HomeMy WebLinkAbout20952-zFORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUP~C¥
No Z-23186 Date AUGUST 30, 1994
THIS CERTIFIES that the buildin~
Location of Propert~ 505 BUNGALOW LANE
House No.
County Tax Map No. 1000 Section 123
Subdivision Filed Map No.
ADDITION AND ALTERATION
MATTITUCK, NY
Street Hamlet
Block 3 Lot 7
Lot No.
conforms substantially to the Applioation for Building Permit heretofore
filed in this office dated JULY 28, 1992 .pursuant to which
Building Permit No. 20952-Z dated SEPTEMBER 11, 1992
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 A PARTIAL SECOND STORY ADDITION AND ALTERATIONS TO EXISTING
ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
H034278
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
JAMES & JANET MALONEY
N/A
APRIL 12, 1993
TANDY PLUMBING & HEATING MA~CH 4, 1994
Rev. 1/81
FORM NO. 0
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)
Oo
N-N. 2095~Z
Permission is hereby granted to:
~.-~~...~.....~~..~~~...~ ...... . ~~.../~
at premises located at ...~'..¢~.~.....~.....~.~..~..~...'...~./..~.....~,...~. ~..~.' ../~
Coun~ Tax Map No. I000 Section ......... Z~.~.... 81~k ........ ~. ........ Lot No ..... ~ ...............
pumu~nt to oppllc~tion d~t~ ~.~-.....~ · ~ ............................. , 19.~, ~nd opprov~ ~ ~h~
8ulldlno
.........................
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPidtTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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:
I. 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
l~ss than 2/10 of i% 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 writing to the applicant.
C. Fees
I. 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-existinK Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Qertificate of Occupancy - Residential $1~.O0wCommercial $15.00
..
,New Construction ........... Old Or Pre-existing Building .... ~ ...........
Location of Property...~?.~ ......... ~.~.~.'.~.~ .~. ~ .... ~ ........... - .~. -~././.~.~..~ ........
..
House No. Street Hamlet
Onwer or Owners of Property ..... ~.~..a4.~ .......................
County Tax Map No 1000, Section..../.~...~. .... Block ...... :..~..~....[i~Jt .... [i~'.~,'[.[i''. ....
Permit No..~.?.?. it ..~/.././~J~.~..Applicant .~;(.~.~. ...
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ......................
TOWN OF $OUTHOLD
~)FFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. ! 1971
TEL. 765-1802
CERTIFICATION
Building Permit No.
Owner
(please print)
Plumber'-~ ~
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumber' s signat~)
to befo~mf^?i~ ;
~_n day of / ,~ C~L/L/~/TM
Notary Public,
ounty
VERONICA F. CIOONE
NOTARY PUBLIC, ,State of Nete York
No. 52. 4661406
Qulllfled In Suffolk Co'~ll'lY /'')l .//
/.--
Notary P~lic
ou~D~tzo.~ ~ ._~{ ~ ~th
'OUNDATION {2nd)
:OUGH FRAME &
-PLUMBING
iNSULATION PER N.
STATE ENERGY
CODE
FILIAL
ADDITIONA'L COMMENTS:
. . ..
Mr. Thomas Fisher
Building Inspector
Southold Tow~ Building Department
Main Road
Southold, New York 11871
Dear Mr. Fisher,
This is a request to amend building permit number 20952Z.
Enclosed are plans and a survey for the addition of a porch to the
front of the house and a deck to the back. A letter from the New
York State Department of Environmental conservation indicating that
this construction is beyond their jurisdiction according to article
25 is included.
As per our converstion of two weeks ago, a building permit is
not necessary to pave the driveway mentioned in the letter to the
DEC.
If you need any additional
298-8798. Your cooperation
appreciated.
information please contact me at
with this matter is greatly
Sincerely,
s A. MalOney~, Ph.D.
FORM
TOWN OF SOUTItOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTtIOLD, N.Y.
NOTICE OF DISAPPROVAL
Date JULY 29,
.......................... , 19 92
To James A. Maloney
505 Bungalou Lane
Mattltuck, N.Y. 11952
PLEASE TAKE NOTICE that your application dated .... .J.u. ly..2.8., ............... 19 92
for permit to BUILD A 2ND STORY ADDITION '
Locatinn ~fP ..... *- 505 BUNGALOW ~ 14ATTITUCE, N.Y.
House No. Street Ham/et
County Tax Map No. 1000 Section 123 Block 3 Lot 7
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following grounds ...............................
A. NEED MOP. R DETAILED PLANS.
NEED .A. LICENSED ARCHITECT OR A LICENSED PROFESSIONAL ENGINEER TO
OKAY. pLANS.
C. NEED A NELEASE FROM 'l'lte; "NEW YOP, K STATE DEPT. OF EI'i¥IRO~I~,TTAL
.......... lo' '~;.~;/~;~i.' ' ;.'2'o; ';E'~;~ 70'. ...... '"'
N
.......... · ,.J/,~.~;2,;.''_ ..____.__ ...... ~ ........................................
Building Inspector
RV 1/80
New York State Department of Environmental Conservation
Building 40--SUNY, Stony Brook, New York 11790-2356
(516) 751-7900
NO PERMIT NECESSARY
-T t DA~L -WETLANDS
Thomas C. Jorlincj
Commissioner
Based on the information you have submitted, the New York State
Department of Environmental Conservation has determined that the project
is listed in Part 661.5 of 6NYCRR (Tidal Wetlands Land Use Regulations)
as a use not requiring a permit or notification letter of approval.
Therefore, no permit is required under the Tidal Wetlands Act (Article 25
of the Environmental Conservation Law).
Please note that any additional work, or modification
as described, may require authorization by this Department.
tact this office if such are contemplated.
to the project
Please con-
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 yours,
Deputy Regional Permit Administrator
August 26, 1992
Department of Environmental Conservation
Building 40
State University of New York
Stony Brook, N.Y. 11790
Dear Ms. Marilyn Peterson:
As per our conversation of August 24, 1992, this is a request for
a letter of no permit necessary concerning construction at 505
Bungalow Lane, Mattituck, New York, (Tax Map # 1000-123-03-07,
Application ID: 1-4738-00224/00002-0). The construction consists
of a second story and widening of a cantilevered bay window. This
construction is within the footprint of the existing one-family
residence in that the building will not be closer to the property
boundaries or tidal wetlands, the foundation will remain as is and
the ground around the building will not be affected. The addition
meets the requirements of category # 26 found on page 20 of the New
York State Department of Conservation publication, Tidal Wetlands
Land Use Regulations 6 NYCRRPart 661. AS you requested, drawings
identifying the second story and the widened bay window are
attached.
Sincerely,
,~ dc'
765.t802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ *~INAL
BUILDING DEPT.
INSPECTION
FOUNDATION IST ~ ] ROUGH PLBG.
FOUNDATION ZND [ .] IN//SULATION./
FRAMING ~/]~FINAL
REMARKS:
.... ....
DATE , INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ]~OUGH PLBG.
FOUNDATION 2ND [ ~ INSULATION
[ ] FRAMING
FINAL
DATE,
INSPECTOR~~/~-~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST ~GH
[ ] FRAMING
REMARKS:
PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FINAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~'- 85 JOHN STREET, NEW YORK, NEW YORK 10038
Date ~pplication No, on/itc
o~y the el~trlcal ~uipment ~ ~scrlb~ be~w a~ int~uc~ by t~ applicant ~ on the a~ve appl~ation nu tuber in the p~m~es of
inthefottowlngloca~iqn] ~,B ..... ~nt ~ IstFI. ~ 2nd FI. Oll~' Section~O~l~k'12~ Lot
/at, Clt ~ i
examined on and found to be in compliance with the Na~onal Elect~cal Code.
FIXTURE fl FIXTURES
OUTI.~TS ECEPTACtES FLUORESCENT OTHER
DRYERS
RANGES OVENS EXHAUST FANS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
P/1}IEI,B03 RI',S ~ 1 -. t0 C'TR.
E R V I C
~[~ ^.w.o.
NO'O E COND O~ CC COND
OF HI-LEG
NO OF NEUTRALS
OF NEUTRAL
505 BIIt{C;/lh0W LII,.
t4M*¥l"i'[ICKt NY, 11"152 GENIEI~ALMANAOER
Per
This ce~ificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentio{s.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FORM
TOWN OF SOUTHOLD
TOWN HALL
SOUTNOLD, N.¥. 11971
Examined ~'~ ..... ,19~
Disapproved a/c .....................................
BOARD OF HEALTll ~ .......
~"] SETS O~/PLA~$ ..........
~SURVEY .....
SEFIIC FO~:! ..............
c^LL ~{t= ~.%~ .........
........
.APPLICATION FOR BUILDING PERMIT
Date ................... 19...
· I INSTRUCTIONS
a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3
;ets 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 pubI/c streets
~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
:ation,,
¢. 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 appl/cant. Such permit
hall be kept on the premises available for inspection throughout the wsrk.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
hall 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
/uilding Zone Ordinance of the Town of Southold, Suffolk County, New York. and other applicable Laws, Ordinances or
{egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
~he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to
Omit authorized inspectors on premises and in building for necessary inspections. /] .~///~
(S/_gfiature of applic.nt, o. name, ifa co~-~;r'a'd'o'n) ....
......
(Mailing address of applicant)
;rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
-
,amc of owner o remlses . ,.
(as ze tax roll or latest deed) ' '
.~ applicant is a corporation, signature of duly authorized officer.
· (Name and title of corporate officer)
Builder's License No ........ xQL-~..C..~C. ~ ........
PI tuber s License No ....... d/..~..~..~-rt~. ..........
Electrician's License No .... .~Y'Lr~.. ~'.-e.5 ..........
Other Trade's License No. .~..~_-.A.%~- .~.
Location ,of land on which proposed work will be'done ........
... :. ,-..
/-louse Num her / Street Hamlet
County ra× Map No. ~000 s~io~ ~3 mo~k 0 2 o ~
Filed Map No Lot '
Subdivision ..................................... . .............................
(Name)
State existing use and occupancy of premises and intended use anU occupancy of proposed construction:
b. lntended use and occupancy ...Z.. ~ 5 ~ ..... : ..... :"~'"" ........... ~'~''
3. Nature of work (check which abp icable~ New Buil-~' ,~'
i ..... Demolition ............ ~. 03her Worle '~)
4. Estimated Cost v-/O_ 0"8"0 s~ ~ : (Descr/ption).
5. If d~velling, ~number of dwellinglunits ..... /. ........ Number o : .(to be. paid on filing this application)
· Ifgarage numberofcars .. i / fdwelhng,,umts on each floor .
6. If business, commercial or mlw-~ -- ' .................................... z'
, ~ ~-/~,,u U,xLcn~ oz caen tgpe ol use FY'. ....
-. ~aimensions of existing structures, if any. Front . '~2 ., , , z · .~Fy .. ', .....
la~menslons of same struc*,, .... .~,~- · · ' ................. ,~ ...............
o. lalnlenslons of entire new construction. Front .. 7 ......... ,~.. mumuer ol,.htones . . .~ ........ ! ;~ .....
................. Kear ............... Depth ...............
Height . .. ............. Numiber of Stories ......................... ..
9. Size of lot. Frdnt ..... /.00. . . . ~o o/ ~,.> ..... , .......
r' ' ............ Name of Former Owner ..... .~.e~l~/~, . 5-.~'.F-~/... .
I 1. one or use d~stnct in whic re sea are situated .......
&Joes proposed construction violate ~-., .,...'~. , ' .' .................................. ' .......
13. Will lot be reorade,~
14. Name of Owner of pre~ni' ~.4~.~.~. ... Will excess fill be removed from p Yes
remlses:
. sea ... · ....... Address
Name of Architect .......... ;..:~.v~,~. ................... Phone No .............
Name o ontractor... ,, ~o~ ............... Phone No ................
................ Address ............... ;... Phone No ................
15. Is this property within 3(~0 feet of a tidal wetland? *Yes ..... No .....
· If yes, Southold T<.wn Trustees Permit may be required.~' ....
.... PLOT DIAGRAM'
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions f'rom
property lines. Give street and block m tmber or description according to deed, and show street names and indicate whether
interior or corner lot.
..... being duly sworn, deposes and says that he is the applicant
FATE OF NEW YOILK, ,. ~ _
~ (Contractor ..............................................
agent corporate officer ere ) ' '
said owner or owners, ~d is duly autjmrized to perform or have performed the said work and to m~e and file this
>lication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
rk will be performed in the/m~ner set ~ort ~ in the application fi ed 'w'
om to before me tiffs / / I I there ~th.