HomeMy WebLinkAbout40159-Z � ,o D Town of Southold 10/28/2015
ff G�� P.O.Box 1179
;,v 53095 Main Rd
_ VI * Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 37868 Date: 10/28/2015
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 280 Madison St, Greenport
SCTM#: 473889 Sec/Block/Lot: 33.-5-23
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/30/2015 pursuant to which Building Permit No. 40159 dated 10/7/2015
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"recreation room in basement(constructed in 1965)and deck addition to an existing one family dwelling as
applied for.
The certificate is issued to Madison Street Kids LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Auto ' ed S' nature
TOWN OF SOUTHOLD_ _
NA oma`: BUILDING DEPARTMENT
�� ts
1.41TOWN CLERK'S OFFICE
11 SOUTHOLD, NY
*
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 40159 Date: 10/7/2015
Permission is hereby granted to:
Madison Street Kids LLC
3120 Albertson Ln
Greenport, NY 11944
To: legalize an as built finished basement (recreation room) as applied for.
At premises located at:
280 Madison St, Greenport
SCTM # 473889
Sec/Block/Lot# 33.-5-23
Pursuant to application dated 9/30/2015 and approved by the Building Inspector.
To expire on 4/7/2017.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $764.80
CO -ALTERATION TO DWELLING $50.00
$814.80
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Buildin,Inspector
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 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 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
Date. 2.cl' SePir '24l yr
New Construction: Old or Pre-existing Building: %no, (check one)
Location of Property: / 6441,4S4-00 g.',Lem Az�'�`'
House No. Street Hamlet
Owner or Owners of Property: OOld V7VLC 'T S KV bS
Suffolk County Tax Map No 1000, Section 413, Block Lot 2a,
Subdivision Filed Map. Lot:
Permit No. qo L 5 9 Date of Permit. Applicant: R., IFIAccadorr po.
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ '1, 5000 O0b
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Applicant Signature
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] ULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: 1./ cto
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DATE f INSPECTOR
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT you have or need the following'before applying?
TOWN HALL ' . . r ... ,--: • :,--,- -'-:-, ''• • ,Boa'rill'O01ealth * • 'I '' '
,. „ .•
SOUTHOLD, NY 11971 4iets4Bililding Plans' I ' -
TEL: (631) 765-1802 Planning Board approval I
FAX: (631) 765-9502 . . - - , , F.,.... . Sin-Vs6y I
SoutholdTown.NorthFork.net PERMIT NO. .15-.7 ' , Check . I
.. .. i . !'Septic Form ' ' '''' •i
A 4/ ,,,, N.Y.S.D.E.C. `• I
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1 Trukees
, C.O.Application
Flood Permit I
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Examined /i ',,20 ", • Single&Separate !
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Storm-Water Assessment Form
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Contact: ' 1
Approved ,20 •, S ''' ML to: g. S 4,12-alert'T
tioZetS VAINSTO kJ 1 tar,.Cul(i4004
Disapproved a/c
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"dap' Phone: igal.--714.P.— Z:110
Expiration ,20 27--' <,„
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• Li -P-PLIC-ATICIN TORSTALDPIOVERIVIIT.' -
SEP 3 .0 2015 i _ 5 „: . .- ,5._ •,,,,,, lc , 1
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L_DC,DEP r ' ' ' - -- ' INSTRUCTIONS:----7'
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a. This application MUST be completely filled in byty,fieWitaf'or idinkf'afid.submitted to‘the Building Inspeetor with 4,
sets of plans, accurate plot plan to scale. Fee according to schedule.
b._Plot plan showing-location of lot and ofbuildings._on_prerniserelationship to adjoining premiSes or public streets or
areas, and waterways. I
c. The work covered by thisqpplicationinay,a,idt,be conripenced,beforsriance:of.Building Permit. I
d. Upon approval of this application,the Building Inspector will issue a Building Permit to the apPlicantI Such a permit
shall be kept on the premisesvailaNe,for inspectionthroughotiit-thqvg,ork, , „ •' . -,• S , . . •,
e. No building Shall:be occUpied"difuS'ed in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occup,ancy. _ , - , , .
f. Every building permit shall expire if the' bi•W.a.iathoriiel' i ri-of CoM`Mended within 12 months after the date of
issuance or has not been completed within 18-months from sucli:date,',Ifpgzoning amendments or other regulatiOns affecting the
property have been enacted hi the-interim,the Building Inspecfdr;YnaYauthorize; in writing,the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS:HEREBY MADE46:-.th ,BuildirigOepiaiiiment fdr the issuance Of a Building Permit pursuant to the
Building Zone Ordinance of the ToWn,of SptithdialiSii,f911(CiinrityldieW 71•Ork?,-ariCI:Otherapplicable Laws,,Ordinances'or
Regulations,for the construction of buildings, additions, or alteerp.tidni'd4Orremoval or demolition as herein described.The
applicant agrees to comply with all applicable laws, ordinances,bui1ding'p:?cle'ithou-sing Ode, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
.„ ,.,
" . - " :' 1.7 , ,e- . , OP
-
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• , (Signature of applicant or name,if a corporation)
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S . 4 4.200(1„vAmserO
ew A ... CVICIR-41:4 U e
_ . 5 - Nailing'.iddres's'Of applicant);
State whether applicant is owner, lessee, agent, architect enginee)general contractor, electrician, plutber or builder
. ,
Name of owner of premises, M.A-Otc.coSt ,Ilritzer. Ka 115 ,,LLec,
(A's"on'the fax.r911,or.iatest,4eed).i,
,
If a 'cant is a core er7 ican, signature of duly authorized officer
. __ . _ . . . _ .
• i
(Name aá titl- o .rporate officer)
Builders License No. . . '
,., ,
Plumbers'License No. , ; . , v ,..,'. ,, , • ,-,,, • „
-.,• -1,,
.
Electricians LiCense*No. se.ss E. ''' .-sAc.E:r. ‘ !' ' 5' _ ,.
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Other Trade's License No. , 5 - S
1. Location of land on which proposed work will be done:
Is foxy t sow; ST-ceei' 4 getw 9 al' 1 t ct 44 Si SI
House Number Street - Hamlet ,
., i---!:3'01.-(:,.1 ....",: ..1'). .i7T • ,
. .
County Tax Map No. 1000 Section 33 Blo,.,...,,ipk . ..,I_„,,I ,'in;if •
-„,,, w . ,-, ' ' ----'' Lot
.•),iu--i I --• t,,c J-11-it.LAuc,
t.,c':1;;Ic; '':.,1,/:'JI:;51;IM',17,
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 �.tt A.14/—.0 MI L.(, AtZtalt4
b. Intended use and occupancy SA Me
3. Nature of work (check which�ap.plicable): New Building ' _ Addition Alteration V!'"
Repair Removal, Demolition Other Work PIADUtkith ITEC A04314
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of'dwelling units (l Number of dwelling units on each-floor 1
If garage;'number'of cars' ' j t
6. If business, commercial or mixed.occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Gail Rear 444 Depth 2..:419
Height ''"Number of Stories I
Dimensions of same structure with alterations or additions: Front 6o 'Rear 6tti
Depth 2 tom" Height ,t ..,:; Number of Stories
8. Dimensions of entire new construction:;Front:., j,;F ,`�,t l,.� " WRe'ar itl tU .�` .Depth 24+
Height 10)t Numbof"Stories .. ` ' '1 ;)
9. Size of lot: Front la I' Rear . ;IOC&fl, . . Depth /3)% 4v/04.s44-te
10. Date of Purchase S/5/1114-- • Name of•Form'er,.owner ' ' b .re. .cemz A,1:7-04 I
11. Zone or use district in which premises are situated"_:.:' ., • 'REetoe-A f . •
12, Does proposed construction';violate any,zoning law„ ordinarice'or:regulation?,YES• ' NO�'
13. Will lot be re-graded'? YES NO V Will excess fill•be~removed' is 's? YES a/
• � , � , „ , fromiprem e E NO
It 444,tottoN CO'
14. Names of Owner of premises 44c._ :• .Address :,14;t2E.em Quer . . •Phone No.
, MINIM
Name of Architect ..1.,:. , •' .`,Address.` `<';:,i, ,', Phone No
Name of Contractor '1 .. • -none No.'
15 a. Is this property within 100 feet of a tidal wetland;or:a:�frdshwaterwetland?,W.ES`•.,:•,;•'!NO ✓
* IF YES, SOUTHOLD TOWI ,TRUSTEES'&�D:F Ct;PERIvIITS'MA:•Y`�B=EIREQUIRED.- • .
' N
b. is this property'within'•300';feet”of a'tidalwetland?. lYES?''L '
* IF YES, D:E.C:,PERMITS MAY`BE•REQUIRED:` "{_.., ' " '
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point oii'property•i's'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 i
STATE OF NEW YORK)
SS:
COUNTY OF61K ) - -
ob acirca±, _ beingduly,sW;orn' , deposesand says that(s)he is the-applicant
(Name of individual signing contract) above named; •
(S)He is the
(Contract r,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 true 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.
Sworn to before me this
day of .p- ri+ r. - , 2015
f - -
Cej
Notary Pu. 'c TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK Signature of Applicant
NO.01 DW6306900--•. <• .
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2.0&
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TOWN OF SOUTHOLD PROPERTY REC9RD CARD
OWNER?"' ,-,---- 1 STREET Zg- ;) VILLAGE DISTRICT SUB. LOT
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LAND IMP. TOTAL DATE REMARKS .
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HEAD ROorl ,
. S.7 s F AREA Live load 40 psf, Dead load 10 psf,Snow load 20 psf
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� �M, Design code: NYS residential code 1965 or later for improvements
K." D V/ W Atm. °Veit. 2,`1+44-,0C34
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5Tt�®s . �/1411U LAT/D $6Tw$E N S'Tu� R
s "3 ,/.44104Materials:
• t'Aut40.p.i 44 t ;EStt�ss Footings: 6in thick concrete aft below grade
• Y' - f3ws�'+kQ,nr r Cioo ti A Foundations: Concrete block and concrete slab at grade
ST4Ps Studs and base plates: 2in x 4in timber
AS-6V st.X' %ASS- PGOA OLPIM'"A'~Rr4OtO V m44• Insulation: R13 between studs
H s AT, 1N 4 0 Headers and Joists:2in x Bin
I— — — _. _ a __
, r --.----T -----r-7:-:. Drop ceiling: Client choice
I ® =3 -� --� Windows and doors: Client choice
t+'� 5r0� H:It:
Egress Window: Client choice
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. 1 W G ` *Day Building C O fee$5 it fee-as built=two times normal1 S tt FI' �1 I; •
�y I' 1 ' ELfCTMC.At_ 1 ra srectto�SCt $V1`DIW 4 PAaMt't 3qq to3
�( Ci�►Ra4GE : cINtSHIED REC. [2.�oM �t LN-FlNt5MED SA ,
1oN la ,� _ 4sc ,ISLAS cvfER. f 1 APPROVED AS NC 7- ,
' DATE:/Q ' ;Sill'.#-/°(-----1e- •pRyFEE:_ '�.__V___' _ BY •
I 8A R., NOTIF BUILDING D� +r ATI / 765 1802 8 AM TO •.%R THE ;IlCLVSC'"r FOLLOWING INSPEC .
L — .___ — — — -- _ 1. FOUNDATION - Tv>> iEQUIRED .
_ - FOR POURED C ,TETE
• ��� 2. ROUGH - FRAMIN3 & PLUMBING
CO , ,� Fj ,,;-� ODES OF 3. INSULATION
NE��, •���,�� STATE;;E TOWN CODES 4. FINAL - CONN UCTION MUST
AS REQUIRED :, n •"a III s" BE COMPLETE_ =0R C.O.
_ ALL CONSTRUCTION SHALL MEET THE
• 0 2 4 6 I 1 o zo F} ' IN �' ' REQUIREMENTS OF THE CODES OF NEW
LAS �1 J .1 1 1 1 1 YORK STATE. NOT RESPONSIBLE FOR
"�" `- DESIGN OR CONSTRUCTION ERRORS.
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C.\\,,,s% RAgent: Mariah Mills NCV ®wta No �q 2�f� '1- R 0 BAddress: 13 Madison Stree Green ort NY 11944 :' CUPA �A.SSE IS UNLA REV No o .SCTM #:1000-33 -5-23 Robert ® Barratt Title: As-built rec room ®, t,taAWN SY FLo� �u •. Professional Engineer
4295 Vanston RdIT�11'U� CERTIFICATE � ��Cutchogue These plans are an instrument of the service and are the property of the design professional whose seal is affixed CHECKED �4t ��
NY 11935 hereto.Infringements will be prosecuted to the fullest extent of the law.Contractor shall verify all field + OF OCCUPANCY -conditions and dimensions and be solelyresponsible for field fit.The desi n rofessional assumes no liabili for it _ A
Phone 631 875 0275 omissions due to unknown or unforeseen field conditions and or additions based upon comments not formally F O
y __—. —, SCALE g 4=, ��. /.
Fax 631 734 2730 acknowledged as revisions to these plans -/