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HomeMy WebLinkAbout27982-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29084 Date: 11/18/02 THIS CERTIFIES that the building ADDITION Location of Property: 2725 PINE NECK RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 6 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 31, 2001 pursuant to which Building Permit No. 27982-Z dated JANUARY 2, 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DANIEL V O'BRIEN & WF (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1063039 07/05/02 PLUMBERS CERTIFICATION DATED N/A CIV A- lik&'Aa Authorized S gnature 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. 27982 Z Date JANUARY 2 , 2002 Permission is hereby granted to: DANIEL V & WF O'BRIEN 42 PENN ST PORT JEFFERSON STATION,NY 11771., for . ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 2725 PINE NECK RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0006 Lot No. 002 pursuant to application dated DECEMBER 31, 2001 and approved by the Building Inspector. Fee $ 347 . 70 Authorized Signature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD o \J 1 IAC 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)Sion-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. �Ol/ /S o200�, New Construction: Old or S Pre-existing Building: 1/ (check one), (� / Location of Property: 979 //�B /I/er-*///1 oA UoaAp`O House No. Street Hamlet Owner or Owners of Property: AAeZe L (Z .4xAO ZLePn/ / /L'A) Suffolk County Tax Map No 1000, Section ZO Block 45� Lot aL. Subdivision r� p / Filed Map. / ,Loot: Permit No. 02/�a o2- Ti Date of Permit. C/ �i ���� Applicant: Oq rlle L Health Dept. Approval: Underwriters Approval: Planning Board Approval> Request for: Temporary Certificate Final Certificate: [/ (check one) Fee Submitted: $ a2 S 00 o�J _ 1e�W Ie G Applicant Signature rJ�r PLrrr.1rJi P�PrJ�rJ�rJ�rJ��tr.PrJ�rJ�cPrJ�rJ�r1rJ�rJ�rJ�rJ�rJ�rPr Pr PrJ�rJ�r�rJ�rJ�rJ�rJ�rJ�cPcPrJ�rJ��PcPrJ�rJ�rJ�rJ�PrJ�rJ�rJ�rJ�rJrJ�r�rJ�rJ�rJrJ�cPr�rJ��PcPrJ� C51 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 BUREAU 40 FULTONSTREETTF ELECTRICITY NY 10038 ^ i 5 5 5 CERTIFIES THAT 5 Upon the application of upon premises owned by S 5 JIM SAGE ELEC. INC. DANIEL O'BRIEN S P.O. BOX 38 2725 PINE KR GREEN ORT, NY 11944-0038, SOUTHOLD, NY 11971 5 5 5 5 Located at 2725 PINE NECK RD SOUTHOLD, NY 11971 5 5 Application Number: 1063039 Certificate Number: 1063039 5 5 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 Outside, S �5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 rj found to be in compliance therewith on the 5th Day of July, 2002. 5 5 Name OTY Rate RAing Circuit Type S 5 Service 5 5 1 Phase 3W Service Rating 200 Amperes 5 5Meters: Service Disconnect: 1 200 cb 5 1 5 5 5 5 5 5 5 5 5 5 5 S seal 5 5 5 1 of 1 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. O cPrJ�rJrJ�rJrJ�rJ�rJrJ��PrJ��Pr�rJrJ�rJ�rJrJ�rJ�rJrJ�rJ@JrJ�r�rJr 1:11 i]AL2 011 J:1153,�1r f 11011:J��Pr :111:1�rJol lg , I. !rJ�rJ�rJrJr_IrJ�rJ�rJ�rJrJ�rJrJdP O ,rgj a- 70 - 6 - z TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET `,,'n` r• VILLAGE DISTRICT SUB. LOT 1 /1/ e t en14 w jrA, EQRMER OWNER N E )� j t ACREAGE �. S J W t YPE OF BUILDING RES. 1�1!© SEAS. VL. FARM COMM. IND. CB. MISC. LAND IMP. TOTAL DATE REMARKS 6 rTU t� d tll f�Tr'/Ii `3 �7 D .300 d 3S0 o :-''' 5-1212 J , �U lS9.Leo 4ez tJ, s-o V. G' >pjely-+wr= 3;'l ` � If �yGB / kJ &-e, f `Sbd 6 �s �I � •.`r� a. Gf.✓�ii:.. Fri'. f"�C �'(?--4..a �.. -slid �( a//f 4 *f7"� AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 !:�tH• t S Tillable 2 Tillable, 3 Woodland Swampland Brush.land., House Plot Total ', ,, � �;�: �� ■■■ �'fir�■` ic�l%%71■■■0111■ 4 '® Foundation Bath ExtensionExtension U t;-V Basement Floors 4 Extension �-_ Ext. WallsInterior Finish 6C r 7 13, . • Fir- Place Heat ' ®® Porch •e4 Q Porch Rooms Ist Floor f12 1. �;lt Patio Rooms 2nd Floor Garage Driveway • : BUILDING PERMIT EXAMINER CRECK LIST DATE REVIEWED: Al/a /O&, .DATE SUBMITTED:i.? /,2( /01 APPLICANT SCTM# DISTRICT: 1.000 SECTION: �'D BLOCK: 46 LOT:_ STREET:oD-4a S ���,, c�� a . CITY: Eo�T-t-t c,jt SUBDIV. NAME: PROJECT DESCRIPTION: ADD Imo- o rt Tri ARCHITECT/ENGINEER.a FAST TRACK? pyo SINGLE & SEPARATE CERTIFICATION-REQUIRED? Nz> NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconfomdng at any time after 711A ZONING DISTRICT: R-y0 CONFORMING? h & REQ. LOT SIZE:_ yo,000 ACT. LOT SIZE: A0'1340REQ. LOT COV6�6 ACT. LOT COV. 18.6 "o REQ. FRONT - 3S- PROP. FRONT REQ SIDE sS ACT. SIDE= / f Y v' REQ. REAR PROP. REAR Y35- WATER FRONT? A10 DESCRIPTION: PANEL #:" FLOOD ZONE:- AGENCY ONE:AGENCY PERMITS REQUIRED FOR REVIEW APPRQXALS REQUIRED: SUFFOLK COUNTY HEALTH DEPT: YES or ED #): DTE: / / PERMIT#:R10- NEW YORK STATE DEC: PRE-mc Sims YES o O SOUTHOLD TOWN TRUSTEES: YES o .TOWN ZONING BOARD APPROVAL: YES o TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES o O NYS ENERG : YES R NO : -r 1I / EGRESS (18 H min.?4 sq total) VENT(SQ. FT. x 4%) LIGHT(SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP 39 -Z/C/0 Z-3-7 9 8 , HAVE PRE CO'S : Y OR N BP/ y ,6!-Z/C/0 Z- /3 (/�a , NOTES: 4bbl to 0 b FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : .5a SF SECOND FLR : SF INIT OTHER TOTAL TOTAL: D SF FEE FEE FEE 'OT 1( b p9 SF)- (S,50 _SFX s, so=$V -Lo-+s �.;0 +$ _$ M-1802 BUILDING DEPT. INSPECTION [ FO NDATION 1 ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY RE RKS: DATE O s i y INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ 'FOUNDATION IST [ ] ROUGH PLBG. C � [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ) FIREPLACE & CHIMNEY REMARKS: DATE OINSPECTOR , v 765-1802 BUILDING DEPT. INSPECTION [ ] FO DATION IST [ ] ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL ( ] FIREPLAgE & CHIMNEY ARKS: R ®!� 1 Zoe DATE O INSPECTOR 7?Fz 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ IR H PLBG. [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPL CE CHIMNEY REMARKS DATE O N PECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ X,FINAL PLBG. [ ] FOUNDATION 2ND [ TION [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY c R RKS: 4-� DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS• 0)%- let DATE Q7/ INSPE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS LATION [ ] FRAMING INAL [ ] FIREPLACE & CHIMN Y REMARKS: DATE �� INSPE VA 17 NO— Mr '-M�AMFI-Mou �•. �� , 77 �i :1 M 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 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. Chectj_y7/r'2. Septic Form N.Y.S.D.E.C. Trustees Examined -2 20 D Contact: Approved Z 20 0 7— Mail to: Disapproved a/c Phone: y„?8 - 1$71 2, n� Building Inspector DEC 2610 APPLICATION FOR BUILDING PERMIT ,yr BLDG.JVJM OF DEPT. 0 " i I Date 120 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 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 lie 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 Occupanc} is issued 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 inspections. y(Signature of applicant of if a corporation)z ,oer,.•v J��4- (Mailing address of app cant) State whether applicant is , lessee,agent, architect, engineer, general contractor, electrician,plumber or,builder Name of owner of premises 1A,J/�'L A,r�� 1 eexJ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. %y 6e To Alec' d Plumbers License No. Electricians License No. Other Trade's License No. r i/ 1. Location of lando which pos w k wil be done: House Number Street Hamlet County Tax Map No. 1000 Section f;7a Block 6 Lot Subdivision Filed Map (Name) State existing use and occupancy of premise and intended useCyd oc ancy of proposed construction: a. Existing use and occupancy /C b. Intended use and occupancy /, A2 c Nature of work(check which applicable): New Building Addition­ �<_Alteration Repair Removal Demolition Other Work (Description) Estimated Cost 3J a00 Fee (to be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures,if any: Front tee i9 Rear Depth Height Number of Stories 0.✓e Dimensions of same structure with alterations or additions: Front aped R Depth Height Number of Stories �'!� Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front �/9� Rear .9e -LDepth / 0. Date of Purchase 2 h /� /�J�lame of Former Owner Zfc 44o/f� Lele f- 1. Zone or use district in which premises are situated 0 Dv /h o Zc �r e- /✓.,J/.Pi cT 2. Does proposed construction violate any zoning law, ordinance or regulation: d 3. Will lot be re-grad o Lees ,¢ Will excess fill be removed fro��ggpr es: YES NO �eL i ��Cee,v 7-- J, .v d>xee 4 p� 4. Names o er of premises Address e > Phone iso. � ! Name.of Architect Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES O /f/V • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on properly is at 10 feet or below,must provide topographical data on survey. TATE OF NEW YORK) 'OUNTY OF J-�Tc% }/ 1909,01eL being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, i)He is the f�wti (Contractor,Agent, Corporate Officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; iat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner set forth in the application filed therewith. wornn t -before me this day of f(Y-4 (✓ 20 Notary Public Signature of Applicant McmGOr MM JR. Nshry PAk,State of New Yak NL 01G06W554 GoVed in Suffolk Co CwmisAm E*m J*10, 002 1 I D.Q.r/fe L MAF AT I V' i IIt J QQ U"AUTHOrMD ALTVATION 0; AD�In f �_• Q i_ - W 'I 10 THIS SUCVIY IS A V10LATlON OF Slf1ICN 77(9 Cf THE NEW YCEK SIA7 FDVCAIlCN 4W. CON'.'. O7 THIS !U/VY A'npI EFA[ t-"D SU:."VCi 'S lK,E) SAL OC I ����.�� i 1 Ey•CLi:C t!At r_kcLt N"•1 —� IO CI I. VATIC tLUL CC:Y. !1 1 G'JACA vi-'< iN!^I'At:D I O r O!::Y Y r, C IS iii;l A a, nSo..._ 0•II 1.T L!:.: Lel '� \V • TO 1HF ' fu kL i I OwnLCS: ._.a'• S.LJV J..�T rt^J YJ. it J.�� _ _ __ xi 'r-_— Gnl:, � itivr vA�IC• C:.�.: i•.�. �• i • !: . ._ . '_ I-' L-- O-I:�,: Iii f%i:=F . . _ - -•-- --- --=�:--- I MAP I ' Cu r U t9 LFj I17 1 w s T ll 1.. 1 - U.VAUTH0T:17FD ALTEF'ATTCN O2 ADJI❑ EO THIS 5MVEY IS A VIOLATION CY ,�. SECIICN 77C9 CE THE NLw YC:.K STAT FUVCANON iAW. L i •!1 l Eti W '1 CONES Of THIS !t!;"y A1nV• Ac tHE Lv.D sv,,VLV02'5 IN-'D SEAL 01 ul p J ,5:7c Ay F. D $AI !HILL NOt 'E - U)—y0•i_ F pH - I 10 EL A. VALID fI VE IC:T. G it t-j �✓' i f G9ASA vIIf' IN.;Ir A/:J HK,!7N "'Alt ON:T T. . E E 1 15 A'-C O.. n.Si...- O'TI AGt:.0 ,.,....n c.'_T-C r....o:<• A TO IN[ 29 — No 1 I ta: C".G c:S GNANf�6 10 AC: + Ownt'-s I I � �JrSI .-w`i:r F:YL. �o:,� t Tv1� i � �T I ^c . Ne c K lr-<cIlk.9 .w_!1v Llai i . c�R.�c •-� ...� 07-1 at..., KN-5 *-7��c I�Dluc�c.�+-VES ___ __ ..,, ._,._.._..,. _.._, ....,. . _.__._ -_.. ,., ._ ._ _.___.._. __�__ .._._____.__. __�.__ ,.,r __ _—_� jauN o,� Loc.4T%oN-iv�YP�-.�E�7 ._._...__. .____., _ UNVWRITERS CERTIFICATE REQUIRED APJt0VEDASNOTED OCCUPANCY OR DATE- 14a B.R#22;y USE IS UNLAWFUL PLUMBING 'f WITHOUTCERTIFICpSE ALL PLUMBING WASTE FEE: JY • 9D BY:-c-� &WATER LINES NEED NOTIFY BUILDING DEPA TMENT AT OF OCCUPANCY TESTING BEFORE COVERING 765.1802 9 AM TO 4 PM FOR THE - "--"— FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE PROVIDE SMOKE-DETECTING PROVIDE ANTI-SCALD AND/OR 2. ROUGH - FRAMING i PLUMBING ALARM DEVICES THERMAL SHOCK PREVENTING 1 _- rNcMliM h, -T- I. 3. INSULATION 7S 4 FINAL - CONSTRUCTION MUST AS TO PART, 721.1 DEVICES AS TO PART. 902.6(K) BE COMPLETE FORC,O. , N.Y.S BUILDING CODE. N.Y. STATE BUILDING CODE. ALL CONSTRUCTION SHALL MEET ;Q y' Q THE REQUIREMENTS OF THE N,Y. d STATE CONSTRUCTION d ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS PLUMBER CERTIFICATION CONTENT BEFORE f — � - - - -- ,, _ mgr-zGy CdLUL a�TniJ 5 15, f� r. mi T4W 1.1 b e^W' 4JJS c� 1aFyw�1a� ( Y FIC TE OF OCCUPANCY + �+ �' =-' rM ------ %`,- USED EM CANOT exp; 'tNJ, rSO I UST WATER .._r...-- : LA-lrr♦J. - -- 'ler 'L2' R,n, w 6 as1�nl�iT + b' iJt� ttf, S 77 •L 16' + 42 Id"3 '4 cs '6 4L*r POFCEEL 2110 of 1% LEAD. 'I lStiQ1 r dFGc�C�' �Nefl�Nin.6 t} � _ _ Ta - - - - � 4 f �Lrn/iS 'S7y I q z If co per tubing is used I — 1 � 1. z s I ( l jo4► 7 al. al it � ' I J _ or star distributing +. G W iG hKYs " i sysi m: Piping shall be nC' GR. I . rx�w wnu ua P w�tic of pas K or L only e t t �' S w7t _ rt� __ + WRITERS CERTIFICATE C m4 41,rp I _ G p ti' a Ww+w 'I, 4dt r fr q� HT1 i P,Jn tid1 foJ( CS N.Y REQUIRED I 1 — � ; •, +r{Td,tLN � Cov'�niAS T7 ate' Q"�E wecc . 5RKS7Z _ fll l g'.. 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