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Home My WebLink About28908-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPA/~CY No: Z-29838 Date: 11/14/03 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 855 HORTON AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 141 Block 1 I~t 24.1 Sulxlivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 13, 2002 pursuant to which Building Per,Lit No. 28908-Z dated NOVEMBER 13, 2002 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 DORMER ADDITION, COVERED PORCH ADDITION ~ ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. Ge certificate is issued to STEVE ROSIN of the aforesaid building. ( OWNER ) SUFFOLK COUNTY DEPARTMENT OF HF~%LTHAPPROVAL ET.R~-£~ICAL CERTIFICATE NO. PLIH~BERS CERTIFICATION DAr~ 11/12/02 N/A N 511465 HOWARD E WOLBERT 01/03/0q Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28908 Z Date NOVEMBER 13, 2002 Permission is hereby granted to: for : STEVE ROSIN 5610 GT PECONIC BAY BLVD LAUREL,NY 11948 CONSTRUCT DORMER ADDITION, ALTER3~TIONS AND PORCH ADDITION AS APPLIED FOR. (MAINTAINING PROPER SETBACKS) THIS PERMIT REPLACES BP#25178. at premises located at 855 County Tax Map No. 473889 Section 141 pursuant to application dated NOVEMBER Building Inspector to expire on MAY HORTON AVE MATTITUCK Block 0001 Lot No. 024.001 13, 2002 and approved by the 13, 2004. Fee $ 150.00 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. 25178 Z Date SEPTEMBER 16~ 1998 Permission is hereby granted to: for : STEVE ROSIN 5610 GT PECONIC BAY BLVD LAUREL~NY 11948 CONSTRUCTION OF A DORMER ADDITION~ALTERATIONS AND PORCH ADDITION (MAINTAINING PROPER SETBACKS) AS APPLIED FOR. at premises located at 855 County Tax Map No. 473889 Section 141 pursuant to application dated JULY Building Inspector. HORTON AVE MATTITUCK Block 0001 Lot No. 024.001 27 1998 and approved by the Fee $ 75.00 Building ~Inspecto~ ' 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 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 certify'mg 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 New Construction: Location of Property: ~-~" House No. Owner or Owners of Property: ~ '~,/~., Suffolk County Tax Map No 1000, Section Subdivision Permit No. O, Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Date. Old or Pre-existing Building: 9// (check one) Ave, Mo, qc;.C ck- Street Hamlet Block 1~ / -- [ Lot~, / [/~/~.<,3 ~ _FiledMap. Lot: DateofPermit. q' /qO- q~ Applicant: S-{-~A/~_~ ~)coiV3 Underwriters Approval: ~ ~ I '"/~ Final Certificate: Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-1823 Telephone (63i) 765-1[ BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Building Permit No. (please print) Plumber: {please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signatm:e) Sworn to before me this _/~. day of '7~.~, 20 d ~.- Notary Public, County MARIE A. WOODS Notary Public, State of New York No. 01W05031~60 Qualified in Suffolk County /J[~ My CommiSsion Expires Aug. 15, ~Or,g~' ~'~',,~'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS xlT-~z, 3 BUREAU OF ELECTRICITY {'~ 40 FULTON STREET, NEW YORK, NY 10038 JANUARY ~. 3, ~3 ~. :.., 1 ,c- /.): N 511465 THIS CERTIFIES THAT only the e~ct~cal equipment as desc~bed be~w and in~oduced by the applicant named on the above applica~on number is in the premises of STEVE ROSIN, 855 HORTON A%~NUE, ~TTITUCK, ~¢ in the fol~wing loc~on; ~ Basement ~ 1st FI. ~ 2nd FI. OUT Section Block Lot d~ ~ER ~7.2~ was examined on and found to be in compl~nce with the National Electrical Code. FIXTURE FIXTURES OUTLETS RECEPTACLES FLUORESCENT OTHER RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DIMME SYSTEMS NO. OF FEET E R V I C OTHER APPARATUS: G.F,C.I:-i P.O.BOX 518 LAUREL, NY, 11948-O518 iIGBNERALMANAGER Per certificate must not he altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER, November 11, 2003 FAIRWEATHER-BROWN DESIGN ASSOCIATES, lNC. P.O. Box 521 205 Bay Avenue Greenport, N.Y. 11944 631-477-9752 (fax} 631-477-0973 Mr. Michael Verity, Chief Building Inspector Southold Town Building Department Southold, New York 11971 Re: Rosin Residence Building Permit No. 28908Z Dear Mr. Verity: In response to our phone conversation, this is to confirm that to the best of my knowledge, belief and professional judgmem, the bedroom on the second floor of the above referenced project is in compliance with Section 711.1 of the New York State Uniform Fire Prevention and Building Code, which was in effect at the tiome the Building Permit was issued. Please let me know if you require any additional information or action on our part. Thanks for you help in this matter. BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. [ ] F~~MNiDNA~ION2ND i i IFNiNSAU~ATION ] FIREPLACE & CHIMNEY RE~.,~s: ~_ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTIO [ ] FOUNDATION 1ST [ ~ ROUGH PLBG, [ ] FOUNDATION 2ND [~/]~INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE //~2//~ ~/~ ~ 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN~ATION [ ~INAL [ ] FIREPLACE & CHIMNEY INSPECTOR 7~5-J.~02 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION REMARKS: DATE :OUNDATION (1st) POUNDATION 2. (2nd) ROUGH FRAME & ,PLUMBING· INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORH NO. I TOWN OF SOUTDOLD BUILDIN(~ DF, PARTHRHT TOWN DALL SOUTIIOI,D, N.Y. 1197 I TEl.: 765-1802 Diseppn:,ved a/c ................... BOARD OF HI~AL~tl ...... ; ....... 3 SliTS OF PLANS ........... :--. SHRVgY ........................ CIIE~K ......................... SEPTIC FORH .............. ..,. · lthll. TO: .................... APPLICATION FOR BUILDING PERHIT INSTRDCTIONS a. 'lhls application mst be c~Ietely filled in by LTpe~rlter or in ink rind md~ltted to tim Padldlng Inspector wi 3 sets of plans, accurate plot plan to scale. Pe~ accoaii.g to ad~iule. b~ Plot plan abo~d~ location ag lot and o~ buildings on premiss, ralationsldp to adjoJnl~ premises or I~d)lic streets or areas, and 8ivinB a detailed description si layont o[ property mst I~ drmm cu tim dlagr~n ~hJe. h la parr of this appl iratl~. c. 'Ils ~ork co. red by this application ~y not be c..,~.:nced b~fora isaua~c~ o[ Dulidlng Pemlt. d. UIx~ appr~ral o[ tills application, tl~ llulld|ng Inspector viii issue a Ilulldtng t~mit to ti~ applicant. ~ch permit s~mll be.bept cu tim p.~,d~e available ~or tnal~Cttcu thtn~ugJ~ont tim ~rk. e. No building dm11 be occupied or used in ~ole or in part ~or any parpus~ ~hatav~r until a Certi[Icate of Occupancy shall Imve been granted by tim I~dldl~ Inspector. APPI.ICATIQt IS }~ ~ to tim l~dlding Department [or tim lssuanc~ o[ n liuildir~ Penn|t pursuant to the I~uildlng Zo~ Ordinanc~ o[ the To~n oE ,~o.thold. ~uf~olk Count-y, 1~ York. and otl~r _applicable I~s, Ordltmncea or l~egulatinss, ~or tim construction 0[ I~dldtngs, additions or alterations, or for ~1 or/d~olition, as berain described, lhe applicant agm~s to coaply with all applicable l~s. ordinsnc~s, ~din~x~, housing code, and relo,lati.s,,.~! to ad~it .thoriz~d i--tara on ~.d.. and in building/_~gor/~dma~(q~-'ctl~ons. . ...... ..... : ............. (Signature ag applicant, or nm~, t[ a corl~rattcnO State ~%ether applicant Is mr, lessee, agent, architect, engtnser,'general contractor, electrician, pl~ber or t~dhle ......... ........................................................................... .... ' ......... . .......... '"iii ii (as on the tax ~oll or latest deed) I~ apptlcant ia a corporation, signature of duly antlorizcnl slitter. ? Pl~bers Ltceru~ Ilo. ~ ........................ Electricians T.icense No.. ~...~-..~ .......... Otl~er Trede'a Li~ ~. , ................... ~. l~ati~ of 1~ ~ ~td~ p~ ~ viii ~ ~ .............................................................. I~ ~r St~t l~et ~ T~ ~p ~. I~ ~tim ..... ~ ..... Bl.~k ...../~. ........ lot ..~:..~.~'/' .... ~ivlsi~ ...................................... F{I~ ~p ~ .......... · ..... l~t..... .... .. .... (~) 2. State exlsti~ a. F~sti~ ~ a~ ~ ...~ .................................................................. b. Int~ m ~ ~ ............... ~~ .......... :~ ......... · oY ~ to ~l~g ,Ol~Uq YFIAT~ fl. I0. 11, 12. 13. 14. 15. -- - / _ If garage, i~f~d~r o~ ~r8 ...................................... If Ixmilmas, ~rcJal or mi~'~qm~, s~cJ~ ~l:ure fl~ ~[ent ,~,~ .... ~'.~.~) ............ '.. ~.,~,~ o~ s~o~....tS. ............ .~e I~pth ... ~ .......... thl$,t ...~. .......... ~t~r ol Stories ..~ ....... l)iu~nsl~m o~ entire ~ ~t~ti~: ~t ................ ~ar ............... ~pd~ .............. I~iO~t........ ........... .. ... . ~,ier o~ Storle~ ................... .. s~ o~ ,~, ~ ....~72.~ .......... ~ .... !~.~ .......... ~,,, .../~..~ ......... ~,,.~ ,,~ ~,,~,~, .~g..12../~. ~ o~ ~,o,,,~ ~ .~,..~.~ ................... ~ or u~ district la ~idl ~rml~s am si~ ~?0~/~ ~a propel ~mt~Ll~ violate a~ ~ln8 1~, o~ll~e or regula~i~ . ~ .................. ~ill lot I~ r~r~ ...~ ............. ~ltl ~az fill ~ r~ PI,OT DIhGRAH ~ l~cate clearly and dleci~tly &ll ~ildi~e, ~mfl~r ~lsti~ or pro~, ~ l~icete all ~t-~ fr~ i)rol~rty ll~s. Oi~ ot~t m~ bl~ ~r or ~ecripti~ ~Jn8 to (~, a~ &~ strut ~me ami t~licate ~A~tl~r Interior or co~ ........... ........... I~ i~ tl,~ ..... ~ .................................................................................. (~tr~t()r, ~ent~r~rate o~Eleer, eta.) of ~id (M~r or ~ra, m~ t~ ~t~ ~tlmrJ~ to I~fom or h~ i~rfoe.~ tim ~id ~EK m~l to n~ke fl~l file thifl fll~;licati(~t; that all states,ts ~)tald iff thla al~lleatl~t fire t~ to ~e 1~8~ of his h~l~e that Use ~rk ~ill I~ ~rf~n~l In tl~ n~fli~r ~ f~rth t~ the fl~llcflti(~ fll~ ~)~ to I~fore ~ Offs C/ ~A~A~ (SJ[t~ml~mre Of A~)I l~t~t) T~J~8,~ .................. belial (Italy ~r~, delx)ses taxi rays Llmt he is the eppl. i(uJm: