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HomeMy WebLinkAbout30048-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29995 Date: 02./04/04 THIS. CERTIFIES that the building ADDITION 1,ocati.on of Property: 280 YOUNGS. AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 141 Block 1 Lot 31 Subdivision Filed Nap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this. office dated JANUARY 29, 2004pursuant to which .Building Permit No. 30048-Z dated JANUARY 29, 2004 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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING. CONSTRUCTION CERTIFIED BY ROBERT O'BRIEN, PE ON 1/27/04. The certificate is issued to DANIEL H WALOSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ N/A PLUMBERS CERTIFICATION DATED N/A -"L Au/hger'izZd Signature ' Rev. 1/81 I 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) . , 452 1T 30048 Z Date JANUARY 29, 2004 Permission is hereby granted to : DANIEL H WALOSKI 280 YOUNGS AVENUE MATTITUCK,NY 11952 for CONSTRUCTION OF AN "AS BUILT" DECK ADDITION AS APPLIED FOR at premises located at 280 YOUNGS AVE MATTITUCK County Tax Map No. 473889 Section 141 Block 0001 Lot No. 031 pursuant to application dated JANUARY 29, 2004 and approved by the Building Inspector to expire on JULY 29, 2005 . Fee $ 300 . 00 f f. Axithorized ure ORIGINAL Rev. 5/.8/02 i Form No:.6 TOWN OF SOUTHOLD (77- BUILDING -BUILDING DEPARTMENT TOWN HALL 765-1802 FEB 4 2_094 a APPLICATION FOR CERTIFICATE OF OCCUPA CYj This application mustbe filled in by typewriter or ink and submitted to the Building Depaat with the fo ` 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. 1 4. Swornstatement from plumber cerrifying,that the solder used in system contains less than 2/10 of 1%lead. $. Commerci4bui ding,industrial building,multiple residences and similar buildings and installations, a certificate of Code Compliahi from architect or engineer responsible for the building. 6. Sctbridt Planning Board Approval of completed site plan requirements. B. For existing buildings,(pror to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey ofproperty 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. i C. Fees 1. Certificate of Occupancy-New dwelling$25.00;Addjr o s 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. a , l O �1 h New Construction. Old or Pre-existing Building: (check one) ...Location of Property:_ a..}f p �(0 w n1 C�S pro A-7r t T--t GIS t", � y House No. Street Hamlet Owner or Owners of Property: D A--)t t4 . LA ) A—L�o S Suffolk County Tax Map No 1000, Section 1.4. -1 3 T&01 Block 1 %4 1 - 4 ItIt Subdivision Filed Map. Lot: Permit No. 3 DO` Date of Permit. I X90'1 Applicant: pAIA)I e-(- 14-• W A'e-obft,� Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ✓ (check one) Fee Submitted: $ is •0 t) Applicant Signature € N.RbBERT 0'81RIE,IVPRE. CONSULTING ENGINEERING SERVICES . ';2074 MAIN ROAD, P.O. BOX 45.6, LAUREL, NY 11948 631-298-5252 i ;' ',L ,JAN 2 9 2OW January 27, 2004 i i L it I i I Southold Building Department Town Hall Southold, New York Re: Certificate of Occupancy for As-built Side Deck 280 Youngs Avenue, Mattituck, New York 11952 Gentlemen: li I hereby certify that the deck at the above-captioned property appears to be structurally sound. Further, that it was constructed in accordance with the building codes in effect in 1987, when it was built. Very truly yours, l OF HF.is, Y - O �¢I F. 0, 'P Robert O'Brien P. E. No 05210 p�®FESSIO1� ,I i TOWN, OF SOUTHOLD' PROPERTY RECORD CARD 6WNER STREETS VILLAGE DIST. �I SUB. LOT 4 V�..�C��. � JFK\1.Y 4'N. e .m.✓ FORMEOOWNER N E r OF BUILDING E /D SEAS . VL. FARM .n` COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL BATE REMARKS yrs v-Q a !5'U+ AGE BUILDING CONDITION NEW NORMAL BELOW -- ABOVE FARM Acre Value Per Value +\ —� Tillable Acre Woodland FRONTAGE ON WATER FRONTAGE ON ROAD Meadowland b, House Plot DEPTH / 4 q BULKHEAD Total - - DOCK n.sxrzrvnMRirt^N}ryR±k lb VhM w.,arW4 srtc..Yd'4R vNwaw n++..xy V` COLOR w t t i 7 TRIM ':, . V — 6 , M. Bldg. 3 i / Z. - Extension a Extension jd� - - ----- Extension _ Foundation Bath Dinette 25- if Basement : Floors K. Porch oX i \122 e6 Ext. Walls Interior Finish v 23 L.R. Breezeway Fire ! ce o Heat � DR. Garage �?-.A 2 X4'7-c, /Type Roof ., Rooms tst Floor BR. - Patio Recreation Room Rooms 2nd Floor FIN. B O. S. Dormer Driveway Total i A PR D AS NOTED - - µ _ _� _ i �d _ DATE: 7c� — -------- FEE. FEE. NOTIFY BUI D NG D--PART ENT AT _ 3 TO PM THE " _ \ R 78 /x8 $FEC ION' 1. FOUNDATf0 - 0 El FOR POU DCO ETE I _ 2. OUCH F AMIN & PLUMBIN .77 � BE COMPLET POWC:9. " j ALL-GO ION SHALL-MEEte REOUI OF THE CODES OF N W STATE OT RESPONSIBL F W rt „ DESIGN OR C NSTRUCTION ER 0 S._ ` ' fi - .. _.._ i `i GCUPA CYOR ' Tk , 9F islu _ r Or OCCUPANCY .�y� ,J/_oc .Q-,d �2 2a' .Ow,.v'iP a:S S«t,c � ''• / f ��`ESS(OEJ0" II FIELD INSPECTION REPORT ; DATE COMMENTS m FOUNDATION(1ST) -- --------------------------- FOUNDATION(2ND) Q.3 Q y ROUGH FRAMING& y PLUMBING t 1 > INSULATION PER N.Y. STATE ENERGY CODE FINAL i ADDITIONAL COMMENTS O A - d H O x , H x d 'b H TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT '"�` Do you have or need the following,before"applying? TOWN HALL ` Board of Health SOUTHOLD,NY 11991 -d3 sets of Building Plans TEL: (631)965-1802 Planning Board approval FAX: (631) 765-9502 y - Survey - www: northforkmet(Southold/ PERMIT NO. � j ( Check Septic Farm N Y S_D.E.C: L/��� Trustees xam ned F 20 Contact: k approvedr ,/3 ¢Y J�2 ¢ 20 Mail to:a SSt3 V0 4"'CA ' iDisapproved a/c � li g Phone: xpiration i a- 201 . ding Inspector y s , i BUILDING PERMIT 2 � i,�APPLICATION FOR t Date 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 so 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 eas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. F rr d.Upon approval of this application,the Building lnspeetor will issue..a Building Permit to the.applicant. Such a permit. hall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used.in whole or in par' for any purpose what so ever until the Building Inspector tissues a Certificate of Occupancy. f Every building permit shall expire if the work authorized has not'commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the propertyliave been enacted'in the irtterim;r'ne Building inspector rl autho zr,in writing,the extension of the.percvt for an . addition six months.Thereafter, a new permit shall be required. 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 inspectio (Signature of applicant or name,if a corporation) (Mai address of applicant) 1196"7- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises 1b A-nl H . L'l A_L- 0 (As on the tax roll or IIatest deed) If applicant s:a_cospoxation,-signature=o duly adLhc7rized-o411eer -- - -- - —- -- - (Name and title of corporate officer) Builders License No. '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 iHamlet County Tax Map No. 1000 Section I q 1 .©0 Block 01 - 0 Lot' 6ai;;i6dy=o •'i Subdivision Filed Map No- Lo't (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy R ESi il C A.d C C b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other WorkpERMr i Fof, "ASS 19—i 0 0f!L-KW (Description) 4. Estimated Cost ®C3.©-0 Fee C k�u r+ '34 j (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor A 'lf garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front 1; Depth Height Number of Stories Q &)'A°Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth k 5e"�' v44u, 10. Date of Purchase ©i ( Nameof Former Owner 11. Zone or use district in which premises are situated P-e' 10" A 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES_NO 14.Names of Owner of premises Drktot CL ;w 44 J- -Address 2-ft rta PA.�I Phone No. 3"�Si `lv7fil i Name of Architect Address Phone No Name of Contractor Address Phone No. V 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C.PERMITS MAY BREQUIRED. b. Is this property within 300 feet of a tidal wetland?* YES NO vti// * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale,with accurate foundation plan and 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 ) D a L, uJA—,L-o�SKx- beingdijy sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 tt performed in the manner set forth in the application filed therewith. Sworn to before me this ( day of 201)+ Notary Public 7�/C~•M� Signature of Applicant �s JOAN A.JAc08S Notary Public,$tate of New York Na 4702900 Qualified m Suffolk county commission Expires March 31,2007 t,. IF rc a t a TYb M 'I - t '-� 'hal 4`f° 4 I �'.F r��` l,� c P'RO - �' r„ _ f MA MTWK IF a REW YORK dd:.: V^ Q � •I A. 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