HomeMy WebLinkAbout32867-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32277 Date: 04/03/07
THIS CERTIFIES that the building HEATING SYSTEM
Location of Property: 2800 PINE TREE RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 2 Lot 16
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 29, 2007 pursuant to which
Building Permit No. 32867-Z dated MARCH 30, 2007
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 INSTALLATION OF NEW HEATING SYSTEM FOR REAR COTTAGE "AS BUILT" .
The certificate is issued to IMELDA CORCORAN FARRELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 3023333 02/15/07
PLUMBERS CERTIFICATION DATED N/A
1
Authorized Signature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
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) 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
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00
Date. R6f0CA 20D
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 2-Wo PCMe—Fe-e _P-ea
House No. Street U Hamlet
Owner or Owners of Property: T W-0-�d a Gar
Suffolk County Tax Map"No 1000, Section L+ Block 6 Z Lot
Subdivision I�l.1SSGtM [�f/ WI S Filed Map. 7 Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ �5-0 0 ,� L—) 1,
L"I/plicant Signature
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. 32867 Z Date MARCH 30 , 2007
Permission is hereby granted to :
IMELDA CORCORAN FARRELL
95 DEAN DR
CUTCHOGUE,NY 11935
for
HEATING SYSTEM FOR REAR COTTAGE AS APPLIED FOR "AS BUILT"
at premises located at 2800 PINE TREE RD CUTCHOGUE
County Tax Map No. 473889 Section 104 Block 0002 Lot No. 016
pursuant to application dated MARCH 29, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 30, 2008 .
Fee $ 300 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
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5 BY THIS CERTIFICATE OF 5
5 COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 5 BUREAU OF ELECTRICITY 5
40 FULTON STREET — NEW YORK, NY 10038
5 5
5 CERTIFIES THAT y
5 5
5 Upon the application of upon premises owned by
5 5
5 ROSLAK ELECTRIC IMELDA CORCORAN
5 PO BOX 164 2800 PINETREE ROAD 5
5 CUTCHOGUE, NY 11935-2453, CUTCHOGUE, NY 11935 5
5 5
5 Located at 2800 PINETREE ROAD CUTCHOGUE, NY 11935 CJ
5 Application (dumber: 3023333 Certificate Number: 3023333 5
5 5
5 Section: Block: Lot: Building Permit: BDC: ns11 5
5 5
5 Described as a occupancy, wherein the premises electrical system consisting of 5
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 5
5 Basement,
5 5
5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
5 authority having jurisdiction, and found to be in compliance therewith on the 15thDay of February,2007. 5
5 Name QTY Rate Rating Circuit Tyne C5,
5 Miscellaneous 5
5 oil burner and safety shut off 5
SAppliances and Accessories 5
5 Furnace 1 0 Oil 5
5 Wiring and Devices 5
5 Switch 1 0 General Purpose 5
5 5
5 5
5 5
5 5
5 - 5
5 seal
5 5
5 1 of 1 5
5 5
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.
5 5
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck,N.Y. 11952
(631)298-7116
Date: February 5, 2007
To: Town of Southold Building Dept.
Re: Heat System Le.ar,House
Amelda Corcoran�-
2800 Pine Tree Rd.
Cutchogur,NY 11935
Permit#31001
To Whom It May Concern:
After an inspection of the heating systems were Aformed on the above property, it is
deemed that the furnace and hot water heater were installed correctly as per all state and
local codes. Any other questions concerning this matter please call.
f a i P �Y® ;\:} Sin,erely
LU \
1 s i
11b; _: James J. ID o i
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck,N.Y. 11952
(631) 298-7116
To: Town of Southold Building Dept.
Date: January 31, 2007
Re: Insulation Inspection/Energy Code Cert
Imelda Corcoran Farrell
2800 PineTree Rd.
Cutchogue,NY 11935
To Whom It May Concern:
After a on site Insulation/energy code inspection was performed on the rear house of the
above mentioned property, it is deemed that the type and placement of insulation was
installed correctly, and meets all building and energy codes at the time of construction.
Any other questions please call.
incerely
Ylu
i
m J. eerkoski
���FES$`
OF SOUlyo�o
Ag)-L �
cout `l,Nc�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
P
REMARK "
DATE � ��� � 7 INSPECTOR
FIELD INSPECTION REPORT . DATE COMMENTS
b
FOUNDATION(IST) y
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FOUNDATION (2ND)
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ROUGH FRAAEI�G& '
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INSULATION PER N.Y.
STATE ENERGY CODE (J
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD ROPERTY RECORD_ CARD L5
OWNER STREET 2�eo VILLAGE DISTRICT SUB. LOT 7/
FORMER OWNER N E ACREAGE ,v7
S W TYPE OF BUILDING
RES. 6 SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
���ooa� / i/oyl 70 �areAvar, j' �a
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm Acre Value Per Acre Value FRONTAGE ON ROAD e G-ea ae fc� z",
Tillable . 1 BULKHEAD
Tillable 2 DOCK
Tillable, 3
Hoodland
swampland
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TOWN OF SOUTHOLD PROPERTY RECORD CAA
OWNER STREET VILLAGE DIST, =' j SUB. LOT_
FORMER OWNER N E ACR.��
S ; W TYPE OF BUILDING /4
IRES. SEAS VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland.. FRONTAGE ON ROAD
Meadowland DEPTH
House Plot BULKHEAD
DOCK
Total
I '
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TOWN OF SOUTHOLD - BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL MAR 2 ZQU�
� ' � I Board of Health
SOUTHOLD,NY 119711 ----_J 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. 3 D46 7 e�_ Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined ,200 Contact:
Approved ,20_42�7 Mail to:
Disapproved a/c
Phone:
Expiration ,20e
' Building Inspector
APPLICATION FOR BUILDING PERMIT ►V IOVr� 2-?L
Date , 20 t)J
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 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.
OCCUPANCY,-OR ���',h
USE IS UNLA F (Signature of applicant or name,if a orporation)
O
WITHOUT CERT1,F. UNDERWRITERS CE tiF(� Pea is Dr i v e �fcko ve N �1°ys
(Mailing address of appli a t)
OF OC,CU_PANCY ,� REOUIRED
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
APPROVED c6 ED
�wvle
B.P.# 7
Name of owner of premises IRA ed J Q C-OrCor0_,IA L ny. _
(As on the tax roh orlil&1Ktyd d)DING DE:IARTMENT AT
If applicant is a corporation, signature of duly authorized officer 765-1802 + .=;,t TO 4 PIN FOR THE
FOLL044-ING !NSPECTIONS:
(Name and title of corporate officer) 1. FOUNDATION - T\N`0 REQUIRED
FOR POURED CONCRETE
2. ROUGH - FR.AIVING & PLUMBING
Builders License No. 3. INSULATION
Plumbers License No. 4. FINAL - CONSTRUCTION MUST
Electricians License No. BE COMPLETE FOR C.O.
Other Trade's License No. ALL CONSTRUC-fIOIti SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
1. Location of land on which roposed work will be done: YYOOR�K STATE. NOT RESPONSIBLE FOR
2 D 0 ?1 e. v2 u l�l N �1 7 RUCTIO �R OV
House Number Street Hamlet U
r
County Tax Map No. 1000 Section l 0 q Block Q Z Lot ` 6
Subdivision N U 55c1 U FW M Filed Map No. j Lot 4
(Name)
2. State existing use and occupancy of premises and intended use and occuparWy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy �e(,k 'I F -01SIzARM
j' !
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee 30
(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
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
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 NO
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* 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.
'F
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;'mustprovide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF ,S U L�
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing
contract) above named,
(S)He is the60-YA
(C tractor,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 true to the best of his knowledge and belief, and that the work will be
performed in the mariner set forth in the application filed therewith.
Sworn to before me this
day of 20
Notary Public Signature of Applicant
LOT 41
MAP OF
NASSAU FARMS
FILE No. 1179 FILED MARCH 28, 1935
SITUATED AT
PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-104-02-16
SCALE 1"=20'
MAY 11 , 2006
AREA = 18,450.44 sq. ff.
0.424 ac.
d °
d
Fa °
N/OlF / cF°
/ 9 d
T SANDERSON
HOMAS McKAY °
LOT 40 / °
/ 297.47 °
1 STORY FENCE FOUND
FRAME HOUSE / POST&RAIL FENCE 0.5'N. 0.fi'W. PIPE a /
HOUSE FENCE
30D FENCE 0.5'N.
-c_VERHEAI>vARES
r N 85°56'20 C STOCKADE FENCE
FENCE OONC.WALK
C ,r, FENCE O.L. ° GRAVEL DRIVEWAY .
yn f 16.6' 0
0.5'N. 1.4E. m SLATE 13.7'
STEPS •e
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UST-E
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r nm ° ., f A SLATE P <
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6.2'
SNOW FENCE ° ° , ° e ° ° c ° °
FENCE / '�••�CHMNEY 30.6' DIRT DRIVEWAY a d" S
d ° FOUND PIPE a �iOVERHEAD WIRES
FENCE
DIRT DRIVEWAY •r < 11 ��
° UTILITY
—-I .
O.s'
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STOCKADE FENCE HOUSE UL 05-1 310.93'
S S. FiOfQ'Pp
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-' S .... ROW°F:EES :gym 1.2'S. a,oFRAME
G H O' FWND •. 'J ... ppS7 NH RAIL FENCE �+� HOUSE J��•
'Z PI ..- .. ... roz S�Tt
� �m
-AAAy`O HEDGE ROW u�� Nm LOT 42 N/O/ �2 Tr
c v 4- F O
x S 85"47'20 W ROBERT A. MCCAUGHEY
\ 0 F
9� BASIL NA SANTINI
& BEVERLY L.
SANTINI
I
STEELING ROAD
i
i
I
PREPARED IN ACCORDANC WITH THE MINIMUM
STANDARDS FOR TITLES AS ESTABLISHED
BY THE L."L.'.AND ROVED AND ADOPTED
FOR SUCH USE BY TH EW YORK STATE LAND
fi
TITLE ASSOCIATION.
ti pF I -V,Y0
L n N.Y.S. Lic. No. 49668
UNAUTHORIZED ALTERATION OR ADORION
TO THIS SURVEY IS A VIOLATION OF
SE Joseph A. Ingegno
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING _ Land Surveyor
.� THE LAND SURVEYOR'S INKED NOT E
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED,AND ON HIS BEHALF TO THE Title Surveys - Subdivisions - Site Plans - Construction Layout
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON,AND
TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 Fax (631)727-1727
TUTION.CERTIFICATIONS ARE NOT TRANSFERABLE. _
OFFICES LOCATED AT MUNG ADDRESS
THE EXISTENCE OF RIGHTS OF WAY AND EASEMENTS OF RECORD, IF , New York 11901 Riverhead, New York 11901-0965
ANY,, N 322 ROANOKE AVENUE P.O. Box 1931
NOT SHOWN ARE NOT GUARANTEED. RIVERHEAD - -