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HomeMy WebLinkAbout34155-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33984 Date: 10/01/09 THIS CERTIFIES that the building PORCHES AND DECK Location of Property: 676 EQUESTRIAN AVE FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 4 Lot 14.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9, 2008 pursuant to which Building Permit No. 34155-Z dated SEPTEMBER 12, 2008 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 SCREENED PORCH, COVERED PORCH AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ELLEN D HARVEY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 4030451 06/19/09 PLUMBERS CERTIFICATION DATED N/A A ho zed igna re Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT D TOWN FALL 765-1802 SEP 14 2009 APPLICATION FOR CERTIFICATE OF OCCUPA CY BLDG.DEPT. This application must be filled in by typewriter or ink and submitted to the Building De IiQ, 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 DDaate. 10 l.' New Construction: Old or Pre-existing Building: V (check one) Location of Property: b-7(o ��t j�-1?e,,�, Are— House No. f Street Hamlet Owner or Owners of Property: rA-t e ' �-� ( mi Suffolk County'rax Map No 1000, Section � Block � Lot � r Subdivision Filed Map. Lot: Permit No. Date of Permit. AO Applicant: + Health Dept. Approval: Underwriters Approval: l� Planning Board Approval: Request for: Temporary Certificate Final Certificate: — (check one) Fee Submitted: S L 74p� App c int Signature O rJ�rJ�r��r�clr�rJ�rJ�r.Pr�r�rfrJ�rJ�rJ�rJ'rJ�rJ�rJ�rJ�rJ�rJ�rJ�r��.Pr.PrJrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJrJ�r�rJ�rJ�rJ�rJ�r�rJ�rJ�r�r�cPrJ�rJ�rJr�rJ�rJ�rJ�r�rJ�r�cPrlr�r..PrJ� C� NJ BY THIS CERTIFICATE OF COMPLIANCE THE S 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 S BUREAU OF ELECTRICITY 5 540 FULTON STREET — NEW YORK, NY 10038 C� 5 CERTIFIES THAT L 5 5 5 Upon the application of upon premises owned by 5 5 5 5 Z&S CONTR. INC. ELLEN HARVEY PO BOX,202 676 EQUESTIAN AVE 5 FISHERS ISLAND, NY 06390-0202, FISHERS ISLAND, NY 06390 CC, SLocated at 676 EQUESTIAN AVE FISHERS ISLAND, NY 06390 5C 5 5 Application Number: 5 Pp Certificate Number:4030451 4030451 5 5 5 Section: Block: Lot: Building Permit:* BDC: ns11 S 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 First Floor,Outside,Porch, 5 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 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 5 authority having jurisdiction, and found to be in compliance therewith on thel9tn Day of June, 2009. 5 5 Name OTY Rate Rating Circuits Type 5 Miscellaneous 5 5 ADDITIONAL SURCHARGE Wiring And Devices 5 S Fixture 3 0 Incandescent 5 5 Receptacle 2 0 GFCI �� 5 Switch 2 0 Gen,Purpose 5 5 5 5 5 5 5 5 5 5 5 5 5 - seal 5 � of 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 o ����MEUMU ���2PLp������������������������OPE M0229����������0���J 10 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. 34155 Z Date SEPTEMBER 12, 2008 Permission is hereby granted to: ELLEN D HARVEY 756 RUGBY RD BRYN MAWR, PA 19010 for ADDITIONS AND ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING, FRONT PORCH AND DECK AS APPLIED FOR. at premises located at 676 EQUESTRIAN AVE FISHERS ISLAND County Tax Map No. 473889 Section 009 Block 0004 Lot No. 014 . 002 pursuant to application dated SEPTEMBER 9, 2008 and approved by the Building Inspector to expire on MARCH 12, 2010 . Fee $ 200 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN, OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the followin ,before applying TOWN HALL Board of Health 1V A SOUTHOLD, NY 11971 Ysets of Building Plans TEL: 765-1802 / Survey PERMIT NO. T/ J Check Septic Form N�4- .N.Y.S.D.E.C. �I A- Examined //Z�20 Contact:Trustees Approved e ,20:�ff Mail to; Z>J 4,,4 W, z, Disapproved a/c ;Do J& aoa ��S Phone; r 64-39" ` z,,// Building Inspector c � APPLICATION FOR BUILDING PERMIT Date 9' � , 200e 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 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 a Certificate of Occupancy 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. e i0114 V anu (Signature of applicant 6r name, if a corporation) 90 4,x .20a tad s Ji/4" AV ,o63pv (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder C7'G✓�erza-� l�r� 1� Name of owner of premises (:!�Ileli �, �Y�n-+e t /i4� 64,14 s ►^r (as on the tax roll or latest d ed) If applicant 's a co or�tature of duly authorized officer �1a0 (Name title of corporate officer) Builders License No. 593 Plumbers License No. 3 5ly-Fs— Mt? Electricians License No. </7F29-1"E Other Trade's License No. 1. Location of land on which proposed work will be done: Co 7�e 2 ucs�_ta11 House Number Street Hamlet i County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. 'Existing use and occupancy .., S�� ,y,k 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 3U UL0� 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 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: 13. Will lot be re-graded A/0 Will excess fill be removed from premises: YES NO 14: ?`names ofOwner ofpromises AddressAot3ew Phone No. Gd/- 27`c--7705_� Name of Architect 6r)w" Address3L?_JVk� 1 Phone No_ S=GO-Fy7-j'3a9 Name of Contractor24S Addres .20a FlAly \ Phone No. 631-7 7c?V No��i S�on���w� C�-. G1D357 15. Is this property within 100 feet of a tidal wetland? *YES NO X • IF YES, SOUTHOLD TOWN TRUSTEES 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_S!f(!Ik / being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, ;S)He is theme, �i-i➢'+tri� (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; hat 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. Sworn to before me this V` day of Se, eek bee 200d' g �Le,�, L otary Public Si ture of Applicant MARY B PANKIEWICZ Notary Public State of New York 00 -8267950 Commission Expires:y j§01a CV o Qua ar ,&(-(olk CbuM_�, 1 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT LICE fJ IA�J P 7J�f f2 FORMER OWNER N ' E ACR. ►M L-L0 4ca Ee w S Sa A/yf �� �A/d�.��- � S t W1 TYPE OF BUILDING ,ES-7- 0 SEAS. VL. FARM COMM. CB. MILS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 0- Zoo . ".),0� o �' �Z s G z - sly v<. i /0 pr illable FRONTAGE ON WATER foodland FRONTAGE ON ROAD ieadowland DEPTH ouse Plot BULKHEAD )ta x gip; `� „., � • • . � . 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NEW YORK STATE CODE COMPLIANCE CHECTMIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Wind Speed: 12OMPH Seismic Design Categoryi B Weathering: Severe Frost Depth: 36" Termite: M-H ' Decay: S-M Design Temp: 11 Iee,Shield Underlay: YES Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE DULL FRAMING DESIGN ELEMENTS: YIN HEADERS: YIN WALL STUDS: YIN GII=RS: YIN CEILING JOISTS: YIN I+LOOR JOISTS: YIN ROOT{RATTERS: YIN LUMBER SPECIES AND GRADE: YIN DESIGN LOAD CALCULATIONS: Y/N LING: YIN DEAD: YIN SNOW': YIN SEISMIC: YIN �WND: YIN `7TD\TDOW AND DOOR SCHEDULE: l\�ISSLI TEST REQUIREMENTS: YIN EGRESS 5.7 S.F.: Y/N LIGHT 8%o: Y/N TNT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: YIN MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: YIN LOCATION OF FIRF, PROTECTION EQULPMENT: Y/N TRUSS DESIGN: YIN CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCL? Y/N (RETURN TO PAGE ONE) BUILDING PERMIT EXAMINER CHECKLIST *Date Submitted: ?/9/4P7 *Date Reviewed, /1 �pplicaut:Z �O� G(;C�77 Owner, krchitect/Engineer: Gordon d Estimated Cost: �o o- !CTM# 1000-_� `'7' - �`y� Subdivision: Zone: 46Conformiog? �d 'roperty Address: CAS n 1/--e_ City: Pre Cos? luilding Permits (Open/Expired): BP as ZZZ/C/o Z_ Info: BPor4 <�ZZ/C/o Z-�`7.3/,Info: i�f4a IP -Z/C/0 Z- Info: BP Z/C/o Z- Inf ; BP -Z/C/o Z- fo: jingle & Separate Search Required? Y ok(�betermination: :BQ. Lot Size: ACT. Lot Size: a S� RE . Lot Covj6 oACT: Lot Cov. ,EQ. FroiAD ACT. Front - REQ Side ACT, Sideo2,0+- REQ. Rear S-D "'PROP. Rear MQ. Height . ACT. H ight 'roject Description: P1 _Dn-� Mf'Cir, -►- � , Vaterfrout? Y or(NII f yes, water body: Pauel# Flood Zone: Bullchead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED luffolk Count), Health: Y oi� If yes, *Bed#: *Date: _/_/_ *Permit#: Town Septic: Y oz 1 - If no, certification required: Y or N Received: Y or N By: dYS DEC: mr-DEC 9n05 Y o1LQ_ Date: —/_/_ Permit #: or NJ Letter - Notes: iouthold Trustees: Y or 0- 11 a(e: /_1 Permit #: or NJ Letter - Notes: iouthold ZBA: Y of N Date: / / Permit h: - Notes: iouthold Plauuing: Y o Date: -/ /� Permit #: - Notes: Cown Landmark C of A: Y oiDTE: /_/ *NYS CODE Compliance (page 2): Y or N :Votes: Fee Structure: Calculation: Foundation; SF 1. ( SF)- ( SF)= SF X $ _$ 00 First Floor: SF + Initial Fee: $ Second Floor: SF + Additional Fee ( : $ Other: 5 UU SF 2. ( SF)- ( SF)= SF X $ _$ Total: SF + Initial Fee: $ + Additional Fee $ TOTAL: $ N OT E : CO OKU)I NAXE DI ST.&,NC ES Arr- M�ASU I -T-:D FP�ONA U. S, COA.S`r Ate.! D GE:ODV-T►C SUV-VMY 7MIA.WGUI...AMON ©� .Z 5.85•. Zp�-s�D"W. 73•�2 7 co {1 LI ���� �O OV cp 15 p {,5 M I a l_O T H I AN-IN AV E t� 1.1 E. • ', t„ e e. IM PLAI.I OF PI�OI---"ESK-rY Or TAD. LENN SPE Y F'I SH EICS I SLAV ID - KEW `(OKY : I'` - 2:0 FT. Guam eed to Alen D. HarM and Tad Glenn Sperry,,Fidelity National Title nsuranm CoMany of New York and North Fork Bank in C t-(h tit D L��. Y'AL M E l_ accordance with the Nfinimum Standard*for Title Surveys bf the New may* W I CH , co N AS E CT I C U T Y6rk State Land Title Msocfatiot JA,t J U, ,,V;r- '' Z Z, 1981 �T'992t31�� _ q'� /� 41 M 0 rn Q Lo M co Lu t R I Cc I— wV - --- -rRl NA = U zz Z (V r.�,Yv c> V W O O P ri --- _ T z = co Z 000 0 I i pI co� O 000zx o "'(4) z co �t- , .�, g7 t3, i tip 1 xi w 7Z :t l ALL CONSTr;w Vl? ru►i .-;;' i% N SH!,I L I MEET THE REQUIREMC'ENTS OF THE �.' , I IV) ty CODES OF NEW YORK STATE. 0-1 CERTIFICATION.OF fi NAILING & CONNECTIONS QUIREQ: R1 Iv RETAIN STORM WATER RUNOFF AS REOU"=,, _' �',g`,1;� CONDI F PURSUANT TO CHAPTER 236 �, ,T H _pT v�� xk .�,�......_._.�___._.__ .: - . OLD TOWN[BA , , � ..y,rru�P OF THE TOWN CODE. SOUTHOLD TOWN PLANNING B - SOUTHOLD TOWN TRUSTEES 7 �� AP ► �° N.Y.S.DEC P ��� VED AS N�I ED y" DATE: _ ru`.F'.s 1 /S FEE:Q�dl/,: C1 ` By: {�� NOTIFY BUILD.NC DEF',".�3TMENT Al' OCCUPANCY 'N E a .,`;•i FOR THEFOLLCI R OR _ • -18Q2 CAM �.Cl C;��'eS: USE IS UNLAWFUL 1. FOUrdDATIOr,I - fry.���o REQUIRED ,�NG I J -- FOR POURED Nt:cRETE ROUGH !YITHOUT CERTIFICATE 2. ROUGH - FRAMING & PLUMBING s. INSULATION '.�F OCCUPANCY o.Wi 4. FINAL - CONSTRUCTION MUST • ►.�s .�H �f BE COMPLETE FO'i C.U. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. O� O L W 1— � � zz a) 2 U OOCC, W U 1`— 00 U H Zoo / Z = w z o0 F— Z � 000 coZ co IL I I I t-�l L I I 41 I +k f V O LL 11 -} —. ._ 7Z; Z: �1a U3 lj) LK N Vz to r 4 ! N � I � � I I � i I j I ( .CaR�Dc".. .. � f { ... + I �i•I"CSFk �RAC�G 1 f i � I i I � I �• I i t I I O RG.H— _ 0 Q � O W 0 WU w To m usal , W O O ce) � 00 C7rZ o� U _ 00 to Z 00 o WZ0 � Oco 00 z � oo O co Z t:7wn 7 p co a :.erg 7�- Gf2 ftl to y i f :4xq-.Pps:,r,W ;1 63 `T.✓�nt.'- .2X8, °5_�'-tC�'��.�i =- t 'f4:K 4, \A Rc4-►.A1�,,� EPU P t:7.=Z'�.:" IaSr 1� 9asT t.�N�c� EPnt -TRAM S '-' � I LAM r -,pov4A SEGTtt 6 ,