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HomeMy WebLinkAbout28702-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29063 Date: 11/07/02 THIS CERTIFIES that the building ADDITION Location of Property: 555 BEEBE DR CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 7 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 2002 pursuant to which Building Permit No. 28702-Z dated AUGUST 27, 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. The certificate is issued to WALTER M DOROSKI & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //,"Ith7(zed ignature 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. 28702 Z Date AUGUST 27, 2002 Permission is hereby granted to: WALTER M & WF DOROSKI 555 BEEBE DRIVE CUTCHOGUE,NY 11935 for CONSTRUCTION OF A REAR DECK ADDITION AS APPLIED FOR at premises located at 555 BEEBE DR CUTCHOGUE County Tax Map No. 473889 Section 097 Block 0007 Lot No. 013 pursuant to application dated AUGUST 21, 2002 and approved by the Building Inspector to expire on FEBRUARY 27, 2004 . Fee $ 150 . 00 thor6,ze ignature COPY Rev. 5/8/02 Form No.6 TOWN OF SOUTHOLD ! i BUILDING DEPARTMENT TOWN HALL 765-1802 r" 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$25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00, Additions to accessory building$25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. / / Z� New Construction: Old or Pre-existing Building: (check one), Location of Property: ffs ��6 /? 6 p R C c tC oG c, e-- House No. Street Hamlet Owner or Owners of Property: W Q�t`�r(�' i�>G R-y-5 kJ_— Suffolk County Tax Map No 1000, Section Block Lot z 3 Subdivision Filed Map. Lot: Permit No. r2 (�f d� Date of Permit. Z12 7Z 6 I Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approvals Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ OO I(dG 4V,),-/7) Applicant Signature 7- 13 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 6�55 VILLAGE DISTRICT SUB. LOT at,ow All /6^, e e d a e. A ar FORMER OWNER N E ACREAGE rs W TYPE 01 BUILDING .ES.C;;�l 0 SEAS. FARM comm. IND. CB. misc. (Vo 9 1 1 1 LAND IMP. TOTAL DATE RE��a op. )�6 lal 44- 66d &Irl z Ls 700 7 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Form Acre Value Per Acre Value fK01v E14 o2 V6 illable I D e� ill / 76 illable 2 illable 3 Voodland ,vampland rushland iouse Plot oto I • ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■7Allll�l�■■■■■■■■■I�1■■■■ ■'■■■■■�■lAt AV■■■�I■■■■ ■■■■■■■■■■■■■■■■■■■■ Foundation ■■■■■■■■■■■■■■■■■■■■ Both Basement .. WallsExtension Ext. , . Interior Finish Extension 0Fire Place Porch AtticPorch Rooms Ist FloorB reezeway Patio Rooms 2nd Floora Garage3�®� Driveway o7. o�0g�ff0�,�-�O CA = Town Hall,53095 Main Road 0 • Fax(631)765-1823 P.O. Box 1179 y�0 �aO� Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD August 22, 2002 Walter&Ann Doroski 555 Beebe Drive Cutchogue, NY 11935 To Whom It May Concern, Following a review of your building permit application, to construct an addition to a single family dwelling at 555 Beebe Drive, in Cutchogue, it has come to our attention that building permit#16752-Z, dated February 23, 1988 has expired and has no certificate of occupancy, which is a violation of Southold Town Code. In order to rectify this matter, you must submit a check in the amount of$543, schedule a final inspection and move forward with an application for a certificate of occupancy. It is your obligation to rectify this matter as soon as possible and remit all of the fees associated with this action. Please contact this office within the next 30 days. Failure to do so will result in further action. If you have any questions, you can contact this office at (631) 765-1802, between the hours of 8:00 a.m. and 4:00 p.m., Monday through Friday. Respectfully Y ut a Signature CC: File 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FO ATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 1(910i-4o .-- INSPECTOR _ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE A CHIMNEY REMARKS: 12 DATE INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS ro J FOUNDATION(1ST) ---- - ------_ ------ p y -------------------------------------- rA FOUNDATION(2ND) -- - --- z � � o 1 ROUGH FRAMING& m H PLUMBING - - r INSULATION PER N.Y. --- H STATE ENERGY CODE 411 FINAL ADDITIONAL COMMENTS O -- z m ro O -- z r y d ro BOARD OF HEALTH . . . . . . . . . t FORM NO. 1 3 SETS OF PLANS . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . CHECK . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT ' ' ' TOWN HALL SEPTIC FORM . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.. 765-1802 NGTIFY , CALL Examined . . . . �1��. . . . . ., roti MAIL TO: . . Jxe $ O o. ( . . . Approved . . . . . . . Permit N . . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . 2 ti� � J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 1 R _` ( . . . . Pector). . . . . . . . . . . � '° 1 te' M:- ra APPLICATION FOR BUILDING PERMIT . . . . . . . . . . . . . . . . . . . � Date •> INSTRUCTIONS 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy shall have been granted 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 authorized inspectors on premises and in building for necessary insCCpecrr;ion, . -- (Signature of applicant, or name, if a corporation) (Mailing address of applicant) qty State whether applicant is owner, lessee, agent, architect, engineer,, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . .��r�/�! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises X. -/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . . . . . . . . . . .r��� g ,21.✓ . : . . . . . . . . . �c!rf ( vt. . ` : . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . 3 7 . . . . . . . . . . . . Block . . . .7. . . . . . . . . . . . . Lot . . J.3 . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) ?. State existing use and occupancy of premises and intendeduseand occupancy of proposed construction: a. Existing use and occupancy . . . . .F��.,.� . . �r/ 1���_. . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work. . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height`� . . . . . . . . . . . Number of Stories . . /S. . ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . .;L-Y.' . . . . . . . . Depth Ypq . . . . . . . . . . . . Height Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 lSD' F `f. . 7 �f / -�� 9. Size of lot: Front . . ./?.�i�. . . . . . . . . . . . Rear . l.6 ,. . . . . . . . Depth D. . .�s. �. �. 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . .S. Yet 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . .r� o� . . . . . . . . . . . . . . . . Will excess fill be rem ved from premises: Yes Q- 14. Name of Owner of premises . .T>q?ZP k_i. . . . Address . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . .(;v . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . Address . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L5. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No� . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEW YORK, S.S OUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )ove named. aisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief;and that the irk will be performed in the manner set forth in the application filed therewith. vorn to before me this . . . .at . . . . . . . . . .day of. . . ' 14... >tary Public, . . . . . . . . . County I ( ' DA M. BOHN l(I•_�-�D— NOTARY PUBLIC, State of New J1k- .. .. . . . v No.01 B06020932 (Signature applicant) Qualified in Suffolk Countyy Torm Fvniroe RA—m, o nn/4 BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: g /� APPLICANT.IDo Qo�t� DATE SUBMITTED:B /� SCTM# DISTRICT: 1,000, SECTION: °l , BLOCK: , LOT: 13 STREET ADDRESS: 55E Leae CITY: SUBDIVISION:coug� PROJECT DESCRIPTION: ESTIMATED PROJECT COST: K ARCHITECT/ENGINEER: NIA FAST TRACK?_ SINGLE&SEPARATE CERTIFICATION-REQUIRED? 1VA NOTES: LOTS 40,000SF-100-24. Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time afte ZONING DISTRICT: ° CONFORMING? /Jo REQ. LOT SIZE: '40,bov ACT. LOT SIZE: Zl,9B-REQ. LOT COV. a° �� ACT. LOT COV. REQ. FRONT 35 PROP. FRONT ✓ REQ SIDE 10/25 ACT. SIDE REQ. REAR w PROP. REAR '5-c) ' REQ. HEIGHT PROP. HEIGHT WATER FRONT? A110 DESCRIPTION: PANEL #: /63 FLOOD ZONE: X APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or�(BED #): DTE:_/_/_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y oAfD NEW YORK STATE DEC: P1X-DEC glin5 YES ordsp SOUTHOLD TOWN TRUSTEES: YES oR 2 TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES oon NYS ENERGY: YES ORS : V-4e EGRESS(18 H min.? 4 sq total) VENT(SQ. FT. x 4%) _ LIGHTo BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: ��3 SF FEE FEE FEE 1. ( 5-1�01 SF)- (_ _SF)= SF X $ _$ +$ +$ 2. ( SF)- ( _SF)- SF X $ _$ +$ +$ _ $ pS NOTES � A B.P. _ 0.14 �' a ' D ' M BY: 4, N p�p�TMENT AT 765-1802 9 FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE MBINGI� 3. INSULATION 4. FINAL - CONSTRUCTION MUST ,t BE COMPLETE FOR C.O. �I- ALL CONSTRUCTI SHAL MEET '� O ��•� 6', THE REQUIREMENTS OFT E N.Y. ' J-J64 O STATE CONSTRUCTION & ENERGY © tz O CODES. NOT Rg*!ONSIB E FOR - j DESIGN OR CONSTRUCTION iRRORS - r \\ aZ z�= tri 1J ,/ L't1 /7 aro 74s-o. LOT 2. (VRLQt N.T 1 �5/�GhGt p,- Palo/ \�l\ OCCUPANCY OR ! USE IS U.aCA�EUL • ITHOUT CERttftCATE ER /1/l. A�vv ANTOI&E-TTE" . R7 of oCCUPI►hCY Ccs rc�oGv�; NY . ' f7 t rd Jena" /58.7 A / :.. M :AMLNDED':J17NE , 988 "01ERICK VAN TUYL,P.C. c!jA al J. `�" & J'1 SCK I01, 17p ;dc--.— 0.cfcP�Gc Q �-- , ... .. H�jot, �,�`� t� 1 q4 � � r dra► i � ` Nnr "Na Moto _w. 'Z OOK -14R o u i SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF .THE SUFFOLK CO. DEPT. OF HEALTH SERVICES APPLICANT SUFFOLK COUNTY DEPT. OF HEALTh SERVICES — FOR APPROVAL Of CONSTRUCTION ONLY �j ✓ jr �' �_' DATE: ���\ ` V, H. S. REF. NO.: .57-50-IB2 R cj,v�- V r APPROVED: fqot SUFFOLK CO. TAX MAP DESIGNATION: > DIST. SECT. BLOCK PCL. o Ora C O /o00 97 7 i3 1 ± h�o.� I \QI OWNERS ADDRESS: 4ZI Kea, t ,� .,��, r Vj DEED: L. P. Y `+k 0 "" �� / TEST HOLE STAMP dr�� . 76 �� C .�C'�" !�✓ / 'O. O LAG. 7 Una.Merird aneretfon«addill" to this owv@v Is a vlaetlon of Section 7209 of"New York ew, SLED / 1 Fetmoon L ——__—`— L-C7 / f i/R L Et N.T , Codes of No awvw map not bowy the land survoWt Inkaed seal YG�sl d�nC l t / h o T D` empossed seal shelf not be oon kkmd r .� Is be a valid atre Bopp, i GUW91 in kvlkated hereon shall run MAP DF PROPEF2 7-Y r f� k owo&and on�"�'n wthee°� #t$*oernoenY.governmental agency ani Z A:zV,�'�fE�i �b / kxabnp InsMu9on noted hereon arw 11X .__.__/,� —�._:__�� / C to the assignees of the lending Moti. _ 7,—E— l Mlon.Guarantees are not transferable AL T�"� /� A Vo AV To/,,VE-T Z90 to additional institutions or subepuard / owners. A7 t7 le-Q SEAL CU TCf��G UE; /VY f LlYY�1 c (.J(�iPC ziKVE{y`p f riQOF �y 9 -, MAP AMENDED. :f.UW5 ]'f,148$ RODERICK VAN TUYL,P.C. {46 �2 . V .► ._ T g. LICENSED LAND SU VEYORS ��yyo'S ti� 4 � 255 GREENPORT NEW YORK s`cdteunSJ�