HomeMy WebLinkAbout27343-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28901 Date: 09/30/02
THIS CERTIFIES that the building ADDITION
Location of Property: 475 WILLIS CREEK DR MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 115 Block 17 Lot 17.15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 19, 2001 pursuant to which
Building Permit No. 27343-Z dated JUNE 4, 2001
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 COVERED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to MICHAEL & LINDA MCDONNELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 3167 09/16/02
PLUMBERS CERTIFICATION DATED N/A
u oriz d Sig ture
Rev. 1/81
I
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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)
PERMIT NO. 27343 Z Date JUNE 4 , 2001
Permission is hereby granted to:
MICHAEL & LINDA MCDONNELL
475 WILLIS CREEK DR
MATTITUCK,NY 11952
for .
CONSTRUCTION OF PORCH ADDITION AND INGROUND SWIMMING POOL AS
APPLIED FOR. TWO CO. S REQUIRED.
at premises located at 475 WILLIS CREEK DR MATTITUCK
County Tax Map No. 473889 Section 115 Block 0017 Lot No. 017 . 015
pursuant to application dated MARCH 19, 2001 and approved by the
Building Inspector.
Fee $ 225 . 00
Auth ri ed Signature
',�"
COPY
Rev. 2/19/98
I
I
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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. Swom 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:
1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic
features.
2. A properly completed application and 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 Building- $100.00
3. Copy of Certificate of Occupancy-$25.00
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
Date. `/ /Z 3 A Z,
New Construction: Old or Pre-existing Building: (check one).
Location of Property: 1-17-r lkli l /S C e e e/1 Q R , /,7,4 /7/ /!/c- N ( , //XV---
House No. Street Ha et
m
Owner or Owners of Property: �/c//i9Q L 7� �/N Q/9 // cQ e/✓✓t/e L/I
Suffolk County Tax Map No 1000, Section //J Block / 7 Lot f 7,
Subdivision Filed Map. Lot:
Permit No._2_- 7.. 33Q3 2 Date of Permit. Applicant: Xe L /V`[JoN.ye �L
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
bequest for: Temporary Certificate Final Certificate: !/ (check one)
Fee Submitted: $ 2- ,r 0 0
A want Signature
I
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street Center Moriches,New York 11934 • Tel: 631-878-3500 +Fax: 631-878-3764
Application No: 3167 Date:9/16/02
Issued to: Mc Donnell
Address-.475 475 Willis Creek Dr
-- Village :Mattituck Zip: 11952
Introduced By: MODERN ELECTRIC License#:4253-E
was examined and found to be in compliance with the National Electrical Code
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BAYVIEW AT MATTITUCK
HOMEOWNER ' S ASSOCIATION
633 East Main Street • Riverhead, NY 11901
October 30", 2000
Mr. & Mrs. Michael McDonnell
475 Willis Creek Drive
Mattituck, NY 11952
Dear Mr. & Mrs. McDonnell,
The board has reviewed your renovation plans and is delighted with the
proposed improvements. "Those plans are approved subject to your providing
us with a color for the siding.
It is the hope of-the board that we can influence you to reconsider the
siding material and opt for traditional cedar shingles. It has been our
experience that authentic cedar gives a better appearance and added value to a
home. Though the synthetic version at first blush offers a benefit in terms of
maintenance, it is still uncertain whether that material will age as gi-aceliilly as
the cedar.
In an event, we would like to see the same material used throughout the
house and wish you the best with the project. Please feel free to call with any
questions.
Your Board of Directors,
Bill Blatykas
,Jim Donohue
Bob Keith
Fred Seifert
.John Strode
I
S 1-ATE OF NEW YORK )
ss
COUNTY OF SUFFOLK )
�F tAU �vu�S� p•� , being duly sworn, deposes and says
That deponent is over the age of 18 years and resides at
�oywraw'-k k-�M hl �• �oi'sc$
1
That on the _a day of tANQ-tAr 200deponent architect/engineer,
licensed by the State of New York, hereby states that s/he accepts full
responsibility for the accompanying plans compliance with the New York State
Fire Prevention and Building Code (9 NYCRR); said plans pertain to property
located at SCTM# 1000-
street address 41
PIKtiT�T4JtA4, 11 `{• t�SSZ-
P. E•
rchitect/Engi
Sworn to before me this
Z- g§ty of_1'1'�yC j1 , 2//.
[A (I T � c �
rzysl.w�. a;
/ L9 ��/
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INS TION
[ ] FRAMING [4;FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
ago CL—
DATE ?/ INSPECTOR
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� 234� 2- -
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
1 L
DATE )Z Q), INSPECTOR
i
FIELD INSPECTION REPORT DATE —COMMENTS
.I
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FOUNDATION ( 1ST)
FOUNDATION (2ND)
II
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ROUGH FRAME &
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PLUMBING
�I
INSULATION PER N_ Y.
q
STATE ENERGY Ii n H
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CODE
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FINAL10
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IUVVIN
BUILDING
yr �t.EPARTM t$U1L1)iNU 1'h1tM11 AYPLA( AIION C hEC;KL1S
BUILDING DEPARTMENT q Do you have or need the following,before applying
/,
TOWN HALL card of Health
SOUTHOLD, NY 11971
TEL: 765-1802 "3 sets of Building Plans
-Survey
---
PERMIT NO. jlL .Check
,eSeptic Form
N.Y.S.D.E.C.
Examined 20 Trustees
Contact:.
Approved_ L 1. 202L-
' Mail to:
Disapproved a/c
Phone: /0.3
Building Ins ect r
APPLICATION FOR BUILDING PERMIT
Date /y 200 /
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, and waterways.
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 a 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 what-so-ever until a Certificate of Occupan
is issued 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, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
x (Si a of applicant or name, if a corporation)
__�_ (Maili g address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrici plumber or builder
p wnreP
Name of owner of premises C '
(as on the tax roll or latest deed)
If applicant is a corporation, sign ture of duly authorized officer
(Name and title of co orate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which propos d wor don will be ,
e� /'�i9 / /,' Al //qJ"7�
House Number Street hlamlet
County Tax Map No. 1000 Section //s Block / 7 Lot /7,
Subdivision Filed Map No. Lot
(Name)
Mate existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy PR/rr7f)R y �es iQ taut -e
b. Intended use and occupancy PR i rY14 lCeri Q eAl c e
i. Nature of work (check which applicable): New Building Addition
Alteration
Repair Removal
Demolition Other Work__ o/
Estimated Cost ?�/J_ o 00 4- Bort) Fee (Description)
If dwelling, number of dwellingunits (to be paid on filing this application)
_Number of dwelling units on each floor I
If garage, number of cars C,114
If business, commercial or mixed occupancy, specify nature and extent of each type of use. ,VIA
Dimensions of existing structures, if any: Front Rear
Height Number of Stories Depth
Dimensions of same structure with alterations or additions: Front
Rear
Depth Height 9 Number of Stories
Dimensions of entire new construction: FrontRear.
Height Number of Stories Depth
Size of lot: Front Rear. Depth
0. Date of Purchase Name of Former Owner —C f! 14.1f 1q
1. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation:
3. Will lot be re-graded Will excess fill be removed from premises: YES NO
4, Names of Owner of premises Address
Name of Architect Phone No.
Name of Contractor Address Phone No
Address Phone No.
5. Is this property within 100 feet of a tidal wetland? *YES _NO
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE QUIRED r
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
TATE OF NEW YORK)
��ff
__ S:
'OUNTY OF 00
,G ✓ "` mell being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
�)He is the QUj"A,
(Contractor, Agent, Corporate Officer, etc.)
C said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
iat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
z�rformed in the manner set forth in the application filed therewith.
wom to before me this /
-- 1 7 day of IPUW-620Qif
Notary Pic Si ture Applicant
W ; �( la►� 1,6sellc
t-s4raP4o, * 0-LAVA-VO
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EXISfING5K11.IG�YffOK�NJJN, vERIFY OCCUPANCY „
51ZE AND LOCATION,
USE IS UNLAWFUL
DA5VOWDENOTE551M NM 11X6" TRIM ALLAROWDEXIS NG WITHOUT CERTIFICATE
OF HO-15E BEYOND WNDOW5 (TT) COLOR BY OWNER.
REMOVE EXISftNG SIDELDE AND INSfPI-I. DEMO EXI5fING MI?OR OF OCCUPANCY
NEW FILL Hf.WNL70W W. 5W IN MUMIN5, WPU-,C BY Ov1MER)
'i NEW ASf11M-f 9NCLE5, NEW CERfNN1EED CEDAR IMPRESSIONS NEW aRrAIW D at2AP IMM5510N5
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DIMENSIONS ARE TO BEVEKIFIEDINFIELD -- -------- ----_--- 765-7862 9 AM TO n
GENEPPLCOWKTORAl
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ONS.
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MATCH MXISTING H(.Gf 5OFFIf MIF.) E�IW. S/4" 5'-15/1" EOWL T FOR POURED REQUIRED
CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
O BEFol
COMPLETE FOR C.O.
N SHALL MEET
NEWIZ" 2IAMETERFIDEPGLA55N5CAN cawnN,caoR DY aWAER.<r P)
r I THEREQUIREMENTSOF THE N.Y.
STATE CONSTRUCTION & ENERGY
0 MaTqq IA I w1l 1 11 1 CODES. NOT RESPONSIBLE FOR
--- --- 00 11 lITII 111111 IllTIl 1111111 11111111111 111111 111111 lill
a I DESIGN OR CONSTRUCTION ERRORS
2°
0 111111 11 IT 11 — UNDERWRETERS QU RED CERTIFICATE
FIR5f FLOCK 0'-0" i _ — — —
PORCHELEVANON
"IMMEDIATELY"
GP.ADE VPT'JES 12" I " ENCLOSE POOLTO CODE
EXISip�i WNDOWS f0 REMNN, NEW Ips-gig NEW I"XIO CORTER tPIM.(fYPJ NEW FIXED 50. PICiIRE UPON COMPLETION
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NEW 1411 WDE CA5T 5TONE VENEE
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(TYPICAL UNM ALL CaUMN5,) NEW RANTER DOT( VERFY SRE W1TH NEW RANTER PDX, VERIFY SIZE WTH OWNER(1W)
PoffOM of TPJM PoPTOM OF Tm QI
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AND SrnE BY OWNER.
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EX. EX. EXJ EX. EX
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