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HomeMy WebLinkAbout8980-zFORM NO. 4 f TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-30184 Date: 05/10/04 T~IS C~RTIFIES that the building NEW DWELLING Location of Property: 19430 MAiN ROAD MATTITUCK (HOUSE NO.) (STREET) (H~LBT) Com~nty Talc Map NO. 473889 Section 115 Block 7 Lot ll Subdivision Filed Map No. Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 23, 1976 pursuant to wt~ich Building permit ~o. 8980-Z dated NOVEMBER 23, 1976 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 ATTACHED TWO CAR GARAGE, & 2ND STORY 10 X 14 WOOD DECK, The certificate is issued to CAROLYN MYRON of the aforesaid building. (OWNER) SUFFOLK COLR~TY DEPARTMENT OF }~L~LTI{ APPROVAL 6-S0-208 ELECTRICAL CERTIFICATE NO. N3777753 PLN~BERS CERTIFICATION D~£~D N/A 03/21/78 o3/09/78 This updates CO ~-15835 Dated 6/I0/1987 to include dock as per certification from Joseph Fischetti, PE dated 4/I3/04 & as per affidavit from owner Carolyn Myron dated 4/~/04. ~~t ~o r i~z~g Rev. 1/81 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 8980 Z Date ......................... ~.¢t~'.~...2~ .............. 19..26. Permission is hereby granted to: ', Eu ~r~uc, ..i~.¢,or, ..&...So~z~...i~.~e ...A/C .....C~u~ olin Niesner ........... ~w..~/:~;~:Dr, ......................................... to b~,il~ ..uaw...oue ...£ ~'~tll%~.. dw~ l~Ll~.~-~ ...................................................................................... et premises located et ....Lot...$ ....... ]~a~tw~o~..i~en~ .......................-...-~ ...................................... ............................................ Ea.~a~Jd...Cou;u.t. &. · Ha :i..a · · .~,~ o e~t. .......... Ha.~%/,~o~lek· ..................... pursuant to app}ication doted ................ ~{0-~......2.~ ....................... , 19..,~/0., and approved by the Building Inspector. Hertoll to b~lld shell & tz. imt owner to complete balance 61.00 Building' 'Inspector Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 AP?LICATION FOR CERTIFICATE OF OCCUPANCY TNs application must be fi/led in by typewriter or ink and submitted to the Building Depamnent with the following: Ao For new budding or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusual natural or topograpNc features. 2. Finai 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 siwAlar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit plarmmg Board Approval of completed site plan requirements. For ex~sting bui[d~ngs (prior to Apri~ 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 pr~perly c~mp~eted applicati~n and c~nsent t~ ~nspeet signed by the applicant. ~f a Certi~cate ~f ~ccupancy is denied, the Builddng Inspector shall state the reasons therefor in writing to the applicant. C~ Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, SwLmufing 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 $I5.00 Date. New Construction: Old or Pre-ex/sting Building: Location of Property: __ ?7~&~'~ ~,~ ~7~ r~r~/ House No. Street Owner or Owners of Prope~y: ~/~ ~ /~ ~ ~ Suffolk Co~ty T~ Map No 1000, Section Sub~s~on (cheek one) Hamlet Block 7 Lot Filed Map. Lot: Permit No. Date of Permi. t. . Applicant: Health Dept. Approval: Under~vrkers Approval: Planrfing Board Approval: Request for: Temporary Certificate Final Certificate: (checkone) Fee Submitted: $ STATE OF NEW YORK: :SS.: COUNTY OF SUFFOLK: CAROLYN MYRON f/k/a CAROLYN MIESNER, residing at 55 Eastward Court, Mattituck; New York 11952, being duly sworn, deposes and says: I am the owner of real property situate at 55 Eastward Court, Mattituck, New York, SCTM# !000-115-7-11 (the "Premises"); I have ow~._ed the Premises since July $, 1976. The dwelling w/th the attached two-car garage on the Premises was constructed in 1977 by Eugene G. Horton & Sons, !nc. The second sto~W deck was constructed after the temporary C.O. was issued on March 23, 1978, and existed at the time the permanent C.O. was issued on June i0, 1987 as it presently exists. This affidavit is made to induce the Town of Southold Building Department to amend the permanent C.O. dated June 10, 1987 to include the second stow deck on the C.O., knowing that it will rely on the statements herein made. CarolyffMyron f~a Carolyn Miesner f ~ '~ Swollen to before me this Z~_d~y of April, 2004 ~f./Notai~ Pub'lic ' 21/affb l dg PROFESSIONAL ENGINEER 1725 HOBART ROAB I PO Box 619, SOUTHOLD, NEW YORK 11971 TEL631-765-2954 · FAX631-614-3519 · e-mail: joseph@~schetti,com Date: Reference: April 13, 20O4 55 Eastwood Court Build~ng Inspector Southold Town Main Road Southold, NY 11971 Dear Sir, I inspected the footings and the deck structure for the above referenced home. I certify that the rear 2nd floor deck wMch was constructed in 1978 bee~ constructed in accordance with the pre 2003 New York State building codes. ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... .Z.1.5.8.$.5 ....... Date June 10, 1987 THIS CERTIFIES that the building New one-family dwelling. Location of Property 55 Eastward Court Mattituck Hou$~ ~oi ............................................... Street Hamlet County Tax Map No. 1000 Section ..... 1.1..5 .... Block ....... 7. ....... Lot .... 11 Subdivision ...... ~$.t.w. qq~l. Fla. n. 9.r ......... Filed Map No....5.6.0. 6. .Lot No .... .1 ......... conforms snbstantially to the Application for Building Permit heretofore filed in this office dated November 23, 1976 8980Z ..................... pursuant to wlfich Building Permit No ...................... dated ........ November. ................. 23, 1976.. 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 ......... New one-family dwelling with attached two-car garage. Tile certificate is issued to CAROLYN E. MIESNER ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval 6-SO-208 UNDERWRITERS CERTIFICATE NO. N377753 PLUMBERS CERTIFICATION DATED: N/A Temporary C.O. #Z8961(3/23/78). --'~.~..~'d , .~. B~lding Inspector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitted m ~--.------ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and instalta- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildincjs. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. C_ertificateofocc~p_~n_c_y ....... _~2.~5.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certifi~-0T~'~[Jpancy on pre-~s-t~g'dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.Oo $ 20.00 .~.? 5.Updated C.O. $ 50.00 Date .... .~.~.~,~7 .............. New C on s t; r uc t, i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............................................. House No.----~ Street Hamlet Owner or Owners of Property . .~./.'~...'~...~..~....~.... ~? / ,.,j~..,~.~/C~ County Tax Map No. 1000 Section .... I.Io~ ........ Block .... % ......... Lot ..... ]{ Subd vs on ~ .~ ......... Filed Map No..~'~¢.~ .... Lot No .... } ......... Permit No..~.¢~.~.... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval .... Fee Submitted * .... .~. ~.. % . · .~[~t.q.~ ......... Construction on above described building and permit meets all applicable codes and regulations. "~' ~. '~,,Q,~DO Applicant .......................................... Rev. 10-10-78 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ottice Southold, N. Y. TE I~ 1TM O t~/~( Certificate Of Occupancy THIS CERTIFIES that the building located at . .~..5.. Map No...~..~.0. ~.. Block No ........... Lot No ..... ~ ............................ conforms substantially to the Application far Building Permit heretofore filed in this office dated ......... ~... ~.~, 19~. pursuant to which Building Permit No. ~.~.~ dated ........... ~F.. ?~., 19~., was issued, and conforms to all of the req~e- ments of the applicable provisions of the law. The occupancy for which ~is certificate is i~.~d i~ ..~...~}ff.e..~ .... ~.%... 6~ .... ~) ..... ~ ............................ The certificate is issued to ... Y.('. '? X Z. ~ .......... '..~ ....... L~ ..... .'. .......... ~.. (owner, l~a; C~) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ~ ~ Street ~ ~ sr t~/~ ~ "0 ( 0 (J K' Building Inspector , TOWN OF $OUTHOLD ~ ~,~ ' ,~ '~..~ C/~ TOWN CLERK'S OFFICE'/~ ~ ~ ~j ~. ~ ~' sou .o D, .. ~xomi~ed ........... ~ .................. 9 .... ................................. ...................... , APPLICATION ~ ~'~~~ D~ ' -- r .... ~ ~ ~~. . Novembe~ 25 ~ 7 ~. ?,~ ephc t,o m?t be completel~ f, lled n by ~pewrter ac in i~b~jn tri licate t 'e Inspector, with 3 sets of plans· accurate plot plan to ~ale. ~ee according to schedule P o th Budding ' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detail~ description of layout ofproper~ must be drawn on the diagram which is pa~ of this app cat on~ c.. Z_be work covered by this application may not be commenced before issuance of B~ilding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant Such nerm;~ shall be kept on the premises available for inspection throughout the work. -- ' ~ '"'--~ , e,.,, No ~uilding shal~ ~e ~ccupJed or used in whole or in part for any pumose whatever until a' Ce~ifjcate of Occupancy sna. nave ~een grantee ~y the Building Inspector. ~o ~ ~ ~ ~ I ~ ~' APPLICATION IS HEREBY MADE to the Buildin~ Department ~or the issuance of a~ Build ng Permit pursuant to the Building Zone Ordinance of the Town of Soutko d, Suffolk County, New York, and other app cable Laws Ordinances or~ Regulations, for the construction of bu Id ngs, additions or alterations, or for removal or demo ifion, as herein described. The applicant agrees fo comply with all applicable laws, ordinances, building code, housing c~e, and regulations, and to admit authorized inspectors on premises and i~ buildings for n~essaq inspections. Eugeue O. H.o. rtou & Sous Inc. (Signature of applicant, or name, if o corporation) New Suffolk, N.Y. 11956 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractorc electrician, plumber or builder. General contractor Name of owner of premises Carolyn ~iesnem If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ..4: ............................................ Plumber's License No ......... Other Trades kicense No ............................................... 1. Location of land an which proposed work will be done. Map No.: ............ ~.....~.~ Street and ~"-~'~r East~¢ard Court ~-7~, .. ~z'-:/~._. ' ........................ Municipality 2. State existing use and accupancy of premises and intended use and occupancy of proposed construction: vacant lot a. Exisiting use and occupancy .................................................................. ... b. Intended use and occupancy ........ ..r~....w....o..~...e.....f.~.l.~..d...w..e. ll..~..~... Repair .................. Removal .................. Demo man .................... Other Work ~ ~0 (Description) 4. Estimated Cost ....... ~ .5. .8. ~ . .0..0. .0. .~. .0.. .0. ............................. Fee..f. ......................................................... (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 ....... ,~,.8. ........................ Rear .~.8.. ...................... Depth 25 Height .................... Number of Stories ............................................................. ......................................................... 9. Size of lot: Front 2.00 t Rear .....2...0..0...t ............................. Depth 200 10. Date of Purchase ........................................................ Name of Former Owner ..~..go.p..q~,...~.gm..~..s., Co.z~. .......... 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 regraded ............ ~ ........... Will excess fill be removed from premises: (x) Yes ( ) No Carol .~70_ Miesner ...................... ]4. Name of Owner of premises .................................................. Address ................................ Phone No. 298 ~687 Name of Architect .............................................................. Address ................................ Phone No ....................... ............................................................ ,, 734-6~10 Nome of Contractor EoHOZ"ton & Sons Address .~.x,,~.w...~.o.~,~.... Phone ixlo ....................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ ¢ ¢ COUNTY 0,~ ....................... ~ ....... . ~ '""~ .................. ~...~--~.-~-.-..k..~. Q.~..--¢~.-~-.~- ................................ being duly sworn, deposes and says that he is the applicon (Name of ~ividual signing contract) above named. He is the ........ ...(~,...~...C .~..:C.~-.,~ ......... ..~..~..~..'..~.. ............................ .. (Contractor, agent, corporate officer, etc.) gf 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to befor~ me this .......... -~J~.. day of ~.~-~,~... ................... , 19.'~...~.... C~ A ~ ~ ~, ('~ ................... .... ............................... - (~(S'g a re of applicant) // [LI?,BETH ANN NEVILLE /' THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OGSERVATIONS AND/OR FROM DATA OEITAINED FROM OTHERS. THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES APt:~ICANT .... ADDRESS facilities for %his toc~t, icn hav~ b~e~ ~s~cted by this d~en~ Services el., ZF.6' x vacant RO D ( AI YS F?te 87o39 '~0"E 25? e~=F. Tfg' · -' MONUMENt' SUBDIVI~/ON MAt~ F/tED I.N rile OFF/CE OF i'HE CLERK OF SUFFOLK COUNTY ON dUNE 21, 19Fl AS NEARESt, WATE~ MAIN ~ MttFS~ WA~ SU~LY PfflVA~ WELTS REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHE~D, NEW yORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: CAI?O/YN MIESNEI? LOT NO. I, "EASTWARD MANOR ~' AT GUARANTEED TO: MA TTITUC~ TOWN OF sOuTHOtD SUFFOLK CO., N.Y. SCALE: I , ,.. ,,,,, ,,, ,..- , - ,, , I A~oVED A~ NO~ED  X ~ B,~Ul*~ BACKFILLING ~OUNDA' ~ :'~, ~' '1~~~ ~ I ~ ' '/1' ~:l , . ,,, ,,' I ~' ,,, ~, ~ ' ' L I SALES FLOOR PLANS SHT. ~ OF DESIGN APPROVAL DATE MKT. NA~E ~ MO EK NO.