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HomeMy WebLinkAbout23117-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 0-25183 Date AUGUST 5, 1997 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 300 DEEP HOLE DRIVE MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 12 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 1, 1995 pursuant to which Building Permit No. 23117-2 dated NOVEMBER 17, 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 GARAGE, DECK, OPEN PORCH, SECOND STORY ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WARREN W. & MARY A. JACKSON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO.-N-405224 - DECEMBER 9, 1996 PLUMBERS CERTIFICATION DATED AUG. 30, 1996-CUTCHOGUE EAST PLUMB.&HEAT Building Inspec 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 COMPLE11ON OF THE WORK AUTHORIZED) N2 23117 Z Date ...111V 19.F Permission Is hereby granted to; . m..... ._M Q to 4 Ile ..v... , at premises located at....., - ..''•~4fPl° County Tax Map No. 1000 Section f 5 Block .......12 . Lot No . r~. ~........I 19,1.. and approved by the pursuant to application dated Building Inspector. Fee l/ Building Inspector Rev. 6/30/80 k Form No. 6j TOWN OF SOUTHOLD {g a BUILDING DEPARTMENT 1997 TOWN HALL 765-1802 _O n/^ OF SO 3RI9N 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 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: 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. V 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25m. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ........7. 3 l New Construction.........~.L.. Old Or Pre-existing Building........,............ f?:~,~~/~CJG~ ?/1~ Location of Property.. lrii..Q / .IY.OG .el......... House No. Street Hamlet Onwer or Owners of Property..A~'~~',Y/. ~.t?CGiO../ County Tax Map No 1000, Section Block .......Lot....... V Subdivision ....................................Filed Map............ Lot...................... Permit No.. ....Date Of Permit.. Applicant. Health Dept. Approval ..........................Underwriters Approval......................... r Planning Board Approval Request for: Temporary Certificate........... Final Certicate..,K Fee Submitted: $ ............................4j Y. . S3237 PLI T co -z;Qsi9-3 TEL. 765-1802 C.. TOWN OF SOUTHOLD OrrtCE Or BUILD1I'IC, 1NSILCTOR o a~M, P-0. 130X 1179 ~O~~S? ' ` TOWN II,1LL ~Ol ~O~t SOUTHOLD, N.Y. 11971 C E R T I F I C X~ p T O N i Date j 30 76 i i ~ I I ' Building Permit No. OwnercK SO (pleas- nt-)--- - y n Plumber r~ D.~, N. S I I N 'r ipl.ease printj-__.____'_ C/ CILO v I i 1 cn,rtify that the solder used in the water supply system contains less than 2/10 of to lead. `I r~ (plumber's signature) Sworn to befor,2 me tt:is -~_day of usr 19Y~ ~ j dotar7 Public, Su-rr~l-r, y Public ' County RICH ARI.) P1OpICekfiIRCIty Notary Puhlio, 3ru?0 of N_,' . rk Qualified in Suffolk County Term Expiros January 31, 1889 O~cgpFFO(,I-CD Town Hall, 53095 Main Road y x Fax (516) 765-1823 P. O. Box 1179 W of Telephone (516) 765-1802 Southold, New York 11971 ~,j, OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 29, 1997 M&M Warren Jackson 300 Deep Hole Dr. Mattituck,N.Y. 11952 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 # 23117-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & GGLI G• /S ' a PLUMBING' C LLw O G C N Ji 9z 3. /L u n INSULATION PER N. Y. STATE ENERGY CODE. a r 4. FINAL / ' A ITIOPIAL COMMENTS: ~ 2 • x H • 9 \ - H ' S • p. m ro H '"a.3k.~WFa..*w«, a..~:.,Skv&7b-hvr..m s ~~a.n•.~ ,r, , . , . ~ - ,~'F _ 30 IR,~, JUiw Z 1997 f2e1 Aerin,'i ~L.3 8LDG. s sir. G(> tmv 4!. r aJ y . 74cAfooA-- TOWN OF Hol n ,,..owY t3 valdI(~ ~~a~r~~~ r; „~rrz SOV71VOW, /V / o a)/(O m ~,oyf~,yc~<w cvu~ld like Vo s-eytlOil le 4(',C 19714f m-uz~y~s t~I°ri~~ P ?P7 CCJ7~o©~t wvr~. VOW eOASWeV-A404~~ M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _ DATE / INSPECTOR i I174~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]",R PLBG. [ ] FOUNDATION 2ND [ INS TION [ ] FRAMING [ [ ] FIREPLACE &QQCHIMNEY REMARKS: DATE C 1-- INSPECTOR 4-77410~4 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [UGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE -3 INSPECTOR gjx-,, 76S-1802 UILDING DEPT. SPECTION [ /OUNtDATION iST ROUGH PLBG. DATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL [ ] FIREPLACE IMNEY REMARKS: DATE INSPECTOR r -7 M-1802 BUILDING DEPT. INSPECTION [ ] F NDATION 1ST ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMAR X~ CA DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: r DATE ' I INSPECTOR Aa" THE NEW YORK BOARD OF F f % UNDERWRITERS PAGE 2 1000977 BUREAU OF ELECYRICITV• I 88 JOHN STREET, NEW YORK, NY 10038 bate DECEMHER 09,1996 Application No. on file 12'725496/96 N 405224 THIS CERTIFIES THAT only the electrical equipment as described baton, end introduced by the applicant named on the above application number in the premises of MR. WARREN JACKSON, 300 DEEP HOLE DRIVE, MATTITUCK, N.Y, in thefolloainR location, 12 Basement L1'lst F6 ® 2nd Ft. GAR/ATTIC/OIJT Section Block Lot r,os examined on DECEMHER 05 , 1996 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACIES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER NAT. K. W. AMT. K.W AMT KW AML K. W. AMT H. P. I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. T. AMP, qMT. AMPS TRANS. AMT. H p, SYSTEMS AMT WATTS NO.Of FEET SERVICE DISCONNECT NO. OF S E R V I C E AMT. "P. TYPE METER 1 [W 103W 303W 304W NO. OF CC. COND A. W. 0. EQUIP. PER J0, OF CG COND NO OF HI-LEG A. W G. NO.Of NEUTRAIS A. OF III LEG OF NEUTRAL OTHER APPARATUS: E. ZEIS ELECTRIC LIC. #2804-1 ' L L 260 JEFFERSON ST GUS ZETS CENTERPORT , NY, 11721 GENERAL MANAGER 11 X 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000977 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK,°.NY 10038 Date DECEMBER 09,1996 Application No. on file 12725496/96 N 405224 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant' named on the above application number in the premises of MR. WARREN JACKSON ~,tt-, 300 DEEP HOLE DRIVE, M.ATTITUCK, N.Y. in thefollowing location; [!a Basement Ej Ist Ff. Ci 2nd Ft. GARIATTIC/OVT Section Black Lot um examined on DECEMBER 05,1996 and found to be in compliance with the National Electrical Code. fIKTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST PANS ,I OUTLETS ECEPTAClES SWITCHES INCANDESCENT FLUORESCENT OTHER NAT. K W. AMT K.W AMT. KW, AMT K. W. AML H P 63 a0 48 63 1 10.a 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS JELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. OIL H. P. GAS H. P. AMT NO. A. W. G. AMT. AMP AMT. AMPS. TRANS. AMT. H P. SYSTEMS NO. OF FEET AMT. WATTS B F 7 SERVICE DISCONNECT NO. OF S E R V I C E I AMT. AMP. TYPE METER I A, tW i % 8W S 3W J % AW NO.OF CC COND A. W. G. NO OF HLLEG A. W G' NO Of NEUTRALS A W G EGUW. PFR% OF CC.COND. OF H4LEG OF 'NEUTRAL i 1 200 C8 1 K 1 2/0 1. 2/0 I~ OTHER APPARATUS: WELL PUMP-1 4 TON AIR CONDITIONER-1 f 3 TON AIR CONDITIONER-3 MOTORStl°F H.P.,2-F H,P.,1--4 H.P.,1-3 H.P. j PANELBOARDSt2-1. CM 60 ! G.F,C.1t-8 SMOKE DETECTOR:-6 A <<< Continued on. Page 2 GENERAL MANAGER Y Per This certificate must not be altered in any manner; return to the office of the Board if into Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MIST NOT BE.;ALTERED IN ANY MANNER. New York State Department of Environmental Conservation 1s Buidinq 40 - SUNY, Stony Brook. New York 11790-2356 Phone (516) 444-0365 n 2 W Fax i (516) 444-0373 5 2 EIRAUeTt Canwnhwkmw ~o-ee. o(~rwr<•e- 300 Dater as, /9~s PLX&, Ck' IVY /l96-~2- RE: / IM- D//y//oooa~-.o Dear AV. Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: a,4-1 nerefore~,/in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act: Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are takes to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result fmm your project. Such precautions may include maintaining an adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. very truly your/s,, I'I Deputy Regional Permit Administrator mm~` NOV - i 1995 cc:, 1 Albert J. Krupski, President FF014,COG Town Hall John Holzapfel, Vice President o yt 53095 Main Road William G. Albertson P.O. Box 1179 Southold, New York 11971 Martin H. Garrell Oy • Peter Wenczel Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 21, 1995 Warren W. Jackson 300 Deep Hole Drive Mattituck, NY 11952 Re: SCTM #115-12-4 Dear Mr. Jackson, According to the information given, a.copy of the survey submitted and an on-site inspection, to construct a 1,600 s.f. addition, a 626 s.f. of garage and an 8' X 10' shed as per plan which shows that the shed is more than 75' from wetland, the Southold Town Board of Trustees has found this project out of our jurisdiction under the Town Wetlands Ordinance. Please note that any activity within the 75' of Wetland area will require an application from this.office. If you have any questions, please call our office. Yours truly, Albert J. Krupski, Jr.NOV - 1995 President, Board of Trustees y T~ViI€ 187"OnC AJK/djh CC. Bldg. Dept. t~-..~,< ' CAC tt~~ -w . • «nn~- IS t5. 0. 4t!1_,, !i Irrr w ' BOARD OF HEALTH FORM NO.1 J,3 SETS OF PLANS TOWN OFSOUTHOLD.SURVEY.................... BUILDING DEPARTMENT ,,,CIIECK , , • , - ' , , . • • • • • , TOWN HALL SEPTIC FORH SOUTHOLD, N.Y. 11971 q TEL.: 765-1802 NOT I FY ; ~ *:S)-4 CALL J... VV Examined 1971 HAIL TO: Approved / ~ 19J. Permit No. -P . Disapprove da/c ~l (Bu' ng Inspector) APPLICATION FOR BUILDING PERMIT Date 19 - INSTRUCTIONS 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 on premises, relationship to adjoining premises or public streets or areas, pnd giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation•A 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 issued 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 any purpose whatever,until a Certificate of Occupancy 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 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, I usin code, and regulations, and to admit authorized inspectors on premises and in building for necessansp ctions. f ! (Signature of applicar , or name, if a corporation) 340 A0AIWAled e Qe....ffiPT7/7~0~ ~l? . (Mailing address of applicant) /fJ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. CI~JN 2. - ../~l'/~1<.~y?'?T . Name of owner of premises A ~~!t?..r!Y.'. . M/F p (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . Plumber's License No. Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . 300 O. e4p. l1!aGf.. 'ae....... ~lifs~7lrrreA-- /V Pyr.~ , 1. .4 House Number Street Hamlet County Tax Map No. 1000 Section ...:J157 • • • Block Lot ....Z Subdivision Filed Map No. Lot............... (Name) 2: State existing use and Occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ?1!°: /e+¢a/ b. Intended use and occupancy . . I I 3 Nature of work check which APplicable): New Building , . Addition Alteration Repair oval , , , , , , , , , , , , , , Demolition . . . . . . . Other Work (Description) 4. Estimated Cost . . Fee . (to be paid on tiling this application) 5. Ifdwelling, number garage, number r of units Number of dwelling units on each floor If cars .dwelling business, commercial mixed occupancy, specify nature and extent of-each type of use 6• Height s ors of exstinstructures, if any: Front Rear Depth nberofStories rw Dimensions of same structure with alterations or additions: Front . . . . . . Rear Depth . I Dimensions . . . .ensions . .of. . . . .entire new construction: ' Height . . . . . ; , . Number of Stories . rntction: Front Rear Depth Height . . . Nu~lberofStories 9. Size of lot: Front O , . Rear ~ . Depth . 10. Date of Purchase / Name of Former Owner k/~L1fC . 11. Zone or use district in which pr emises are situated , , , , , , , , , , , , , I , . , • 12. Does proposed construction violate any zoning law, ordinance or regulation: fl/® 13. Will lot be regraded . ' t • • • • • • • • • • • . • • , ....Will excess fill be removed from premises: es: o 14. Name of Owner of premises Address , Phone No. Name of Architect Address Phone No. Address . Phone No........ , , . 15. Is this property twithin 300 feet of a tidal wetland? * l~ No......... If yes, Southold 'down Trustees Permit may be required. ed. , 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'number or description according to deed, and show street names and indicate whether interior or corner lot. I r I STATE OF NI R COUNTY I,CtiYC~ b __'S being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Ile is the I........ C~uUY~,Q (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyauthorized 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 the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this S ..day of, 19~~ Notary Publ(, ..CLAIRELG~I' . • Couuyz.. Notary Public, State of N I W York . , , No.48796D6 Qualified in Suffolk Coumy (Signature o C applicant) cant Commission Expires Decemb~r 8,19 I to n, II U) c z p .OR.D{NA2yw F.rIGHA,' WATEfL= " MARk1 a ' BANK„.... 9 X m 6 ro I m - r%~ e - _ ..g 1 _ `J j 4 1 } r c g ~ o j N to ~ z Z i (V ' C.11 tp i p m I «l~- - I~~ck~1 f r~, i I I ~ta_ r I cn ' 62 i I s ' J I5 I 5,2 0 W, I O.0 `-264.26 TO WrW SUP'FOt.,ic ildM. rJ A O m DEEP 140LE DRIVE ~ t I I y ~ I ' BS..~magn g3~$, ~'R98 ICJ ~ o .Z ro $ G G t/_~ j ~ s.m;o~ m No ama~ 5.~ j_j S oN°1 8•a a oF'3 m6§ j o->Qano K Sn; o3Q l Z-7- 5 n 1.3 ~o r J1'?i ~(Tl a a" m l° m tYJ j ~ ~ rR) Ut I d ~ rn C7( C.) ` II ;rra O { cxy l-. --T-7 ZZ - L rn IQ 1 j I' w I j r~ to Cs~ ? (J) ~7 0 -t7 M M io T", ~-u 1 1~I-i ;.n v t~ kn hl i J~ ..,7n t~ r~, , } i w qo"E 50, 27 A P-\ / °@r °aY dV~V~ 4viGE ~tQC b y. 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