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Home My WebLink About29848-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29822 Date: 11/07/03 THIS CERTIFIES that the building ALTERATION Location of Property: 11535 MAIN RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 142 Block 2 Subdivision MATTITUCK (HAMLET) Lot 16 Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 22, 2003 pursuant to which Building Permit No. 29848-Z dated OCTOBER 30, 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 SECOND STORY ALTERATION AS APPLIED FOR. The certificate is issued to MARYELLEN REIAVHARDT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1175241 10/27/03 PLUMBERS CERTIFICATION DA'r~D N/A 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. 29848 Z Date OCTOBER 30, 2003 Permission is hereby granted to: MARYELLEN REINHARDT 11535 MAIN ROAD MATTITUCK, NY 11952 for : ALTERATION TO SECOND STORY (INSULJtTION, SHEETROCK, & ELECTRICAL UPGPJtDE) TO EXISTING SINGLE FAMILY DWELLING. (THIS PERMIT REPLACES BP#21223-Z) at premises located at 11535 MAIN RD County Tax Map No. 473889 Section 142 pursuant to application dated OCTOBER Building Inspector to ex~ire on APRIL MATTITUCK Block 0002 Lot No. 016 22, 2003 and approved by the 30, 2005. Fee $ 150.00 A~i~d Si~nat ure ORIGINAL Rev. 5/8/02 ~O~-r NO. · TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PER.~IT (THIS PER/~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..... ~.~......v~./..~.....~...~. ............. at premi ,~ocated at ....... J..~..~.....~..-,~. .........~..~..../..~.z~. ........................................ .................................................................. L.L..~..~ ................................................................. County Tax Map No. I000 Section .../...~...~.~.. .... Block ........ ~ ...... Lot No.../..-~. ............. pursuant ,o application dated ............... ..~..~.. ....... L~. ...... , J9..~7~.., ond approved by the Building Inspector. Building I~e~t~'r~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOVCN 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 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 Plarm~g Board Approval of completed site plan requirements. B. For existing~bllil~s (priol' 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 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. Novomber 7, 2003 New Construction: xx Old or Pre-existing Building: LocationofProperty: 11535 Main Rd (check one) Mattituck House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Street Hasnlet Maryellen Reinhardt 142 Block 2 Lot 16 Filed Map. Lot: Date of Permit. 10/30/03 Applicant: Permit No. 29848-z Health Dept. Approval: Planmng Board Approval: Request for: Temporary Certificate Fee Submitted: $ 25.00 Underwriters Approval: Final Certificate: xx (check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by RICHARD REINHARDT 11535 MAIN ROAD MATTITUCK, NY 11952 RICHARD REINHARDT 11535 MAIN ROAD MATTITUCK, NY 11952 Located at 11535 MAiN ROAD MATTITUCK, NY 11952 Application Number: 1175241 Certificate Number: 1175241 Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the Name Miscellaneous bathroom & laundry only Appliances and Accessories Future Appliance Feeder Future Appliance Feeder Wiring and Devices Switch Fixture Receptacle 27th Day of October, 2003. QTY Rate Rating Circuit Type 4 0 15 Amps 1 0 30 Amps 3 0 General Purpose 1 0 Incandescent 1 0 GFCI A visual inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated, OU~DA'TION (1st) OUNDATIO:; (2nd) OUGH FRAHE & -PLUMBING NSULATION PER N. Y. STATE E~ERGY CODE FINAL ADDITIO};A'L COMME};TS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1803 Examined ................ ,19... Approved .~. ~... [.7 .... 19q~. Permit No..~. ~..~...~. 3 ~- Disapproved a/c ..................................... S0ARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 sti'eets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this appli- cation. 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 i~sued a Building Permit to the applicant. Such permit sh,all 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 whatever until a Certificate of Occupancy shall have been granted 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. Jo admit authorized inspectOrs on premises and in building for necessa ' 'ons. . (Signature of applicant, or name, if a c p t'o ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premisesq .~C' .C-0ck .~>..q~.~.~k~......~..~ .~:.~. · .~-~....J:~.~.~. ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ ./XD./'~-. ............. Plumber's License No 7t~ .~..~...~---~.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................... ree~t .y....[fr~..~...,.~. .................... .: ............. House Number fi:~. '~././.~/.C '~' ' '~i Hamlet County Tax Map No. 1000 Section ...:...~.~.~....~.... Block i ...... ~ .... i... Lot .... .~.~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises a/a/d intended use and occupancy of proposed constructioni · 3.Nature ofwot-k (check which applicable): New Building .... Addition ......... "; Alteration .......... Repair .............. Removal .............. Demolition )ther Work ............... 4. Estimated Cost... ¢~..~..~. ...... i.' .................. Fee ...... ~.~.t ~:~ d9 (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor. · If garage, number of cars ..... ............... 6. If business, commercial or m(xed occupancy, specify nature and extent of.each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear Depth ............... Height ............... ~umber of Stories .......... Dimensions of same structur,, with alterations or additions: ~'r;~ ......................................... ................. Rear .................. Depth ................... Height ·: .......... ~ Number of Stories .......... .2 .......... 8. Dimensions of entire new construction: Front .............. : Rear ............... Depth ............... Height ............... Number of Stories ................. 9. Size of lot: Front ......... . .......... :.. Rear ....... ..... {3;~'~1( ............... ' ........ 10. Date of Purchase .................... v ...................... 11. Zone .................... ......... Name of Former Owner ............................. or use district in which premises are situated ....................... 12. D°es proposed construction violate any zoning law, ordinance or regulation: ' 13. Will lot be regraded ................................ ....... ' ..................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address Name of Contractor ................... Phone No ................ .......................... Address ................... Phone No.... 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, S0uthold Town Trustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block numb~s~p~~ to deed, and show street names and indicate whether interior or corner lot. STATE OF Nt~OR~,.~ /J~ SS or ' . .... · t 4.e.i. ..... (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the ................ ~ ~ .~.C.. ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before m~(~ d ~' ............ '~'~ .... aY~Tr~',~ · ~,~/~ ;~) .... ,19... / · ' ' CL~IItE L GLEW No. 4879806 ~ ,.___,0 .wfl' _~d in Suff~ll[ Co~r~~>4~ (Signature of applicant)