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Home My WebLink About27436-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28897 Date: 09/26/02 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 1525 MILL RD (HOUSE NO.) County Tax Map No. 473889 Section 106 MATTITUCK (STREET) (HAMLET) Block 9 Lot 8.1 Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 0~/NE 27, 2001 pursuant to which Building Permit No. 27436-Z dated JUNE 27, 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, ALTERATION AND ATTACHED TWO CAR GAR3kGE ADDITION TO Ai~ EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ·"ne certificate is issued to FRED M & MARTHA S CARTER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTIWENT OF HEALTH APPRO~%L ELECT~ICAL C~TIFICATHNO. PLUMBERS CERTIFICATION D~r~u Rev. 1/81 N/A 58131 07/31/02 03/15/02~<~~~RICHARD C~RNETTA Authorized Si~ture FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28898 Date: 09/26/02 THIS C~TIFIES that the building Location of Property: 1525 MILL RD (HOUSE NO.) County Tax Map No. 473889 Section 106 ACCESSORY MATTITUCK (STREET) (H3LMLET) Block 9 Lot 8.1 Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 27, 2001 pursuant to which Building Permit No. 27436-Z dated JUNE 27, 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to FRED M & MARTHA S CARTER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~RALTH APPROVAL N/A ELRt-£~ICAL CERTIFICATE NO. 58131 07/31/02 N/A PLUMBERS c~KTIFICATION D~£~3 Rev. 1/81 Authorized S~ ~r e FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIT~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27436 Z Date JUNE 27, 2001 Permission is hereby granted to: HAROLD J & ORS CLARK 171 SOUNDVIEW AVE MONTAUK,NY 11954 for : AMENDED PERMIT 2 CAR GAP~AGE ADDITION AND ALTER3~TION TO A 6 BED.SIN FAMILY DWELLING W/ACCESSORY 2 CAR GARAGE IN REAR YARD AS APPLIED FOR 2 CO'S REQ at premises located at 1525 County Tax Map No. 473889 Section 106 pursuant to application dated JUNE Building Inspector. MILL RD M_ATTITUCK Block 0009 Lot No. 008.001 27, 2001 and approved by the Fee $ 1,741.20 ~~ure Rev. 2/19/98 COPY This Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT .... TOXVN HALL 765-1802 APPLICATION FOR CERTIFICATE 01~ OC~U'PA.NCY' - - application must be filled in by typewriter or ink and submitted to the Building Department with't'~-'~ollowing: 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 Uuderwriters. 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. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 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. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Location of Property: Owner or Owners ofPrope : .- Suffolk County Tax Map No 1000, Section ~ [0~ Block Old or Pre-existing Building: House No. Street (check one) Hamlet DO 0 ? Lot Subdivision Permit No. 2.7 ~ _3 ~ ~ Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Filed Map. Lot: Applicant: ~ Unde~fiters Approval: Final Certificate: ~ (check one) Elec t'icol Znspec Hon Cet. H£ico Date Electrical Inspection Service, Inc. A~)nlication # 7/31/2002 375 Dunton Avenue 58131 East Patchogue, NewYork 11772 (631) 286-6642 Issued to: Fred & Martha Carter Street: 1505 West Mill Road Village: Mattituck Zip: 11952 Section: Block: Lot: Town: Southold Lic.# 1988-E Introduced by: P. D. Marcley Inc. wo~ ex. mined and found fo be in compliance wifh ?he/V~Honal Elecf~'ic~l Code/VFPA 70 [] Commercial [~NV Defects [] Pool [lst FIoor []Indoor []Basement [] Hot Tub [] Residential [] Det. Garage []Attic []2nd FIoor [~Outdoor [] Addition []Survey Switches Receptacles Fixtures 36 46 31 Dishwasher Washer/Amp Dryer/Amp 1 1 1 Furnace Oil Gas Circulator X X Meter Amps Phase UG/OH Telephone [] [] 5 Other Equipment: 1- Jacuzz/ GFI Heaters A/C Fans 4 5 2 Oven Range/Amp Garbage Disposal I gas Smoke Detector Bell Transformer 7 1 Television Carbon Monoxide 5 2 Building Permit # Hugo S. Surdi President Rough [nspection: 12/11/2001 Inspector: Ed Scavelli Final Inspection: 7/30/2002 Inspector: Ed Scavelli This certificate must not be altered in any manner. Inspectors may be identified by their credentials Solder Lead Content Affidavit STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) .'~! d ~,r'o/ ~O/m ~¢ ~ being duly swom, deposes and says: I am a licensed plumber. I certify that all installations will be in accordance with the Code of the /--~wt9 and the state of New York State building Construction Code and the lead content of solder used for any piping of potable water will not exceed one fifth (0.20%) of one (1) percent. I submit this affidavit with full knowledge that the Building Department and the rely upon the truth of the statements and information contained herein. Plumber's Name Plumber's Address Plumber's Signature License No. Swom to before me this /ff~-~day of No~ Public, S~te of New York CAROLINE k. CORNEA NOTARY PUBLIC STATE OF NY QUAL. NASSAU CO. 01~47707B9 COMM. EXPIRES APRIL 30, 2002 BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: Co.c -~ DATE REVIEWED: ~ /.~2 /01 DATE SUBMITTED: ~ /.~t2/01 SCTM#--- DISTRICT: 1,000 SECTION: STREET: /.~>~' /~, // PROJECT DESCRIPTION~ ACC OR N/D: ARCHITECT / ENGINEER: BLOCK: ~ LOT: $, / CITY: FAST TRACK: YES o(~ SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o~')4~ OTES: rtcr.~:,-.-.-.,c /-,0~.~ ~ LOTS 40,000SF -100-24. Lot recognition.(CREATED before June 30, 1983), UNDERSIZED LOI"~'~OM JAN.1997 100-25. Merger.(A nonconforming at any time after 7/!/83) ZONING: PERMIT ESTIMA~AMOUNT:_$ ,~?-~O ~ .00 PERMIT USE: EXISTING: ..,,qSP°d INTENDED: ~ ZONING DISTRICT: g4~\ C, CONFORMINC~S~R NO REQUIRED LOT SIZE: ~ ~E _SQFT. WHERE ACTUAL LOT SIZE FROM~ ACTUAL LOT SIZE: //~:~<3 SQFT. REQUIRED .n~ REQUIRED REQUIRED 1sT FOUND: FRONT: ~O ' PROPOSED: ~d' SIDE YD: ~ '/~_' PROPOSED:.$P '/~q~ ' REAR: ..~.~' ' PROPOSED:~' 2ND F0'ErND: FRONT: · ACTUAL:__' SIDE YD:__'/ ACTUAL: '/ ' REAR:__ ACTUAL: LOT CO~rERAGE:..,~J~OWED: .,2~% EXISTING:~sf ,"~/o NEW: / sf "% TOTAL: '~' sf.~_% CORNER? YES ak NOt WAT ER FRONT? YES o~'qO'. ~)~-SCRIPTION: .... FLOOD COMPLIAKN~ ZONE: PRE-FIRM 3/18/80 PANE"L~: '/t-o~/ FLOOD ZONE: X , AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPLzICATION TOWN SPETIC PERMIT: ~ or~_~ SUFFOLK COUNTY HEALTH DEPT: ~_.~'or NO, (BED #): ~ DTE: ~ /,%2_/~ ! PERMIT #:RI 0- APPROVALS REQUIRED: NEW YORK STATE DEC: eRE-DEC 9aris YES ~r~ SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES o , o TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OR NO : EGRESS: VENT: LIGHT: BUILDING PERMITS OPE~N/EXPIRED: BP .-Z / C/0 Z-~//c/o~.~o~, HAVE PRE CO'S :YORr~) BP -Z/C/0 Z-} ' , FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : 9~?O.3 SF SECOND FLR : ~ t.P~ SF INIT OTHER TOTAL TOTAL: _(O~'~2. SF FEE FEE FEE = $ /4t/o..6o June 27, 2001 To Whom It May Concern, This letter is to request expedited review of our building plans due to special circumstances. My 79 year old mother has breast cancer. She underwent her second surgery two days ago and is still in the hospital. She is the primary caretaker for my 82 year old father who is legally blind and had a stroke in November 2000. As her condition progresses she will be unable to care for herself and my father. It is for these reasons I am requesting the rapid review. The plans submitted will add upstairs bedroom space for my family and provide living space downstairs for my parents, so we can care for them. I thank you for your assistance in this matter. Sincerely, Fred M. Carter, II, M.D. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. [ ]/~OUNDATION 2ND [ ] INSULATION [/J~qAMING [ ] FINAL [ ,,,/] FIREP~ACE//&~HIMNEY REMARKS. ~ DATE 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~RO"GH PLBG. [ ]/~*DATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ~GHPLBG. [ ~INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE /:'/(~/ INSPECTOR/~:>h~ 765-1802 BUILDING DEPT. INSPECTION FOUN~)~TION~ 1ST [ ] ROUGH PLBG. [ ]/F~JNDATION 2ND [ ]INSULATION FRAMING ~) ~ [ ] FINAL [ ] F~;IE*~A~& CHIMNEY '765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUG~ [ ] FOUNDATION 2ND [ / ]~,~LATION [ ] FRAMING [C.~ FINAL []FIREPLACE&CHIMNEY DATE ~-~//~?~/~ ~~'~ INSPECT~(' FIELD INSPECTION R~PORT' DATE II FOUNDATION ( IST)' }[ FOUNDATION (2ND) COMMENTS ,, II ROUGH FRAHE & ~u~iN~ 11 II II ii Ii INSULATION PER N.Y. Ii STATE E~(;Y CODE II II I[ II II fl II FINAL I{ il Il II :fOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Do you have or need the following, before applyint Board of Health · ~ · 3 ict~ 'of Buil~ling PIans Survey · ApprOVed ' ~,~ ~ ,20 ~! Disapproved a/c · ' a/This application MUST be %mp1¢t~iy 'fiilcd'~ 1>~ {~ewrJtcr or sets of plans, accurate plot plan to scale. Fee according to s.ct~edule. .:. ~'. b~:plot plan showing location of lot and ofbuildingS'o,.n"pmmiscs~.~ hreas, and waterwayS. '. ' ' ...... c. The work covered by this application may' not be commenced d.. Upon approval of this application, the Building Inspector will 'shall be' ~ept on the premises available for inspection througho.ut'the wort Truzt~e$ Contact:, ' Mail to: APPLICATION FOR BUILDING PERMIT Date ~" ~ ,200J, INSTRUCTIONS 631 298-4579 ~ 6a~ 29s-nss~ NORT~ FO~( ORT~op~ SPORTS MEDI~ ..... Di~' ~ c, No building shall be occupied or used in whole or/p part for a~ ~.~.^.o.s., ~.~.c.s. is issued by the Build.ing Inspector. 55 SOund Ave ~PLICATION IS ~Y ~E to ~c BUilding Dcp~ucn~ ~c~ Building Zone Ordin~ce of ~c. To~ of Sou~old, Suffol~do~, New Yor~ ~d o~ ~P-p~~ ~ - Re~aQom, for ~c dom~cQon of b~l~,, additiom, or'~t~Qo~ or for rcmo~ or dcmoliQon appliC~t a~ccS to co~ply ~ all applicable'laws, or~dcs, b~l~g code, hom~g code, ~d rc~adon~ ~d to a~it au~ofizcd in~cctOrs on premises ~d in building for nc~a~ ~pcctions. L · .. ' (Si~e of app~c~t or ~, if a c~oration) Statewhcther applic~t is o~er, lessee, agent, ~cMtcct; ~neer,' general con, actor; olectnc~, pl~bcr or builder (as.on ~e t~ roll .or latest deed) If applic~t is a co~oration, silage of duly authorized, officer ~e ~d title of co~o~te officer) -,.:' Builders License No. Plumbers License N'o. Electricians LiCense No. 0th~i:'Trade's License No. House Number Street CountyTax Map No. 1000 Section Subdivision ~ame) · ......... Hamlet(".-:<',: i 0(o' "Block ~ ,Lot P/m'6 .' I ' Filed Map No. Lot ' Location Of land on which proposed work will b)~'dope: . ......... , ....................... , i//-2 .-u... '.. ,' f / 'b. · Addition., Other Work 3. Nature of work (check which applicable): New Building Repair Removal Demolition l. Estimated Cost '~ ~-'c~C~ t ;. if dwelling, number of dwelling units If garage, number of cars Intended use and occupancy_. ~ ,l~ ~o ,;~ ,c-o c.> ~ .,~ ~ ~. c-._._, s / - r / . ~ Alteration Fee (Description) .(to be paid on filing this application) Number of dwelling units on each floor ,. If business,.qO~ercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front 5-53' 't0" Rear_ ~' I o" DepthS,- Height. . t~' ..~['" Numberof~t0ries ... ', ( ·. 'Number of Stories., Rear Depth Depth _ 6 '-~'4 ,. '~ '~ 'Dimensions of same structure with alterations or additions, Front plot · . . D~pth. - ~"7 ~ hO '* Height r:~(::: ,,~ ~menszons of entire /...Height new construction: Front Number of Stod~s_ '. Size 0flot: Front 1'7,~ ' Rear Rear 0' Date °fPurchase~O ' O ) Name of Former Owner Q ~_t._~q.~, ~__. l'Z°ne°f'Iusedistrictinwhichpremisesaresituatc/?*. ) 2. Does proposed construction violate any zoning law, ordifiance or regulation:, tx, J 3. Will lot be re-graded ~'-'~ C) Will exee~s fi!~be removed .Name ofCon~act0r .~,~ % ~ ~ c Q~gssv l~'~ ~C ~;~¢ Ph°ne No 5. Is this prope~.wi~iB 100 feet cfa tidal wetl~d~ *~S NO · ' ~ YES, SO'HOLD TO, TRUSTEES P~TS MAY BE ~Q~D 5. Provide su~ey, to scale, wi~ acetate fo~dation pl~ ~d dist~ees to prope~ lines. 7. If~levation at any point on prope~ is at 10 feet or belo~, m~t provide topogap~ rATE OF ~W YO~)" ...... SS: 3~ oF ) ~mc of indi~u~g,qon~acO above namc~, * :g' *z. m, deposes ~d says ~at O)hc is ~c applic~t )He is' the (Con,actor, Agent, Co¢omtc Officer, etc.) said ~.~f[~;~)s'.~ly auto.ed to pcrfo~ or ~v, pcffO~cd ~o ,~d work ~d m.v · · · rfomcd in ~7° ~-~mcu m rms appdcadon ~c me to ~e besfofhi~ ~owledge ~d belief; i~hcau°n' 'om~fore mc th~ ' " No.~513~ " ' ' '" S.C,T,bL NO. DISTRICT: I00 SECTION: 106 BLOCK: 9 LOT(S): 8 18'18'20" E [ 174.93' ~[~ ~ ~ ~.o.,'s i 0 ~ ~ ~[ o~ ~, r ~ ~ 0 / I ~t~. R = 25.0' MILL ROAD cox AREA: ] 14,~40 S.E. OR 2.~3 ~RC~S ~Ee~r~o~ ~or ~ ro ~o~r ~ ~o~err u~5 oe ro ~ ~ ~eEcno~ or rE~cE5, ~mo~ sreocr~s o~ ~ or~En ~o~o~rs. ~/o~ s~5onr~c~ sr~5 ~coe~o o~ o~co~o~ ~ ~or ~n~r~o ~ss ~c~ r ~o~r o~ r~ ~ts~s ~r r~ n~ o~ m~ or: SOFTWOOD KENNETH M. WOYCHUK L.S. P.0. Box 8, ~at~tuek, New York llOfi~ N. Y~ 5~ UC ~0~ 50227 maln~lnln~ ~ rz~ora~ of Robzrt L Thomas D. Re!.lly P,E. Co,t, ultl=g E:uglneer BLOG DEPT, THOMAS I) REILLY, P.E. T245T40 P.01 FACSIMILE TRANSMISSION .o, or P^Gs(s)w/cewR~ / FROM: THOMAS I:~EILLY ~' BRIAN REILLY ROB CUMMINGS DAWN'BYERS imm i m i m COMMENTS AND/OR INSTRUCTIONS;