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Home My WebLink About28496-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. CERTIFICATE OF OCCUPANCY No: Z-29377 Date: 04/22/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 5905 WESTPHALIA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 14 Lot 1 Subdivision Filed Map NO. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 24, 2002 pursuant to which Building Pez~uit No. 28496-Z dated JUNE 25, 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 TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to HARBORVIEW HOMES INC (OWNER) of the aforesaid building. SUFI~)LK CO[~I~f DEPARTi~BIqT OF HF~%LTH APPROVi~L R10-02-0114 04/14/03 ELEt-rKICAL CERTIFICATE NO. 69028C 12/27/02 PLUMBERS CERTIFICATION D~r~a3 07/30/02 BERTSAND PLUMBING & HEAT ature Rev. 1/81 April 16, 2003 Town of Southold Building Department Main Road Southold, NY I 1971 2002 Dear Sir or Madam: Please omit the pool and deck structures from your plans on file for permit #28496Z, located at 5905 Westphelia Road, Mattituck, NY., as these items will not be constructed. If you have any questions regarding this matter, please contact my office. Issue Date 12/27/2002 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 69028C East Patchogue, New York 11772 (631) 286-6642 Issued To: Street: Villige: Section: Harbor View Homes Inc. 5905 Westphalia Road Mattituck Zip: 11952 113 Block: 1.4 Lot: 1 Contractor: Super Power Electric Town: Southold Lic.# 5118-E Was examined and found to be in compliance with the National Electdca~ Code. ~] Commercial [] NVDefect$ [] Pool ~ lstFIoor ~ Indoor [] Basement [] HotTub [] Residential [] Dat. Garage [] Attic ~] 2nd Floor [~ Outdoor [] Addition [~] Survey Switches Receptacles Fixtures GFI Heaters 24 40 36 9 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps 1-20A 1 20 1 30 1 40 Furnace Oil Gas Circulators Smoke Detector 1 x 2 7 Meter Amps Phase UG/OH Jacuzzi Television 1 200 1 /~ 1 A/C Fans 5 Microwaves Bell Transformer 1 CO Detector 1 Bldg. Permit: Other Equipment 1-40 Circuit w/main 1-Oil Fired Water Heater 1-20A Well Pump 1-30Amp NC Disconnect Hugo S. Surdi President Rough Inspection: 10/29/2002 Inspector: Ed Scavelli Final Inspection: 12/24/2002 Inspector: Ed Scavelli This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Town I Inll, 53095 Mnl. Road P.O. Box 1!79 Soulhold, New Yolk 11971 Fox (516) 765-1823 1 olephone {5 t 6) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: July 30, 2002 Bullding Permit No. 2~8496Z (please print) umber; ~_e_r~t._s_aB~d..~l_u.m~bi. ng& .Heating, Inc. (please prl~lt) I certify that the sol. der used contains less than 2/!0 of 1% lead. in the water supply system Plumbers Signature) Sworn to before me this 30th day of July 2002 Notary Public, Suffolk County Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/24/02 Receipt: 2228 Transaction(s): Subtotal 1 Septic Permit - Construct - Resid. ~ { '~ - J~ - I $10.00 Check#: 2228 Total Paid: $10.00 Name: Harborview, Homes Inc. 278 Jamaica Avenue Medford, NY 11763 Clerk ID: LBOHN Internal ID: 57426 STATE OF NEW YORK] COUNTY OF SUFFOLK) SS: BEING DULY SWORN~ DEPOSES AND SAYS; THAT DEPONENT IS OVER THE AGE OF 18 YEARS RESIDES AT THAT ON THE __DAY OF , 2002 DEPONENT ARCHITECT/ENGINEER~ LICENSED BY THE STATE OF NEW YORK, HEREBY STATES THAT HE ACCEPTS FULL RESPONSIBILITY FOR THE ACCOMPANYING PLANS COMPLIANCE WITH THE NEW YORK STATE FIRE PREVENTION AND BUILDING CODE (9 NYCRR); SAID PLANS PERTAIN TO PROPERTY LOCATED AT SCTM 1000-113-14-1, AI~$DFFITE"CTfE'NGINEE-R---"'-'~ HI ~K~ SWORN TO BEFORE ME T S DAY OF ~%A-~ ~ 200'"~ BUILDING PERMIT EXAMINER CHECK LIST APPLICANT :~ ~.~.z~ ~ DATE REVIEWED: d'/dT/02 DATE SUBMITTED: ~' /,~//02 SCTM# DISTRICT: 1,000, SECTION: II"~ , BLOCK: Iq , LOT: [ STREET ADDRESS: ~-qO~' O~Tiatl~U~ ~.J>. CITY: ~,~llS"rocY~ S~DWISION:~~ PROJECTDESC~TION: ~b ~Cd~ ~STm~T~ PROJECT COST: ~ ~ ~~~/ENG~ER: m~ FAST S~GLE & SEP~TE CERT~ICATION-~Q~D? ~ NOTES~&~*~ ~o~.~ ~TS 40,000SF ~100-24. i~t tecogmition.(CREATED before June 30, I983), UNDERSIZED LOTS FROM JAN.1997 100-25 Merger.(A nonconfom~ing at any time after 7/1/: ZONiNG DISTRICT: REQ. LOT SIZE: ~*q~ REQ. FRONT f~ ~ REQ. REAR F,, CONFORMING? 1/~q ACT. LOT SIZE: _5o7', ~:l~ REQ. LOT COV. ~,~d'~ ACT. LOT COV. PROP. FRONT ~a'~ REQ SIDE__ /~.~~T, SIDE__ ,y~-./fffir PROP. REAR J REQ, HEIGHT PROP, HEIGHT. / ~PERMIT#:R10- o2 WATER FR~p]N..T.T~FLOODff'~ v~D?SCRIPTION: PANEL #:/~/~ ZONE: JPROVALS REQUIRED SUFFOLK COUNTY HEALTH D~PT'//~NO, (BED #): TOWN SEPTIC RECEIPT: Y or~.J ~ NEW YORK STATE DEC: PRE4)EC 9a/Ts YES or~9/ SOUTHOLD TOWN TRUSTEES: YES or~ TOWN ZONING BOARD APPROVAL: YE~,~SmlI~ . . TOWN PLAN. BOARD APPROVAL: ~E~~//ff/a~/~' TOWN HISTORICAL PRE (SPLIA): "YES o~K) NYS ENERGY: ~R NO :~ '5'''~ EGRESS (18 H min.? 4 sq total) 7 VENT (SQ. FT. x 4%). BUILDING PERMITS OPEN/EXPIRED: BP t~d -Z / C/0 Z- , HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- , NOTES: LIGHT (SQ. FT. x 8%) FEE STRUCTURE: FOUNDATION: (! t go SF FIRST FLOOR: ,~9t~ SF SECOND FLOOR: / t'~ SF OTHER: ' ! ' SF TOTAL: ~__SF 1. ( ~tOt~ SF)- (~/0 SF)=~: Iq$:~ INIT OTHER TOTAL FEE FE FEE 2. ( _SF)- C_ SF)= SF X $ :$ +$ +$ = $ 765-1802 BUILDING DEPT, [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~* DATE __INSPECTOR.~ 765-1802 BUILDING DEPT. INSPECTION [ ]/~UNDATION 1ST [ ~ FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL DATE INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ PLBG. [ ]/~OuI~DATION 2ND [ ] INSULATION [ ~/J,/~MING [ ] FINAL [/,/] FIREPLACE&CHIMNEY REMARKS:'~~)'/~/',~ ~' ~~ DATE /~'~__~_INSPECTOR+~~ 76~.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~] ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION [/,~~ING [ ] FINAL FIREPLACE & CHIMNEY INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND [ ] ROUGH PLBG. [ ~N~JLATION [ ]FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE INSPECTOR 765-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ~N~LATION [ ] FRAMING ~ FINAL ] FIREPLACE & CHIMNEY DATE ~n;r~) ~sfrcn,:>~ ~o~ I v~, ~ co~ FO~ATION (2~) ~ ~ ,7'7 / / : / ~ ~S~ATION PER N.Y. ~ ~ STATE E~RGY CODE ~ ~D~O~ CO~ ' ' ~ TOWN OF SOUTHOLD BISILDING DEPARTMENT ' TOWN HALL SOUTHOLD, NY 11971 TEL." (631) 765-1S02 FAX: (631) 765-9502 Examined ,,,/~ ,20 Approved / , 20 /'" Disapproved a/c ' Expiration ~/~'5:'"' ,20~k~ BUILDING PERMIT APPLICATION CHECKLISq Do you have or need th[ f$11ov~ng, before applying' Board of Heaith-~'o 3 sets of Building Pla~ Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: APPLICATION FOR BUILDING PERMIT Date ~/L~ff/(~ , 20 0 ~ INSTRUCTIONS a. Th/s 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 perm/t 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 applicm~t 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. (Signature of applicant or name, if a corporation) Melan£e Francis (Mailing address of applicant) State whether applicant is owns, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Ageng Name of owner of premises Debra Coen, (As on the tax roll or latest deed) If, applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 5905 Westphalia Road, Mattituck, House Number Street Hamlet County Tax Map No. 1000 Section 113 Subdivision [~O? 0 ~- (Name) ' ' Block 14 'Lot' Filed Map No. ~f5 3 Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant land b. Intended use and occupancy One family dwelling Nature of work (check which applicable): New Building Repair Removal Demolition 42 'Estimated Cost ] -? 0 5. 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 0 t~/~ t~ 0,-, Dimensions of existing structures, if any: Front ~AJ Height. Number of Stories 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. RESIDENTIAL 7. Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height. ! 8. Dlme_n_s~ons of entire new constmcUon: Front ~ ,~ , ~,' H~i~h~'~, ~ ~r' Number of Stories 9. Size of lot: Front I ~-~ Rear r&~- 0 10. Date of Purchase Number , ar) Depth 0~*~ q'Name of Former Owner __ of~t~ries Rear ~ ) ' Depth '~ 11. Zone or use district in which premises are situated one family residential 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO x 13. Will lot be re-graded? YES x 14. Names of Owner of premises Debra Coen Name of Architect Name of Contractor '../4~d~. ma ~o 15 a. Is this property within 100 feet ufa tidal wetland or a freshwater wetland? *YES * 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. __ NO__ Will excess fill be removed from premises? YES NO x A~ 372 Brooklyn Avenue~. . uoress !~e~lelx~n.~xlV llglRrnoneiNo. C./o ~*l/.-~-~'~ Address~Phone No g ~/-o~ ~; 6~ Address/'7o& t~,..t~,~//~d,~PhoneNo. 6 ':31 ~7-~?~ NO X 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 SUFFOLKo Melanie Francis being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the .~*nt (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 ail 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 ~ 1%-°O'' day of i(~r~W, L. . g0(~ ~ ~ ~~ { Si~at~e of Applic~t ~ ~~~'~~ ~.~ ~ ~' ~ ,. . ONL'~ ApPROVeD O~ DATE OF APPROVA~ %~EXPIRE5 THREE YEARS FROM 'L