiO~OF I ~'l / ~ NAILING & CONNECTION ~.~ 51TE PLAN / zl 7,~ I ~l Z EXIST. EEPE~ ~ EXIST. BED~ M EXIST. KITCM~ EXIST.