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HomeMy WebLinkAbout26238-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27728 Date: 06/05/01 THIS CERTIFIES that the building ACCESSORY Location of Property: 4322 WESTPHALIA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 9 Lot 9.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 23, 1999 pursuant to which Building Permit No. 26238-Z dated JANUARY 4, 2000 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 TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to JEAN A SAUNDERS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N558610 05/16/01 PLUMBERS CERTIFICATION DATED N/A r. A th riz d Sig ature 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. 26238 Z Date JANUARY 4, 2000 Permission is hereby granted to: JEAN A SAUNDERS 4322 WESTPHALIA RD MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY GARAGE IN THE FRONT YARD AREA AS APPLIED FOR. at premises located at 4322 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0009 Lot No. 009 . 002 pursuant to application dated NOVEMBER 23, 1999 and approved by the Building Inspector. Fee $ 50 .20 Authoriz Signa re ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 JUN 4 ? 01 APPLICATION FOR CERTIFICATE OF OCCUPANCY t. A ^" A. This application must be filled in by typewriter OR ink and sub ' t3" '.liiya 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 o� 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 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 - .25vi 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . .?. 1 .� .. J. . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . Old Ogr�Pre-existing �Buil/d�in . . (� Location of Property. . .4.'_;' '.'�, . ,11,•(�J,P 1, IEKaAcj . .12 . . . . . . . . . . . . . . . ':t� Ur'l -, . . . , . . House No. I1,� Street Hamlet Onwer or Owners of Property. .q� .. . .�M S�(:'a•. ,, . . . . . . . . . . . . . . . .��. . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . .), I� . . .Block. . . . . . 1 . . . . . . . .Lot. . . . l:'�?.. . . . . . . . . . . . . Subdivision.^^. ../-.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. .ff. . . . . . . . . . . . . . . . . . . . — Permit No. . l S4 3$ . .Date Of Permit. . .�.��.IUl . . . . . .Applicant.6.C�G c7 (r L7�3ertmsK . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . .. . . .65 . . . ., . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Au-a0eJj Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.� . . . . . . . . Fee Submitted: $. . . 1. . . . . . . . . . . . . . . . . . . . . Q�� nI e'c SgJ r✓6 APPLICANT FIELD—INSPECTION—REPORTDATE COMMENTS _ -----_-----_ Q ': p===— 'V ctkc�6// Le, / ri- H OQ FOUNDATION OST) ) if If ii FOUNDATION (2ND) lf----jj-_�-_ ROUGH FRAME & jj �i to PLUMBING II + II jj H —11 INSULATION PER N. Y. u--- Ii STATE ENERGY n CODE _ n c ee II p ..Ghtp ---II II FINALII ADDITIONAL COMMENTS: CI H H z � c>y ro H I: THE NEW YORK BOARq 0"F FIRE UNDER�NRITER=S PiGx l 1185077 BUR'EpU OF ELE.0RICIT, x 40 FULTON STREET, NEW YOi�K, NY.40038 c 9 Date MAY16,2001--1Applaeaibno orale 123'$6$(�1/Olt N X8870 t _ - THIS CERTIFIES THAT _ only the electrical equipment as described beloiP;hnd antroduc'ed by the applicant agmr•d an the ab' e,appheahgn number Ls Ln the prg irLses of JEAN SAUNDERS, ' 4322 WESTPHALIA ROAD, MATFITUCKT..`NY in the following location; ❑ Basement 0.Ist Fl,'," 1712ud FL : GA$ Se [rgn ; Bdock LTtt ., was examined on MAY 04x2001 -- vpnd founlf ro b'e an campLiur/.ee w0 the NaHonal,l;'lectract{{Code FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES QdKING DECKS OVENS DISH YJASHERS R2fHAUST PANS,: OUTLETS INCANDESCEN FLUORESCENT OTHER AMT., K.W, AMT, K.W AMT „I(W'' AMT :':K.Wt AMT. I H.P. 3 3 3 3'. DRYERS FURNACE MOTORS FUTURE`APPLIANCE FEEDERS SPECIj RE( PT' TIME G10CK5 BELL UNIT HEAVERS MULTI gUTIET bfMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT: NO .A;;W G AMT.. •AMP AMT AMPS TRANS AMT H:P NO,pF°FEET dAMi• WATTS 1 40 L SERVICE DISCONNECTNO.OF RY I C E METER NO•OF CG COND A W O •• A W:G A W G AMT. AMP. TYPE E6UIP. 102W 103W 303W 304W PER :•OPMCOND'.d. NO OF Nl LEG :.OF HI-LEG , ,NO.QF NFUtIEAL3 •OF NEUTRAL='� = 0 1 .O,THER APPARATUS: ` . 9 PANELBOARDS:1-3 CIR. 60 G.F.C.I:-1 `I . I w K s E. r ROSLAK ELECTRIC LIC P.O.BOX 164 CUTCHOGUE, NY, 11935-2453 GEM€pAt}J ANAGEH This cedillcafe must not qe altered in any mgnney,return jo.the ollice of fhe`Board If{nc¢irSCT InsRgctor§maybe Id9T11{IIQT�_by tha)ir crQzlentl, IS, o�oSUFFO(e{'�� o� Gyp Town Hall,53095 Main Road y Z Fax(631)765-1823 P.O.Box 1179 WG • Telephone(631)765-1802 Southold,New York 11971-0959 'y�J 9" �aO� BUILDING DEPARTMENT TOWN OF SOUTHOLD January 9, 2001 Geraldine Berkoski P.O. Box 1097 Cutchogue, NY 11935 RE : Saunders, 4322 Westphalia Rd. , Mattituck To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file . XX The check is (not on file . ) $25 . 00 No Health Department Approval on file . No final inspection has been made . No Plumber Solder Certificate on file . (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 26238-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ` e 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS -ATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIM,N,EY/' REMARKS: / zz ,DATE © INSPECTOR z3 F-jz: M-1802 BUILDING DEPT. ��ECT14N [ FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE $ CHIMNEY REMARKS: �� �a- _ 1 � DATE INSPECTOR J +_. BOARD OF HEALTH . . . . . . . . . . . . . . . !i FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . �iq3 T0WN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . G_. ...,_ TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: > �r CALL . . . . .7?. Examined . .•.. jj....,�11Z0� 7y pp MAIL TO: . . . . . . . . . . . Apprw '. Permit No. ..rX.(�stf ! 4.� .................................... Disapped a/c ................. ........... .................................... (Building I tor) APPLICATION FOR BUILDING PERMIT yyjj Date. .�d� . . . . . . . 19. /-7, INSTRUCTIONS a. 'this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 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 giving a detailed description of layout of property mist be drawn on the diagram which is part of this application. 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 permit shall be,kept on the premises available for inspection throughout the murk. e. No bbiilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATICN IS HRRM 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 applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in bu'1 'ng'for neces ar inspections. ignature of applicant,, o�`i`` if Forporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ......................... Nam of owner of premises ...�.... � ............ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....................................I.................... (Nam and title of corporate officer) +,� IQ Builders License No. ...7!j V I........... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. Baa ... .............................r.�-h. .................. Haase Number Street HHLaamlet County Tax Map No. 1000 Section ..... �� ..... Block .......9....... Lot ....1.: -�...... Subdivision ...................................... Filed Map No. ............... Tut ............... (Name) 2. State existing use and occupancyoCf;")�remises and intended use and occupancy of proposed construction: a. EScisting use and occupancy ...,H0.5�J. th.4 h. Intended use and occupancy ...... Vl!vt cA0:..1 ........ ................................. �+.=P, ; ¢r f: _ •rte i Nature of work (c)eck :.nidi appliC61e): flew building ..W.- Addition .......... Alteration ........ .. Repair ............ Rronval .. ....... Demolition ............ Other Work .................................. (Description) Estimated Cost ..1 E ...II,...... fee .......................................I...... (to be paid on filing this application) If dwelling, l' • ng, number of dwelling hmYts ............ liurber of dwelling emits on each floor .......... ... ... Ifgarage, rxnber of cars .... .........I..........I........... i If business, commercial or mixed occupancy, specify nature and extent of each type of use......... . ............ I Dimensions of existing structures, 11f any: Front................ Rear ............... Depth .......I........ . Height ......................... *nber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... height .�................... Nmber of Stories ............... 1� Dimensions of entire new construction: Front ..."`��......... Rear ....d.%...... Depth .... 1....... height ......................... Nupber of Stories ..................... Size of lot: Front ..... Rear .................... Depth .................... ). Date of Purchase ............ Nae of roarer Owner ....................................... . I. Zone or p district in which renisea are situated ............... p ..... Does proposed construction violate r#In9 zoning law, ordinance or regulation: ... �....... ... 3. Will lot be regraded ...Goy'......J.... Will excess fill be removed from premise@: Y No rte........ None i. Nanea of Owner of premises .......�.......��'?... Address ..... ..... Name of Architect ..................'L......... ...... Address ......... mone No. y�.. ( ,y Name of Contractor .., r!/.h1.6? rY l W ...... Address �z 1"� ' (M��IQFP�e kiione No. .r '.�In— S. —5. Is this property within 300 feet of p tidal wetland? * YES .......... NO .......... d *IF YES, 9JO11UD TOtdl TCGMM'31 PMRl MAY w 14m.Z. POT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ram property lines. Give street and block nudber or description according to deed, and show street nares and indicate Nether interior or corner lot. it rAlE or HN i I i ,SS JUN(Y OF .. u r=T •.•..(�e��t(el�n4e6, C• -Kw.�.'� ...Ir............being duly sworn, deposes and says that he is the applicant I e of individual signing cant Vanract) xwe nmed, .. is Che .... ... ..,..'....{............................................................... (contractor, agent corporate officer, etc.) I f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained inithis application are true to the beat of his knowledge and belief; and hat the work will be performed in the mannerset forth in the application filed therewith. i worn tobeforerre this Q G� ).. ay of " Z1 ..... Notary1' ELIZABETHASTATH"ISS � �/r NOTARY PUBLIC,State of Newt * ignature of Applicant) No.01 ST6008173,Suffolk Co Term Expires June 8, 5URVEY OF PROPERTY 51 TUATE NA77I TUCK TOWN OF 5OUTHOLD ,s Branch" 5UFFOLK COMM NEW YORK �Ioward ck Creek SURVEYED: 04-2G-9G of �Ijatt11t1 N AMENDED: OG-10-QG GARAGE FINAL: 02-08-01 1$0.8 SUFFOLK GOUNTY TAX MAP o +11T # 1000-113-G-G.2 N19 39 Ime aF apparent— /amber high water 4-99 dock GERTIFIED TO: JEAN SAUNDERS t0O Of blvfF N-------------- d5 " S 0 o _ W dirt drive Fryne patNou+a o ash d � ryas % w v3 3o 0A9'3�W , 3 - % 9 w' 'oi 9 - dpi vr4 , WEST��`�jA NOTES: ■ MONUMENT O PIPE SET $ Ar -x—x—x- IF WIRE FENGE -L—°—°- WOOD FENCE �.��� 5 � ��a0 �%'So,P�ePa° 'e S9; AREA = 64, q21 5F OR 1,4G ACRES SFS t.°"• E ° :O:om°ac3nol tronifele o'aeaG`�a �,:i�J[ JOHN C. EHLERS LAND SURVEYOR GRAPHIG 5GALE I"= 50' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 ------ - RIVERHEAD,N.Y. 11901 369-8288 Fac 369-8287 REFERENCE # 99-150FL q i Q N CEG m �2x??L'R . 2x2izT I6 i I y - � ii� iidn 2 eru Fiv� 7 /nT - m w Y f W W b GU(�__�i �-1 T 71l���/q� ¢ O 0 3 cc - - - - ----- ------------- - -- - - - - - - _SIGr F�rya [oiJ I I I I 1 i I I 12° � 2xic� lai�r^� IUI YVILF 411 av erg ' I c� ' I � - - - - - - -��--•---------- --- �. � I I' Yl GDe.IGYLfa�r l, ' -----i— — ' �'FINrmYtGt; W� IO+Cry ! budvpo-a IL 'Cr 6dO' A414 n� = . . / 4 ' a K, 6A . . P- - t tl y2 W- I i} �'' �P . ' moi I �'• e" rte; o + --- � �,p�� - r W ttj BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: S , _ Reviewed: 3 D O Architect/ Date Engineer: Submitted: SCTM #: c� a District: 1.000 Section: (t3 Block: ! Lot: Project 43 a a ' n Subdivision Location: GJ�esj��0.J[.t.�, �e'l�T_l"1 Name: _ Single&separate Required certification: (Yes/No) '^ (� eq. Req Zoning District: /� [Lot Sim. Actual: t0 V(/� (Lot'coverage o�Proposed. � % Req. `� tf QZ Req. RW [Front Yard Proposed: [Side Yard Proposed: l [Rear Yard Proposed: J Project Description: sa,tru�.r� AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County P Health Dept. 1� New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? J Flood Zone: '� 7v/ 0