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HomeMy WebLinkAbout44090-Z �� c�UFFOt�CS Town of Southold 9/11/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40687 Date: 9/11/2019 THIS CERTIFIES that the building AS BUILT ADDITION Location of Property: 350 Donna Dr., Mattituck SCTM#: 473889 Sec/Block/Lot: 115.45-23 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 8/12/2019 pursuant to which Building Permit No. 44090 dated 8/22/2019 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: "AS BUILT"DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Anderson,Charles&Janet of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED uth riz ignature =nom TOWN OF SOUTHOLD Fot, �,o q BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • SOUTHOLD NY 4 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44090 Date: 8/22/2019 Permission is hereby granted to: Anderson, Charles 350 Donna Dr Mattituck, NY 11952 To: legalize "as built" deck addition to existing single-family dwelling as applied for. Additional certification, may be required. At premises located at: 350 Donna Dr., Mattituck SCTM #473889 Sec/Block/Lot# 115.-15-23 Pursuant to application dated 8/12/2019 and approved by the Building Inspector. To expire on 2/20/2021. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $678.40 CO -ADDITION TO DWELLING $50.00 Total: $728.40 Buildi g Inspector 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, 19S7) 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming po61$50.00,Accessory building$50.00,Additions to accessory building$50.00,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$15.00 Date. .--New Construction: Old or Pre-existing Building: 1C (check one) Location of Property: 360 VO N111} 7DA(Ve- M/$TI`1 uc< House No. Street Hamlet Owner or Owners of Property: (28191&t6 &W—&C5C)4 / Suffolk County Tax Map No 1000, Section J`j� Block /L Lot Z,j Subdivision n' Filed Map. Lot: Permit No. V Date of Permit. Applicant: Health Dept. Approval- Underwriters Approval: Planning Board Approval: / Request for: Temporary ,rtificate Final Certificate: (check one) Fee Submitted: $ Applicant Signature SOUTyo� # # TOWN OF SOUTHOLD BUILDING DEPT. cvurm, 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] SULATI/OWN [ ] FRAMING /STRAPPING [ FINAL A Vvi f [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: fAht, I 6��-�I � I r s DATE 3 a INSPECTOR FIELD INSPECTION REPORT I DATE COMMENTS FOUNDATION(1ST) y ------------------------------------- FOUNDATION (2ND) .z �o ROUGH FRAMING& t=i PLUMBING y r INSULATION PER N.Y. STATE ENERGY CODE F ii i lk FINAL o ADDITIONAL COMMENTS o Z b ® H y tC H 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 Gets of Building Plans TEL: (631) 765-1802 —Planning Board approval FAX: (631) 765-9502 lz� rvey Southoldtownny.gov PERMIT NO. Check Septic Form -14.Y:S D E.C. Zo ees .Application od Permit Examined 20 a "' Single&Separate ' } ' Truss Identification Form Sto -Water Assessment Form AUG 1 2 2019 Contac . Approved ,20 Disapproved a/c T ' '�` �" 350 TIorlyfl p,Q• /rlArlrUG(; �� Phone: 691 Zl9- 333 Expiration U ,20 Buil b pector APPLICATION FOR BUILDING PERMIT Date , 20 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. j,e (Signature of applicant or name,if a corporation) (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises alVe,Z5 f .119XJF7- AIUD6ie,56V (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) B ilders License o. Plut ers Lice e No. Electrics icense No. Other T de's icense No. 1. Location of land on which proposed work will be done: 4gzlzF- IVIArlTuce- House Number Street Hamlet County Tax Map No. 1000 Section / Block Lot c Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended se and occu ancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Ca n(-):: � 3. Nature of work(check which applicable): New Building Alteration Repair Removal Demolition Other Work (Description) Estimated Cost Fee (To be paid on filing this application) 5. If d ing, number of dwelling units Number of dwelling units on each floor If garage, umber of cars 6. If business, comme 'al or mixed occupancy, specify nature and extent,of ea ype of use. 7. Dimensions of existing stru res, if any: Front ear Depth Height mber of Stories Dimensions of same structure with a a . s or additions: Front Rear Depth Heigh Number of Stories 8. Dimensions of entire new co uction: Front Rear Depth Height Number of Stories 9. Size of lot: Fro Rear Depth ;10.XDateurchase Name of Former Owner 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 4. 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_X * 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OFA i L-' C.h a r�g Andrrlc being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the af�P (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 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 manner set forth in the application filed therewith. Sworn to before y this day 20� QQ pXP TRACEY L. DWYER Notary Pu i NOTARY PUBLIC,STATE OF NEW YORK Signature of Applicant NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2� Scott A. Russell ST(0>�E�IM�JWATIEIR. [ANA(Gi]E IEN T SUPERVISOR ��SOUTBOLDTOWNI3ALL-P.O.Box 1179 (f®ro' Town of Southold 53095 Main Road-SOUTHOLD,14 WYORK11971 Q AWTER 236 - STORMWATER.MANAGEMENT WORK SHEET (TO BE COMPLETED BY THE APPLICANT) IDOIF.S THIS P13OJECT INVOLVE ANY OF THE FOLLOWING: (CHECK ALL THAT APPLY Yes No. _ Q A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. Excavation or f illing involving more than 200 cubic yards of material within any parcel or any contiguous area. [B/C; Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. [][ D. Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. 0[9/E. Site preparation within the one-hundred-year f laodplain as depicted �� on FIRM Map of any watercourse. ❑ F: Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below-with-your Name, Signature, Contact on;Da#�&-C ty Tax Map Number! Chapter 236 does not apply to your project. If you an ed YES to ono or more of the above, ease submit Two copies of a Storm-water Managemcnt Control Plan and ompleted Check List Fcirrn to the Building Dep ent ,&F---your Bni}ding rermit Application. S.C.T.M. 1000 Date APPCANT- (Property Owner,Design Professlonal Agent,Contractor.Other) DBI,kt Section Block Lot AmJ FOR BUILDING DEPARTMENT USE ONLY "may Contact lnformatlon n,kvmK�.mb,, viewed By: ,J - - - - - - - - - - - - - - - - - �a� a_ Date Property Address /Location of Construction Work: / Approved for processing Building Permit. — — — ,3$0 �O/L/A0� �Q��� — — Stormwater Management Control Plan Not Required. ElStormvaler Management Control Plan is Required. (Fonvard to Engineering Department for Review.) FORM sMCP-TOS MAY 2019 Scott A. Russell °su p Sr 0>>Rj\] WA\r]F]E1R- SUPERVISOR � z WAN A\(G]E LENT SO=OLDTOWNHALL-P.O.Box 1179 ` Town of Southold 53095 Main LT Road-SOI HOLD,NEW YORK 11971 ' � y CHAPTER 236 A STORMWATER.MANAGEMENT'WORK SHEET (TO BE COMPLETED BY THE APPLICANT) DOFS THIS PI30TECI' INVOLVE AMY OF THE FOLLOWING: (CHECK ALL THAT APPLY) Yes No, [J�A. Clearing, grubbing, grading or stripping of land which affects more than 5,000 square feet of ground surface. El[v(B. Excavation or f illing involving more than 200 cubic yards of material within any parcel or any contiguous area. [][�(C; Site preparation on slopes which exceed 10 feet vertical rise to 100 feet of horizontal distance. oda Site preparation within 100 feet of wetlands, beach, bluff or coastal erosion hazard area. 0[�E. Site preparation within the one-hundred-year f loodplain as depicted on FIRM Map of any watercourse. Installation of new or resurfaced impervious surfaces of 1,000 square feet or more, unless prior approval of a Stormwater Management Control Plan was received by the Town and the proposal includes in-kind replacement of impervious surfaces. If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name, Signature, ContaS�,"r-nation;-Date-&-County Tax Map Number! Cbapter 238 does not apply to your project. If you answed YES to one or more of the above�, p ease submit Two copies of a Storm-water Management Control Plan and,a,t�mpleted Check List Form to the Building Dep ttment with your Iluihling Permit Application. S.C.T.M. 1000 Date APPL CANT- (Property Owner,Design Pr ofesslonaL Agent,Contractor.Other) District lntiE. Scction Block Lot /• AmA FOR BUILDING DEPARTMENT USE ONLY Contact lnformaiion n �m , Reviewed By: (� — - - - - - - - - — — — — — — — Date / Property Address /Location of Construct on Work: — Approved for processing Building Permit. — — ,360 7�o�/�r1.9 7����_� — — Stormwater Management Control Plan Not Required. EJStorM ater Management Control Plan is Required. (Forward to Engtneermg Department for Review.) FORM " SMCP-TOS MAY 2014 SUFFpL k AVE . ... NUE ��-so --/y SU1?yOLX COMITY HEALTH DEFARTZ 9AT / DATE n 31977 H. D- R%r- # -� 4 - tb The setrage PI:sposal'azta r; ^;, ,;�•;r,].y N •r..ILs fort '.=::i ! =�': a 3 boon facilittcs far ' fd inspocted by t}13:3 r '. :' a: c ' to Lb satisfactory. 81 23 0 chief of Conoral pn" neerinsr b b ' ,• Ser�3cas . � ,• S.87°/9'20"E; LQ /82.001 O Q y as.a. Lw 1,over M (V (\. O •. G�S=6Den��'�SfiPt1GT.�NK V � � N't. O V I ; -I 4i r n3 ~-- IV 870/4 2G7"Iy a 4 O 25 NinE: a -- MONUMENT o = STAKE + SUEDI V/S/ON MAP F/CED IN THE OFFICE ' OF THE CLERK OF SUFFOLK COUNTY ON JAN. 26, /965 AS FILc.NQ 4256.- SS��E OF NFlY r •�o�gto IV, roGO.p� ' THI LOCATION OF WELLS AND CESSPOOL: XoSROwONA lij0 DATA OB>RINARE FROM BD FBON O H MS , REVISION$ 'YOUNG & YOUN r 4,0' 99,E o NOV 3,/976 400 OSTRANOER AVENUE, RIVERNEAD, a MAY/7,1977 ALDE:N W. YOUNG H mvib S11$' G PROVEGSIONAL LNOIN[ER AND LAND LAND SURVEYOR.N.Y.@. LIC, NO, 12045 N.Y.11. LIC. NO. 4909] • SURVEY FOR: .u•noa.r.o ALTERATION OR ADDITION TO .'•7 SVnVf• IS A V1OLAt+ON OF SECTION BEN MENDOZZA ' 1 Of 1,4c NEW TORK STATE EDUCATION •� 4« LOT 24 It DEEP HOLE CREEK\ESTATES " f: 0/ TN15 SURIEY MAP NUI BLARING •t Larm S.4•E+OR S INtEO SEAL :R V943 4f L' •.!41 SMALL NJT BE CON-DEPEO • H! A "t LID rRUf COPY AT MATTITUCK GUARANTEED TO: AMERICAN TITLE INSURANCE CO. :A'+chi![• %OC3'FD NEnfON SnAU RUM n n0 tNi ��RShb !0R A•Iru r•If TOWN OF j� SOUTNOLDSAMOSSANK �•[i �i ;A!IIA4ff,AMU UN tr14 Blt1A�f SOUTHO LD •4f • T„E :CVPANr•SOVEANNENTAL •'.'.Y 4V; I rNE•140 INST111IT-ON LISM) 13Y J •f•:N,Au TO Tn1E ASSIGNEES Q;F Y14E SUFFOLK CO., N.Y. ;'•.r, •1I111ruT:N GUARAVIM ARE IP4•,5tl44q♦,E• SO 400 T•UNLL SCALE: I+F C 4.0, •DATE: +.'('T. I0, 1975 NO. 5-699 r P66LJ 1[1 ON .•n I Z d �C 'O CD V d m c APPROVED AS NOTED Lu ' N DATE: - B.P.# � ix 'o FEE: ' BY: _ NOTIFY BUILDING DEPAP 'r: AT 765-1802 8 AM TO 4 PM 'F THE FOLLOWING INSPECTIONS: !i 1. FOUNDATION - TWO REC ",FD ! FOR POURED CONCRET 2. ROUGH - FRAMING & PLL G 3. INSULATION j 4. FINAL - CONSTRUCTION h" ' BE COMPLE'c 'OR C.O. t. ? ALL CONSTRUCTION SHALL PJ�-dT THE C71 REQUIREMENTS CF THE CODE_ :-�:NEW YORK STATE. NOT RESPONS,:. Z- FOR DESIGN OR CONSTRUCTION ERRORS. w ,v I C V ' COMPLY WITH ALL CODES OF d 1 NEW YORK STATE & TOWN CODES h V a t10u's w • AS REQUIRED AND CONDITIONS O fi { _ s> �T4�F. 4 TOWN TRUSTEES 1 C W" M ' OCCUPANCY OR W USE IS UNLAWFUL IL WITHOUT CERTIFICATL © _ N_ _ 0 OF OCCUPANCY I } 4%44 PT 1 p" !15 �� 1 J 1 � .. k to'' co M�d�r 't�G��I MCA -- � 6 2x� T >=J �/4�� ,�ddttional I N �� Certification I '4X4 P�T:s PT, 2 X ' .��1ST'�@����o,c. May BelZequired. � p t 2-2X W` ►' S I 4 T p �vtrt'us' Tx 15 pr Q- - G � a iLr). to t�I ISI In Cv�0 IL 0 '-4 , I-- o1�7 .2 r;�6riod 5c�,!.!✓ 1/4 - 110" � � I U� 0 � > �,;c- 14.