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Home My WebLink About28331-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29634 Date: 08/11/03 THIS CERTIFIES that the building ADDITION Location of Property: 3480 CR 48 MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 4?3889 Section 141 Block 3 Lot 15 Filed Map No. __ Lot No. -- Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24, 2002 pursuant to which Building Permit No. 28331-Z dated APRIL 26, 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 WITH INGROUND SWIMMING POOL (WITH FENCE TO CODE) ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT & VERA JEAN BROWN ( O WNE R ) of the aforesaid building. SUFFOLK COUIFI~fDEPARTMENT OF~IgALTHAPPROVAL N/A ELECTRICAL CERTIFICATE NO. 1074419 09/16/02 PLUMBERS CERTIFICATION D~r~3 N/A Rev. 1/81 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) PERMIT NO. 28331 Z Date APRIL 26, 2002 Permission is hereby granted to: ROBERT BROWN 11815 SOUND AVE MATTITUCK, NY 11952 for : CONSTRUCTION OF A DECK ADDITION WITH SWIMMING POOL TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 3480 CR 48 County Tax Map No. 473889 Section 141 pursuant to application dated APRIL Building Inspector. MATTITUCK Block 0003 Lot No. 015 24, 2002 and approved by the Fee $ 546.60 COPY Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1502 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must bc 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,.a~n~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. Ifa 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, Cowanercial $15.00 New Construction: Location of Property: Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. '2- ~ ~ ~2~, ~ Health Dept. Approval: Date. ~,~' Old or Pre-existing Building: House No, Stryet It41 Block Filed Map. (check one) Hamlet Lot Lot: Date ofPermit.~. 2O,,~_.Applicant: V~2:{' ]~p4~IA}-I ~,(/~, Underwriters Approval: [,t9 '7 q c{I ~ Planning Board Approval: .... ~/~ .... - ..... Request for: Temporary Certificate Final Certificate: / (check one) Fee Submitte~ * Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREet ~ NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by Q.C. ELECTRIC INC. P.O. BOX 518 LAUREL, NY 11948-0518, Located at Application Number: 1074419 Section: Block: Described as a Residential ROBERT BROWN 11815 SOUND AVENUE MATTITUCK, NY 11952 11815 SOUND AVENUE MATTITUCK, NY 11952 Certificate Number: 1074419 Lot: Building Permit: BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Outside, Pool/Spa, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the Name Appliances and Accessories Time Clock/Switch Pool/Spa Bonding Furnace Wiring and Devices Fixture Receptacle Receptacle 16th Day of September, 2002. QTY Rate Ratine Cimuit Type 1 0 1 0 1 0 Gas 1 0 Pool/Spa 1 0 General Purpose 1 0 GFCI 1 0 General Purpose Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. FAIRWEATHER-BROWN DESIGN ASSOCIATES, INC. P.O. Box 521 413 Main Street Greenport, N.Y. 11944 631-477-9752 (fax) 631-477-0973 JUN 2 6 2OO3 June 23, 2003 Mr. Gary Fish, Building Inspector Southold Town Building Department Southold, New York 11971 Brown Residence Deck and Pool Building Permit No. 28331 Z 11815 Sound Ave. Mattituck, N.Y. Dear Mr. Fish: Pursuant to your request, based on my inspection of the job site on a daily basis throughout construction, the construction of the deck appears to be structurally sound, and in compliance with generally accepted construction practices. Based on the information at my disposal, and to the best of my judgement, belief and professional judgement, the project in question appears to comply with the New York State Uniform Fire Prevention and Building Code. If you require any additional information, please do not hesitate to contact me. f~ ~ : Date Applicant/ ~ Owners Name: e V' ,. v' Reviewed: Architect/ ~ Date Engineer: _ [~"~_ ~ Submi,led: SCTM ~: Districl:~ Sec~on: 1~/ Block: 3 Lo,: ]W Project f~ Subdivision Single&sepmate Required~ }n ccmficalion: jYes Req ~ Rcq z [R~r Yird Project Description: /~ ~' ~ REQUIRED FOR REVIEW N.A. NO YES Permit . Numb.er 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: .J NOtes: 765-Z802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] I~UL~TION [/] FINAL [ ] FIREPLACE & CHIMNEY REMARKS= DA~E ~///~/~ INSPECTOR INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG, [ ] FRAMING [//] FINAL ~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] FRAMING [t.~ FINA/~ /~/ [ ] FIREPLACE & CHIMNEY REMARKS: ~ , *' . ~",, DATE ~///~0--~ INSPECTOR FIELD INSPECTION REPORT ! DATE FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL _ TOWN OF SOUTHOLD DEPARTMElqlT BUILDING TEL 765-180 BUILDING PERMIT APPLICATION CHECKLIS'I Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey. Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT ,' Date_~t {[3 INSTRUCTIONS ,20 q-_ 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 o~?remises, 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 Occupanc is issued by the Building Inspector. APPLICATION IS HEREBY MADE to thc Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Cofinty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alt .erations 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 adnfit authorized inspectors on premises and in building for necessary'inspections. ~(S~~name, if a corporation) (Mailing address of applicant) State whether applicant is.o_wne~ lessee, agent, architect,_ engineer, general contractor, electrician, plumber or builder Name of owner of premises (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. Location of land.on which l~roposed work will be donei House Number Street County Tax Map No. 1000 Section Subdivision :Hamlet Block 'g2 · Filed Map No. (Name) State existing, use and occupancy of premises and intended use and occupancy of proposed con~tructidn: a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building. Addition Repair Removal Demolition Other Work Estimated Cost If dwelling, number of dwelling units If garage, number of cars Fee Alteration (Description) (to be paid on filing this application) Number of dwelling units on each floor 3. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~ Rear "'~ ~;~ Height ~: '~O Number of Stories ~ ~,~. ~r ~la'r~c~ Depth Dimensions of same structure with alterations or additions: Front Rear Height '~t Depth Height Dimensions of entire new construction: Front Number of Stories Size of lot: Front ['g-q, [c~ Rear Number of Stories Rear ~ Depth 0. Date of Purchase Name of Former Owner 1. Zone or use district in which premises are situated ~-~C.~ ~ 2. Does proposed construction violate any zoning law, ordinance or regulation: ~) 3. Will lot be re-graded ~0 Will excess fill be removed from premises: YES 4. Names of Owner ofprmnis~s F~¥~-~Je~c't' x~ I!~'~- ~'~(-~ ~ Phone No.'"~ - Name of Architect ,~¢))c'M.~ Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. ;TATE OF NEW YORK) SS: :OUNTY OF ) ~f-Zg~t::B~V',~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, ~ ' g)He is the (Contractor, Agent, Corporate Officer, etc.) [ said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this .application; tat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ;rformed in the manner set forth in the application filed therewith. ~'o.un to~efore me this/q (~)_ '~'~. day of ~ 20 Notary Public ~Si~ature of Applicant REBECCA A. VILARDI NOTARY PUBLIC, STATE OF NEVi' YORK QUALIFIED IN SUFFOLK COUNTY NO: 01W06039106 COMMISSION EXPIRES MARCH 27, ~22~-~/_..) ~