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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.