HomeMy WebLinkAboutZ-27923FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 27923
Date: 09/07/01
TEIS CERTIFIES ttmmt the building
Location of Property 5075 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 125
subdivision
DWELLING
LAUREL
(STREET) (HAMLET)
Block 0001 Lot 013
Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCC[rPANCYi~3MBER Z- 27923 dated SEPTEMBER 7, 2001
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 ONE FAMILY DWELLING WITH ACCESSORY SHED *
The certificate is issued to HAROLD AVENT
of the aforesaid building.
(OWNER)
N/A
N/A
N/A
Aut~ized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
NAME OF OWNER (S}: ~AROLD AVENT
OCCUPANCY: A-1 RESIDENTIAL
AD~I'l-r~u BY: HAROLD AVENT
LAUREL
MAP NO.: LOT (S)
FLAROLD AVENT
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 125.-1-13
SOURCE OF P,~Q[~EST: RAROLD AVENT, 1/21/01 DATE: 09/07/01
ACCESSORY STRUCTURES:
WOOD FRAME
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P.E~: BP #27598-Z-COZ-27922 (STRUCTURAL REPAIR FLOOR)
INSPEci'~U BY:
DATE ON INSPECTION: 01/29/01
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
! /
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 o{ 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.
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 a 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 $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 of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Jam. 23, 200]
Date .........................................
New Construction ........... Old Or Pre-existing Building...;~ ............
Location of Property..~.~....~..~.. .......... .~..~.~.~.~ ............................
House No. Street Hamlet
Onwer or Owners of Property .... ~/~,..A~....~.~.~.~. ......................................
County Tax Map No i000, Section...~...O~. ...... Block .... ~2 ........ Lot...~./~ ..............
Subdivision ................................ -- · . Filed Map ............ Lot .................. ....
Permit No ............ .... Date Of Permit ............... . Applicant ............................ .
Health Dept. Approval .................... ... ... Underwriters Approval .........................
Planning Board Approval ...................... ..
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $.~0'00 .... ~ .~.~.,~. "~...~
CONSENT
TO
INSPECTION
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
· which is shown and designated on the Suffolk
County tax map as District 1000, Section /o~", Block O/ , Lot 0/2
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances,~rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any information obtained in the conduct o~
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
' ' (signature)
(print name)
(si~na[ure)
(print name)
.!r
June 20,2001
{1~ 7, Z5TM 1,7~'
_ 8-075"
Joseph Fischetti, PE
Professional Engineer
1725 Hobart Road
Southold~ New York,
631-765-2954
PROFESSIONAL ENGINEER
Mr. Gary Fish
Southold Building Department
Main Road
Southold, NY 11971
Date: June 27, 2001
Reference: Avent Property
Dear Mr. Fish,
With regard to the above referenced property, the design submitted was for the cellar
portion of the floor s~ructure only. No representation can be made as to the structural integrity of
the crawl space because of the limited visibility available.
· .I can not make neither positive nor negative representations as to the soundness of the
rcunammg portion of the floor structure. Ifa further i~pection reveals no negative indications,
such .as. floors not level, walls with cracks, doors that do not close, it be could assumed that the
mmmnmg smmture may not contain any defects. There can be no determinations of the
soundness of the floor structure without the complete removal of the floor surface to completely
inspect the sub-structure.
If you have any questions regarding this matter please call.
Fischetti, PE
AUGUST 8, 2001
AFTER iNSPECTING THE HOUSE AT 5075 MAIN ROAD, LAUREL, WE MADE
THE ACCOMPANYING DRAWING AND FOUND THE FOLLOWING:
1. THE HOUSE WAS BUILT APPROXIMETALY 1760 AND WAS BUILT
WITH THE LOCAL BUILDING MATERIALS OF THE TIME.
THE HOUSE HAS SETTLED OVER THE YEARS OVER THE OLD
CHIMNEY BASE, APPROXIMATELY 8' X 9', WHIClt DUE TO ITS SIZE,
HELD ITS OKIGiNAL HEIGHT. THE HOUSE SETTLED DOWN AROUND
THE CHIMNEY BASE AND SEEMS TO BE HOLDiNG ON A STATIONARY
CONDITION NOW.
THE VARIED SIZE FLOOR BEAMS AND GIRDERS HAVE SOMEWHAT
OF A SOFT SHELL ON THE OUTSIDE BUT ARE STILL SOLID iNSIDE.
SOME HAVE BEEN REPAIRED WITH NEWER 2" BEAMS SISTERED TO
THEM ON THE WEST SIDE
A SUBSTANTIAL REPAIR HAS BEEN MADE iN THE ROOT CELLAR
WITH A NEW SUPPORT SYSTEM.
5. WITH GOOD MAINTENANCE THE HOUSE SHOULD BE FINE.
P0L SEQ:
63
THE STATE INSURANCE FUND
199 Church Street New York, N.Y. 10007 (516) 233-3848
46E 4/01/2002 - 4/01/2003 585 4EIR
495 538-0
NEW YORK CONSTRUCTION CLASSIFICATION PREMIUM ADJUSTMENT PROGRAM
WORKERS COMPENSATION PREMrUM CREDIT APPLICATION
The New York Construction Classification Premium Adjustment Program is ~vaileble to qualified employers engaged in
200 East 42nd Street
Nm~v York, NY 10017
Attention: Auditing Division
WITHOUT AN APPLICATION, YOUR PREMIUM WILL NOT REFLECT ANy PREMIUM CREDIT. A NEW
APPLICA~TION MUST BE FILED EACH YEAR IN ORDER TO BE CONSIDERED FOR A PREMIUM
CREDIT UNDER THIS PROGRAM.
August 27, 2001
Building Department
Town of Southold
P.O. Box 1179
Southold, New York 11971
Diane Herold, Architect
P.O. Box 884
Westhampton Beach, New York 11978
RE: 5075 Mvfin RoM, Laurel
On August 3, 2001, Eroie Davis, Davis Bros. Engineering Corp., and I inspected thc
,foundation of H~rold and Loretta Avent's house m 5075 Mlfin Road, Laurel. ~ais
mspe¢fiun was made to ascertain the condition of the foundation and floor framing only
and provide tbe informA~un to the Town of Soulhold Building Department for purpos~
of review for the issuing of a Cer6fieat~ of Oceupaany for the blxiJdlng
Ralph Willi~rn~ of Orient end a reepected historlan in the area hM looked at the house
attd ~titrlolgd ~ or~nnl ~ dasd to t~ 17602. This beu~e is typical of houses of
tiffs age that havo sloping floors and doors tbet have been cut to flint slope. In pa~ieular,
the floors of this house slope away from the l~rge central fireplace foundation consisting
of solid rabble, brick z~:l stone. Tbe foundation below the orJ~-4nal section of the house
is stacked stone. The fo-na,6on below thc rear addition is cun~xe~ block creating a
cellar for the meehanicnl equipment and a crawl space. The original floor joi~ are henri-
hewn logs that ~e mortised into log girders. The floor joists in the rear addition are
fi-am mS to supper~ the deteriorated floor jois~
The ~sting foundation shows no evidence of continuing deterior~ion at this time and
hasstabili~,~l. Also, at this time, th¢floorjoistsareinstablvenndifion. For fl~ age of
the.house ~mt foundation, it is rcesonshle to expect l~e conditions that exist. With good
mmmenance, the house should confinun to have a stable foundation and floor ~
Sincerely,
Diane Hcrold
NEW YORK CONSTRUCTION CLASSIFICATION PREMIUM ADJUSTMENT PROGRAM
APPLICATION INSTRUCTIONS
1) ~De~r~nzi~e~. t~.c .classi~ication code appHcable to al.! emploveez of the business.
uo~ clerical workers, salespersons and executive officers (unless they are excluded
from coverage) but does t~t /oc/ude subcontractors and/or indePendent contractors.
oone so)~: ~ l?~s~ ~ludes both ,e/io~ble an~ f~on-eHo/b/e c]assificafion codes.
~)
For pOlicie~ effeCtive::Prior= to 4>/1/01, determine the total gross :wares (exe~ premi~
overt.fine pay, bonUSes, commi~qfo~S) and hOUrS worked for each,employee. Fo~ policies
.ef~ect~ on ~or afro. 4./01/01,.de?rmine the limited payroll (excluding ~miurn overtime
raY, oonuses, ¢0mm~z~10ns) alia n0urs wor~ for each~ empl0yee Performing commercial
~ork in ~.0.~? Wtt. rh. th? parr0.n t~t~t!o. ~w~ For empl~ ~ work o.
~ee or two~tamily ~e~ld.e,n,t~l. h0usmg% report the total gross *ages and h0ut~s worked.
~w:.progrnm uses me unr~ quarter ~July~ August and September) payrOlls as shown
Policy Inception Date
April 1, 2001 thru March 31, 2002
April 1, 2002 thru March 31, 2003
April 1, 2003 thru March 31, 200,1
April 1, 2004 thru March 31, 200~
Third Quarter Payroll
2000
2001
20O2
2003
sho~u~e~. _-,_~ .o~,nours ..~ ~? a~. nom- ~d 2 ho~ ~ S9~ ho~, the ~ploy~
mcmu~ on ~e appu~on ~or 42 ho~ ~ $6 ~r ho~ (~5~. ~e ~on~
$3 ~d for ~e 2 ho~ of over~e ~ ex~M~ ~ Io~ ~ the ~ ~o~ ~
pro~rly ~)
Total the payrolls and hom-s worked by classification code as well as by the type of
worked perf0rm~ (rsidential or ¢ommercialL List each applicable classification code on
the application showing the resident, ia] total payroll a~d the limited commercial payroll
on separate lines. This me~ns that the same classification code could appear twice on the
same application. Hours worked for non-eligible classification co~e~ are not required. The
~y~ol]s of ail employees are to ~ illchlded, eve~ tho~ ~.rnino an hourly wa~e that is
ess thall the minimtlm hourly wage for el~ibiHty under the ~rogram (current'iv $13 00
per hour), ~ '
The pr~ ~-ants credits bases on the a~erage hourly wage for thoze ctn~U'~c, nfions
codes ~lif~ible for the program. If an employer has more than one poUcy which can be
combined for experience rating pm-poses, include the total wages and [~our~ worked for all
policies on the application. An example of this would be wrap-up poHcie~
4) List each executive officer on a .~,/~a.,*a~e line showing the applicable classification COde
for each executive officer. Also indicate each executive officer's title.
5) List the actual quarterly wages for each executive officer. The Potting Board will make
any adjustment for minimHlll ~lld maximum wages when the application is proc. e~
Iclna~l~ ~ ex. ecu~ve officer for 520 hours If they are ¢las~ied LmdeF a~ eligible
assulca*oon coae. rrom, s wor~ed are not necessary if the executive officer is class~ied
undeF an ineligible classification code.
6~ Sign and~ date the appUcation and mail the applicatlon to.'
New YorkCompensation In~tranceRating Board
200 ,zt42nd Street
New--~rk. NY 10017
Ar m Audtt Delmrtment
(SEE RE,tERSE SIDE)
AUGUST 8, 2001
AFTER INSPECTING THE HOUSE AT 5075 MAIN ROAD, LAUREL, WE MADE
THE ACCOMPANYING DRAWING AND FOUND THE FOLLOWING:
1. THE HOUSE WAS BUILT AFPROXIMETALY 1760 AND WAS BUILT
WITH THE LOCAL BUILDING MATER/ALS OF THE TIME.
THE HOUSE HAS SETTLED OVER 7HE YEARS OVER THE OLD
CHIMNEY BASE, APPROXIMATELY 8' X 9'; WHICH DUE TO ITS SIZE,
HELD ITS ORIGINAL HEIGHT. THE HOUSE SETTLED DOWN AROUND
THE CHIMNEY BASE AND SEEMS TO BE HOLDING ON A STATIONARY
CONDITION NOW.
THE VAR/ED SIZE FLOOR BEAMS AND GIRDERS HAVE SOMEWHAT
OF A SOFT SHELL ON THE OUTSIDE BUT ARE STILL SOLID INSIDE.
SOME HAVE BEEN REPAIRED WITH NEWER 2" BEAMS SISTERED TO
THEM ON THE WEST SIDE
4. A SUBSTANTIAL REPAIR HAS BEEN MADE IN THE ROOT CELLAR
WITH A NEW SI~PORT SYSTEM.
5. WITH GOOD MAIN iENANCE THE HOUSE SHOULD BE FINE.