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Home My WebLink About28195-ZFORM NO. 4 TOW~ OF SOUTHOLD BUILDING DEPAt~TMENT Office of the Building Inspecuor Town Hall Southold, N.Y~ CERTIFICATE OF OCCUPANCY No: Z-30071 Date: 03/08 04 T~IE CERTIFIES that the building ALTERATION Location of Property: 300 PACIFIC ST (HOUSE NO.) (STREET) CoUnty Ta~Map No. 473889 Section 141 Block 4 Subdivision Filed Map No. Lot No. MATTITUCK (HAMLET) Conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15, 2002 pursuanu to which Building Permit No. 28195-Z dated MARCH 20, 2002 was issued, and conforms uo all of the requlremenus of the applicable provisions of the law. The occupancy for which this certificate is issued is FOUA/DATION REPAIR TO AN EXISTING ONE FANIL¥ DWELLING AS APPLIED FOR. The certificate is issued to THOMAS KOCH & WF 9WNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~EALT~I A~PROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~3 03/08/04 N/A 1196470 THOMAS G KOCH 03/03/04 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) 28195 Z Date MARCH 20, 2002 Permission is for : REPAIRS TO AN hereby granted ~o: THOMAS & WP KOCH 300 PACIFIC ST MATTITUCK,NY 11952 EXISTING FOUNDATION AS APPLIED FOR at premises located at 300 PACIFIC ST MATTITUCK County Tax Map No. 473889 Section 141 Block 0004 Lot No. 019 pursuant to application dated MARCH 15, 2002 and approved by the Buildin? Inspector. Fee $ 150.00 h~Autl z'ed Signature ORIGINAL Rev. 2/19/98 Form No. ~J TOWN OF SOUTHOLD BUILDING DEPARTMENT 765-1802 APPLIC ~TION FOR CERTIFICATE OF OCCUPANCY ~ l;~i~ "B ~ · Ttfi~ application must be filled in by typewriter or ir~ and submitted to the Building Departmei~l wi~ t~]~gL~.~ 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 topograph'lc features~ 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approv-a~ ~ electrical installation from Boarc~ of Fire Underwrkers. 4. S~,:om sta~eme~nt from p!mber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. C9/nmgreiai build/rig, industrial buil&g, multiple residences and sinfilar buildings and installations, a certificate of~C~de COmplia~ace bom architect or engineer respons~Ie for the building. 6. Submf* P]ar~hing Board Approval of completed site plan requirememts. B. F~r e~&```~ ~ng b~dings (pri~r t~ April 9~ ~957) n~n-~nf~rming ~ses~ ~r buildings and `*pre-exi~ting~ ~and uses: 1. Acehr~te saruey of property showing ali property lines, streets, buiiding and tmusuat natural or topographic t'eatnares. 2. A p~erly completed application and consent to inspect signed by the applicant. If a Cert/ficar[e of Occupancy is der~!e~ the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees [. CertilScate of Occupancy - New dwelling $25.00, Additions ~twelling $25.00, Alterations to dwelling $25.00, Swimn~g pool $25.0~3, Accessory building $25.00, Additions to accessory building $25~00, Businesses $50.00. 2. CertifiCate of Occupancy on Pre-e~mting Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Ocenpancy - Residential $15.013, Commercial $15.00 Date. New Construction: Location of Property: ~O House No. Owner or Owners of Property: ~O/w)~ ~' Suffolk County Tax Map No 1000, Section Old or Pre-existing Building: k/ (check one~ Street Hamlet I I lock I? Filed Map. Lot: Subdivision Permit No. ~ }r/qo~-_ Health Dept. Approval: Date of Permit. ~/~2o [D g( Applicant: Underwriters Approval: Plarming Bpard Approval: Request for: Temporary Certificate Fee Submitted: $ F/hal Certificate: (check one~ Applicant Signature Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971-0959 Fax, 531) 765~9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN 01' SOUTItOLD CERTIFICATION Date: Buildillg Permit No. 0Please print) ,(Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day of /~[/~r'.~.. , 20 0 Nota~ Public, ~~ County ~t~ Ceris~ ~T~ F~D~fO, SI~O of~N~w ~ualified ~n Suffolk Coun~ ommi~on Expires May 29, ~0 (Plumbers Signaturel BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORk BOARD Of FIRE UNDERVVR TERS BUREAU Of ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by THOMAS & HELEN KOCH 300 PACIFIC ST PO BOX 191 MATTITUCK, NY 11952 THOMAS & HELEN C. KOCH 300 PACIFIC ST PO BOX 191 MATTITUCK, NY 11952 Located at 300 PACIFIC ST. MATTITUCK NY 11952 Application Number: 1196470 Certificate Number: 1196470 Section: 141 Block: 4 Lot: 19 Building Permit:28195Z 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: Basement, Outside. was inspected in accordance with the National Electrica~ Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 3rd Day of March, 2004. Appliances and Accessories Furnace Fanels Wiring and Devices Receptacle Service 1 Phase 3W Service P~ting 200 Amperes Service Disconnect: Meters: 1 QTY Rate Rating Circuit Type 1 0 Oil 1 200 20 2 0 General Purpose 2 0 General Purpose I 200 cb Invoice Total $0.5C $0.5C 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. ERT O'BRIEN, RE. ~ ~ ,~'GNSULTING ENGINEERING SERVICES 2074 MAIN ROAD. P.O. BOX 458, LAUREL, NY I 1948 631-298-5252 January 13. 2004 Town of Southold Building Department Southold, New York Attention: Gary Fish Re: Building Permit No. 281957 Koch Residence 300 Pacific Street Mattituck Ne~v York 11952 Dear Mr. Fish: On December 16, 2003. I performed a visu~J i.nspe¢.tio~n at the above-captioned residence of the brick chimney and its concrete ~51~k ~un~iA(ion wall in the basement. There were no signs of distress and it appears to be structurally sound. Documentati.o,~,was provided showing that a stainless steel flue liner was in- stalled in the original unlined brick flue for the heating boiler. Attached is a letter dated January 7, 2004, from Kolb Mechanical Corp., certifying that the flue and mechanical equipment installation comp les with state and Iocai ~odes. Verytruly yours, ' ~ c: .{.',,~'~ .I-;* Robert" Oii.,,Br"en P. E: Heating and Air C~ndit~oning 1150C Sound Avenu~ PO. Sox I05 Mattiu]ck. WY 11952 516 2£8 515 298 5534 Fax Stop A Traz~e. Januaw 7,2004 Mr. Tom Koch P.O. Box 191 Mattituck. New York 11952 Re: 300 Pacific Street. Mattituck NY 11952 Dear Mr. Koch. I have insoected the chimney at the above named residence on 1/06/04. This chimney is used to vent flue gases for a Thermopride. model #OH5-85, oil fired forced air furnace and an oil fired Bock model #32E, hot water heater. I found the installation complies with all applicable state and local codes. Should you have any further euestions, please feel free to contact me. ~erely Andrew Fohrkolb Owner Kolb Mechanical Corp. BUILDING DEPT. ~ INSPECTION / [~/~ FOUNDATION 1ST [ ] ROUGHPLBG. [ I FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE BUILDING DEPT. INSPECTION [~ FO.~INDATION 1ST [ ] ROUGH PLBG. [ ~]/FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]'FINAL [ ] FIREPLACE & CHIMNEY DATE oir SO JTilOLI) }iUILDING DEPART1VIEN'T TOWN HALL SOUTHOLD. NY 11971 tEL: (631) 765q802 FAX: (631) 765-9502 / Examined ~.~//~) ,20 ~ Approved /~-?~, 20(~ D~sapproved a~c Expiration BUILDING PERMIT APPLICA&ION~CHECKLIS T PERMIT NO. C~8 ~55 Do you lmve or need the following, before apply/ng? Board of Heatth ,¥'3 se~s of Building Plans planning Board approval ~urvey Septic Form N.Y.S.D.E.C. Trustees Contact:. Mail to: Phone: Buitding Inspector ~"'----~ ,~.~kPPLICATION FOR BUILDING PERMIT iNSTRUCTiONS / ,200 q a. Th/s apphcation MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets ofplzms, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relalionship to adjoining premises or pubhc streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building permit. d. U~on 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 what so ever until the Build/rig Inspector issues a Certificate of Occupancy. £ Every b~idkng permit shail 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 property have been enacted in the interim, th? Building Inspector may authorize, in writing, the extension or'die, permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION tS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town o£ Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction ofbm2d/ngs, additions, or alterations or for removal or demolition as here/n described. The applicant agrees ;o comply with all applicable laws, ordinances, building.code, housing code, and reomalations, and to adrrdt author/zed inspectors on premises and in building for necessary mspections~ (Signature of applicant or name, if a corporation) t3sx tq t , /¢V ' (M~iling address of ai~p~iean{) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises /~OCt~/ '-~>,W~/,ff c~ 6CfP'- (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. Plumbers License No. Electricians License No. Other Trade's License No. Log. ation of land on which proposed_work will be done: House Number Street County Tax Map No. 1000 Section /~7~/ Subdivision (Name) Block ]-/ Filed Map No. Lot /? Lot 2. StRte ex~stmg use and oecuparrey of premises and intended use a~d occupancy of proposed cons~ctwn. a. Existing use a~d ocCUpancy_ O~r~- /L~,O9 / ~,h/ c-~z/~'LL//f~ ' b. Intended use and occupancy ~'j¢2,o9~" Nature of work (check wt~ch applicable)~ New Building Repa/r _RemOval Demolition Estimated Cost ~/~, 006~ If dwell/rig, number of dwelling units If garage, number of cars ~t/~/ Addition Alteration other Work/ ,*O, 77¢/f (DescriPtion) Fee ¢/~'O, DO (To be paid on filing th/s-application Number of dwelling units on each floor 6. If business, commercial or mixed~ occupancy; specify nature and extent of each type of use. 7. Dimenszons of existing structures, if any: Front Height_ Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear " 8. Dimensions of enthre ne;v construction: Front ~ Height. Number of Stories Rear Depth 9. Size of lot: Front 10. Date of Purchase Rear Depth NameofFormerOwner ~'O~:~ ~-~ ~l/lp,.~l ~Jt,~l /~t~ __ 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. 14. Will lot be re-graded? YES NO v/' Will excess fill be removed ~om premises? YES ? NO__ Names of Owner of premises. ~/-/ Address Name of Architect Address Name ofContracto.r,~'J~,¢c/$ ~ ,,~C.t¢£1E~t'L. Address .Phone No. Phone Phone No. t 5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~ IF YES. SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED. b. Is this propers, within 300 feet of a tidal wetland? * YES NO ~/ · IF YES_ D.E.C. PERMITS MAY BE REQUII~ED. __No 16. Provide survey, to scale, with accurate foundation plan and distances m property lines. lT. If elevation at any point on property is ar 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF?o'p'p'OL/d ) 7~,~ ~ ,~ ~ £ ~, //ff'~ e '{ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)tte is the (Contractor, Agent, Corporate Officer, e~c.) of sa2d owner or owners, and is duly author/zed to perform or have performed the said work and to make a~d file this applicauon: that all statements contained in this application are la'ne to the best of his knowiedge ancO/belief: and that the work wilt be performed in the maturer set forth in the application filed therewith. Swcrn ro before me this dayof f'~ 6.,t-c~- 20 ~_, otary HNDA J. CO~PER N~e~ Public, S~e of New York Term ~res December 31, Signature of Applicant Apptica~omfor buil~ir~:permit: Thomas and Helen Koch for residence at 300 Pacific Street, Na[[ituCk, Town of Southold,, County of Suffolk, State of NeW York. For.the pur~se of excavation of crawl Sp~ceand existing 6-foot basement to the depth of 8-foot cement block wails constructed on 8-inch-deep by 16-inch width concrete footings attached by homeowner, Submitted: APPRO~ED~S NOTE~ , 765-180~gA~TO ~ .~ ~:.~ ~ THE FOLLOWING t, FOUNDATION - FOR POU~CO~ ~;,~:,~ ~: 2. ROUGH - FRA~4 ~,~ ~ ~ IN~U~TION · FINAL, OO~gT:~jC~ DN ~UST BE COMPLETE ~o~ ALL CONSTEUC~=~- ~ALL MEET THE REQUIE~:~; :S O~: THE STATE CONST~:;L~ :;2~ & ENERGY CODES. NOT ~E '~LE FOR t~ ~J T