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Home My WebLink About28400-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29131 Date: 12/17/02 T~IS CERTIFIES that the building ADDITION/ALTERATION Location of Property: 500 SUNNYSIDE RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 63 Block 1 Lot 3.2 Subdivision Filed F~p No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated M3~Y 17, 2002 pursuant to which Building Permit No. 28400-Z dated MAY 17, 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 AND ALTERATION TO Aiq EXISTING ONE FAMILY DWELLING AS APPLIED FOR. · ~ne certificate is issued to MARTINE BASCHNONGA (OWNER) of the aforesaid building. SUFFOLK COUlqTY DEPART~4ElqT OF E]~Ju~ APPROVAL ELECTRIC_AL CERTIFICAT~NO. PLUMBERS CERTIFICATION D~£~d3 12/09/02 N/A 65145C 09/30/02 JOSEPH TUOMEY 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. 28400 Z Date MAY 17, 2002 Permission is hereby granted to: MARTINE BASCHNONGA 134 AUDLEY STREET KEW GARDENS,NY 11418 for : ADDITIONS AND ALTEP~ATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 500 SUNNYSIDE RD SOUTHOLD County Tax Map No. 473889 Section 063 Block 0001 Lot No. 003.002 pursuant to application dated MAY 17, 2002 and approved by the Building Inspector to expire on NOVEMBER 17, 2003. Fees 150.00 ~0~i ~~rix S Rev. 5/8/02 ORIGINAL Form No, 6 ' ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 i APPLICATION FOR CERTIFICATE OF O~tL~PANCy 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. Co 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. 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: House No. Old or Pre-existing Building: Street Date. ~! /_ ~ . (check one) Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Lot Filed Map. Lot: Date of Permit. Ad/ar ? Underwriters Approval: Final Certificate: ~ (check one) A~plicant Signature P. LA E'OX ] 17 !-;uuthokL N~,s York Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF 8OUTHOLD CERTIFICATION Date: (pl.~ase print) {9~,ase prin; I ~rti6/that the solder us~l in the water supply system cotatains less than 2/10 of 1% load, (Plumber, Signature) Sworn t~ b~fom m, this Noisy Pub}lo,..~°unty COSALIE MASTERSCN Notary Public, Stale of New York No. 45~5531 Qualified in Commissio~ Expires JUry ~.~ o Issue Date 09/30/2002 Electrical Inspection Certificate Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Issued To: Peter and Martine Baschnonga Street: 500 Sunnyside Road Villige: Southold Zip: 11971 Town;-S~thold Application Number 65145C Section: Block: Lot: Introduced Ice Electric (L) Lic. # 4586-E Was examined and found to be in compliance with the National Electrical Code. [] Commercial [] NV Defects [] Pool [] 1st Floor [] Indoor [] Basement [] Hot Tub [] Residential [] Att. Garage [~ Attic [] 2nd Floor [] Outdoor ~ Addition [] Survey Switches Receptacles Fixtures GFI Heaters PJC Fans 3 I 4 1 1 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector / Other Equipment Bldg. Permit: Hugo S. Surdi President Rough Inspection: 07/23/2002 Inspector: Ed Scavelli Final Inspection: 09117/2002 Inspector: Ed Scavelli This certificate must not be altered in any manner, inspectors may be identified by their credentials, TOWN OF SOUTHOLD Pk-OpERTY-,RECORD CARD-~,,~_.~ - ~--~ VILLAGE DIST. :)WNER STREET ~' ~_.~¢,~.., SUB. LOT :ORMER OWNER ...~ . :iJ '"- N E. I ~ S W ~PE OF BUILDING ES:/D S~S. VL. FARM COMM. CB. MICS. Mk'. :olue ~ND IMP. TOTAL DATE R~ARKS I ' : / ' ~ ' 3.30 ~ ~' . ' ~-o :~c~ ~ '//~r/ ~:~/~x P~,~ ~z ~~s :~. ~','~'-- llab;e FRONTAGE ON WATER 'o~land FRONTAGE ON ROAD eadowland DEPTH ~use Plot BULKH~D ,ta I BUILDING PERMIT EXAMINER CHECK LIST DATE ISSUED: / /02 DATE REVIEWED: ~'-//-~/02 DATI~'SUBMITTED: ~--_//-~ /02 APPLICANT: ~'1~ 0df'lrl'l~_ SCTMS a~STmCT: ~,000, SaCT~O~: ~ , erocr: / , LOT: ~ EST~ATED PROJECT COST:¢/~~ ~HITECT / EN~ ~Z FAST T~CK?~O S~GLE & SEPA~TE CERTIFICATION-REQUIRED? ~ NOTES: LOTS 40,000SF -100-24. Lot recognition.(CI~ATED bemre June 30 [983), UNDERSIZED LOFS FROM JAN.1997 100-25 Merger (A noncantbrming at any time after 7/1/~ ~Q. LOT S~E~¢~O . flCT. LOT SIZE~ ~Q. L~OV. ~0~ ACT. LOT COV. ~Q. FRONT ~ ~ffP~P. FRONT~-~ S~E /~7/~ ACT. S~E / ~Q. ~ ffi / PROP. ~ / WATER FRONT.'? ~ DESC~TION: e~L ~:/~_ FLOO~ ZON~:_~ , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH/.D_EPT: YES or~(BED #): DTE: / / PERMIT #:R10- TOWN SEPTIC RECEIPT: Y ~) NEW YORK STATE DEC: PRE-DEC 9/1/75 YES SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES ort~ TOWN PLAN. BOARD APPROVAL: YES or TOWN HISTORICAL PRE (SPLIA): YES / Ot~: NYS ENERGY: YES __~:z~ x 40/0) rt"/t'4~ LIGHT (SQ. FT. x 8%) EGRESS (18 H min.? 4 s~-%tal) ~ VENT (SQ. FT. BUILDING PERMITS OPEN/EJ~PIISJED: BP HAVE PRE CO'S: Y OR N BP _,zz~q~ c,Q -Z / C/0 NOTES: ~---~'C?_ 0 '4-~/ C /O / FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: 1. ( SF)- ( SF): SF X $ 2. ( SF)- ( SF)= SF X $ SF SF SF SF INIT SF FEE =$ +$ +$ =$ +$ +$ OTHER TOTAL FEE~.~~~ _ =$ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]--FO/u~ATIoN 2ND [ ] INSULATION [ ~ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~//~,~ ~ DATE INSPEG'~rOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ R~OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ~ON [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS~/ ,~ ~ / DATE 765-1802 BUILDIN~ DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATI~01~ [ ] FRAMING [ ~_]~-INAL [ ] FIREPLACE &_CHIMNEY RE TOWN O¥'~ SOUTHOLD BUILDING DEPARTMEN TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examh~ed 6'A? ,20 ~' .Approved 5'//;¢ ,20 ~' Disapproved a,c t'~xpiration [¢7 ,20 ..ff BUILDING PERMIT APPLICATION CHECICLIS? PERMIT NO. Z~?4~d7 ~ Do you have or need the following, before applying5 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: Building Inspector t APPLICATION FOR BUILDING PERMIT i ~ Date ,~2ar~ ~o ,20o~- INSTRUCTIONS .... ~'"'--a. Th/s application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 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 z~reas, and waterways. c. The work covered by this application may not be comrncxlced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Perm/t 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 perrmt shall expire if the work authorized has not commollCed within 12 months after the date 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 cfa 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 apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on prem/ses and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) 5rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises '---~,~ q--e~ ~ ~ c~ ~c._C-, (As on the tax roll or la'test deed) if 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. dy=Il ~qj.. Location of land on which proposed work will be done: House Number Street'~ Haml~ County Tax Map No. 1000 Section Subdivision (Name) Block i i Lot Filed Map N6. Lot State existing use and occupancy of premises and intended use and occupancy of proposed constrUction: a. Existing use and occupancy <~ ,~_s\~ ~-"~.,~,,, \--, ~ ~,~ c>Ka -,~ o~ \ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Rep air Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition b-~/'' Alteration Other Work Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing stmctures, ifany:FroTM '~f~ -O Rear 4-~- O Depth Height Numberof Stories - ~- ~o Dimensions of same structure with alterations or additions: Front ,~ % -- o Rear Depth ~ ¢..~' - (,o" Height Number of Stories '-T-'~-~ ¢ $. Dimensions of entire new construction: Front '~r ~n.. Rear Depth ~9 Height --7 .-' O" Number of Stodes ~ e_ 9. Size oflot: Front /4~-- ~cl Rear I(~z¥- -~-~ Depth /zbo 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed conshmction violate any zoning law, ordinance or regulation? YES__ NO 13. Will lot be re,graded? YES NO k//'Will excess fill be removed from premises? YES__ 14. Names of Owner of premises Name of Architect Name of Contractor NO Address S~ ~,^n~ ~, Phone No. Address Phone No Address ~v c5-~,.,~-¥ ~A Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a tSeshwater 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 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: COUNTY OF ) ~--- z-7~ ~ .~-,~ & ~ ~--,~- ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual s/fining coni~act) 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 tkis application; that ali 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 fi/ed therewith. Signature of Applicant N~F Lauer GREEN FIELDS LANE N/F Graseck N 72'$9'20" E N/F Conwoy Bros. 27.4' S 72'28'50' W N/F Winterling 164.37' N/F Actu ' ~ ~: 1000-063-01-,3.2 GUARANTEED TO, ~f~r 8o$chno~qq Morfine Boschnongo - Modne Midlond Morfgoge Corp. FTdellfy Notionol Title Ins. Co. ~98-16512 Town of Southold SURVEY OF DESCRIBED PROPERTY si TUA TE SOUTHOLD. TOWN dk: SOUTHOLD SUFFOLK COUNTY, NEW YORK SURVEYED FOR: t44RllME B~.~I-I~ SUR1/EYED: 5 August, SC41.E: 1 '-,JO' AREAS,. 21,266 S.F. or .4aa ACRES 1998 DnaqJItK~d ghmflm e~ addition to Ifl~ i ~rvey Is e vlolal~ ~ ~ 72~ ~ SU~D B~'., ' I ~ .. ~ ~ ~ ~. sr~ ~s~.-~. I - . . New S~Co~~ I~956 .~ I ..... 8 725 ~ . !:~ OCCUPANCY OR /.~:: .~... USE IS UNLAV~;FUL I WITHOUT CERTIFICATE ~PROVED AS NOTED OF OCCUPANCY NOTIFY BUILDIN( 788-1802 e AM TO 4 PM FOR THE FOU.OW1NG INSPECTIONS: ~_. 1. FOUNDATION' TWO REQUIRED q ~. ROUGH - FRAMING & PLUMBING · FINAL · CONSTRUCTION MUST BE COMPLETE FOR C.G. ALL CONSTRUCTION .HALL MEET ~ T.E REQU,REME,TS OF TNE ,.Y. BTATE CQN&T~ U CT!O~I~ ~E NER GY CODES. I~O~T -~IES~i~I'I~B~.E FOR 295 BENNETT ROAD ', GREENPORT, NY 11944 * 4..r'a'l'6) 477-3065 - LIC. # a3llljIl~JlJl~l 295 BENNETT ROAD · GREENPORT, NY 11944 · (516) 477-3065 · LIC. # 24,139-HI 295 BENNETT ROAD · GREEN?ORT, NYl1944 · (~1!~/~477-3065 · LIC.-#~i~I~I~!~I