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Home My WebLink About28382-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29331 Date: 03/25/03 T~IS CERTIFIES that the building ADDITION Location of Property: 670 GABRIELLA CT MATTITUCK (HOUSE NO.) (STREET) (HAMLET) Co%~nty Tax F~ap No. 473889 Section 108 Block 4 Lot 7.24 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10, 2002 pursuant to which Building Permit No. 28382-Z dated MAY 13, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to THOMAS J RILEY of the aforesaid building. (OWNER) SUFFOLK COUNT~ DEPARTI~ENT OF ~EALT~ APPROVAL ELECTRICAL CERTIFICA~ NO. PLUMBERS CERTIFICATION DA'r~a3 Rev. 1/81 N/A N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEP, MIT NO. 28382 Z Date MAY 13, 2002 Permission is hereby granted to: THOMAS J RILEY MATTITUCK,NY 11952 for : CONSTRUCTION OF A 12.5'X 28' DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 670 County Tax Map No. 473889 Section 108 pursuant to application dated MAY Building Inspector. GABRIELLA CT MATTITUCK Block 0004 Lot No. 007.024 10, 2002 and approved by the Fee $ 150.00 A~thorized Signature COPY Rev. 2/19/98 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 l~ropcrty 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, theBuilding 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, Swimrmng 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. -~/~_o~ ~t4, New Construction: ~ Old or Pre-existing Building: (check one) Location of Property: ~'3 ~") C~-~'(;~I~ ~JC- House No. Street - Hamlet Owner or Owners of Property: i(~'"'-'~ Suffolk County Tax Map No 1000, Section I 00(~-'~ 0~-4~q-/~ '~lolck Lot Subdivision ~'I ~',~'X,akI~tAI.~; =~s.~.j~t -..Q-- FiledMap. q~l~ Lot: } ~ PermitNo. DateofPermit. ~2) ~-O~_~ Applicant:C~"--~'~Oq0cO Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ ~' (check one) Applicant Si~ature SCTM # Districl LO00_ Section JOKBIock 'Z4~_ l.m _~o2~Z~ Re~ iewed: Date Submilied J)l'OjeC[ I.ocatio(~ Project Description: REQUIRED FOR REVIEW N.A. Suffolk County Health' Dept. New York State D.E.C. Town Trustees Town Zoning Board approval: Town Planning Board approval: ,-// Flood Plane Elevation ??? Flood Zone: Permit NO YES Number Notes: 765-1802 BUILDING DEPT. .. SPECTION [ //]"FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNOATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~: DATE INSPECTOR 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~'~iLAT~- - [ ] FRAMING [~/'FIN~ ~~ [ ] FIREPLACE & CHIMNEY ~' DATE ~n~ e~se~cno~' ~eORr FO~DATION (1ST) F O~ATION (2~) ROUGH F~M~G & PLL~G ~'SU~ATION PER N. Y. STA~ E~RGY CODE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 F~'(: (631) 765-9502 Exmnmed q- / /0 ,20 ~ ;~. Approved fi[ t g · 200 ~--. Disapproved a/c__ axpi a on ' I / ( 3 _ ,20 3 PERlVI1T NO. BUILDING PERMIT APPLICATION CHECKL1S T Do you have or need the follo%~ng, before appl~ang? Board of Heakh 3 sets of Buildzng Plans planning Board approval Survey Check S*pfic Form__ N.Y.S.D.E.C. Trashes Contact: APPLICATION FOR BUILDING PERMIT ~ ;;~ ~ .,~.-~ Da~e ,20 ~ s.,.'i~: INSTRUCTIONS : tpplication MUST be completely filled ~ by typewriter or in ink and su ,l?mit~ed to the Bmldmg 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 areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Perm/t. d. Upon approval of th/s application, the Building Inspector will issue a Building Permit to the applicant. Such a perrrul shall be kept on the prem/ses available for inspection throughout th* 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. £ Every building permit shall expire if the work authorized has not commenced W~tbin 12 months after the date of issuance or has not been completed within 18 months fi.om such date. If no zorfing amendments or o~er re,clarions affecting the property have been enacted in the interLm, the Building lx~pecter may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new p~m/t slm/1 be required. APPLICATION IS I-I~ ~Ry MADE to the Building Department for the issuance ora BuildZng Perrmt pursuant to the Building Zone Ordinance of the Town of $outhold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or d~aaolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to adrmt authorized inspectors on premises and in building for necessary inspections. address of appl/cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Bmlders License No. Plumbers License No. Electr/cim~s License No. Other Trade's License No. Location of land on whi? m'o~osed work will be done: . , _ -7o ('4--- C, -k House Number Street Hamlet County Tax Ma, p, No. 1000 Section I OC~ Subdivision ~_..\~ ~o,'~o \~..o~ ~aaka;[ \ Filed Map No. occupancy of proposed constmcUon: State existing u~c and occupancy ofprermses and intended use and a. Existing use and occupancy ~'_~ ~ b. Intended use and occupancy Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost O 5. If dwelling, number of dwelling units [f gara§e, number of cars Fee Addition Alteration Other Work · (Description) (To be paid on filing tiffs application) Number of dwelling units on e~.cJa floor 6 If business~ commercial or m/xed occupancy, specify nature and extent of each type of use. 7. DimensionsofexistLngstmcmres, if any: Front ~9.Z) Rear '~-~-~ Depth Height_ Number of Stodes ~ Dimensions of same structure with alterations or additions: Front Depth Ct0 .. ~.- Height. ~,. Dimensions of entire new construction: Front '-~ Height Number of Stories O. Size of lot: Front "~[ ~./ Rear I ~0--0 \ 10. Date of Purohase ~ ~q\ C~ Name ofFormer Owner Zone or use d/strict in which premises are situated -3 Number of Stories ~ea~ .3 Depth Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO __ Will lot be re-~aded? YES__ NO ~iill excess fill be removed from pmmi~? YES__ Rear ~_~(o '~ NO 14. Names of Owner of prcuuises Address Name of Arctfitect Address Name of Contractor ~I/V/V' ~ Address 15 a. Is this property within 100 feet of a tidal wetland or a freshwater w~tland? *YES * [F Y-ES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BI~ b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Phone No. Phone No Phone No. NO 1 (5 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 1,7EW YORK) SS: COUNTY OF ~r'3',~ ~' ~-~. I ~.{ being duly sworn, deposes and says ttm~ ,s,be is the applicant ~e of individual s/~ing con, ct) a~ve ~ed, (S)He is the (Contractor, Agent, Corporate Office, 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 me this day of_ ~ ~ 20~)o~/~ I N'o~a~' P~blic - -- LINDA J. COOPER Notary Public, State of New York No. 4e22563, Suffolk Ce~nty ~ -- ] ONlOVd$ .LNflO0 HJ.ON::I'I J. SOd .L,90d I~Y38 1~¥~8 O0~O-LLt 11~91 AN '~UOdN33~O OVO~ NIVH InoA¥7 ems i~l 'Je:luo3 o! Jo~ruo3 .94 'ouJooq jo doll uo olm.~ :los :$J.$10(' 'puflo.,6 podof. 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