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HomeMy WebLinkAbout27922-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29945 Date: 01/06/03 THIS CERTIFIES that the building ADDITION Location of Property: 1350 MILL RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 10 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 19, 2001 pursuant to which Building Permit No. 27922-Z dated NOVEMBER 20, 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 ATTACHED TWO CAR GARAGE ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GABRIEL L DARIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1075256 09/19/03 PLUMBERS CERTIFICATION DATED N/A /A4jizj Sig tune 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. 27922 Z Date NOVEMBER 20, 2001 Permission is hereby granted to: GABRIEL L DARIN PO BOX 653 MATTITUCK,NY 11952 for CONSTRUCTION OF AN ATTATCHED GARAGE ADDITION AS APPLIED FOR at premises located at 1350 MILL RD MATTITUCK County Tax Map No. 473889 Section 106 Block 0010 Lot No. 003 pursuant to application dated NOVEMBER 19, 2001 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 *� c. .6NTCForm 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 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. t 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$25.00,Alterations to dwelling$ 5.00, 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. 1 -6- New Construction: / Old or Pre-existing Building: (check one) P Location of Property: M=Lc P%D ac� House No. Street Hamlet Owner or Owners of Property: G Suffolk County Tax Map No 1000, Section i Block (o Lot 3 Subdivision Filed Map. Lot: Permit No. 219 22 -L Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: � (check one) Fee Submitted: $ 2 c�L46 t2e,C (.o s-�, ` Applicant Signature a 5 Q 7 9 4,2). 5 5 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS 5 BUREAU OF ELECTRICITY 5 5 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by C, 5 5 5 DARIN GABRIEL GABRIEL DARIN S 5 P.O. BOX 653 13550 WEST MILL RD 5 5 MATITTUCK NY 11952 MATTITUCK, NY 11952 5 5 Located at 1350 WEST MILL RD MATTITUCK, NY 11952 S 5 5 5 Application Number: 1075256 Certificate Number: 1075256 5 5 5 5 Section: Block: Lot: Building Permit: BDC: NS11 5 5 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 SBasement,First Floor,Attached Garage,Outside, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation,as set forth below,was 5 5 found to be in compliance therewith on the 19th Day of September,2003. 5 5 Name OTY E& HIMU Circuit IY29 5 5 Miscellaneous 5 gagrage addition 5 Wiring and Devices 5 Cj Receptacle 12 0 General Purpose 5 Switch 2 0 General Purpose 5 Fixture 2 0 Incandescent 5 GFCI Circuit Breaker 3 0 15 amp 5 Service 5 1 Phase 3W Service Rating 200 Amperes 5 Service Disconnect: 1 200 cb 5 Cj Meters: 1 ` 5 S 5 5 5 5 5 S sea, 5 S S 5 1 of 1 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 a 03 G2� 9 gnrry BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: i L/j/01 .DATE SUBMITTED: / A /01 APPLICANT NAME: SCTM# DISTRICT: 1,000 SECTION: lryBLOCK: jo LOT: STREET: / 50 til CITY: SUBDIV. NAME: t; PROJECT DESCRIPTION: C ARCHITECT/ENGINEER: FAST TRACK? SINGLE& SEPARATE CERTIFICATION-REQUIRED? A.-I 0 NOTES: / LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/8: ZONING DISTRICT: -66 CONFORMING? YE5 REQ.LOT SIZE: ACT.ACT. LOT SIZE:�� 3�� ,Q. LOT COV: o`�'i�, ACT. LOT COV. REQ.FRONT . .6b PROP. FRONT Q SIDE__//S ACT. SIDE Sz 88 REQ. REAR PROP. REAR �a7 G WATERFRONT? '�`) DESCRIPTION: !� PANEL #: /! FLOOD ZONE: , AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS REQUIRED: IRED: SUFFOLK COUN'T'Y HEALTH DEPT: YES or (BED#): DTE:—/—/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YESO SOUTHOLD TOWN TRUSTEES: YES o TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES o N NYS ENERGY: YES OR NO : n- EGRESS (18 H min.? 4 sq total) VENT(SQ. FT. x 4°�012/!:: LIGHT(SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP_ 6&q -Z/C/0 Z- HAVE PRE CO'S : Y OR N BP/ -Z/C/o Z- 40bl nil NOTES: �- FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND FLR : SF INIT OTHER TOTAL TOTAL: ;L2-U SF FEE FEE FEE OT( © SF)- SF)= _SF X =$ +$� +$ =$ l M-1802 BUILDING DEPT. INSPECTION 1/4 FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY R ARKS: nt= Q GJ Jr og Z'v sg DATE )0 / INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [,;/FRAMING [ j FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ��ca�.—�L�- �4 • -n DATE DY INSPECTOR �� suaoiNc DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ) FIREP CE 6 CHIMNEY t REMARKS: 51 ;� C -(Q zle-el 4-�4 5674-4j..."RA .?tlz3 DATE_// INSPECTOR �Gc� ij;a 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS ON [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: t Q- ��) Cz� DATE �( I? � INSPECTOR lrinw-(INSPECTION REPORT DAT_6 COMMSNT _ S -aaaa�a-aex=xa=�==�==cx ! �7� rODLTDATION ( !STY dDA,TION (2ND) ROUGH FRAME & o f PLUMBING 7-7 [l-SOLATION PER N. T. STATE ENERGY g � con$. 99 r FINAL P A,DDXTI.ONAL S. $ • r D S U TOWN OF SOUTHOLD �`�`°' `� 9 � BUILDING PERMIT APPLICATION CHECKLIST: BUILDING DEPARTME Do you have or need the following,before applying TOWN HALL , SLIDE.DEPT. = Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Examined / ,20 a/ 1 _ Approved // 0 20 0/ PERMIT NO.c-D- �-90 O Disapproved a/c A—L /�- Building Inspeelor APPLICATION FOR BUILDING PERMIT Date 19 1W , 20_5j>_ 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 sale.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 must be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such a permit shall 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 to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) �a � 6S3 0-1 c Jit: 119Sz (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder R PPL-'Tc 9,W-T a 5 oval o E R Name of owner of premises aNZhGL L -DAR:W (as on.the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 01.00 e� Plumbers License No. ` Electricians License No. Other Trade's License No. ` 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section o(o Blocl" #a Lot Z Subdivision Filed Map No. Lot (Name) .� 2. State existing use and occupancy of premises and inten use and oceu b5LQf proposed construction: a. Existing use and occupancy RsS--bC-JLE b. Intended use and occupancy ��ARRC 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost .# \oo00 Fee (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 a 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. _ 7. Dimensions of existing structures, if any: Front 51 j -i " Rear y6' o '` Depth -3o' o" Height of Stories I Dimensions of same structure with alterations or additions: Front Gib Rear 6i Depth 3a` Height L- ' Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 155 , Rear 15 I Depth 5S(6 10. Date of Purchase 05 19 7 Name of Former Owner �a3C-�T �t�(�►J 11. Zone or use district in which premises are situated l� 12. Does proposed construction violate any zoning law,ordinance or regulation: V30 13. Will lot be re-graded a Will excess fill be removed from premises: YES NO 14. Names of Owner of premises Gf\%-SEL L. 3DRRLt3Address 13Sb V).V-,Lu-op, Phone No. 298-1x94 Name of Architect Address Phone No Name of Contractor Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *YES NO_ V/ — • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAYBE REQUIRED 16. Provide survey, indicate scope of project, to scale,with distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the C*J%..1 1J`(? (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. Swornto ^to before me thi� � day of Y`— • 20 0!� - / .� . otary Public Signature of Applicant JOYCE M.VMKINS Notary Public,State of New York No.4952246,Suffolk County Term Expires June 12, .2003 �'OC BER T l 50'E Q tiN/ O, F Q yno,� z{0.0• r EP *J.O j'so y CARCTN O jp i10 2�40 / SR r.l(f-''� rs f QR`cq ' / 9323 ACRES v �vDSi X ti Ian 70 \� h N,O,F t c. SNUL""A 556.90• c r / � SURVEY FOR �AC�f.� Unauthorized alteration or addition to this survey is a vide- Aft tion of section 7209 of the Newyork State Education Law. meow DQ/Q/ C this not urveyor AT MATT/TUCK t� Wy ---- eP basting the lends Of NQ M/� ERs R/GyT _—finked- I or.-tossed sNi shall trot be considered to be e P NT o validcoPv. TOWN OF SOUTHOL40 OF W4)0, r� 0 GUARAN fEEO TOr Guarantees or certifications indrekled hwaon shall run onN .SUFFOLK COUNTY N.Y to thePerso-torwhomthesurvey b r * IRST AMERICAN TTi. I £ INSURANCE COMPANY OF prapareA,arxt on his 'f ,,=half to the title company,governmental bgenc-:and len- SCAL E- n_ W YORK institution listed hereon,and to the assignees of the r BERT B KAREN DARIN ?ending institution Guarantees or cartifiptions are not \� 1 '"• tp :ransierable to additional insdbaiom w subsequent owner's. zs� �a:ene F p�AN0 B 14, jr N0 28725 R/YERHEAD/ N.Y T;,li T 'z qq ir he LL 0 Ic 0 0 40, cc --- -- ----- - "kle4 R 1 2 2002 w laF NEW j, mr 032254-1 aV oP9UFESSID 0 a 1 i P � f i✓ i W 032254-1 A V 9 _ Op r Np E 1 0 05 OL o IL J m za' d � F j itt i 1 (x8 }»RtJG{Ea� I p 0 G. . 114$ "e- I � 2• IahxW'/2lvL 1�_ - i 4NPc�1Fte� �tRAr� 7 flid ZA At , +qn, 44 ILI 0322 541 NOFESSIOFIP ;. � n ti `l N D OrC I I I j - I o l I �i CU11 � � [✓� UJ ° i M j ¢ W Z A vlkjEel. I I H I � _ I pc . Fr uur IJ V - I L_ SFO 0322541 �y>V• b ' - p�'��FESSIpNP