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Home My WebLink About27362-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29497 Date: 06/04/03 T~IS CERTIFIES that the building ADDITION Location of Property: 3625 GR3~ND AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 107 Block 1 I~t 5.1 subdivision Filed Map No. -- Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16, 2001 pursuant to which Building Pel~it No. 27362-Z dated JUNE 7, 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 TRICIA ALLISON of the aforesaid building. (OWNER) SUFFOLK COUi~I~f DEPART~4ENT OF ~EALT~ APPROVA~ N/A ELECTRICAL CE~TIFICAT~ NO. 76100C 05/28/03 PLUMBERS CERTIFICATION DA'~ N/A Rev. 1/Sl 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. 27362 Z Date JUNE 7, 2001 Permission is hereby granted to: MICHAEL & TRICIA ALLISON MATTITUCK,NY 11952 for : CONSTRUCTION OF DECK AND PORCH ADDITION TO SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 3625 County Tax Map No. 473889 Section 107 pursuant to application dated MARCH Building Inspector. GR3~ND AVE NLATTITUCK Block 0001 Lot No. 005.001 16, 2001 and approved by the Fee $ 75.00 ORIGINAL Rev. 2/19/98 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 fi'om Health Dept. of water supply and sewerage-disposal (S-9 fomQ. 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/I0 of 1% lead. 5. Cmmnercial 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 unusuo[ 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, Swinmfing 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. B- 0'5 New Construction: 7 Old or Pre-existing Building: Location of Property: ~..~ ~:> ~ ~ C_D~ ~t~O~ t~& House No. Street Owner or Owners of Property: ~l'~ ~~ Suffolk County Tax Map No 1000, Section ~ 0 ~ ' O0 Subdivision Permit No. ~::~--/3/f-)~-~ _Date of Permit. __ (check one) ~(~ ~- 4-: '~0F---k] ~Ha~llet~ Block~, ~_0_ Filed Map. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~)..~ - oo 195 Underwriters Approval: _ Final Certificate: V Lot Lot: Applicant: '~---~(~ 't 0__ 'll~ ~3~ (check one) Applicant Signatur'e Issue Date 05/28/2003 Electrical Inspection Certificate Electricallnspection Service, Inc. Application Number 375 Dunton Avenue 76100C East Patchogue, New York 11772 (631)2864642 Issued To: Tricia Allison Street: 3625 Grand Avenue Village: Mattituck Zip: Section: Block: Lot: Contractor: Mack Electric (L) 11952 Town: Southold Lic. ~ 4550-E Was examined and found to be in compliance with the National Electrical Code. [] Commercial [] NVDefects [] Pool [] lstFIoor [] Indoor [] Basement [] HotTub [] Residential [] Det. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 3 6 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi / Television CO Detector Bldg. Permit: 27362 Other Equipment ~ORCH Hugo S. Surdi President Rough Inspection: 05/27/2003 Inspector: Ed Scavelli Final Inspection: 05/27/2003 Inspector: Ed Scavelli This certificate must not be altered in any manner. Inspectors may be identified by their credentials. 76S-1802 BUILDING DEPT. [ ]]~FoO~NDATION 1ST NDATION 2ND INSPECTION [ ] ROUGH PLBG. [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY INSPECTOR BUILDING D£P.r. [ ] ROUGH PLBG. 2ND [ ] INSULAI'iON FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONIST [ ] ROUGHPLBG. [ ] F~OU~DATION 2ND [ ] INSULATION [~] FRAMING [ ] FINAL [ ] FIRE~J~CE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ].~iDATION 2ND [ ] INSULATION FRAMING [ ] FINAL FIREPLACE & CHIMNEY REMARK~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSU~."ON [ ] FRAMING [~]~NAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE FOuNDATIoN FOUI~ATION ROUGH FRAI~ & PLUI~XNG IB~JLATION PER N. ¥. STATE ENERGY CODE FINAL ADDITIONAL COl~fl~qTS: .FORM NO. I ]iTOWN OF SOUTHOLD I{~ILDING DEPAR'IIVlENT TOWN HALL · ~JIOUTHOLU. N.¥. 1197 I [~TgL: 765- 1802 A~o~ed .... .~=.~. ....... , ~... ee,~it ~ ............... Disapproved a/c .................................. ~ APPLICATION FOR BUILDING PEP~IT INSTRUCTIONS ~ BOARD OF HEALTH ............... 3 SETS OF PLANS SURVEY ........................ CHECK ...... SEPTIC FORM ................... TRUSTEES ...................... NOTIFY: CALL .. , MAlL TO: .................... a. This applicaticm must be completely filled in by typewriter or in ink and sul~itted to the Building Inspector wi 3 sets of pl~, accurate plot plon to seale. Fee according to sehechle. b. Plot pla shc~ng location of lot and of buildings on premises, relation~iP to ndjoining premises or public streets or areas, and giving a detailed deseripcins of layout of property nttst be dra~n on the diagr~ ~hich is part of this application. c. ~e ~ork covered by this application my not he cce~eseed before issuance of Buildlng Permit. d. ']pe~ approval of this applicatie~, the Building Inspector will ison~ a Building Pemit to the applicant. Sud~ pemit shall be l~pt o~ the pr~mdses available for inspection thron~mt the work. e. No building shall he occupied or used in ~hole or ia part for any purpose whatever umtil a Certificate of Occupency shall have been granted by the Buildiug Inspector. APPLICATI~I~ IS ~ ~ ~o the Building Depart~nt for the isseance of a Building Permit Paronant to the Building Zo~ Ord~nonce of the Town of Santhold, Suffolk Coonty, New York, and other applicable La~s, Ordin~ces'or Regulations, for the constructiofl of buildings, additions or al£eratio~s, or for r~val or d~lirion, as herein described. The appllcanr agrees to comply with all applicable l~s, ordinonces, building code, housing c~de, and regulations, and to ~,~t anthorlzed inspectors on premises and in beildlng for necessary inal~ctions. (Signature of ~pplicant, or r~, if a corporation) (Mailing -~a~reas of applic~amt) State ~tmtt~r applicant is mr, lessee, ageut, architect, engineer, general contractor, electrician, pltmber or builder ................................................................................................... Pr ses ....n3. .... .................................... (as on tim tax mi1 or latest deed) If applicant is a corporatic~, signature of duly authorized officer. Builders License NO .......................... Plumbers Liceu~ 1~o .......................... Electricians Liceoae ~r ~'s ~ ~. , '. ~ti~ of la m ~,i& ~ ~ rill ~ ~..~h~.~...~.C~.. ~.~: ......................... ~ ~r St~t ' ~ivisi~ ..................................., ; ~Fil~ ~ ~ ................ ~t .............. . 2. S~te ~sti~ ~ ~ ~.~ of ~s ~ int~ u~ ~ ~ of ~ ~ti~: ..................................... 3. Nature of ~ork (check dfidt sppllcable): ~ l~dlding .......... b~klition ......... Alteration .......... ~epair ............ l~,~ral ............. ll~olition .... ........ Other Work .~.¢~t~..~..CO,~.C... ~..o.Cq-Jx .... . (0escription) 3..4 4. Estimated Cost . F. . .. fee .............................................. (to be paid on fiIing this application) 5. If &~lllng, ta~er of d~elllng units ............. Nta~ber of ~lling tmlts on each fl~¢ If garage, ml~ber of e~rs ...................................... ; , 6. If business, cu~,ercial or mlz~l occupancy, specify nature taxi extent of ead~ type of use ...................... ?. Dimensions of existing structures, if any: Front ................ Rear ............... l~.pth ................. Beight ......................... Kl~ber of Stories ...................... Dimensions of same structure with alteratltms or additions: Front ............... Rear .............. Depth .................... Height Nmber: of Stories ............... Beight ......................... Ntmber of Stories ..................... 9. Size of 1o~: Frtmt .................... Rear .................... Dep0~ ............... ..... I0. l~te of Purchase ..................... N~e of Former Owner ............................ :~ .......... I I. Zone or use district in ~ich premises are s~tuated ............................................................. 12. Does proposed constxxm~ion vlolate any zoning l~a, ordinance or rngulatlon: ....................... 13. Will lot be rngraded .................... Will exeens fill be remm~l f'rom premises: ~ 14. N,~mes of Owner of i,~'~nlses ...........................t~lress .............................. Pho~ No ............ IxLmm of Ar~itect .................................... A~dress ............................... Pt~ee No ............ Na~e of Contrsetor ................................... Address ............................... Plane No ........... 15. Is this property within 300 feet of a tidal ~etland? * YES .......... ~ ...~.... PLOT DI AGRAH Itmate clearly and distinctly ail Imildings, ~hether existing or pro.?ed, and indicate all set-beck dimensions fxc~ property lines. Give street and block ~ber or description according to deed, a~ .~ street onraes ar~t indicate .......................................................... being duly s~m, deposes and says Umt be is the applicm~t (Nam of individual signing contract) above rimed, Ile is the ................................................................................................... (Contr~2tor, agent, corporate officer, etc.) of said ommr or o~ers, and is ~ly ~ri~ to ~rfo~ or hm ~r[o~ Um ~id ~ md to ~ ~ file this a~l. leati~; ~at all ~tat~ts c~ta[~ in ~is ~lieati~ a~ t~ to ~ ~st of h{s ~1~ a~ ~lief~ a~ that ~ m~ will ~ ~rfo~ in tbe mm~r mt forth in ~e ~licati~ fil~ t~. (Signature of ^l~01.1cant) MAP OF IdE NRY ,..1014 N FLOZEN C.E A. P4-',,VL.A K PAVL..A K ~ ~TTITLIC K, $CAL~: SO''- I" 0 APJ~ROVED AS NOTED NOTIFY BUILDING DE~ARTIv~NT AT 765-1602 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I FOUNDATION - TVVO REQUlilED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBllIC 3. INSULATION 4, FINAL - CONSTRUCTION MUS BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE N STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FC DESIGN OR CONSTRUCTION ERROFL ~.~::CU?ANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY ,iI