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Home My WebLink About23031-zFOI~M TOWN OF SOUTHOLD BUILDING DEPADTMENT TOWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT N°_. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZE.D/ ............ ................... 23031. 'Z ........................ , .......................... ~.~. ~.~,......~....-... ~,~ .................... ~, ......... Counh/Tax Mop No. '1000 Section ........ .~..,~'~.,,,,, Block ......... ./..-,.~... ........ Lot No../.,~.'"'"" ............ pursuant to appllco,on doted ......... ~.../..~... ............ 19....~......,~.., and~ approved bythe Building Inspector. ildlng in Rev. 6/$0/80 FOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. C~I~TIFICA~K OF O~=UWANCY No Z-25225 Date SEPTEMBER 3~ 1997 THIS CERTIFIES that the building. NEW DWRTJ.ING Location of Property. 1100 'r~u~RESA DRIVE MATTITUCK, N.Y. House NO. Street Hamlet County Tax Map No. 1000 Section 115 Block 13 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 14~ 1995 pursuant to which Building Permit No. 23031-Z dated SEPTEMBER 29~ 1995 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 DWR~.ING WITH GARAGE BELOW AS ~PLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALT~ APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED DOROTHY LESSER R10-95-0097-JULY 24~ 1997 PENDING -- MARCH 7, 1997 JULY 28, 1997 - DANIEL KUJAWSKI Euildin~nspector~ Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP.~NCY 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 su~ey 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-disposaI(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. 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 ~r~iting to the applicant. C. Fees i. Certificate of Occupancy - N.~w dwelling-~5.00-q Additions to dwelling $25.00, Alterations to dwelling $2~.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . ?l? ........................... New Construction....)~ ..... Old Or Pre-existing Bqilding .............. ocationof Property ...... ..... .... ..... " ' .................... House No. Street Hamlet Onwer or Owners of Property .................................................................. ~ounty T= ~p ~o ~0oo, Section ..... LI.~.. ..... ~loc~ .... (J. ......... ~ot .... 7~ .............. Subdivision ......................... Filed Map.. ~.~.~. ..... Lot .... ( .............. ~ermit ~o.J,3~3t ...... ~ata Of Permit ................ Appliaant ............................. Health Dept. gpproval...~.l.~....?~..~-~. 74 .~nderwziters Approval. Planning Board Approval ........................ Request for: Temporary Cartificata..~ .... Final Certicate ........... FIE~') IH,%~EC. TtObl RI{PORT FOllNDATION (IS'F) DATE ~___ ~-~~ -~-----~ ,: .... / tl FOUNDAT I ON (2ND) H FRAME ROUGI1 i'NSIII.ATION PER bi. Y. STATE ENERGY CODE COMMENTS ff FINAl, ]~ ADDITIONAL COMMENTS: THE NEW YORK BOA. RD OF FIRE UNDERWRITERS WE ARE IN THE PROCESS OF iSSUING A CERTIFICATE OF COMPtJANCE FOR THE ELECTRICAL INSTALLATION AS COVERED tN AN APPLICATION NOTED BEt.OW. ~,,~,o,~,o..o, t/~t/~('-' ~~ 01:lOH 0 dOZ .G ~"-3 c 84-RIVERHEAD/27280 P885 3 300 s Sap 20 1995 MiTek Industries, Ino Wed Oct 18 08 22,28 1898 Pa0 ¢~-0-~ !-~4 r ~5.o.o I 1-0-0 7-9-4 7-2-12 4×4 = 8 3x6 = 6x8 ~ 2x4 II 5 3X6 = T LOADING (P$O ~ SPACING 2-0-0 TCLL 400 ~ Plates Increase 1,15 TCDL 70 Lumber Increase 115 BCLL O,0 Rep Stress tncr YES ~CDL 100 Code TPI TC 099 8C 0.81 WB 0 45 DEFL (in) (Icc) Vder] Ver[(LL) 0.22 718 999 Ver~(TL) 0.3t ?/6 999 Horz(TL) 0,12 5 n/a Min Length / LL der] = 240 PLATES GRIP M20(20ga) 258/216 Weight: 147 (lbs) Max Upiilt 1=-30(icad case 4), 5=-30(I0a0 case MiTek® 84-F~IVERHEAD/8160F P885131 3x6 FP 1x3 4x8 1x3 ~6 1x3 8x4 1×6 3x4 1~ 3x6 Ix3 4x8 LOADING (pst) TCLL 40 0 TCOL 10.0 BCLL 0{3 BCDL 5 0 LUMBER TOP CHORD 4 X 2 SYP No.1 BOTCHORD 4 X 2 SYP SS WEBS 4 X 2 SYP No 3 CSt TC 0 95 BC 0 89 WB 0 87 (Matrix} DEFL {in) (IGc) l/deft PLATES GRIP Vert(LL) 092 18/19 387 M20(20ga) 2581216 Ve ff ITL) 126 18/19 282 M16(16ga) 2181155 HorZ(TL) 021 16 n/a Min Length / EL deli = 360 Weight: 168 LOAD CASE(S) Standard 1995 MiTek TOPCHORD Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (5~6) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. Owner: ~ ' (please prince) Plumber: ~ O~, ~( )~.,L] ~t,~2~/ (please print~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Plumbers S~atu]~e) Sworn to before me this Notary Public, ~ County UNDA J. COOPER Notary Public, State of New,~,Yo~..~ No. 4822563, Suff~k ~ f~ Tefra Expires December 31, 1~.~~ 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~J~SULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INOCULATION [ ~NAL 765-1802 BUILDING DEPT. INSPECTION ,OU.D~..O.,S. [] ROUO. p-.,o. ,OU.O~..O.~.O Il ..~U-J..O. FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ~I~ULATION [ L,/] FINAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT. IINSPECTION [~'~ ROUGH PLBG. ,~JDATION 1ST [ ] [/,~ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ '.~-~UGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [~'RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~-'-~',~ ~/~ DATE INSPECTOR !I1]11 m [llJJl TOWr OF SOUTHOLD tUUJ ,~lll~l~' ! ~ [L~J~ BUILDING DEPARTMENT; ~ L i I TOWN HALL DJs~pprowd ~/c .... . .................. /~ ..... : ......................... INSTRUCTIONS 3 SETS OF. P~bIS....... · su~v~ ..,,' ...... "'"'.. .-c,IEc~ .................. --SEPTIC F O RI'I ............ CALL HAIL TO: Date . . J ..... , 19 ~ ~t. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scaie, Fee according to schedule. ,b. Plot plan showing location of lot and of buildings on preinises, relationship to adjoining premises or public sti'ee, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl cation. c. The work covered by tiffs application may not be commenced before issuance of Building Permit. d. Upon approval of tiffs application, tile Building Inspector will issued a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout tile work. e. No building shail be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of South61d, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describb~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, anll regulations, and t. admit authorized inspectors on premises and in building for necessary insr>e~tions. ~ // (Signature of applie'ffnt, or name., ~f a cqrporation) .... ¢.,.0.,. . .:7...'... (Mailing address of applicant) State whether applicant ~sto~-nw'~er~'~lessee, agent, architect, engineer,[~ener~l contract~)'~ electrician, plumber or builder ................ ~..r~-~...Y.T ............ :' > ........ ~ .................. . ................ . .......... Name ofownero~prem,ses ~*, :.~.~_5~.,~ [JC~(i~thetaxroliorlatestdeed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ZI' Builder's License No .... ¢.; ............... Plumber s Lmense No ............ . .......... Electrician's License No...-D.;. t.. ] ............. I. Location of land on which proposed work will be done., k~-,*..C.¢. :, ......... ; ..... ;; ;- . .......... .... ....................... i ........ ....' .............................. '.: ............ ltouse Number Street tlamlet County Tax Map No. 1000Secti~n ...:....,[L~. ...... Block ......... L3...'... Lot../.ff. ............ Subdivision ~)e.~ .~.,~,~.(.~. g.~"~.~..,'. Filed Map No. ,.L~.~...~:2 ...... Lot ..t./ ........... .... /" .... (~ame)' ' , 2; State existing use and occupency of premises and intended use aud occupancy of proposed construction: a. Existing use and occupancy ..... ':. ':. ( ':: ........................ b. Inteuded use and occupancy · 3.Nature of work (check which applicable): New Budding ..... /kddition .. Alteration Repair .............. Removal .............. Demolition ..... : ......... Other Work ............... · .". 'i.. .............. ' ' (Description) 4. Estimated Cost ..... -~..~3.~. ~..~. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .. [. . Number of dwelling nnits on each floor ................ . If garage, number of cars ........................................................................ 6. If business commercial or mixed occupancy, specify nature and extent of.eac.[~ tv~e of use ..................... 7. Dimensions ol~x~sting stmcthres, if any: Front .... ~..5 ..... Rear,.. ~.~.& .... Depth ......... ~ ..... Height ..... ~ ......... Number of Stories.. [ .............. ~3 ........ 2 ..................... Dimensions of s~me structure with alterations or additions: Front ................. Rear .................. ' Depth .... ' ................... Itei~t ....... .,, ~ ........... Number .o[Stofies ......... ~ 2 .......... 8. Dimensions of entire new construction: Front ..... ~. ..... : Rear .... q~ ....... Depth .... ~ ......... Height ...&~.t ........ Number of Stories..~. ........... ~ ..... ~ ................ .,.~ .............. 9. Size oflot: Front ...... J~ ........... Rear ..... [~...; .... ' ....Devth ...1~..~..~.1 ........ lO,Date of Purchase ......... '. .......... ....... ~ N~ o~[~o~er Owner ...~, .~ . ~.&t.t~ ...... 1 1. Zone or use district in which premises are situated.. ~% ~.%J ........ ~ ..................... 5 ....... 1 2. Does proposed construction violate any zoning law, ordinance or regulati~: . .N.O.... ........................ 13. W~116t be regraded ....... ; .................... Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Nmne of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No..~ ..... ' *If yes, Sout~old Town Trustees Permit may be required. PLOT DIAG~I Locate clearly ~d distinctly ~1 budd~gs, whether existing or proposed, m~d, indicate ~1 set-back dimensions from property 5nes. Give street and block number or description accord~g to deed, and show street nines and indicate whether interior or corner lot. ~ . I ot 3 t/ ~ . JTATE OF NEW YORK, S.S ~OU~Y OF .................. ~ ( ...... ~ ...... ~?}.~g ~'. .......... . ......... being duly sworn, deposes and says that he is the applicant (Name of ind~idual signing contract) move named.~- le is the ....... ~ ~ .~ ............. (Contractor, agent, cor'porate officer, etc.) f said owner or owners, ~d is duly authorized to perform or have peffo~ed the said work and to m~e and file this pplication; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the :ork will be perfo~ed in the manner set forth in the application filed therewith. worn to before me this . ~.~ .... :.~ ...... County & - ' - . } . ~/. '. ~' 5~~ '~.~ .. faPplicant) - ~. ~3, O, I ~ 0 0 t / 0 N/O/F F.R. ZALESKI N. 2'40'40' NIOIF F.R, ZALESKI N. 2'40,dO~ E. $. ~'40'40' ~. I00.00' THERESA DRIVE