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29604-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29674 Date: 08/29/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 750 KNOLLWOOD LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 107 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 24, 2003 pursuant to which Building Permit No. 29604-Z dated JULY 24, 2003 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 ACCESSORY GARAGE IN REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ELIZABETH ROSS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1156725 08/08/03 PLUMBERS CERTIFICATION DATED N/A A ho zed Erignature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29604 Z Date JULY 24 , 2003 Permission is hereby granted to : ELIZABETH ROSS PO BOX 652 MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REAR YARD AS APPIED FOR . REPLACES BP 25280 at premises located at 750 KNOLLWOOD LA MATTITUCK County Tax Map No. 473889 Section 107 Block 0001 Lot No. 015 pursuant to application dated JULY 24 , 2003 and approved by the Building Inspector to expire on JANUARY 24 , 2005 . Fee $ 75 . 00 Authorized Signature COPY Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25280 Z Date OCTOBER 23, 1998 Permission is hereby granted to: ELIZABETH ROSS 142-10 ROOSEVELT AVE FLUSHING,NY 11354 for CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REAR YARD AS APPLIED FOR. at premises located at 750 KNOLLWOOD LA MATTITUCK County Tax Map No. 473889 Section 107 Block 0001 Lot No. 015 pursuant to application dated SEPTEMBER 8 98 and approved by the Building Inspector. Fee $ 35 . 00 B i in Inspector COPY Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ! ! ' AUG 2 6 2003 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 12 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 a 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 $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 - .25V: 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date , August 22: 2003 New Construction. . . . . . . . . . . Old Or Pre-existing Building. . X. (detached frame garage) Matt tuck Location of Property. . . .Z50_ . . . . . . . . . Lane . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. , ,Elizabeth S.. Ross . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .107.00 . . . . .Block. . 01.00. . . . . . . . .Lot. . 015;009. . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . X. . . . . . . . Fee Submitted: $,25. . . . . . . . . . . . . . . . . . . . . . . . . . L o _Z 14ig - A. / .G �. Wickham, Agent � � a 9 � �y APPLICANT o srn�n�L3rsrrPLns��PLnrsPLLLPLL-�rr�n� r1ns1r��l�n��lrrrs�l ��n�l�Ia��l��Is�lrr�n�lrnr�r��l�l tr��n o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 55 40 FULTON STREET — NEW YORK, NY 10038 55� CERTIFIES THAT �c 5 Upon the application of upon premises owned byJAMES CCSU 5ETH ROSS .O. BOX 305 AY KNOLLBWOOD LANE5 5 LAUREL, NY 11948, MATTITUCK, NY 11952 5 Located at KNOLLWOOD LANE MATTITUCK, NY 11952 Application Number: 1156725 Certificate Number: 1156725 CC e5 Section: Block: Lot: Building Permit: BDC: NS11 C� 5 Described as a Residential occupancy, wherein the premises electrical system consisting of r.1 5 electrical devices and wiring, described below, located in/on the premises at: 5 First Floor,Detached Garage, Outside, 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was 5 5 found to be in compliance therewith on the 8th Day of August,2003. 5 5 Name OTTY Rate Ratine Circuit Type C� 5 Wiring and Devices 5 5 Receptacle 1 0 General Purpose 5 Switch 5 0 General Purpose 5 rj Fixture 4 0 Incandescent 5 5 Fixture 1 0 Fluorescent 5 Receptacle 2 0 GFCI 5 5 5 5 5 5 5 5 seat 5 5 5 5 I of I 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 O cn�l-cl-�I-rJ'arJ�cnrJ'�n�l-��n�l-rJ'r P�rt�r�rJ��n�l-cnrJ'�l-r��l-�I-c.rrJ��l-�l-r�rJ��l-�I-cn�l-u�l-cncn�l-r�rJ�rJ'rJ��nrJ��l-u�nrJ'�r-rJ'�l-rJ�rJ'rJ�l-�rt�n�l-� o ' v. t•' - � � 1� a { - ` _ ♦" F` a '•�,Tr'��TFFi ,SII^ .. 5 4.4 '� +�. t �~ ♦s d 11 I it _ 1 Y � 1 � � 'vli�� 1 v •. Ir 0040 -45 1, r ` } � ♦. � �� �!/��..�Y 3 �t `3,` lit ♦F .A y 'i' � ,. .:i. \. . Ky.'s s t •, -. '' ,, s r \� A n�1 mak♦ K 1 l l ' alb 1- a , t r • .y of A- v _ 4 t a d ♦' -' A.''`k'k . � a... 2�'X .Atl �.'L4, yy'M♦♦�.?Tv 5 ggc . 17 ♦�. 'S. s a�,. 'y �, ,., < `!, ,i.. .µ:'x S$.�: K.4i ° I 't Y. nc . ht;'�f .., • 3.. �.•a.:.' a '�, .±fir.,.. _. +.. .< a . 1 M-1802 BUILDING DEPT. .INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A IMNEY REMAr 1 DATE l ( INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: .4412z-�� DATE /5 INSPECTOR X M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST X11 LBG. [ ] FOUNDATION 2ND ON FRAMING [ ] FIREPLACE A CHIMNEYy� REMARKS: aAe�O DATE INSPECTOR 70AW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSUL N [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 7A 0 INSPECTOR 'l—LD I:.S:'EC7l0'i :E COMMENTS La , I . m a �C{ =OUNDATION ( 1st ) ti ?OUNDATIOtJ ( 2nd ) _ m- 2, z o ROUGH FRAME tr PLUMBING .. o C4 o 3. z En INSULATION PER N . Y. y STATE ENERGY CODE a Z 4 . FINAL - 0 2 ADDI IONAL COMMENTS : �e _ 5 M -V .� M .. a H G O z x Z m r3 H . - x O m a BOARD OF UULTU ... .. . .. .. .. .. . FORK NO. 1 3 SETS OF PLANS'..... . . . . ....... TOWN OF SOUTUOLD SURVEY ...... . .,. . ..,.,..• • •••• • • • BUILDING DEPARTMENT CHECK ...... . . .I . .... . . . . . . . . . . TORN HALL SEPTIC FORH . ... . . . . . . . . . . . . . . . SOUTIIOLD, N.Y. 11971 TEtn 765-1802 NOTIM H/ ppCALL ....r ' Umnined.. ... /1��� .., 19 0. _ MAIL. Tol . . .. . . . . . . . . . . . . . . . . ApproveK1....C.�/j v..., 19 rennil' No. ........... . Disapproved a/c ........... .................................. . . .... ............ ...................................... O (Ikril �alioctor) . SEP 8 ICATION FOR BUILDING PERMIT Date.. .. .... .��/j�...49.98 , BLDG-DEPT INS7'RUC'fT0NS A. 'Ibis application must be completely tilled in by typewriter or in ink and auluitted Co dile Building Tmhpectcr wi 3 seta of. plans, accurate plot plan to scale. Fee according to adwUl.e. b. Plot plan showing location of lot and of buildings on premises, relationship W aWaigg phenises or public at recta or areas, and giving a detailed description of layout of property meat be drawn on the diagram which In part of tills application. c. The work covered by this application may not be caamenced befoo issuance of Duildlag Panait. d. Upon approval of this application, the iluilding Inspector wilt lam a DAMPS ha dt to tie applicant. Sud' permit alsll be kept on tle premises available for inspection thro lout the work. e. No building shall be occupied or used in s; hole or in part for ahph purpose r9hatever until a Certificate of Occupancy aliall have been granted by the Building Inspector. AFFLIC1ChLON IS hIOMEY bMW to the Building Department for to issaahhcs of a liuildingParait pursuant to to Wilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ar Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. lbe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations,Iand to admit authorized inspectors on premises and in bulldtmfor necessary peetioaa. (Signatttuuroct s llcant�. or mama. if a 'rporeCiai) ...................... . (Mailing address of applicant) Slate oihedher applicant is oxer, lessee, agent, architect, eegineer,'Eeoeral contractor, electrician, pludher or buihN .................. .......................................................... Naof r of premises .f— 'L�2��f N "' m care S S (as on the tax roll or latest dead) If applicant is a corporation, signature of duly ouL'lwrized officer. .............................I............ (Nmc and title of corporate officer) builders License W. le72€�) ..&4;//E2 Plumbera License No. . Electricians License No. Other Trade's License No. I. Iocotioh of lad on which proposed work will be done... ........... � ..��:T�: .................. 1"14 77—/ rX✓e,� . ........................................................... . .................................................. louse timber Street Ilaalet Canty Tax Map No. 1000 Section ......l.V.7... Block ...../......... ioot ....1 ...... Sutxlivision ...................................... Filed Map Vo..-V73...eez. Lot ............... Want)' 2. State existing use and Occupancy ofp(r/ a and Intended use and occupancy of proposed construction: a. ixi. ting-use and occupancy ./ S '�'�NC',' .. ...........................................•........................... b. Inter4ed use sod occupancy ..... "::K......'.4 Y�::r' .�: ...:... .........� .............. HitDtro of +ork (dtedt Witdt appliesblo)I Lkw DdIding ..,.1..... Addition .......... Alteration .......... Repair ............ Removal ............. valolition ............ Other Pork ...... (Nscr f ption) ltntimsted cost ...� .�� ......... fee. ...:................................... (to 1e peid.au filing thus nptptfention) if dmIling, anter of dwelling unite ............ A"ber of dwelling unite on earl floor ... ....... .. .... if garnge, anter of care .......eo'. ............ ........ If hoilineas, Call rcdal or mix4 occupency, specify nature and extent of earl[ type of use...................... enelons of existing structures, if anyt Front.....C� 2' nim . Rear ......���" ' Ikp[h ....... .......... Buielt ....... ................. Rim er of Stories ...................... nimensioos of ems stns:tirre with alterations or'aklitionet Front ............... Rear ....... ..... ... teptlt itaigltt N,nber of Stories i ninmsio,a of entire new eonstructdont Front ...IS........ Rear �...... Depth . ..... .. Ile1,01t ........... ......... Haber of Stories ../................. Slur of tot,l Prrxtt ....Ile ......... Rear .... 0.7 .......... naDa_pth 1. Niue of Purdesa .....�g 7.2...... vera of Fortner Owter ..., �.�:/ql� g� ......�. ...1. Zone I. Zoor use district In u hidt premises are situated ....16L.A4r�tilft: e P s't.,i...Aa :i;.i .... ... 2. Poem proposed construction violate may t:oaing taw, ordInanta or regulati ....... l / 3. Will lot be regraded I...... .:.0....... Will excess fill le removed 1!.:'.,^•' yn M1. Nates of Owner of premises tlo.� 5��117 time of ArdtitactE�lt. .E .. K.�F� Y�.. Mdress .Qana. ....t-."w`Al` . . Il1ae No. � o?toC r ,/ Mitts of Contractor ..>.`3.2.*.�4....414-Ale....... Address ..�i� .�?(Sl.�'19wne No.-4rr1.eA?/ 5. Is this property widdo 300 feet of a tidal wetlanll a YM .......... No ..,x .. slF YRS, "MUD MM 71=11RS8 I'd MIT HAY ODS MWIRM. - FLAT DIAGRAM- Incate clearly and distinctly all buildings, rAether existing or proposed, and indicate all act-back dhrenafons from property lines. Give street and block number or description according to deed, and allow street nares arld indicate �dletler interior or corner lot. ' l stunt at MN YtXtR, Y.Sr✓7... . .Will; duly vwvrn, detx>sen atxl says that lie in the appl.irsme (Newt of hxltvidt�tl etgning contract) above nmed, Ilein the ...... a W N-�............... ...... ............................. .............. .... (Contractor, agent,-corpornte officer, etc.) of amid (mer or owners, and is duly authorized to perform or btrve pmrfrtrnml the ma td work and to nuke aril file this mpqultcntian thnt till state aall to contained In this npplicatton are true to the beat of his knowledge mel Nil lef,' mel titmt the ark will ba performed In tie mover er met forth In the opplication filed therewith. >rn to before me this.QCle .....A:: .....tiny of Notary Public ......Ne`TAR�YN 'N„( �.�Y19�•J"�/'�./".�". }'Ole • . •• .�.. l't°•304916DU (Si •�tM. a of Applicant) I ., r DISCS' � ' Izsi �'+�If,r mL •' t 1) 12'' 7 U 12" Z� �utaitrCY�gr" � ' �" �� 11,,.10 .jen"a1'� ZSE - /drwa�n ".frac . Gt� C?tst ✓t�r� l {.mss . - - - - - ��'1' { G �9�C�"101-� ,rS . ;��-el..l„�►-meq EI© 1� ?e ,� -- � Z oto OCCUPANCY OR ` 4y � �• USE IS UNLAWFUL _ WITHOUT CERTIFICATE - _ '2",Z OF OCCUPANCY f 1 � I ' 2x'2'C,J. =F ,��G�rc� �r� t —I ---' - UNDERWRITERSEQ RED CERTIFICATE -- I I I APPRM AS� n o FEE�3,f 0� : - g pn �ffr� e2;CP NOTIFY BUILDING AT lb, 786-7802 9 AM- 4 PM FdR THE p+ - FOLLOWING INSPECDONf. 1 'FOUNDATION - TWD BEIDUMED vx FOR POURED CONCRETE 2. ROUGH - FRAMING B PUIMIllm ., . - 1 3. INSULATION . b 4. FINAL - CONSTRUCTION MUST rep.- BE COMPLETE FOR C.O. - ALL _;,V TONSTRUCTION SHALL EQUIREMEN S OFTHE N Yr 0 HE R STATE CONSTRUCTION 9 ENERGY w C011ES . NOT RESPONSIBLE FOR "i ° CM OR CONSTRUCTION ERRORS - 4 0. m IE K cc - a v s !lar/,3g r1 _ i = EU ZW