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Home My WebLink About24440-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26015 Date: 10/09/98 THIS CERTIFIES that the building ADDITION Location of Property: 625 EAST SIDE AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 3 Lot 15.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 1997 pursuant to which Building Permit No. 24440-Z dated OCTOBER 29, 1997 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 MUD ROOM ADDITION ON EXISTING DECK OF ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD C & JANICE KELLAR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N-461876 08/11/98 PLUMBERS CERTIFICATION DATED N/A c Build ng Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT r TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLE11ON OF THE WORK AUTHORIZED) 24440 Date......OCTOBER.......29.......................... 19...97... Permission is hereby granted to: RICHARD C KELLER .......................................................................................... 625 EAST SIDE AVE .......... ... ..... ........ . .... .. ................................,. .... MATTITUCK,NY 11952 ............................................................................... to CONSTRUCT, A MUD ROOM TYPE ADDITION ON AN EXISTING DECK OF A ... SINGLE FAMILY DWELLING AS APPLIED FOR .................................................................................................................................................................. .............. . ..........................................................................................................................r...I............... .......................................................I........................................................................................................... ................. . .............................................................................................................................................. 625 EAST SIDE AVE MATTITUCK at premises located at.......................................... .................................... . .................... .. .................. ................................................................................................................................................................. County Tax Map No. .....473889 Section ....099..... .. Block ......0003 Lot No. „015 001 pursuant to application dated . SEPTEMBER 19 19.......97. a approved PP roved b Y the Building Inspector. Fee$......... . ...... ... ..... ......... Building insp for Rev. 6/30/80 Form No. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildint 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildir 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 an "pre-existing" land uses: , I. 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; Buildina - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .0.�:1. :. .Z--�. t. ,. �.�.. . . . . . . . .. . . . . . . ter`" New Construction. . . . . . . . . . Old Or Pre-existing Building..t . . . .. . . . . . . . . . Location of Property. . .�O.Z: .. .E�c•. .._. . ► . .'kV...E:7, . . . ...Imt4 ;[;1 I Com. . .. . �.g :�. . . . . House No. .••Street Hamlet Onwer or Owners of Property.. .�i C . . �9�NI,C , ..Z l.;,L . . . . . . . . . _ . , , , County Tax Map No 1000, Section. . 1.1 . . . . .. . .Block.3.. . . . . . . . . . . .Lot A��'.V.01. . . . . . . . . . Subdivision. ./.�.��. .//,. .,,,,. . . . . . . . . . .. . . . . . . . . . . . . . . ..Firled Map. . . . . . . . . . . .Lot. . . . . . . . . . . .. . . . . . . . Permit No. .... . . .Date Of Permit. . . .Applicant.L,>IfA PP: .Q Health Dept. Approval. . . . . . .` . . .. . . . . . . . . . . . . .Underwriters Approval. O.`.V. . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . .. . . . . . . . . Request for: . . . . . . . . . Final Certicate . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . APPLICANT• Z Z7 -.(� A+ Ism THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001272 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date AUGUST 11,1998 Application No. on fcle 16353698/98 N 461876 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of MR. DICK KELLER, 625 EAST SIDE AVENUE, HATTITUCK, NY in the following location; ❑ Basement ® Ist Fl. ❑ 2nd FL OUT Section Bibck Lot was examined on AUGUST 06,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 2 1 2 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.I TIME CLOCKS BELL UNIT HEATERS M SYSTEMS ET DIMMERS !TOIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT, AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS I - H SERVICE DISCONNECT NO.OF S E R V I C E METER .OF CC COND. A.W. W.G. A.W.G. AMNO T. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.CON D. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: 2DANA P. FOX LIC.#525 E L , 467 EAST MAIN STREET RIVERHEAD , NY, 11901 GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board If Incorrect.Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ass-lWz suauiNa DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION I INO [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: 4J DATE / ��INSPECTOR X65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ir FINAL [ ] FIREPLACE & CHIMNEY 1 REMARKS: DATE z INSPECTOR I 111 1,11 I ll'il'bl:(I tillIill UIVI' I)�1'I: w •--�. - - •I-. +.-.mow t:Ullllf�llli � --•--•�. �-.-- •. �' .-www• .•�..-----•----- i;I \ I I`UMIIIAT IU11 ! v f ('--- ,S It w•f�YA wwrwww wwwwlMM wwww www '-w+.+w•!•+.��..-f+r+w, n�..w,�,,.��wwn^ww�T^w•1ww�t• IIt1111:11 irllAlll: /� 1'1.1111 II I NO -- ------------------------- -- -w.w ww ww R•wwt,w,,w rr -----w-w--------w-------------w---www• I II:i111.A'I'I fill 1'Iat 11. Y N I'ATR I'.NVIMY ----------------- --- --------------�_w- ww w-w_-w---- I'I IIA1. . ---- .--------- w------ -------- ----------------------w_-www------w- ---------------w Nlll 1'I'I(MAt. (;(111111►,!r!'!t : !:� .....--------------_ww-_.,---www-----------_--www-www-ww-.R.-------www--_---- - -------------- 6. • I•I r. u • 1'I I I BOARD OF HEALTH . . . 4 . . . . . . . . . . . +l FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . .�. TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . SER F9 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL �j MAIL TO: Examnined. f!l.. ., 19.... . . . . . . . . . . . . . . . . . Approved-_ .. �� 19.... Permit No. ..:� ... .................................... Disapproveda/c .................................. ... ........................................... ?ATION .. ... .. ...... g Inspector) APP FOR BUILDING PERMIT Date.. . . .. . . . . . . . . . . 19. . . . INSTRUCTIONS a. lois 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 must 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 work. e. No building shall be occupied or used in whole or in part for arty purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HERM MARE 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 building for necessary inspections. ,��,/ (Signature of applicant, or name, if a corporation) 67,5,F-A51 Stp�-- AvF-, N)A`VTIT0LV_ NY i 10152- ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ........Fl�f'.r!:1GANT_,I,S .. 0Wt.T"rc:R av,cl AmRC,i�1T �GT ............................................... Hare of owner of premises ,(,1 Ci VA A 1: t O...a ti d...J _IC _� L i� ................................... . (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. ........... .N' A` . ............ Plumbers License No. .............N.a`. ..... Electricians License No. ........l!.+'�. �/.r...... Other Trade's License No. _8.0`o ..0 1. Location of land on which proposed work will be done..... ... .. .............................. ..................... :��:t.. :�.�?: ..A. .K uv ..............1 House Nm.rmber Street Hamlet County Tax Map No. 1000 Section ...9.9......... Block ...S.......... Lotil. !J......... Subdivision ...................................... Filed Map No. ............... 1,1ot ............... (Name) - 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy �.`.Q�-c�C.� ....�. ..r- 25... .......................... b. Intended use and occupancy .. �. G ....................................................... ............. . JO >h� J r«arm L 3. Phture of work (check which applicable): New Building ........ Addition ...... Alteration .......... Repair ............ Removal ............. I)enolition ............ Otter Work- .... (Descriptio) 4. Estimated Cost 10 ... .(3:�. ....... f. 4 -11;,"............................ .... (to be paid on filing this application) 5. If dwelling, number of dwelling units ... ........ Hurber of dwelling units on each floor ................ Ifgarage, number of cars. ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 63' Dept,' `�-� • 7.t . . 7. Dimensions of existing structures, if any: Front.-�� '.3........ Rear ........ m ... ... �5 t ileiglmt ... ................ Number of Stories . Dimensions of same structure with al terat ions or add i t ions:•-Front.....�D:�D.' �.... Rear .�l Depth .....2Akt.7....... Height ...... ...... ... N nicer of Stories .�:... ........ 8. Dimensions of entire new construction: Front ...... Rear ............... Depth Height ..t1i...�................ Number of Stories .I................... .. ......... 9. Size of lot: Front' ... ........ Rear ..? !.1�........ Depth ��. d-. ; `cc Yt 10. Date of Purchase ..��.... (.�._ 96...... Name of Former Owner .V,N.U.T V_r ESYS 4�I M...... 11. Zone or use district in which premises are situated ..RES1•P'_.n T I AL ........... ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................... 13. Will lot be regraded .....N'� .......... Will excess fill be removed from premises: YES � Iii. Names of Owner of premises R' i",c i�/k��i q.��g►:. Address -�3!&A%NAA I l;V 0:. Phone Name of Architect .......... �5.�'IQ!ra.�r...'I.f1r1 ... ............ h �! Address .................. Plmore No. .............. Name of Contractor ................................... Address .... .......................Phone No. .•. 15. Is this property within 300 feet of a tidal wetland? * YES'�,/!......... NO .......... ..- -. •.- *IF YES, SWfHCtD MM TII EEKS PERMIT MAY BE W4HRI0. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block ember or description according to deed, and show street names and indicate u(Iether interior or corner lot. W S i t_1 M IT a Ft_A>JPS LA 2 SSa Ry y �121,� �pPIT10N � X 5'TO R`! � dol �cn C>DA�fat � �J 43z, smir or. KW neat, S OUMIY OU. C S -' ................................being duly sworn, deposes and says that he is the appi.i it (Name of individual signing contract) above named, lieis Lhe �YY.n! ...... ..... ..........^..�........................... ............................. (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 all statements contained in this application are true to the best of his knowledge and belief; and that time work will be performed in the manner set forth in the application filed therewith. Sworn to bgqefpre me thishCti�T .......`..1..... y of .......... .19. /C�j �� < FC Notary Publ. c ........ ' r i ra YI .... . ..... w _til 0' (Signature of Applicant) 6640 MA-60-EM,X vwn=I ::M 9T PS WALL FIN. PANEL 2u+ , Ico" '0 - c, o ncarru?_x{sr_ ` 11l16" PLYWP SHEATH'CI • �- Zx15r. 6WLDI14c� - "` xlsr. SU � IInG II46ULATWIU - _ M '(AL FlA5NtN41 �� 43" xA-3� SKYL1 Clµr 71 �.X15T.LH��W."(e�ti�•51f}I�q 1° '%LVEMAW dOf`_ ftp li -� Y I._ w7r', �l i I. Ft_ ' - -� Ii:.� YwC 6XT. A �' � � FLgSH'4. i _ -__ II: - 41 ( 5/16" x co' LAG f II r: II . _ 1 1 T N A Oi Y iIIDDITIOW �I _ F_XI �T. 2xI3 dbI SFS : 17-1 LXISr DEGIC PLANKSi , , � ! � i E LEC i I pEGe, � 1 N � 1 ainE II > 1 KILNIK4i �IFLAsN,,.4 ) 71 BLOCKING l O.. A4-i0n ADE 1)ETAI l_, SECT, ,:A, :,�:: + . I ADD �TIO n� noorr,oti � 2x10' 7REATEDJdtSiS 7� c.� � NOPTN ELEVATION WEST_ ELEVATION 4. A NOTES : 5CpLr- :.-/> '_ EX IST 1 N . OND �T10r,f5 Cj - - - --16 -- ----'- --- -p---- - EUIVAI ) OIV N 14tH WALL SCALE- 114_" C>" TD 9�- 5r-T It< t j cxls sL oy. — --- — — — -- t ,LANT AT tjP—CK , w sEM'Twtnv �a Pv I 2PJ1hOV� R�LOGA76 } � _ J-9; t : APPL' k. 24" d,c • RVC71U� 5TEP5 r �- - - - -- 4, Lnr- FR„AM'm Td e (o" 0 , C. , DOU13LEP 4T TUE F 3• — " SKYLIGHT PE'C.A'14 C, 5tMP5t�' VsPUC�sxlSr.JOISTS ��-; -"-�- -r-•-r-�" 1 til rvun, 3=B° w�Tx-CiA w. fL I •- L hn I7 of 0.DAt'APJGt ON I'I'Uk.�.k Gtictnt GL.f F6 unt5'f'- > ^� �a TIDAL � -�- "' LA45 oA GA R0.1AGi= Q � A I - kANC� ,Rh AT F_ACH JOt )r. bbl t! , •4P6R JaIST. Wr.TLANvs 11 N hi / \ I FLOOp, CDYEKINI -f0 86 I LA N Q &n.o6• SHEET VIN-(L. 1D11ZloW a 7Z-y h ECK j o " . INSI}LATIOrA 70 B 4 AM-r- 8, FIN1541E� ROoFIr1G ANp W y 1 I XT WGLL`J f 2pOIF, 1" FOaM '61DIt1CI TD MATCH EX.I5TINy _ " c 4 I BLUE,SOARD OVER, tS m rGO NG. $LAB9IS"Jc(� P.M DELI: t'�G Al CaADr�' '�-- 9- - - - - - <. F-bLT AT FL - . d -- - - 1 2.k 16 S TRBAT60, IPI' O•C- - ,.y23 Rp Pv "'-- --—_ -. - -- 7- Tta kE i5 NO WEAtttsCt o - PLUMBWN 7 N 1' - -- -IZ �_-- 1 - -� ' WORYG ra B� DDNE� ( _ .. EXISTING CONDITIONS , PAQT PLAN AT DE.CSC n l n '' I ``'1`Iu�Ua � � -- PLOT PLAN °I �� TVI,�lN9I"��a�l� . 3 CA La , I" c 125 --- --- 1 _ ' of OCCUPAMCII $EE COUNTY TAX MAP W4 I600,3EGL99,9LK 3_,LOT 15.1 v ADDITION to RESIDENCE- or M1'�. N11L5. ZiCPikU C. ICELLER. 1 625, U-1467 61DC.. AVFNUE✓ , MATTITUCK, N. Y, OS52 tzI(:0xz.D C. V—QLL�,e., aQct VTLCT . WPT. 18, 1997 FaIttiIV Cera �"kAta":,^,'t""ittAGtlL➢m1 Ef2Rbaf ,