The URL can be used to link to this page

Home My WebLink About28125-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29191 Date: 01/13/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 3485 MINNEHAiqA BLVD SOUTHOLD (HOUSE NO.) STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 3 Lot 11 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 26, 2002 pursuant to which Building Permit No. 28125-Z dated MARCH 1, 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 ONE FAMILY DWELLING WITH COVERED FRONT PORCH AND ATTACHED ONE CAR GARAGE AS APPLIED FOR. The certificate is issued to BMA CONSTRUCTION CORP ( OWNER ) of the aforesaid building. SUFFOLK COUNT%[ DEPARTMENT OF HRAL~APPROVAL R10-01-0146 12/31/02 ELEt-r~ICAL CERTIFICATE NO. 111656 lZ/~1/02 PLUMBERS CERTIFICATION D~C~D Rev. 1/81 Authorized Signatu~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII,DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28125 Z Date MARCH 1, 2002 Permission is hereby granted to: MICHAEL C & WF TISBO 62 STRATFORD PLACE SYOSSET,NY 11791 for : CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTACHED GARAGE AND COVERED FRONT PORCH AS APPLIED FOR at pre~uises located at 3485 MINNEHAHA BLVD SOUTHOLD County Tax Map No. 473889 Section 087 Block 0003 Lot No. 011 pursuant to application dated FEBRUARY 26, 2002 and approved by the Building Inspector. Fee $ 999.60 Rev. 2/19/98 COPY Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY a ~ [~, ~ 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. 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, thc Building Inspector shall state thc reasons therefor in writing to thc 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: 23 ~ ~ House No. Owner or Owners of Property: .J~ ~'~ Suffolk County Tax Map No 1000, Section Subdivision Permit No. ;~1/~: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submit[ed: $ Date of Permit. Date. Old or Pre-existing Building: Street ~) 7 Block Filed Map. ¢ _ J ,.-- 0 '~Applicant: Underwriters Approval: Final Certificate: (crheck one) .3 Lot /// Hamlet Lot: (check one) Applicant Signature 575BmadHdlow Road, Mdv~ N? 11747 (631) 694-3040. F,a,X: (631) 420-8436 NYSCCH ID# 10478 HARRY GOLDMAN WATER TESTING MAIN ROAD MATTITUCK, NY 11952 Attn To : 631-298-4640 Federal ID Collected : 1/3/o3 8:30:00 AM Point No: Received : 1/3/03 3:38:00 PM Location: Collected By : JD99 Copies To : Client LABORATORY RESULTS Lab No. : 0301056-001A Parameter(s) Results Units Lead 0.05 % Client ID.: FRANK NATALE Sample Information... Type : Solder Origin: Dist. Routine 3485 MINNEHAHA BLVD,SOUTHOLD SOURCE(CWL-HWH) (28125Z) Limit Method Number Analyzed 0.2 SW6010A 1/9/03 2:09:00 PM Result(s) reported meet(s) Regulatory Limit(s). Result(s) flagged with W Exceed Regulatory Limit(s). Limit noted. Date Reported: 1/10/03 Page 1 of 1 Laboratory Manager LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. 670 MIDDLE COUNTRY ROAD ST. JAMES, NEW YORK 11780 (631)265-3075 Fax(631)265-6057 Application No.: 111656 Permit Number: 28125Z Block: Lot: Section Owner: BMA Construction Address: 3485 Minihaha Blvd. Municipality: Southold OwnerPhone: NY Agent: Top Gun Electric Address: P.O. Box 1464 Southold NY 5150E top gun 11971 License#: Agent: No. ITEM SIZE No. iTEM SIZE No. ITEM SIZE 27 Switches: 0 SubFeeds: 0 PoolsAbvBIo: 43 Receptacles: 0 Timers: 0 PoolslnGround: 5 GFCl Devices: 1 Transformers: 0 Pools Filter: 4 Dimmers: 2 ACEqulpmentCentral: 20/30 0 Pools Lights: 20 MediumBaseFixtures: 0 ACEquipmentWindow 1 CO Detectors: 0 FluroescentFixtures: 0 MotorsbyHP: 0 Disposal: 0 HID: 0 Generators: 0 Metal Halide Lamps: 1 RangeOvenCookTop: 1 WhirlpoolHotTub: 0 RefrlgUnits: 1 DryerElectric: 1 Microwave: 0 WalkinBox: 2 ExhaustFans: 0 WaterHeaterElectric: 0 ExhaustUnit: 0 CeilingFans: 7 SmokeDetectors: 0 SteamShower: 1 DW: 0 TrackLightingStrip: 0 BreadWarmers: 1 Laundry: 0 ElectricHeat: 0 GarbageDisp: 3 HeatingEquipMotors: 0 PumpMotor: 0 CentralVac: 0 ExitSigns: 0 Disconnects: 0 ChandellerLifts: 0 EmergencySigns: 0 FutureOutlets: 0 ElevatorLifts: LOCATIQN OF WORK: []Basement []FirstFIoor [] SecondFIoor [] Outside [] Addition ~ Survey [] New Const. Comments New Residence Final 11/13/02 / Additions OH [] UG '~ Amp: 2~)0 Phase: 1 Volts: 24._.Q Wire AL Conductor 4/0 # of 1_ Temporary [] Type: Size: Meters: MernberI. A.E.I.Electrical CertificateCertificate No. 111656 LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC. THIS CERTIFIES TH/~r%OUR L/~AL DISTRICT Certificate Issued on: 11/11/02 INSPECTOR CONDU pTl~D Alq II~SPECTION OF THE VISIBLE PORTION O F TlliE E~LEC:TRICAL Issued to BMA Construction INSTALLATION DES(;RI~E[7 H~L~REIN AND IS Address: 3485 Minihaha Blvd. COMPLIANT W~.H TJ{E/CU~F~NT NATIONAL Southold NY ELE~ Top Gun Electric P.O. Box 1464 ~/ IAEI Certified Inspector SouthoId NY 11971 BUILDING PERMIT EXAMINER CHECK LIST APPLICANT NAME: ~:~Lt~ SCTM# DISTRICT: 1,000 SECTION: STREET: ~/~ BLOCK: ~ LOT: DATE REVIEWED: .~ /Z~/0L ,DATE SUBM1TTED:,Z. //_g/0~... PROJECT DESCRIPTION: ARCHITECT / ENGINEE :1~~/o~"-~- FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? /,~C-~ NOTES: LOTS 40,000SF -100-24. Lot r~ognition.(CREATED before Sun¢ 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any time attex 7/1/83) ZONING DISTRICT: ~'~o CONFORMING? K° REQ. ~T SIZe: q0~ooo ACT. LOT S~E:~ ~Q. LOT COV. ~Q. ~O~ ~f PROP. FRO~ ~ ~ ~Q S~E / o / 2 ~ ~Q. ~ 3X PROP. ~ 7 ? ACT. LOT COV. ACT. SIDE WATER FRONT? r~/-) DESCRIPTION: PANEL #: FLOOD ZONE: /~/ , ..a_,~- _a ~ · ~,~ __ AGENCY PERMITS REQUIRED FOR REVIEW 3~PPROVALS REQUIRED: SUFFOLK COUNTY HEALTH DEPT: ~_~.~r NO, (BED #): .¥ DTE: ?//~/o / PERMIT #:R10- NEW YORK STATE DEC: ra~-oec 9nas YES SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA):~ YES oN~ NYS ENERGY: ~$JOR NO: .4 ~/~ EGRESS (18 H min.? 4 sq total) ,./VENT (SQ. FT. x 4%) ~/ BUll,DING PERMITS OPEN/EXPIRED: BP ~- -Z / C/0 Z- HAVE PRE CO'S: Y O~'~ BP -Z / C/0 Z- NOTES: LIGHT (SQ. FT. x 8%). {t FEE STRUCTURE: FOUNDATION: (./~3 SF FIRST FLOOR: /; Tqo SF SECOND FLR: q7 ~ SF TOTAL: ~/_~ ~.~3.Z SF 'OT(~;~oQ SF)-(~ffC> SF)=~,t~o~ SFX$.30 INIT FEE +$ +$ OTHER TOTAL FEE FEE = s qq t.cc> Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 02/22/02 Transaction(s): Septic Permit - Construct - Resid. Receipt: 1022 Subtotal $10.00 Check#:1022 Total Paid: $10.00 Name: Bma, Construction Corp. 225 Stewart Avenue Bethpage, NY 11714 Clerk ID: HELENEH Internal ID: 50176 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) Title No. 603S8031 JEANINE SCHNEIDER, being duly sworn, deposes and says: THAT she is a Title Officer of Paragon Abstract, Inc., Agent of First American Title Insurance Company of New York, and that she has had a search made of the records of the County Clerk of the County of Suffolk with reference to an application for a single and separate search affecting premises: DISTRICT: 1000 SECTION: 087.00 BLOCK: 03.00 LOT: 011.000 THAT the said records indicate the following chains of title as to the subject premises and adjoining premises: SUBJECT PREMISES: Section 087.00 Block 03.00 Lot 011.000 Nichols Properties, Inc. to .~Ienry M. Aldrich and Deborah M. Aldrich, his wife ~Hex~ M. Aldrich and Deborah M. Aldrich, his wife Siglain and Dorothy Siglain, his wife Dated: 12/15/56 Recorded: 12/24/56 Liber 4233 cp 268 Dated: 12/1/76 Recorded: 12/2/76 Liber 8151 cp 425 Edward Siglain and Dorothy Siglain, his wife to Lewis L. Edson Dated: 3/2/84 Recorded: 3/13/84 Liber 9527 cp 134 Dated: March 15, 2001 Schneidler ~ Title Officer - Notary Pub~m~ ot~t~ of N*,w York No. ~4714972 Oua!ified h'~r~ Cmmty 200 Co.orate Pl~a Suite 103 Islandia, New Yo~ 11722 aant ~y: MM La~e~det 3100~ PITNIC & ldA_RGOLIN 51~ 234 199,9j Feb-25-02 ~:I4PMj 003/006 l)s(m o~]h]#~,: Now~R~' 14,'~01. 765-1802 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CNIMN)~Y DATE ~~ 765-1802 BUILDING DEPT. INSPECTION ] F~NDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE ~/~/~/~ INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ]/~UNDATION2ND [ ]INSULATION ['~ FRAMING [] FINAL [ ] FIREPL~&CHIMNEY ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]_~LATION [ ] FRAMING [ ~'FINAL [ ] FIREPL~(~E & CHIMNEY f/fi ~?.' ~ ~ . :~"2~ . ..-4-:;.:, ----, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ].~.A-?tON [ ] FRAMING [ ~ FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR I~.D ~a'ECTtON R~'ORT ...................................... /,. ~~ /~.~ ~_~ PL~B~G ~S~A~ON PER N. Y. STATE ENERGY CODE //~~~ ~D~ON~ COUNTS / k' ~ /~ / ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 PERMIT NO. o'Og~l~ ~-- Do you have or need ~e follo~g, before applyin~ Bogd of Heal~ ~3 sets of Building Plans ~S~ey., --Check / Examined 3/~ ,20 07_-- Approved .~/ , . ,20 o2- Disapproved a/c Septic Form ---"N.Y.S.D.E.C. ~00 t · "~mstees ! ea~ t Conta~'~.x~S Mail to: }[ [}i! Coq ? 6 L~ [L~J 1 APPLICATION FOR BUILDING PERMIT Date ~. ~,[- ,20o~ ~~~ i INSTRUCTIONS a. This application ~ST be completely filled in b7 ~e~ter or in ink and submiRed to the Building ~spector with 3 sets &plans, accurate plot pl~ to scale. Fee according to schedule. b. Plot plan showing location of lot and &buildings ~n'premises, relationship to adjoining premises or public s~eets or areas, and wate~ays. c. ~e work covered by this application may not be co~enced before is$~ce of Building Pemit. d. Upon approval of this application, the Building ~s~ector ~11 issue a Building Pemit to the applicant. Such a pe~it shall be kept on the premises available for inspection t~oughoet'~e work. e. No building shall be occupied or used in whole or in pa~ for any pu~ose what-so-ever until a Ce~ificate of Occupar~ is issued by the Building Mspector. ~PLICATION IS HE,BY ~E to the Bulldog Dep~hnent for ~ issu~ce of a Building Pemit pursuant to the Building Zone Ordifiance &the Tom of Southold, Suffolk?o~W, New York, ~d other applicable Laws, ~dinances or Re~lations, for the c~ns~ction of buildings, additions, orMterations or for removal or demolition as herein described· The applicant a~ees to co~ply with all applicable laws, ordinan6?, building code, housing code, and re~lations, and to admit authohzed inspectors on premises and in building for neee~s~ inspections. (Si~e o~plic~t o[ name, ifa co.ora:ion) '" - ' (Mailing add~ess ~fapplicant) "~ -~ State whether applic=t is omer, lessee, agent, mchitect, engineer, general contractor, electfici~, plumber or builder Nameofownerofp~'emises ~ ~ ~ C. OCr!? (as .on the tax roll or latest deed) If applicant is a corporation~ignature of duly authorized officer "CNam~ ~nd t~tle o?c(~orate c~fficer) ' . 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 N~ber S~eet County Tax Map No. 1000 Section Subdivision (Name) ~' ' Hamlet · ' Block O % Filed Map N~. Lot / / Lot ~.,,,. ,...~.,~ u~ oa~u c,,.cupm~cy oi premises ay.d intended use ~nd occupanc)f of proposed construct.ion: a. Existing use and occupancy · ,~/ ~_/, c' O, PS,~-W~ ~ cq t,,,.'~'~ b. Intended use and occupancy Nature o£work (check which applicable): New Building Repair Removal Demolition Ssti, ted Cost If dwelling, number of dwelling units If garage, number of cars // Addition Other Work Fee Alteration (Description) (to be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Dimensions of entire new construction: Front Height Number of Stories Size of lot: Front Rear Number of Stories Rear Depth Rear Depth 0. Date of Purchase Name of Former Owner I. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re-graded & ~ 1~ a ta..O... Phone No '4'I t t _ Phone No. NO,,/. YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 4. Names of Owner 0fpremises Name of Architect Name of Contractor L~)O./~I) _f' t~ Address 5. Is this property within !00 feet of a tidal wetland? *YES Will excess fill be removed from premises: YES NO// Address 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: :0UNTY OF ) :.-7_7 ~fT~ _/.4a 0tt.~.o..-~~ being duly sworn, deposes and says that (s)he is the applic~t - ~'~go~d~vid~al ~i~i~g con=act) above named, i)lie is th ~ ~ ..... ~Con~ct~r, ~genfTOo~orate Omcer, etc.) said o~er or o~ers, and is duly authohzed to perfom or have perfomed ~e said work ~d to ~e ~d file this application; ~a~ all statements contained in this application are ~e to the best of his ~owledge and belief; and ~at ~e work willSe :flamed in the manner set forth in the application filed therewith. worn to before me this. ~ Notaw Public HELENE D. HORNE Nota~ Publio, State of Now York No. 49513~ Qualified in Suffolk Coun~ Commission Expires May 22, ~ ~ SUi~O~ COUNTY OEPAR~ OF I~.ALTLI SERVICES FOR MAXIMUM OF ,,~// BEDROOMS EXPIRES THRF_.~ YEARS FROM DATE OF APPROVAL 6P C) / / SURVE'r' OF PROPEP-.'I-'K 51TUATE.. ~~OLD TOI/~i: 5Ut:POLK C, OIJN'I'T', I,,i'K SURVE'r'ED 03-13-02 FOUNDATION LOC. 04-30-02 SUFFOLK COUNTY TAX # I OOO-~-/-3-11 SUFFOLK COUNTY DEPT. OF HEALTH SERVICES REP. # RIO - OI - OI4~ CERTIFIED TO: BMA CONSTRUCTION CORP. N S NOTES, · MONUMENT FOUND AREA = 11~4-/ SF OR 0.2~ ACRES FEN1A AE 8 LINE IS THE 8 CONTOUR A~ ~ETERMINED FROM A L/SOS BENCH MARK REFERENCED TO NOVD '2q TOP OF FOUNDATION LOCATION IS REFERENCED TO N~VD '2q DATUM ®RAPHIC SCALE 1"=20' 6 EAST MAIN STREET N.Y.S, LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\~Ip server\d~PROS\02-137.pro 5URVET OF: PROPERTT 51TUATE-. 50UTHOLP TOHN; 50LJ'T'HOLD 5L,TT, OLK 6,Ot)N"rr', NT' ~I)RVE'fED) 0~'-1~-02 FOUND)ATION LOC. 04-90-02 FINAL 0-'/-0~-02, SEPTIC LOC__,. 0~-1:~-02 SUFFOLK COL)NTT' TAX # I000-,~'"/-:~- I I SUFFOLK. COblNT¥ D)EPT. OF HEALTH ~ERMId__.E~ REF. :~ RIO - OI - 0146 CERTIFIED) TO: BI'dA CONSTRUCTION CORP. I I I I I I I I i ~ I L~~ ii / .~ / / / / 6 N W S E NOTES: · f"IONU~FNT FOUND) AREA = 11,24-/ 5F OR 0.2(, ACRE5 ®P-.APH lC. SC. ALE 1"=20' 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVBR/~AD, N.Y. 11901 369-8288 Fax 369-8287 REFAHp server\d~PROS\02-137.pro