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HomeMy WebLinkAbout28066-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28462 Date: 05/24/02 T}{IS u~RTIFIES that the building NEW DWELLING Location of Property: 810 GREENFIELDS LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Ta_x Map No. 473889 Section 63 Block 5 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 30, 2002 pursuant to which Building Permit No. 28066-Z dated FEBRUARY 4, 2002 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 COVERED FRONT PORCH AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to ZOUMAS CONTRACTING CORP (OWNER) of the aforesaid building. SUFFOLK CO~ DEPARTMENT OF I{EALTI{ APPROV;%L R10-01-0228 ELECR~RICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'l'~a3 Rev. 1/81 05/07/02 05/06/02 1044733 05/06/02 HI-TECH PLUMBING 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. 28066 Z Date FEBRUARY 4, 2002 Permission is hereby granted to: ANTHONY & WF MEZZAPELLE 156 NORTH TITMUS DR MASTIC,NY 11950 for : CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTATCHED TWO CAR GARAGE AS APPLIED FOR at premises located at 810 GREENFIELDS LA SOUTHOLD County Tax Map No. 473889 Section 063 Block 0005 Lot No. 022 pursuant to application dated JANUARY 30, 2002 and approved by the Building Inspector. Fee $ 1,045.20 COPY Rev. 2/19/98 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 follt : A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual na 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% 5. Commercial building, industrial building, multiple residences and similar buildings and installations,.. ~ :ficate of Code Compliance from architect or engineer responsible for the building. 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" ,:; i uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topogn~ i ! z features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate ofC~ z ?ancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelli~ ~ $ i:-i.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Busines,,. :i 0.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cormnercial $15.00 New Construction: Location of Property: t) or Pre-existing Building: . (check Old one) House No. Street Hun Owner or Owners of Property: Suffolk County Tax Map No 1000, Section ~> ,~ Block Subdivision m PrO OF ~O~lt6l~D~ ,~'-'qO~ct~ FiledMap. Date °f Pennit.~O 7,--- Applicani: Underwriters Appro.val: Lot Vermit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fe~ Submitted: $ '~. ~'-.00 Final Certificate: (check one) Town Hail, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 5 ~823 Telephone (6. ~ ~5-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Building Permit No. Owner: ~9~.~/~-~ (please print) (please print) Plumber: I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day of /t/,~¢)/ , 20o~, Notary Public, ~tt F I~LI( County " BUREAU OF ELECTRICITY ' 4o FuL -o S-m -ET - NEW YORK, NY OO3S CERTIFIES TItAT Upon the application of upon premises owned by DOUBLE-POLE ELECTRIC P.O. BOX 147 PATCHOGUE, NY 11772-0147, Located at Application Number: 1044733 Section: Block: Described as a Residential ZOUMAS HOMES GREEFIELD LANE SOUTHOLD, NY 11971 GREEFIELD LANE SOUTHOLD, NY 11971 Certificate Number: 1044733 Lot: Building Permit:28006 BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Attached Garage, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 6th Day of May, 2002. Name QTY Rate Rating Circuit Type Alarm and Emergency Equipment Sensor 1 0 Carbon Monoxide Sensor 5 0 Heat Appliances and Accessories Furnace 1 0 Oil Range 1 0 40 Amps Dish Washer 1 0 1.2 KW Exhaust Fan 1 0 F.H.P. Wiring and Devices Receptacle 39 0 General Purpose Switch 29 0 General Purpose Fixtm'e 36 0 Incandescent Paddle Fan 4 0 Receptacle 6 0 GFCI Receptacle 1 0 20 amp Laundry Receptacle 1 0 30 amp Dryer Service 1 Phase 3W seal Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE . YORK BOARD OF FIRE UNDERWRITERS ;', BUREAU OF ELECTRICITY 40 FULTON STREET - NEW ¥ORI<, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by DOUBLE-POLE ELECTRIC P.O. BOX 147 PATCHOGUE, NY 11772-0147, Located at Application Number: 1044733 Section: Block: Described as a Residential GREEFIELD LANE SOUTHOLD, NY 11971 Lot: ZOUMAS HOMES GREEFIELD LANE SOUTHOLD, NY 11971 Certificate Number: 1044733 Building Permit:28006 BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Attached Garage, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 6th Day of May, 2002. Name QTY Rate Rating Circuit Type Service Disconnect: 1 200 cb Meters: 1 seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised sear at the location indicated. STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) c../VtcoS/A , being duly sworn, deposes and says: That deponent is over the age of 18 years and resides at That on the ~--' day of ,)4~doA~.~'/Zoo,z.200g..deponent architec_.____~Vengineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York. State Fire Prevention and Building Code (9 NYCRR); said plans pedain to properly located at SCTM#- 1OO0- ~,Z,- _q'- ~ Z..- ~~ Not~ ~b~, StYe of NewYo~ __~/e~n~eer ~~ Qualified In Suffolk County ~ Appointment Exp~ _~r~.0,.3J07/2,~0J Sworn lo ~[oro mo this cc: Applicant BUILDING PERMIT EXAMINER CHECK LiST SCTM# DISTRICT: 1,000 SECTION: ~ BLOCK: DATE REVIEWED: t / $ t/02 DATE SUBMITTED: I //~o/02 LOT: CITY:%owaxto c.~ DESCRIPTION: APPROVALS REQUIRED SUBD1V. NAME: PROJECT DESCRIPTION: ~ki'-~00~d~ ESTIMATED PROJECT COST: $ 1~'o~ ,o o ARCHITECT / ENGINEER: ~/~:~ $/~i~ FASTTRACK? S~GLE & SEP~TE CERT~ICATION-~Q~D? ~o NOTES: /.~ ~TS 40,000SF-100-24, ~t reco~ition.(C~ATED before June 30, 1983), ~DERS~ED ~ FROM J~.1997 ~0~5. Merger.(A nonc~o~ing at anytime afl~ 7/1/8 ZO~G DIST~CT:~ ~-~ COlOr'G? ~Q. LOT S~E: ~ o ~Z~ ACT. LOT S2E: .~Q. LOT COV.~-ff ACT. LOT COV. ~Q. FRONT _~ PROP- FRONT ~ ~Q S~E /~Z,~ ACT. SDE ~Q. ~ ~o PROP. ~ ~ /ff~- ZOO: ff / SUFFOLK COUNTY DEPT(,.T..~r NO, (BED #):~__ DTE: HEALTH TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: ~'m~-DEC 9a/7~. YES o~ SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES ort TOWN PLAN. BOARD APPROVAL: YES o~ TOWN HISTORICAL PRE (SPLIA): YES o~ NYS ENERGY: YES OR ~ ,.-- ~t~', ,,~ EGRESS (18 H min'? 4 sq t~-~al) ~~- k 4°/o) / J/~~~. x 8%) BUILDING PERMITS OPEN/EXPIRED: gP' ' -Z/.12Z0 ~- N k, Q.__'/~ HAVE PRE CO'S: Y OR N BP NOTES: -' ! ! FEE STRUCTURE: FOUNDATION: I; .,~.~? SF FIRST FLOOR :.~.,,_Z_i~ SF SECOND FLR : SF TOTAL: ~ _ ,~ .~ ~/ SF FOT(~;~H SF)-( ~Y0 SF)=~/~/k SFX$ 1NIT OTHER FEE FEE TOTAL FEE 765-1802 BUILDING DEPT. I oiPECTION [ N l ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE //~~ ~NSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ~FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 765-1802 BUILDING DEPT. INSPECTION ~~~UGH PLBG. [ ] FOUN/~TIONIST [ ] ~JJ~DATION 2ND [ ] INSULATION ~,,]'~ FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY ,,,A,.~s.- ~ a~~?~~~ DATE~_~,~,~INSPE~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] RO~LBG. [ ~ INSULATION [ ] FINAL [ REMARKS: ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [] ROUGH PLBG. [ ]FOUNDATION 2ND [] IN~TION [ ]FRAMING [/.~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS, ~)~' IFIELD INSPECTION REPORT I DATE I COMMENTS ...................................... o~ ~~C~~ ~~_~. FO~DATION (2~) ~ g ROUGH F~G & PL~B~G ~S~ATION PER N. Y. STATE ENERGY CODE ~D~ION~ CO~ENTS / TOWN HALL IL ~': BLDG. DEPT. SOUTHOLD, NY 11+i' XOwN 9F SguTHOLD TEL: 765-1802 Examined ¢ / ,20. '~' Approved ~'/~/ ,20 ~" Disapproved afc BUILDING PERMIT APPLICA. TION..CHECKLIST Do you have or need the following, before applying ? Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. ~' ~d~{g Inspector C°ntact:T~ cON/ ¢TINO COt . M~ ~__ PO Box 361 "~ RJ~er, NY 11792 APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20tO ca_ a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 a Certificate of Occupancy is is!;aed by the Building Inspector. , 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 author/zed inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) r (Marling address of applicant) I ! 7~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nam ofown rofpr , s a4 o-z (as on the tax rbll or latest deed) If applicant is a corporatio~amre of dul.~ authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electhcians License No. Other Trade's License No. ' 1. Location of land on which proposed Work will be done: House Number Sfi'eet Hamlet County Tax Map No. 1009 Section . $ ~-- Block ~'- Lot ~ ~ Subdivision fi'hlLla o /[ ~_ 00~t.~tt.-,-ag ~ Filed Map No. (_,,% I?; Lot et<) _C0 State exis.qng use and occupancy of premises and intended use and occupancy7 of proposed c'onstmetion: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition - t Cost ~' 29 007 4. Estima ed~ _ ..... ~,~io(~5.~'2 Fee 5. If dwelling,/ umberg q ng units 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, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear 10. Date of Purchase Depth Height Dimensions of entire new construction: Front ~ ~ .IZ// Rear Height 0. O Number of Stories ~ Size of lot: Front /t--q"O Rear / Ctr~. ~o 7._- Depth Number of Stories / // Name of Former Owner 11. Zone or use district in which premises are situated Depth 12. Does proposed construction violate any zoning law, ordinance or regulation: rr~ O , 13. Will lot be re-graded , Will excess fill be rem?yed from premises: YES '- o 14. Names of Owner of pren!ises ~v~0 ~,~ ,c. ~-~t44-- L~li[~ NameofArchitect ~-Z~tr AJtco~,~. . Address Name of Contractor ~.O[J~h4e_ trft>tu~(aaoL_Address r, qo. - .... 15. Is this property within 100 feet of a tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE RErQUIRED 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. STATE OF NEW YORK) SS: COUNTY OF ) _]~'- '-~,~ [-L~.J '~ u ~ ~ berg duly sworn, d~oses ~d says that (s)he is ~e applic~t ~me of indi~du~l'si~ing con,ct) above nmed, (S)He is ~e ~ ~ ~ ~ ~ ~ A~ ~ 4~ ~ (Con~cior, Ag~t,~o~o~te office, e~c.) ' 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 t~efore me this ~[t/ ' dayof 7~r/' Notary Public 20mq m~i~'. ~-. N 71'11'QO'E' 150,OO' 7t t.47' 1 ¢4a.S)l :FOLK COUI'~TY DEPAR';}'~E;~4T OF r~EALTH :~£R¥1CES =ERMIT FOR APPROVAL OF C~N.C.,TRUCTIOt4 FOR A )IRE.~ THRF. E YEARS FROM DATE OF' APPROVAL S 70'31'20'"W No. 01-51'9 ~FOR ~ mlmllm mime-mm, mm m '~1 e ~qmll 1mi 'ami # mqm m mm m m,-m{ -mm, mm 'nm ~m amman mm 'mLm - CERllFIED ONLY TO: J"-- HAROLO F, TRANCHON JR. latlet. U~. HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR 1866 WADING RNER-IdANOR RD. WADING RIVER, NEW YORK, 11792 631-929-4695 LOT NUId~E)~ lO MAp OIr GREEI~ tis AT SOUTHOLO SITUAtEU AT SOUTHOLD ~ OF SOUTHOLD - SUP'PuLK COUNTY N.Y. SCALE 1' = 40' DATE 10--2,5-2001 F1LEO MAP Ne. 6313 OlATE 11--10--1975 TAX MaP Ne. (REF ONLY)1000-63--5-22 ~ 500 LOT AREA= 42,220 sq. ft. GREENFIE S ~. ~ 7~'~ l'02"E ~50.~' ~0~. Z , ~ ~ ~ ~ ~ LONe IS~D ~L~ FOUND. LOCA~ON 2-15-2002 R~S~ D~ING 1-~1-2~2 ~~A~~~~~ JOB No. 01-519 RLE No. GREENFIELDS AT ~U~OLD ~~m~~~ SU~ED FOR u~~~m~A~~'~ LOT NUMBER 10 ~ ~ ~ ~ ~ ~ ~ ~' M~ OF GREENRELDS AT SOU~OLD ~m~~ ~~~.~ SI~A~D AT ~U~O~ ~ ~ ~,~ ~ ~T ~ m ~ ~ TOWN OF SOU~OLD - SU~OLK COUN~ N.Y. ~~~~'s~ S~E 1" = 40' ~ 10-25-2~1 ~~~m~A~~. ~D M~ No. 6.315 DA~ 11-10-1975 CERTIFIED ONLY TO: T~ ~ No. (REF ~L~ 1000--63--5--22 DISK 5~ HAROLD F. TRANCHON JR. P.C. ~ND SU~EYOR  '" R~ER-~NOR RD. WADI~ RNER, ~/~ ~ , ~ ~66 WADING NEWYORK, 11792 N. . No. 048992 651--929--4695 ~ROLD F. T~NCHON JR. PENN. LIC. No. 21~-E LOT AREA= 42,220 LOT NUMBER 20 47' Z GREENFIEI.DS N 71'1 l'02'E 19.3 DWrl L!N~ 66.2 LANE rD. 150.00' ~ON. CERTIFIED ONLY TO: EDWARD R. GILBERT & RICHARD C. SCHWARTZ NORTH FORK BANK SUNRISE ABS3RA~ CORP. N.Y. LIC.'~. 048992 HAROLD F. TRANCHON JR. PENN. LIC. No. 2115-E JOB No. 01-519 FILE No. GREENFIELDS AT SURVEYED FOR EDWARD R. GILBERT & RICHARD C. SCHWA,~TZ LOT NUMBER 10 MAP OF GREENFIELDS AT SOUTHOLD SITUATED AT SOUTHOLD TOWN OF SOUTHOLD - SUFFOLK COUNTY N.Y. SCALE 1" = 40' DATE 10-25-2001 FILED MAP No. 6315 DATE 11-10-1975 TAX MAP No. (REF ONLY)1000--63--5--22 DISK 500 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR ~66 WA~NGRNER-MANOR RD. WADING RNER, NEW YORK, 1~92 651-929-4695 .9-,9E t II · .0-,9 i !! !