HomeMy WebLinkAbout29827-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29812 Date: 10/31/03
THIS CERTIFIES that the building ADDITIONS & ALTERATIONS
Location of Property: 11535 MAIN RD MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 142 Block 2 Lot 16
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21, 2003 pursuant to which
Building Permit No. 29827-Z dated OCTOBER 21, 2003
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 ADDITION & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to MARYELLEN REINHARDT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 1175241 10/27/03
PLUMBERS CERTIFICATION DATED 10/28/03 HARDY PLUMB.& HEATING
Auf_ orized Signature
Rev. 1/81
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. 29827 Z Date OCTOBER 21 , 2003
Permission is hereby granted to:
MARYELLEN REINHARDT
11535 MAIN ROAD
MATTITUCK,NY 11952
for
CONSTRUCTION OF ADDITIONS & ALTERATIONS TO A ONE FAMILY DWELLING
AS APPLIED FOR. THIS PERMIT REPLACES BP#25342 .
at premises located at 11535 MAIN RD MATTITUCK
County Tax Map No. 473889 Section 142 Block 0002 Lot No. 016
pursuant to application dated OCTOBER 21, 2003 and approved by the
Building Inspector to expire on APRIL 21, 2005 .
Fee $ 150 . 00
Au or ' zed i ature
COPY
Rev. 5/8/02
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. 25342 Z Date NOVEMBER 19 , 1998
Permission is hereby granted to:
MARYELLEN REINHARDT
11535 MAIN ROAD
MATTITUCK,NY 11952
for
CONSTRUCTION OF ADDITIONS & ALTERATIONS TO A ONE FAMILY DWELLING
AS APPLIED FOR.
at premises located at 11535 MAIN RD MATTITUCK
County Tax Map No. 473889 Section 142 Block 0002 Lot No. 016
pursuant to application dated MAY 6 98 and approved by the
Building Inspector.
Fee $ 75 . 00
Building nspecto
COPY
Rev. 2/19/98
Form No.6 I —�? /C2-�
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. Sworn statement from plumber certifying that the solder used in system contains less 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.
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
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-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 // jr
Date. /D/e27/ 0
New Construction: _Z Old or Pre-existing Building: (check one)
Location of Property: M_-5r M&P A%oQ Aglyll%UGC`
House No. Street Hamlet
Owner or Owners of Property: m4e_ � 4{.V &1;L) XWbT
Suffolk County Tax Map No 1000, Section /72 Block 02- Lot
Subdivision g Filed Map. n Lot:
Permit No. a��j o2/ atee of Permit. I� -2-4- l��pplicant: A .4It6 kJ,"A� V_
Health Dept. Approval: Underwriters Approval: 47
--- �
Planning Board Approval: A.)1A
T
Request for: Temporary Certificate Final Certificate:_ � (check one)
Fee Submitted: $
i '
i
-5- Applicant Signature
—
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o ��ln�rs�l-�fsL3frssLrL3rL3LrL3fE3 r�n�n�LPsLPLPLrL3 n�n�n�l�l�r�l�I�l�l�nrn��rn1jnrrrn�����s�lr3l o
5 BY THIS CERTIFICATE OF COMPLIANCE THE 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 BUREAU OF ELECTRICITY 5
55 40 FULTON STREET — NEW YORK, NY 10038 55
5 CERTIFIES THAT 5
5 Upon the application of upon premises owned by 5
SRICHARD REINHARDT RICHARD REINHARDT S
5 5 11535 MAIN ROAD 11535 MAIN ROAD 5
MATTITUCK, NY 11952 MATTITUCK, NY 11952 5
CC5 55
Located at 11535 MAIN ROAD MATTITUCK, NY 11952 e5
Application Number: 1175241 Certificate Number: 1175241 r5
Section: Block: Lot: Building Permit: BDC: NS11 5
Described as a Residential occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 5
5 First Floor, 5
5 5
S5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5
found to be in compliance therewith on the 27th Day of October,2003. 5
5 Name QTY Rate Ratine Circuit Type 5
5 Miscellaneous C
5 bathroom&laundry only CCCS
SAppliances and Accessories
5 Future Appliance Feeder 4 0 15 Amps 5
5 Future Appliance Feeder 1 0 30 Amps 5
5 Wiring and Devices 5
5 Switch 3 0 General Purpose
5 Fixture 1 0 Incandescent 5
5 Receptacle 1 0 GFCI 5
5 A visual inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to be
5 in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. L+
5 5
5 seat 5
5 5
I of I 5
5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
5 5
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P.
Oct 29 03 01 : 51P
TEL. 765-1802
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 1179
TOWN HALL
SOUTHOLD, NY 11971
CERTIFICATION
Date: 10
Building Permit No. (D?)dc)J Z
Owner: Mari em %"Of
(plrint)
Plumber: Hardy Pilumbina,Heating &Air Conditioning. Inc.
(please print)
I certify that the solder used in the water supply system contains less than
2110 of 1% lead. I also certify that I installed an anti-scold and/or thermal shock
preventing device at all bathing and/or showering fixtures in conformance with part
902.6(k) of the N.Y.S.F.P.A.B.C.
rimb 's signature)
Sworn to before me this VT
C27thday ofD�Y"
(
NotaryPublic,
nu O� - County Mary Public)
MIMI New Yok
MAGGed 0wrisdaMmE o�na 7
o
s� Y-2, � "-("
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOU ATION 2ND [ ] INSULATION
[ t FRAMING [ ] FINAL
[ j FIREPLACE & CHIMNEY
REMARKS: i f
ZaL
r
DATE11ZC71-� INSPECTOR
j les-1802
i
/ "UILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
L
DATE � � � INSPECTOR
I
ACL
76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ZAL
LA
[ ] FRAMING [
[ ] FIRE =NEY
REMARKS:
L
l
L
;DATE l INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
( ] FRAMING [ INAL
[ ] FIREPLACE A CHIMNEY
REMARKS: —
z
3
DATE �O az7 �.3 INSPECTOR ,/
l
FIELD INSPECTION REPORT DATE COMMENTS
IIQJ `�f,
II
FOUNDATION ( 1ST) _ I if
l
I C
FOUNDATION (2ND)
----
,i/fes% 77
cJ/ c
ROUGH FRAME S jlj---�
PLUMBING if
it
II
II
INSULATION PER N. Y. n—__—moi
STATE ENERGY if
CODE i n
-----------
If
II 0
II J /L Qq CL t4
II II L � H
n n 3
u �
FINAL _-__-gyp
n �
ADDITIONAL COMMENTS:
— — -- -- -------- — -- --- ----- --
r 1 c e 4�
� s �
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ea
ro
H
id � -
BOARD OF UBALTN . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . I . . . . . .
` BUiLOING DEPARTMENT CHECK
. . . . . . . . . . . . . . . . . . . . . . . . .
. _. ..,..._of TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
` 3. "` SOUTHOLD, N.Y. 11971
i l"% i u tiO2iiHOLD TEL: 765-1802 NOTIFY: ( �/
j,�yj,- CALL .
99f� dt D I . . . . . . . . . . . . . . . . .
L''bmmined.!.X!.:•../�..., 191.`f - MAIi. TO: . . . . . . . . . . . . . . . . . . . .
w .�1 q6 oZS3 ��i
Airovctil.'?�. ......., 19.!.. Permit Iki. ...........:ir... ...................................
Disappnrved a/c ................................... ...................................
_ (Ifrilding Ina tor)
APPLICATION FOR BUILDING PERHI'r
Oate. . . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. 'Ibis application oust be cohpletely filled in by typewriter or in ink aril submitted to the Building Inspector w
3 seta 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 giving a.detailed description of layout of property mist be drawn on the diagram u#hich In part of
this application.
c. 'Ibe work covered by this application may not be ommenced before issuance of Building Permit.
d. Upon approval of this application, the Building inspector wilf issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the work.
e. No building shell 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.
APPI.ICNrI(N IS HEREBY MM 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 iows, Ordinances or
Regulations, for the construction of buildings. additions or alterations, or for reroval or demolition, as herein
described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, arxl
regulations,imid to admit authorized inspectors on premises and in building for necessary inspections.
. ..........
(Signature of applicant, or name, if a corporation)
.........:....d .. .....':
(Hailing address of applicant)
State whether applicant/is owner, lessee, agent, architect, engineer, general contractor, electrician, pltrdber or builik
..............I........I.W���r�b./7..11//,L;1 ....................................................................
Name of carer of premises ..../<ILFa � ../.,tom/I•NffA4�r��r..............
.............................................
(as an Bre tax roll or latest deed) �d
if applicant is a corporation, signature of duly authorized officer.
.........................................................
(Nave and title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
I. location of land on which proposed work will be done..............................................................
ll.1�3 ............ ;A%v..... .1?.......................I....RIO ...i�cX..........................
(louse Nunber Street 1laalet
County Tax Map No. 1000 Section .....!�:..... Block .....2......... bet ..f to..........
Subdivision ...................................... Filed Map No. ............... let ...............
(Nm e)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constriction:
a. Fxisti use and E rJ�hX E Y � tE'...........................................
bYl occupancy ......../�..S.... .. ....r7....
b. Intended use and occupancy Fs«
3. Ncuure of work Zeck %thidt applicable)[ New building .......... Addition ...4!..... Alteration ..l!......
itelwir .... ....... Removal ............. Demolition ............ Other Work ..................................
yy�ttppQQ �`2� ........(Description)
4. I!stivated Cost !!.lQf QQ ............ fee .....f.C).rk-A.......
................ .
(to be paid on filing this application)
5. If d+elling, dxaber of dwelling units ......j..... timber of. (Melling units on each floor .......'-//.:....
if garage, u ...........
timber of care :77. ((
.......................
6. If Ixhehhesa, comnercial or mixed occupancy, specify nature and extent of each type of use.......................
7. Lihmonidxts of existing structures, If any: Front.....10....... Rear ....2y..... Depth ....SP�5`........
............. Muber of Stories ...... .............
Dimensions of sere structure with alterations or adklitions: Front ........ .... Rear ......... ... ...
Depth ...)p?3............. Iklgiht ...Wf ............ Nnber of Stories ....a...
8. Dimenxiaha of entire new construction: Front .d/ ,,., Rear ............... Depth ..............
lieigitt .........................gMother of Stories ..�.""...................
9. Size of lot: Front ......!�1.•.J..'T.... Rear ..,.Ltp.O....... Depth ....
10. Dw a of Purchase .....�. .l.2....... Name of Former (Mier .../.!/.L lks ........_............ .
II. Zone or use district in %Abed premises are situated ......fQ .Q'FF14...........�.. ....................... ...
12. Does proposed axuy
truction violate any zoning law, onlinadtce or regulation: ....... .-:.17...........
13. Will lot be regraded .................... will excess fill be removed from premises: YES ND
14. Nares of Owner of premises ...f'LG�...f'�t4J �pl, /vkireea ..1/ .. (. ......4f�!�I€/L`.. I'fane No. a1g " '`, ..
Nate of Architect /� ►�1 ..� 9'z,z Address Jft...l� G ....N 4.. etxx,e No.Z./ .7Tf.�OZ/
Pare of Contractor .......Q" ........... heiress .................../.. .......Ilton No. ...............
15. Is title property within 300 feet.of a tidal wetland? * YRS .......... NO .....Y....
*IF YES, SDUDKID T" 7ld6SfM PERMIT MAY 013 MAIIRFD.
PIAT DIAGRAM -
Locate
IAGRAM -locate clearly and distinctly all bolldings, whether existing or proposed, and indicate all set-back dimensions
Fran property lines. Give street and black rznber or description according to deed, and show street nares and indicate
%Amther Interior or corner lot.
S1'A'I13 0E N;W WALK,
(1lIN1Y (1R(��,s�// 4.1k:..... ppp 1
......... r- L4.......�....../4:EIHh#A.t7iniug duiy s,,,xn, delxtses atxl says Lhat he is the applicam.
(Rite of itdivi(Mal. signing contract)
alxwe tuned,
lieis the .........R.w.^1.f:.1:.............................................. ............................. ..
(Contractor, agent,-corporate officer, etc.)
of said (mer or wttera, and is duly authorized to perform or have perforted the said work mid to nrke six] file this
algil ieatiat; that all statements contained in this applicaCi(xh are true to the heat of Ilia lumledge std beAief; six]
that the work will In performed In tide manner set forth in Lite nppl.icaticm filed therewith.
Sworn to before me this
T.
. ......(P.. .......day of .. A:.':`......19.1qq
19.1K..
Notary INJA id;'OrAlagi�. '
(Signatire of Applicant
ELIZABETH ANN NEVILLE
Notarryy Public,State of K.:w York
No. 52-5125850,Suffolk Countu
Term Expiros October 91, 79 .
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COPPER ROOF
COPPER ROOF FLASHING AS RED.
�4 FLASHING AS REO.
�1 A" 0V D AS NOTEDDI : OCCUPANCY OR
'} DATE:jGB.P.#
USEt� UNLAWFUL
FEE:�'�' --BY:
WITHOUT CERTIFICATE
NOTIFY BUILDING DE E AT OF OCCUPANCY
765-1802 9 AM TO 4 FOR E O 2%10 LEDGER
2X10 LEDGER FOLLOWING INSPECTIONS: s®`6
s 1 FOUNDATION - TWO REQUIRED
Aas g FOR POURED CONCRETE 18" 11 WRC SHINGLES 12 ti*�
18' p1 WRC SHINGLES 12 ti�a 2. ROUGH - FRAMING & PLUMBING
e
,3. IN.S•ULATION VENT HOLES
VENT
RED�6� 4. FINAL - CONSTRUCTION MUST As RED.
BE COMPLETE FOR C.O. BIRDS A/WTHA AREa 2%6 2X6 JOISTS 0 16 O.C.
BIRDS MOUTH RAFTER
AS RED. 2x6 JOISTS 0 16' D.C. ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR R19 KRAFT FACED
INSULATION KRAFT(ACED DESIGN OR CONSTRUCTION ERRORS INSULATION
NS
5/8" GYP. BIRD.
5/6" GYP. BRO. `
If copper tubing is used PROVIDE OPENINGS FOR 2%4 STUDS 016" O.C.
2x4 STUDS 016" O.C. for water distributing EMERGENCY ESCAPE AS R13 BATT INSUL.
R13 BATT INSUL system; piping shall be REQUIRED 61f PART. 714 OF
5/B" GYP. BOARD UNE OF
5/8" GYP. BOARD of types K or L only N.Y. STATE BUILDING CODE. EXT. HOUSE
UNE OF
EXT. HOUSE
PROVIDE ANTI-SCALD AND/OR UNDERWRITERS CERTIFICATE
THERMAL SHOCK PREVENTING REQUIRED
DEVICES AS TO PART.902.6(K)
18" SHINGLES OVER N.V. STATE BUILDING CODE. 18" SHINGLES OVER
/30 BUILDING FELT ON /30 BUILDING FELT ON
PLUMBING PROVIDE SIAOKE•DETECTING 3/4"PLYNVOD
3/4" PLYWOOD PLU
3/4• PLY. SUB—FLOOR ALARM DEVICES 3/4" PLY. SUB—FLOOR
PLUMBING WASTE 2x4 SILL i
2x4 SILL &WATER LINES NEED AS TO PARL 72L1 PLATE (TIP.)
PULE (TW) R19 BATT INSUL.
FLOOR INSUL. TESTING BEFORE COVERING Ny S BUILDING CODE. 0 FLOOR
WOLM. 2%6 SOLE
WOW. 2%6 SOLE PLATE (TYP.) 2xe JOISTS 0 i6" O.C.
PLATE (TYP.)
2X8 JOISTS 016" O.C.
PLUMBER CERTIFICATION A H,µoR 60I.�
pKc uoR polv5
PG& 1115 Coot CRAAL SPACE ON LEAD CONTENT BEFORE Pr;P, mys Ccft
\j/\ CERTIFICATE OF OCCUPANCY CRAWL SPACE
SOLD USED IN WATER ExT. BLOCK FID. WALL
SUPPIL YSTEM CANNOT ° REPAIR OR REPLACE
EXCEED 1�O OF �%LEAD•
6 MIL. POLY VAPOR BARRIER
0 FRONT PORCH
\WALL
!C% 0 LAUNDRY ROOM /\\\//\\\ •I FOUNDAPON/SLAB MONOLITHIC POUR
/\// L•_ \� 3000 LBS. GRAVEL MI% + 2" ROUGH CONIC. SLAB
// • W/1'4 REPAR 0 12" O.C.
VERT. AND HORZ. °• 6 MIL. POLY VAPOR BARRIER
°
EXT. CONC. FOOTING
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Frederic Schwartz Architects } 11535 Main Road 1/2" = 1' — 0" ^ of 1I 2] 4
180 Varick Street 75th Floor \ h ,,�U Q- Mattituck New York 11952 1 I_ _L
New York New York 10014 02 — ,t0 d1r.eq, "O. G
tel. 212 741 3021 toe. 212 741 2346 6 OF NES