HomeMy WebLinkAbout28336-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP]kRTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28608
Date: 07/18/02
THIS CERTIFIES that the building ALTEP~ATIONS
Location of Property: 4700 PARADISE POINT RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 81 Block 3 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 24, 2002 pursuant to which
Building Perm/t No. 28336-Z dated APRIL 29, 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 WINDOW REPLACEMENT & BAY WINDOW ADDITION TO EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
· ~ne certificate is issued to A WILLIAM BERTSCH, JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL C~TIFICATENO.
PLUMBERS c~TIFICATION DA'r~O
N/A
N/A
N/A
//~i Z e d Signature
Rev. 1/81
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. 28336 Z Date APRIL 29, 2002
Permission is hereby granted to:
A WILLIAM JR BERTSCH
OYSTER BAY,NY 11771
for :
WINDOW ALTER3~TIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR
at premises located at 4700 PARADISE POINT RD SOUTHOLD
County Tax Map No. 473889 Section 081 Block 0003 Lot No. 004
pursuant to application dated APRIL 24, 2002 and approved by the
Building Inspector.
Fee $ 150.00
Rev. 2/19/98
COPY
1'OWlf OY SO~THOLD
BIITLI~ II~
T0~ HALL
APPLICATION FOR.CERT~FICATE OF OCCUPANCY
A. This. ap~licatiun must be filled in by typewriter OR ink and submitted to ~ha building
InspeCtor with the following~ £or new buildin& or new use:
1. Final sut'v!y, of,property with accurate location of ell buildings, property lines,
streets, and unusual natural or topographic features.
l. Final Approval'from Health Dept. of Water supply and sewerale-dispossl(S_9 form).
3. Al~proyal o£ electrical installation £rom Board of Fire Underwriters,
~. Swot~ statement ,from plumber certifyin8 that the solder used in ~ystem contains
lass =has i/lO of iI lead.
5. C~ercial bulldint, industrial building, multiple residences and {imilar buildings
an~ installations, a csrt£iicata of Code Co~plia~ue from architect Or engineer
responsible fo=the buildi~g.
6. Submit Plsnnin8 ~oard Approval of completed site plan requirements.
$. For extgtin8 bu~ldings.(prior to April 9, 19}7) non-conforming uses~ et buildings and
9pre-exis~ing" laud uses~ .
1. Accurate survey of property showing all property lines, streets, bui/dtn8 aed
unusual natural or topographic ~eatures, '
2, A properly comp'leCid application and a consent to inspect si~ned by the applicant.
If a Ce~tificate of Occupancy is denied, the Building Inspector shall state the
l. Certificate of Occupancy - New dwelling $25,00, Add~tions to dwelling $25.00,
Alrsra~ions =o dwellin.g $2~,00, gwlmmlng pool ~2~,00~ Accessory bu~ldtns
· Addl~ione ~o accesser7 buildtn~.~2~,*00, Businesses $50.00.'
Copy of Cer=i~£ca~s of OcCUpancy - ~
4,Updated Certificate of 0c~*upsncy - $~0,00
~,Temporary Certificate of Occupancy - Residential $1~,00, Co~erctal*~$15,00
~ew Couet~uctton ........... Old Or P_rs-existin~ BUildtn~.....~... .......
House 8o, Street Hamlet
ty Map IO00 ,
Ioun Tax 'No , Section ............. Block ............. Lot ...................
.................................... Filed Map ............ Lot .......
~ubdi~iSlon .
[ealth Dept. Approval .......................... Underw~lcersApproval .........................
· lanntn8 Board Approval~ .......................
lequest forl Temporary Certi~i¢lta ........... Final Cert£caCe.., ,~T .....
~ee Submtttedt $,
~, ~ ~::~ ? ~,: TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET ':r/~,,>'D,~'~, _ . VILLAGE DISTRICT SUB. LOT
~:~) ' ACREAGE
~' W C~ ~PE OF BUILDING
/
RES. ,~ I p SEAS. VL. FARM CO~. IND. CB. MISC.
~ND
IMP.
TOTA~
DA~E
REMARKS
:-
"- '~ ~ ,~,-/C~ /~
~ AGE BUILDING CONDITION
~w ~o~ ~ow ~ov~ P" ~ ~-~,,z /' ::?, ,'~
Form Acre VoluePerAcre Volue ~.. ~.g~ ~ t:~/t ~/_:,
Tilloble 2
/
Tilloble 3 ,
'
FORMER OWNER
'V~ood bnd
S~mplond
Brushlond
House Plot
Toro I
CLAD ULTIMATE DOUBLE HUNG
BASIC UNIT ELEVATIONS
SCALE: 1/4" = 1' 0"
W1NDOWS & DOORS
Rgb Opg. 3-0 3/8 (924)
Frame Size 2-11 3/8 {899)
Sash Opg. 2-10 (864)
Glass Size 30" (762)
CUDH3024
CUDH3026
CUDH3028*
3-1 7/8 (962)
3-2 3/8 (975)
3-1 3/8 (949)
3-0 (914)
32" (813)
CUDH3222
CUDH3224
3-5 7/8 (1064) 3-9 7/8 (1165)
3-6 3/8 (1076) 3-10 3/6 (1178)
3-4 (]018) 8-8
36" (914) 40" (1016)
CUDH3622
CUDH3624
CUDH3626*
CUDH3628*
CUDH4022
GODH4024
CUDH402~
CUDH402~
* THESE WINDOWS MEET NATIONAL EGRESS CODES FOR
FIRE EVACUATION. LOCALCODES MAY DIFFER.
4.19
BUILDING PERMIT EXAMINER CHECK LIST
DATE IS~SUED: / /02
APPLICANT: ~ ~ .'--'_-~a&,zlx~c~ DATE REVIEWED: t~ Z~-702
. _ DATE~S~MITTED: ~
SCTM~ DIST~CT: 1,000, SECTION: ~ ., BLOCK: ~ , LOT: ~
PROJECTDESC~TION'. ~~ ~_ ~. ~.1,'~~%1~'~_. .-~..~}C ~j,,~5'
EST~ATED PROJECT COST~ t:. ~ ~CHITECT / ENG~EER: ~/~ FAST T~CK? ~a
S~GLE & SEP~TE CERTWICATION-~QU~D? ~0 NOTES:
~TS 40,000SF -100-24. ~t reco~ition.(C~ATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25 Merger.(A nonconforming at any time after 7/1/83
ZO~G DISTraCT: ~-~o COlOr.G?
REQ. LOT SIZE:,C~r~ ACT. LOT SIZE:~_/~REQ. LOT COV. ,~ ACT. LOT COV.
REQ. FRONT - ~ PROP. FRONT REQ SIDE /J"Z'.~ 1'-- ACT. SIDE
REQ. REAR ~.~ PROP. REAR~-~ / ' / ,- -/ ~_ .,,--_._o" ......
°
WATERFRONT? DESCRIPTIOn:
PANEL #: FLOOD ZONE: , - -- - '
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES or~, (BED #): DTE: /
TOWN SEPTIC RECEIPT: Y or(i~
NEW YORK STATE DEC: PRe-DEC 9a/7~ YES or
SOUTHOLD TOWN TRUSTEES: YES or{~ '~::o~ ~ {o15 -
TOWN ZONING BOARD APPROVAL: YES
TOWN PLAN. BOARD APPROVAL: YES
TOWN HISTORICAL PRE (SPLIA): YES
NYS ENERGY: YES ORNO : "'/A ,~ ~ t~',,~.~.
EGRESS (18 H min.? 4 sq total) v~' VENT (SQ. FT. x 4%)
BUILDING PERMITS OPEN/EXPIRED: BP /~0 -Z / C/0 Z-
HAVE PRE CO'S: Y OR N BP -Z / C/0 Z-
NOTES: ,.o-~'-." '"~- \ :' "~ :._'_ ~ -'
/ PERMIT #:RI0-
LIGHT (SQ. FT. x 8%) -~
FEE STRUCTURE: FOUNDATION:
FIRST FLOOR:
SECOND FLOOR:
OTHER:
TOTAL:
1. ( SF)- ( SF)= .SF X $
2. ( SF)- ( SF)= SF X $
SF
SF
SF
SF 1NIT OTHER
SF FEE FEE
=$ +$ +$ = $
__=$ +$ +$ = $
TOTAL
FEE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]~II. ATION
[ ] FRAMING [ ~J~ FINAL
[ ] FIREPLACE & CHIMNEY
DATE ~/~ 7/~2 ~ INSPECTOR
FmLD INSPECTION REPORT I DATE
FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAxVILNG &
PLU1M[BENG
INSULATION PER N. Y.
STALE ENERGY CODE
FINAL
TOWN OF SOUTHOLD
BUILDING DEPARTMEN~I'
TOWN HA_LL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
Exammed //// , 20
Approved ,20
Disapproved a/c
Expkafion 20
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before apply/ng?
Board of Health
3 sets of Building Plans
Planning Board approval
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
· ~flding in~&4,or
APPLICATION FOR BUILDING PERMIT
Mail to:
Phone:
INSTRUCTIONS
Date
,20
a. Th/s 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 adjomlng 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 apphcant. 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
f_s~u_a~n~ce ~r ha,snot been. co, mP!,ete.d Wi .thin 18 mo.n.t.h.s from such date. If no zoning amendments or other regulations affecting the
v,op~ Ly nave oeen enacrea m me interim, the Bufldmg 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 ora Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinm2ces or
Regulations, for the construction of buildings, additions, or alterations Or for removal or demohtion 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 prern/ses and in building for necessary inspections.
(~jlgmature of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee~g~ architect, engineer, general contractor, electrician, plumber or builder
Nmne of owner ofpremises&rZ'rgu.~, k/u x kLA A.~ F~-cal-~aM
(As on the tax roll or latest deed)
Ii' applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
Filed Map No. W~c,'?) ;..:~t/i :: ~:~ '~
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 12
b. Intended use and occupancy_
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost / ~t d)O~. ,o
5. If dwelling, number of dwelling units o,az
If garage, number of cars ~( z,,
Addition Alteration X
Other Work
Fee / ~'~, °~ (Description)
(To be paid on filing this application)
Number of dwelling units on each floor o~ v-
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front (:5~'c~)' Rear ~6a' da" Depth
Height /4-'0" Number of Stories 0~4 ¢_
Dimensions of same structure with alterations or additions: Front ~,e~'r~
Depth cog'(~" Height, 1,4 'o" Number of Stodes
Dimensions of entire new construction: Front gcc' c~" Rear 86~'$" Depth 6q'c~"
Height Iz¢o'' Number of Stories o~.
9. Size of lot: Front Rear Depth
10. Date of Purchase 6~Pr. ~ 1~9~1 Name of Foimer Owner &r~x~uo.
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
NO )<
13. Will lot be re-graded? YES NO ~: Will excess fill be removed from premises? YES__ NO
14. Names of O~er of premises ~. ~.~ Ad.ess o~ ~ ~.~. Phone No.(S~J
Name of~ ~ou~ ~. ~L~q6 Ad,ess P.O. ~ox 1~ "~hone No
N~e of Con,actor Ad&ess e~ u~ q, ~.w. I I~ Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~, * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet ora tidal wetland? * YES 'K. NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
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 )
..3e~-~,4 r~. ~o LC ~5 being duly sworn, deposes and says that (s)he is the applicant
('Name of individual signing contract) above named,
(S)He is the
(Contractor, 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 tree 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.
8UZANNE M. ~A
~ Public, State of New~
No. 01GA~7~2
Qualified in N~sau ~u~ ~
~ion ~ir~ ~g~ ~, ~ _
Signature of Applicant
SUP. VET OP PI~OPEP-..."I-~
51TUA'T'E.. PARADI5:1= POINT
TOI, NN.: .5,01.)THOLP
5UPt=OLK OOUN"F'¢, NY'
SURVE"r'EP 04-15-02
SUFFOLK. COUNT'F TAX ~
1000-81-~,-4
/ MASONFt¥
PAflO
TOP OP DAN~
. (--TI-%LINE~ ALON®
851:43 29"W 125.58'
CER'I'~',~-D TO:
A. W~.f.[AM BHRTSCH ~'r.
NOTES:
· MONUMENT FOUND
ALL PROPOSED ACTIVITY HILL OCCUR
INSIDE FEI'dA FLOOD ZONE X
AREA = 2q,422 SF OR 0.~8 ACRES
®RAPHIO SC. ALE I"=
SOUTHOLD
BAy
JOHN C. HLERS ][_,AND SURVEYOR
6 EAST MAIN STREET N.Y.8. LIC. NO. 50202
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287 REF.\~Ip Server\d~'ROS\02-154.pro