HomeMy WebLinkAbout40430-Z �r4�0 CSG Town of Southold 2/3/2016
P.O.Box 1179
53095 Main Rd
PSouthold,yNew York 11971
*,
CERTIFICATE OF OCCUPANCY
No: 38081 Date: 2/3/2016
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 380 Washington Ave, Greenport
SCTM#: 473889 Sec/Block/Lot: 41.-1-39
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
1/20/2016 pursuant to which Building Permit No. 40430 dated 1/26/2016
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"BATHROOM RENOVATION TO AN EXISTIN ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Stepnoski,Jean
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40430 01-20-2016
PLUMBERS CERTIFICATION DATED
•size ti Signat d re
o g3 LXio� ` TOWN OF SOUTHOLD
i a� a BUILDING DEPARTMENT
x TOWN CLERK'S OFFICE
oy� �o�,-
_ ,� SOUTHOLD, NY
0 * ',t,,.'
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#: 40430 Date: 1/26/2016
Permission is hereby granted to:
Stepnoski, Jean
PO BOX 993
Southold, NY 11971
To: legalize an "as built" bathroom renovation as applied for.
At premises located at:
380 Washington Ave, Greenport
SCTM # 473889
Sec/Block/Lot# 41.-1-39
Pursuant to application dated 1/20/2016 and approved by the Building Inspector.
To expire on 7/27/2017.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $515.20
CO -ALTERATION TO DWELLING $50.00
cD........----
Tota : $565.20
i , _
Building 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 J
Date. ' (9.0
New Construction: Old or Pre-existing Buildin : (check one))
Location of Property: 7( S� I Nf�� 11 V(7.)
P. ,P��piirI V�g_ 7
House No. Street, Hamlet
Owner or Owners of Property: '2 p n QS j
Suffolk County Tax Map No 1000, Section L Block l Lot 3 q
Subdivision /,,[ /G Filed Map. Lot:Permit No. / 0-7 a (d Date of Permit. Applicant j\1 u nib(yr Q 11+
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: —�
Request for: Temporary Certificate Final Certificate: y (check one)
Fee Submitted: $ 0 61)`J1
� kchrgic
Applict• gnature
,„ ...
. 0IIIi*of sour*®
Town Hall Annex 1 ,`O ' l® : Telephone(631)765-1802
54375 Main Road _ Fax(631)765-9502
P.O.Box 1179 %% `n �€ 7 �.- 'Ck. %
Southold,NY 11971-0959 1`�A_ . . - 4Z=0 � roger.richert(a�town.southold.ny.us
Couture,*
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Stepnoski
Address: 380 (28)Washington Avenue City: Greenport St: New York Zip: 11944
Building Permit#: 40430&40400 Section: 41 Block: 1 Lot: 39
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Dan Wilcenski Electrical License No: 4723-ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor X Pool
New Renovation 2nd Floor X Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 200A Heat OIL Duplec Recpt 39 Ceiling Fixtures 18 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 8 Wall Fixtures 8 Smoke Detectors
Main Panel 200A NC Condenser Single Recpt Recessed Fixtures 13 CO Detectors
Sub Panel NC Blower Range Recpt 20A Fluorescent Fixture Pumps
Transformer - Appliances DW Dryer Recpt Emergency Fixtures Time Clocks
Disconnect 200A Switches 21 Twist Lock Exit Fixtures TVSS
Other Equipment: Certificate Includes 2 - Storage Sheds.
Notes: "Electrical Survey"-"As Built" "No Visual Defects", 2-Exhaust Fans
Inspector Signature: rpa ------) Date: January 20, 2016
Electrical 81 Compliance Form.xls
_ ��,iii i0V S0045,o
- "I p l
Town Hall Annex-_ - - ; Telephone(631)765-1802
54375 Main Road ; y __ Fax(631)765-9502
.' P.O.Box 1`179 G. • - 1 t�'$ '
' Southold,NY 11971-0959 - - '`O.
• `lycOUN11*1 1''�
BUILDING DEPARTMENT
_ { TOWN=OF SOUTHOLD _
,, _ , - CERTIFICATION
1 Date: i ) l' (�' 'l' (0'
) .
. '41)'-i- -0- ''
Building Permit No. - g l'-e�°n pii)-41 N \-1 1 lot yg
{__ , _ Owner: , p—n' ' k 1 ' , .
_. ,
' - -(Please print);
P_lumber:_.S eC i4,5 J tC.1Fr�— �1 A' 1-`v iNii � -11,- &-o-S
(Please print) L�cc:33SC o � - ,� .
. , I certify that the solder used-in the water supply system contains less than 2/10-of 1% '
lead. . '
-
__ - `- _- � ; (Plumbers 'gnature).
- Sworn Ito before me this -( �l l
-
of n UUP/l, -20 I (f Ruth ate of� day � , Notary Public State of New York _
No. 01L06054063
Qualified in Suffolk County
M Commission Expir6 q 1' 20.
, . ,)_ ____ , -
• Notary Public,• = -County
Michael Mapes, P.E.
Michael Mapes, P.E.
163 Peninsula Path
Riverhead, N.Y. 11901
Phone: 631-369-2170
January 18,2016
Southold Town Building Department
Town Hall Annex Building
54375 Route 25
P.O. Box 1179
Southold,NY 11971
Re: Stepnoski Residence
28 Washington Ave
Greenport,N.Y. 11944
2nd floor bathroom as-built plans
To Whom It May Concern,
Please fmd please find the enclosed as built plans for the above referenced property 2nd floor
bathroom which I inspected on January 16,2016.
The bathroom and plumbing appear to be in accordance with the NYS codes.
If there are any questions please feel free to call me at 631-369-2170.
Sincerely,
Michael Mapes, P.E. ; ,
`'•,OI 07o501 � r
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631)765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. 4) V Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Storm-Water Assessment Form
.2_ C,
( Contact:
Approved ,20Mail to: o -
Disapproved a/c (/ds
Phone: i G�,`�>
Expiration '7 Iii ,20_1_
_7 (11.
I;) = 11-1-7) Building Inspe
" ��I JAN 2 0 2016 . !PLICATION FOR BUILDING PERMIT
— — - -- I Date I I, 10 , 20 / ( 2
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit 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 regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an
addition six months.Thereafter,a new permit shall be required.
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
authorized inspectors on premises and in building for necessary inspections.
J" $ r71" I
( gnature o ..plicant or nam , . corporation)
)4A-9
�)o 'nl l °c9 1
(Mailing address of applicant)
State whetherlicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
P/r,
V��
v .
Name of owner of premises S—V-e no3T) I
(As on the tax roll or latest deed)
If app 1' a. t is a corpor.t'. s ' .. • e of duly authorized officer
(Name and tit 4 of corporate of r)
Builders License No'
Plumbers License No. `-I (7 (9 a 5 -yy-) P
Electricians License No.
Other Trade's License No.
1. Locat' n of land oil which proposed wok will be ne:
lur-S-- Ek7atSh I n STOK) I v€, . ejr-eer) pni 0'1 1 i 61) LI(-1
House Number Street " Hamlet
County Tax Map No. 1000 Section LI I BlockJ Lot 3 I
Subdivision Filed Map No. Lot
2. State existing use and occupancy of pren>es and i tend u and occ pancy o roposeoil construction:
a. Existing use and occupancy , C N vvl r t ) t,£1 'i2 e
b. Intended use and occupancy N vi,i t L {`j t 0�v1, ;CZ,
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work t,1 o r0. cni (
j.17 (Description) f r0/0`-101A
4. Estimated Cost . v�-7�O . Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use._
t
7. Dimensions of existing structures, if any: Front . , Rear 3D I Depth 3 Cs, , 14 +
Height Number of Stories I\ fL
Dimensions ofame structure with alterations or additions: Front V v Rear ( A
Depth f) [0\7 Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 1 D ® 3`6 Rear v , Depth /6?n _
10. Date of Purchase Ter( (g ) Name of Forme ner I A
11. Zone or use district in which premises are situated �V
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NOX
13. Will lot be re-graded? YES NO( Will excess fill be removed from premises?YES NO
14.Names of Owner of premise J 2pf10S..I Address Phone No.
Name of Architect Address Phone No
Name of Contractorf1'e�.61/1411,1 iV Addresst{&SAID OR_ (/ ' Phone No. ^9(os--Ss-Is—
, 00`14-71)
s—
,01 1-7a id, A)L( 119 I
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES . NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO .X
* 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 on property is at 10 feet or below, must provide topographical dattaa 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� o I
MICAS • M U l e L-( being duly sworn,deposes and says that(s)he is the applicant -
(Name of individual signin contract)above nakned,
(S)He is the Y V (J t
c�
(Co actor,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/4(2 before me thbti
of e t)O i L/ 20 1 Le ,
, 1 11 r '
- . 1, _.�>f �1'lll.�ll1A.�
Notary Public Ruth Love l ;' re of pp icant'
Notary Public State of New York r
No. 01 L06054063
Qualified in SuA; County
Commission Expire. 11 20 1__
S C T.M. NO. DISTRICT: 1000 SECTION: 41 BLOCK• 1 LOT(S):39
LOT 7
LOT 8
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EDGE OF PAVEMENT 0..C.-)
N-- CONC.
WA
THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
UPDATE SURVEY 10-06- 15 LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA: 9,554. 10 SQ.FT. or 0.22 ACRES ELEVATION DATUM:
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUC-TURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF. LOTS 20 & 21 INCL. CERTIFIED TO: MCCARTHY REALTY MANAGEMENT; '
MAP OF: WASHINGTON HEIGHTS
FILED: DEC. 29, 1927 No.651
SITUATED AT: GREENPORT
TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
•
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
4„.,,,eAA i P.O. Box 153 Aquebogue, New York 11931
FILE # 15- 124 SCALE: 1 „=20' DATE: AUG. 2 1, 2015 PHONE (631)298-1588 FAX (631) 298-1588
N.Y.S. LISC. NO. 050882 1 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk
4 _ 3 4 2 1
941)Nak-\-\OiJ t4C_ crS � 8.
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WINDOW , ,+� D
WINDOW
AZED AS NOTED
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® TUB ® .;'ATE: f (� B.P.II4°43°1-
CLOSET =EE. 51L BY._ -OM--
NOTIFY BUILDING DEPARTMENT AT
2'-0° 'G5-1802 8 AM TO 4 PM FOR THE
THROUGH FOLLOWING INSPECTIONS:
ROOF I. FOUNDATION - TWO REQUIRED
3° ii F it `OURED CONCRETE
1 2. ROUC H - FRAMING & PLUMBING
SHOWER
�Y �I�` C LAMA 'nay ,
C ATTIC f , A__,..AT CU LA F L . : ':i'1,1„8Te��V MUST C
BE + 1' cC 0.
WITHOUT ROUT CE TIFICA CONSTR►cR1 " SHALL MEET THE
NEW
O ® r:::3
2'-0OF OCCUPANCY , STATE. O ESPE O SIBLEES FRWC \,rRK STATE. NOT ;.ESPONSIBLE FORDESIGN OR CONSTRUCTION ERRORS.
1
j_ 1
TO BASEMENT
2'-ou 3" 11I
BEDROOM PLUMBING RISER r
COMPLY `':'_. FH ALL CODES OF _
B NEW YORK S T A i`E & TOWN CODES 01 •��� ;\ B
PL' ,";F.F.R CERTIFICATION AS REQUIRED A1 . .� ‘•, ; 6 OF /q�y%,�,P,E.1- ®•4r 0
FLOOR - cv;til T ENT BEF E . ,,.
scale 1/ , - TE OFOCC�JPA/1CY �'� ( p,_:, ,,,?%
S� - ► •OARD
SOLDER USED°1N WATgfo_ n_�
SO f:iiOLr TOWN TRUSTEES '�o /%�/G ,
SUPPi:Y SYSTIt�D G
I�` w ®,o 07050A ,
,ExbEED:21:1,0bF 1%LEAD' x' - ___� �_ -� .
t ys'�'x3° �Y`-n4 'v'y.?x .+i n'�'? i1"t:, :.sa f t- S7_
NOTES: Map es,P.E.
1. FLOOR PLAN SHOWS AS BUILT CONDITIONS DURING INSPECTION 1-16-2016 163 Michael chaelPENINSULAPATH
A 2. DESIGN BY OTHERS RIVERHEAD,N.Y 11901 A
PLUMBING PHONE 631-369-2170
ALL PLUMBING WASTE TITLE:STEPNOSKI RESIDENCE
&WATER LINES NEED 28 WASHINGTON AVE,GREENPORT,N.Y.
TESTING BEFORE COVERING RC 2nd FLOOR BATHROOM PLAN n
DRAWING NUMBER
DATE 1-18-2016 I�--1/4"=1' I s°u,1 or I
4 I 3 + 2