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HomeMy WebLinkAbout28639-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29028 Date: 10/29/02 T~IS CERTIFIES that the building ADDITION Location of Property: 430 GREEN WAY (HOUSE NO. ) (STREET) County Ta3~ Map No. 473889 Section 109 Block 5 Subdivision Filed Map No. __ Lot No. __ CUTCHOGUE (HAMLET) Lot 14.19 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7, 2002 pursuant to which Building Permit No. 28639-Z dated AUGUST 8, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ~e certificate is issued to PHOEBE Y CUSHMAN ( OWNER ) of the aforesaid building. SUFFOLK COUI~TY DEPARTI~ENT OF ~EALT~ APPROVAL ELEt~r~ICA~ CERTIFICATE NO. PLU~BERS CERTIFICATION DA'r~ N/A N/A N/A Rev. 1/81 ~/~ignature 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. 28639 Z Date AUGUST 8, 2002 Permission is hereby granted to: PHOEBE Y CUSHMAN PO BOX 905 CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 109 pursuant to application dated AUGUST Building Inspector to expire on FEBRUARY Fee $ 150.00 430 GREEN WAY CUTCHOGUE Block 0005 Lot No. 014.019 7, 2002 and approved by the 8, 2004. Rev. 5/8/02 ORIGINAL I:OI'IH ~(I. 6 1 ()%N f)F ,',,(),UTIIOLI) BUILDING DEPARTMENT TOS~qN HALl, 765-1802 This application must be filled in by typewriter or ink and subnfitted to the Building Depamnent 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 Api)roxal fi'om Health l)el~t, ofxvalur supply and suwerage-disposal 3. Approval of electrical installalion ti-{)m Board o1' I:irc [lnde~vriters. 4. Sworn statement fi'om plumber certil}dng that thc solder nsed in system contains less than 2/10 of 1% Icad. 5. Commercial building, industrial building, multiple residences and sinfilar buildings and installations, a certific of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requ/rements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land us{ 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 Occupam 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 $25.0{ Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.0 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Photocopy of Certificate of 0coupaney - $ 0.25 4. Updated Certifieat~ of Ocoupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Nc*tConsim~on: _..~4C~2. QldorPre-em~tingBuilding: - (checkone) ' aou e No? St t. .- -((/ · ' ltam d Suffolk C°unty Tax. MaPNol000, SCtion ~tOO~ Block '5 Lot Iq, 15 · Subdivision Filed Map.. Lot: Permit No. ~ cO'~-~ £\ Date of Pem~itc'~. kOol ~)'~ .... Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate _ Underwriters Approval: Final Certificate: Fee Submitted: $ (cheek one) '' "~ignature' ~,Appl'c~nt BUILDING PERMIT EXAMINER CHECK LIST AP P L I C AN T :'7--~o~'4 &~.~.~ DATE REVIEWED: ~ / {B'/. DATE SUBMITTED:~/:) /. SC]M# DISIRK : 1,0(}0, St¢CiiON: PROJECT DESCRIPTION: ~ot. lg~'v~r-- ESTIMATED PROJECT COST: ~ 16_Ir FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? ~o NOTES: LOTS 40,000SF -I 00-24 [mt rccognition.(CREA'fl 1) before June 30. 1983), UNI)EI~.SIZED I.OTS FROM JAN.1997 100-25 Me~ge~ (A no~/confi~nning at any __ CONFORMING? -I't'~ ACT. LOT SIZE: ~,tot" REQ. LOT COX,/. ¢~,~ A(, . LOT COV. .... PROP. FRONT_~ t r/ r ACT. SIDE PROP. ~ Q. HEIGHT PROP. HEIGHT~ ZONING DISTR1C, T: REQ. LOT SIZE: REQ. FRONT REQ. REAR WATEP, FRONT? //to DESCRIPTION: PANEL #: /~ :~ FLOOD ZONE: ~ , APPROVALS REQUIRED SUFFOL~ COUNTY HEALTH p-~P~ T: YES or,BED #):__ DTE: / / PERMIT #:R10- TOWN SEPTIC RECEIPT: Y o~:L.) NEW YORK STATE DEC: PRE-DECglI/?5 YES of~--~~ SOUTHOLD TOWN TRUSTEES: YES ~ TOWN ZONING BOARD APPROVAL: YES ~ TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES ~ ~' NYS ENERGY: YES OR ~ ~ / _/ EGRESS (18 H min.? 4 sq total) ~ VENT (SQ. FT. x 4%) "f,?'"~ LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP ~o,~ 2, z....- -Z / C/0 Z- q'~t ~g,-.- HAVE PRE CO'S: YORN BP -Z / C/0 Z- .,. NOTES: FEE STRUCTURE: FOUNDATION: SIr FIRST FLOOR: SECOND FLOOR: S F OTHER: SI: TOTAL: /ZP. _SF INIT ()TIqER 'IOTAL FEE FEE FEE 1. ( __ SF)- ( SF)~ St.' X $ =$ +$ q $ 2. ( SF)- (_ _SF)= SF X $ =$ +$ __ +$ = $ 765-1802 BUILDING DEPT. [ ~FOUNDATION 1ST [ ] PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROU~,~PLBG. [ ]/~tULATION [ j/]' FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR ~//~~ 765-1802 BUILDING DEPT. INSPECTION ROUGH PLBG. INSULATION FINAL FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY DATE INSPECTOR F~E,~,D IN$~ECTIO~ REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUG:I~ Fi:~ANI~qG & PLUIVIBING INSLrI.~TION PEP,- N. ¥. STATE EN'Ei~G-'Y CODE ADDxi'iOH.4.L COMMllll'q~ TOWN OF SO/dTHOLD BUILDIN~G DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved ,20~ Disapproved aJc Expiration'"' / - ,~Q~ ,2/ BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO.~ // k-I~ildin Do you have or need the following, before apply/ng? Board of Health 3 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Date&~ j INSTRUCTIONS ,200& 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 conm~enced 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./q ' [,.(Signature~f applicant or name, if a corporation) ! (Mailing ~ddr~s~'4-f'appli~t) ' i/fO ff~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ,4~~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer Name and t~tle ( ' o cuqoorate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. House Number Street " [ ' County Tax Map No. 1000 Section /O c] Block 2~ Lot Subdivision Filed Map No. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constructiOn: a. Existing use and occupancy ~ ~ b. Intended use and occupancy ~ Nature of work (check which applicable): New Building Repair Removal Demolition Addition ~ Alteration Other Work 4. Estimated Cost /O,~t2t9 Fee 5. If dwelling, number of dwelling units ~7//~ Number of dwelling units on each floor If garage, number of cars 7]//'/')- 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 Heigh[ Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories (Description) (To be paid on filing this application) Depth Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES 13. Will lot be re-graded? YES__ 14. Names of Owner of premises Name of Architect Name of Contractor NO b//Will excess fill be removed from premises? YES Address Phone No. Address Phone No Address Phone No. 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 of a tidal wetland? * YES NO * 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 data on survey. STATE OF NEW YORK) SS: c o U.~T Y OF ) J~'J~~ ~ . being duly sworn, deposes and says that (s)he is the applicant (~Lame o~findividual 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. Sworn to before me ~ dayof . 20_ O,_~ ~otary Public - JOYCE M, WILKINS Notary Public. 8tare of New York mrm Exl~iresJune 12, ~')00..~ S i,ff~at {ire o'b--fSk~l~lic hnt - Lot 25 vacant IOA* Lot 19 Area = 40,105sq. ft AL, 89°12'10"W. Recreation Area · vacant UNAUTHORIZED ALTERATION OR ADDITION TO THiS SURVEY IS A VIOLATION OF SECTION 7Z09 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR*S INKEO SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED GUARANTEES {ND~CATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE REVISIONS MAle..~, 1972' MAR. ~9 ,19X? SEPT, 27, 1979 JAN. 7, 1980 dAN. 9, 1980 MAY 30, 1980 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON A~I[ FROM FIELD ORSERVATIONS AND OR FROM DATA OBTAINED FROM OTHEII'$ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMEN1 OF HEALTH SERVICES APPLICANT: .......... ADDRESS TEL ..... NOTE: · = MONUMENT SUBDIVISION MAP F/LEO IN THE OFFICE OF ~/E CLERK OF SUFFOLK COUNTY ON FE~. 15,1974, AS FILE N~ 6066. SUFFOLK COUNTY TAX MAP DIST. SECT. BLOCK LOT. I000 109 5 14.19 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY 'FOR: JOHN A. CUSHMAN LOT NO 19, "FAIRWAY FARMS./, · ow. o. PLAN VIEW CUSTOMER -- DATE 07/31/02 · APPROVEDAS NOTED DATE~B.R# 2~'~ ~',',',',',',',','~ RBS 1093 PULASKI STREET REF DeckO22H~ZEiE~ I.")'""0 BY: '~r-~------~- RIVERHEAD, NY NOTP~Y BUILDING DEPARTMENT AT [631) 727 771:3 76S-1802 9 AM~.-~'O 4 PM FOR THE FOLLOWING INSPECTIONS: 1. F(JUN~A]-I(JN - TWO REQUIRED FOR POURED CONCRETE 2C' 3. INSULATIOi LOAD AND SUPPORT: post support. Your deck will support a 54 PSF live Icad. OCCI.IPAI CY OR USE tS WiTH©UT CERTIFICATE OF OCCUPANCY Posts have 36" below-ground DECK AND POST HEIGHT: You selected o height of 24" from the top of decking to level ground. The top of the deck support posts will therefore be 15.25" above ground level. Your salesperson can provide information for uneven or sloped ground, JOISTS: Set joists on top of beams, 16" center to center. NOTE; The design may require knee braces and bridging between joists, Your materials list includes the necessary items. The suggested design is not a finished building plan. You ore responsible for oil measurements being correct, for verifying that the design (and any substitutions or modifications that you make) meets ell local building codes and requirements. To verify that the suggested design, and any substitutions or modifications, is consist-ant with conditions et the construction site, review the design with your architect. Aisc consult your architect for proper construction and use of materials in the structure, Be sure to follow the deck construction detail available from your store salesperson. BEAM LAYOUT CUSTOMER -- DATE 07/31/02 REF Deck02212 RBS 1093 PULASKI STREET RIVERHEAD, NY I~SI) 727 7713 5' 7~ 5' 7~ BEAM BEAM POST POST LABEL LENGTH COUNT SPACING A 36' 9'" 5 9' ~ I/2"' B 36' 9'" 5 9' ~ I/2" O 86' 9" 4 12' 2" Pos[ spac. ing is measured center-[o-cen[e~. Deeh of concrete fca[ers --- 36 inches,