HomeMy WebLinkAbout26742-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPDRgCY
No: Z-28498
Date: 06/10/02
· l~fS CERTIFIES that the building ADDITION
Location of Property: 2355 REEVE AVE MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 100 Block 1 Lot 43
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 24, 2000 pursuant to which
Building Permit No. 26742-Z dated AUGUST 29, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to NANCY E STROKER
( OWNER )
of the aforesaid building.
SI/FFOLK COUIFi~f DEPART~qT OF NRALT~ D~PPROVkL
EI~BOI'~ICAL C~TIFICATE NO.
PLUMBERS CERTIFICATION DA'r~
Rev. 1/81
N/A
N/A
N/A
~/~ure
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)
PE~IT NO. 26742 Z
Date AUGUST 29~ 2000
Permission is hereby granted to:
NANCY E STROKER
166 DUANE STREET
NEW YORK~NY 10013
for :
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 2355 REEVE AVE MATTITUCK
County Tax ~ap No. 473889 Section 100 Block 0001 Lot No. 043
pursuant to application dated JULY 24~ 2000 and approved by the
Building Inspector.
Fee $ 75.00
Rev. 2/19/98
COPY
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FORCERTIFICATE 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:
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.
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. ~ccurate 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.S25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Oc~npancy - i .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .... .~..~1~ .................. 'i ...........
New Construction .... .~. ..... Old Or Pre-existing Building .................
Location of Property... ~.~.~....~...~...~... ~...~.~. ....................... ~..~.-~...c~.. .........
House No. Street Hamlet
Onwer or Owners of Property ...... ...~..~..~....~.~.~.~.. ......................................
County Tax Map No 1000, Section ..... ~.~. ..... Block .... O~.~ ....... Lot....~ ..............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No....~.~.?.~.~..~...Date Of Permit....~l~.~l.O.~ ...... Applicant.. ~-~..~.~Q~-~.~ ..........
Health Dept. Approval .Underwriters Approval.
Planning Board Approval
Request for: Temporary Certificate ........... Final Certicate..
Fee su mitted. ~
· $ .............................
BUILDING PERMIT REVIEW CHECK LIST
Applicant/
Owners Name:
Architect/
Engineer:
SCTM #:
District: 1,000 Section: __
Date
Reviewed:
Date
Submitted:
Block: ,/ Lot: ~'--~
Project
Location: ,,~. 3 ~"-5-- ~
Single & separate Required
cemfication: (Yes / No)
Req.
Project Description: fl-~
AGENCY PERMITS
REQUIRED FOR REVIEW N.A.
Suffolk County Health Dept. ~
New York State D.E.C. t~
Town Trustees
Town Zoning Board approval: ~
Town Planning Board approval:
Flood Plane Elevation ???
Flbod Zone:
Notes:
-Permit
NO YES Number
765-1802
BUILDING DEPT.
INSPECTION
[
[
[
[
REMARKS:
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] I,~LATION
[4 FINAL ~
,DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]~ON
[ ]FRAMING //~o ~FINAL
[ ] FIREPL(~& CHIMNEY
DATE //~/ INSPECT~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSULATION
[/~] FINAL
REMARKS:
II-;l.I) INSI-'I'SCTI¢ N REPORT DATE COMMENTS
II
)U~ATION (IST) jj
~ATION ( 2~ ) ~
II
II
PLUHBING JJ "
NSULATION PER N. Y.
4l II
II II
STATE ENE RG'Y
4{ --Ii,
II 11
CODE
il --Il.
II Il
Il II
[I [{.
Il
Il
Ii{_
Il
FINAL
ADDITIONAL
~2 ~12000
t. '..D~. DEPT.'"--'--
,.. TOWJ~, OF SOUTHOLD
FORM NO. I
TOI~ O~ SOUTHOLD
BUILDING DEPARTHENT
TOI~ HALL
SOUTHOLU, N.Y. ! 197 !
TEL: 765- 1802
././
.... ...... , .... Pe t NO ................
Disapproved a/c ..................................
BOARD OF HEALTH ...............
3 SETS OF PLANS ......... ' ......
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
DEC ...........................
TRUSTEES ......................
CALL ..................
MAlL TO: ..................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date...~..~.. ].'~..' .... , 20.~X
a. 'Ibis application :~st be c~letely filled in by typewriter or in ink and submitted to the Building Inspecto:
3 sets of plans, a~curate plot plan to scale. Fee according to schedule.
b. Plot plan showing lc~atiofl of lot and of buildings on premises, relationship to adjoining promises or public
streets or areas, and giving a detailed description of layout of property mast be dr~an on the diagram ~aich is part ,
this application.
c. ~e work cowred by this application my not be cc, menced before issuance of Building Pemit.
d. Upon apv~val of this application, the Building Inspector t~ill issue a l~ailding Permit to the applicant. S~
permit shall be kept on the pr~aises available for inspection throughc~t 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.
~ICATI~ IS ~.:~t ~ to the Building Deparr-~ut for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Tc~n of Southold, S~ffolk Connry, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for r~oval or demolition, as herein
described. The applicant agrees to cc~ly with all applicable l~s, ordinances, building code, housing code, and
regulations, and to ~mit authorized inspectors on praises and in building for necessary inspections.
..........................
( ignarur~t of applicant, or nane, if a corporation
....
(Mailing a.4aress of applicant)
State whetber applicant is mr, lessee, agent, architect, engineer, general contractor, electrician, plu:nber or bui~
bleme of c~ner of prmises ~a~t,W ~k0
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly anthorlzed officer.
(Nam and title of corporate officer)
Builders License No ..........................
Ph,-hers License No ..........................
Electricians License No ......................
]. tocatio~ of laai on which proposed work will be done ............................................................
Boise I~ ,~_r Street ~let
comty TaxMap m. 1000 Section .~.~.~.~J~..J.0.0fJL~.?~lock ................ tot ................
S~bdivision ...................................... Filed Map No. tot
2. State existing use and occupancy of promises and intended use and occupancy of proposed construction:
a. stlng ...............................................................
~. P.~a,r~ of ~ork (check d~id~ applicable): Ne~ Ooilding .~.~.L..~ .... ~,~dition .......... Alteration ......... '.
......................... ~r of Stories ......................
~pth .................... ~i~c .................... ~r of Stories ...............
IMi~c ......................... ~r of Stories .....................
~ress ...........
PLOT DIAGRAH
t~cate clearly and distinctly all buildings, ~e~t~r existing or proposed, a~d indicate al! set-back dimensions
~,uo pcoperty lines. Oiv~ street and block ntraber or descriptio~ according to deed, and sho~ street hanes and indicate
~etber interior or corner lot.
Naue of in~lividual signing contracO
~e is the ...................................................................................................
(Contractor, agent, corporate officer, etc.)
)f said owner or owners, and is duly ~uthorized to perfom or hav~ perforu~d U~ said work a~l to make and file this
~pplication; that all stat~ents contained in this application are true to the best of his knowledge and beliefl and
hat the work will 1~ perfon~l in the maturer set forth in the application filed therewith.
X
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THIS SURVEY NOT TO
BE USED FOR TITLE
PURPOSES
NOTE:
I. SUBDIVISION MAP FILED IN THE OFFICE OF THE
CLERK OF SUFFOLK COUNTY ON MAY Z?, 1988 AS
FILE NO. 8532.
2. ·: STAKE FOUND
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION
'1 AM FAMILIAR Wl3PI THE STANDARDS FOR APPROVAL AND CONSTRUC~ON OF SUBSURFACE
SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL ABIDE BY ]HE CONDI110NS
SET FORTH THERE)N AND ON ]HE PERMIT TO CONSTRUCT.'
APPLICANT'S SIGNA]IJRE:
APPLICANT:
S1REET ADDRESS:
CffY: STA]~: ZIP CODE:
TELEPHONE NUMBER:
Young & Young, Land Surveyors
400 Ostra~der Aven~e, Riverhead, New York l fgOl
5 ! 6-?27-2303
AldeT~ ~. Young, Z~roJ'es~r~o~al Engineer & Za~d S~eyor
Howard ~. Young, La~d S~eyor
Thom~ C. ~olpert, ~ofes~onal Engineer
Kenneth F. Ab~zzo, Land Su~eyov
SURVEY FOR:
STEPHEN J. TUTHILL E~ SUSAN C. TUTHILL
LOT NO. 5, "OREGON HEIGHTS"
At: MATTITUCK Town of: SOUTHOLD
Suffolk County, New York
I000
Suff. Co. Tax Map' ~
District
CERTIFIED TO:
STEPHEN J.TUTHILL
SUSAN C. TUTHILL
NORTH FORK BANK ~ TRUST
LAWYERS TITLE INSURANCE COMPANY
I I00 I I I 43
Section Block Lot
OCT. 12,1994
APR. 14, 1994
FEB. 17, 1994
JAN. 19 1994
DATE :NOV. O, 1995
SCALE : 1"= 50'
JOB NO. : 95- 08:55
SHEET NO. :1 OF 1
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